Celiac disease is a pathological deviation in which gluten intolerance is noted by the human body.
This is a rather rare phenomenon, occurring in just 1% of the population. For celiac disease, stool disorders, gastralgia, nausea, etc. are characteristic symptoms.
The disease is more often diagnosed in childhood, but its development is not excluded in adults.
What it is?
Celiac disease is a disease accompanied by chronic inflammation of the mucous membrane of the small intestine, provoked by gluten intolerance (a protein substance found in wheat, rye and barley). Another name for pathology is gluten enteropathy.
Hypersensitivity to gluten is due to the presence of L-gliadin in its composition. This substance has a toxic effect on the mucous membranes of the intestines, and provokes a violation of the absorption of nutrients in the digestive tract. In 85% of the total rejection of products containing gluten, contributes to the full restoration of digestive function. But this is not a lightning process. It can last from 3 to 6 months, and sometimes more.
It is noteworthy that men suffer from celiac disease more often than women.
Causes of development
The exact causes of celiac disease are extremely problematic. But the main prerequisites for its development are:
- Hereditary predisposition In particular, a failure in the genes responsible for protein digestion. This causes hypersensitivity of intestinal epithelium cells to gluten, which, in turn, provokes inflammatory processes in the intestinal mucosa. Under the influence of such a pathological process, absorbability and digestion of food is impaired.
- Autoimmune origin. In this case, the occurrence of celiac disease is associated with the activity of the phagocytic protective mechanism of immunity. The cells of the immune system attack the cells of the intestinal mucosa. This attack is a specific reaction to irritation of the gastrointestinal epithelium that occurred during the breakdown of gluten proteins. The ingestion of even the minimum number of them can lead to hyperactivity of immune cells.
- Viral etiology. In many patients suffering from celiac disease, during laboratory blood tests, antibodies to certain strains of the virus were observed. In particular, to enterovirus.
Gluten enteropathy can occur as a separate disease, or as a syndrome caused by various developmental abnormalities, infections, or taking antibacterial drugs. Despite the form of the pathological process, its symptoms are the same in both cases, and are fully manifested.
Symptoms of Celiac Disease
For the first time, gluten enteropathy is diagnosed in children. In this case, the child has the following abnormalities and ailments:
- growth retardation compared to the same age;
- muscle hypotonia;
- apathetic states;
- occasional appearance of spastic abdominal pain.
The child has emotional lability, fatigue. But often the disease manifests itself in people in adulthood, and may be accompanied by such symptoms:
- drastic weight loss (from 5 to 30 kg);
- decrease or sweat of appetite;
- general weakness;
- pain in the abdomen;
- frequent glossitis and gingivitis;
- a decrease in calcium levels with the subsequent development of osteoporosis;
- iron deficiency anemia;
The most common symptom of celiac disease is diarrhea. It can repeat up to 10 times a day, and is accompanied by a discharge of liquid, mushy, watery or frothy stools.
Pronounced abdominal pain, which is of a permanent nature, does not occur in celiac disease. If this symptom does appear, then it is cramping in nature, and manifests itself predominantly before or after bowel emptying. With an attack of flatulence, the pain becomes dull, diffuse.
Symptoms of atypical celiac disease
Atypical form of celiac disease is the most common. First of all, it manifests itself:
- ulcerative stomatitis;
- increased bone fragility, accompanied by frequent fractures and dislocations (osteoporosis);
- dermatitis herpetiformis;
- hemorrhagic syndrome;
- the development of autoimmune thyroiditis;
- the occurrence of diabetes;
- epileptic seizures;
- the development of Addison's disease;
In men, there are problems with potency, in women - failures of the menstrual cycle and the development of secondary infertility.
The preliminary diagnosis is made on the basis of the medical history collected by the doctor. To confirm or deny it, an immunological study is required.
To find out the exact causes of indisposition, it is advisable to:
- endoscopic examination of the small intestine;
- Ultrasound of the abdominal organs;
- MRI of small intestinal blood vessels;
- radiographic examination.
Additionally, a biopsy of the intestinal mucosa can be carried out with further study of the biopsy with a microscope.
The risk group, according to Russian scientists, includes people:
- suffering from diarrhea;
- rapidly losing weight (biopsy of duodenal mucosa is prescribed;
- with iron deficiency anemia;
- suffering from long-term osteoporosis, accompanied by the defeat of all bones;
- with allergies and diagnosed autoimmune diseases;
- with diagnosed infertility, not associated with dysfunction of the sexual sphere.
Celiac disease provokes a wide range of disorders in the body, so it is a general medical problem. It is very important to identify the disease in a timely manner, since this is the only way to prevent the development of diabetes and cancer of the gastrointestinal tract.
Thanks to the mass screening, doctors were able to prove that celiac disease is a far from uncommon disease. In people at risk, it occurs several hundred times more often than people who do not belong to these groups. Also, during the research, it was found that patients almost never associated stool disorders with the use of bakery products, so they did not receive proper treatment.
Celiac Disease Treatment
To date, specific therapeutic measures for the complete cure of the disease does not exist. However, there are effective ways to help minimize the symptoms of celiac disease in adults and children. Due to the exact observance of all the recommendations of the doctor can also significantly improve the functioning of the immune system.
Gluten free diet
One of the most common ways to combat celiac disease is lifelong diet, eliminating from the diet foods containing gluten. In this case, the caloric intake of food should be twice as high as in people who do not follow such a specific diet. Meal should be divided into 5 - 6 times a day.
Lifelong adherence to this diet is a very difficult thing. However, there are a number of rules, following which it is possible to greatly facilitate this process. The main recommendations are:
- Cooking food exclusively at home. This will help control the ingredients used and their quantity. If you prefer to eat in cafes or restaurants, then visit only those establishments that you trust. Choose only those dishes that you know the composition of, or warn the chef about your disease, and ask him to tell you what ingredients the dish you ordered contains.
- Buying food marked "gluten free." As a rule, you need to look for it on the shelves with dietary food. Do not eat products based on modified starch, dextrin, hydrolyzed vegetable protein. Various sauces and seasonings are also banned.
- Ordering dietary food through the Internet. However, be careful and carefully study the information about the supplier.
- Cooking separately for themselves and for the family. It is advisable that you have your own dishes. After cooking, thoroughly wipe the surface to remove any flour or particles of prohibited products from it. Ensure that your food is always in a lidded container.
- Careful and cautious attitude to the use of certain medications - Festal, Mezim, Complivit, Allohol, Novo-Passit in the form of syrup, etc. The shell of these drugs contains gluten, so their reception can trigger another attack of the disease. When a doctor prescribes these drugs, warn him about your illness and ask for a replacement.
- Studying the composition of some cosmetics, as they may contain gluten. First of all, it concerns lipstick.
As for alcohol, it is allowed to use only tequila, rum, natural wine or brandy, gin. However, the amount of alcohol should be minimal.
In celiac disease, the patient must abandon:
- wheat and cereals made on its basis (semolina, as well as couscous);
- egg groats;
- any kind of bread;
- instant noodles;
- any desserts;
- many varieties of cheese;
- any kinds of canned food;
- sauces (including mayonnaise and ketchup);
- sweets and chocolates with fillers;
- all types of instant coffee;
- cornflakes and popcorn;
- cocoa and tea;
- packaged store soups;
- bouillon cubes;
- semi-finished products and other products in breading;
- products containing dyes, flavors, preservatives;
- different types of kvass;
- beer made from wheat or barley;
- wheat vodka and whiskey.
Along with this, doctors recommend that patients with celiac disease be included in the diet:
- rice, buckwheat and millet porridge;
- products made from corn or rice cereals, soybeans and potato starch;
- different types of vegetables;
- vegetable fats;
- a bird;
- different varieties of fish;
- lean caviar;
- weak brewed coffee (not soluble!);
- herbal teas;
- decoction of the hips;
- soups in broth made from lean fish or meat.
At the very beginning of treatment, dairy products should be excluded from the menu. But gradually it should be added to the diet, and you need to start with sour-milk drinks or low-fat cottage cheese.
Patients with celiac disease are assigned different multivitamin complexes to prevent vitamin deficiencies. Iron and folic acid (vitamin B9), vitamin D should be obligatory components of such preparations.
In case of diarrhea, fastening preparations are prescribed by the doctor (Lopedium, Loperamide, etc.). In the event of dehydration or the risk of such occurrence, rehydration solutions are prescribed. Intravenous infusions of drugs that eliminate the deficiency of vitamins and microelements can be administered.
The digestion process is normalized by taking enzyme preparations and probiotics. If necessary, the patient may be assigned antihistamines and immunomodulatory agents. The elimination of inflammatory processes is carried out through the use of hormonal drugs (Prednisolone).
When prescribing tablets, medications must be borne in mind that many of them contain starch, which can be gluten. Therefore, all drugs are selected exclusively by a doctor, and applied under his careful supervision.
Patients with concomitant disorders of the endocrine, digestive or cardiovascular systems are further examined by an endocrinologist, a gastroenterologist, or a cardiologist. The patient is taken to the dispensary account, and throughout the entire period of treatment is under the careful control of highly specialized specialists.
With the latent course of celiac disease, serious complications may develop in the form of:
- ulceration of the intestinal mucosa, which can cause bleeding or perforation;
- development of intestinal obstruction;
- the occurrence of hypovitaminosis or avitaminosis;
- the development of a refractory form of celiac disease, in which no therapy will be effective;
In the absence of treatment, celiac disease can lead to the development of oncological diseases of the stomach - lymphoma or cancer of the small intestine, esophagus (less often), stomach, colon, etc. In pregnant women, the risk of spontaneous abortion or premature birth increases. Sometimes patients with celiac disease give birth to children with low body mass or impaired functioning of the nervous system.
To date, it is not possible to completely cure celiac disease, so the only option is to follow a special diet. If you neglect it increases the risk of death.
Compliance with all the recommendations of the doctor gives hope for a full recovery of the body. It can take from 3 months to six months. In this case, the patient must undergo a preventive examination at the gastroenterologist every six months. Patients who exactly follow all the recommendations of their doctor, have all the chances to lead a full life, and avoid the adverse effects of the disease.
A protracted course of celiac disease without proper treatment has less optimistic predictions. In this case, the disease may be complicated by oncology, characterized by a malignant course.