Causes, symptoms and treatment of celiac disease in children and adults
The content of the article:
What is celiac disease?
Celiac disease is a disease accompanied by intolerance of foods containing gluten. Pathological reaction to a substance gives the human gut. The disease is congenital and inherited. However, a complete picture of its development is still not completely understood.
Caught in the intestines, gluten can't be broken down completely as a consequence – the formation of toxins. They have a negative effect on the walls of the organ, damaging them. This process in children is accompanied by copious vomiting, the isolation of foamy stool, bloating. If a child has gluten intolerance, it can be understood immediately after the introduction of complementary foods, as a pathological reaction occur after the food of the intestine.
Adults with celiac disease, lifelong treatment of flatulence, disorders of the chair, not suspecting the true cause of permanent dyspepsia.
As celiac disease can easily be confused with chronic diseases of the digestive system, information about its prevalence is significantly underestimated. So, there is evidence that Russia is suffering from a disease, one person out of thousands. Although the disease is called celiac disease is not quite right. Gluten intolerance is just a way of life. He'll just have to stick to a certain diet, which implies the absence of this component in the products.
There are a few interesting facts about gluten intolerance:
From this disease that people suffer for many centuries, it emerged from the time when man began to sow wheat, rye and other cereals for human consumption;
Most often disease of the population is female, while there are racial differences. For example, in Japan, China and Africa celiac disease almost not diagnosed. Scientists believe that all matter in the dietary habits of the population in these countries, and their genetic status;
Some regions of Russia still did not recognize the celiac disease so such a diagnosis there to meetimpossible;
Some foreign scholars are of the opinion that gluten intolerance significantly affects the risk of developing cancer of the digestive system, so the disease is considered to be precancerous;
The risk that a child of parents who are carriers of this disease is 1:10.
Causes of celiac disease
Scientists put forward theories that explain the development of disease in humans:
Immunological. This theory is based on the fact that people with gluten intolerance, blood has certain antibodies to it. There are many autoimmune antibodies to cell structures of the intestine. Intraepithelial lymphocytes, whose number increased perceived once ingested gluten, as something alien. As a result, they begin to damage the intestines.
Enzymatic. This theory is based on the absence in the small intestine enzyme that can split the incoming gluten. This assumption has a right to exist, however, evidence it is not. After all, if a person follows the diet, the enzymes in the intestines recover fully.
Virus. Studies have revealed that the vast majority of sick people have increased rate of antibodies to one of the types of adenovirus. However, due to adenoviral infection, the disease can not develop, as it is innate. The fact is that gluten and adenovirus have similar antigenic condition.
Photoreceptors. This theory is based on the fact that the internal surface of the intestines of sick people has certain violations. They are associated with the violation of protein composition in the small intestine, with the result that he is unable to digest gluten.
It is worth noting that most scientists believe immune theory is most likely. However, to reject the remaining assumptions is not necessary, it is better to combine them. The result is the following picture: due to the lack of the special enzyme, the body is unable to break down gluten, as it happens accumulation of poisoning with intestinal toxins. He, in turn, gives the reaction, utilizing certain receptors. In this "fight" corruption occurs in the intestine, interrupts its ability to digestion and absorption. As for adenoviruses, they are considered a possible instigator of the immune response to gluten, trapped in the intestine.
The symptoms of celiac disease
Educational literature describes only three possible manifestations of the disease. However, symptoms is much more simple, they are perceived as different pathology of the digestive system. In the result of a correct diagnosis exhibited very rarely, and people being treated for other diseases. And therapy is absolutely effective.
However, we should not forget about existing cases of a negative result of the biopsy of the intestine to detect celiac disease. The entire clinical picture and blood tests indicate the presence of disease.
In 1991, the pathology was visualized in the form of the iceberg. On top of it are people who have a genetic predisposition to develop the disease. Also at the top of the iceberg are proven options that have been set on clinical grounds with very little. Under water is a huge proportion of people who suffer from the disease, but they have not diagnosed. The Foundation of the iceberg are the people with a genetic predisposition to the disease. It manifests itself from birth, and as a result the impact of negative factors, for example, after suffering stress or due to decrease in immune power.
In addition, the negative impact of early introduction in the diet of foods rich in gluten. For example, semolina, which I simply adore all the grandmothers could trigger the early development of the disease. Besides worsened and the severity of pathology.
Symptoms of celiac disease in children
Bright's disease will manifest three characteristics:
- Increased frequency of defecation. The chair can be five times a day or more, it is plentiful, has a mushy consistency. On the surface of the excrement is observed, the gloss resulting from fat. Sharp and unpleasant smell, color varies, may be present foam. To wash away the feces problematic.
- The baby's stomach bulges forward, which sometimes makes the doctor suspect rickets.
In the first two years will be noticeable lag in weight. After a two-year age gap more pronounced in child growth. At the same time, should pay attention to the fact that inadequate weight gain will start to show after baby introduce solid foods. Before his weight was normal.
If these symptoms are pronounced and additional signs.
They begin to appear due to the lack of the child's body with many nutrients:
- The child may be passive or aggressive. He gets tired quicker, are often irritated.
- Skin flakes, hairin a poor state. Is often observed in atopic dermatitis.
The child having not typical for the child's age frequent fractures. Normally, they are rare because the bones of the baby elastic.
- Incorrect posture.
- Of the child a painful, miserable.
- Muscle tone is reduced.
- Frequently observed pathology of the oral cavity. The baby recurrent stomatitis, gums bleed, develops caries, the enamel is in bad condition, it may crumble.
- There are signs of anemia.
- A toddler can resemble a spider, his thin limbs and protruding forward tummy.
As children get older there is a disorder of the reproductive system. The girls are not on time menstruation occurs, and the boys formed a sexual dysfunction.
The symptoms of celiac disease in adults
The disease can be latent and atypical. The latter form develops after the achievements of the patients 30 or even 40 years.
Overall, manifestations of the disease are the following:
- Neurological disorder, manifested in depressive disorders and migraines.
- Skin diseases such as dermatitis.
- Stomatitis, glossitis, thinning of the enamel.
Biochemical blood analysis shows the decrease in cholesterol, increase in transaminase, phosphatase, and albumin.
- Arthritis. In addition, joints can ache for an undetermined reason.
Found that up to 8% of women with infertility have celiac disease. After they started to follow a special diet, they were able to get pregnant and have a baby.
If a person is suffering from a latent form of the disease, it is to show themselves not to be. Rarely there may be minor indigestion and dermatitis. Detect pathology is possible only by chance.
Complications of gluten intolerance
The latent form of the disease is dangerous, if you do not know about it for a long time:
- Cancers of the gastrointestinal tract.
- Autoimmune form of hepatitis or thyroiditis
- Scleroderma, myasthenia gravis, etc.
Diagnosis of celiac disease
To confirm the diagnosis, the patient will need to go through three stages of research:
- A blood test. You need to determine the number -, antigliadin-antibodies, to detect the presence or absence of antibodies to endomysium, reticulin and tissue transglutaminase.
- If the result is positive, a biopsy of the small intestine. The study will provide information about the state of the villi of the mucous membrane, whether inflammatory response and whether cells with altered receptors. It was the biopsy is the most important phase of the study.
- The patient is assigned a gluten-free diet for a period of 6 months. If his health improves, the diagnosis is confirmed finally.
Diet will be assigned, even if you have received a negative biopsy, but a positive immune tests. When a gluten-free meal plan gives visible results, the doctors indicate potential celiac disease.
After 12 months, the patient again gives blood for immunological study. After another 12 months it is necessary to perform a biopsy, the condition of the gut has to be excellent.
Differential diagnosis of
Before sending a man to the biopsy procedure (performed under General anesthesia), you must determine whether disorders result from allergies, immunodeficiency, infections, etc.
It is important to know that in celiac disease in Calais will not be of mucus and blood, and a gluten-free diet will give a positive result.
Treatment of celiac disease
If a person is really suffering from a disease, he will have a lifetime to adhere to a gluten-free diet. To do this from the menu it will be necessary to exclude pasta and bread, barley, semolina and oatmeal, cheap sausages, burgers, pastries and sauces. In addition, it is important to give up beer, cocoa, coffee, cheese, yoghurt, curds, preserves, ketchup and mayonnaise.
If 100 g the product has 1 mg of gluten – the figure will be critical for the patient.
Allowed to eat:
- Fish and meat;
- Eggs and natural milk and products on its basis;
- Fruits and vegetables;
- Buckwheat, millet and corn.
- Marmalade and chocolate.
Children under the age of 12 months, you will need to feed mixtures based on soy or casein hydrolysate. When there is a need for introduction of complementary foods, you can use gluten-free cereals.
When the diagnosis is installed, you might need therapy on symptoms:
- To restore microflora: Enterofuril (as an antiseptic), Linex, Bifiform, Actimel (as probiotics), Hylak Forte (as a prebiotic).
- To normalize the process of digestion – Pancreatin or CREON.
- To eliminate bloating – Plantex or Espumizan.
- To resolve diarrhea – Imodium or Smectite.
- For the normalization of water-electrolyte balance, Calcium Gluconate and Panangin.
- For a set of muscle mass required full correction power with an increase in the caloric content of food.
- If there are signs of beriberi, the patient will need to drink multivitamin complex. In severe cases, intravenous nicotinic acid and vitamins K, A, D, E, V.
- Corticosteroids are prescribed for the treatment of autoimmune diseases.
- If detected protein deficiency, require receiving albumin and amino acids.
You also need the elimination of co-morbidities, if any.
Patients should not take some drugs. This applies to those funds, the composition of the capsule or shell which includes gluten. For example, the Festal, Complivit, Mezim Forte and others. You also cannot take products that contain malt, for example, Novo-Passit.
Celiac disease is not a sentence
If the diagnosis is true, we often give patients a disability. However, when a person adheres to the diet, the quality of his life is almost not affected, and the prognosis is reasonably favorable. After 14 days disappear problems with the gastrointestinal tract, and after 60 days of normal fluid and electrolyte, mineral, vitamin and protein balance in the body.
Children after 12 months of fully catch up in the physical development of their peers. However, if the diet is broken, it will lead to the return of all negative effects and increases the risk of developing cancer.