Whipple’s Disease: Causes, Symptoms, Diagnosis, Treatment
About Whipple's Disease?
Whipple's Disease is an uncommon bacterial infection usually affecting the gastrointestinal system. This disease affects the normal digestion by hampering breakdown of foods like fats and carbohydrates and thus affecting the body’s ability to absorb nutrients. This condition can also affect other vital organs of the body to include the brain and heart. If left untreated or with inadequate treatment, Whipple's Disease can prove to be fatal; however, this condition is treatable and appropriate antibiotics can cure the condition.
What Are The Causes Of Whipple's Disease?
The root cause of Whipple's Disease is the bacterium Tropheryma Whipplei. This bacterium affects the mucosal lining of the small intestine in the beginning resulting in formation of small lesions in the intestinal wall. This bacterium also causes damage to the villi which line the small intestine. This disease progresses with time to affect other vital organs of the body. There is not much information available about the bacterium Tropheryma Whipplei which causes this disease. Researchers are not really sure as to where this bacterium originates from, although it seems to be present in abundance in the environment. Some researchers are of the opinion that individuals who go on to develop Whipple’s Disease have a genetic immune system defect making them vulnerable to this disease when they are exposed to this bacterium. As stated, Whipple’s Disease is an extremely rare medical condition.
What Are The Symptoms Of Whipple's Disease?
Symptoms of Whipple’s Disease Include:
- Abdominal cramping
- Pain in the abdomen, worsening after eating
- Weight loss
- Joint inflammation
- Enlargement of lymph nodes
- Hyperpigmentation of the skin
- Chest pain
How Is Whipple's Disease Diagnosed?
In order to diagnose Whipple’s Disease, the treating physician will do the following:
Physical Examination: The treating physician will conduct a detailed physical examination to look for any indicators which may suggest Whipple’s Disease like abdominal tenderness or hyperpigmentation of the skin.
Biopsy: Another important part in the diagnosis process is biopsy of the tissues of the small intestine
Blood Tests: The physician may also order blood tests like CBC to look for presence of anemia which will be detected in the hematocrit count
What Are The Treatments For Whipple's Disease?
Whipple’s Disease is normally treated with antibiotics either in combination with other medications or as a standalone therapy, which eliminates the bacteria causing the infection. The length of the treatment is about a year for complete symptoms relief even though the affected person may experience symptom relief much quicker than that. The antibiotic chosen is such that it not only destroys the bacteria in the intestinal system, but also has the capability to destroy the bacteria which might have entered the brain or the central nervous system.
Since the duration of treatment for Whipple’s Disease is quite lengthy, the physician will do regular monitoring of the condition to look for any signs of resistance to the medication. In case of any drug resistance, the physician may change the antibiotic.
In majority of the cases of Whipple’s Disease, the treatment starts with a 14-day course of intravenous Rocephin following which the individual will be given an oral course of Septra or Bactrim the duration of which will be for about a year or two for complete elimination of the bacteria from the system and prevent relapse.
In severe cases of Whipple’s Disease where the bacteria enter the nervous system, treatment consists of an 18 month course of oral doxycycline in combination with hydroxychloroquine. Some of the side effects of this combination of medications are loss of appetite, nausea, vomiting and photosensitivity.
Usually an affected individual will start experiencing symptom relief within a couple of weeks of starting the antibiotic with complete symptom relief in about a month but followup testing is required for a couple of years to make sure that the bacteria is completely eliminated from the system so that there are no relapses of the disease. In cases of recurrence of the disease periodic checkups are advised and in case of presence of bacteria repeat treatment with antibiotics is recommended.
As Whipple’s Disease results in difficulty with absorbing nutrients thus the treating physician will suggest nutritional supplements so that the body is not devoid of adequate nutrition in the form of vitamin D, folic acid, calcium, and iron.