The year is 2005. A university professor Flavia Anastacio de Paula deals with a scene that become routine. His middle son, Emilio ,with only two years, sem stop vomiting for hours. Under weight, with chronic constipation, hyperactivity crises, frequent pneumonia, severe pain in the legs and weight and height much lower than indicated. Emilio began to get sick when he was only six months old. At época, Flavia began a Via Crucis: find out what the child's illness. In four years he passed over 15 different doctors, dozens of clinical and laboratory examinations and regular hospital admissions. In September 2007, at four, Emilio was finally diagnosed: he was bearer of celiac disease.
Celiac disease
Still unknown by the majority, disease characterized by intolerance to the gluten, a protein found in wheat, barley, oats and rye. The first global survey of the disease, released in late July, indicates that it causes death near 42.000 children every year in the world. In an interview with the SEE site, Peter Byass, Epidemiologist coordinator of the study that met the department of public health and clinical medicine at the University of Umea, Sweden, and Health of the University of Witwatersrand, na África do Sul, estimates that in Brazil 200 children die every year due to this evil.
Some international studies even claim that one in 100 people in the world being a carrier of the disease; others, More than half of these people do not know they are sick. In Brazil, little is known about the incidence of the disease, already missing national surveys. Data from a survey of the Federal University of São Paulo, held in 2007, point out that 1 each 214 Brazilians have the disease. Data on celiac disease are few, scattered and often outdated.
The danger of gluten:
Coeliac disease was discovered in 1888 by British pediatrician Samuel Gee. In the decade of 1940 Gluten has been recognized as the cause of the disorder villain. During periods of food shortages War, the Dutch physician Willem Karel Dicke noted that the lack of bread and wheat-based products reduced the number of cases, linking the protein and eventually to disease. Dicke would create, still in early 1950, the first gluten free diet for patients with celiac disease.
De lá the cá, some important steps were taken to control the problem, as the resolution of symptoms (chronic diarrhea, abdominal swelling, anemia and vomiting) and the appointment of a food treatment. But, even if it is a known evil, studied, with treatment and tests for the diagnosis established, celiac disease remains silent and hidden in most patients.
Difficulties:
Cases like Emilio are a minority, but are far from it is an exception. Although gluten intolerance appear milder usual way in most cases, 20% have extreme symptoms of celiac, Miranda Sipahi segundo Aytan, Coordinator of Clinical Gastroenterology Laboratory and Experimental USP. Others may have only one symptom, as migraine, thrush and flatulence. Because it is not as severe or alarming, end up making diagnosis difficult. That is why, Celiac disease is usually represented as an iceberg. At the tip are patients like Emilio, his mother and his two brothers: persons suffering, is very, with the condition. Throughout the rest of the huge mass of ice, patients would be like Rachel Benati.
The art teacher, today 48 years, It took two decades to receive the diagnosis of disease. “Os médicos não investigavam a doença celíaca, because only detected anemia. I even had any diarrhea crisis, mas a constância maior era das prisões de ventre”, says. Today, Raquel is vice president of the Rio de Janeiro branch of the Celiac Association of Brazil (Acelbra) and secretary of the National Federation of Celiac Associations of Brazil (Fenacelbra), which has about 20.000 associated. Your job is to guide institutions in the celiac and help raise awareness.
“Os médicos relutam em fazer o diagnóstico, especially when you do not have classical picture. Conheço muita gente que foi até o consultório especificamente pedir para fazer o exame.”
Diagnosis and complications:
Research to complete the diagnosis usually follows three steps: family history of the disease, blood test and biopsy of the small intestine by endoscopy. Because genetic, the disease may be present in one or more members of the family. Serologic testing of blood, in turn, designed to detect disease antigens. When this blood test gives positive, It is made intestine endoscopy with biopsies. This test finally, It is considered definitive for a diagnosis. Nessa fase se procura saber se as vilosidades da mucosa intestinal foram agredidas e atrofiadas – uma característica da intolerância ao glúten.
Family history alone is not enough to detect the disease. To know for sure, only after examination of blood combined with biopsy.
Even in milder cases, detection is critical. Complications of the disease can lead to problems like osteoporosis, autoimmune diseases, lymphoma and other cancers and thyroid problems. “Há ainda casos em que a pessoa fica infértil ou pode ter abortos repetidos”, says Vera. This is because exposure to gluten causes the immune system to work always above its limit. It causes the immune cells to proliferate. Essa hiperatividade pode acabar resultando em linfoma – que é justamente uma proliferação exagerada das células de defesa. The reason this happens is not yet known in medicine.
Complicated diet:
According to Vera Lucia Sdepanian, residence course coordinator in pediatric gastroenterology Unifesp, a gluten free diet is only indicated after positive diagnosis. Otherwise it can hamper disease recognition process. “Quando se para de comer glúten, the antigens are no longer detected in the blood test and intestinal villi will return to normal after six months. Like this, no examination will be positive for the disease, mesmo que a pessoa seja intolerante.”
” A rigor não existe problema em uma dieta sem glúten. The protein is not essential in the human diet, according to nutritionists. The only major difficulty is precisely the great food restriction, since most of the processed food contains the ingredient. “
Gluten is present in almost all!
Não é fácil fazer uma dieta sem glúten”, diz John Cangemi, gastroenterologist specialist at the Mayo Clinic disease, US us. “Trigo, barley and rye are components of many types of food, and is part of drugs, sweets and other products. One can, simply, não se dar conta da presença deles.” Vários outros alimentos além dos pães contêm a proteína, as beer, cheeses, canned pates, inlaid, mayonnaise, ketchup and some industrialized spices. Chocolate theoretically has no gluten, mas como é feito na mesma esteira das bolachas – e corre risco de contaminação – é vendido com o selo It contains gluten.
“O paciente terá de conviver com muitas limitações alimentares, mas uma boa orientação nutricional pode tornar sua vida mais simples”, says André Zonetti de Arruda Leite, Medical Assistant Clinical Gastroenterology discipline of gastroenterology department of FMUSP.
If you read this report by the end, Share with your friends!!! It is important to pass this so that as many people read and see that gluten is no freshness. Thousands of people are dying of Celiac Disease, while our friends giggle when we say intolerant.