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What Are Gluten Allergy Symptoms?

Well, It Depends on What Condition You Actually Have

By

Updated May 15, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

What Are Gluten Allergy Symptoms?

'Gluten allergy' symptoms vary

Getty Images/Burazin

So you have persistent symptoms — possibly digestive, possibly skin-related or even neurological — and you're wondering, do these symptoms mean I have a gluten allergy? You might be surprised to learn that there are several different conditions that people refer to as a "gluten allergy," and your specific symptoms will depend on which of these conditions you actually have (if any).

You see, medical science doesn't actually recognize the term "gluten allergy." Instead, when people refer to a "gluten allergy," it's likely they mean one of four different conditions: celiac disease, non-celiac gluten sensitivity, dermatitis herpetiformis or gluten ataxia. None of these is a true allergy. It's also possible that someone who refers to a "gluten allergy" actually means a wheat allergy, which is a true allergy.

Here's a guide to the different sets of symptoms for the different forms of "gluten allergies":

Celiac Disease: A Whole-Body Experience

When your doctor hears you say "gluten allergy," she's likely to think first of celiac disease, which occurs when your immune system mounts an attack on your small intestine in response to ingestion of gluten-containing foods. Celiac affects about one in every 133 Americans.

There are more than 100 different symptoms potentially caused by celiac disease — every case is different, and in fact some people don't have any symptoms at all. But there are some symptoms that appear frequently in people ultimately diagnosed with celiac disease, including:

  • Diarrhea and/or constipation
  • Abdominal pain and/or heartburn
  • Bloating
  • Fatigue
  • Brain fog
  • Anemia
  • Joint pain
  • Rashes
  • Depression and/or anxiety

The absence of these symptoms doesn't necessarily mean you can rule out celiac disease: as I said, some people have no symptoms at all, or suffer mainly from neurological symptoms (such as migraines and tingling in their arms and legs). Take a look at this article for a comprehensive overview of possible celiac signs and symptoms: Celiac Disease Symptoms

Non-Celiac Gluten Sensitivity: No, It's Not Celiac Disease

So you have diarrhea and/or constipation, abdominal pain, bloating, fatigue and brain fog — you must have celiac disease, right? Not so fast ... you also might have non-celiac gluten sensitivity.

Gluten sensitivity — a condition that's only been accepted by researchers and clinicians over the past couple of years — causes symptoms that are really similar to those of celiac disease. In fact, it's not possible to tell the two conditions apart without medical testing. Here's a partial list of what you might experience if you have non-celiac gluten sensitivity:

  • Diarrhea and/or constipation
  • Heartburn and/or "stomach ache"
  • Bloating
  • Flatulence
  • Fatigue
  • Brain fog
  • Headaches (including migraine)
  • Rashes and/or eczema

Like those with celiac disease, people with the non-celiac gluten sensitivity form of "gluten allergy" also report joint pain, anxiety and/or depression, and even tingling in their arms and legs. Check out this article for the complete rundown of symptoms: Gluten Sensitivity Symptoms

Wheat Allergy: This Is a Real Allergy

People who are allergic to wheat — actually, truly allergic to it — sometimes also experience gastrointestinal symptoms and rashes, but they also experience more "typical" allergy symptoms, like a runny nose. People occasionally refer to a wheat allergy as a "gluten allergy," but true wheat allergy doesn't necessarily involve gluten — it's possible to be allergic to many different components of the wheat plant. Symptoms of true wheat allergy include:

  • Nasal congestion
  • Itchy, red, watery eyes
  • Hives and/or itchy rashes
  • Swelling of lips, tongue and/or face
  • Nausea, vomiting and/or abdominal pain
  • Diarrhea
  • Difficulty breathing

The most dangerous potential symptom of wheat allergy is anaphylaxis, a potentially life-threatening systemic allergic reaction. People experiencing anaphylaxis from wheat allergy may find themselves coughing, wheezing or having difficulty swallowing; their hearts may beat rapidly or slow down; and they may have a large drop in blood pressure. Anaphylaxis is a medical emergency, so if you experience these symptoms, call 911 immediately. For more information on true wheat allergy symptoms, diagnosis and management, see: Wheat Allergy

Dermatitis Herpetiformitis: The Itchiest Rash Imaginable

It's not unusual for a true allergic reaction to result in a skin rash, so it makes some intuitive sense to call dermatitis herpetiformis a "gluten allergy," as it causes a remarkably itchy, persistent rash. But this rash is not the result of a true allergy: dermatitis herpetiformis is an autoimmune skin condition that occurs when (you guessed it) you've eat gluten grains. Symptoms include:

  • Reddened skin
  • Multiple small bumps that look like pimples
  • Itching and burning
  • Purple marks where bumps are healing

Dermatitis herpetiformis can occur anywhere on your body, but the most common locations for this rash are your buttocks, elbows, knees and on the back of your neck. If you're about to have an outbreak, the itching usually starts even before you see the bumps appear. The condition is closely related to celiac disease. Full information on the condition appears here: Dermatitis Herpetiformis - The Gluten Rash

Gluten Ataxia: Scary Brain Disorder

The last of the potential "gluten allergy" conditions is also the most uncommon: a brain disorder called gluten ataxia. When you suffer from gluten ataxia, gluten consumption actually causes your immune system to attack the part of your brain called the cerebellum, potentially resulting in damage that's eventually irreversible. Symptoms of gluten ataxia include:

  • Problems with walking and your gait
  • Clumsiness and lack of coordination
  • Deterioration of fine motor skills
  • Slurring of speech
  • Difficulty swallowing

Gluten ataxia is progressive: sufferers may start out with what may seem like a minor balance problem, but can ultimately wind up significantly disabled. While about one in four people diagnosed with gluten ataxia has the characteristic villous atrophy of celiac disease, only about one in 10 (and not necessarily the same people) has gastrointestinal symptoms. Here are more details on the condition: Gluten Ataxia Symptoms

So How Can You Tell Which 'Gluten Allergy' You Have?

It's clear you can't tell from symptoms alone. The truth is, you'll need to see your doctor and have some medical testing to determine which of these gluten-related conditions — if any — you might actually have.

If you have gastrointestinal symptoms that may point to celiac disease, you'll likely start with celiac blood tests. If those are positive, your doctor will likely recommend you undergo an endoscopy, a procedure that enables your physician to look directly at your small intestine and take samples for laboratory examination. Read more about all this: Celiac Disease Tests - How To Get Diagnosed

If, on the other hand, your celiac blood tests are negative, then your doctor may consider the possibility of non-celiac gluten sensitivity or another condition such as irritable bowel syndrome. Here's some more information: Gluten Sensitivity Tests

Wheat allergy is usually diagnosed with skin prick tests, although your doctor may also use a blood test that looks for specific antibodies to wheat proteins. Here are the details: Diagnosing Food Allergies

For people with rashes they believe may be dermatitis herpetiformis, the first step is likely a visit to a dermatologist, who may recommend a skin biopsy of characteristic deposits of antibodies in your rash area. Learn more: Skin Biopsy for Dermatitis Herpetiformis

And finally, if your symptoms are indicative of gluten ataxia, the path to diagnosis unfortunately isn't straightforward, although there are several tests your neurologist may want to perform. For more information: Gluten Ataxia Diagnosis

Regardless of which of these "gluten allergies" you think you have, your first step should be a call to your doctor's office to make an appointment. Your physician can help you determine what medical testing, if any, you may need.

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