Celiac sprue : causes, symptoms , diagnosis, treatment
Gastroenterology / / May 12, 2016
Celiac sprue - a hereditary disease of unknown etiology, in violation of the digestive (intestinal absorption) caused by damage to the small intestine Some foods (wheat, barley, rye and possibly oats) containing proteins gluten cereal gluten and those close to him cereal proteins- avenin, hordein, etc. and abnormal intestinal inability to digest the gluten and, in particular, one of the main components of the gluten -. gliadin.It has mixed autoimmune, allergic, hereditary genesis, inherited in an autosomal dominant manner.
Alternative names: sprue;nontropical sprue;intestinal infantilism;celiac disease;gluten intolerance;gluten enteropathy;Gee's disease;glyutenochuvstvitelnaya enteropathy.
Celiac sprue is widespread among the indigenous population of the Far and Middle East, India, the natives of South Africa, Zimbabwe and the Caribbean.It may also affect the Europeans who migrated to these countries, and its signs can persist for many years.The only manifestation of chronic disease is a violation o
Treatment - nutritional deficiency correction and the introduction of broad-spectrum antibiotic tetracycline type.After each treatment should be repeated test the absorption of vitamin B12.In extreme cases, the sprue prescribe steroid hormones and steroids.In chronic cases, the sprue is not recommended to stay in countries with hot climates.In the development of the disease play a significant role immune disorders.
Causes and risk factors for celiac sprue
The exact cause of celiac sprue is unknown.Sheath intestinal villi is to help absorb nutrients.When people with celiac disease eat foods containing gluten, their immune system reacts to damage of the villi.These damages affect the ability to absorb nutrients properly.Man completely saturated - no matter how much food he eats.
The disease can develop at any point in life, from infancy to late adulthood.
People who have a family member with celiac disease have a higher risk of developing the disease.The disorder is most common in Caucasians and people of European descent.Women are affected more often than men.
People with celiac disease are likely to have the following diseases:
- autoimmune diseases - such as rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome;
- Addison's disease (chronic adrenal insufficiency, or gipokortitsizm);
- Down's syndrome;
- bowel cancer (or colorectal cancer;
- intestinal lymphoma (a rare malignant tumor of the small or large intestine);
- lactose intolerance (or hypolactasia)
- thyroid disease;
- type 1 diabetes (insulin-dependent diabetes, juvenile diabetes);
Symptoms of celiac sprue
Symptoms of celiac disease in different individuals may vary This is one reason why the diagnosis is not always put at once, for example, one person may have constipation, the second - the diarrhea, and the third can not have all... no problems with the chair
Gastrointestinal symptoms include:
- abdominal pain, bloating, gas, upset stomach;
- decreased appetite (and your appetite may be increased or unchanged);
- diarrhea- permanent or occasional;
- lactose intolerance (often when a person is diagnosed, usually it goes away after treatment);
- nausea and vomiting;
- diarrhea, which has an unpleasant odor, oily or bloody;
- unexplained weight loss (although people at the same time and can be overweight or of normal weight).
Due to the fact that the intestine does not absorb a lot of important vitamins, minerals and other parts of the food, the following symptoms may occur for a long time:
- a slight dizziness;
- depression or anxiety;
- stunted growth (in children);
- hair loss;
- itchy skin;
- long menstrual periods;
- mouth sores;
- muscle cramps and pain in the joints;
- bleeding from the nose;
- tingling or numbness in hands or feet, etc.
Children with celiac disease may have symptoms such:
- defects in tooth enamel and tooth discoloration;
- delayed puberty;
- diarrhea, constipation, greasy or foul-smelling stools, nausea, or vomiting;
- irritation and restlessness in behavior;
- strong increase in weight;
- slower growth or growth below normal height for their age.
diagnosis of celiac sprue
- Albumin (can be low);
- alkaline phosphatase;
- clotting abnormalities factor (coagulation factors - a group of chemicals found in platelets and plasma and ensuring its collapse);
- check may lower cholesterol;
- complete blood count (test for anemia);
- analysis of liver enzymes;
- prothrombin time
blood tests can detect some specific antibody, called "antibody classes IgA to tissue transglutaminase" (or tTG, antibodies against transglutaminase, immunoglobulins of class G - determination of serum class G immunoglobulin for the enzyme tissue transglutaminase being sensitive andspecific method for diagnosing celiac disease in patients with an immunoglobulin deficiency isolated A. subject GFD and achieving remission of antibody concentration is gradually reduced and may become negative analysis why research on anti-TG, IgG can be used to assess the patient's adherence to a gluten-free dietand a blood test is recommended to take this diet).The doctor prescribe these tests antibodies, if celiac disease is suspected.
If the test is successful, usually performed endoscopy and biopsy (tissue sample analysis pieces) from the first part of the small intestine (duodenum).A biopsy can show a seal in the gut villi below the duodenum.
genetic blood test can also help determine what can be dangerous for celiac disease.
subsequent biopsy or blood test can be assigned to a few months after diagnosis and treatment.These tests will help to test the response of a patient's body for treatment.Normal results mean that the patient has responded to treatment, the diagnosis is confirmed.However, this does not mean that the disease is completely cured.
Treatment celiac sprue
Celiac disease can not be cured until the end.However, the symptoms disappear after proper treatment, and the villi in the intestinal lining healed, if this patient will be throughout his life to follow a gluten-free diet: will not eat food, drink beverages and medicines containing wheat, barley, rye, and,possibly oats.
If the patient - celiac disease, it is important that it has consulted the competent dietitian who specializes in celiac disease and the gluten-free diet.A specialist can tell the patient, where they can buy gluten-free products, and share important information that will explain the disease and its treatment methods.
dietitian can also provide advice on the conditions that are commonly found together with celiac disease - such as:
- lactose intolerance;
- vitamin or mineral deficiency;
- weight loss or gain.
Recommended celiac patients to carefully read food and medicine labels products to detect any hidden sources of gluten-containing (gluten) grains and ingredients associated with them.Observing discipline and meal planning, the patient will recover relatively.
But we should not start a gluten-free diet before diagnosis "celiac disease" ( "sprue").Diet affect the diagnostic indicators of disease.
doctor may prescribe a patient with celiac disease vitamin and mineral supplements to correct deficiencies in the diet.Sometimes corticosteroids (such as prednisone) may also be prescribed for short term use.After a well-balanced gluten-free diet, as a rule, you only need competent treatment.
When a patient diagnosed with "celiac disease", he can consult a dietitian who specializes in celiac disease and the gluten-free diet.Support groups can also help the patient cope with the disease and diet.
P Projection of celiac sprue
gluten-free diet cures the intestinal damage and prevent further damage.Healing usually occurs within 3-6 months in children but can take 2-3 years in adults.
rare long-term damage to the intestinal mucosa will be done before diagnosis.
Some problems caused by celiac disease will not go away - for example, problems with growth and damage teeth.
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Complications of celiac sprue
patient must all life continue to closely follow a gluten-free diet.If untreated, the disease can cause complications, life-threatening.
postponement or absence of correct diagnosis after the diet will deliver the patient to the risk associated with celiac disease - such as for example:
- autoimmune disorders;
- bone disease: osteoporosis, kyphosis, frequent fractures;
- certain types of colon cancer;
- a low hemoglobin level (insufficient number of red blood cells) in the blood (anemia);
- low blood sugar (hypoglycemia);
- infertility or repeated miscarriage;
- liver disease.
recommend to consult a doctor if there are symptoms of celiac disease.
Prevention celiac sprue
Because the exact cause of celiac disease is unknown, there is no known way to prevent its development.However, at the stage of early diagnosis and treatment knowledge of the risk factors (eg, in the presence of a family member with the disorder) may increase the chances for a long healthy life.