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Ask the Doc: Is working in a bakery bad for celiac?

Q. I am a bakery manager. Last month I tested positive on the celiac blood tests. My father has been diagnosed with celiac, has both genes associated with the disease, as well as lactose and soy allergies now. I have had diarrhea for about a year and a half. My CBC didn’t show much to worry about but I was a little low on vitamin D, not dangerously so, just none stored up.

In my bakery I don’t actually work with the flour, but the bakery is an open environment. We also have  a cake decorating area and a coffee bar, where I generally work, about 30-90 feet away from the dough prep area. Is it possible that I will still be able to continue working in the facility as long as I wash my hands frequently, wear a mask when I am within 5 feet of dough prep area?

I am very concerned because I have been in the bakery industry my entire adult life, it is what I know. I started when I was 18 am now 39. The first 16 years were spent in a bakery that worked with frozen dough the one I currently manage is a full scale mostly scratch bakery. My plan was to see how an exclusive gluten free diet worked and if that did not change my symptoms and reduce my numbers then I would HAVE to consider a career change. However the more I read the more fearful I become that it is inevitable that I will have to change my job.

Do you have any advice or similar case examples you may be willing to share?

A. You need to get a biopsy, to assess the extent of your celiac disease: the more advanced the biopsy, the greater need to protect yourself. Gloves and a mask are a good idea.  There is some data on how much gluten will injure a celiac patient, but that data was generated in stable celiacs who have a normal biopsy, and may not apply to your case. I have had two patients who had minimal , and I mean MINIMAL gluten exposure and became symptomatic.  One was a waitress who was exposed to serving bread, buns, toast, pancakes, etc. She even could tell if someone switched the scoop from wheat to her grain bins at Whole Foods. Another patient would get sick just walking near a bakery!!!!

Health and happiness,
Dr. Aron

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