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      Frequently Asked Questions About Celiac Disease   09/30/2015

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to FREE Celiac.com email alerts What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease? - list blood tests, endo with biopsy, genetic test and enterolab (not diagnostic) Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet Free recipes: Gluten-Free Recipes Where can I buy gluten-free stuff? Support this site by shopping at The Celiac.com Store.

Cross Contamination Question
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I am a foodservice chef in a small Midwestern college, and serving our student with gluten intolerance is a huge priority for us. We will soon be opening a new facility that features a lot of made to order items, especially in our Asian wok area. We intend to have saute pans specifically designated for non-gluten cooking.

 

Are there steps that must be taken when washing these pans? Could we possibly cross contaminate our pans by washing them with pans that have had pasta cooked in them? By the way, it is a three step process where they are scrubbed in one sink, rinsed in another, and then sanitized in a third sink. Any help that you can offer will be greatly appreciated.

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A lot will depend on how thorough the process is at each stage. If the pans are rigorously scrubbed in phase one, and then physically processed in the second phase, they should be clean after the third phase. But just dipping in soapy water and then in "clean" water will not be enough. The sanitizer will kill micro-organisms, but gluten is not alive and thus can not be killed.

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Chef Steve, can I just say that my heart is warmed at the action that you are taking to ensure the safety of your students? Thank you, thank you.  :)

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Having worked in restaurants and used this method myself, I can say it is pretty rare to see any significant length of time pass without any small food particles ending up in the rinse water. If you wash the gluten free dishes first, it shouldn't be a problem. If not, you could end up with an issue. I wonder also if the pans are stainless steel or non-stick. If they are non-stick they would be absolutely not safe to place into gluteny dish water at all. Once the smallest scratches are in the coating, gluten can get in and contaminate the pan. I think as long as you wash these first, and your other gluten free prep items, it shouldn't be a problem. Or, as much as this will seem a burden and waste of time and resources, drain and wipe out the sinks and refill with fresh water if you need to wash.

 

I think it is great that you are taking the steps needed to keep your student safe. Other things that you may not thought of, cutting boards and utensils are big ones. If they are in a different color they will be easy to identify. I short but extremely emphasized "training" on gluten free will help your entire staff. You could look into local(ish) certification trainings for the head chef.

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I'm surprised you don't use a mechanical dishwasher (Not a human one).  Colorado State seems to do a good job with gluten free food.  Maybe you could ask them about their procedures?  I know that at the Deli sandwich counter - they have a purple box with the gluten-free tools in it.  They get out a big mat and put it down then paper then get the gluten-free bread and fresh ingredients not sitting out & used for gluteny sandwiches.  I'm sure they changed their gloves, too.  This was reported by my son from the previous school year.

 

You could use paper plates and utensils for the allergy kids if that would work better.

 

http://www.gluten.net/Programs/awareness-programs/gluten-free-restaurant-awareness-program

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    • Good advice Ennis!  I would add baking and freezing some gluten-free cupcakes to have on hand, so that she is never left out.  Be sure to read our Newbie 101 tips under the coping section of the forum.  Cross contamination is a big issue,  If the house is not gluten free, make sure everyone is in board with kitchen procedures.   Hopefully, your GI talked about the fact that this AI issue is genetic.   Get tested (and your TD1 child).  TD1 is strongly linked to celiac disease.  About 10% of TD1's develop celiac disease and vice versa.  Get tested even if you do not display any symptoms.    http://www.cureceliacdisease.org/screening/ https://celiac.org/celiac-disease/understanding-celiac-disease-2/diagnosing-celiac-disease/
    • What does weak mean?  Like you squat down and and you can not get back up?  Or are you fatigued?  When you said blood panel, was your thyroid tested?  Antibodies for thyroid should be checked if you have celiac.  So many of us have thyroid issues.  
    • We are not doctors, but based on the results you provided, you tested negative on the celiac screening test.  You could ask for the entire celiac blood panel to help rule out celiac disease.  The other IgA that was high?  It normally is given as a control test for the TTG IgA test (meaning if the celiac test results are valid).  In your case, the TTG IgA test works.  Outside of celiac disease, you might have some infection.  Discuss this with your doctor as he has access to your entire medical file.  I would not worry about it though over the weekend!  
    • See: http://www.cureceliacdisease.org/faq/can-a-skin-biopsy-for-dermatitis-herpetiformis-dh-confirm-celiac-disease-or-is-an-endoscopy-still-needed/ Take a copy of that with you or mail it to the doc. How many endoscopic biopsies did they take? Those with dh tend to have patchier damage than "normal" celiacs.
    • Ironictruth, I think that is a very insightful thought. since different antibodies present for different body systems all the ways gluten affects the body is still not well understood. Here is a case of presumably someone who had the gut damage of a celiac but also had neurological damage. http://www.nature.com/nrneurol/journal/v3/n10/full/ncpneuro0631.html entitled "A case of celiac disease mimicking amyotrophic lateral sclerosis" so it has happened in the literal but since this is not well understood people don't make the connection today. I would also point you to this hindawi article on the "Lesson's learned from Pellagra" but I am afraid we haven' learn't yet. https://www.hindawi.com/journals/cggr/2012/302875/ notice specially the 2.1 section clinical feature of pellagra and all the neurological symptom's once associated with a Pellagra patient. quoting "The neurological manifestation did not stop there because other degenerative conditions, such as an amyotrophic lateral sclerosis-like picture, were described, with fasciculation of the tongue and upper and lower motor neuron signs. Cerebellar syndromes occurred and vertigo was frequent. Headaches, sensory and pain syndromes, epilepsy, and involuntary movements were noted as well as sleep disturbances. Cord lesions were also seen, as was optic atrophy, so there were multiple sclerosis (MS), like variants." which tells me doctor's don't recognize pellagra today when they see it because they haven't seen it in 75+ years. ***this is not medical advice but read the hindawi journal on lesson's learned and I think you will see yourself in their many descriptions of all the way Pellagra presents itself to doctor's and patients still suffering today and you can see why it (like celiac) is hard to pin down today because it presents in so many ways it can be soo overwhelming and since vitamins are not a focus anymore today (especially b-vitamins) that today I believe we are doomed to repeat history's lessons unless the current generation learns again all the ways pellagra presents itself today. good luck on your continued journey. posterboy by the grace of God,  
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