The most common symptom of either wheat intolerance or coeliac disease is some form of gastrointestinal discomfort. Usually, such discomfort after eating bread is a clear indicator of gluten intolerance. Three conditions fall under this umbrella: coeliac disease, non-coeliac gluten sensitivity (NCGS), and wheat allergy.
The last diagnosis, wheat intolerance or allergy, isn’t strictly a gluten-related condition. However, it’s grouped together with the other conditions due to the similarity in symptoms and causes. So, what is the difference?
Understanding Coeliac Disease
Coeliac disease is a severe autoimmune condition where the body’s immune system attacks the small intestine whenever gluten is present. Because the small intestine is responsible for nutrient absorption, prolonged autoimmune attacks can impair this process, leading to malnutrition.
For example, children with coeliac disease can experience stunted growth and development.
Individuals with coeliac disease are also more likely to develop other autoimmune disorders, such as Hashimoto’s thyroiditis, rheumatoid arthritis, diabetes type 1, and Addison’s disease.
Common symptoms of coeliac disease include:
- Diarrhoea or constipation
- Weight loss
- Bloating and gas
- Stomach pain
- Nausea and vomiting
However, as the disease progresses, symptoms related to malnutrition can develop. Most commonly, individuals will feel extreme levels of fatigue due to an iron-deficiency anaemia. Other symptoms and conditions that can arise include:
- Joint pain
- Cognitive impairment
- Headaches
- Tingling extremities
- Hypersplenism
- Increased liver enzymes
- Osteoporosis
- Mouth ulcers
The only treatment for the condition is the complete and total elimination of gluten from your diet. Supplements may also be prescribed to counteract nutritional deficiencies, and vaccinations may be advised if the spleen is involved.
Understanding Wheat Intolerance
Wheat intolerance, also known as wheat sensitivity, is a condition where the body has difficulty digesting wheat and responds with a range of digestive and systemic symptoms. Unlike coeliac disease, which is an autoimmune condition, wheat intolerance does not involve an immune system attack on the small intestine. However, it can still cause significant discomfort and health issues.
In individuals with wheat intolerance, consuming wheat-based products can lead to digestive distress and other symptoms. It’s essential to differentiate this condition from coeliac disease and wheat allergy, as the management and implications of each can differ significantly.
Common symptoms of wheat intolerance include:
- Bloating and gas
- Diarrhoea or constipation
- Stomach pain
- Nausea
Beyond these digestive symptoms, people with wheat intolerance may experience a range of systemic symptoms, although they do not typically include the autoimmune-related complications seen in coeliac disease. These can include:
- Fatigue
- Headaches
- Joint and muscle pain
- Mood swings or irritability
Wheat allergies are also a possibility. People with this condition aren’t allergic to gluten but to other proteins specifically found in wheat. Symptoms are characteristic of an allergic reaction, including shortness of breath, throat swelling, skin rashes (urticaria), diarrhoea, and abdominal pain. In severe cases, reactions can become anaphylactic – where a person cannot breathe or regulate their blood pressure. This is a medical emergency, and you should immediately seek help.
Determining Which Condition You Have
If you’re experiencing symptoms after consuming wheat-based products, you need to get tested for coeliac disease, wheat intolerance, or possibly a wheat allergy. While the final treatment is broadly the same, understanding the underlying condition is important for long-term management.
Conducting an at-home test is the best first step. There are tests available for both coeliac disease and wheat intolerance. Two options include:
- Intolerance Test: This test evaluates a hair sample against 970 food and non-food items to identify specific intolerances. It offers a comprehensive report that assists individuals in modifying their diet and lifestyle based on the findings.
- Coeliac Self-Test: An easy-to-use, rapid at-home test that identifies antibodies associated with coeliac disease in a blood sample, providing a quick preliminary result that can aid in deciding whether to seek further medical consultation for a definitive diagnosis.
After receiving the results, speak to your doctor. In the case of coeliac disease, an endoscopy must be performed to take a small biopsy from the small intestine. It’s the gold standard for diagnosis. Your doctor will check for damage to the villi – the tiny structures responsible for nutrient absorption – which are typically damaged in coeliac disease.
If coeliac disease tests are negative, you can use the results of the intolerance test to guide an elimination diet. This involves three simple steps:
- Identification of Triggers: An elimination diet involves removing specific foods or food groups believed to cause adverse reactions, helping to identify dietary triggers of symptoms.
- Systematic Process: After a period of avoidance, these foods are gradually reintroduced one at a time, monitoring for any recurrence of symptoms to pinpoint the offending items.
- Guided Nutritional Adjustment: The diet is typically conducted under the guidance of a healthcare professional to ensure nutritional balance is maintained and to interpret the results accurately for long-term dietary planning.
Whatever your results, you’ll probably have to give up gluten. Thankfully, that’s no longer as hard as it sounds. There are tons of gluten-free food options, and restaurants increasingly cater to these dietary requirements. Reach out to a doctor or nutritionist for further information.
