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Q: How can we handle wheat allergy?

Krishna: 

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Wheat allergy is an allergic reaction to foods containing wheat. Allergic reactions can be caused by eating wheat and also, in some cases, by inhaling wheat flour.

Avoiding wheat is the primary treatment for wheat allergy, but that isn't always as easy as it sounds. Because wheat is found in many foods, including some you might not suspect, such as soy sauce, ice cream and hot dogs. Medications may be necessary to manage allergic reactions if you accidentally eat wheat.

Wheat allergy sometimes is confused with celiac disease, but these conditions differ. Wheat allergy occurs when your body produces antibodies to proteins found in wheat. In celiac disease, a specific protein in wheat — gluten — causes a different kind of abnormal immune system reaction.

 with wheat allergy is likely to develop signs and symptoms within minutes to hours after eating something containing wheat. Wheat allergy signs and symptoms include: swelling, itching or irritation of the mouth or throat, hives, itchy rash or swelling of the skin, nasal congestion, headache, difficulty breathing, cramps, nausea or vomiting, diarrhea, anaphylaxis. The last one is more dangerous.

For some people, wheat allergy may cause a life-threatening reaction called anaphylaxis. In addition to other signs and symptoms of wheat allergy, anaphylaxis may cause: swelling or tightness of the throat, chest pain or tightness, severe difficulty breathing, trouble swallowing, pale, blue skin colour, an dizziness or fainting.

If you have wheat allergy, exposure to a wheat protein primes your immune system for an allergic reaction. You can develop an allergy to any of the four classes of wheat proteins — albumin, globulin, gliadin and gluten.

Sources of wheat proteins: Some sources of wheat proteins are obvious, such as bread, but all wheat proteins — and gluten in particular — can be found in many prepared foods and even in some cosmetics, bath products and play dough. Foods that may include wheat proteins include: Breads and bread crumbs, rotis and puris, naan, paratha, thalipeeth, khakhra, chivda, laddu, halwa, khichdi, rava dosa, upma, cakes, muffins and cookies, noodles, biscuits, pastries, cereal bars, several sweets, breakfast cereals, pasta, couscous, farina, some sauces, semolina (upma or bombai ravva), other wheat products like bambino, spelt, crackers, hydrolyzed vegetable protein, soy sauce, meat products, such as hot dogs, dairy products, such as ice cream, natural flavorings, gelatinized starch, modified food starch, vegetable gum and several other products.

Any of these things can cause allergy when consumed. If you have wheat allergy, it's possible you might also be allergic to barley, oats and rye. Unless you're allergic to grains other than wheat, though, the recommended wheat-free diet is less restrictive than a gluten-free diet.

Some people with wheat allergy develop symptoms only if they exercise within a few hours after eating wheat. Exercise-induced changes in your body either trigger an allergic reaction or worsen an immune system response to a wheat protein. This condition usually results in life-threatening anaphylaxis.

Certain factors may put you at greater risk of developing wheat allergy:

  • Family history. You're at increased risk of allergy to wheat or other foods if your parents have food allergies or other allergies, such as asthma.
  • Age. Wheat allergy is most common in babies and toddlers, who have immature immune and digestive systems. Most children outgrow wheat allergy by 16, but adults can develop it, often as a cross-sensitivity to grass pollen.

Tests will be conducted to find out whether you are allergic or not to wheat. 

Avoiding wheat proteins is the best treatment for wheat allergy. Because wheat proteins appear in so many prepared foods, read product labels carefully. But it is not always possible to avoid them completely. 

Medicines used to treat wheat allergies

  • Antihistamines may reduce signs and symptoms of minor wheat allergy. These drugs can be taken after exposure to wheat to control your reaction and help relieve discomfort. Ask your doctor if a prescription or an over-the-counter allergy drug is appropriate for you.
  • Epinephrine is an emergency treatment for anaphylaxis. If you're at risk of having a severe reaction to wheat, you may need to carry two injectable doses of epinephrine (EpiPen, Adrenaclick, others) with you at all times. A second pen is recommended for people at high risk of life-threatening anaphylaxis in case anaphylactic symptoms return before emergency care is available.

Emergency medical care is essential for anyone who has an anaphylactic reaction to wheat, even after receiving an injection of epinephrine. It is better to consult a medical doctor in case you suspect a severe wheat allergy reaction. 

Scientists are working on several types of immunotherapy to treat food allergies. Immunotherapy exposes you to small amounts of the allergic substance and then increases that exposure over time. The hope is that your body will become desensitized to the allergen, and you'll have fewer or no symptoms.

Several small clinical trials have been done on an oral form of immunotherapy for wheat allergy that showed reduced allergy symptoms.

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