What is Celiac Disease Celiac Disease used to be a condition that plagued so many women that when they went for a physical, almost nine times out of ten, they would be diagnosed with Celiac Disease. To talk about celiac disease, you probably need to start with your doctor’s education. Celiac disease has always existed as a standard disease, and there has even been talk about its clinical presentation, diagnosis and treatment. But in reality, that is a misconception. Chinese obstetrics and gynecology has been out of step with international standards for many years. In the past, obstetricians and gynecologists regarded the columnar epithelial ectropion of the cervix, which occurs during the physiological period of the cervix, as a pathological phenomenon, and so diagnosed it. For example, the name of the disease “cervical erosion” was canceled and replaced by the physiological phenomenon “cervical columnar epithelial ectasia”. Therefore, from that time onwards, the diagnosis of “cervical erosion” should have been abolished in China, but due to the slow updating of the knowledge of many physicians, even five years after the revision of undergraduate textbooks for this diagnosis, there are still many physicians diagnosing “cervical erosion”. In the end, celiac disease is actually a misperception of what used to be a normal manifestation of the cervix. Pathophysiologic Mechanisms So, let’s talk about why celiac disease has been misperceived as an abnormal disease in the past. The normal picture is a coronal view of the area where the uterus meets the vagina. During a gynecological examination, the part of the cervix that the doctor can see from inside the vagina is the yellow part, i.e., the appearance of the cervix. In the cervix, there are two different types of cells, as shown in the picture, close to the vagina is the squamous cell, and close to the uterus in that direction is the columnar cell. The two types of epithelium are different in appearance, that of the cervix as seen under gynecological examination. The central part of the cervix, which looks somewhat like “erosion,” is covered by columnar epithelium, while the relatively smooth outer part of the cervix is covered by squamous epithelium. Columnar epithelial cells and squamous epithelial cells are in a dynamic equilibrium, somewhat similar to the stalemate area of the war, this area is named “squamous-columnar junction area” in medical science, this area is also a good area of cervical cancer (cervical cancer and cervical celiac disease does not necessarily correlation, the following decomposition). The squamocolumnar junction area is susceptible to estrogen. Before puberty, the ovarian function is not perfect, estrogen is low, columnar epithelium will rely on the inner side, to the menstruation, columnar epithelium will be affected by estrogen, more towards the outer side of the development, so there are more similar to the “celiac disease” like columnar epithelium in the mouth of the cervix in the examination found in the menopausal. After menopause, the estrogen level decreases, and the columnar epithelium starts to return to the inner side, so the “celiac disease” will not be visible at that time. Therefore, in essence, the so-called cervical erosion is actually columnar epithelial ectropion. In the past medical textbooks, there is also the so-called graded diagnosis of cervical celiac disease, called mild, moderate and severe, that the size of the range is the degree of inflammation of the degree of severity, the area of less than 1/3 is mild, 1/3-2/3 is moderate, more than 2/3 is severe, if you understand the so-called “cervical celiac disease” as I mentioned earlier, the real mechanism, it is very good to understand. If you understand the so-called “cervical erosion” I mentioned earlier, the real mechanism, it is very good to understand, this is in fact affected by estrogen columnar epithelial ectropion of different degrees, are normal physiological phenomena. Clinical manifestations Normal physiological phenomenon, there is no special clinical manifestations. Some people may have contact bleeding, but it is just an individual difference of the cervix, just like some people chew something hard, teeth or mouth blood, it is understandable. Here we need to mention cervicitis, if there is an increase in leukorrhea, yellowish, odor, these are the manifestations of cervical inflammation, is in the cervix after the infection appeared after the symptoms. Cervical sacs and hypertrophy are also the result of chronic inflammation of the cervix. Do you need treatment If you understand the content of the previous, it is not difficult to understand the so-called “celiac disease”, in fact, is a normal physiological phenomenon, do not need to carry out any treatment, now if a query to the Internet to the many methods of treatment of celiac disease, are all wrong. At the same time, by the way, for symptomatic cervicitis, need to be treated. The specific treatment method depends on different hospitals, but usually, acute inflammation can be treated with suppository medication, while chronic inflammation can be treated with physical therapy methods such as laser or freezing. Do you need regular checkups? Regular checkups of the cervix are necessary, and this is not to prevent celiac disease, but to prevent cervical cancer. Will it develop into cancer if not treated Cervical cancer is related to human papillomavirus (HPV) infection. Some so-called high-risk types of HPV are susceptible to precancerous changes and cervical cancer when they persist in the squamous-columnar junction area of the cervix. Cervical cancer has seen a dramatic decrease in mortality since the availability of pap smears, and the key is early prevention and treatment. It is now recommended that women after the age of 21 should have an annual cervical smear, after the age of 30, combined with HPV, and if 3 consecutive HPV and cervical smear tests are negative, the interval can be extended to 3-yearly tests, and screening can be stopped after the age of 65. Does it affect fertility Understanding that celiac disease is a physiological phenomenon means that it does not affect fertility.