Whipple disease is a rare disease resulting from bacterial infection that leads to inadequate absorption of nutrients (malabsorption) from the intestine. It is believed to result from infection with bacteria known as Tropheryma whippelii. The infection usually involves the small intestine, but over time, the disease may affect various parts of the body, including the heart, lungs, brain, and eyes.

Digestive signs and symptoms are common in Whipple disease and may include:

• Diarrhea
• Stomach Cramping and pain, which may worsen after meals
• Weight loss, associated with the malabsorption of nutrients

Other frequent signs and symptoms associated with Whipple disease include:

• Inflamed joints, particularly the ankles, knees and wrists
• Fatigue
• Weakness
• Anemia

Less common signs and symptoms

In some cases, signs and symptoms of Whipple disease may include:

• Fever
• Cough
• Enlarged lymph nodes
• Skin darkening in areas exposed to the sun and in scars
• Chest pain

Brain and nervous system (neurological) signs and symptoms may include:

• Difficulty walking
• Vision problems, including lack of control of eye movements
• Confusion
• Memory loss

Symptoms tend to develop slowly over many years in most people with this disease. In some people, symptoms such as joint pain and Weight loss develop years before the digestive symptoms that lead to diagnosis.

Whipple disease is caused by a type of bacterium called Tropheryma whipplei. The bacteria affect the mucosal lining of your small intestine first, forming small sores (lesions) within the wall of the intestine. The bacteria also damage the fine, hairlike projections (villi) that line the small intestine.

Not much is known about the bacteria. Although they seem readily present in the environment, scientists don't know where they come from or how they're spread to humans. Not everyone who carries the bacteria develops the disease. Some researchers believe that people with the disease may have a genetic defect in their immune system response that makes them more likely to become sick when exposed to the bacteria.

Whipple disease is extremely uncommon, affecting fewer than 1 in 1 million people.

Treatment of Whipple disease is with antibiotics, either alone or in combination, which can destroy the bacteria causing the infection.

Treatment is long-term, generally lasting a year or two, with the aim of destroying the bacteria. But symptom relief generally comes much quicker, often within the first week or two. Most people with no brain or nervous system complications recover completely after a full course of antibiotics.

When choosing antibiotics, doctors often select those that wipe out infections in the small intestine and also cross a layer of tissue around your brain (the blood-brain barrier). This is done to eliminate bacteria that may have entered your brain and central nervous system.

Because of the lengthy use of antibiotics, your doctor will need to monitor your condition for development of resistance to the drugs. If you relapse during treatment, your doctor may change your antibiotics.

Treatment for standard cases

In most cases, Whipple disease therapy begins with two to four weeks of ceftriaxone or penicillin given through a vein in your arm. Following that initial therapy, you'll likely take an oral course of sulfamethoxazole-trimethoprim (Bactrim, Septra) for one to two years.

Possible side effects of ceftriaxone and sulfamethoxazole-trimethoprim include allergic reactions, mild diarrhea, or nausea and vomiting.

Other medications that have been suggested as an alternative in some cases include oral doxycycline (Vibramycin, Doryx, others) combined with the antimalarial drug hydroxychloroquine (Plaquenil), which you'll likely need to take for one to two years.

Possible side effects of doxycycline include loss of appetite, nausea, vomiting and sensitivity to sunlight. Hydroxychloroquine may cause loss of appetite, diarrhea, headache, stomach cramps and dizziness.

Symptom relief

Your symptoms should improve within one to two weeks of starting antibiotic treatment and go away entirely within about one month.

But even though symptoms improve quickly, further lab tests may reveal the presence of the bacteria for two or more years after you begin taking antibiotics. Follow-up testing will help your doctor determine when you can stop taking antibiotics. Regular monitoring can also detect development of resistance to a particular drug, often indicated by a lack of improvement in symptoms.

Even after successful treatment, Whipple disease can recur. Doctors usually advise regular checkups. If you've experienced a recurrence, you'll need to repeat antibiotic therapy.

Taking supplements

Because of the nutrient-absorption difficulties associated with Whipple disease, your doctor may recommend taking vitamin and mineral supplements to ensure adequate nutrition. Your body may require additional vitamin D, folic acid, calcium, iron and magnesium.

Because so little is known about the bacteria that cause Whipple disease, risk factors for the disease haven't been clearly identified. Based on available reports, it appears more likely to affect:

• Men ages 40 to 60
• White people in North America and Europe
• Farmers and other people who work outdoors and have frequent contact with sewage and wastewater

An uncommon bacterial infection called Whipple disease typically affects your joints and digestive tract.

• Whipple illness disrupts normal digestion by making it difficult for food to be broken down and by making it more difficult for your body to absorb nutrients like fats and carbs.
• Your brain, heart, and eyes are just a few of the many organs that Whipple illness can infect.
• Whipple illness can be deadly or seriously debilitating if not properly treated. However, Whipple disease can be treated with an antibiotic course.

Cure

• Antibiotics that can kill the bacteria causing the illness are used to treat Whipple disease, either singly or in combination.
• The goal of treatment is to eradicate the germs, which usually takes a year or two. However, symptom relief usually happens considerably sooner, frequently in the first week or two. After taking an entire course of antibiotics, the majority of patients who have no issues with their nervous system or brain fully recover.
• Doctors frequently choose medicines that penetrate the layer of tissue around your brain and eliminate infections in the small intestine when making their selections (the blood-brain barrier). To get rid of any bacteria that might have gotten into your brain and central nervous system, this is done.

Conditions
Memory loss,Enlarged lymph nodes,Vision problem,Confusion
Drugs
Ceftriaxone,Penicillin,Ulfamethoxazole-trimethoprim
Symptoms
Diarrhea,Stomach pain,Weight loss,Fatigue