Unhealed intestines in celiac disease tied to lymphoma
People with celiac disease whose intestines are slow to heal are at increased risk of cancer of the immune system, or lymphoma, according to a new study.
|Last Updated: Aug 07, 2013, 04:02 PM IST|Source: Bureau
New York: People with celiac disease whose intestines are slow to heal are at increased risk of cancer of the immune system, or lymphoma, according to a new study.
Researchers found that people with celiac disease who had persistent damage to their intestines after being diagnosed - possibly due to lack of adherence to a gluten-free diet - had rates of lymphoma almost four times higher than the general public.
However, it`s not clear whether everyone with celiac disease should have follow-up biopsies to look for such damage, according to Dr. Daniel Leffler, from The Celiac Center at Beth Israel Deaconess Medical Center in Boston.
"It`s still only worth doing a test for a problem if you can fix the problem when you find it," said Leffler, who wasn`t involved in the new research. "Right now the only treatment we have (for intestinal damage) is a gluten-free diet."
Among people with celiac disease - about one percent of Americans - the immune system reacts to gluten, a protein found in wheat, barley and rye. Eating foods with gluten damages the small intestine and keeps the immune system on overdrive, so patients are advised to adopt a permanent gluten-free diet at diagnosis.
The new study included 7,625 people in Sweden who were diagnosed with celiac disease and had their intestines biopsied a year or so later. Of those people, 43 percent still had damage to their intestines on the follow-up exam.
Dr. Peter Green from the Celiac Disease Center at Columbia University in New York and his colleagues tracked the Swedish patients for an average of nine years after their follow-up biopsy. During that span, 53 were diagnosed with lymphoma.
Based on biopsy results, the researchers found that people whose intestines had healed after their diagnosis were not at any higher risk of lymphoma than average. However, those with persistent damage developed lymphoma 3.8 times more often than would be expected among the general public.
Leffler told Reuters Health it`s impossible to know whether everyone in the study who had intestinal damage had strayed from a gluten-free diet.
"We don`t actually know whether the only issue in these people who didn`t heal was gluten exposure. Some people may take a longer time to heal," he said, such as those who were diagnosed at an older age.
Although it`s still up for debate whether people with celiac disease should get regular biopsies - in part because there`s not always much doctors can do with the results - Leffler said they should continue to follow up with their gastroenterologist and dietician, even if they are feeling fine. But any extra risk of lymphoma should not make those patients overly concerned, he added.
Among 3,308 people in the study with persistent intestinal damage, 41 - just over one percent - were diagnosed with lymphoma, according to findings published in the Annals of Internal Medicine.
"Even with the significantly increased risk of lymphoma, it`s still a small risk," Leffler said. "I would caution against an undue paranoia about the increased risk of lymphoma."
Reuters
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.
Cookies Setting
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device and the processing of information obtained via those cookies (including about your preferences, device and online activity) by us and our commercial partners to enhance site navigation, personalise ads, analyze site usage, and assist in our marketing efforts. More information can be found in our Cookies and Privacy Policy. You can amend your cookie settings to reject non-essential cookies by clicking Cookie Settings below.
Manage Consent Preferences
Strictly Necessary Cookies
These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms. You can set your browser to block or alert you about these cookies, but some parts of the site will not then work or you may not be able to login.
Functional Cookies
These cookies enable the website to provide enhanced functionality and personalisation. They may be set by us or by third party providers whose services we have added to our pages. If you do not allow these cookies then some or all of these services may not function properly.
Targeting Cookies
These cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They are also used to limit the number of times you see an advert as well as help measure the effectiveness of an advertising campaign. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.
Performance Cookies
These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we may not know when you have visited our site, and may not be able to monitor its performance.