Celiac disease is a disease of the small intestine caused by intolerance to protein (gluten). The clinical picture of this disease is most pronounced in childhood, while in adults and adolescents less severe symptoms are observed.
Celiac disease: what is it?
This is a hereditary disease in which, against the background of genetic breakdowns, tolerance of the main component of cereal crops, gluten, is impaired. Outwardly, people with such a pathology look absolutely healthy. As soon as they eat a piece of bread or another flour product, the immune system begins to attack intestinal cells, destroying their structure. Such a pathological process leads to impaired absorption of nutrients from the intestinal lumen resulting from the breakdown of products. As a result, the body loses the existence of energetic material, which directly affects its functioning.
Inflammation of the mucosa lasts as long as a person eats foods that have gluten in their composition. If we take into account the widespread use of wheat flour today, we can understand the danger of the disease. To trigger inflammation, sometimes a few milligrams of this substance is enough, that is, just a couple of breadcrumbs.
Until recently, it was believed that celiac disease is an exclusively hereditary disease, so its symptoms should appear in the first months of a child's life. For this reason, in adults and adolescents, the occurrence of this ailment was extremely unlikely. However, recent studies have fundamentally changed the approach to celiac disease. Symptoms in adults can occur during life under the influence of a number of adverse factors.
Main reasons
The reasons for the development of this disease are still poorly understood. Experts put forward several hypotheses to explain the occurrence of the pathological process.
- Genetic. In 97% of patients, certain markers are detected that indicate a change in genetic material.
- Enzymatic It is assumed that the disease develops against the background of a deficiency of certain enzymes responsible for the breakdown of gluten.
- Viral In the protein there is a fragment with a certain sequence of amino acids identical to the E1B type of adenovirus.
Each of these theories has its own complaints. It is believed that in adults, celiac disease can occur against the background of stress, intestinal infections or surgical procedures.
The clinical manifestation of the disease in children
A typical form of the disease has three characteristic symptoms: frequent stools, a bulging stomach, and stunted growth / weight. Feces have a mushy consistency, smell bad, and glisten due to the presence of fat. An insufficient weight gain usually alarms parents after the introduction of complementary foods, when the child should grow and develop normally.
Doctors also identify other signs of celiac disease. In children, symptoms of pathology are usually associated with a lack of nutrients entering the body and a deficiency of certain vitamins.
- Fast fatiguability.
- Frequent bone fractures.
- Poor condition of the skin and hair (dryness, peeling, atopic dermatitis).
- Hypotension.
- Improper posture.
- Anemia.
- Gum bleeding, stomatitis.
In each case, celiac disease manifests itself differently in children. The symptoms listed above can appear both in a complex and have a single character. In the future, girls have problems with menstruation, and boys are diagnosed with sexual dysfunction.
Symptoms of celiac disease in adults
The clinical picture of the disease in adults characterizes atypical and latent forms. The first option appears in 30-40 years. It represents one of three signs of a typical form and two accompanying. As a rule, extraintestinal symptoms prevail (migraine, atopic dermatitis, arthritis, nephropathy and others).
In clinical studies, 8% of women who have been treated for infertility for a long time have been diagnosed with celiac disease. Symptoms in adult women practically did not appear, that is, they did not know about the existence of such a disease. After the appointment of nutritional restrictions, they all managed to try on the role of the mother.
The latent form may not appear for a long time, only occasionally disturbing the patient with intestinal disorders. The disease is usually diagnosed with a random examination.
Possible complications
Patients diagnosed with celiac disease are at increased risk of developing bowel cancer. According to statistics, this form of a tumor of a malignant nature occurs in 8% of patients after the age of 50 years. Doctors suspect oncology if, against the background of the gluten-free diet, the symptoms of the disease have resumed.
Another likely complication is ulcerative eunoeilitis. This is a disease characterized by inflammation of the ileum wall . It is accompanied by fever and acute soreness in the abdomen. The lack of timely treatment threatens with multiple bleeding, as well as perforation of the intestinal wall.
Infertility, impaired fertility are the result of malabsorption syndrome. Also, celiac disease can lead to protein deficiency, a violation of mineral metabolism. A lack of vitamin D contributes to a gradual decrease in bone density. In 30% of cases, the spleen decreases in patients; in 70% of patients, doctors diagnose arterial hypotension.
Screening for the diagnosis of celiac disease
The presence of the disease can be determined based on the characteristic clinical picture and test results. Today, there are many informative techniques to detect this mysterious ailment.
Typically, patients are prescribed genetic tests, serological tests for celiac disease. A morphological evaluation of biopsies of the upper small intestine taken during endoscopy is also performed.
A diagnostic examination is usually prescribed before dietary restrictions are imposed. Serological tests in children under 5 years of age are not very informative, therefore, a biopsy sample is taken for the study instead of blood.
A year after the start of treatment, a second examination is usually prescribed. It should show a positive trend. After another year, they do a second biopsy. By this time, intestinal villi are almost completely restored.
Drug therapy
All patients are recommended complex therapy for a disease such as celiac disease. What it is? It pursues several goals at once: restoration of normal bowel function, correction of mineral deficiency.
Pathogenetic therapy implies the observance of a special diet, which provides for the exclusion of a factor provoking the disease - gluten. This is not just a food restriction for a while. It must be adhered to for many years to finally overcome the disease of celiac disease. What is this diet, we will discuss later in this article.
In 85% of cases, this measure leads to the disappearance of symptoms and normalization of bowel function. The final recovery after the disease is usually observed 3-6 months after the start of the diet. If necessary, patients are prescribed saline solutions, folic acid and iron preparations, vitamin complexes.
If a change in diet does not bring the desired results, signs of celiac disease persist, patients are prescribed hormonal drugs as an anti-inflammatory treatment (Prednisolone). The lack of dynamics in the treatment against the background of the exclusion of gluten from food indicates that the diet is followed with some violations, or there are concomitant pathologies (Addison's disease, giardiasis, lymphoma).
Gluten-free diet - the basis for the treatment of celiac disease
Patients with this diagnosis should understand that now their health directly depends on discipline and patience. Treatment involves adhering to the so-called gluten-free diet for several years.
Celiac disease is gluten intolerance; therefore, all foods containing this substance should be excluded from the diet. These include cereals, cereals, pasta and pastries.
In addition, you should limit the consumption of hidden sources of gluten (semi-finished products, prepared spices and sauces, frozen vegetable and fruit mixes, canned food, alcoholic beverages). If you do not have the opportunity to eat at home, you must carefully study the composition of dishes in the restaurant or cafe menu.
The diet should preferably consist of fresh fish / meat, vegetables, fruits and rice. In addition, today you can find on sale special gluten-free products that are absolutely safe for people with celiac disease.
Disease prevention
In the materials of this article we talked about why celiac disease occurs, what it is. How can you prevent its occurrence?
Doctors cannot propose specific preventive measures. To prevent the development of dangerous complications, experts recommend a gluten-free diet for several years. In the presence of hereditary diseases in the next of kin, it is necessary to regularly undergo medical genetic testing in order to clarify the possible development of celiac disease in future generations. Women in a position with such a diagnosis are at risk for fetal cardiac pathologies. Pregnancy management in this case should be carried out under the constant supervision of a doctor.