Years of misconceptions about “celiac disease”

  The term “cervical erosion”, a term used in obstetrics and gynecology, has been used to diagnose “chronic cervicitis” for more than 100 years, since 1850 until the 1980s. Cervical erosion has long been considered the most common sign of chronic cervicitis, but by cervical erosion we mean a bright red (smooth or granular) appearance of the vaginal area of the cervix without inflammatory changes such as interstitial edema, congestion, and infiltration of inflammatory cells in the area.  In the 1980s, American obstetrics and gynecology monographs and textbooks removed the term “cervical erosion” and replaced it with “cervical epithelial ectropion or displacement (cervical ectopy). In recent years, our textbooks on obstetrics and gynecology have also abandoned it and called it cervical ectopy, which is a physiological manifestation and does not require treatment. This physiological phenomenon lasts from female puberty to the next decades. Chronic cervicitis or endocervical ectocervix with infection is diagnosed only when the endocervical ectocervix is infected by pathogens with granular or papillary changes. Treatment is not necessary in cases of endocervical ectocervix without infection. Unfortunately, to date, a significant number of obstetricians and gynecologists in China continue to use the term “cervical erosion”, providing unnecessary treatment and causing harm to women who have “cervical erosion” but no cervical disease.  For decades, physiotherapy such as electro-ironing, laser and freezing have been advocated in China for moderate and severe cervical erosion. In recent years, LEEP (i.e. cervical electrosurgical loop excision) technology, which is used specifically for the treatment of cervical pre-cancerous lesions (CIN) in western developed countries, has also been used for the treatment of cervical erosion. Driven by economic interests, this treatment has a tendency to further expand, which is very worrying!  What are the dangers of treating “celiac disease”? First of all, the treatment of “celiac disease” is against medical ethics, as the woman being treated may not have cervical disease, and it is unethical to bring physical and mental burden and economic loss to the woman due to the treatment! Secondly, treatment without cervical screening may miss invasive cervical cancer or high grade precancerous lesions (CIN3/AIS), which is dangerous for women with the disease. In addition, the treatment may cause harm such as adhesions or atresia of the ectocervix, trauma leading to “cervical inflammation” or “cervical endometriosis” causing post-coital bleeding or prolonged leukorrhea, impaired cervical function leading to miscarriage or preterm delivery during pregnancy, post-operative The presence of cervical stenosis and scar tissue can affect the expansion of the cervix during labor and cause cervical obstructed labor, etc.