Celiac disease: still too much fake news about a disease that affects more than 265,000 people in Italy

More than 265 thousand people in Italy suffer from it. But it is the classic tip of the iceberg, because there are an estimated 400 thousand undiagnosed cases. Yet coeliac disease - a permanent inflammatory bowel disease that can only be treated with a gluten-free diet - is still a little-known pathology. So much so that a lot of fake news circulates about it, such as the one that attributes slimming effects to a diet without the protein complex present in certain cereals such as wheat, rye, barley, and spelt. "Nothing could be more untrue," says Rossella Valmarana, president of AIC, the Italian coeliac disease association, which on the occasion of the world day dedicated to this disease (16 May) debunks many myths. 'Today it has even become fashionable to adopt a celiac diet: it is mistakenly believed that it increases performance,' Valmarara continues. 'Many also think that this disease is an allergy to wheat. Once again, this is not the case: it cannot cause anaphylactic shock or skin rashes. Instead, it is a completely different disease, with a genetic predisposition but no family history and for which there is no treatment. It mainly affects women and can manifest itself at any age with symptoms not only of a gastrointestinal nature'.

Italy was the first country in the world to adopt a specific law, 130 of 2023. Legislation thanks to which screening for type 1 diabetes and coeliac disease was approved for children between two and ten years of age throughout the country. A pilot study, carried out in Lombardy, Marche, Sardinia and Campania, showed that 2.9 per cent of children were positive for the test indicating the risk of developing the disease. A disease that entails a high cost for procuring the appropriate food. The State grants a bonus, the amount of which is correlated to age group and gender, also in relation to caloric requirements, to help patients pay for gluten-free products. There are more than twenty thousand of these on the market, which are now readily available not only in pharmacies but also in large organised retail outlets. 'But the cost of these products has increased, with a loss of purchasing power for bonuses,' Valmarara explains. 'That is why not only in Italy but also at the European level we are leading a battle to reduce VAT, bringing it down to 4%.

Celiac disease used to be considered a rare disease. Not any more. It is a chronic disease that presents itself with very different symptoms. In the classic form it causes diarrhoea, abdominal pain and weight loss. In the atypical form, the clinical picture is very variable: it can include a sense of fatigue, hair loss, infertility and, in women, repeated miscarriage. It can also manifest as iron deficiency and osteoporosis: it is not uncommon to discover coeliac disease in people who fracture their bones easily. And many patients with this disease tend to later develop autoimmune diseases such as thyroiditis, lupus and type 1 diabetes.

Only 3% of genetically predisposed people actually develop the disease, which requires a gluten-free diet for life, as we have seen. Generally, it is the family doctor or paediatrician (in the case of children) who prescribes the tests necessary to diagnose the disease. Examinations consisting, for adults, of specific blood tests and a biopsy of the small intestine. In children, the diagnostic procedure, according to European protocols, is different: it does not require a gastroscopy, for example. 'In all cases it is essential, when the alarm is triggered, in the presence of suspicious symptoms, not to eliminate gluten from the diet,' Valmarara notes. 'This is so as not to delay the diagnosis.