Imagine that for your entire life you have felt sick. Between the fatigue, stomach pains, and nausea, you have been stuck in an endless cycle of dining roulette. The doctors assume that you are “just sensitive” and treat these symptoms with a variety of medications, but they never find the cause. Yet the older you get, the worse it gets. Before long, there have been visits to specialists, countless tests with inconclusive results, and the uncomfortable feeling that everyone thinks you are a hypochondriac. As the symptoms increase, it becomes impossible to lead a normal life out of fear that your stomach may stage a revolt, especially when it comes to traveling or even spending a day at the beach. You may or may not have been pulled over when speeding for a bathroom and forced by sheer desperation to throw your wallet at the officer’s face while yelling, “I am about to shit my pants” and screeching off toward your house. Needless to say, your life is scoring a wee bit low on the fun-scale.

Then the day comes when you are told that there is a cure for what ails you and you will only have to give up one thing and one thing only to feel better: gluten. So, what is the big deal? It is only one little thing, right? And besides, what the hell is gluten anyway?

I can tell you firsthand that giving up gluten is no small feat. For many other gluten-sensitive people, their experiences mirror those described above. In the case of Michael Varnadore of Summerville, he found his answers through two-and-half-years of trial and error. His biggest challenge was gaining a complete understanding of what gluten is and in which products it can be found.

As Varnadore and I have both discovered, gluten’s senior superlative was evidently for the “most popular food additive.” It is a protein composite found in food processed from wheat, barley, rye, spelt, kamut, and oats. It is valued for its ability to give elasticity to dough, bind ingredients together, and provide a source of protein. In a nutshell, it makes things light, fluffy, and delicious.

From the obvious foods such as bread and pasta to less obvious items like luncheon meat, soy sauce, and french fries, gluten has made its way into almost every product in the grocery store. Just to make things even more complicated, it is not always explicitly named in the ingredients list, which is why there are now a number of companies labeling their products as gluten free. If this sounds a little overwhelming, then you can begin to understand how avoiding it can be more of an art than a science.

Instead of focusing on what cannot be eaten, sometimes it is easier to find out what you can eat. Fresh fruit, vegetables, beans, brown rice, eggs, alternative flours, dairy, tofu, seafood, and certified meat are all safe. There are a number of companies making gluten-free products including bread, snacks, desserts, cereal, and beer, although they will make a serious dent in your wallet.

There are millions of people like Varnadore and me who are negotiating these dietary challenges, yet not everyone has the same gluten-related issues. The spectrum of reactions to gluten can be divided into the following groups: wheat allergy, celiac disease, and gluten sensitivity. Wheat allergies are similar to other food allergies; they can cause hives, respiratory distress, and nausea. Those with celiac suffer from an inflammatory reaction in the digestive system when they are exposed to gluten; the reaction damages the villi (tiny hairs) in the small intestine and leads to the inability to absorb nutrients. Symptoms range from diarrhea to stomach pain, mouth ulcers, lactose intolerance, weight loss, anemia, migraines, lethargy, and joint pain. If you do not get diagnosed or choose to ignore the disease after you have been, you may end up suffering from malnutrition or developing intestinal cancer, diabetes, and other debilitating conditions.

My condition isn’t quite as dire. I suffer from gluten sensitivity. Unfortunately, others like me exhibit the symptoms of celiac, but they test negative for a wheat allergy and celiac disease. However, they can alleviate their symptoms by switching to a gluten-free diet.

According to the Mayo Clinic, an estimated one in 100 people suffer from celiac, although many of them are undiagnosed and millions more are gluten sensitive. Although there is no definite number, recent studies have shown that gluten intolerance has steadily increased over the last 50 years. What is causing this rise in the number of cases? A variety of factors are believed to contribute, including an improved capability for diagnosis, the increase of gluten in diets, and the significant rise in other health conditions due to poor lifestyle choices.

Unfortunately for many individuals, it may take years to get diagnosed with a gluten-related condition. Kellen Lawson, an astrophysics major at College of Charleston, was diagnosed with celiac last November after a lifetime of stomach issues, blinding migraines, and malnourishment. Thanks to the keen eye of a friend’s mother, a nurse practitioner, he finally underwent testing. Like many individuals who are unable to digest gluten, he is also lactose intolerant, adding yet another challenge to his diet. He has spent the last year learning how to cope with the disease while also attending class, working, and having a social life. Naturally, the things he misses the most are really good pizza and being able to eat out anywhere with friends. The silver lining is that his migraines and stomach pain are gone and he has learned how to prepare the majority of his meals from scratch, which is a good thing, since he says his friends and family “still have no idea what gluten is.”

Luckily for Varnadore, Lawson, and many others, more and more people are aware of gluten allergies and celiac disease. There are currently dozens of gluten-free websites, new products on the market, cookbooks, and even gluten-free restaurants. Most major cities have an impressive selection of eateries, grocery stores, and meet-up groups interested in finding gluten-free, vegetarian, locally sourced, raw, vegan, or nut-free food.

So how does Charleston fare in the gluten-free world? Most of the large grocery store chains in the area carry gluten-free products, with Whole Foods, Trader Joe’s, Earth Fare, Harris Teeter, and Bi-Lo among the best. As for local restaurants, there seems to be a few leading the charge while others slowly get on board.

Tarteletteblog.com‘s Helene Dujardin, a writer, chef, and fellow gluten avoider, feels that Charleston restaurants still need a lot of education and training when it comes to food allergies. Although local chefs have demonstrated their culinary talents by showcasing local products and creating delicious meals for the all-eating omnivores, she believes that they are still a long way off from addressing dietary restrictions in their menus. Dujardin explains that this is an issue that goes beyond the chefs and begins with those on the front lines: the waitstaff. As the middlemen for the restaurants, the front-of-house staff must accurately communicate the capabilities of the kitchen and, in turn, explain the needs of the customers to the chefs.

Chef Michael Carmel, culinary department head at the Culinary Institute of Charleston, is working on addressing these issues. His students are trained on how to handle food allergies and preferences through a variety of courses from kitchen sanitation to menu development. Carmel believes that catering to those with dietary restrictions, whether it is gluten, nuts, or animal products, “is not only a business opportunity but it is essential.” In his eyes, ignoring these groups is limiting your customer base and missing an incredible opportunity to stand out.

Rebecca Powell, head of the Gluten.net Chef to Plate program, echoes this sentiment. “Gluten-free customers are very loyal. If they have a good experience, they come back with their friends and family,” she says. Chef to Plate is a national program designed to help restaurants create staff and customer awareness about gluten-free dining by providing free educational materials and listing participating restaurants online. In addition to this program, Gluten.net also provides industry audits and certifications for those interested in getting the gluten-free label for their product.

Although there are not currently any Charleston restaurants participating in the Chef to Plate program, a handful have started to train their staff and create gluten-free menus, including Five Loaves Café, Crave, Caviar and Bananas, Patat Spot, Mustard Seed, Fat Hen, the Daily Dose, 82 Queen, Basil, Café Kronic, Glass Onion, East Bay Deli, Hominy Grill, S.N.O.B., Charleston Crab House, Chai’s, and Mellow Mushroom.

Patat Spot owner Phillis Kalisky Mair has always catered to customers with food allergies at her European friet and falafel snack bar thanks in part to her sister’s own gluten sensitivity. The restaurant boasts gluten-free falafel, gluten-free fries, and homemade pita, and it will soon offer gluten-free beer and desserts. In addition to catering to those with gluten allergies, she is also conscious of people who are allergic to nuts. Although Mair acknowledges that it is a little more expensive to make some of the products, she has attracted a loyal fanbase. “So many people have food allergies and they have to continuously worry about cross-contamination,” Mair says. “We have had customers come in, see our selection, realize that we understand their challenges, and they literally jump up and down.”

Chef Fred Neuville of Fat Hen has received similar praise from customers for his wide variety of gluten-free options, accommodating kitchen, and well-versed staff. He relishes crafting new items for the menu that can be enjoyed by customers with food allergies. “There are so many things that you can make gluten free,” he says. “Why not make something great so people can come in and enjoy themselves?” After taking a look at the menu, it’s easy to see that he is putting thought into action. From gluten-free boiled peanut salad and crab cakes to duck confit and butternut squash rice, Fat Hen makes eating gluten-free dishes seem like fine dining.

When most gluten-free individuals are asked what culinary delights they miss most, two of the most common answers are pizza and beer — especially if the person you’re asking is me. Thankfully, Michael Shemtov, co-owner of Mellow Mushroom’s King Street and Avondale locations, listened to the collective voices demanding delicious gluten-free pizza and beer. While working at the Mellow Mushroom corporate office in Atlanta, he saw an increasing number of e-mails from customers that had spent their lives loving pizza and beer, only to discover they could no longer have it. Not only were these customers no longer able to come into the pizzeria, but it meant that their families and friends would be coming in less often as well.

“Gluten-free customers have the veto power on eating out with their family, friends, and co-workers, so it is not just about those living without gluten,” Shemtov says. “Not catering to these individuals is very shortsighted.”

Over a span of two years, the company partnered with a number of gluten-free companies to develop the signature dough they now offer in their restaurants. Pair this dough with a well-trained staff, a separate prep area, and a bottle of Estrella Damm Daura beer, and gluten-free magic is made. Recently, the West Ashley Mellow Mushroom hosted a private gluten-free party in which the entire restaurant was scrubbed down and they served gluten-free friendly food to over 150 customers. Shemtov encourages restaurants to tap into this enthusiastic crowd that he describes as “tremendously loyal” and “very well networked with one another.”

In the end, the consensus seems to be that the Holy City has much to learn about gluten sensitivity — but it’s getting there. To support and encourage this growth in gluten-free understanding, the first ever Gluten/Allergen Free Expo in Charleston will be kicking off on May 5 from 11 a.m. to 4 p.m. at the Omar Shrine Convention Center at Patriots Point in Mt. Pleasant. There will be gluten-free vendors and presentations from nutritionists, doctors, and chefs speaking on gluten-free living. Check out the event website, charlestongfafexpo.blogspot.com, for more info.

Top 10 Gluten-Free Must Haves

1. Udi brand products, from bread to muffins

2. So Delicious Coconut Milk Beverage

3. Glutino brand products, especially the bagel chips

4. Diggity Doughnuts’ gluten-free cinnamon-sugar donut holes

5. Redbridge gluten-free beer

6. Patat Spot bean potato cakes with cucumber dill sauce and friets

7. Pamela’s Products’ gluten-free flour mix

8. Five Loaves Café’s soups

9. Gluten-free Chex cereal

10. Vegetarian burger from HoM sans bun