About such a disease like celiac disease Modern doctors know almost all. However, these knowledge - no more than fifty years. Therefore, it is not surprising that the ordinary people know little about celiac disease. What is the disease? How does people live with this ailment? For answers to these questions let's turn to a specialist.
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Probably there is not a single ailment in which the doctor does not recommend you at least to lean on one products and refrain from others. But it happens so that the diet becomes the main medicine. And irreplaceable and the only one when it comes to celiac disease. Our correspondent talks with the Senior Researcher of the Film Branch of the Healthy and Sick Child of the NCCSC RAMS, Candidate of Medical Sciences by Elena Alexandrovna Roslaselovaya.
- Explain what kind of new attack - celiac disease?
- This disease is really «Regarding new». There is even the theory that the spread of celiac disease is associated with the emergence and mass distribution in the world of new wheat varieties - with high gluten content. Of this flour, a delicious and lush bread turns out, but the human body (more precisely, the small intestine did not have time to adapt to the absorption of such food, and therefore the disease. Only 50 years ago, scientists found out that the celiac causes the gluten - protein of wheat, then studies have shown that not only wheat «to blame», But other cereals are also dangerous to the health of many people.
Coleciakiya - a hereditary chronic disease resulting from the lesion of the mucous membrane of the small intestine by proteins of some cereals (gluten wheat and rice, barley gordene, Avenine oats).
- But the doctors know about how this disease is to determine and how to treat?
- Now the situation has changed for the better. 15 years ago 90% of sick children entered the leading medical institutions of the country with any other diagnoses - chronic enterocolitis, intestinal dysbioticery, enzymesopathy, centers, and. Now doctors already know about this disease, and sometimes we are faced with the problem of hyperdiagnostics - diagnosis «Tseliacia» put even more often than it really is. Methods for the diagnosis of blood celiac disease are indirect, they allow only to suspect the disease. To form a diagnosis requires verification and clarification - according to the results of the biopsy of the mucous membrane of the small intestine. But it must be done necessarily in the acute period of the disease (no more than two months after the start of the diet, and best - before). There are cases when doctors, suspecting celiac disease, prescribe a diet, and in half a year they send to the examination, is incorrect and harmful.
- In fact it is rare?
- How many sick celiac disease in Russia is unknown. There are no general statistics, studies have not been conducted. Foreign statistics of recent years on celiac disease is very alarming - the numbers are simply frightening. In the 70s it was believed that the disease is rare, its frequency is 1 case by 4-6 thousand. Population. But when serological methods of diagnosis of celiac disease were distributed 10 years ago (specific antibodies are determined in the blood) and it became possible to carry out mass surveys of the population, completely different data appeared.
Today it is believed that in Western European countries, it is sick 1 of 100-200 people, that is, one percentage of the population has atrophy of the mucous membrane of the small intestine. That is, or these people are sick, or risky at any time have serious health problems.
It is known that if someone is sick in the family, the risk of birth of a sick child is 10%. Above risk and in families where there are patients with diabetes.
- Is it possible to cure celiac?
- The disease is incurable - it is for life. Although all the manifestations of the disease can be minimized and even almost get rid of them. But this, unfortunately, does not mean cure, since the mucous membrane of the small intestine remains sensitive to gluten.
- How celiac disease is manifested? At what age in humans can be suspected and define exactly this disease?
- In the classic manifestation of celiac disease, this is an example of disruption of intestinal splitting and suction - manifests itself with long diarrhea in combination with «violation of nutritional status». Simply put - exhaustion. And as a result - various deficit states. For example, a shortage of vitamins and microelements in the body leads to hair loss, the nails are poorly growing, the skin becomes dry, the inflammation of the mucous membrane of the mouth (stomatitis) begins. Because of the iron deficit, anemia develops, teeth deteriorate.
In general, celiac disease is most often pronounced at the earliest age - on the first second year of life. That is, as soon as the child is starting to give manna or oatmeal, bread, crackers... These are all products containing gluten. The hidden period can last from several days to several months, and then the child has a chair (becomes either liquid, or very abundant) and behavior changes. Child like «loses interest in life», Edakaya «Children's depression», When the kid does not want to communicate, seeks to be alone, sluggish. Sometimes - very irritable and aggressive. Disrunt appetite - from absolute reluctance there is before the desire to eat constantly. And yet, nevertheless, the child is thinner, and quickly and very significantly, that it is impossible not to notice, - such children reach the state of hypotrophy of the 3rd degree! In this case, the child increases the belly. In severe cases, shipless swelling.
Of course, if there are such significant and bright manifestations, usually the child is quite quickly sent to specialized branches, in the hospital.
- But if the disease is congenital - why it is manifested very early, and other years live calmly and do not even suspect it?
- There is no answer to this question yet. It is not known how the process of atrophy of Village in the intestines is launched. There are many people who have a celiac disease hidden. They may not have any complaints and consider themselves healthy.
- So maybe they really are healthy? Why treat them from celiac disease?
- First, it should be borne in mind that the treatment of celiac disease consists only in strict and lifelong observance of a gluten-free diet. (In the acute period, when the child is exhausted and t. D., Of course, treatment is necessary, including vitamins, enzymes, sometimes - hormones. And then - only diet.)
If a person is sick of celiac disease, but leads the usual way of life without any restrictions in nutrition, it has about 400 times higher (compared to other people) the risk of malignant diseases of the gastrointestinal tract. Compliance with the same diet for 5 years reduces this risk to population.
Moreover, it is with celiac disease that some severe diseases are associated, for example, type 1 diabetes, autoimmune thyroiditis, liver cirrhosis. In addition, many cases of infertility, repeated miscarriage, delays of sexual development, low-speed, chronic anemia, even mental disorders are also associated with hidden celiac disease.
- Of course, wheat, rye, barley are considered toxic cereals with celiac disease. The protein of these cereals is destroyed for a man, ill cake.
Under great suspicion of oats. The World Health Organization for Finding out this cereal is now being conducted. According to our practical observations, Oats in all kinds also need to be excluded from food. But the official conclusion will be only after the completion of the study.
Sick celiac disease can not eat bread and bakery products, pastries, pasta, etc. And absolutely all other products that contain «hidden» gluten.
- Although it is difficult, but probably somehow you can live without bread and macaroni?
- But it is important that neither gram of gluten did not get into the body. No difference - White bread polbaton or flour spoon in dishes! The destructive effect of the same. And here it is the list of prohibited products begins to expand rapidly! Very many food, such as yogurts, sauces (ketchup, mayonnaise), sausages, boiled sausages, instant coffee and others, have gluten-containing substances in their composition, without which their production technology is impossible. But on the package, because it is not specified - contains gluten there or not. Moreover, even one-time tests do not guarantee a certain «Purity»: for example, in the same yogurts may include starch, but for technology it does not matter wheat whether, rice, on the quality of yogurt will eventually affect it. And for a sick person, it is very significant!
- Is it real for a person adherence to a special diet?
- In our conditions - very difficult. In large cities are sold already gluten-free products (a special icon is put on the package). But they cost significantly more expensive. Cookie bundle - about 200 rubles. Pasta - 170 rubles per pack...
Observe such a diet easily when the child is still small. But he grows, and here him and his parents are expecting serious problems, more socially social than medical.
Such a child cannot be given to an ordinary kindergarten; He can't go to visit, for a birthday to a friend (because there is surely a cake, candy, pies!) and in loved by all children «McDonalds». To school such children are forced to walk with their special meal.
In accordance with the Order of the Ministry of Health N 117 of 1991, children with celiac disease were disabled since childhood. Currently, the function of determining disability is transferred to the Ministry of Labor and Social Development. Today, the disability of such patients is often removed. It is formally correct, because, if the diet is observed, they look completely healthy, they are in order all tests! However, they remain sick people and should be observed annually from specialists, to keep an expensive diet.
A separate problem - the young men subject to the army. I believe that sick celiacs young people should not be called into the army, since they cannot be arranged there. But neither in the Mintrude social protection, nor in the Ministry of Defense, this question is not resolved - just not considered!
This is a really important social problem. It turns out that the state is more profitable to spend huge funds for the treatment of malignant tumors and severe autoimmune diseases, lose people in young, working age, rather than organize social assistance and the possibility of diet. After all, complications in patients who are not able to observe the diet develop already in 30-40 years. Perhaps patients with celiacs do not need life disability. In European countries, they simply receive benefits - compensation for food; In some countries, recipes for these products is discharged. But these questions need to decide today.
In developed countries, the society of patients with celiac diseases created there are greater social assistance. For several years, a regional public organization has been actively working in St. Petersburg «Emilia», which combines about 800 patients with celiac children and their parents. They managed to organize imports of gluten-free products from abroad, agree with some domestic producers, open the shore of gluten-free products. Rest of children in a specialized summer children's camp, discovered several special groups in kindergartens.
Recently, such an organization is registered and starts its activities in Moscow, it is called ROO «Help patients with celiac disease».
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