Cervical erosion is a frequent and common disease in women The literature reports that its incidence is as high as 40% to 60% in married women of childbearing age. The female cervix is divided into an internal and an external opening. The endocervical epithelium is a slender, mucus-secreting red columnar cell, and the exocervix is covered by a grayish-yellow squamous epithelium. Under the influence of certain factors such as estrogen, the squamous epithelium of the outer opening of the cervix is covered by columnar epithelium and celiac disease is formed. Under the colposcopic observation of the surface of the celiac disease, it is actually a complete columnar epithelium, because the columnar epithelium is a single layer, and the mesenchymal stroma underneath it is red, so it is observed by the naked eye as a red celiac-like. So celiac disease is not a disease, and can even say that the more celiac disease, the healthier. Celiac disease is not really celiac disease Compared with the normal smooth cervix, it just intuitively feels like celiac disease. This change is related to the displacement of the cervical squamous and columnar epithelial junction. The cervical “erosion” observed colposcopically is an area of squamous-columnar junctional transformation. The reason why many women are so afraid of this disease is largely because they are frightened by the word “celiac disease”. Celiac disease is often asymptomatic, and many women are accidentally found to have celiac disease during a normal medical checkup without any previous symptoms. Why is this? This is because celiac disease itself is not an inflammatory disease, that is, it is not a pathological sense of epithelial loss and inflammatory reaction, but the cervical columnar epithelium is ectopic, is one of the physiological changes of the cervix, not a pathological change. When there is no pathogenic microbial infection, i.e., when there is no inflammation, patients with celiac disease may have no clinical symptoms, or only show increased secretions. Some patients may have bloody leukorrhea or bleeding after intercourse. Of course, there are some patients with more severe symptoms, in addition to abnormal leukorrhea, there may also be back pain, vulvar and vaginal itching and other symptoms. However, this is not due to celiac disease itself, but mostly due to the combined inflammatory infections. Sex is not the direct cause of celiac disease Some people believe that celiac disease is caused by sex, so once diagnosed with celiac disease, they are quite rejected to have sex. In fact, this view is wrong. At present, the real etiology of cervical celiac disease is still not clear, it is generally believed that mechanical stimulation or injury after marriage, such as childbirth, abortion or too frequent sex life, can cause different degrees of cervical squamous epithelial destruction, cervical local resistance is reduced, easy to cause cervical inflammation. However, clinical findings, no sex life of women, there is still cervical erosion, sometimes even severe erosion. This shows that sexual life is not the culprit that leads to celiac disease. At the same time, experts remind unmarried, or sexually inactive women, if there is a persistent increase in leukorrhea, or accompanied by changes in color and texture, should also be timely to the gynecological clinic, in order to identify the cause, timely treatment. Celiac disease does not necessarily lead to infertility In the past, it was believed that celiac disease is often accompanied by inflammation, and the inflammatory cells will phagocytosis of sperm, but also lead to a change in the nature of cervical mucus, which prevents sperm from penetrating the cervical mucus to reach the uterine cavity. As the sperm cannot reach the uterine cavity successfully, it naturally fails to meet the egg, and conception is not possible. However, it is now found that in more young women, celiac disease is only a change in the type of cervical epithelial cells and is not associated with an inflammatory infection, and therefore does not lead to infertility. For women who are ready to get pregnant, if celiac disease is not accompanied by any symptoms, fertility experts recommend that they should actively try to get pregnant without rushing to do much treatment for celiac disease. If there is excessive leukorrhea or yellowing of the leukorrhea that is causing discomfort, it can be treated with appropriate medication and pregnancy can be attempted after the symptoms improve. Celiac disease has nothing to do with cancer Many women with celiac disease are worried about cervical cancer, believing that the heavier and longer the celiac disease is, the more likely it is to develop cervical cancer. Theoretically, cervical erosion is a physiological change, i.e., it is caused by the replacement of the squamous epithelium of the cervix by the columnar epithelium, rather than true erosion. Cervical cancer, on the other hand, is an abnormal change in the squamous epithelium of the cervix, mainly due to human papillomavirus (HPV) infection. The two have different causes and pathogenesis, and different pathologic changes. Therefore, simple cervical erosion, if not combined with HPV infection, does not lead to cervical cancer. However, women with celiac disease should be reminded that during gynecological examination, cervical exfoliative cytology should be performed to preliminarily exclude the possibility of cervical cancer. Because it is difficult to distinguish early cervical cancer from celiac disease during gynecological examination alone. If possible, HPV test should be performed at the same time of cervical exfoliative cytology to exclude the possibility of cervical cancer and precancerous lesions. Is vaginal douching helpful in treating celiac disease? The surface of female vaginal mucosa is squamous epithelium, which is affected by female sex hormones and undergoes cyclic shedding, which has a protective effect. At the same time, squamous epithelial cells can secrete glycogen, which is broken down into lactic acid by the lactobacillus bacteria parasitized in the vagina, thus maintaining an acidic environment in the vagina and inhibiting the growth and reproduction of bacteria. Under normal circumstances, it is not recommended that women do excessive vaginal douching, which is not beneficial to maintaining the acidic environment of the vagina, but will lead to bacterial imbalance, which can lead to vaginal inflammation. Celiac disease is not caused by bacterial infection, if the application of disinfectant, antiseptic, antipruritic, anti-inflammatory type of lotion to douche the vagina, may destroy the vagina’s own protective barrier, not only is not beneficial to the celiac disease, but also may result in secondary infection of the vagina. Therefore, if celiac disease is not accompanied by vaginal inflammation, do not advocate the application of local vaginal douche. Can celiac disease be cured? At present, the most widely used methods for treating celiac disease in China are medication and physical therapy. It is often believed that physical therapy can cure celiac disease in one go. In fact, in the absence of a clear cause, no matter what kind of conservative treatment, it is impossible to completely cure celiac disease. Clinically, it is often encountered that after physical therapy for celiac disease, the eroded area becomes smooth (columnar epithelium is replaced by squamous epithelium), but after a period of time, celiac disease reappears. The reason for this is that no matter whether you apply microwave, ironing, laser or freezing methods, the principle is to destroy the columnar epithelium on the surface of the erosion, so that it is necrotic, scabbing off, and the newborn squamous epithelium grows in to achieve a “cure”. If the real cause of the disease is not removed, celiac disease may occur again. Should I treat my celiac disease or not? In recent years, there have been some new ideas in the academic world about the treatment of celiac disease. When there is no pathogenic microbial infection, celiac disease may have no clinical symptoms, or only show increased secretions, and does not need to be treated. (1) <30 years old, for simple, superficial celiac disease is mostly physiological changes, do not need special treatment. < span=""> (2) >30 years old, or granular erosion, asymmetric erosion, with contact bleeding, cervical hardness is different, should be cervical lesion three-step screening, except cervical lesions. (3) Granular or papillary erosion should be treated if combined with inflammatory symptoms such as increased leukorrhea and vulvovaginal itching. If cervical cancer is excluded, physiotherapy is often advocated. (4) There are many methods of physical therapy, but the principle of treatment is the same and the efficacy is similar. The key is to grasp the correct indications, standardize the operation and pay attention to the treatment period. Does physiotherapy have any effect on pregnancy and delivery in the future? Treatment with physical methods such as laser may cause slight damage to the cervix, which may affect the dilatability of the cervix during labor and delivery in the future. It is best to go to the hospital for a checkup before you plan to get pregnant. If the celiac disease does not affect your pregnancy or is not associated with an acute infection, you can get pregnant first, and then undergo 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, physical therapy 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 celiac disease, so physical therapy will not lead to the narrowing of the cervical opening, and will not cause infertility. The treatment of “cervical erosion” is contrary to medical ethics Over the past few decades, the domestic cervical erosion of moderate and severe advocate for ironing, laser, freezing and other physical therapy. In recent years, the LEEP (Laparoscopic Electrosurgical Excision of the Uterine Cervix), which is specially used for the treatment of pre-cancerous cervical lesions in western developed countries, has also been used for the treatment of cervical erosion. It is worth mentioning that, driven by economic interests, this treatment has a tendency to expand further, which is very worrying! What are the dangers of treating “celiac disease”? First of all, the treatment of the so-called “cervical erosion” is against medical ethics, as the treated women may not have cervical diseases, and it is unethical to increase the physical and mental burden of the women and their financial losses! Some unethical hospitals and doctors seize the patients’ fear of cervical erosion and violate the “three-step principle” by doing colposcopy without cervical TCT and then holding enlarged pictures of the so-called “cervical erosion” to scare the patients, and some patients who have been infected with cervical erosion have to be treated in the same way as those who have been infected with cervical erosion. Some patients who fall into the trap are given either intravenous fluids for anti-inflammatory treatment or local douching or even physiotherapy according to their suggestions, which is actually spending money to cure their health, not to mention suffering; secondly, treatment without cervical screening may miss invasive cancer of the cervix or high-grade pre-cancerous lesions, which is dangerous for the women being treated. In addition, treatment may cause other harms, such as: adhesion or atresia of the external cervical os causing obstruction of menstrual blood drainage, trauma leading to long-term inflammatory reaction of the cervix or endometriosis of the cervix, causing post-coital hemorrhage or bloody leukorrhea, and impaired cervical function leading to miscarriage or preterm labor during pregnancy. Cervical cancer has been recognized for more than 200 years and is the most common malignant tumor in underdeveloped countries and regions. In most areas of China, due to limited medical conditions, clinicians are accustomed to judge whether the cervix is diseased or not by visual observation only, but only a few invasive carcinomas of the cervix can be recognized by the naked eye. Some smooth cervixes may have hidden lesions inside the cervical canal, and it is usually difficult to determine whether there is cervical disease only by visual observation. Invasive carcinoma of the uterine cervix originates from the squamous or glandular epithelium of the cervix. The early stage of its natural history is a persistent infection with high-grade HPV, leading to a slow disruption of the maturation and differentiation process of the epithelium in the migratory zone of the cervix, and this early stage is known as precancerous cervical lesions (≥CIN II/AIS). The primary method of screening the cervix is cervical cytology, and the secondary method is high-risk HPV DNA testing. The routine diagnosis of invasive carcinoma of the cervix and its high-grade precancerous lesions is based on the “three-step technique”, i.e., cervical cytology, colposcopy, and histopathology. There is only one strategy for treating high-grade precancerous lesions: excision of the entire lesion.