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Cancer: Small-Bowel Lymphoma Associated With Unrecognized Celiac Disease
In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I foundedÂ The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.View all articles by Scott Adams
Eur J Gastroenterol Hepatol 2000;12:645-648.
Celiac.com 08/13/2000 - According to Drs. Simon D. Johnston and R.G. Peter Watson from Royal Victoria Hospital in Belfast, Northern Ireland, UK, the incidence of undiagnosed celiac disease is higher among those with small bowel lymphoma, as reported in the June issue of the European Journal of Gastroenterology and Hepatology. According to the researchers: It is not clear whether the increased risk of small bowel lymphoma seen in typical celiac disease also applies to unrecognized or screening-detected celiac patients. To find an answer, they retrospectively identified 69 cases of small-bowel adenocarcinoma and 69 cases of small-bowel lymphoma from five pathology laboratories in Northern Ireland.
From a group composed of one patient with known celiac disease, and 12 with previously unrecognized celiac disease, the clinical presentation of adenocarcinoma and lymphoma patients was similar, but perforation was much more common among lymphoma patients. Further, 13 of the lymphoma patients, but none of the adenocarcinoma patients, had villous atrophy at a distant site, all of which were enteropathy-associated T-cell lymphomas. According to the researchers: Comparing the small-bowel lymphoma group to our random sample of the general Northern Ireland population as controls, the odds ratio of 15.72 for unrecognized celiac disease in the small-bowel lymphoma group, clearly indicates that there is an increased risk of unrecognized celiac disease among small-bowel lymphoma patients. Additionally, (s)ince a protective role for a strict gluten-free diet has been demonstrated, it follows that every effort should be made to diagnose celiac disease at every opportunity and raises the issue of whether population screening for celiac disease should be carried out.
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