In scary and unwelcome news - if you have celiac disease, you are likely to experience a higher risk for non-Hodgkin’s Lymphoma (NHL).
NHL is a cancer of the lymphatic system, which includes components of the immune system such as lymph nodes and spleen.
There's good news too. Your lymphoma risk will taper off the longer you follow a gluten-free diet. Overall, your NHL risk depends on how your body reacts to the inflammation, intestinal damage and nutritional deficiencies brought on by villous atrophy (decrease in size of a normally developed organ or tissue) in celiac disease.
After food passes from the stomach into the small intestine, nutrients are normally absorbed through the villi - which are microscopic, finger-like tentacles that line the wall of your small intestine. In patients with untreated celiac disease, inflammation makes the villi shrink and flatten, negatively affecting nutrient absorption.
Studies show that patients with celiac disease are significantly more likely to develop NHL than people in the general population. People with severe or refractory celiac disease appear to be at highest risk.
One study found 40 cases of NHL out of 1,285 celiac patients, a rate of 3.1%. Another study found a much higher rate (over a 5-fold increase) in people whose celiac disease was severe enough to lead to hospitalization. Unfortunately, people who have been hospitalized are more likely to have refractory celiac disease, which doesn't respond well to the gluten-free diet.
Interestingly, researchers have also found a higher NHL risk in non-celiac siblings of diagnosed celiac patients, indicating there may be a genetic component which raises the risk both for celiac disease and lymphoma.
Lymphoma in patients with celiac disease typically develops in 5-10 years following diagnosis. Patients who develop disorders of the lymphatic system, including lymphoma, tend to be older and are more likely to suffer from symptoms of diarrhea, abdominal pain and weight loss, indicating severe villous atrophy and poor macro- and micro-nutrient absorption.
The most recent medical research indicates that NHL risk depends on how long gluten was consumed prior to the diagnosis of celiac disease, and how long a gluten-free diet is maintained. For instance, when adults spent 10 or more years on a gluten-free diet, their lymphoma risk returned to almost normal.
So if you have celiac disease, the best thing you can do to protect yourself against getting NHL is to stick rigorously to a gluten-free diet.
And if you ever develop any symptoms of NHL, including swollen lymph nodes, fatigue, unexplained weight loss, fever and night sweats, then you should consult your physician right away and make sure they know about the connection between celiac disease and NHL risk.