Celiac disease in adults: symptoms, diagnosis, treatment

Gluten intolerance is not as common as other digestive disorders. Today, according to estimates of experts on the globe, about 1% of the population is faced with this pathology, which manifests itself in stool instability, severe abdominal pain and other unpleasant symptoms. A disease in which gluten intolerance is observed is called celiac disease. For the first time, the disease is more often recorded in childhood, but often begins to develop in adulthood.

General description of celiac disease

The disease provokes the failure of the small intestine, when there is severe damage to the villi covering the organ. Because of this, the absorption of fiber, fat, protein and gluten is impaired.

In addition, the condition of such patients is complicated by the insufficient production of the food enzyme gliadininopeptidase. It is essential for the digestion of gluten, proteins, and some grains.

When such problems appear, the patient has a gluten intolerance that cannot be fully absorbed. As a result, the patient develops a severe allergic reaction to oats, rye, wheat and barley.

Attention! Today, the majority of patients with celiac disease live in the United States, Europe and Northern Ireland. This ratio is associated with the great progress in diagnostics carried out in foreign countries, as well as the fact that in the CIS countries the disease has not yet received the necessary recognition.

Types of disease and their features

Today gastroenterologists distinguish four types of celiac disease.

1. Typical shape. It manifests itself in a large number of symptoms associated with the work of the digestive tract and other systems. In adults, it is rarely diagnosed for the first time, more often it occurs even in childhood.
   

   Signs of celiac disease in children

2. Atypical form. Symptoms of the disorder appear by the age of 35-40 and are mixed. They partially relate to the work of the digestive tract, but they are more manifested in the form of malfunctions of the brain, bones, and the reproductive system.
   

   In the atypical form, the reproductive system suffers

3. Latent form. It is considered one of the most dangerous, since it does not make itself felt before the occurrence of such dangerous diseases as diabetes mellitus, cancers in the digestive tract. It is determined by chance when passing diagnostics for other diseases of the gastrointestinal tract.
   

   Celiac disease is often only diagnosed after diabetes is detected.

4. Refractory form. In fact, incurable celiac disease, which manifests itself in adulthood and old age. With it, complete atrophy of the villi of the small intestine is observed.
   

   In old age, incurable celiac disease is more often diagnosed.

Symptoms of celiac disease in adults

Taking into account the type of disease, the symptomatology of the pathology can be of a different nature and affect different systems of the body. With celiac disease, patients are faced with the following unpleasant symptoms:

• severe pain in the abdomen, flatulence and the release of strong-smelling gas;
  

  Severe abdominal pain and flatulence occur

• the stool becomes unstable, diarrhea is more often worried, in which the feces foam heavily;
• feces are colored gray or light;
  

  Feces become unnatural gray

• when analyzed for dysbiosis, there is no pathogenic microflora in the stool, despite the obvious symptoms of the predominance of pathogenic bacteria;
• there may be a complete lack of appetite;
  

  One of the signs of celiac disease is loss of appetite

• the patient begins to rapidly lose weight;
• from time to time there is nausea, which can turn into vomiting;
  

  Nausea and even vomiting may occur

• since fats are poorly digested, the feces become fatty and poorly washed off;
• taking into account the deterioration of the patient's condition, the abdomen begins to noticeably increase, the mucous membranes become bright.
  

  The abdomen gradually increases

In some cases, due to a violation of the absorption of substances necessary for the body, patients have severe edema of the lower extremities, bones can break without serious mechanical impact.

Often, fluid accumulates in the small intestine, which further increases the volume of the abdomen. Multivitamin deficiency leads to severe dryness and flaking of the skin, teeth begin to decay, stomatitis may appear, nails and hair suffer.

Due to the improper functioning of the intestines, problems appear not only on the physical, but also on the psychological level. The patient becomes irritable, depressed, signs of negativity are present.

Often people with celiac disease suffer from insufficient growth.

Attention! Approximately 10% of women suffering from celiac disease cannot get pregnant or the pregnancy ends in miscarriage at any time. Only a strict diet and constant intake of multivitamins can minimize the risk of problems.

Because of celiac disease, many women cannot bear and give birth to a baby.

The reasons for the development of the disease

To date, the exact causes of the autoimmune disease associated with gluten intolerance are not known. There are only versions according to which celiac disease occurs:

• genetic predisposition, in almost 100% of the diseased, certain changes in DNA were identified, but similar differences exist in about 40% of the healthy population;
  

  Often celiac disease occurs due to a hereditary predisposition

• viral lesion, analyzes revealed that there is a chain of amino acids in gliadin, which is similar in type to adenoviruses;
• enzyme disorders, the worse the digestive enzymes are produced in patients, the higher the likelihood of developing gluten intolerance;
  

  The disease can occur against the background of a lack of digestive enzymes

• prolonged stress, pregnancy and childbirth, they can affect the state of the digestive system, which ultimately leads to a smoothing of the villous layer;
• intestinal infections that disrupt the microflora and structure in the small intestine;
  

  Intestinal infections - disease provocateurs

• surgical interventions in the abdominal cavity.

Diagnosing celiac disease

When gluten is exposed to the patient's body, a large number of antibodies to this substance are detected in the blood. They can be detected using special laboratory tests. In addition, it is imperative to apply the method of endoscopic examination and analyze the feces.

Table. Diagnosing celiac disease

Procedure	Peculiarity
Detection of antibodies to tissue transglutaminase	This enzyme is responsible for gluten metabolism. In celiac disease, large amounts of immunoglobulin A and G are found.
Detection of antibodies to endomysium	They check how much the connective tissue has been destroyed or formed in the muscles of the small intestine due to exposure to antibodies of this type.
Detection of antibodies to gliadin	The most informative blood test. When antibodies to gliadin, which is part of the gluten structure, appear, the patient will definitely develop intolerance in the active stage.
Stool analysis	It is necessary to control the quality of food digestion.

During endoscopic examination, a fibrogastroduodenoscopy (FGDS) procedure is performed, which allows you to obtain a visual image of the gastrointestinal tract and take tissue for biopsy. It consists in placing a special probe in the gastrointestinal tract through the esophagus. Through it, the doctor will be able to assess the condition of the esophagus itself, the gastric cavity and the final segment of the duodenum. At the tip of the probe there is a small camera for displaying an image on the doctor's screen.

A small tip can be placed on the probe, which are small forceps for grasping a small piece of mucous membrane. The biomaterial is sent to the laboratory for microscopic examination.

The analysis is carried out using a special reagent. It is dripped onto the tissues of the organ and they look at how much the structure of the villi has changed.

Attention! With celiac disease, the villi of the small intestine suffer from atrophy, they decrease in size, and there is almost no glandular substance in them. This is the main manifestation of the pathology in which the patient does not tolerate gluten and gluten-containing foods.

Diet with the development of pathology

If a patient has been diagnosed with celiac disease, products containing gluten should be completely excluded from the menu. Even a small amount of this substance can lead to the rapid destruction of the villi in the small intestine. For treatment, it is necessary to completely remove foods from the diet, which include rye, barley, wheat, oats and triticale.

No less dangerous are the products listed below, which contain so-called hidden gluten:

• deboned meat and fish from bread crumbs;
• shop sausages and semi-finished products;
  

  Store-bought sausage contains gluten

• dairy products containing thickeners, including baby curd snacks;
• frozen mixes of vegetables and fruits;
  

  Frozen vegetable mixes may contain traces of gluten

• sweets, which include waffles, soy filling;
• drinks with wheat, barley, including vodka and beer;
  

  Most alcohol is produced from gluten-containing foods

• industrial sauces and ketchups.

Attention! A gluten-free diet implies a mandatory study of the composition of foods if the patient has to eat outside the home. If a small amount of a prohibited substance enters the digestive tract, severe abdominal pain and diarrhea can develop with lightning speed.

When compiling a menu, patients are advised to eat various types of rice, corn, millet, buckwheat, beans, potatoes, fresh fruits, nuts.

You can make flour from cereals and use it for baking and making pancakes. In addition, a large selection of gluten-free products is gradually emerging in the dietary departments. These include sweets, baked goods, special flours, and other gluten-free diets.

Attention! With proper nutrition, the patient manages to completely restore the villi in the small intestine in 4-12 weeks. This puts celiac disease into remission, and with the right diet, the disease no longer reminds of itself.

Medicines for the disease

There are no specific medications against the development of celiac disease. The main treatment is to maintain a proper diet, which allows the small intestinal villi to regenerate over time.

If the disease is found in a late stage or proceeds in a complicated form, the patient is hospitalized. To stabilize his condition, he is injected with intravenous solutions with protein and fat emulsions, for example, "Albumin" and "Polyglobulin".

Vitamins containing folic acid and calcium are often prescribed. They normalize the metabolic process and reduce the load on the entire body.

To eliminate unpleasant symptoms, digestive enzymes, antidiarrheal, normalizing microflora and antispasmodic drugs are prescribed. Enzymes are drunk for 3-4 weeks, medicines for diarrhea and abdominal pain are taken until the unpleasant symptoms are completely eliminated, but no more than 3-10 days, taking into account the patient's condition. Vitamins will help to strengthen the immune system and get rid of problems with nails, skin and hair. The most effective medicines can be found in the table.

Table. Effective Medicines for Celiac Disease

A drug	Type of	Single dose	Number of daily intake
"Abomin"	Enzyme	1 tablet	Three, if necessary, a single dose is increased to 2-3 tablets. The daily number of receptions does not change.
"Creon 10000"	Enzyme	1-2 capsules	Depends on the patient's eating habits, usually "Creon 10000" is taken 4 times a day, but no more than 15 capsules per day.
"I took"	Antispasmodic	1-2 tablets	Three, do not exceed a dose of six tablets.
"Maxigan"	Antispasmodic	1-2 tablets	Three, do not exceed a dose of six tablets.
"Nifural"	Against diarrhea	2 tablets	4 times a day, no more than 10 days.
Enterol	Against diarrhea	1 capsule	1-2 doses, no more than 10 days.
"Complivit"	Vitamins	1 tablet	Once a day, no more than 30 days. In severe conditions, you can take 2 tablets per day.
"Vitrum plus"	Vitamins	1 tablet	Once a day, no more than 30 days.
"Linex"	Probiotic	2 capsules	Three times a day.
"Bifiform"	Probiotic	1 capsule	Three times a day.

Attention! If the introduction of solutions to improve metabolism and the use of vitamins does not give the desired effect, hormonal preparations are administered to the patient. This is done only as a last resort, with a short course of therapy and under the strict supervision of a gastroenterologist. But recent studies have shown that corticosteroids do not have the desired effect and do more harm.

Celiac disease is a congenital pathology of malfunctioning of the digestive tract. When symptoms of the disease appear, active treatment should be started immediately, which mainly consists in the use of correctly selected products. The disease cannot be completely cured, it can only be introduced into the latent stage, after which constant monitoring of the patient's condition will be required to prevent relapses.

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