Celiac disease in children and adults - causes, symptoms and treatment of celiac disease

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Celiac disease in children and adults - causes, symptoms and treatment of celiac disease
Celiac disease in children and adults - causes, symptoms and treatment of celiac disease
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What is celiac disease?

Celiac disease is an intolerance to foods containing gluten. A pathological reaction to this substance gives the human intestine. The disease is congenital and is inherited. However, the full picture of its development is still not entirely clear.

Gluten that has entered the intestines cannot be completely broken down, as a result - the formation of toxins. They negatively affect the walls of the body, damaging them. This process in childhood is accompanied by profuse vomiting, foamy stools, and bloating. If a child has gluten intolerance, then this can be understood immediately after the introduction of complementary foods, since a pathological reaction will occur after the food reaches the intestines.

Adults with celiac disease can be treated for lifelong flatulence, stool disorders, not suspecting the true cause of persistent dyspeptic disorders.

celiac disease
celiac disease

Since celiac disease is easily confused with chronic diseases of the digestive system, its prevalence is significantly underestimated. So, there is evidence that in Russia one person out of a thousand suffers from the disease. Although it is not entirely correct to call celiac disease a disease. Gluten intolerance is just a way of life. He will just have to follow a certain diet, which implies the absence of this component in the products.

There are some interesting facts about gluten intolerance:

  • People have been suffering from this pathology for many centuries, it has appeared since the moment when a person began to sow wheat, rye and other cereals for food;
  • The female population is the most affected, with racial differences. So, in Japan, China and Africa, celiac disease is practically not diagnosed. Scientists believe that the whole point is both in the nutritional habits of the population of these countries, and in their genetic status;
  • Some regions of Russia have not yet recognized celiac disease as a disease, so such a diagnosis cannot be found there;
  • Some foreign scientists are of the opinion that gluten intolerance significantly affects the risk of developing cancer of the digestive system, so they refer to the disease as a precancerous condition;
  • 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 the disease in humans:

  • Immunological. This theory is based on the fact that people with gluten intolerance have certain antibodies to it in their blood. In addition, autoimmune antibodies to the cellular structures of the intestine are detected. Intraepithelial lymphocytes, the number of which is increased, perceive gluten that has entered the body as something foreign. As a result, they begin to damage the intestines.
  • Enzymatic. This theory is based on the absence of an enzyme in the small intestine that can break down incoming gluten. This assumption has the right to exist, however, there is no evidence for it. After all, if a person adheres to a diet, the enzymes in the intestines are fully restored.
  • Viral. Studies have shown that the vast majority of sick people have an increased rate of antibodies to one of the types of adenovirus. However, as a result of an adenovirus infection, the disease cannot develop, since it is congenital. The thing is that gluten and adenovirus have a similar antigenic state.
  • Pathoreceptor. This theory is based on the fact that the inner surface of the intestines of sick people has certain disorders. They are associated with a violation of the protein composition in the small intestine, as a result of which it is not able to absorb gluten.

It is worth noting that most scientists consider the immunological theory the most likely. Nevertheless, it is not worth rejecting the remaining assumptions; it is more expedient to combine them. As a result, the following picture is formed: due to the lack of a special enzyme, the body is not able to break down gluten, as it accumulates, intestinal poisoning with toxins occurs. He, in turn, gives a reaction by activating certain receptors. In this "fight" damage occurs to the intestine, its ability to digest and absorb is disturbed. As for adenoviruses, they are considered a possible provocateur of an immune reaction to gluten that has entered the intestines.

Celiac Symptoms

Symptoms of celiac disease
Symptoms of celiac disease

Educational literature describes only three possible manifestations of the disease. However, there are many more symptoms, they are simply perceived as other pathologies of the digestive system. As a result, the correct diagnosis is extremely rare, and people are treated for other diseases. Moreover, the therapy is absolutely ineffective.

However, do not forget about the existing cases of negative intestinal biopsy for celiac disease. In this case, the entire clinical picture and blood tests indicate the presence of the disease.

In 1991, pathology was visualized as an iceberg. At its peak are people who have a genetic predisposition to develop the disease. Also at the top of the iceberg are confirmed variants that have been established on clinical grounds, and there are very few of them. Under water is that huge proportion of people who suffer from the disease, but they have not been diagnosed with it. The basis of the iceberg is people who have a genetic predisposition to the disease. It manifests itself not from birth, but as a result of exposure to negative factors, for example, after suffering stress or due to a decrease in immune forces.

In addition, the early introduction of gluten-rich foods into the diet has a negative effect. For example, semolina porridge, which all grandmothers simply adore, can provoke the early development of the disease. In addition, the severity of the course of the pathology will also worsen.

Symptoms of celiac disease in children

Vividly the disease will be manifested by three signs:

  • Increased bowel movements. The chair can be five times a day or more, it is plentiful, has a mushy texture. There is a sheen on the surface of the stool due to fat. The smell is sharp and unpleasant, the color varies, foam may be present. Washing off feces is problematic.
  • The baby's belly bulges forward, sometimes causing the doctor to suspect rickets.
  • In the first two years, there will be a noticeable lag in weight. After two years of age, the child's lag in growth is more pronounced. At the same time, it is worth paying attention to the fact that insufficient weight gain will begin to appear after the baby is introduced to complementary foods. Prior to this, his weight was normal.

If these symptoms are pronounced, then there are other signs as well.

They begin to appear as a result of a lack of many nutrients in the child's body:

  • A child can be passive or, on the contrary, aggressive. He gets tired faster, often irritated.
  • The skin is flaky, the hair is in poor condition. Atopic dermatitis is common.
  • The child has frequent fractures that are uncharacteristic for childhood. Normally, they rarely happen, since the bones of the baby are elastic.
  • Bad posture.
  • The look of the child is painful, unhappy.
  • Muscle tone decreased.
  • Pathologies from the oral cavity are often observed. The baby has recurring stomatitis, the gums bleed, caries develops, the enamel is in poor condition, it can crumble.
  • Signs of anemia.
  • The baby may look like a spider, he has thin limbs and a protruding belly.

As the child grows older, there is a disorder in the reproductive system. Girls don't get their period on time, and boys develop sexual dysfunction.

Symptoms of celiac disease in adults

Pathology can be latent and atypical. The latter form develops after the patient reaches 30 or even 40 years old.

In general, the manifestations of the disease are as follows:

  • Neurological disorders manifesting in depressive disorders and migraines.
  • Skin diseases such as: dermatitis.
  • Stomatitis, glossitis, thinning of enamel.
  • Nephropathy.
  • Infertility.
  • Biochemical blood test shows a decrease in cholesterol levels, an increase in transaminases, phosphatases and albumin.
  • Arthritis. In addition, the joints may ache for an unknown reason.

It has been found that up to 8% of infertile women have celiac disease. Once they started on a special diet, they managed to get pregnant and have a baby.

If a person suffers from a latent form of the disease, then it will not manifest itself in any way. Rarely, minor digestive disorders, as well as dermatitis, can be observed. It is possible to detect pathology only by chance.

Complications of gluten intolerance

Complications of celiac disease
Complications of celiac disease

The latent form of the disease poses a certain danger if you do not know about it for a long time:

  • Cancers of the gastrointestinal tract.
  • Diabetes
  • Pericarditis
  • Autoimmune form of hepatitis or thyroiditis
  • Scleroderma, myasthenia, etc.

Diagnosis of celiac disease

To confirm the diagnosis, the patient will need to go through three stages of research:

  • Blood test. It is necessary to determine the amount of antigliadin antibodies, to detect the presence or absence of antibodies to endomysium, reticulin and tissue transglutaminase.
  • If the result is positive, then a biopsy of the small intestine is necessary. The study will provide information about the condition of the villi of the mucous membrane, whether there is an inflammatory reaction and whether there are lymphocytes with altered receptors. It is the biopsy that is the most important stage of the study.
  • A patient is put on a gluten-free diet for 6 months. If his he alth improves, then the diagnosis is confirmed definitively.

Diet will be given even if biopsy results are negative, but if immune tests are positive. When a gluten-free diet shows visible results, doctors talk about potential celiac disease.

After 12 months, the patient again donates blood for an immunological study. After another 12 months, a biopsy should be performed, the condition of the intestine should be excellent.

Differential Diagnosis

Before a person is sent for a biopsy procedure (performed under general anesthesia), it is necessary to determine whether digestive disorders are the result of allergies, immunodeficiency, infection, etc.

It is important to know that with celiac disease there will be no mucus and blood in the stool, and a gluten-free diet will give a positive result.

Celiac disease treatment

If a person really suffers from a disease, then he will have to adhere to a gluten-free diet for life. To do this, it will be necessary to exclude pasta and bread, pearl barley, semolina and oatmeal, inexpensive sausages and sausages, cutlets, confectionery and sauces from the menu. In addition, it is important to give up beer, cocoa, coffee, cheese, yogurt, cottage cheese, canned food, ketchup and mayonnaise.

If 1 mg of gluten is present in 100 g of the product, this indicator will be critical for the patient.

Allowed for consumption:

Treatment of celiac disease
Treatment of celiac disease
  • Fish and meat;
  • Eggs and natural milk, as well as products based on it;
  • Fruits and vegetables;
  • Buckwheat, millet and corn;
  • Beans;
  • Marmalade and chocolate.

Children under 12 months of age will need to eat formulas based on soy or casein hydrolyzate. When the need arises for the introduction of complementary foods, gluten-free cereals can be used.

When the diagnosis is established, symptomatic therapy may be needed:

  • To restore microflora: Enterofuril (as an antiseptic), Linex, Bifiform, Aktimel (as probiotics), Hilak forte (as a prebiotic).
  • To normalize the digestion process - Pancreatin or Creon.
  • To eliminate bloating - Plantex or Espumizan.
  • To eliminate diarrhea - Imodium or Smekta.
  • For the normalization of water and electrolyte balance - Calcium Gluconate and Panangin.
  • To gain muscle mass, a complete nutritional correction with an increase in the calorie content of meals is necessary.
  • If there are signs of beriberi, the patient will need to drink a multivitamin complex. In especially severe cases, nicotinic acid and vitamins are administered intravenously - K, A, D, E, B.
  • Glucocorticosteroids are prescribed for the treatment of autoimmune diseases.
  • If a protein deficiency is detected, albumin and amino acids will be required.

In addition, the elimination of comorbidities, if any, is necessary.

Sick people should not take certain medications. This applies to those products that contain gluten in the composition of the capsule or shell. For example, these are Festal, Complivit, Mezim Forte and others. Also, you should not take products containing m alt, such as Novo-Passit.

Celiac disease is not a sentence

If the diagnosis is really confirmed, then often patients are given a disability. However, when a person adheres to a diet, his quality of life practically does not suffer, and the prognosis is quite favorable. Already after 14 days problems with the gastrointestinal tract disappear, and after 60 days the water-electrolyte, mineral, vitamin and protein balance of the body normalizes.

Children in 12 months are completely catching up in the physical development of their peers. However, if the diet is broken, this will lead to the return of all negative phenomena, and the risk of developing oncology also increases.

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