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, we need to start from the education of doctors. In the unified textbook for Chinese medical students, Obstetrics and Gynecology, before 2008, celiac disease has always existed as a standard disease, and even talked about its clinical manifestations, diagnosis and treatment. But in fact, that was 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. In 2008, the 7th edition of the textbook of Obstetrics and Gynecology for undergraduates clearly stated in its preface that it should be in line with international standards and emphasize the updating of knowledge……. clinical diagnostic and therapeutic standards are constantly updated. 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 country should cancel the diagnosis of “cervical erosion”, 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 a lot of physicians in the diagnosis of “cervical erosion”. The answer to this question is “celiac disease”. Celiac disease, in the end, is actually a misperception of what used to be a normal manifestation of the cervix. The central part of the cervix, the part that looks a bit like “celiac disease”, is the appearance of the columnar epithelium that covers it, while the relatively smooth outer part of the cervix is the part of the cervix that is covered by squamous epithelial cells. Columnar epithelial cells and squamous epithelial cells are in a dynamic balance, somewhat similar to the stalemate zone in a war, this area is named “squamous column junction area” in medicine, this area is also the most common area of cervical cancer. The squamocolumnar junction area is easily affected by estrogen. Before puberty, the ovarian function is not perfect, and estrogen is low, the columnar epithelium will lean to the inner side, and after menstruation, the columnar epithelium will be affected by estrogen and develop more towards the outer side, so there will be more columnar epithelium similar to “vesiculation”, which is found at the cervical opening during the examination, and after menopause. 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 celiac disease is actually cervical ectropion. In the past medical textbooks, there is also the so-called graded diagnosis of cervical ectropion, called mild, moderate and severe, see Figure 4, that the size of the range of the degree of inflammation is 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 “celiac disease” that I mentioned earlier, the real mechanism, it is possible to understand the so-called “celiac disease”. If you understand the real mechanism of the so-called “cervical erosion” I mentioned earlier, it’s very easy to understand, this is actually 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. Understanding that celiac disease is a physiological phenomenon means that it does not affect fertility. The concept of celiac disease in China has changed since 2008, but many doctors still diagnose and treat celiac disease without understanding and learning about this new concept. It is typical to over-treat celiac disease with medication, infusion, and even LEEP and laser.