Gluten Allergy – Symptoms, Signs, Test, Diet in Adults and Children

What is Gluten Allergy?

A gluten allergy, also known as gluten intolerance or gluten sensitivity, is a disorder where a person experiences adverse effects due to gluten in the body. Despite the term gluten allergy, it is neither an allergic nor an autoimmune disorder. However, the ingestion of foods with gluten may lead to symptoms of wheat allergy or celiac disease.

Gluten allergies affects up to 6% of the population. Gluten sensitivity is sometimes mistaken as wheat allergy or celiac disease. Celiac disease is the complete intolerance to gluten and an ingestion of only a small amount can produce severe symptoms.

Gluten is a kind of protein that is derived from wheat, rye and barley. Gluten is responsible for the elasticity and shape of the dough. It is also partly responsible for baked goods rising properly. Gluten is found in almost every staple food in the Western world. Gluten has two components: giladin fraction and glutenin fraction.

Gluten Allergy rash pictures on arm, forearm

Image Source – baseluna.net

Gluten Allergy Symptoms and Signs

Gluten sensitivity is more apparent in children and the condition can usually resolve itself by the age of three. However, it can persist up to adulthood, but with lesser severity. There are general symptoms in all patients, but there are also specific symptoms differing from adults and children.

General symptoms

• Bloating – The changes in the integrity of the intestines cause enteric reactions to the ingestion of gluten. Patients usually experience abdominal bloating.
• Abdominal discomfort – Abdominal discomfort may also be felt, such as the presence of distention, because of irritation of the intestinal mucosa.
• Diarrhea – Diarrhea is the body’s way to eliminate gluten that is causing bad reactions in the body. Patients usually experience diarrhea following the initial reaction of bloating.
• Pain – Pain may be felt, especially when patients consumed large amounts of gluten. The contraction of the abdomen as a result of diarrhea may produce abdominal pain.
• Headache – There will also be presence of headache as a result of the circulation of gluten in the bloodstream that may reach the brain. Sensitive individuals do not tolerate circulating gluten in the body well.
• Muscular disturbance and joint pains – Muscle and joint pain may also be experienced following gluten ingestion. The gluten may travel to these areas and cause reactions in them.
• Tiredness – A general symptom of gluten allergy is tiredness because of limited nutrient absorption in the intestines.
• Lethargy – Allergic reactions to gluten may also cause lethargy or drowsiness because of intolerance to the substance.

Symptoms in adults

• Schizophrenia – Severe gluten allergy may show up as schizophrenia because of intolerance of the brain tissues to gluten.
• Migraine – Migraine headache may also be experienced by adults because of the gluten circulation to the brain.

Symptoms in children

• Attention deficit hyperactivity disorder.
• Children often times manifest hyperactivity because of increased serum glucose and gluten, which acts as a central nervous system stimulant.

How to Test for Gluten Allergy

Testing for gluten allergy is done by ruling out the presence of celiac disease and wheat allergy. A complete medical history is also taken to determine the symptoms associated with the intolerance to gluten. Specific diagnostic tests include:

• Antibody testing – The absence of anti IgE antibody may confirm the absence of wheat allergy and the possible occurrence of gluten sensitivity. The presence of anti-giladin antibodies may also indicate gluten sensitivity.
• Serological tests – Blood tests are done to check IgA deficiency and tTG/EMA/dAGA. Absence of the serological markers rule out celiac disease. Absence of HLA DQ 2 or DQ8 also excludes celiac disease.
• Intestinal biopsy – Intestinal biopsy is also done. The absence of Marsh III classification or villous atrophy, may indicate glutens sensitivity. However, there may be mild changes in the intestines.

The diagnosis of gluten sensitivity is ascertained when a gluten-free diet relieves the symptoms.

Treatment of Gluten allergy

The treatment for gluten allergy is focused on diet modification to prevent the intolerance to gluten. Aside from diet modification, other adjunct managements may be tried out to prevent vitamin deficiencies that arise because of diet restriction. These include:

• Vitamin supplements – Vitamin supplements are required, especially for vitamin B deficiency. Patients who do not consume gluten containing foods may eventually suffer from vitamin B deficiencies, leading to neuropathies. Gluten sensitivity also leads to malabsoprtion of vitamins in the gut.
• Iron supplements – Most of the foods rich in gluten are also rich in iron; thereby diet restrictions may also lead to iron deficiency, which may contribute to anemia. It is important to take iron supplements with Vitamin C rich foods to maximize its absorption.
• Calcium supplements – When the gut becomes sensitive to gluten, it does not allow for maximum absorption of calcium in the intestines, thereby, calcium supplements must be given.

Diet Needed in Gluten Allergy

The primary treatment in gluten sensitivity is diet restriction. Gluten must be temporarily eradicated in the diet to prevent gluten sensitivity reactions. After 2 to 3 weeks of gluten-free diet, the patient usually has witnessed a reduction in symptoms Gluten rich foods such wheat and barley should be avoided. Most breads and pastries should also be avoided because they contain gluten. Other foods containing gluten include:

• Rye
• Oats
• Beer
• Rice
• Millet
• Corn
• Buckwheat
• Bread
• Cereal
• Pasta
• Crackers
• Chips
• Gravy
• Condiments
• Sauces and spices

One should read the labels of all foods. Presence of malt extract, baking powder, artificial flavoring or modified starch all contain gluten in those products.

However, because of considerable restriction in the diet, patients with gluten sensitivity often lack the necessary vitamin B and fiber. Patients also get too much of the simple starches and lack complex starches, which are more essential in providing dietary fiber. Because of this, gluten-free oats have become available for people with gluten sensitivity in order for them to consume oats without the effects of gluten in the body. Gluten-free oats may be started one year after the diagnosis to prevent oat-sensitive enteropathy. To support gluten-free diets, certain gluten-free testing is also done on oats, barley and rye.

Gluten allergies may eventually be outgrown by the child, especially when oats are already included in the diet. A gluten allergy is different from celiac disease, which is the permanent intolerance to gluten that produces severe effects on the child or adult.