Celiac disease is considered as a protein intolerance cereals - gliadin. Until now, different terms are used to refer to celiac disease, including non-tropical sprue (from Holland. sprue - foam, as the patient chair is sometimes reminiscent of the foam) and glutenovaya enteropathy.
Patients with celiac disease gliadin causes atrophy of small intestinal mucosa, resulting in impaired syndrome intestinal absorption, leading in turn to the development of malnutrition, rickets syndrome and many other metabolism disorders substances. However, exactly how the gliadin leads to atrophy of the small intestinal mucosa, completely unclear.
Causes
According to the literature, some features of the mucosa of the small intestine of patients with celiac disease predisposes to the effects of gliadin. These may be:
- inability enzymes cleave polypeptides. Some authors attribute the disease with decreased enzyme activity, do not provide fully splitting gliadin. Unsplit gliadin, in turn, has a toxic effect on the mucous membrane of the small intestine;
- increased mucosal sensitivity to gliadin, when the epithelium becomes a target immunoassay process;
- innate characteristics of the receptor apparatus intestine cells, contributing to damage to the epithelium;
- especially receptor apparatus intestine cells, prepared by some viruses.
As you know, important in the development of celiac disease are genetic factors. type of transmission is probably autosomal dominant. Among the closest relatives of the patient, according to research, disease incidence varies from 2 to 12%.
manifestations of celiac disease
Celiac disease manifests after administration gliadinsoderzhaschih in food products.
Very often such a product is a semolina, which is usually administered in the food at the age of 4-6 months. So a classic case of the manifestation of celiac disease occurs at 6-8 month of life.
In some cases gliadinsoderzhaschie products, including certain mixtures of artificial feeding may be administered before the deadline, which implies a correspondingly early manifestation of the disease.
On the other hand, many children manifestation of celiac disease occurs in the later stages, sometimes after 5-6 months. or more after the first administration in gliadinsoderzhaschih food products, sometimes after infectious diseases (intestinal infection SARS), But often for no apparent reason.
Typical symptoms of celiac disease are frequent bulky stools pasty with a grayish tinge, weight loss, abdominal enlargement, in the future - neurodevelopmental disability. The first three symptoms may occur simultaneously or in any sequence, making it difficult to timely diagnosis of the disease. The degree of symptoms also fluctuates, and very significantly.
Celiac disease is often accompanied by secondary metabolic disorders. Suffer all kinds of exchanges, especially protein. Violation of the absorption of calcium and vitamin D leads to the development osteoporosis and the formation of rahitopodobnyh deformities of the skeletal system. Malabsorption of lipids and carbohydrates affect energy metabolism. Polyhypovitaminosis formed. lactase deficiency often accompanies celiac disease, marked distension and rumbling in the stomach after drinking milk, the chair becomes foamy and becomes sour smell. Against the background of celiac disease may be formed alimentary allergyIncluding intolerance to cow's milk protein.
If untreated, it is lagging behind in psychomotor development of children, especially 1-2-th year of life, lose their acquired skills, become apathetic.
Diagnostics
The diagnosis is based on clinical manifestations, anamnesis data, endoscopic and histological studies of the small intestine mucosa and identifying AGA blood.
Additional tests may be lipidogram feces, which will differentiate pancreatic lesion by lesion of the intestine. Xylose test allows a whole to assess the degree of malabsorption of monosaccharides. definition carbohydrates in feces It allows you to set the degree of lactase deficiency. However, it should be emphasized that these methods are complementary, and their results may be indicative for the presence of celiac disease, but they can not definitively confirm the diagnosis.
celiac Disease treatment
The mainstay of treatment for celiac disease is strict adherence to the diet. From power to exclude all cereals except rice, buckwheat, corn, as well as foods that may contain them, including sausages, some canned food. Usually diet supplemented with the exception of lactose and allergens.
Children first year of life soy blend or mixture based on casein hydrolyzate can be assigned. Good effect gives an introduction to fat diet based on medium chain triglycerides, which are degraded and absorbed in the intestine is much lighter than conventional long chain. The diet is supplemented posindromnoy therapy. Strict adherence to diet in a timely beginning of the treatment makes it possible to ensure the normal development of the child.
It is now considered a proven, life dieting that is required for celiac disease as well as a departure from her not only It is fraught with possible aggravation of the process, but significantly increases the risk of malignancies, including lymphoma bowel. Observations show that in the case of strict dieting and conduct adequate additional treatment of children with celiac disease do not lag behind their peers or by physical or mental of development.
