Gluten is a protein compound found in the grains of wheat, rye, barley and related grasses. Gluten is poorly digested in your gastrointestinal tract, so it can reach the lower part of your bowel where bacterial fermentation produces byproducts that cause gassiness, bloating, abdominal cramping and diarrhea. According to the American Celiac Disease Alliance, this condition, called gluten intolerance, is uncomfortable and inconvenient, but it does not damage your intestine. If you have gluten intolerance associated with other symptoms such as skin rash, however, you could be suffering from a more serious condition, such as a wheat allergy or celiac disease.
Immune Response
While gluten intolerance merely reflects your inability to completely digest gluten, celiac disease and wheat allergy are caused by immune responses to gluten or other substances in wheat products. Wheat allergy stems from activation of a branch of your immune system that prompts the release of histamines and leads to wheezing, itching, hives, swelling of your lips and tongue, abdominal pain and diarrhea. Celiac disease involves a different branch of your immune system that produces antibodies against the proteins found in gluten. These antibodies can also attack your own tissues -- your joints, bones, liver, reproductive and nervous systems, endocrine glands and skin -- leading to a multisystem disease that is sometimes life-threatening.
Skin Problems
Gluten intolerance alone does not cause skin rashes. Wheat allergy can cause hives -- splotchy, raised, reddened areas that usually itch -- or it can be associated with other types of rashes. Typically, a rash caused by wheat allergy erupts within minutes to hours of wheat consumption, and it can last several hours to several days. A special type of skin rash called dermatitis herpetiformis -- intensely itchy or painful reddened patches covered with chickenpox-like blisters -- is seen in 10 to 20 percent of people with celiac disease, according to "American Family Physician." While not all people with celiac disease have dermatitis herpetiformis, everyone with dermatitis herpetiformis has celiac disease.
Treatment
Gluten intolerance, wheat allergy and celiac disease are all managed the same way: avoidance of wheat products. People with wheat allergy may be sensitive to non-gluten components in wheat, so they can sometimes tolerate other grains. With gluten intolerance and celiac disease, you must avoid all gluten-containing grains. This can be difficult, because gluten is used in innumerable food products. Once gluten is removed from your diet, your symptoms, including rashes caused by wheat allergy or celiac disease, will gradually resolve. The immediate symptoms of wheat allergy may require antihistamines or, in severe cases, more intensive medical therapy. Dermatitis herpetiformis can be treated with a drug called dapsone until it resolves on a gluten-free diet.
Considerations
Although most people eat grain products with impunity, exposure to gluten can lead to a spectrum of complaints in gluten-sensitive people. If you are sensitive to gluten, your symptoms can range from transient abdominal discomfort to allergic reactions or serious abnormalities in multiple organ systems. Skin rashes are common in people with wheat allergies and celiac disease, although the rashes in these conditions differ in appearance, underlying immune mechanism and response to treatment. If you suffer from gluten intolerance that is associated with a rash, see your doctor for an evaluation.
