Many patients are confused about “celiac disease” when they visit the clinic! So, is celiac disease a disease or not? Does the cervix rot away? In fact, this is a misconception of normal physiological phenomenon in the past. To understand celiac disease, we must start with the composition of the cervical epithelium. The cervical epithelium is divided into two components: the seemingly “rotten” columnar epithelium in the cervical canal and the smooth squamous epithelium on the surface of the cervix. During a normal gynecological examination, the doctor can only see the green part of the picture on the left, but not the blue part. The blue part is the so-called columnar epithelial area, while the green part is mostly squamous epithelium. In women of childbearing age, under the influence of estrogen, the columnar epithelium grows outward, turning the area originally belonging to the squamous epithelium into a columnar epithelial area, and the so-called “cervical erosion” appears in the center part of the picture on the right. In fact, this is the result of the ectropion of the columnar epithelium in the cervical canal, which is a normal physiological phenomenon. After menopause, the estrogen level of the female organism decreases, the ectopic columnar epithelium returns to the cervical canal, and a smooth cervix can be seen again during gynecological examination. 1. Is celiac disease really not an inflammatory manifestation? When there is inflammation, it can also be manifested as cervical erosion, especially in acute cervicitis, where the cervix is not only visible as a reddish, fine-grained erosion zone on physical examination, but also bleeds easily. However, cervical inflammation can also have symptoms such as abnormally increased leucorrhea, odor or combined vulvovaginal itching. If there are no such symptoms, merely what is seen on physical examination cannot be diagnosed as cervicitis and does not require treatment. 2. Is cervical erosion a precancerous or cancerous lesion? Of course it cannot be equated! The diagnosis of cervical precancer or cancer is based on cervical cytology (TCT), human papillomavirus (HPV), colposcopic biopsy and other auxiliary examinations, not on physical examination, and a smooth cervix is not the same as no precancer. 3.What if celiac disease is accompanied by bleeding after intercourse? Vaginal bleeding after intercourse requires high alert and prompt medical attention. It is best to perform cervical fluid-based cytology test (TCT) and HPV test for early detection of cervical cancer. When conditions such as cervical cancer are ruled out, symptomatic treatment is sufficient. 4.Does severe cervical erosion need to be treated? At one time, OB/GYN textbooks were graded according to the extent of cervical erosion: an area of less than 1/3 is mild, 1/3-2/3 is moderate, and more than 2/3 is severe, and was considered to be related to the degree of inflammation. It has been found that this is just a different degree of columnar epithelial ectropion, all of which are normal physiological phenomena and do not need to be treated.