[professional term] Someone once translated this as “cervical erosion”, but unfortunately, you look through the authoritative foreign textbooks on obstetrics and gynecology, you actually can’t find the diagnosis of “cervical erosion”. Then look for wikipedia, automatically transferred to the “cervical ectropion” this word to go, it seems wikipedia is quite intelligent, know this chinenglish translation want to explain what the problem. What is Celiac Disease? Celiac Disease is a disease that has plagued many women, and when they go for a medical checkup, almost nine times out of ten, they will be diagnosed with Celiac Disease. To talk about celiac disease, we may 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”. So from that time onwards, the domestic should be canceled “cervical erosion” diagnosis, but due to the slow updating of the knowledge of many physicians, even in the undergraduate textbook revision of this diagnosis after five years, there are still many physicians in the diagnosis of “cervical erosion”. In the end, celiac disease is actually a misperception of a normal manifestation of the cervix. Pathophysiologic Mechanisms] So, let’s talk about why celiac disease has been wrongly recognized as an abnormal disease in the past. Look at the following schematic diagram, Figure 1 Schematic diagram of the cervix Normal Figure 1 is a coronal view of the area where the uterus and vagina are connected in the human body. If a gynecological examination is performed, the part of the cervix that the doctor can see from inside the vagina is the yellow part, which is the appearance of the cervix (Figure 3). On the part of the cervix, there are two different types of cells, as shown in Figure 2, the squamous epithelial cells (Squamous cells) near the vagina and the columnar epithelial cells (columnar cells) near the uterus in that direction. The two types of epithelium are different in appearance. Look at Figure 3 below, which shows the appearance of the cervix 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 a cervical ectropion. Figure 2 Structure of the cervix histologically Figure 3 Appearance of the normal cervix In the past medical textbooks, there was also the so-called graded diagnosis of cervical ectropion, which was called mild, moderate, and severe, see Figure 4, and it was believed that the size of the range was the degree of inflammation, with an area of less than 1/3 being mild, 1/3-2/3 being moderate, and more than 2/3 being severe, and that, if you understand what I mentioned earlier, so-called If you understand the real mechanism of the so-called “cervical erosion” that I mentioned earlier, it’s very easy to understand, this is in fact the degree of columnar epithelial ectropion after the influence of estrogen is different, are normal physiological phenomena. Figure 4 Cervical non-erosion, is the degree of columnar epithelial ectropion is different 【Clinical manifestations】 Normal physiological phenomenon, there is no special clinical manifestations. Some people may have contact bleeding, but it is only 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. 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, and 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. Specific treatment methods need to be determined by different hospitals, but usually, acute inflammation can be treated with suppository medication, and 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, not for the prevention of celiac disease, but for the prevention of cervical cancer. [Will it develop into cancer if left untreated] Cervical cancer is related to human papillomavirus (HPV) infection. Some of the so-called high-risk types of HPV are prone 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. Currently it is recommended that women after the age of 21 should undergo cervical scraping once a year, and after the age of 30, combined with HPV, if 3 consecutive HPV and cervical scraping tests are negative, the interval can be extended to once every 3 years, and screening can be discontinued after the age of 65. [Does it affect fertility?] Understanding that celiac disease is a physiological phenomenon means that it does not affect fertility. Why are so many hospitals still treating celiac disease? As I said before, the concept of celiac disease in China has been formally written into the teaching materials since 2008, but many doctors have not understood and learned this new concept, and are still diagnosing and treating celiac disease. What is infuriating in society now is that many unscrupulous hospitals use celiac disease as a signboard to attract patients to gynecological outpatient clinics, allowing healthy people to go to a celiac disease checkup, followed by medication, infusion, and even LEEP and laser, with thousands of thousands of dollars in treatment fees, making it a typical over-treatment method. We hope that more members of the public will realize this problem and avoid being over-treated.