Sushi and Japanese restaurants with IBS, celiac disease or food allergies

Often, yes, especially if you keep things simple. Monash University suggests grilled tofu, seafood, beef or chicken with steamed rice and seaweed, plain raw tuna or salmon with condiments on the side, or rice noodles as Japanese options for people following a low-FODMAP approach. For celiac disease, the questions are about soy sauce, how the sushi rice is seasoned, and cross-contact at the sushi counter. For food allergies, fish, shellfish, sesame and soy are all common.

Japanese menus range from very simple (a piece of grilled fish, a bowl of rice) to complex (rolls with several sauces and fried toppings). The simpler the dish, the easier it is to know what's in it.

These are starting points, not guarantees. Every kitchen is different, so you still need to ask about your own triggers or allergens.

Monash's broader advice for Asian-style dining is to avoid heavy sauces and heavily flavored, rich and spicy dishes, since garlic and onion are common in Asian cooking, and to choose plain meat, fish and rice-noodle dishes with fresh salad and vegetables.

In Japanese food, much of the flavor comes from what's added at the end: dipping sauces, glazes, dressings and mayonnaise-based toppings. Asking for these on the side lets you decide how much to use.

• Glazes and marinades. Ask what's in teriyaki-style glazes and marinades, including garlic and onion.
• Dressings. Salad dressings and sauces on rolls can contain garlic or onion; ask, or have them on the side.
• Broths. Ask what a noodle broth is made from if garlic and onion are triggers for you.
• Condiments. Monash's suggestion is to have condiments on the side, so you stay in control of the amount.

FODMAPs add up across a meal, so a few small extras can matter. See FODMAP portion sizes and hidden garlic and onion for more.

Sushi looks naturally gluten-free, but there are several places gluten can come in. Beyond Celiac advises calling ahead or asking your server how the sushi is prepared.

• Soy sauce. The Celiac Disease Foundation lists soy sauce and teriyaki sauce among the things to ask about. Ask whether the restaurant has a labeled gluten-free soy sauce, or bring your own. Our guide is soy sauce gluten-free? explains the labels.
• Sushi rice. Beyond Celiac notes that some sushi rice is seasoned with a non-distilled vinegar that may be made from wheat, and that sushi rice is sometimes prepared with a broth that contains gluten. Ask how the rice is seasoned.
• Imitation crab. The Celiac Disease Foundation suggests asking whether imitation crabmeat or seafood is used, since it isn't the same as plain fish.
• Sauces, toppings and fried pieces. Beyond Celiac points out that many multi-ingredient rolls use special sauces, toppings or fried breading that contain gluten. Ask about tempura batter and crunchy toppings.
• Cross-contact at the counter. If the sushi maker doesn't change cutting boards, knives and gloves between rolls, Beyond Celiac says cross-contamination is likely. Ask for freshly washed surfaces and utensils.

If the sushi maker can't accommodate your request, Beyond Celiac suggests ordering something else from the menu. Our guides to eating out with celiac disease and gluten-free vs celiac-safe cover the wider picture. If you think you might have celiac disease but haven't been tested, talk to your doctor about testing before going gluten-free.

Fish, shellfish, sesame and soy are the allergens most worth asking about at a Japanese restaurant.

• Fish. FARE lists imitation fish and shellfish, such as surimi (sometimes sold as "sea legs" or "sea sticks"), among unexpected sources of fish.
• Shellfish. FARE advises people with shellfish allergy to steer clear of seafood restaurants, where cross-contact risk is high, and notes that shellfish protein can be in the steam where shellfish is cooked. The AAAAI adds that in seafood restaurants, fish and shellfish may be stored or prepared together, and fried foods may share oil with seafood.
• Sesame. FARE lists sushi among foods that may contain sesame, along with dressings, marinades and sauces, Japanese snack mix and the Japanese dessert goma-dofu. Sesame seeds are also used as a garnish on many rolls.
• Soy. FARE lists soy sauce, shoyu, tamari, miso and edamame among soy ingredients to avoid with a soy allergy.
• Egg and wheat. Ask about egg in rolls and toppings, and wheat in tempura batter, sauces and soy sauce.

If you have a fish or shellfish allergy, a sushi restaurant is a high cross-contact setting, and it's worth talking with your allergist about whether to eat there at all. Wherever you eat, read any packaged food labels every time and take "may contain" statements seriously. If you have a severe reaction, use your prescribed epinephrine and call emergency services. Our major allergens guide has more.

1. Check the menu online and pick a few simple dishes: grilled protein with rice, sashimi, or single-filling rolls.
2. Call ahead outside busy hours if you have celiac disease or an allergy, and ask about soy sauce, the rice and how the counter is managed between orders.
3. Say your most important need first. "I have celiac disease" or "I have a sesame allergy" signals a safety need. For IBS, name the ingredients you avoid.
4. Ask for sauces and condiments on the side.
5. Keep rolls simple. Fewer toppings and sauces means fewer things to check.
6. Watch for garnishes like sesame seeds or crunchy toppings when the dish arrives, and ask if anything looks different from what you ordered.

If you eat out often, our guide to eating out with IBS covers planning, portions and takeout.

• "Do you have a gluten-free soy sauce, or could I use my own?"
• "How is the sushi rice seasoned? Is the vinegar wheat-free, and is any broth used?"
• "I have celiac disease. Could the chef use a freshly washed board and knife and change gloves for my order?"
• "Is the crab real crab or imitation crab?"
• "Is there sesame in this roll, the sauce or the garnish?"
• "Is there garlic or onion in the dressing or glaze?"
• "Could I have the sauce on the side?"
• "Is the tempura batter made with wheat flour, and is it fried in shared oil?"

For more on wording, see talking to restaurant staff about allergies.