If you have celiac disease and follow a gluten free diet, you may find yourself dealing with certain challenges. In addition to cooking gluten free meals for yourself, you’ll also have to find gluten free options for eating out. Unfortunately, this isn’t always easy.
Keep reading to learn more about the challenges of being gluten free, including eating out on a gluten free diet. You’ll also receive some simple tips for ordering out and for what to do if you accidentally consume gluten at a restaurant.
What Are the Challenges of Celiac Disease?
Celiac disease is an autoimmune condition that affects roughly 1% of average Americans, or about 1 in every 133 Americans. When a person with celiac disease consumes gluten – a protein found in wheat, barley, and rye – their immune system recognizes the protein as a foreign invader and produces antibodies to fight it. Unfortunately, in the process of destroying the gluten, those antibodies also damage healthy tissue in the small intestine.
As common as celiac disease is, many people who have it go undiagnosed for years. The challenge is that the symptoms of this condition are so widely varied that it never manifests in the exact same way in two different people. Symptoms of celiac disease may include the following:
- Chronic diarrhea
- Unexplained weight loss
- Bloating and gas
- Abdominal pain or cramping
- Nausea or vomiting
- Iron-deficiency anemia
- Headaches and chronic fatigue
- Loss of bone density
- Itchy, blistering skin rashes
- Numbness or tingling in extremities
- Joint pain and inflammation
- Acid reflux and heartburn
- Mouth ulcer, eroding tooth enamel
If left untreated, celiac disease can lead to some very serious health problems. As the small intestine sustains more and more damage, the body’s ability to absorb and utilize nutrients becomes impaired – this can lead to malnutrition, chronic fatigue, iron-deficiency anemia, and even osteoporosis.
Unfortunately, there is no cure for celiac disease aside from going on a gluten free diet. Even then, the condition itself is not cured but symptoms will resolve. It could take months, however, for the damage to the small intestine to heal and many people with celiac disease develop IBS or leaky gut syndrome. Once you go on a strict gluten free diet, you must adhere to it or suffer the consequences – accidental consumption of gluten (called being “glutened”) can cause a severe reaction.
In addition to the practical challenges of following a gluten free diet, there are other challenges related to having celiac disease. Celiac disease is an “invisible illness” which simply means that it doesn’t always manifest with outward signs. This means that people often misunderstand the seriousness of the disease and fail to take it seriously. It can also be a challenge to eat out at restaurants or to simply enjoy a meal prepared by friends.
Simple Tips for Ordering Out
Just because you follow a gluten free diet doesn’t mean that you have to completely give up on eating out. It simply means that you have to be more careful about where and what you eat.
The best thing you can do to protect yourself from accidental gluten consumption is to plan ahead. If you are able to choose the restaurant, take the time to do some research and find a few options that offer gluten free menu items. It is important to distinguish between “gluten free” and “gluten free friendly” on menu items. Gluten free friendly usually means that alterations can be made to remove gluten-containing ingredients, but the restaurant may not have a dedicated gluten free food prep area to prevent cross-contamination.
When looking up your options for eating out, know that certain types of cuisine are more compatible with a gluten free diet than others. Italian food, for example, is very heavy in pasta and bread so it may not be the best choice. Mexican, Latin American, Thai, Indian, Greek, and Middle Eastern food all tends to be fairly gluten free friendly. Also, fine dining establishments are more likely to be prepared to make special accommodations than fast food or quick-service establishments.
Once you’ve chosen a restaurant, review the menu – you may also want to call and ask about gluten free options. If the restaurant doesn’t offer a gluten free menu, there are certain things that can be made gluten free if they aren’t already. Here are some menu items you should be cautious about:
- Salads – These can be prepared on shared cutting boards and may come with croutons or salad dressings made with unsafe ingredients.
- Sauces and Marinades – Many sauces are thickened with flour and marinades may contain unsafe ingredients like soy sauce.
- Soups – Soups are often thickened with flour (particularly cream-based soups) or might be made with a soup base that contains unsafe ingredients.
- Roasted Meats – While meat is naturally gluten free, it can be cooked in sauce or marinade that contains unsafe ingredients (au jus may contain flour as well).
- Fried Foods – Many fried foods are breaded or battered before frying and, even if they aren’t, they are typically fried in the same oil as breaded foods.
- Sandwiches – Even if a restaurant offers a gluten free bun, sandwiches and burgers are usually prepared on the same equipment as gluten-containing ingredients.
In addition to looking for gluten free items on the menu, you should also talk to your server. Make sure they understand what celiac disease means and the severity of your condition – you may even want to talk to the manager, so they can help guide the cook preparing your meal. If you eat out often, it may be beneficial to print special cards that explain celiac disease and provide tips for cooks and servers to ensure your safety.
When eating out, one of the most beneficial things you can do is to ask your server plenty of questions to see if they understand what gluten is, and what their cross contamination practices are. If they are unable to answer, your risk becomes much greater.
What to Do If You Accidentally Get Glutened
Even if you are extremely careful about explaining your condition and ordering a meal free from gluten-containing ingredients, there is always a risk of being glutened when you eat out. All it takes is for one person to forget to change their gloves or to not wipe down the cutting board before assembling your burger. If you’ve accidentally ingested gluten, your body will let you know – sometimes immediately.
For a person with celiac disease, even the smallest gluten particles can cause a serious reaction as well as intestinal damage that could take months to heal. When you accidentally eat gluten, your immune system kicks into high gear and starts producing those antibodies to fight the gluten proteins. Individual reactions vary, but some symptoms of being glutened may include the following:
- Acid reflux
- Brain fog
Surprisingly, the symptoms of being glutened may not line up with the symptoms you had before your celiac disease was diagnosed. In fact, many people develop opposite symptoms. For example, if you had chronic diarrhea before being diagnosed with celiac disease, consuming gluten after starting a gluten free diet may cause constipation instead. The key is to look for a pattern that will clue you in to the fact that you’ve eaten something you shouldn’t.
So, what do you do if you accidentally consume gluten? Here are some steps to take:
- Drink lots of water. Drinking water will help to flush your system, helping to eliminate the gluten as quickly as possible – it may also help prevent dehydration if you’re experiencing diarrhea. In addition to water, try drinking bone broth or coconut water to replenish your electrolyte stores, especially if you experience vomiting.
- Get plenty of rest. Many people experience fatigue after being glutened, so don’t be surprised if you find yourself needing more sleep than usual. Give your body time to heal by giving yourself a break from work or school, if you can.
- Take probiotics. If you have celiac disease, consuming gluten can be very damaging to your digestive system. Taking probiotics may help to repair some of that damage and restore your balance of healthy gut flora.
- Stick to your diet. After being glutened, you may not feel up to eating again right away but, once you do, it is important that you get right back on your gluten free diet. Don’t be tempted to use it as an excuse to indulge in the foods you’ve been missing out on since you’ve already been glutened – you’ll just compound the damage and it will take longer to heal.
Everyone is different, so it may take you two days to recover from being glutened or it might take the better part of a week. Once you’ve experienced it a time or two, you’ll see how unpleasant it can be and you’ll be much more careful in the future.
Looking for a simple way to avoid accidental gluten at a restaurant? Try bringing your own gluten free staples like bread and crackers instead of taking the risk. Schär offers a line of gluten free snacks and breads that make it easy to go gluten free, even if you’re eating out.