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Whipple: Whipple's Disease and the Whipple Procedure

An Overview of Whipple's Disease

Whipple's disease is a very rare, infectious disease that causes malabsorption, an inadequate absorption of nutrients. The disease can affect any part of the body, but it occurs primarily in the small intestine.

Causes of Whipple's Disease

Whipple's disease is caused by a bacterial infection of the small intestine; however, if given enough time and left untreated, it can spread to other parts of the body. The bacterium responsible for the infection is Tropheryma whippelii.

Who's At Risk?

The bacteria can infect anyone, but most cases of Whipple's disease occur in Caucasian males between thirty and sixty years old.

What Exactly Happens?
Once the bacteria, Tropheryma whippelii, enters the body, lesions begin to appear in the small intestine. The wall tissue thickens, and the villi, which are responsible for aiding in the absorption process, are also damaged. This reduces the surface area of the small intestine causing malabsorption of nutrients.

Symptoms of Whipple's Disease

Whipple's disease is a malabsorption disorder, so its symptoms are similar to many other malabsorption disorders. Symptoms include:

weight loss
fatigue
anemia
malnutrition
diarrhea
abdominal pain
weakness.

Patients with Whipple's disease also experience fever and arthritis. Whipple's disease is a slow-developing disease so many of the malabsorption symptoms listed above don't show up for years. People often have fever and arthritis years before any of the other symptoms show.

Depending on the extent of the infection and which organs are affected, other symptoms may show up as well. For example:

If the infection reaches the heart, the patient may experience heart murmurs.
If the infection reaches the liver, the patient may have an enlarged or inflamed liver.
If the infection reaches the brain, the patient may display neurological symptoms such as confusion, forgetfulness and memory loss.

Untreated Whipple's Disease
Not seeking treatment for Whipple's disease is not a wise choice. The disease causes malnutrition and, if it's left untreated for an extended period of time, it can prove to be fatal.

Diagnosing Whipple's Disease

A diagnosis of Whipple's disease is made through a biopsy of the small intestine.

Treating Whipple's Disease

The primary form of treatment for Whipple's disease is antibiotics. The type and dosage of the antibiotic used is dependent on the location, spread and severity of the bacterial infection.

For patients suffering from severe nutritional deficiencies, dietary supplements may be given to alleviate some of the symptoms.

Symptoms normally disappear after one to three months of continuous treatment, but a full recovery doesn't take place until approximately two years of continuous treatment. Even then, relapse is highly possible.

Seeing Double
Whipple's disease and the Whipple procedure have nothing to do with one another. Both just had the benefit of being discovered or first described by a man named Whipple.

The bacteria that cause Whipple's disease were discovered by Nobel Prize winner George H. Whipple.
The Whipple procedure was first described by a surgeon named Allen O. Whipple.

The Whipple Procedure

The Whipple procedure, also known as a pancreaticoduodenectomy, is a surgical procedure in which part of the pancreas is removed. The procedure is used to treat pancreatic cancer and a variety of other serious conditions involving the pancreas.

In the Whipple procedure, the gallbladder, the common bile duct, part of the duodenum (small intestine) and the head of the pancreas are removed. Depending on the situation, part of the stomach may also be removed.

The surgical procedure takes approximately four to seven hours. The patient is usually hospitalized for eight to ten days following the procedure. About one quarter of Whipple procedure patients struggle with malabsorption and are typically prescribed supplemental lipase which helps with the breakdown of fats in the intestines.

Resources

A.D.A.M., Inc. (updated 2002). Whipple's disease.

Meddles, J. (nd). Diet & nutrition: Pancreatic enzymes: Your questions answered. Pancreatic Cancer Action Network (PanCan).

Medical College of Wisconsin. (updated 1999). Whipple's disease.

National Digestive Diseases Information Clearinghouse. (updated 2004). Whipple's disease [NIH Publication No. 04-4685].

Pancreatic Cancer Action Network. (2003). Pancreatic enzymes: Your questions answered.

Penn State: Milton S. Hershey Medical Center. (updated 2005). Whipple's disease.

Tufts-New England Medical Center: Department of Surgery. (nd). Whipple procedure: Pancreatic cancer and pancreatitis.