1. The Mediterranean Network for the management of food induced diseases WORKSHOP MEDI-CEL The Mediterranean Network for Celiac Disease V Progress Meeting - Istanbul, June 30 th July 1 st 2012

2. Montenegro (Crna Gora)

3. Contry: Montenegro Location: Southeast Europe Area total 13,812 km2 Population (2011) 625,266 Density 50/km2 Government: parlamentary republic Capital: Podgorica Montenegro

4. In Montenegro lives 145 126 children under 18 of age The total number of boys is 75 367 of girls 69 759 132 coeliacs

5. Referal center - Podgorica Clinical Center of Montenegro Institute for childen s diseases Ministry of Health Republic health insurance Coeliac society of Montenegro

6. Pimary care: Pediatricians and General doctors ( lack of awareness of CD in children) Referal center - Podgorica Clinical Center of Montenegro Institute for children s diseases Pediatrition – gastroenterologist endoscopist Pathology department Laboratory

7.  Undergraduate and postgraduate education of physicians at University of Montenegro  Training for some young doctors  Training for physicians specializing pediatrics, 3 months  Society of Pediatrics ( lectures, meetings...)  Publication on the field of CD in national health journals and congress proceedings

8. Institute for children s diseases  ESPGHAN guidelines are applied  Diagnosis is in majority of cases confirmed with small bowel biopsy  We colected data and prospective study about CD  Support for national association

9. Diagnostic Anti tTG Anti-gliadin antibody (AGA) Endoscopic and biopsy small bowel mucosal Patochystological examination (Marsh classification modified by Oberhuber) HLA (not widely available the nearest place is Belgrade, Serbia) We sometimes screen family members serologically and never genetically

10. Coeliac society of Montenegro Establiched 2003g Web page Education - lectures, seminars, Training for specific population groups –preschool and school children, teachers in vocational school etc Give brochures, recepies, news, medical advaice etc Adults and children 

11. After the diagnosis: Written instructions on gluten free diet Some recepies Recommendation to join the patients’ society

12. Gluten free diet  The situation of the gluten free diet in Montenegro, in relation to cultural and traditional attitudes  Some companies from Europe are present on our market, as well as some minor local producers  Traditional naturally gluten free foods are: potatoes and corn.  Children who suffer from coeliac disease have 4 to 10 kg of gluten- free flour

13. Problems  Awareness and recognition of celiac disease begins at the primary health care level  We havenot support groups nutritionits, nurses, psychologists...  Gastroenterologists-1  Society of Pediatricians, Society of Gastroenterologists - lectures, meetings,  Coeliac society of Montenegro - articles in newspapers, interviews for radio and TV, educational workshops for family members and interested