For cases of long-term diarrhea and weight loss, we should be alert to the presence of malabsorption in the small intestine. Diagnosis of gluten-free bowel disease must first be differentiated from malabsorption caused by other intestinal organic diseases and pancreatic diseases. X-ray examination, the determination of small intestinal absorption test alcohol gliadin protein antibodies, endoscopy and small intestine mucosal biopsy can be initially diagnosed, and then the treatment test can be explained with the Mai glue, in order to finalize the diagnosis.

 

The clinical manifestations of the disease are essentially malnutrition syndromes caused by digestion and malabsorption of nutrients. The clinical manifestations are very different. A large number of patients are very light and undetectable. The performance of adult patients may not be typical. The signs of celiac disease are as follows:

 

(A) Diarrhea, abdominal pain 80% to 97% of patients have diarrhea, typical cases of fatty diarrhea, faecal faint, large quantities, grease-like or foam-like, often floating on the water, more than a foul odor, daily stool frequency from several More than 10 times, most patients have recurrent or intermittent diarrhea; a few early or mild cases can be without diarrhea, or even constipation, often can be missed diagnosis, abdominal pain is less common than diarrhea, mostly abdominal pain, often appear before defecation There may be mild tenderness in the abdomen, and in some cases there is marked abdominal distention, nausea and vomiting.

 

(B) weight loss, fatigue, fatigue, varying degrees, almost for the performance, weight loss, fatigue mainly due to protein, fat and other absorption disorders, the other dehydration, potassium deficiency, loss of appetite is also an important factor, severe cases can be cachexia.

 

 

(C) vitamin deficiency and electrolyte imbalance in the performance of calcium and vitamin D deficiency can cause hand, foot and ringworm, paresthesia, osteoporosis, osteomalacia can cause bone pain, vitamin K deficiency can cause bleeding tendency, vitamin B group deficiency can cause tongue , Stomatitis, angular cheilitis, beriberi, pellagra-like pigmentation, vitamin A deficiency can cause hair follicle keratinization, corneal dryness, night blindness, etc., more than half of patients have anemia, accompanied by inguinal muscle, a small number of patients may have muscle Tenderness and clubbing (toe).

 

(d) edema, fever and nocturia common edema, fever due to concomitant infection caused by the onset of urine output more than the amount of urine, may have IgA nephropathy, infertility, bleeding tendency.

 

The most critical issue of dietary therapy is to avoid diets containing malt, such as various types of wheat such as barley, wheat, oats and rye. If the gluten in the flour is removed, the remaining starch is not "toxic" and the patient can eat it. Corn and rice, buckwheat, beans, potatoes, sweet potatoes and other products can be eaten, fruits, meat and milk are not limited. After dietary treatment, the symptoms begin to improve significantly in 3 to 6 weeks, and diarrhea reduces weight gain. Dietary therapy often lasts for 0.5 to -years. Ineffective or untreated patients often die of cancer, neurological complications, and jejunal ileal ulcers.