A rare bacterial infection caused by Tropheryma whipplei bacteria is called Whipple’s disease. It negatively affects the bowel’s ability to absorb nutrients. The most common symptoms include joint pain, chronic (long-term) diarrhea, abdominal (belly) pain, and unusual weight loss. Physicians usually treat this infection with antibiotics.
Generally, it is an infection of the small intestine, which causes malabsorption. The bacterium that causes this infection often lives in dirt. However, a combination of antibiotics may destroy this bacteria and reduce the symptoms.
While bacterial infections are common, Whipple’s disease happens quite rarely. It affects 9 in 1 million people in the United States. Furthermore, if you get T.whipplei, you may not develop the infection.
Symptoms
This bacterial infection develops in several stages (phases) and begins with joint pain. Thereafter, this symptom may come and go. The most affected joints are the large ones in the ankles, elbows, hips, knees, and shoulders. Sometimes, it is called the prodromal phase. Unfortunately, this stage may last 7-8 years until you develop other symptoms of this infection. Check below for other symptoms of Whipple’s disease:
- Pain in the belly (abdominal area)
- Swelling in the hands or feet (edema)
- Diarrhea
- Fatigue (extreme tiredness)
- Fever
- Skin color changes
- Swollen lymph nodes
- Unusual weight loss
Approximately 30% of people who develop this infection experience central nervous system problems. Check below some symptoms:
- Swallowing or balance problems
- Confusion
- Personality changes
- Memory loss
- Seizures
Causes and Risk Factors
Healthcare professionals have identified the bacteria that often live in dirt and cause Whipple’s disease. Anyone who is exposed to this bacterium is at risk of developing the infection. However, this infection occurs in rare cases, and experts do not fully understand why other people do not develop an infection. According to some research, the factors listed below may increase your risk of developing Whipple’s disease. Examples include:
- Age – People over 60 years old are at increased risk of developing the infection if they are exposed to Tropheryma whipplei bacteria.
- Exposure to soil – People whose work involves frequent exposure to soil or livestock are also at increased risk of developing this bacterial infection.
- Genetic mutations – Physicians have found a connection between the gene that produces IFR4 and Whipple’s disease. This is an essential protein used in B cells, T cells, and other immune cells.
- Weakened immune system – People who have diseases that weaken the immune system or who administer immunosuppressants are at higher risk of developing the infection.
What Are The Potential Complications of Whipple’s Disease?
This is a progressive infection that negatively affects the intestine’s ability to absorb fats, carbohydrates, and other nutrients. Over time, it may also cause some complications. These include:
- Dementia
- Anemia (this is a condition in which red blood cell levels are low)
- Heart problems
- Pleural effusion
- Uveitis
- Oculomasticatory myorhythmia
If this bacterial infection impacts your nervous system, the condition can be fatal.
How to Prevent Whipple’s Disease?
It is not certain because this bacterium is almost everywhere, especially in dirt. To prevent this infection, it is important to know how it occurs. However, not everyone who is exposed to this bacterium develops an infection.
At higher risk of Whipple’s disease are people with weakened immune systems or who follow a treatment with immunosuppressants. If your immune system is compromised, you should regularly wash your hands with soap and warm water, especially if you work in dirt and mud.
Diagnosis
Usually, diagnosis of Whipple’s disease involves a physical examination and evaluation of your medical history. Physicians may also ask some questions about the symptoms and perform some tests to confirm the condition. For example:
- Complete blood count (CBC) – This is a blood test that is used to check red blood cell count, white blood cell count, and platelets. It helps diagnose multiple health problems, including anemia, some types of cancer, and infections.
- Upper endoscopy – During this procedure, doctors use a small and flexible tube with a lighted camera on the end to examine the esophagus, stomach, and the first part of the small bowel (also known as the duodenum). The tube that carries food and drinks from the mouth to the stomach is called the esophagus.
- Polymerase chain reaction (PCR) test – This is a specific test used to amplify certain DNA segments to detect pathogens or genetic markers. In such cases, it is used to detect the bacteria that cause Whipple’s disease. To perform this test, doctors will collect a small amount of blood, saliva, mucus, or tissue.
- Small intestine biopsy – When doctors suspect this infection, they may take a small amount of tissue from the small intestine for testing.
Treatment
While some people may recover fast with treatment, sometimes it may take a long time to destroy this bacteria. However, doctors usually recommend different treatments for people with Whipple’s disease. It depends on the severity of the condition, overall health, your age and preferences, and other factors. Check below some common treatments often prescribed by doctors for people with this bacterial infection:
- Antibiotics – This group of medicines is used to treat bacterial infections. If you suffer from Whipple’s disease, you may need intravenous (IV) antibiotics for 2 to 4 weeks. Thereafter, your doctor may prescribe oral antibiotics that should be taken for up to 1 year.
- IV fluids – These solutions are often given IV to prevent or treat dehydration. Sometimes, drinking electrolyte beverages is enough.
- Vitamins and nutrient supplements – In some cases, healthcare professionals may recommend vitamins and other supplements that your small intestine cannot absorb.
However, previous treatments may also cause some adverse reactions. For example:
- Skin rash
- Yeast infections
- Nausea
- Vomiting
- Dizziness
- Diarrhea
If you experience any of the previous negative effects, do not hesitate to contact your doctor.
Frequently Asked Questions
What are the symptoms of Whipple’s disease?
People who develop this bacterial infection usually experience the following symptoms. Examples include:
- Abnormal weight loss
- Fever
- Diarrhea
- Abdominal pain
- Arthralgias
Visit a doctor if any of the symptoms listed above occur.
Is there a cure for Whipple’s disease?
Yes, especially if the patient does not develop brain or nervous system complications. A combination of antibiotics may destroy this bacteria, which allows a complete recovery. If you suspect you have this infection, immediately see a doctor.
What conditions can be mistaken for Whipple’s disease?
There are some diseases that can be mistaken for this bacterial infection. These include:
- Inflammatory bowel disease (IBD)
- Sarcoidosis
- Rheumatoid arthritis
- Lymphoma
- HIV infection
- Vasculitis
- Neurological disorders
- Infectious diarrhea
This article does not contain a complete list of health conditions that can be mistaken for Whipple’s disease. Ask your healthcare provider if you have additional questions.
