Jsou to trochu \u0161okuj\u00edc\u00ed \u00fadaje. U dosp\u011bl\u00fdch trv\u00e1 v pr\u016fm\u011bru osm a\u017e dvan\u00e1ct let, ne\u017e se celiakie projev\u00ed \u010diteln\u00fdmi p\u0159\u00edznaky a ne\u017e ji l\u00e9ka\u0159i pacientovi p\u0159esn\u011b diagnostikuj\u00ed. Tahle nemoc je toti\u017e z\u00e1ludn\u00fd chamele\u00f3n.<\/p>\n
\u010cast\u00fdmi p\u0159\u00edznaky b\u00fdv\u00e1 t\u0159eba to, \u017ee posti\u017een\u00fd \u010dlov\u011bk trp\u00ed pocity nevolnosti a c\u00edt\u00ed se unaven\u00fd. Tak\u00e9 ho mohou tr\u00e1pit bolesti b\u0159icha, opakovan\u00e9 pr\u016fjmy, bolesti kost\u00ed, svalov\u00e9 k\u0159e\u010de, celkov\u00e1 slabost, podr\u00e1\u017ed\u011bnost, pla\u010dtivost a tak d\u00e1l. M\u00e9n\u011b b\u011b\u017en\u00e9 p\u0159\u00edznaky jsou z\u00e1cpa, zvracen\u00ed, plynatost, ko\u017en\u00ed vyr\u00e1\u017eka, porucha r\u016fstu, deprese, \u0159\u00eddnut\u00ed kost\u00ed, zv\u00fd\u0161en\u00e1 kazivost chrupu, neplodnost, vypad\u00e1v\u00e1n\u00ed vlas\u016f aj.
\nUveden\u00e9 p\u0159\u00edznaky se objevuj\u00ed v r\u016fzn\u00fdch kombinac\u00edch a intenzit\u011b. N\u011bkdy se prom\u011b\u0148uj\u00ed i podle toho, jak se nemoc vyv\u00edj\u00ed. Jinak se choroba projevuje ve stadiu akutn\u00edho vzplanut\u00ed, ve f\u00e1zi bez p\u0159\u00edznak\u016f, ve zklidn\u011bn\u00e9m obdob\u00ed, nebo ve f\u00e1zi potencion\u00e1ln\u00edho sklonu k t\u00e9to poru\u0161e. Jinak se m\u016f\u017ee hl\u00e1sit u d\u011bt\u00ed a jinak u dosp\u011bl\u00fdch.<\/p>\n
„V ka\u017ed\u00e9m p\u0159\u00edpad\u011b jde o autoimunitn\u00ed chorobu, kterou u lid\u00ed s d\u011bdi\u010dnou dispozic\u00ed vyvol\u00e1v\u00e1 lepek,“ vysv\u011btlil gastroenterolog doc. MUDr. Pavel Kohout CSc. „U \u010dlov\u011bka, kter\u00fd onemocn\u00ed celiaki\u00ed, zp\u016fsob\u00ed lepek z\u00e1n\u011bt v tenk\u00e9m st\u0159ev\u011b, n\u00e1sledn\u011b i poruchu tr\u00e1ven\u00ed a vst\u0159eb\u00e1v\u00e1n\u00ed. Naru\u0161\u00ed rovn\u011b\u017e dal\u0161\u00ed funkce st\u0159eva a postupem \u010dasu dojde na jeho sliznici k nevratn\u00fdm zm\u011bn\u00e1m.“
\nNemoc m\u016f\u017ee vyvolat chudokrevnost, \u00fanavu a bolesti kloub\u016f, ale tak\u00e9 osteopor\u00f3zu (\u0159\u00eddnut\u00ed kost\u00ed). N\u011bkdy zp\u016fsob\u00ed i pot\u00ed\u017ee s ot\u011bhotn\u011bn\u00edm. Celiakii ob\u010das doprov\u00e1z\u00ed cukrovka nebo onemocn\u011bn\u00ed \u0161t\u00edtn\u00e9 \u017el\u00e1zy, zvy\u0161uje v\u0161ak i riziko vzniku zhoubn\u00fdch n\u00e1dor\u016f. Tak\u00e9 proto je d\u016fle\u017eit\u00e9, aby ji l\u00e9ka\u0159i zachytili a l\u00e9\u010dili v\u010das.<\/p>\n
U n\u011bkoho se choroba projev\u00ed u\u017e v d\u011btstv\u00ed, u jin\u00e9ho a\u017e v dosp\u011blosti. U d\u011bt\u00ed trv\u00e1 diagn\u00f3za obvykle krat\u0161\u00ed dobu ne\u017e on\u011bch zm\u00edn\u011bn\u00fdch osm (u \u017een) nebo dvan\u00e1ct let (u mu\u017e\u016f). \u017deny postihuje nemoc dvakr\u00e1t \u010dast\u011bji ne\u017e mu\u017ee.
\n„Dnes se celiakie zji\u0161\u0165uje pomoc\u00ed testu na ur\u010dit\u00e9 protil\u00e1tky,“ \u0159ekl docent Kohout. „Dom\u00e1c\u00ed testy jsou jenom orienta\u010dn\u00ed, skute\u010dn\u011b spolehliv\u00fd test pat\u0159\u00ed do rukou l\u00e9ka\u0159e, kter\u00fd ho pos\u00edl\u00e1 na vyhodnocen\u00ed do akreditovan\u00e9 laborato\u0159e. Nav\u00edc se v\u00fdsledek obvykle potvrzuje je\u0161t\u011b odebr\u00e1n\u00edm vzorku tk\u00e1n\u011b z tenk\u00e9ho st\u0159eva p\u0159i gastroskopii, u mal\u00fdch d\u011bt\u00ed pak pomoc\u00ed speci\u00e1ln\u00ed kapsle, kterou l\u00e9ka\u0159i zavedou do tenk\u00e9ho st\u0159eva.“<\/p>\n
Dieta jako l\u00e9\u010dba<\/p>\n
Aby to v\u0161echno bylo je\u0161t\u011b v\u00edc zamotan\u00e9, celiakie zdaleka nen\u00ed jedinou formou nesn\u00e1\u0161enlivosti lepku. Existuj\u00ed i dal\u0161\u00ed varianty t\u00e9to poruchy: imunitn\u00ed, autoimunitn\u00ed, alergick\u00e9 atd. Odborn\u00edci odhaduj\u00ed, \u017ee v \u010cR tr\u00e1p\u00ed kolem 50 000 lid\u00ed.
\nPrakticky jedin\u00fd zp\u016fsob, jak nemoc l\u00e9\u010dit, je bezlepkov\u00e1 dieta. Tedy j\u00eddeln\u00ed\u010dek, ve kter\u00e9m pacient vylou\u010d\u00ed v\u0161echny potraviny obsahuj\u00edc\u00ed tuto b\u00edlkovinu. Je v p\u0161enici, \u017eitu, je\u010dmeni, p\u0159\u00edpadn\u011b v ovsu a v\u00fdrobc\u00edch z t\u011bchto druh\u016f obil\u00ed. Posti\u017een\u00fd \u010dlov\u011bk si mus\u00ed d\u00e1vat pozor tak\u00e9 na uzeniny, pa\u0161tiky, konzervy a v\u00fdrobky z mlet\u00e9ho masa. Stejn\u011b jako na pol\u00e9vky, om\u00e1\u010dky, ke\u010dupy, majon\u00e9zy, dresinky, ho\u0159\u010dice, masoxy, s\u00f3jov\u00e9 om\u00e1\u010dky, kyp\u0159ic\u00ed pr\u00e1\u0161ky, pudinky, cukrovinky, jogurty, taven\u00e9 s\u00fdry, r\u016fzn\u00e9 dezerty a tak d\u00e1l. Mohou toti\u017e obsahovat p\u0159\u00edm\u011bs mouky, strouhanky nebo \u0161krob s lepkem.
\nNevhodn\u00e9 je rovn\u011b\u017e pivo, k jeho\u017e v\u00fdrob\u011b se pou\u017e\u00edv\u00e1 slad z obil\u00ed. Pokud si ov\u0161em nekoup\u00ed to speci\u00e1ln\u00ed, ur\u010den\u00e9 celiak\u016fm, ve kter\u00e9m lepek nen\u00ed.<\/p>\n
Probl\u00e9m je, \u017ee producenti potravin b\u011b\u017en\u011b neuv\u00e1d\u011bj\u00ed na obalech sv\u00fdch v\u00fdrobk\u016f \u00fadaje o obsahu lepku. Spolehliv\u00fdm vod\u00edtkem je pouze n\u00e1pis: Bez lepku. Pokud na sob\u011b maj\u00ed zna\u010dku s p\u0159e\u0161krtnut\u00fdm klasem, je to slo\u017eit\u011bj\u0161\u00ed, v n\u011bkter\u00fdch p\u0159\u00edpadech jde o kvalitn\u00ed v\u00fdrobek, v jin\u00fdch bohu\u017eel o zneu\u017eit\u00ed zna\u010dky. Bezlepkov\u00e9 potraviny b\u00fdvaj\u00ed dra\u017e\u0161\u00ed ne\u017e ty b\u011b\u017en\u00e9, n\u011bkter\u00e9 a\u017e osmkr\u00e1t. Nav\u00edc, pokud pacient konzumuje jenom v\u00fdrobky ozna\u010den\u00e9 jako bezlepkov\u00e9, snadno se vystav\u00ed riziku trochu jednostrann\u00e9ho a m\u00e1lo pestr\u00e9ho j\u00eddeln\u00ed\u010dku. Tyto potraviny mohou n\u011bkdy obsahovat mal\u00e9 mno\u017estv\u00ed lepku: a\u017e do 20 mg na kilo. Celiak\u016fm to obvykle nevad\u00ed, ale vad\u00ed to lidem alergick\u00fdm na lepek.<\/p>\n
M\u00f3da v USA<\/p>\n
Velkou m\u00f3dou, zejm\u00e9na v USA, se stala dieta, kter\u00e1 se sna\u017e\u00ed vylou\u010dit nebo aspo\u0148 v\u00fdrazn\u011b omezit konzumaci potravin obsahuj\u00edc\u00edch lepek. Nen\u00ed ur\u010den\u00e1 celiak\u016fm, ale lidem, kte\u0159\u00ed se cht\u011bj\u00ed dob\u0159e c\u00edtit, zhubnout a m\u00edt lep\u0161\u00ed kondici. Stravuje se tak podle n\u011bkter\u00fdch odhad\u016f a\u017e \u010dtvrtina Ameri\u010dan\u016f.
\nNejv\u00edc ji zpopularizoval tenista Novak Djokovi\u010d. Tomu p\u0159ed \u0161esti roky znep\u0159\u00edjem\u0148ovaly \u017eivot zdravotn\u00ed probl\u00e9my, d\u00edky kter\u00fdm m\u011bl probl\u00e9m odehr\u00e1t cel\u00fd turnaj. Negativn\u011b ovliv\u0148ovaly jeho tenisov\u00e9 v\u00fdkony a psychickou pohodu. Tenista je p\u0159i\u010d\u00edtal astmatu.
\nPodle nutri\u010dn\u00edho specialisty doktora Igora Cetkovi\u010de v\u0161ak \u0161lo o nesn\u00e1\u0161enlivost lepku, kter\u00fd ho dr\u00e1\u017edil, a tak\u00e9 o zv\u00fd\u0161enou citlivost na ml\u00e9\u010dn\u00e9 v\u00fdrobky. Kdy\u017e tenista zm\u011bnil j\u00eddeln\u00ed\u010dek a v\u00fdrazn\u011b omezil potraviny obsahuj\u00edc\u00ed lepek, l\u00e9pe se c\u00edtil a byl na kurtu rychlej\u0161\u00ed. Ale tak\u00e9 d\u0159\u00edv regeneroval a l\u00e9pe se soust\u0159edil. B\u011bhem jednoho roku se stal sv\u011btovou jedni\u010dkou. Sv\u00e9 zku\u0161enosti popsal v knize Naserv\u00edrujte si v\u00edt\u011bzstv\u00ed, kter\u00e1 se stala bestsellerem.<\/p>\n
Zdrav\u00e9mu lepek ne\u0161kod\u00ed<\/p>\n
Djokovi\u010de pak napodobovala \u0159ada sportovc\u016f, kte\u0159\u00ed cht\u011bli zm\u00edrnit sv\u00e9 tr\u00e1vic\u00ed obt\u00ed\u017ee a zv\u00fd\u0161it svou v\u00fdkonnost. To, \u017ee se n\u011bkte\u0159\u00ed z nich l\u00e9pe c\u00edtili, p\u0159\u00edpadn\u011b dosahovali lep\u0161\u00edch v\u00fdsledk\u016f, pak p\u0159ipisovali pr\u00e1v\u011b vylou\u010den\u00ed lepku ze stravy.
\nPodobn\u00e9 efekty popisovala tak\u00e9 \u0159ada oby\u010dejn\u00fdch lid\u00ed. „Je pot\u0159eba zd\u016fraznit, \u017ee se jedn\u00e1 o subjektivn\u00ed pocity a subjektivn\u00ed z\u00e1v\u011bry sportovc\u016f i jejich v\u00fd\u017eivov\u00fdch poradc\u016f,“ upozornil docent Kohout. „Nikoliv o z\u00e1v\u011bry, kter\u00e9 by byly potvrzen\u00e9 v\u011bdecky. Pravda, p\u0161enice dnes obsahuje v\u00edc lepku ne\u017e kdysi. Pro zdrav\u00e9ho \u010dlov\u011bka bez dispozice k celiakii nebo k alergii na lepek v\u0161ak nep\u0159edstavuje \u017e\u00e1dn\u00e9 zdravotn\u00ed riziko nebo probl\u00e9m.“<\/p>\n
Co p\u0159inese bezlepkov\u00e1 dieta zdrav\u00fdm lidem<\/p>\n
Zdrav\u00fd \u010dlov\u011bk dodr\u017eov\u00e1n\u00edm bezlepkov\u00e9 diety nic nez\u00edsk\u00e1, na druhou stranu mu ani neu\u0161kod\u00ed. Jedin\u00e9, co mu m\u016f\u017ee hrozit, je nevyv\u00e1\u017een\u00e1 strava, a tedy nedostatek ur\u010dit\u00fdch \u017eivin, vitam\u00edn\u016f a miner\u00e1l\u016f. V\u00fdb\u011br potravin bez lepku b\u00fdv\u00e1 p\u0159ece jenom z\u00fa\u017een\u00fd.
\nJedin\u00e9, co m\u00e1 z pohledu odborn\u00edk\u016f na v\u00fd\u017eivu opravdu smysl, je nahrazov\u00e1n\u00ed v\u00fdrobk\u016f z b\u00edl\u00e9 mouky t\u011bmi celozrnn\u00fdmi. Ov\u0161em ne kv\u016fli lepku, sp\u00ed\u0161 kv\u016fli vy\u0161\u0161\u00edmu obsahu vl\u00e1kniny, kter\u00e9 konzumujeme m\u00e1lo. M\u00e1 toti\u017e na n\u00e1\u0161 organismus \u0159adu pozitivn\u00edch \u00fa\u010dink\u016f. Sni\u017euje nap\u0159\u00edklad vysokou hladinu krevn\u00edho cukru, a tedy i z\u00e1chvaty hladu, podobn\u011b jako riziko propuknut\u00ed cukrovky.<\/p>\n
Bezlepkov\u00e1 dieta znamen\u00e1 to, \u017ee rodi\u010de celiaka zaplat\u00ed za potraviny nap\u0159\u00edklad minim\u00e1ln\u011b o 3000 korun m\u011bs\u00ed\u010dn\u011b nav\u00edc. Zdravotn\u00ed poji\u0161\u0165ovny jim na n\u011b p\u0159isp\u00edvaj\u00ed, nap\u0159\u00edklad VZP.<\/p>\n
„Na bezlepkovou dietu na\u0161im klient\u016fm p\u0159isp\u00edv\u00e1me 8 000 K\u010d ro\u010dn\u011b (na n\u00e1kup speci\u00e1ln\u00edch potravin, ale t\u0159eba i na \u00fahradu ob\u011bd\u016f ve \u0161koln\u00ed j\u00eddeln\u011b apod.,“ uvedla mluv\u010d\u00ed V\u0161eobecn\u00e9 zdravotn\u00ed poji\u0161\u0165ovny Viktorie Pl\u00edvov\u00e1.<\/b><\/p>\n","protected":false},"excerpt":{"rendered":" Jsou to trochu \u0161okuj\u00edc\u00ed \u00fadaje. U dosp\u011bl\u00fdch trv\u00e1 v pr\u016fm\u011bru osm a\u017e dvan\u00e1ct let, ne\u017e se celiakie projev\u00ed \u010diteln\u00fdmi p\u0159\u00edznaky a ne\u017e ji l\u00e9ka\u0159i pacientovi […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":18397,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-24233","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/24233","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24233"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/24233\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/18397"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24233"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24233"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24233"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}