Daily Archives: May 20, 2015

Whipples disease unending war against bacteria

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Whipple’s disease severely affects the gastrointestinal system. The Tropheryma whipplei spirochete attack lining of small intestines. This lining consists of hair like projection called villi which play an important guise in absorbing nutrients. The bacteria attack the villi and affect absorption process. It can spread from bowels to opposite parts of digestive system as well as other organs. Body becomes unqualified to break dejected fats, carbohydrates and proteins.

This disease is progressive in nature and can also affect brain, central nervous system, heart and eyes. Damage caused is irreversible in nature. If not treated inward era limit, it can be fatal.

Symptoms: – Symptoms take a long time often years to develop. Hence much damage has already been caused before the diagnosis.

Common symptoms:-

1.Diarrhea
2.Acute Abdominal pain and cramping especially after food intake
3.Anemia
4.Malnutrition caused by malabsorption of essential nutrients
5.Fatigue and weakness
6.Inflammation of joints in knees, ankles and wrists

Less common symptoms:-

1.Enlargement of lymph nodes and spleen
2.Fever
3.Cough
4.Hyperpigmenatation of skin when exposed to sunlight
5.Chest pain

Neurological/Cognitive Symptoms:-

1.Loss of memory
2.Loss of motor skills
3.Seizures
4.Confusion
5.Visual impairment

Risk factors:-

1.Gender-men are more prone to Whipple’s disease than women
2.Race- Whites in Europe and North Africa

3.Age between 40 to 60

Diagnosis:-

1.Physical exam. :- to check abdominal tenderness and examine skin darkening during Whipple’s disease.
2.Upper endoscopy and Biopsy to examine tissue from lining of paucity intestine
3.Biopsy of enlarged lymph node
4.Polymerase chain reaction test- DNA based test to revelative Tropheryma whipplei bacteria in biopsy sample or spinal fluent sample.
5.Blood tests to detect fall in level regarding RBCs and albumin to check for possibility of anemia.

Treatment:-

1.Antibiotics:-Prolonged antibiotic administration is required to rub the bacteria out. Full course might last up to a year or two. Efforts are made to remove bacteria not just from intestines but also from blood-brain barrier in the brain. Common antibiotics include sulfamethoxazole-trimethoprim, or SMX- TMP, (Bactrim, Septra). With regular monitoring and changes in pattern like drugs may cause full recovery concerning brain et cetera nervous system. In case of relapse, doctors may change the course of drugs. If the cases are severe, antibiotics alike doxycycline (Vibramycin) combined with the antimalarial drug hydroxychloroquine (Plaquenil) are administered for 12 to 18 months. .

2.Intravenous therapy: – In severe cases, antibiotics like ceftriaxone (Rocephin) are administered intravenously.

3.Symptomatic relief treatment

4.Taking supplements: – Supplements of vitamin D, Folic acid, Calcium, Iron including magnesium to rescue from malnutrition.