Whipple’s Disease – Causes, Symptoms and Treatment

Whipple’s Disease Symptoms

First described by George Hoyt Whipple in 1907, this intestinal bacterial infection is more common in middle-aged white men and can be deadly, if left untreated.

Medical Name: Intestinal Lipodystrophy

The Problem: Whipple’s disease is a rather uncommon systemic disease caused by bacterial infection that prevents the small intestines from appropriately absorbing nutrients. This disease interferes with the way the normal digestive system works and impairs the body’s ability to breakdown and absorbs fats and carbohydrates etc. from foods.

What Bacteria causes Whipple’s Disease?

A bacterium called Tropheryma Whipplei causes infection in the small intestines.

What causes intestinal infection?

Though doctors do not know how this bacterium is transmitted to humans, some people may have some weakness in their immune responses that make them more susceptible to this infection. The bacteria is thought to exist in the environment, and have been more commonly found to affect people who are exposed to soil and animals.

It first strikes the mucosal lining of the small intestine, forming small lesions within the intestinal wall. Slowly it destroys the small hair-like outgrowths lining the small intestine and can gradually spread to other organs.

Whipple Disease Symptoms

One striking thing about Whipple’s Disease is that symptoms develop very slowly over a long period of time, so much so that after the initial joint pain surface, later symptoms may often take several years to show up. Apart from joint pain or arthritis in the ankles, knees, wrists, elbows, fingers etc., other classic Whipple’s disease symptoms include:

  • Diarrhea
  • Loss of weight

However, symptoms vary from patient to patient with almost 15% not displaying even the classic symptoms. Other signs of the disease may include:

  • Abdominal pain – Cramping and pain may aggravate after eating.
  • A grey to brown skin complexion – This disorder mainly affects white men, so the darkening is somewhat distinct. Skin nodules may also occur in some.
  • Mental changes – Seizures, delirium, Memory loss
  • Anemia and fatigue
  • Fever and chills
  • Chest pain

A physical examination may also reveal:

  • Enlarged lymph glands and spleen
  • Heart murmur
  • Swelling in body tissues

This intestinal infection causes changes in the albumin levels of the blood, the intestinal absorption of d-Xylose sugar and fecal fat. Being systemic, this malabsorption may affect the lungs and eyes too.

In the worst cases, the infection by bacteria may also severely damage the heart, brain and central nervous system. When the infection spreads to the heart, it is unable to pump fluid through the body and hence this leads to fluid accumulation, externally observable as leg swelling and breathlessness.

Sometimes, drug resistance may also cause the symptoms to recur. In fact, any treatment that lasts for less than a year leaves approximately 40% chance of revival of symptoms.

Whipple Disease Treatment

Whipple’s Disease management usually relies on:

  1. Antibiotics; and/or
  2. Dietary supplements

A relapse is not uncommon even after successful treatment so regular follow-ups are important. If symptoms recur, antibiotic therapy may be repeated.


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