Introduction to Dietary and Digestive Disabilities

Summary

People with dietary and digestive disabilities have specific access needs that affect their eating and drinking, navigating public and private spaces, and using the restroom. These needs can also inform what they need to do when they are at home, in public, at work or school, or attending events.

Overview

Various disabilities affect the digestive system. People with these disabilities have specific access needs in the physical world. These needs can also be supported in communications, digital tools, and other venues. These needs vary, but include:

• Being able to eat or drink
• Being able to avoid substances that cause harm
• Being able to avoid mental health impacts
• Being able to access and use a restroom (see Accessible Public Restrooms (Ta11y))
• Being able to attend to these needs at public venues, at work, at school, and at events, or while in transit by vehicle, train, boat, or aircraft

These disabilities include:

• allergies, intolerances, and sensitivities to specific foods or substances, including sensitivity to alcohol, gluten, and other substances and chemicals
• mental health conditions such as eating disorders
• chronic conditions, such as diabetes, Crohn’s disease, sarcoidosis, gastroenteritis, and irritable bowel syndrome
• digestive system differences, such as colostomies and feeding tube use
• temporary conditions, such as pregnancy or medication-related needs

These disabilities, among others, are listed on useable. Many people with other disabilities also may have specific dietary and digestive needs, for example, autism, spinal cord injuries, and dementia.

The access needs for people with these disabilities vary. This article will discuss meeting the following specific needs, as noted in useable:

• Alternative toileting needs
• Dietary needs and restrictions
• Elimination timing and urgency, or when or how often someone needs to urinate or defecate, and how painful their need to do so is
• Limited continence, or how much someone can control their urination or defecation
• Limited stamina
• Risk from triggers
• Sensitivity to foods or chemicals, including alcohol
• Stress intolerance

Dietary and digestive disability descriptions

Dietary needs and restrictions

This category includes people who:

• Have allergies or sensitivities to certain foods, ingredients, or substances
• Have conditions that are triggered by certain foods, ingredients, or substances
• Consume a certain diet as part of addressing a certain disability or condition

People with these needs often benefit from ingredient listings, allergen-free spaces and surfaces, information on cooking or manufacturing processes, and access to a range of food options.

Common conditions associated with dietary needs and restrictions include:

• Acid reflux disease
• Allergies and intolerances
• Celiac disease and Crohn’s disease
• Diabetes
• Gastroenteritis
• Multiple chemical sensitivity
• Pregnancy
• Sarcoidosis
• Ulcerative colitis

Sensitivity to foods or chemicals, including alcohol

People with sensitivity to foods or chemicals, including alcohol:

• Can experience immediate or near-immediate illness or physical reactions when encountering a substance, some of which can be life-threatening
• May become ill upon ingesting a certain food, chemical, or substance
• May experience physical pain or digestive distress after ingesting a certain food, chemical, or substance

People with these sensitivities benefit from allergen- or substance-free spaces and surfaces, ingredient listings, workplace accommodations, and information about cooking, food manufacturing, and other preparation processes.

Allergies and intolerances are disabilities and conditions themselves. Other conditions associated with sensitivity to foods and chemicals include:

• Alcoholism
• Celiac disease
• Crohn’s disease
• Diabetes
• Pregnancy
• Sarcoidosis

Alternative toileting needs

This category includes people who:

• Need to use the toilet in a specific way
• Need to eliminate by means other than a toilet
• Use products and tools to support elimination

Often, people with these needs benefit from various physical accessibility interventions, extensive and regular restroom access, proximity to restrooms, and workplace accommodations.

Common disabilities that have this need include, but are not limited to:

• Colostomy and ostomy
• Irritable bowel syndrome
• Gastric conditions, such as Crohn’s disease

Elimination timing

This category includes people who:

• Need to use the restroom more or less often than is “typical”
• Experience a high level of pain when they need to urinate or defecate

People with these needs benefit from single-user restrooms, extensive and regular restroom access, frequent breaks to use the restroom, and proximity to restrooms.

Disabilities and conditions that affect elimination timing include:

• Aging
• Bladder and other urinary conditions
• Continence disabilities
• Dementia
• Diabetes
• Interstitial cystitis
• Irritable bowel syndrome
• Pregnancy

Limited continence

This category includes people who:

• Have limited ability to control their urination or defecation
• Have limited ability to wait to urinate or defecate

People with limited continence benefit from continence products such as diapers or pads, extensive and regular restroom access, frequent breaks to use the restroom, and proximity to restrooms. They may also benefit from accommodations in the workplace.

Common disabilities and conditions that affect continence include:

• Aging
• Bladder disabilities
• Continence disabilities
• Dementia
• Gastrointestinal disease

Limited stamina

People with dietary and digestive disabilities often experience fatigue and limited ability to conduct physical activities.

People with limited stamina benefit from rest areas and seating in physical spaces, elevators and platform lifts, flexible scheduling, and accommodations at work and school. Hybrid and virtual options for meetings and services benefit people with limited stamina too.

Common disabilities and conditions that affect continence include:

• Aging
• Celiac disease
• Crohn’s disease
• Dementia
• Diabetes
• Gastrointestinal disease
• Interstitial cystitis
• Multiple chemical sensitivity
• Pregnancy

Risk from triggers

People with risk from dietary- and digestive-based triggers:

• May experience an increase, relapse, or activation of symptoms when encountering certain content
• May experience intense psychological discomfort when encountering certain content

While people can and do seek treatment to reduce the impact of triggers, certain actions can help reduce this risk. These include avoiding certain discussions of weight loss and dieting out of context, and following common etiquette.

This risk affects people with eating disorders and other mental health conditions.

Stress intolerance

Stress can trigger pain, discomfort, digestive distress, harmful outcomes, or illnesses for many people with dietary and digestive disabilities. While people can and do seek treatment to reduce the impact of stress, certain actions can help address this access barrier. Common methods to reduce stress include accommodations at work and school, flexible scheduling, and flexible options for using a product or service.

Stress intolerance affects people with the following disabilities:

• Continence disabilities
• Diabetes
• Gastrointestinal diseases
• Hemorrhoids
• Irritable bowel disease
• Sarcoidosis

Stress can also trigger digestive distress in people with many other disabilities, including mental health conditions, dementia, and autism.

Accessibility Impacts

The most important accessibility impacts for people with dietary or digestive disabilities are physical. For example:

• Someone with an allergy may not be able to use an unclean kitchen where the food triggering their allergy was used. They may not be able to be in the same room as their allergen.
• Another person may need certain equipment to eat, drink, or use the restroom.
• Others may need to eat at times or in places where others do not eat.
• Someone may need to use the restroom more often, and access the restroom more quickly, too.
• Many people need to use an accessible restroom, a restroom with a counter space, or a single-user restroom.

In some cases, processes and policies can pose barriers for people with dietary or digestive disabilities. People with these disabilities may need accommodations at work or school. These can help them avoid a harmful substance, eat or drink when needed, or safely use the restroom. At events and in public spaces, the lack of a restroom or way to avoid an allergen may prevent a person from attending or going to that place. People may also need privacy and space to administer medication, change continence products, or to avoid reacting to a substance. In addition, certain practices or cultural norms can pose access barriers to people with these disabilities. Such practices can increase their exposure to physical harms, or trigger their eating disorder.

Digital and communication accessibility play a smaller role for people with dietary or digestive disabilities. Clear and easy-to-read information about accessibility helps people with these disabilities quickly find needed information about dietary options and accommodations. Learn more from Writing Accessible Content. Many people with other disabilities also have dietary or digestive disabilities, too.

Legal standards address some of these impacts. Other impacts are not covered by legal requirements. These impacts still pose barriers to people with dietary or digestive disabilities. You can help people with these disabilities take part in the community by addressing these barriers.

Supporting Methods

Several methods can support people with dietary and digestive disabilities.These methods are often processes in the physical world, but some also relate to how you communicate or produce digital content.

General guidelines

• Many people with dietary and digestive disabilities also have other disabilities. Following physical accessibility standards can help them ensure that they are able to meet their needs. Pay particular attention to kitchens and restrooms - you can learn more from the various resources in Ta11y.
• Many situations will be unavoidable, or be very individual - for example, less common allergens. Be sure to leave room for people to have options for eating, using the restroom, or taking breaks. You should also respect individual preferences and needs.

For avoiding foods or substances

• You may need to set up certain processes to ensure people are not exposed to foods or other substances that harm them. This may include:

  • Providing dedicated allergen-free cookware or dishware
  • Listing the ingredients in each dish served at a function
  • Not serving food with a specific ingredient at an event
  • Asking attendees not to bring or consume certain ingredients at an event, in a workplace, or at a school
  • Rules for when or how dishware is washed, with which supplies, and by whom
  • Avoiding ingredients processed in proximity to certain allergens
  • Ensuring that areas where food is served are properly ventilated.

  You can learn more from the Resources linked in the next section.

• When planning events where food or drinks are served, let people know if there are vegetarian, vegan, gluten-free, and nut-free options in advance. Make it easy for people to ask about the ingredients of a dish. If people serve themselves food, consider providing ingredient lists with each item.

• If you are planning an event or other function where food is served, let people know in advance if alcohol will be served at the event. Be sure to offer non-alcoholic beverages, and clearly indicate that they have no alcohol. You may need to check if any food contains alcohol, which can be the case for certain dishes.

For restroom access

• Ensure that people have regular access to an accessible restroom. You can learn more from Accessible Public Restrooms (Ta11y).
• Be sure that you provide enough restrooms, so that people can reliably have a restroom available. This benefits many people with elimination timing needs and limited continence. In general, one should provide one toilet for every 15-20 occupants or workers.

Processes, communications, and digital tools

• People with dietary and digestive disabilities may need to request accommodations to attend work or school. They may also do so for events. Common accommodations include allergen-free spaces, restroom or eating breaks, separate food at events, and time off for medical appointments. You can learn more from Accommodations (Ta11y) and the resources below.
• People with dietary and digestive disabilities often use websites to check if places or events are accessible. They need clear information to help address their needs. You can help by writing clear content. You should provide information on allergens, accommodations, facilities, and restroom access, as they apply to you. Learn more about writing clear content from Writing Accessible Content. You can learn more about writing inclusive content from Inclusive Language.
• Make it easy to find human help. People with dietary and digestive disabilities often have specific questions. These questions often address situations that are hard to predict. Learn more from Your Role in Accessibility.
• Avoid discussing or encouraging weight loss or dieting out of context, as this can intensify eating disorders or other mental health conditions.

Examples

Helgi has acid reflux disease, and cannot eat acidic or spicy foods. He avoids certain foods, such as limes, and checks for acidity and spice levels when he goes out to eat. He is highly allergic to peanuts and cannot be in enclosed spaces with peanut dust. When he takes an intercity bus or airplane, he asks the operator in advance to ensure that peanuts are not consumed while he is on board.

Audun has an irritable bowel condition. Under stress, he often experiences stomach pain, diarrhea, and intense pain when he needs to use the restroom. He works from home so that he can reduce stress and address these digestive occurrences.

Gudrun has a urinary condition and frequently needs to urinate. She seeks to be near a restroom at all times, because waiting to urinate can cause her extreme pain. She also has an ostomy bag. She needs a counter and a closed garbage bin in a private restroom to change her ostomy bag, which she throws away rather than flushing down a toilet.

Vigdis has a bladder condition and cannot always control her urination. She wears an adult continence product that she changes regularly in restrooms. She also has ulcers that can cause stomach pain. When her ulcers are causing pain, Vigdis has limited stamina and cannot walk far or do strenuous activities.

Bragi has an eating disorder that can be triggered by discussions of dieting or weight loss. He avoids media that discusses these topics. A surprise discussion of weight loss can trigger Bragi’s symptoms.

Related Ta11y Articles and Videos

Note that some of these articles are forthcoming.

• Accessible Cleaning Practices
• Accessible Hybrid Events
• Accessible Indoor In-Person Events
• Accessible Outdoor In-Person Events
• Accessible Home Restrooms
• Accessible Public Restrooms
• Allergies, Sensitivities, and Intolerances
• Common-Use Areas
• Inclusive Emergency Plans
• Restaurants
• Safety
• Writing Accessible Content
• Personas

References

• American College of Gastroenterology Patient Resources
• American Restroom Association
• Canadian Digestive Health Foundation Digestive Conditions Archive
• Cleveland Clinic Resources on Dietary and Digestive Disabilities:
  • Alcohol intolerance
  • Alcohol use disorder
  • Anaphylaxis
  • Colostomy
  • Eating disorders
  • Food allergies
  • Food intolerance
  • Gastrointestinal diseases
  • Tube feeding
• Food Allergy Canada
• Food Allergy Research and Education (FARE)
• Job Accommodation Network (JAN) Resources on Dietary and Digestive Disabilities:
  • Eating disorders
  • Food allergy
  • Gastroesophageal reflex diseases
  • Gastrointestinal disorders
• United Ostomy Associations of America