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Wheat intolerance and coeliac disease

Key points

  • Wheat is an important and nutritious staple in the UK diet.
  • True wheat allergy is a very rare condition.
  • Coeliac disease is a bowel disease triggered by gluten in susceptible individuals. It is a life-long condition and may present at any age.
  • Coeliac disease is diagnosed following an intestinal biopsy and is characterised by a flattening of the finger-like projections that naturally line the small intestine.
  • Resolution of symptoms occur when gluten is permanently removed from the diet, i.e. upon adoption of a gluten-free diet

Wheat intolerance and coeliac disease: what’s the real story?

Intolerance or sensitivity to wheat has received much attention from the media in recent years. Perhaps as a direct result, the number of people self-reporting an allergy or intolerance to wheat is increasing dramatically. However, there is no evidence that the true prevalence of wheat intolerance is on the increase and self-diagnosis or a flawed diagnosis from an unqualified alternative therapist can often do more harm than good, particularly if it results in poorer nutrition or delays the diagnosis of a serious illness.

Coeliac disease, an autoimmune disease, is the main form of wheat intolerance, caused by an allergic reaction to gluten. It is also triggered by related proteins in other grains (rye and barley). Until recently, it was thought that coeliac disease affected about one in 1500 people in the UK. However, evidence published in February 2004 suggests that about 1 in 100 people have the condition. According to the Food Standards Agency, this figure is based on blood tests in children and hasn't been confirmed by biopsies. So coeliac disease might not be as common as the research suggests. However, many people with coeliac disease don't realise they have the condition and it’s estimated that only 1 in 8 people have been diagnosed.

There seems to be some confusion about the terms used to describe other possible intolerances to wheat. Wheat allergy (antibody mediated) is thought to be very rare. The true incidence is unknown but it is estimated to affect only a tiny fraction of the population. Non-coeliac wheat sensitivity is a term much used and often misused to include wheat allergy. Both coeliac disease and wheat allergy are specific conditions, whereas non-coeliac wheat sensitivity probably includes wheat aversion, which is a psychological rather than a physiological response. For information about food allergy and intolerance, click here.



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