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Can you have celiac disease without a wheat allergy?

My daughter was recently diagnosed with celiac disease and was told to avoid gluten (found in wheat). She does not, however, have a wheat allergy. How could this be? What is the difference between a wheat allergy and celiac disease?

A. Wheat allergy and celiac disease are frequently confused. Wheat allergy refers to an allergic immune reaction to ingestion or inhalation of wheat. Shortly after wheat exposure, a person with a wheat allergy may experience such symptoms as:

• Swelling or itching of the mouth, tongue or lips

• Headaches

• Abdominal cramps and vomiting

• Skin rash or hives

• Breathing problems

• Nasal congestion

• Anaphylactic shock

Wheat allergy is the one of the most common food allergies in the United States. People with severe wheat allergy would need to carry an epinephrine auto-injector in case of anaphylaxis. Children with a wheat allergy are likely to outgrow the allergy.

Celiac disease is an autoimmune process that affects the small intestines. Ingestion of foods containing gluten (proteins found in wheat, rye and barley) damages the lining of the small intestine. Left untreated, celiac disease can lead to long-term intestinal damage and poor nutrition. Symptoms can include abdominal cramps and bloating, anemia, constipation or diarrhea. Many people, however, are asymptomatic at the time of diagnosis.

You can treat celiac disease by following a gluten-free diet. Gluten is found in foods that contain wheat, barley and rye. Gluten is often found in a few unexpected foods as well, such as ketchup and soy sauce. Reading food labels is an essential part of living with celiac disease.