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　　What are the causes of celiac disease

　　15% of patients with celiac disease have malignant tumors. Common complications mainly include the following:

　　1, Neurological symptoms.Peripheral neuritis and changes in the central nervous system (cerebrum, cerebellum, and spinal cord) can be seen, and the cause is still unclear.

　　2, Ulcerative jejunitis and ileitis.When the disease is complicated with ulcers, the symptoms are more severe, which can cause perforation and scar-like obstruction. The prognosis is poor.

　　3, Bone changes.Osteomalacia is the most common, and due to secondary hyperparathyroidism, severe cases can cause fractures.

　　4, Hypopituitarism of the entire pituitary gland.Malnutrition in patients leads to hypopituitarism, manifested as dysfunction of various endocrine glands, such as hypothyroidism, hypoadrenalism, and hypogonadism.

　　In infants and children, the disease is mainly manifested as growth retardation, weight loss, vomiting, diarrhea, abdominal pain, and bloating; in adults, it is characterized by fatigue, emaciation, nausea, anorexia, bloating, and loose stools. Some patients may have no symptoms other than pathological changes in the intestinal mucosa. After the patient follows a 'gluten-free' diet, the symptoms are controlled, and if gluten is stimulated, the symptoms may reappear. A few patients may experience discomfort for several hours to several weeks. In addition, patients often have glossitis, anemia, hypocalcemic tetany, bone pain, osteoporosis, bleeding, and neurological symptoms (depression and peripheral neuritis). Female patients may also present with oligomenorrhea, early menopause, and infertility.

　　This disease is closely related to the consumption of wheat flour, so for susceptible populations, it is recommended to minimize the intake of wheat flour. If the gluten is removed from the flour, the remaining starch can be consumed. The principle is to focus on a diet high in protein, high in calories, low in fat, and non-irritating and easily digestible.

　　The main methods of examination for celiac disease are as follows:

　　1. Blood routine.The examination shows a decrease in hemoglobin levels, platelets may increase or decrease, and white blood cells decrease.

　　2. Stool routine.Sudan-Ⅲ staining of feces shows a large number of fat droplets.

　　3. Live biopsy.Under the microscope, villi show deformation and flattening, nuclear division images increase, and the basal membrane has patchy thickening.

　　The following points should be paid attention to in the diet of celiac disease:

　　1. Strictly avoid all foods and food products containing wheat.

　　2. Improve the nutritional status of patients.Because of the long-term chronic consumption, patients lose a large amount of protein from diarrhea, so it is necessary to provide appropriate high-quality protein on the premise of providing a high-calorie diet. Attention should also be paid to other nutrients such as calcium, magnesium, iron, fat-soluble vitamins, water-soluble vitamins, and folic acid.

　　3. Low-fat and low-residue.Due to the damage to the intestinal mucosa, low-fiber foods such as juices and vegetable juices should be chosen for the initial diet.

　　4. Cooking methods.Try to use boiling, stewing, simmering, and other cooking methods.

　　After the clear diagnosis of the disease, dietary therapy targeting the cause is most important. Weak patients and patients with complications also need symptomatic treatment and supportive therapy.

　　1. Dietary therapyPatients should avoid eating foods containing gluten, such as barley, wheat, oats, and spelt. If the gluten in flour is removed, patients can eat it. After dietary treatment, symptoms usually begin to improve significantly after 3-6 weeks, diarrhea decreases, and weight increases. Dietary therapy often lasts for 0.5-1 year.

　　2. Symptomatic treatment and supportive therapyIn addition to dietary treatment, supportive therapy is also very important. Pay attention to supplementing various vitamins (B1, B12, A, D, and folic acid), correcting electrolyte imbalances, and transfusing blood if necessary.

　　3. Hormonal therapyPatients with extreme weakness, poor response to dietary treatment, and intolerance to gluten-free diet may consider treatment with adrenal cortical hormones. Prednisone (Prednisone) treatment, initially 30-40mg per day, taken in the morning, and then gradually reduced to a minimum maintenance dose.