GGLUTEN-SENSITIVE ENTEROPATHY - NEW VIEW ON PROBLEM

Gluten sensitive enteropathy-celiac disease is an immune-mediated disorder caused by permanent sensitivity to gluten in genetically susceptible individuals. Epidemiologic studies of last years suggest that it is common and may occur in 0,5-1% of the general population. The bowel inammatory and immunologic response results in atrophy and damage in the small bowel and secondary malabsorbtion.The mode of presentation can be quite variable. Celiac disease is generally dened as chronic diarrea and failure to thrive in infants and toddlers, diarrhea is still the most common symptom, but disease may occure in different age groups and with exstraintestinal, sometimes monosymptomic clinic. Clinical forms of celiac disease are: classic, atypical, silent, latent and potential. Denitive diagnose of Celiac disease requires serrologic screening, small intestinal biopsy and effectiveness of elimination diet. Anti-tissue transglutaminase antybody test (TTG IgA and TTG IgG) is highly sensitive, specic and less expensive, thus is recommended for general practice. None of serologic tests are 100% reliable. Denitive diagnosis requires characteristic histologic changes in intestine mucus. Tissue for investigation may be taken from duodenum during gastro endoscopy. Diagnosing only by results of gluten-free diet is not correct. The only treatment for celiac disease is lifelong exclusion of gluten. Early diagnosis and strict dietary restrictions appear to be the only possibility of prevention risk for failure to thrive, delay of sexual maturity, autoimmune disorders, adenocarcinoma of gastrointestinal tract and lymphoma.