Gluten is a protein found in many grains, such as wheat, barley and rye. As awareness increases, it’s become more and more common for people to ask to be evaluated for a gluten allergy or intolerance. Yet, many people are confused about what differentiates a wheat allergy, gluten intolerance and celiac disease.

Here’s a quick explanation of each:

Wheat allergy is an abnormal allergic response to wheat protein, typically starting within a few minutes of eating the food. An allergy to wheat causes symptoms such as: itching, flushed skin, swollen lips, tongue or eyelids, itchy welts (called hives), stomach pain, diarrhea or vomiting, wheezing, cough or difficulty breathing. Wheat allergy is diagnosed by either a blood test or a skin-prick test. Like any food allergy, wheat allergy can be life threatening. If accidentally eaten, a shot of Epinephrine may be needed.

Gluten intolerance is also an abnormal response, but it’s not an allergic response, and it does not cause the same symptoms as a wheat allergy. Generally, it causes vague, chronic abdominal symptoms such as bloating, pain, cramping or discomfort, without any itching or skin symptoms. Some people can tolerate a small amount of gluten, and others seem to have symptoms with any amount. You cannot diagnose gluten intolerance with a blood or skin test. A diagnosis is usually indicated if removing gluten from the diet reduces symptoms and adding it back causes symptoms to recur.

Celiac disease is a condition in which eating gluten leads to damage of the small intestine, and is more severe than gluten intolerance. Symptoms include diarrhea, abdominal pain, weight loss or poor growth. Those with this condition can experience additional issues, such as iron deficiency, anemia, osteoporosis, rashes and a higher risk for certain types of cancer. Celiac disease is diagnosed by a blood test or a biopsy of the intestinal tissue, and should be done while eating a gluten-rich diet. The treatment is complete avoidance of gluten. Screening of the general population for celiac disease is not recommended; however, those who have symptoms and/or a family member with celiac disease should consider being tested.

If you have concerns about wheat or gluten in your diet, talk with your doctor to determine if testing is needed.