Navigating celiac disease can be difficult enough when you stay in, but going out presents a whole new challenge.
It can be exhausting, notes Emily Wyckoff, PhD, a psychologist with Hartford HealthCare’s Digestive Health Institute, but it doesn’t have to be. “Whether it’s in a restaurant, a cafeteria or your own home, the most important thing is to advocate for yourself.”
These strategies will help you manage celiac disease, no matter where you are.
1. In a restaurant
According to Jamie Allers, MS, from Hartford HealthCare’s Digestive Health Institute, celiac safety might be as simple as the size of a restaurant’s kitchen.
“Even if they are using separate cutting boards and cooking areas, if it’s a pizza place or a bakery with a small kitchen, then flour will be in the air and it will go everywhere,” she says.
And when it comes to celiac disease, it’s not just your physical health that’s at risk. Communication is key, says Wyckoff, but asking about gluten free options and cross contamination can be stressful.
“Practice feeling confident,” Wyckoff advises. “Call ahead. Ask your server. If they don’t know, ask the manager. Be assertive. Have specific questions, especially about cross contamination. ‘Is the fry oil also used for breaded items?’ Check reviews ahead of time to see if restaurants are celiac friendly.”
> Related: Is Gluten Causing My Stomach Pain?
2. At school
Whether it’s parents advocating for their third-grader or a college freshman hoping not to “look weird” in the dining hall, navigating a cafeteria can be tricky for a celiac patient.
“Luckily, there is a lot more awareness now, and there is much better labeling of foods,” Wyckoff says.
For young students, the most important thing is for parents to be proactive. Contact the school, meet with the cafeteria staff and make sure their awareness and education will keep your child safe.
“Ideally, bring your own food. But if that’s not possible, make sure you understand your child’s facility,” Allers says. “Their food has to be prepared in a separate area – separate knives, cutting boards, pots and pans, everything. Be aware of the level of control.”
And that doesn’t only apply to the cafeteria – make sure the classroom is safe, too.
Celiac is classified as a disability, so the school will help make the necessary accommodations. From snack time to birthday cupcakes, plan a safe alternative for your child in advance. Talk to your doctor to learn more about what you need to provide to the school for documentation.
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3. At home
If you suffer from celiac disease, your home might be the trickiest location of all.
It can be helpful to create a designated “gluten free space,” which includes separate appliances, cutting boards and utensils. But living and eating with others can cause tension, especially around anyone who thinks a gluten free diet is a fad, says Wyckoff.
“You have to find ways to explain that you have an auto-immune disorder, and the only treatment is dietary,” she notes. “And you have to find a balance between asking folks to accommodate you and making due.
“This might mean bringing your own food to holiday parties, rather than interrogating the host about ingredients and preparations,” says Allers. “Remember that the more ingredients a dish has, the more it increases the chances of contamination. Keep to the basics. Many ingredients may have hidden sources of gluten.”
