• Immediate allergy
• Delayed allergy
• Autoimmune response to gluten proteins. This may cause Coeliac Disease
• Fermentation in the gut due to fructans, the carbohydrate present in wheat.
• Gluten sensitivity

Immediate allergy

When our body produces IgE antibodies to the proteins in the wheat grains, this kind of immediate reaction is caused. These symptoms may take anything from a couple of minutes to 2 hours to show up, after ingestion. The symptoms include hives rhinitis, asthma, swelling, vomiting, diarrhoea, abdominal pain, a flare up of eczema and anaphylaxis.

Delayed allergy

Delayed allergies may take a few hours to a few days to show symptoms. They do not involve presence of IgE antibodies. The symptoms include diarrhoea, eczema etc. Blood tests or skin tests are not very helpful in this case. Therefore diagnosis is done by analysing the patient's symptoms history and a trial of exclusion and reintroduction. The trials must be done only under the supervision of an experienced Dietitian.

Coeliac Disease

Coeliac disease is an autoimmune reaction to gluten proteins found in wheat. It symptoms include bloating, diarrhoea, nausea, constipation, tiredness, sudden or unexpected weight loss, hair loss, joint or bone pain, pins and needles, infertility or repeat miscarriages and anaemia. The reactions damage the lining of the small bowel and decrease the gut's ability to absorb nutrients. This will lead to nutritional deficiencies. Some patients may also develop a skin condition called 'dermatitis herpetiformis' due to celiac disease.

Gut Fermentation

Fructans, a carbohydrate present in wheat, may cause fermentation in the gut. The fermentation is caused by bacteria, which is present in the large intestine, fermenting the fructans that are poorly absorbed. The immune system is not involved in this. Symptoms will include as bloating, gurgling, wind and abdominal pain after eating wheat. For patients suffering from this condition, the dietitian usually prescribes 'Low FODMAP' diet, removing all fermentable foods including fructans.

Gluten sensitivity

Gluten sensitivity is a condition that is yet to be studied completely. The general symptoms include irregular bowel habits, abdominal pain, nausea, reflux, bloating, foggy mind, joint pains, fatigue, depression, headaches, anxiety and a general lack of well being.

• Swelling, itching or irritation of the mouth or throat
• Difficulty breathing
• Cramps, nausea or vomiting
• Nasal congestion
• Hives, itchy rash or swelling of the skin
• Headache
• Itchy, watery eyes
• Diarrhea
• Stuffy or runny nose
• Sneezing
• Asthma
• Anaphylaxis

Anaphylaxis, a life threatening reaction to wheat, is less common among people. But given the fatal nature of this reaction, people must be aware of its symptoms and know how to respond quickly. Anaphylaxis may cause the following symptoms: Chest pain or tightness, Pale, blue skin color, severe difficulty breathing, trouble swallowing, fast heartbeat, dizziness or fainting, swelling or tightness of the throat. People must be aware of this condition and be prepared for any kind of emergency that may occur when ingesting wheat or wheat products unknowingly.