What is the difference?

Celiac disease is a condition where the protein gluten damages the lining of the small intestine. The damaged intestine cannot absorb nutrients very well, which can lead to malnutrition. The symptoms of celiac disease include a painful rash, abdominal cramps, appetite loss, bloating, chronic diarrhea, joint pain, muscle cramps, weakness, and weight loss.

Because those with this lifelong disease cannot tolerate gluten, they require a gluten-free eating plan. Gluten is found in wheat, rye, and barley. Gluten can also be found in oats if they are processed in the same plants that process wheat. Once gluten is gone from meals, the small intestine can heal, which may take months or years. Once the intestine heals, nutrient absorption improves, symptoms disappear, and those with celiac disease can live a long, healthy life.

On the other hand, a wheat food allergy generates an allergy-causing antibody, immunoglobulin E, to proteins found in wheat. A food allergy occurs when the immune system mistakes a specific protein in a food as harmful and triggers a response. Ingestion of the offending food may trigger the sudden release of chemicals, including histamine, resulting in symptoms of an allergic reaction. The symptoms may be mild (rashes, hives, itching, swelling, etc.) or severe (trouble breathing, wheezing, loss of consciousness, etc.). A food allergy can be potentially fatal.

Many individuals use the words food intolerance and food allergy interchangeably, but this is incorrect. Food intolerances are caused by various problems, such as the absence of an enzyme to fully digest food or a medical condition (i.e. irritable bowel syndrome or celiac disease), and only affect the digestive tract; whereas, food allergies affect the immune system and can be much more severe.

Common food allergies include: milk, eggs, peanuts, tree nuts (such as almonds, cashews, and walnuts), fish (such as bass, cod, and flounder), shellfish (such as crab, lobster, and shrimp), soy, and wheat.

Remember celiac disease and food allergies are diagnosed by doctors.

What is the difference in treatments?

For celiac disease, the treatment is to avoid gluten and gluten containing products; and for a wheat food allergy, the treatment is to eliminate wheat and wheat containing products specifically. Therefore, a wheat food allergy can have other grains as long as they do not cause the same allergic response. Medications may be necessary to manage allergic reactions when someone with a wheat food allergy accidentally eats wheat.

How is a food label used in treatment of both celiac disease and a wheat food allergy?

For both celiac disease and a wheat food allergy, it is important to read food labels and medication labels to ensure that the product does not contain items with gluten or wheat. Again, remember that a wheat food allergy only needs to eliminate wheat and wheat containing products and not necessarily all gluten-containing grains and products.

All processed foods have a food label with a list of ingredients. This is the place to look to ensure a person avoids all foods that have gluten or wheat. However, there are some hidden ingredients that food companies do not have to put on the label. These include:

• Unidentified starch:  it must be identified by law as “modified food starch.”

• Binders:  gluten binders are used in many baked or processed products to bind and/or thicken the product.

• Fillers:  fillers are used to increase volume of food without changing the nutrition content drastically.  For example, some turkeys and other meats contain gluten fillers.

• Excipients:  excipients are considered inactive ingredients, which are often used by drug companies. They may contain gluten.

• Extenders:  extenders are used along with fillers in many cases.  Gluten acts as a sticky product that helps bind different ingredients together.  For example, it is used in vegetable-based meat products.

• Malt:  malt most often refers to malted barley, which is a gluten containing grain.

New laws in place specify that the major food allergens be listed on food labels. The allergen must either be included in bold on the ingredient list using its common or usual name or there must be an allergy warning in the same font size as the ingredient list stating that the product contains the food allergen.

Additionally, some symbols may help you identify gluten free products; but, it is best to be safe and check the ingredient list also. Manufacturers can also change their products’ ingredients at any time, so again it is always a good idea to check the ingredient list every time a product is purchased—even if there was not a previous reaction to it. If it is uncertain whether a food contains any harmful ingredients, do not buy the product or check with the manufacturer first. For celiac disease and food allergies, it may take longer to grocery shop, especially at first, but it is worth it to ensure only safe foods are bought and eaten. The best way to make sure you follow the gluten-free meal plan is to make your foods yourself using gluten-free ingredients.

If you have any questions about gluten containing foods, you should consult your doctor and dietitian.

Listed below are additional resources for choosing foods with celiac disease (and a wheat food allergy):

Unsafe Foods for People with Celiac Disease: http://www.celiac.com/articles/182/1/Unsafe-Gluten-Free-Food-List-Unsafe-Ingredients/Page1.html.

Safe Foods for People with Celiac Disease (or a Wheat Food Allergy): http://www.celiac.com/articles/181/1/Safe-Gluten-Free-Food-List-Safe-Ingredients/Page1.html or http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/#examples.