Wheat and Cereal Grain Allergies

Food allergies are common, and affect millions of adults and children. Wheat allergy is the most common grain allergy and is ranked in the top foods that cause the most allergic reactions. But other cereal grains—including corn, barley, and rye—can also cause allergic reactions in some people. In some cases, these reactions can be dangerous.

It is important to know that grain allergies can develop at any age, even in people with a history of tolerating grains previously, although the majority of grain allergies first become noticeable in early life.

Learn more about how to recognize the symptoms of a grain allergy, how they are diagnosed, and steps that can be taken to eliminate certain grains from your diet if you are allergic.

Symptoms of a Grain Allergy

Allergic reactions to grains share common symptoms that can develop within minutes to hours after ingestion.

Common symptoms of an allergic reaction include:

• Itching of the mouth or throat
• Swelling of the lips or throat
• Hives or itchy skin
• Difficulty breathing
• Vomiting and.or diarrhea

Anaphylaxis occurs when an allergic reaction is affecting more than one body system (for instance, a skin rash or hives and difficulty breathing), or when blood pressure suddenly drops which can cause collapse. This type of reaction is life-threatening, and can progress quickly to anaphylactic shock when blood pressure drops. If left untreated, anaphylactic shock can be fatal.

If you are experiencing symptoms of an allergic reaction after eating cereal, pasta, or bread, contact your healthcare provider or seek medical care immediately.

How Common Are Grain Allergies?

More than 30 million Americans suffer from food allergies.

It is unclear what causes food allergies, including those to common grains, but it is believed that genetics may play a partial role. For some people, the timing of exposure to an allergen (such as grains) and environment may also play a role.

Allergy, Sensitivity, or Celiac Disease?

Food allergies are sometimes confused with food sensitivities (also called intolerances). If you're having a reaction to food, it's important to understand the difference between the two, and also how these conditions differ from celiac disease.

Food allergy: During an allergic reaction, the body reacts to the foreign substance (in this case, grain) and your immune system responds rapidly with allergen-specific antibodies that react with the food. This reaction can happen within minutes or hours and can be potentially life-threatening.

Food intolerance: Intolerance is not an allergic reaction, but can lead to a variety of symptoms, most often in the digestive tract. Symptoms of food intolerance can include gas, bloating, and/or diarrhea. Though uncomfortable, food intolerance is not life-threatening.

Celiac disease: This condition is an autoimmune disorder in which gluten (a protein found in wheat, rye, and barley) triggers white blood cells in the body to attack the lining of the small intestine. If left untreated, over time, celiac disease can cause serious health complications.

Diagnosing Grain Allergies

Diagnosis can be tricky. When diagnosing a grain allergy, your healthcare provider will first review your medical history and symptoms.

An allergist may perform specific allergy tests, including:

• Skin prick tests: This highly sensitive test involves placing a small amount of the food allergen on the arm or back and pricking the skin to determine whether a reaction occurs.
• Blood tests: These tests can measure immunoglobulin E (IgE) antibodies to certain foods in the blood.
• Oral food challenge: This test is performed by gradual exposure to increasing amounts of an allergen over a period of time. During an oral challenge, emergency medication and equipment are available in case a reaction occurs.

You can be allergic to more than one grain. One study indicated that patients with a wheat allergy were 20% more likely to be allergic to another grain as well.

Treating Grain Allergies

For children with wheat allergies, the good news is that more than half will outgrow their allergies by their teenage years. In the meantime, the best management for a food allergy is to avoid the allergen. If you are allergic to a cereal grain, you'll need to be diligent about knowing the ingredients in the foods you eat.

If you have an allergy to wheat, your healthcare provider will likely prescribe an EpiPen (also called an epinephrine autoinjector) that you'll need to have with you at all times. You can learn to inject this medication to avoid a life-threatening allergic reaction.

Watching What You Eat

If you are avoiding certain grains due to an allergy, monitoring food labels is critical. Laws require that food labels clearly note if one of the nine major allergens (milk, eggs, wheat, tree nuts, peanuts, fish, shellfish, soybeans, and/or sesame) is an ingredient.

Wheat is one of the major allergens covered by the law—barley, rye, and corn are not.

Sometimes labels aren't always clear.

Follow these tips to help you determine whether a product contains wheat, rye, barley, or corn:

• Nicknames matter: Sometimes, alternate names or even Latin terms are used. Keep your eyes peeled for words like Triticum vulgare (wheat), Hordeum vulgare (barley), Secale cereale (rye), and Triticale (a hybrid of wheat and rye). "Malt" typically indicates that barley is included.
• Grains can hide in other ingredients: Some flours, starches, and sweeteners contain grains. Understand which ones could trigger your allergy (for instance, the sweeteners sorbitol and fructose are made from corn, and maltose is made from barley).
• Pay attention to advisory labels: Though not required by law, a growing number of manufacturers note when facilities process foods that contain allergens, since shared production equipment increases the risk of cross-contamination. Talk to your healthcare provider about whether you need to avoid foods with these advisory labels.
• Look beyond your food: Some medications and supplements include gluten as an ingredient. Don't forget to monitor the labels of these products in addition to food.

Finding Grain-Free Recipes

If you have an allergy to a common grain, finding recipes to accommodate your allergy can be a challenge. There are options that can help you know when food products or recipes should be safe for you.

• Some popular diets, such as Paleo and Whole30 are grain-free. Recipes from these diets may work for your allergy.
• Gluten-free foods do not contain wheat, barley, or rye. If you are avoiding wheat, this may be an option for you. Note that gluten-free does not mean grain-free. Corn does not contain gluten, so gluten-free options will not help you if you have a corn allergy.

A Word From Verywell

If you have a grain allergy, you are not alone. Though it's not always easy, living well with a grain allergy is possible with close attention to product contents and a strong understanding of your specific condition.