Dining out with Coeliac Disease: An Analysis of online Message Board Postings on the Social Implications and the Challenges to Live A Normal Life.

ABSTRACT

Background: Strict adherence to a gluten free diet is the only treatment for coeliac disease. Over the past two decades, there has been a societal shift into less home cooking and eating at restaurants has become an important means of social participation [1] creating significant difficulties for people with coeliac disease. This research aimed to explore the issues that people with coeliac disease need to contend with when dining out, their coping mechanisms and the key aspects that facilitate a normal social life through the analysis of online message board postings. Method: A qualitative approach to the research was selected. Data were collected from The Coeliac, DH and Gluten Free Message Board between November 2012 and January 2013. Posts pertaining to the experiences of eating out on a gluten free diet were identified and analysed retrospectively using thematic analysis. Data were anonymised for confidentiality. Results: The emergent themes examined positive and negative dining experiences, coping mechanisms, informational support/expert knowledge, relationships/spouses and emotional stress. The posts suggested an appreciation of the support of Coeliac UK and the ability to dine out now, with mainstream restaurants offering gluten free choices Negative dining experiences occurred when staff demonstrated a lack of knowledge regarding gluten intolerance, were inhospitable or where illness had resulted from being served food containing gluten. Partners of people with coeliac disease reported stress from these negative consequences. People with coeliac disease experienced guilt, shame, anxiety and fear of being a social nuisance. Positive coping strategies included calling restaurants in advance to check that they are willing to cater for someone with coeliac disease. Discussion: However, despite the coping strategies that people with coeliac disease deploy, the negative dining experiences may lead to a lack of trust and the belief that they will be unable to dine out safely. In support, Coeliac UK [2] found that 22% of sufferers are unable to trust restaurant staff to prepare safe uncontaminated gluten free food. Restaurants may not prioritise education and training initiatives in safe practices in the provision of gluten free meals to diners with coeliac disease. This can place a greater burden on people with coeliac disease in utilising assertiveness skills to ensure their food is safe. Conclusion: Being able to eat the same food as others promotes feelings of unity, which enables greater social participation and potentially increased wellbeing. Restaurants are becoming more aware and adaptive to diners with coeliac disease but there is a need for an increased focus on ensuring safe practices in the provision of gluten free meals.