Скачать или смотреть The Microscopic Fingers That Feed You (Celiac Disease Destroys Them)

This magnified cross-section reveals intestinal villi—millions of tiny finger-like projections (0.5-1.6mm tall) covering the small intestine's inner surface, visible here as wave-like structures with detailed cellular architecture. Each villus is covered with absorptive cells (enterocytes) and contains a central lacteal (lymph vessel) and blood capillaries. Villi increase the intestinal surface area from 30 square feet to 2,700 square feet (a tennis court), enabling 95% nutrient absorption. In celiac disease, gluten triggers immune destruction of villi (villous atrophy), reducing absorption by 50-90% and requiring lifetime gluten-free diet costing $1,500-$3,000 extra yearly, plus $5,000-$15,000 in medical care if undiagnosed.
This video explains:

Villi anatomy: finger-like projections 0.5-1.6mm tall, covered with enterocytes (absorptive cells), each enterocyte has 1,000+ microvilli (brush border), central lacteal for fat absorption, blood capillaries for nutrient transport

Who gets celiac: 1% of population (3 million Americans), genetic component (HLA-DQ2 or HLA-DQ8 genes), can develop at any age
Symptoms: classic—chronic diarrhea, weight loss, bloating, abdominal pain; atypical—anemia, osteoporosis, infertility, short stature in children, neurological symptoms, dermatitis herpetiformis (itchy skin rash)
Silent celiac: 50-60% have minimal or no GI symptoms, discovered through screening or complications
Diagnostic journey: average 6-10 years from symptoms to diagnosis, costs $10,000-$20,000 in failed treatments and testing during delay
Diagnostic costs: celiac antibody panel (tTG-IgA, total IgA, $100-$300), genetic testing ($200-$400), upper endoscopy with small bowel biopsies ($2,000-$5,000 gold standard), must be eating gluten for accurate results
Villous atrophy classification: Marsh 1 (infiltration), Marsh 2 (crypt hyperplasia), Marsh 3a-c (progressive villous atrophy)
Treatment: 100% gluten-free diet for life, no medications cure celiac
Gluten-free diet costs: specialty products cost 200-300% more than regular, adds $1,500-$3,000 yearly to grocery bills, cross-contamination risks requiring vigilance
Nutritional supplementation: iron ($50-$200/year), calcium/vitamin D ($100-$300/year), B vitamins ($50-$150/year), others as needed
Follow-up costs: repeat endoscopy to confirm healing ($2,000-$5,000), annual labs ($200-$500), dietitian consultations ($200-$600)
Complications if untreated: osteoporosis (bone density scans $100-$300, treatment $1,000-$5,000/year), anemia (iron infusions $500-$2,000), small bowel lymphoma (300x increased risk, treatment $100,000-$300,000), infertility treatment ($5,000-$30,000), neurological damage
Refractory celiac disease: 1-2% don't heal on gluten-free diet, may need immunosuppressants ($5,000-$20,000/year) or experimental treatments
Other causes of villous atrophy: tropical sprue, Crohn's disease, infections, medications (NSAIDs), autoimmune enteropathy, requiring different treatments
Dermatitis herpetiformis: celiac skin manifestation, intensely itchy blisters, 90% have villous atrophy even without GI symptoms
Cross-contamination issues: 20 parts per million gluten threshold, dining out challenges, dedicated kitchen equipment needed

Over 80% of celiac patients remain undiagnosed (2.4 million undiagnosed Americans). Screening is recommended for first-degree relatives (10-15% risk), people with autoimmune diseases, unexplained anemia, or persistent GI symptoms. Early diagnosis prevents complications costing tens of thousands.
MEDICAL DISCLAIMER:
Educational content about intestinal villi and celiac disease. This does not constitute medical advice. Never start a gluten-free diet before testing—this makes diagnosis impossible and delays proper treatment. Celiac disease requires formal diagnosis through antibody testing AND endoscopic biopsy while eating gluten. Not all villous atrophy is celiac—other conditions require different treatments. Gluten sensitivity (non-celiac gluten sensitivity) is different from celiac disease and doesn't cause villous atrophy or long-term complications. Self-diagnosis based on symptom improvement on gluten-free diet is unreliable. If celiac is suspected, see gastroenterologist for proper testing. Gluten-free diet is medical treatment for celiac disease, not a lifestyle choice—strict adherence prevents serious complications. Family members should be screened due to genetic component.
SOURCES:

Celiac Disease Foundation clinical guidelines
American College of Gastroenterology celiac disease guidelines
Villous atrophy pathophysiology research
Celiac disease diagnosis and management studies
Gluten-free diet cost analyses

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"Millions of microscopic villi line your intestines, absorbing nutrients. Celiac disease destroys them, causing malabsorption despite normal eating. Diagnosis averages 6-10 years and costs $10,000-$20,000 in failed treatments. Here's the anatomy that 80% of celiac patients don't know is damaged.