A Clinical Update

Nonceliac Gluten Sensitivity—Is it Really the Gluten?

Bernadette Capili, PhD, NP-C; Michelle Chang, MS; Joyce K. Anastasi, PhD, DrNP

Disclosures

Journal for Nurse Practitioners. 2014;10(9):666-673. 

In This Article

Wheat Allergy

Studies in the US suggest that up to 6% of children and 4% of adults have food allergies.[38,39] Wheat is a food that commonly causes an allergic reaction, particularly in infants and children. One or more of the wheat proteins, albumin, globulin, gliadin, or gluten, can cause an allergic reaction involving IgE antibodies. The reactions usually take place within a few minutes to several hours after exposure to the allergen.[40] The symptoms may include: itching in the mouth; swelling of lips and tongue; hives; eczema; rhinitis; tightening of the throat or trouble breathing; drop in blood pressure; GI symptoms, such as vomiting, diarrhea, or abdominal cramps and pain; and, if severe, anaphylaxis.[40] Skin prick tests and allergen-specific IgE testing are useful in diagnosis, along with medical history, clinical presentation, and possible food challenge. For wheat allergy, strict avoidance of wheat and wheat products is necessary.

Although classic IgE-mediated allergic reactions are most common with wheat, non-IgE-mediated reactions to wheat may occur, usually with a slower onset and symptoms generally confined to the GI tract.[41,42] Wheat allergy and gluten sensitivity are both food intolerances, but classic wheat allergy should not be confused with NCGS.

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