Whipple’s Disease – Symptoms and Causes

Overview

The small intestine has a unique lining with ridge-like structures covered by tiny projections called villi. These villi are important for nutrient absorption.

When Whipple disease occurs, this bacterial infection affects these structures, interfering with normal digestion. This makes it difficult for your body to break down foods properly and absorb important nutrients like fats and carbohydrates.

Whipple disease doesn’t just affect the digestive system. It can spread to other organs in the body, including the brain, heart, and eyes.

Joint problems are also common with this rare bacterial infection. Without proper treatment, this condition can become very serious or even fatal.

Fortunately, antibiotics are effective in treating Whipple disease when prescribed correctly.

Signs and Symptoms

Digestive problems often occur in Whipple disease. Patients may experience loose, watery stools and stomach pain that gets worse after eating.

Many people lose weight because their body cannot absorb nutrients properly.

Other frequent signs include:

• Swollen, painful joints (especially ankles, knees, and wrists)
• Feeling extremely tired
• Physical weakness
• Low red blood cell count (anemia)

These symptoms can significantly affect daily activities and quality of life.

Rare Body Signals

Some people with Whipple disease might also develop:

• Elevated body temperature
• Persistent coughing
• Swollen lymph nodes
• Darker skin in sun-exposed areas and scars
• Pain in the chest area

Brain and nerve problems can occur too, including:

• Walking difficulties
• Problems with vision and eye movement control
• Mental confusion
• Trouble remembering things

Most patients develop symptoms slowly over many years. In some cases, joint pain and weight loss appear years before digestive problems start, which often leads to the actual diagnosis.

When To See a Doctor

Contact your doctor right away if you notice:

• Unexplained weight loss
• Joint pain without an obvious cause
• Persistent digestive problems
• Symptoms that don’t improve with treatment

Whipple disease can be life-threatening, but proper treatment usually works well.

Your doctor will run tests to find out what’s causing your symptoms.

If you’re already taking antibiotics for Whipple disease and don’t feel better, tell your doctor. Sometimes the bacteria resist certain medications. The disease can also come back after treatment, so pay attention to returning symptoms.

Causes

Tropheryma whipplei, a specific type of bacterium, causes Whipple disease. These bacteria first attack the mucosal lining of the small intestine, creating small lesions within the intestinal wall.

They also damage the villi, which are tiny, hair-like projections lining the small intestine.

Scientists have limited knowledge about these bacteria. Though they appear common in the environment, researchers don’t fully understand their origin or how humans become infected.

Interestingly, not everyone carrying the bacteria develops the disease.

Some research suggests that people who develop Whipple disease might have a genetic immune system defect, making them more vulnerable when exposed to the bacteria.

Key facts about Whipple disease:

• Extremely rare condition
• Affects fewer than 1 in 1,000,000 people
• Likely involves both bacterial exposure and genetic factors
• Damages intestinal structures and function

Risk Factors

Several factors may increase the chances of developing Whipple disease, although research is limited. The condition appears more common in:

• Men between 40 and 60 years old
• White individuals living in North America and Europe
• People who work outdoors, especially farmers
• Those with regular exposure to sewage and wastewater

The disease affects certain populations more than others. However, since we still have much to learn about the bacteria causing this condition, our understanding of these risk factors continues to evolve.

Health Issues

When Whipple disease damages your small intestine, it harms the tiny, hair-like structures called villi. These villi normally help your body absorb nutrients from food. When they’re damaged, your body can’t get the nutrients it needs.

This poor nutrient absorption leads to several problems:

• Severe Fatigue
• Muscle Weakness
• Weight Loss
• Joint Pain

Without treatment, Whipple disease gets worse over time and can be deadly. Deaths still happen today, mostly because the disease is often found too late.

The infection can spread to the brain and nervous system, causing damage that cannot be fixed. This brain involvement is often what leads to death in severe cases.