Celiac disease symptoms
Celiac - syndrome, a characteristic feature of which is a violation of intestinal absorption.
Celiac disease - a congenital disease of the gastrointestinal tract, which is based on intolerance to gluten protein.This protein is found in cereals (oats, wheat, barley, rye).
first time the syndrome was isolated English physician S. Gee in 1888. He first identified in children with bowel disease, a syndrome characterized by growth retardation, diarrhea and malnutrition.He believed that in such cases the affected colon, in connection with which came the name of celiac affection - celiac .In 1908 it described a similar disease called intestinal infantilism, and in 1909 - severe chronic digestive insufficiency.Only in 1950, a Dutch pediatrician W. Dicke first time as an important cause of chronic intestinal disease of children was described by an inability to digest which is in some cereals (wheat, rye, barley, oats) gluten.
causes of disease
At the moment cause of the disease is not established, it is b
Pathology runs in families, is transmitted as an autosomal recessive trait with incomplete penetrance abnormal gene.About 80% of the patients are carriers of HLA-B8 antigen.The relative risk of developing celiac disease for HLA-B8 individuals in 8-9 times higher than for those who do not have the antigen.However, this does not mean that the antigen B8 contributes directly to disease.
Whatever the mechanism, causing the initial damage to the mucous membrane, at a sufficiently prolonged use of foods containing gluten, develop characteristic changes in the jejunum (atrophic eyunit).He is shortened, and the complete disappearance of the villi damage to surface cells.The sharp decrease in the area of the suction surface, reducing the activity of enzymes performing membrane digestion, accumulation of products of incomplete digestion of nutrients with intracolonic growth of microbial flora lead to a change in the acidity of the food bolus to the acid side, disruption of water transport, electrolytes and protein, as well as enhance their removal from the bloodchannel.Inadequate intake of food fatty acids and bile acids may increase the secretion of digestive juice, bowel motor activity, which leads to a marked increase in stool volume (polifekalii).Suction disorder, as well as loss of protein, fats, electrolytes, minerals and vitamins contribute to the formation degeneration, anemia, rahitopodobnyh state polyhypovitaminosis.Symptoms of the disease
first manifestations of the disease are recorded after the introduction of complementary foods containing cereals.The child appears speeded up, liquid, frothy stools, having a pungent odor.Baby loses weight, becomes listless and pale.He increased his tummy.Treatment enzymes and antibacterial agents do not give a positive effect.
disease develops gradually, after the introduction of the diet of a child glyutensoderzhaschih products (semolina, bread, milk mixtures containing wheat, oat, barley, rye flour).The first signs of the disease - the child's mood changes, lethargy, lack of appetite and weight gain, the appearance of loose stool with an increase in the number of stools at a constant frequency of them.During this period, approximately half of the patients diagnosed with intestinal infections of children, as a rule, not confirmed by bacteriological analysis of feces.In this regard, the child re-appointed by the massive courses of antibiotic therapy, contributing to the development and aggravation of intestinal dysbiosis.After 1.5-3 months after first use glyutensoderzhaschih products in the majority of patients develop major signs of celiac disease - cachexia, big belly size and plentiful, zamazkoobrazny with a greasy luster fetid stool weight per day which can reach 1 - 1.5 kg.Senile unhappy expression on his face, thin limbs, combined with a sharp increase in stomach give sick children a distinctive kind of "spider."The rest of the symptoms of celiac disease can be considered the result of inadequate absorption in the intestine, and the range of clinical manifestations of celiac disease is extremely broad.
most persistent symptoms of the disease are delayed growth and weight gain, decreased muscle tone, delayed the rate of psychomotor and speech development, diarrhea, vomiting, loss of appetite, health instability, abdominal pain, rectal prolapse, osteoporosis with spontaneous fractureslater teething with a tendency to decay, pallor and dryness of the skin and mucous membranes, the phenomenon gipopolivitaminoza (uneven pigmentation of the skin, inflammation of the mouth, inflammation of the tongue, discolored and brittle hair, bruising), swelling, degenerative changes of the internal organs.In the course of the disease is allocated 3 phases of its development: the latent (hidden), phase bright clinical manifestations (acute phase height) and chronic phase.The first signs of the coming improvements are reducing the amount of feces, the cessation of diarrhea.Quite quickly increases the body weight gradually disappear neuropathic symptoms, signs of vitamin deficiencies, anemia, osteoporosis is slowly eliminated.
The disease is diagnosed on the basis of the inspection data, the history of the disease, the characteristic species of the patient.The child's condition significantly improved against the background of a gluten-free diet.In some cases, the results confirm celiac mucosa of the small intestine biopsy.
celiac disease characterized by varying degrees of anemia with a change in the shape and size of red blood cells.In some of the patients revealed a decrease in platelet count, accelerated erythrocyte sedimentation rate, white blood cell count can both increase and decrease.Changes in urinalysis are characterized by the majority of children the emergence of a large number of salts (oxalate), an increased excretion of protein and carbohydrates.Some children in the acute phase of celiac disease observed increased fluid intake coupled with an increase in urine output (polydipsia syndrome - polyuria) with a low specific gravity of urine - 1000-1004.When feces study notes the allocation of a large amount of fat.In most cases, revealed intestinal dysbiosis varying degrees of severity.Analysis of biochemical blood research shows that the most persistent and significant are the changes in the protein metabolism, changes in lipid metabolism, resulting in low levels of cholesterol, total lipids.Radiographic changes in the bone tissue is the presence of a common osteoporosis from mild to severe, possible deformation of the bones.Bone age does not correspond to the passport - the first is always lagging behind at 0.5-2 years.When X-ray contrast studies of the digestive tract are detected violations of the relief of the mucous membrane of the small intestine, the emergence and growth of liquid levels in the intestinal loops when administered with a contrast agent solution or flour gliadin, motor function disorders of various departments of the small and large intestines, colon expansion in diameter.
Endoscopic changes in celiac disease are characterized as atrophic eyunit (inflammation of the small intestine with a decrease in the number and size of intestinal villi, are directly involved in the digestion of food), the jejunum is the characteristic form of "tube" due to lack of folds, motor activity, pale-serovatogo colored mucous due to edema, the presence of a thin layer of white residue (a symptom of frost).It should be noted that more than half of patients with celiac disease is detected accompanying (secondary) disaccharidase deficiency.Appointment agliadinovoy diet contributes not only to the restoration of the mucosa of the small intestine structure, but also increase the activity of digestive enzymes, which is not observed in cases of primary disaccharidase failure.
Treatment of diseases
child is assigned to a gluten-free diet (excluded bread, rolls, cakes, cookies, pasta, sausages).Because the drug is prescribed vitamins and minerals.
Exclusion from the diet food gluten leads to the disappearance of all symptoms of the disease, but the re-use of gluten again causes disturbances of the mucous membrane of the small intestine structure.Therefore, the diagnosis of celiac disease must be confirmed by the results of at least 3 biopsies, which is consistent with WHO recommendations.
mainstay of therapy for celiac disease is agliadinovaya diet, require the total elimination of food made from wheat, rye, barley, oats, which can be replaced by products made from rice, corn, buckwheat, maize, soya.Note that starch, containing traces of gluten, it may be a component of many foods and medicines.Therefore, when a rigid diet is necessary to monitor and in the absence of starch in the composition of tablets shells taken for treatment.Often accompanies celiac disaccharidase deficiency and reduced tolerance to fats also require appropriate dietary correction.The essential point in the treatment of celiac disease is a replacement and symptomatic therapy.
forecast at timely conduct adequate treatment and rehabilitation in general, favorable mortality from celiac disease is virtually zero.Adult celiac intestinal malignant neoplasms frequency slightly higher than in healthy individuals.
favorable prognosis of the disease during the corresponding adequate therapy.
disease specific prevention of the disease there, so it does not set the reason for its occurrence.