Misconceptions about celiac disease

  The incidence of cervical erosion among married and fertile women is as high as 40% to 60%. The female cervix is divided into an inner and an outer opening. The epithelium of the inner opening is a slender, mucus-secreting red columnar cell, while the outer opening is covered by a grayish-yellow squamous epithelium. Under the influence of certain factors, the squamous epithelium of the external opening of the cervix becomes covered by the columnar epithelium and cervical erosion is formed. When the erosion surface is observed under colposcopy, it is actually intact columnar epithelium, which is observed as red erosion-like to the naked eye because the columnar epithelium is a single layer with a red interstitium underneath. This shows that cervical erosion is not true erosion, but only feels intuitively like erosion compared to a normal smooth cervix. This change is related to the displacement of the junction between the squamous and columnar epithelium of the cervix. Many women are also frightened by the word “celiac disease”.  Celiac disease is not an inflammatory condition per se, but rather an ectopic cervical columnar epithelium. When not combined with inflammation, patients with celiac disease may have no clinical symptoms, or may only show increased discharge. Some patients may present with bloody leucorrhea or bleeding after intercourse. Other patients are more symptomatic and may have symptoms such as backache, vulvar and vaginal itching in addition to abnormal leucorrhea. However, this is not due to celiac disease itself, but mostly due to a combined inflammatory infection.  Some people believe that celiac disease is caused by sexual life, so once they are diagnosed with celiac disease, they are quite reluctant to have a sexual life. In fact, this view is wrong. The true cause of celiac disease is still unknown, and women who do not have sex still have celiac disease, sometimes even severe celiac disease. This shows that sexual intercourse is not the culprit of celiac disease.  For women who are preparing to get pregnant, there is no need to rush to do much treatment for celiac disease if it is not accompanied by any symptoms. If it is accompanied by excessive leucorrhea or yellowish leucorrhea that has caused discomfort, it can be treated with appropriate medication and you can try to get pregnant when the symptoms improve.  Many women with cervical erosion are worried about cervical cancer, believing that the heavier and longer the cervical erosion, the more likely cervical cancer will occur. The main cause of cervical cancer is due to persistent infection with human papillomavirus (HPV). Cervical erosion alone, if not combined with HPV infection, will not lead to cervical cancer in the majority of cases. However, early cervical cancer can be manifested as cervical erosion, and it is difficult to distinguish early cervical cancer from cervical erosion only by gynecological examination. If possible, HPV testing should be performed along with cervical cytology to exclude the possibility of cervical cancer and precancerous lesions.  At present, the most widely used methods for the treatment of cervical erosion in China are physical therapy by microwave, electric ironing, laser or freezing. The principle of “cure” is to destroy the columnar epithelium on the erosion surface, causing it to necrotize, crust off and new squamous epithelium to grow in. In fact, in the absence of a clear etiology, no conservative treatment is likely to cure cervical erosion completely. Clinically, it is often encountered that after physical therapy treatment of cervical erosion, the erosion area becomes smooth (columnar epithelium is replaced by squamous epithelium), but after a period of time, cervical erosion reappears.  Treatment with physical methods such as laser may cause slight damage to the cervix, which may affect the dilatability of the cervix during later delivery. It is best to go to the hospital for a checkup before planning to get pregnant. If cervical erosion does not affect pregnancy or is not combined with acute infection you can get pregnant first and wait for laser treatment after delivery. However, if your condition requires it, you should still follow your doctor’s advice and actively cooperate with the treatment.  In principle, physiotherapy only destroys a layer of cells on the surface of the cervix, and through damage repair, the columnar epithelial cells are transformed into squamous epithelial cells, thus treating cervical erosion, and therefore physiotherapy will not lead to narrowing of the cervical opening, let alone infertility.