A diet that controls the amount of everyday intake of pasta, pizza, bread and cake and is richer in lean proteins would be advisable for everybody.

Coeliac disease is a chronic condition with an impact on several aspects of the person’s quality of life, Carolina Ciacci, professor of gastroenterology from the University of Salerno, Italy told The Sunday Times of Malta.

“The psychological imbalance may affect a person with coeliac disease with variable degrees of depression, anxiety, sleep disorders, eating disorders and fatigue,” she explained.

On May 12 and 13, Prof. Ciacci, who is also chairwoman of the Federation of Italian Scientific Societies for Gastrointestinal Diseases, will be the keynote speaker at Malta’s third National Coeliac Conference.

The event, which is being organised by PR consultancy Narrative Structures in collaboration with the President’s Foundation for the Wellbeing of Society, the Italian Embassy and the Italian Cultural Institute, will focus on the quality of life for people living with coeliac.

There will be two talks: on Friday evening, Prof. Ciacci will be addressing medical professionals at the Italian Cultural Institute in Valletta and on Saturday at The Palace in Valletta, she will be speaking to coeliac sufferers and all those interested in increasing their knowledge on coeliac disease and gluten sensitivity.

Prof. Ciacci will discuss the psychological aspects of coeliac disease – “upon diagnosis and during follow-up in children, followed by the transition from paediatric to adult care”.

The factors causing psychological morbidities such as depression, anxiety, sleep disorders, eating disorders and fatigue are directly connected to coeliac disease, Prof. Ciacci explained. “This is due to malabsorption, autoimmunity and physical well-being and/or related to the social restriction secondary to the gluten-free diet.”

Prof. Ciacci said it was still unclear how the gluten-free diet and a good compliance to it influenced these aspects, “in particular in asymptomatic/screening-detected patients who seem to have less psychological comorbidities compared to symptomatic patients”.

However, what is important, she said, was that clinicians recognised and supported their patients with coeliac disease at diagnosis and during follow-up care.

Referring to the cluster of autoimmune conditions – coeliac disease being one of them – Prof. Ciacci said the most common autoimmune disease in coeliac was thyroiditis, this occurring in young adults and mainly in women. It is also called Hashimoto’s thyroiditis.

“In general, it is women who are mostly at risk of developing autoimmune disease, including coeliac.” Referring to testing for coeliac, Prof. Ciacci said first-degree relatives (young people) of a person with coeliac disease should undergo genetic testing.

“If positive, and if the serology is negative and the clinical picture reassuring, serology should be repeated every two to three years because there is a predisposition.”

However, having the predisposition does not mean having coeliac disease: “Around 30 per cent of the general population of western countries share those genes but only one per cent is affected by coeliac disease. On the other hand, if the genetic test is negative, coeliac disease is excluded also in the future.”

The western world eats too much, and too many carbohydrates. The excessive amount of undigested fibres and sugars may cause bloating and abdominal discomfort

Asked about gluten sensitivity, which generally gives coeliac-like symptoms, Prof. Ciacci said people complaining about coeliac disease-like symptoms in whom coeliac disease was excluded by both a blood test and intestinal biopsy may suffer from the so called ‘gluten sensitivity’.

Should we all be on a gluten-free diet? “No”, said Prof. Ciacci, “because there is no scientific evidence to show that the gluten-free diet is the best option for all”.

However, “it is true, that the western world eats too much, and too many carbohydrates (sugars, mainly from cereals). The excessive amount of undigested fibres and sugars may cause bloating and abdominal discomfort”.

In this respect, a diet that controls (not avoids) the amount of everyday intake of pasta, pizza, bread and cake and is richer in lean proteins (from fish, vegetables) would be advisable for everybody.

Special thanks also go to the Malta Coeliac Association, the Malta College of Family Doctors and the Maltese Paediatric Association. This event would not be possible without the support of Barilla and Golden Harvest and Times of Malta as exclusive media partner, as well as Dr Schar, Peak’s Free From and Schnitzer.

For more information or to reserve a seat at Prof. Ciacci’s talks, e-mail information@narrativestructures.com or look up Narrative Structures on Facebook.

A commitment to coeliac awareness

Carolina Ciacci

Narrative Structures launched its first National Coeliac Conference in 2015 to raise awareness on the disease. Stefano Guandalini, world expert, founder and medical director at the University of Chicago Celiac Disease Centre and paediatric gastroenterologist, was keynote speaker that year, followed by Professor of Gastroenterology at the UV University Medical Centre in Amsterdam, Chris Mulder, in 2016.

To ensure an even better quality of life, last year Narrative Structures partnered with Coeliac UK, the world’s largest coeliac NGO, as part of an ongoing coeliac awareness campaign and commitment to making education and training in gluten-free catering available in restaurants, schools and hospitals.

Narrative Structures continues to raise awareness on various health issues. For more information, e-mail information@narrativestructures.com or look up Gluten Free Training on Facebook.