Coeliac disease in Malta

Abstract

"Coeliac Disease (CD) is a condition in which the lining of the small intestine is damaged by exposure to wheat, barley, rye and possibly, oats. This damage is caused by gluten, the protein which gives dough its elastic consistency". (Purvis, 1988). CD can present at any age. Proper diagnosis of CD is very important, since there is a wide variety of symptoms, which can be similar to those of other malabsorption states. A definite diagnosis can only be made by the presence of a flat jejunal mucosa on a small intestinal biopsy and the unequivocal clinical response to a GFD. The condition is permanent and is treated by a strict Glutenfree Diet (GFD), which is lifelong. Compliance to the GFD is of utmost importance in order to prevent complications such as infertility, bone disorders and malignancy. The pathogenesis of CD is not fully understood, but the main implicated factors are Gluten, Host factors and possibly, Adenovirus (Dawson, 1987). The incidence of CD in Malta is about 1:4000. Information on this disease in Malta is very limited, and patient education is limited to one visit to a dietitian after diagnosis. Studies were carried out to establish the clinical aspects of the disease, assess patient compliance and establish patient's needs and knowledge. A booklet was set up, printed and distributed to help CD patients understand their condition, and plans for setting up a CD clinic were made.