Whipple's disease (patient information)

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 * Assistant Editor-in-Chief: Meagan E. Doherty

Overview
Whipple's disease is a rare condition that prevents the intestine from properly absorbing nutrients. This is called malabsorption.

What are the symptoms of Whipple's disease?
Symptoms usually start slowly, and may include:
 * Abdominal pain
 * Diarrhea
 * Fever
 * Gray to brown skin color
 * Joint pain
 * Memory loss
 * Mental changes
 * Weight loss

What are the causes of Whipple's disease?
Whipple's disease is caused by bacteria named Tropheryma whippelii. It can affect any system of the body, but occurs most often in the small intestine. Lesions appear on the wall of the small intestine and thicken the tissue. The villi—tiny, finger-like protrusions from the wall that help absorb nutrients—are damaged.

Who is at risk for Whipple's disease?
Although risk factors for Whipple's disease are unknown the disorder mainly affects middle-aged white men.

How to know you have Whipple's disease (Diagnosis)?
Possible signs:
 * Enlarged lymph glands
 * Fatty stools
 * Gastrointestinal bleeding
 * Swelling in body tissues (edema)

Tests may include:
 * Viewing the intestine with a flexible, lighted tube (enteroscopy), and possibly removing a small amount of intestinal lining (biopsy) to be examined under the microscope
 * Complete blood count (CBC)

This disease may also change the results of the following tests:
 * Albumin
 * Unabsorbed fat in the stools (fecal fat)
 * Intestinal absorption of a type of sugar (d-xylose absorption)

When to seek urgent medical care
Call your health care provider if you have persistent abdominal pain and diarrhea.

If you are being treated for Whipple's disease, call your health care provider if:
 * Symptoms worsen or do not improve
 * Symptoms reappear
 * New symptoms develop

Treatment options
You will need to take long-term antibiotics to cure any infections of the brain and central nervous system. A medicine called ceftriaxone is given through a vein (IV). It is followed by an antibiotic (such as trimethoprim-sulfamethoxazole) taken by mouth for up to 1 year.

If symptoms come back during antibiotic use, the antibiotic treatment may be changed.

Your health care provider should closely follow you, because signs of the disease can return after you finish therapy. Those who have nutritional deficiencies from malabsorption will also need to take dietary supplements.

Depending on the seriousness of the disease, treatment may also include fluid and electrolyte replacement. Electrolytes are salts and other substances in body fluid that the heart and brain need to function properly. Extra iron, folate, vitamin D, calcium, and magnesium may also be given to help compensate for the vitamins and minerals the body cannot absorb on its own.

Diseases with similar symptoms

 * Celiac Disease
 * Chronic diarrhea
 * Clonorchiasis
 * Parkinson's disease

Where to find medical care for Whipple's disease
Directions to Hospitals Treating Whipple's disease

What to expect (Outlook/Prognosis)
Without treatment, the condition is usually fatal. Treatment relieves symptoms and can cure the disease.

Possible Complications

 * Nutritional deficiencies
 * Symptoms return (which may be because of drug resistance)
 * Weight loss