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Most diners order a hamburger without giving much thought to the bun. But for the 2.2 million Americans with celiac disease, that bun can make the difference between patronizing a restaurant or passing it up.

As a result, restaurants that would rather feed those diners than lose them are adding gluten-free items–and sometimes whole menus–to their offerings.

Wildfire, which has five restaurants in the Chicago area, introduced its gluten-free menu about 18 months ago, and word spread quickly on celiac Web sites, which often list restaurants catering to that population’s dietary needs.

“It’s an opportunity to serve people who are afraid to go out for dinner–and I don’t blame them,” says Howard Katz, president of Wildfire.

Gluten, for the uninitiated, is a protein found in wheat, barley and rye. For celiacs, as those who cannot tolerate gluten are called, eating foods that contain the protein inhibits the small intestine’s ability to absorb nutrients, says Michelle Melin-Rogovin, executive director of the University of Chicago’s Celiac Disease Program. The only solution is sticking to a gluten-free diet.

In addition, other people who may not be celiacs have a sensitivity to gluten or wheat and so try to avoid it.

That might seem easy enough. Just skip the pasta and bread, right? But it’s not so simple because gluten sneaks its way into such things as soy sauce, soup thickeners, shredded cheeses and imitation crabmeat. It also can wind up in french fries prepared in the same fryer as battered onion rings, says Cynthia Kupper, a dietitian who is executive director of the Seattle-based Gluten Intolerance Group, which provides education and support to people with gluten intolerance and sensitivities.

(McDonald’s caused a stir last week by acknowledging that the flavoring agent in the oil used to make its fries is derived from wheat and dairy products–though it’s not clear this would pose a problem for celiacs.)

Kupper has helped national chains such as Outback Steakhouse, Carrabba’s Italian Grill and Mitchell’s Fish Market put together their gluten-free menus.

“I don’t go in to revise their menus,” she says. “I weed out the items that aren’t gluten-free.”

At Mitchell’s, which has a restaurant in Glenview, managers kept getting more and more questions about whether certain dishes contained gluten, says regional chef Will Wadsworth. In deciding to develop a gluten-free menu, he called on Kupper, and together they went over every recipe.

The special menu lists all dishes that are gluten-free or can be made gluten-free with alterations. For instance, its Shang Hai sampler bears the notation “GF-Omit ponzu sauce.” The notation on its New Orleans seafood stew reads: “GF-Request sauteed calamari, not fried.”

His chefs also have a spreadsheet listing all gluten-free items, Wadsworth says, and they take extra care in the kitchen when a diner requests a gluten-free meal.

Cross-contamination in restaurant kitchens–cutting a gluten-free bun with the same knife that was just used to cut a wheat bun, for instance–can be a real issue. At Wildfire, for example, regulations are in place to ensure such cross-contamination doesn’t occur. It treats orders from celiacs in the same way it does those from diners with food allergies, says Ruth Hayden, Wildfire’s director of training. A manager is always involved, and a hot-pink ticket is affixed to the order. That signals a need for the kitchen staff to scrub the grill or clean the knife before preparing a gluten-free dish, she says.

Despite those guidelines, occasional incidents of cross-contamination–usually reported later by diners–have occurred, Hayden says.

That’s one reason Mitchell’s, for one, puts a disclaimer on its menu stating that the restaurant and the Gluten Intolerance Group “assume no responsibility for its use.”

Ultimately, Kupper says, “it’s the customer’s responsibility. What the restaurant is doing is doing them a favor.”

To make things easier on both restaurants and diners, Peggy Wagener, president and publisher of Living Without magazine, a quarterly publication for those with allergies and food sensitivities, offers gluten-free dining cards (available through its Web site, www.livingwithout.com). The laminated cards explain what gluten is, which foods likely contain it and which ones don’t. Celiac diners can hand a card to their server, who can pass it along to the chef to guide him in preparing their food.

A celiac herself, Wagener says the diagnosis “does topple your life initially. You can’t go get a sandwich.” Still, “customers should be understanding [of restaurants]. You should call in advance to see if they can accommodate you.”

That’s becoming easier, thanks to the burgeoning array of gluten-free products and restaurants willing to offer them.

Paul LoDuca, chef/owner of Vinci and owner of the two Adobo Grills–all of which offer gluten-free menus–was happy to finally find a source for decent rice ziti, because the pastas he tried initially kept breaking.

“You have to start with quality products,” says LoDuca. Offering a gluten-free menu is easier for restaurants that don’t use a lot of processed foods, he says.

That’s the case at River Grove’s Da Luciano, which may well have the most comprehensive gluten-free menu in the Chicago area.

And it’s for good reason: The owners, Luciano and Rosalia Libreri, have seven children, four of them with celiac disease.

Da Luciano’s menu offers a huge array of gluten-free pasta dishes made with noodles imported from Italy, which Luciano Libreri has found to be superior to those made in the U.S. He also offers breads and pizzas made from a combination of corn, rice and potato flours, and his wife makes cakes, cream puffs, cannoli and other gluten-free desserts.

His chefs take extra precaution when preparing gluten-free dishes, Libreri says. “We have a separate table where the food is prepared, a separate fryer. Everything is separate.”

Not surprisingly, he says he gets a great deal of business via Web users who talk up his menu, which includes a line of frozen pizzas, meatballs and pastas for takeout.

At Wildfire, too, “people have been so excited about this,” says Hayden. LoDuca adds that the response from diners grateful for his gluten-free menus has been amazing.

Even something as mundane as a bun–Wildfire finally found a good rice and tapioca bun to add to its menu six months ago–gets a big reaction, Hayden says.

“People will tell us, `I haven’t had a hamburger in 10 years!'”

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Gluten-free menus

The following Chicago-area restaurants offer gluten-free menus. Many other restaurants will accommodate people on gluten-free diets as well. Always call ahead to discuss menu options.

ADOBO GRILL

1610 N. Wells St., 312-266-7999; 2005 W. Division St., 773-252-9990; www.adobogrill.com.

CARRABBA’S ITALIAN GRILL

1001 W. 75th St., Woodridge, 630-427-0900; www.carrabbas.com.

DA LUCIANO

8343 W. Grand Ave., River Grove, 708-453-1000; www.dalucianos.com.

MITCHELL’S FISH MARKET

2601 Navy Blvd., Glenview, 847-729-3663; www.mitchellsfishmarket.com.

OUTBACK STEAKHOUSE

10 Chicago area locations; www.outbacksteakhouse.com.

P.F. CHANG’S

four Chicago area locations; www.pfchangs.com.

VINCI

1732 N. Halsted St., 312-266-1199; www.vincichicago.com.

WILDFIRE

five Chicago area locations; www.wildfirerestaurant.com.

For more information on celiac disease, visit the University of Chicago’s Celiac Disease Program Web site: www.celiacdisease.net.

— J.F.

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atplay@tribune.com