Celiac Disease - Causes, Symptoms, Diagnosis and Treatment
Celiac - Genetically caused violation of intestinal function associated with a deficiency of enzymes that break down gluten peptide. If celiac disease is developing malabsorption syndrome of varying severity, accompanied by frothy diarrhea, bloating, weight loss, dry skin, delayed physical development of children. To detect celiac disease applied immunological methods (determination of antibodies to gliadin, endomysial, tissue transglutaminase), a biopsy of the small intestine. Upon confirmation of the diagnosis requires a lifelong gluten-free diet compliance, the necessary correction of deficiencies.
Celiac
enteropathy) - a disease characterized by chronic inflammation of the mucous membrane of the small intestine, accompanied by malabsorption and resulting from intolerance to gluten (a protein that is found in cereals: wheat, rye and barley). The structure of gluten proteins include L-gliadin - the substance has a toxic effect on the mucous membrane and leading to disruption of nutrient absorption in the intestine. In most cases (85%) complete exclusion of the gluten from the diet, the small intestine causes a restoring functionality in 3-6 months.
When celiac disease and characteristic atrophic changes of the villi of the mucous membrane of the small intestine. The disease is more prevalent in women, they are suffering from celiac disease twice as often as men.
type I diabetes mellitus, connective tissue disease, juvenile rheumatoid arthritis, autoimmune thyroiditis, dermatitis herpetiformis, Sjogren's syndrome).
Some congenital or acquired features of the small intestine contribute to the occurrence of hypersensitivity intestinal epithelial cells to gliadin. These states include enzyme deficiency, which resulted in poorly digested peptides (and does not fully splitting gliadin). Gliadin accumulation in the intestine contributes to the manifestation of its toxic effect.
Autoimmune disorders, in cases when the target of its own antibodies are intestinal epithelial cells contribute to the reduction of the protective properties and increased sensitivity to gliadin. In addition, the factors contributing to the emergence of intolerance to gliadin, are genetically determined specific characteristics of the cell membrane of the intestinal epithelial receptors, as well as the result of changes in the receptor apparatus of some viruses.
diarrhea, steatorrhea, weight loss, polyhypovitaminosis and other manifestations of malabsorption syndrome.
Celiac disease in children usually begins to manifest itself in 9-18 months. There are frequent and loose stools with lots of fat and there is a decrease in body weight, growth retardation. In adults, the deployment of clinical symptoms of celiac disease can be life provoked by pregnancy, migrated surgical interventions, infections. Those suffering from celiac disease, often noted tendency to sleepiness, decreased performance, often rumbling in the abdomen, bloating, stool instability (diarrhea alternating with constipation). Elderly patients may experience pain and aches in the bones and muscles.
Chair, as a rule, frequent (more than 5 times a day), liquid, foam with the remnants of undigested food. When prolonged diarrhea is likely signs of dehydration: dry skin and mucous membranes.
Progression of malabsorption syndrome leads to severe disorders of internal homeostasis.
In clinical gastroenterology are three forms of flow of celiac disease: a typical (developed on the first and second year of life, has the characteristic clinical manifestations), worn out (extra-intestinal symptoms appears: iron deficiency, anemia, bleeding, osteoporosis) and latent (without the expressed complaints). The latent form is often found in the elderly. In women developing clinical symptoms begins in 30-40 years in males 40-50.
eyunoileit (inflammation with a tendency to ulceration of the wall of the jejunum and ileum). It is characterized by the development of acute abdominal pain, fever. The development of this condition threatens internal bleeding, perforation wall of the small intestine, peritonitis.
When suction severe iron deficiency develops iron deficiency anemia. Sometimes it is the only manifestation of the disease (when worn and latent).
Impaired fertility, infertility can be the result of a long-term malabsorption syndrome. Also prolonged malabsorption leads to poligipovitaminzam, protein deficiency, disorders of mineral metabolism.
Lack of vitamin D in conjunction with a reduced calcium intake of bone density helps reduce their brittleness. In 30-35% of patients with celiac disease shrinks the spleen, 70% of patients had hypotension.
antibodies to gliadin and anti-tissue transglutaminase. The sensitivity of the method is 100%, its specificity for this disease is about 95-97%.
In addition, it is possible to make a biopsy of the small intestine mucosa and identify existing atrophy (smoothing) of the villi and the presence of clusters of lymphocytes in the mucosa.
Additional techniques to refine the patient's condition is endoscopy of the small intestine, the Schilling test and test with D-xylose, ultrasound of the abdomen, CT scan, MRI angiography of mesenteric vessels, bowel contrast X-ray.
Addison's disease, lymphoma of the small intestine, ulcerative eyunit, giardiasis, lack of minerals in the diet: iron, calcium, magnesium).
In such cases, additional diagnostic measures are carried out to identify those states. With the exclusion of all the possible reasons for the lack of improvements prescribe hormone therapy. Three months later, the course of prednisolone conduct a biopsy of the small intestine.
Pregnancy in these women should be carried out with increased attention.
gastroenterologist and be screened annually. For patients who react poorly to the exclusion of gluten from the diet, clinical observation shows twice a year. Prediction markedly degraded if the disease is complicated by the occurrence of lymphoma of the small intestine.