Wheat intolerance

More and more of us claim to suffer from a wheat allergy, so we shun bread and other wheat-based foods like pasta and cereals.

Genuine food allergy is, in fact, rarely to blame, say experts, but wheat sensitivity (also known as wheat intolerance) or simply having trouble digesting wheat is increasingly common.

If eating bread gives you bloating and other digestive symptoms, you could be "sensitive" to wheat. Cutting out bread or changing the type you eat may help.

Isabel Skypala PhD, specialist allergy dietician at Royal Brompton and Harefield NHS Foundation Trust observes that "Probably one-third of patients in my allergy clinic complain of digestive symptoms such as bloating, diarrhoea, vomiting and stomach pain after eating bread". She believes that allergy is unlikely to be the culprit, but recognises that bread-related symptoms are real and wheat could be to blame.

Some patients with eczema notice a difference to the severity of their eczema when eliminating wheat. Others report an improvement in their health when eliminating wheat, e.g. improvement in the symptoms of irritable bowel syndrome (IBS) for example.

Wheat allergy is a reaction to proteins found in wheat, triggered by the immune system and usually occurs within seconds or minutes of eating.

Health problems caused by wheat

There are three key health problems that can be caused by wheat:

  • Doctors are divided over whether or not wheat elimination worksWheat allergy - reactions usually begin within minutes and include itching, sneezing and wheezing. See your GP for referral to an NHS allergy clinic.

  • Coeliac disease - is a condition where food cannot be absorbed in the intestine and the intestine lining is damaged by gluten-containing foods including wheat, barley, oats and rye. See your GP for a blood test.

  • Wheat sensitivity - symptoms like bloating, cramps, diarrhoea and sickness come on quite slowly, usually hours after eating wheat. There's no diagnostic test.

If your symptoms are severe and long-lasting, especially if you have blood in your stools (poo), vomiting or painful stomach cramps, see your doctor to rule out a medical condition.

Elimination diet

There are no tests for food intolerances so, if you have bloating or other minor symptoms after eating bread, it’s recommended that you try an elimination diet, where you completely cut out wheat from your diet for four weeks, then bring it back in gradually to see if the symptoms reappear.

As with dairy intolerance, wheat can be problematic for a great many people. However, like dairy produce, it can be difficult to eliminate totally.

Foods that contain wheat and wheat protein include:

  • Wheat bran, germ, gluten, grass, malt, starch and wheat flour
  • Bread, bran, pasta and cereals
  • Couscous and semolina
  • Cakes and pastries; biscuits; doughnuts
  • Bulgur wheat, durum wheat and flour
  • Hydrolysed vegetable protein (HVP)
  • Beer and soy sauce

This means that, to eliminate wheat, you will have to scrutinise food labels for wheat-based ingredients. For example, wheat can also be found in some less obvious foods, such as some fish fingers (in the breadcrumbs) and sausages (rusk to bulk the sausage).

Specialists believe that any food elimination diet should show positive results within about 6 weeks. If the condition of the individual is improving, it is usual to continue to eliminate the particular food for about a year.

Food diary

It is worth keeping a food diary to help identify particular foods that cause a problem, noting:

  • what foods you eat
  • any symptoms you have after eating these foods
  • when these symptoms come on

You might not need to cut out bread completely. Some people with wheat sensitivity have no problems when they eat toast (cooked wheat tends to be easier to digest), sourdough bread, bread cooked with flour made from French wheat, or some breads from a specialist bakery.

Alternatives to wheat

It is important to remember that B vitamins and iron are lost when avoiding wheat.

Fortunately, there are a wide range of good bread substitutes available, including:

  • Wholegrain cereals, cornflakes, rice-based cereals
  • Rice pasta, rice cakes, rice/buckwheat/potato flour
  • Wheat free biscuits (try your local health food store)
  • Protein foods ( meats, fish, poultry, legumes, eggs, dairy)
  • Fruit and vegetables, especially leafy greens
  • Fortified grain products (rice, corn, oats, barley, buckwheat)

Remember to speak to your GP before eliminating wheat to ensure you have all the information you need to maintain a healthy diet. They can also provide information on whether it is possible to obtain some foods on prescription.

Sources used in writing this article are available on request

Information contained in this Articles page has been written by talkhealth based on available medical evidence. Our evidence-based articles are certified by the Information Standard and our sources are available on request. The content is not, though, written by medical professionals and should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands, or treatments.

Information written by the talkhealth team

Last revised: 18 March 2018

Next review: 18 March 2021