Causes and risk factors
Whipple’s disease is caused due to infection with the bacteria Tropheryma whipplei. It affects small intestine. The bacteria destroy the hair like projection [villi] that line the small intestine. It forms lesions in the intestinal wall. It interferes with the normal process of digestion. It hampers breakdown of carbohydrates and fats and prevents it from absorbing nutrients. With time the infection may spread from the intestines to other organs such as the heart, lungs, brain, joints, and eyes.
Clinical presentation
Patient presents with persistent diarrhoea, which sometimes contain blood, pain in abdomen, bloating. Reduced vision, pain in eyes may be experienced by the patient. Fever, Anaemia, loss of weight, lymphnode inflammation, and discoloration of skin may be seen. Weakness of muscles, numbness, joint pain, tics may be felt by the patient. Insomnia, dementia may be caused. Chest pain, persistent cough, pericarditis, murmurs, heart failure may occur.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. A gastroendoscopy is advised. Small intestinal biopsy to look for the bacteria is recommended. Blood test like Complete blood count [CBC], PCR [polymerase chain reaction] is done.
Treatment
Long term antibiotic therapy is the main line of treatment. A diet high in calories is advised. Supplementation of iron, folate, calcium, magnesium and vitamins. Supportive care with is intravenous fluids is given if necessary.
Other Modes of treatment
The other modes of treatment can also be effective in treating Whipple’s disease. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating Whipple’s disease.
