Gastroenterological disease due to intolerance to the consumption of foods from the seeds of certain cereal plants( barley, rye, wheat) and having a genetic predisposition is referred to in medicine as celiac disease.
What is the disease?
The tenth revision of the international classification of diseases celiac disease is cited as K90.0 and is correctly referred to as "gluten-sensitive enteropathy".
Celiac disease is not found among black people. The disease has similar symptoms with other gastroenterological disorders and is rarely diagnosed on its own, not only because of the absence of the disease.
The risk of getting a pathology from a parent suffering from this form of allergic reaction to gluten substances is approximately 10%.
Photo of a child with celiac disease
Since cereal crops have been cultivated by humans for tens of millennia, a mutant gene that determines an allergy to gluten has appeared in the Caucasian race of mankind around this time.
Causes of
Despite the hereditary nature of the disease, the exact causes of the disease at the present stage of the development of medicine remain unsolved. There are several points of view, which have the nature of scientific hypotheses, not yet built in theory.
According to the immunological hypothesis, the increased concentration of antibodies is considered to be the cause of mucosal damage.
First, the number of lymphocytes determining the receptor perception of chemicals in the intestine increases. Among the mistakenly recognized substances for the immune response is the gluten of cereals. The result of gluten rejection is damage to the cells of the intestinal mucosa.
Supporters of the enzyme hypothesis suggest a lack of intestinal juice enzyme responsible for the cleavage of gluten. An insufficient enzymatic reaction is associated with a malnutrition. When the food is normalized, specific enzymatic activity with respect to gluten is restored.
Inaccuracies are seen in the viral hypothesis, however, the similarity of some of the adenovirus varieties with antibodies to gluten can not be denied. During the course of celiac disease, antibodies to adenovirus were observed in nine patients out of ten.
A similar to the immunological patoreceptor hypothesis is based on the concept of a disturbed balance of the protein activity of intestinal cells. For this reason, there is a violation of receptor activity to gluten.
The most recognized is the rationale for the violation of gluten digestion, integrating all the hypotheses described.
So, gluten, getting into the cavity of the small intestine, is not subjected to enzymatic cleavage due to a lack of the corresponding enzyme.
The next stage of the chain of disorders is the pathology of receptor perception( normally receptors perceive intermediate products of gluten splitting).Excess gluten, not subjected to disintegration and absorption, forms an autoimmune response, which causes damage and death of cells of the intestinal mucosa.
Adenovirus provocation in the formation of an immune response is possible. When considering the immune response of intestinal cells, an alcohol-soluble fraction of gluten is a gliadin protein.
Video about autoimmune disease-celiac disease:
Classification of
There are 3 varieties of celiac disease:
- A typical species that is characteristic of childhood. The clinical picture of this variety is bright: with a delay in growth and weight loss of infants, there is constant diarrhea with abundant release of fecal masses of fat-like morphology.
- The latent variety of celiac disease is manifested in patients no earlier than 30 years: in women after 30 years, in men after 40 years. It can be noted for the first time in patients of older age. The clinical picture is not bright, the disease proceeds with intermediate clinical signs.
- With erased celiac disease, the symptoms of the disease are not of an intestinal nature( anemia by type of iron deficiency, multiple joint pain, destruction of bone plates, bleeding of mucous membranes of different organs).
Symptoms of celiac disease in adults, children and newborns.
Celiac disease has multiple manifestations. Often under suspected dermatological, allergic or gastroenterological disease, celiac disease is concealed.
In medical practice, celiac disease is rarely diagnosed due to the variety of clinical signs that allow a superficial diagnosis of another disease. In contradiction of celiac disease, there are cases of establishing a diagnosis and not confirming it after diagnosis in the form of a biopsy of the small intestine.
In childhood, celiac disease is manifested:
- frequent defecations, which have a fetid odor, a mushy consistency, traces of fat with gloss, foamy mass with a large volume. In the toilet, stools are washed off badly, washed off with the remainder;
- bulging belly, explained by doctors as a symptom of rickets, and parents as a consequence of a good appetite;
- lack of weight and height, felt before the age of two and especially noticeable after the age of two. Observant parents notice the beginning of losing weight with the beginning of artificial complementary foods.
Other signs of celiac disease appear individually in individual children and may not be included in the general clinical complex. They are associated with a shortage of minerals arising from the loss of them through the digestive tract.
Specific additions to the clinical picture can be:
- painful appearance;
- violation of posture;
- anemia;
- changes in behavior towards tearfulness and aggression, or towards malaise and rapid fatigue;
- bulging belly and thin limbs;
- mucosal disorders of the oral cavity and integuments of gums and teeth;
- mild muscle reactions;
- a dull appearance of skin and dermatological abnormalities( lack of moisture, peeling, inflammation symptoms);
- propensity to sprains, fractures and other disorders of the musculoskeletal system due to leaching of minerals.
A growing child with signs of celiac disease has a later period of onset of puberty.
Newborns risk getting celiac disease in the absence of( lack of) maternal milk and introducing artificial mixtures with the gluten component into the diet.
Under the influence of permanently obtained gluten the child with predisposition to celiac disease begins to lag behind in growth, has foaming stinking feces, is noticed in puffiness, constant irritability. When growing up, parents notice later teething.
In adults, celiac disease can only appear atypical or latent, masquerading as pathological processes in other functional systems:
- renal nephropathy;
- a bisexual incapacity to conceive;
- dermatitis of herpes simplex or atopic type;
- headaches, irritability or depression;
- inflammation of articular surfaces and joint pain of unclear etiology;
- biochemical abnormalities in blood analysis.
Statistical studies have shown that the surveyed women incapable of giving birth to a child in some cases showed celiac disease. With the exclusion of gliadin proteins in food, all women were able to become pregnant.
How to diagnose gluten enteropathy in children and adults?
To detect celiac disease, more than one diagnostic examination will be required, and a set of techniques, including:
- In addition to antibodies to gliadin proteins, immunological analysis of blood reveals a high concentration of antibodies to endomysia and reticulin, the presence of transaminoglutase, the location of which should be in tissues.
- Biopsy of the intestinal mucosa is carried out only if deviations in the immunological analysis of the blood are detected. During the examination, the inflammatory process is detected, the condition of the microvilli mucous. On the basis of a biopsy, it is possible to assume the presence of celiac disease, but the final diagnosis is confirmed 6 months after the start of the diet.
- A diet with a lack of gliadin proteins in food gives reason to approve or disprove the gluten non-digestibility. With the disappearance of symptoms after a diet, there is a basis for confirmation of the diagnosis with a potential state of celiac disease.
How to treat a pathology?
Gluten-free diet for celiac disease
Elimination of gluten in food implies the rejection of "meat" semi-finished products( sausages, sausages, etc.) with low cost, pasta and flour products( bread, muffins), oatmeal, pearl barley and manki.
The patient will have to give up ice cream, canned food, yogurts, beer, kvass. Eliminating the symptoms of celiac disease with a gluten-free diet is the most effective way to treat it.
Vitamins
Oral administration of complex vitamin preparations is indicated for celiac disease. Intravenously inject PP, K, A, E, D.
Folk remedies
Salvia and wormwood in the form of infusion are used as a four-fold infusion. In the initial stage of the disease have the effect of anti-inflammatory drugs - chamomile or calendula infusion.
Video on new methods of diagnosis and treatment of celiac disease:
Complications of
Long-term absence of treatment leads to the risk of thyroiditis, hepatitis, oncological diseases of the digestive system. Rheumatoid arthritis, myasthenia gravis, pericarditis after rheumatism, scleroderma, non-insulin diabetes mellitus are not ruled out.
Army
Nutrition of military people does not exclude gluten and a diet with no bread, pasta, etc. in the army is impossible. For this reason, a draftee who has problems with the digestion of cereals must obtain a diagnostic examination in order to identify celiac disease and receive exemption from conscription.
Disability
In celiac disease, the patient is diagnosed with a medical and social examination, where it is not excluded that a third disability group is obtained, followed by a reassessment.
Forecast
In the absence of complications and timely treatment, the prognosis for a patient of any age remains favorable.