Whipple’s disease is caused by Tropheryma whipplei bacteria. It’s a relatively rare disease that affects the digestive system and can spread to the heart, lungs, brain, joints, and eyes. The condition can be life threatening.
Many questions still exist about Whipple’s. For instance, there are those who are known carriers of the disease but never have any symptoms. In addition, the bacteria are not readily transmitted from person to person. Currently, there is no known way to prevent Whipple’s disease.
It is speculated that symptoms occur in people who have a genetic predisposition to developing the illness. White, middle-aged men (between 40 and 60) are more likely to contract the condition than any other group (NDDIC). In places that lack fresh water and proper sanitation, the rate for Whipple’s disease tends to be higher.
Infection with the T. whipplei bacteria is the one and only cause of Whipple’s. The bacteria will lead to the development of internal sores and cause body tissue to thicken.
When the villi (finger-like tissues that absorb nutrients in the small intestine) begin to thicken, their natural shape begins to change. This damages the villi and prevents them from effectively absorbing nutrients. This, in turn, leads to many of the symptoms connected with Whipple’s.
Because it causes your body to be unable to properly absorb nutrients, Whipple’s disease affects many different parts of the body and is associated with a variety of symptoms. In advanced disease, the infection may spread from the intestines to other organs such as the heart, lungs, brain, joints, and eyes.
The most common signs of Whipple’s include:
- chronic joint pain, sometimes with inflammation
- chronic diarrhea, which may or may not be bloody
- significant weight loss
- stomach pain and bloating
- decreased vision and eye pain
- anemia (low red blood cell count)
The following signs do not occur as frequently but can indicate that the condition is getting worse:
- skin discoloration
- inflamed lymph nodes
- chronic cough
- pain in the chest
- pericarditis—swelling of the sac surrounding the heart
- heart failure or murmurs
- problems seeing
- muscle weakness or tics
- problems walking and remembering
Many more common conditions have symptoms similar to those of Whipple’s disease. These range from celiac disease (a genetic predisposition to gluten intolerance) to neurological disorders. Your doctor will attempt to rule out these other conditions before diagnosing you with Whipple’s disease.
The first sign a doctor will look for to determine if you have Whipple’s disease is lesions. An endoscopy is the insertion of a small flexible tube (with a mini camera attached) down your throat to the small intestine. The doctor will observe the condition of your intestinal walls. If the walls are thick, with creamy ragged covering, then you may have Whipple’s.
During an endoscopy, your doctor may remove tissue from your intestinal walls to test for the presence of the T. whipplei bacteria. This procedure is called a biopsy and can confirm an infection.
PCR (polymerase chain reaction) is a highly sensitive test that amplifies the DNA of the T. whipplei from your tissue samples. If the bacteria have been in your tissue, there will be DNA evidence of it. This test can confirm the existence of the T. whipplei bacteria in your tissue.
Your doctor might order a complete blood count (CBC) test. This will help determine if you have a low count of red blood cells and low amounts of albumin, which are both signs of anemia. Anemia is an indication that you might have Whipple’s.
Whipple’s disease is a bacterial infection that can lead to death if not treated properly.
An aggressive course of antibiotics is usually the first step in treatment, including two weeks of antibiotics via IV or directly injected into your blood stream. In addition, you will normally be on daily antibiotics for one to two years.
Other treatment options include:
- ingesting proper amounts of fluids
- taking antimalarial medication for 12 to 18 months
- using iron supplements to assist with anemia
- taking vitamin D, vitamin K, calcium, and magnesium supplements
- maintaining a high-calorie diet due to lack of nutrient absorption
- taking corticosteroids to help ease inflammation
- taking non-steroid pain medication, such as ibuprofen
After treatment begins, many of the symptoms will go away within a month. The best thing you can do is to faithfully take your antibiotics. Relapses are common, and when they occur, additional symptoms, such as neurological problems, can show up as well.