CELIJAKIJA – NEDOVOLJNO PREPOZNAT JAVNOZDRAVSTVENI PROBLEM

Marcela Marčec, Nataša Antoljak, Tomislav Benjak

Celijakija je kronična autoimunosna bolest karakterizirana nepodnošljivošću glutena. Klinička slika obuhvaća nekoliko tipova bolesti i simptome različitih organskih sustava. Prevalencija je u porastu, a ne provodi se masovni probir. Zlatni standard dijagnoze jesu biopsija sluznice tankog crijeva i određivanje serumskih antitijela, ali često se celijakija ne dijagnosticira na vrijeme te se pacijenti vode pod drugim dijagnozama, što povećava učestalost komplikacija bolesti, hospitalizacija, invaliditeta i troškova liječenja. Kvaliteta života pacijenata smanjena je. Liječenje obuhvaća uvođenje bezglutenske prehrane i njezino kontinuirano pridržavanje. U Hrvatskoj je u 2015. evidentirano nekoliko tisuća oboljelih od celijakije, a na listama HZZO-a postoji bezglutensko brašno za pacijente s dokazanom celijakijom. Troškovi liječenja iznose do nekoliko milijuna kuna, no niži su nego troškovi prije postavljanja dijagnoze ove bolesti. Zaključno, celijakija je neprepoznat rastući globalni javnozdravstveni problem te bi radi boljeg nadzora, pravodobne dijagnoze i prikladnog liječenja trebalo podizati svijest o ovoj bolesti.

Celiac disease is a chronic autoimmune disease characterized by gluten intolerance. Clinical presentation includes several clinical types of the disease and symptoms of various organ systems. The prevalence of the disease is rising and there is no mass screening. Gold standard in diagnostics are small intestinal mucosal biopsy and determination of specific serum antibodies, although most patients are not diagnosed on time and have the wrong diagnosis which increases the frequency of complications, number of hospitalizations, disability and expenses. The quality of life is also reduced. The treatment is gluten-free diet and continuous adherence to it. In Croatia in 2015 there were several thousand patients registered with the diagnosis of celiac disease. On the Croatian Health Insurance Fund lists there is gluten-free flour available for diagnosed patients. Total therapy expenses rise up to several million kuna but they are still smaller than expenses before making the right diagnosis. In conclusion it can be said that celiac disease is not yet recognized as a global public health burden that is rising in its importance. The main goal should be raising the awareness about this disease for better supervision and timely diagnosis and treatment.