What Is Whipple’s Disease?

Whipple’s disease was first recognized in 1907 by George Hoyt Whipple. The case centered on a man who had problems with weight loss, arthritis, chronic cough, and fever. More than a century later, doctors still don’t know much about the disease, but they do have ways to treat it.

Whipple’s disease is a bacterial infection. The bacteria usually affect your digestive system, especially your small intestine, but they can cause problems in other parts of your body, too, like your heart, joints, lungs, eyes, and immune system. And up to 40% of people with Whipple’s disease also have issues related to their nervous system, which includes your brain, spinal cord, and the network of nerves that run throughout your body.

If it’s not treated, Whipple’s disease can be life-threatening in a short amount of time.

Doctors only know of a few hundred cases of the condition, most in North America and western Europe. White men and people older than 40 are most likely to get it.

Symptoms

Whipple’s disease can affect how you digest food and take in nutrients. It can make you weak and tired and lead to:

If it affects your nervous system, it can bring on:

In some people, Whipple's disease can cause coughing, fever, and chest pain.

Causes

Bacteria called T. whipplei cause Whipple’s disease. Scientists aren’t exactly sure how the bacteria get in your body, but they think it may be a part of some people’s normal mix of bacteria or it may come in through your mouth. There’s no evidence that it can be passed from person to person.

Researchers have found that many people with the disease work with or near soil, like on farms or in construction, or have a problem with their immune system. It also may be linked to a problem gene.

Diagnosis

If your doctor thinks you might have Whipple’s disease, they’ll talk with you about your medical history and do a physical exam to check for pain or tenderness in your belly or dark spots on your skin. They’ll also test a sample of your blood to see if you’re low on any nutrients.

They’ll probably recommend a procedure called an upper GI endoscopy -- a flexible tube with a camera on the end lets your doctor get a closer look at the lining of your stomach and take a sample to be tested for T. whipplei. You’ll get medicine to help you relax during the procedure.

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Treatment

If tests show that you have Whipple’s disease, your doctor will give you antibiotics through an IV in your arm to kill the bacteria. They also may recommend fluids to keep you hydrated and extra vitamins and minerals to make sure you get enough nutrients.

You should feel better in a couple of weeks, but it may take your small intestine up to 2 years to recover. During that time, you’ll continue to take antibiotics and supplements.

If you have problems related to your nervous system, your doctor will use a combination of antibiotics, steroids, and other drugs, depending on your symptoms.

Whipple’s disease can come back. You’ll need to see your doctor for regular checkups so you can treat it quickly if it does.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on February 28, 2019

Sources

SOURCES:

National Institute of Neurological Disorders and Stroke: “Whipple’s Disease Information Page.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Whipple Disease.”

Medscape: “Whipple Disease.”

Mount Sinai Hospital Department of Microbiology: “Tropheryma whippelii.”

Gastroenterology & Hepatology: “Connecting the Dots: The Many Systemic Manifestations of Whipple Disease.”

National Center for Advancing Translational Sciences: “Whipple disease.”

Mayo Clinic: “Whipple’s disease.”

Canadian Journal of Infectious Diseases and Medical Microbiology: “Rare but not so rare: The evolving spectrum of Whipple’s disease.”

Journal of Infection: “Tropheryma whipplei and Whipple’s disease.”

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