Top questions about celiac disease

  Celiac disease is a term that has been around for a long time in the gynecological community. However, in the gynecological community, some experts now suggest that celiac disease may be a disease that has been misdiagnosed and treated for many years in the gynecological community, and with increased awareness, the gynecological community has come up with many new insights into celiac disease and is changing its diagnosis and treatment. However, many women, out of fear of cervical cancer, have become overly fearful of celiac disease and have serious misconceptions about it. What kind of condition is celiac disease? I hope this summary will be helpful to some non-obstetricians and gynecologists working in the field.  Is celiac disease a chronic inflammatory condition of the cervix?  Celiac disease has been in use in our country for many years. It has been considered chronic cervicitis since the early days of liberation and is considered a high risk factor for cervical cancer. The term “cervical erosion” was gradually eliminated from foreign textbooks and magazines as early as the late 1980s, but in our country it has been used clinically for so many years and has been treated as chronic cervicitis. The term “celiac disease” is no longer considered to be synonymous with chronic cervicitis. The occurrence of cervical erosion is related to hormonal changes in the body.  Are patients with celiac disease prone to develop cervical cancer?  Some media are currently promoting celiac disease as a high risk factor for cervical cancer. Many women with celiac disease are also concerned about the possibility of developing cervical cancer. New research also suggests that cervical cancer is an infectious carcinoma, that human papillomavirus (HPV) infection is strongly associated with the development of cervical cancer, and that the absence of HPV infection does not lead to cervical cancer. Does celiac disease increase the incidence of HPV infection and does it increase the incidence of cervical cancer? Does physical therapy for celiac disease prevent the development of cervical cancer? There are not a large number of evidence-based, prospective medical studies to confirm this. However, since some early cervical cancers or cervical intraepithelial neoplasia (CIN) may also present as celiac disease, the main thing to do for those with cervical celiac disease is to have regular cervical cytology screening and screening for HPV infection to exclude cervical cancer and CIN. Theoretically, simple cervical erosion is a physiological change in which the squamous epithelium of the cervix is replaced by columnar epithelium, rather than true cervical erosion. Cervical cancer, on the other hand, is an abnormal qualitative change in the squamous epithelium of the cervix, for which human papillomavirus (HPV) infection is the main cause. It is important to note that HPV infection is very common and most HPV infections go away on their own; only a small percentage of HPV infected patients will persist and eventually lead to the development of cervical cancer. It can be seen that the pathogenesis and pathogenic mechanisms of cervical erosion and cervical cancer are different, and the pathological changes are also different. Cervical erosion alone, if not combined with HPV infection, does not increase the incidence of cervical cancer and there is no direct relationship between the two.  Does cervical erosion need to be treated?  The need for treatment of celiac disease depends on the specific case. You cannot treat celiac disease as you see it, with medication douches, various physical treatments, or even leep removal of part of the cervix. Nor should all celiac disease be treated as a physiological change without treatment. It may be a physiological ectopic columnar epithelium, or ectopic columnar epithelium, but it can also be pathological, such as CIN, cervical cancer, or mucopurulent cervicitis of the cervix; in addition, with chlamydial infection, the cervix can also present with vesicular changes, often with mucopurulent discharge from the cervical canal. Pathological celiac disease is treated according to the disease, and the choice of treatment is based on the level of the lesion, the extent of the lesion, the patient’s age, marital status, follow-up conditions and technical equipment. For physiological celiac disease without symptoms, regular screening for cervical cancer can be performed and no special treatment is needed. For a few patients with physiological celiac-like changes, because the celiac surface is covered by columnar epithelium, some leucorrhea or bleeding after sexual intercourse may occur, and physical therapy can be used for these symptomatic patients. Currently, physiotherapy is commonly used in clinical practice, such as electro-ironing, laser, freezing, microwave, infrared, ultrasonic treatment and cervical circumferential electrosurgery.