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Symptoms of wheat allergy

Symptoms of wheat allergy vary widely and can be described according to the NICE food allergy guidelines [1].
Classically, IgE mediated wheat allergy shows symptoms of rashes, urticaria (hives), angioedema, wheeze and anaphylaxis. Non-IgE mediated/mixed IgE and non-IgE mediated wheat allergy shows symptoms of diarrhoea, constipation, delayed type eczema, vomiting (particularly in the case of Eosinophilic Oesophagitis) and reflux and in some (very rare cases) blood in stools or food protein-induced enterocolitis syndrome (FPIES).

Symptoms of IgE mediated food allergy [1]

IgE Signs and Symptoms
Usually minutes after food  ingestion
(But may be up to 2 hours)		 Non-IgE Signs and Symptoms
Usually hours or even days after food ingestion
Skin
  • Pruritus
  • Erythema
  • Acute urticaria (localised or generalised)
  • Acute angioedema (most commonly of the lips, face, or around the eyes)
  • Acute flaring of Atopic eczema
 Skin
  • Pruritus
  • Erythema
  • Atopic eczema
Gastrointestinal
  • Angioedema of the lips, tongue and palate
  • Oral pruritus
  • Nausea
  • Colicky abdominal pain
  • Vomiting
  • Diarrhoea
 Gastrointestinal
  • Gastro-oesophageal reflux disease
  • Loose or frequent stools
  • Blood and/or mucus in stools
  • Abdominal pain
  • Infantile colic
  • Food refusal or aversion
  • Constipation
  • Perianal  redness
  • Faltering growth plus one or more of the above gastrointestinal presentations (with or without significant atopic eczema)
Respiratory (usually in combination with one or more of the above signs or symptoms)
  • Upper respiratory tract symptoms - nasal itching, sneezing, rhinorrhoea or congestion (with or without conjunctivitis)
  • Lower respiratory tract symptoms (cough, chest tightness, wheezing or shortness of breath)
 Respiratory (usually in combination with one or more of the above signs or symptoms)
  • Upper respiratory tract symptoms - nasal itching, sneezing, rhinorrhoea or congestion (with or without conjunctivitis)
  • Lower respiratory tract symptoms (cough, chest tightness, wheezing or shortness of breath)
Other  - Signs or symptoms of Anaphylaxis or other  systemic allergic reactions  
References
  1. National Institute for Health and Care Excellence. Diagnosis and assessment of food allergy in children and young people in primary care and community settings.  Clinical Guideline CG116. London: 2011.
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