Whipple Disease Epidemiology - Term Paper Example

WHIPPLE DISEASE EPIDEMIOLOGY REPORT I. BACKGROUND With the many diseases being discovered today, Whipple's disease is one particular illness that is considered rare. However, with its rarity comes a certain level of fatality when the disease is not treated well. Even though the disease was primarily discovered by GH Whipple in 1907, the said illness is still being carefully researched upon by the doctors and the medical experts as well as other concerned professionals on the matter. Within the discussion that follows, a careful analysis of the said disease shall be handled so as to give a bit of an overview on the different issues that cover the epidemiology of Whipple's disease as already known by the experts at present. This particular discussion is aimed in clarifying the different issues about the illness tackled upon herein thus making better implications on how to prevent as well as how to cure the situations that cover the concerns about Whipple's disease. As earlier noted, it was the year 1907 when GH Whipple was able to discover the existence of Whipple's disease. He primarily noted it as a disease that affects the intestinal systems of the body and is caused by the bacterial Tropheryma Whipplei. It could be observed the disease first affects the function of the small intestines as the said part of the body intends to distribute nutrients to the body during absorption. Hence, because of this fact, it could be expected that once the disease develops in the small intestine, it is sure that the entire body system shall then suffer from the said failure. From this point, Whipple recognized that the disease is a fatal matter once it is not given the right attention needed. Although there had been some developed cure, it is still strongly suggested by medical experts that this particular disease be prevented well through regular bowel check ups. It is through the bowel of a patient that the said disease is being recognized. Likely, because of the malfunction of the small intestines, the bowel also becomes loose. With masses of fat present in the bowel, Whipple's Disease naturally is depicted as the (040.2) intestinal lipodystrophy as its ICD description. It could be observed that its name was transformed as Whipple's disease as an honor to the one who was able to state it as a real disease, an epidemic that is dangerous to human kind. II. NATURAL HISTORY The disease usually begins with regular illnesses that might not be easily detected immediately as a part of Whipple's disease. Undoubtedly, this is the reason why the disease only becomes eminent after two years of understanding and diagnosing the situation upon a patient. At some point, it could be said that the major implicative symptoms of the disease may not be easily detected. Because of the prolonged development of the situation, the function of the small intestine begins to weaken slowly, giving a time for the patient to care less about the said matter. However, as noted above, not treating the symptoms early might cause fatal dangers to the patient being affected by Whipple's disease. To understand the different symptoms further, here are the lists of the said events and body-conditions needed to be looked out for: (a)Typical diarrhea: A typical diarrhea usually lasts for three to four days and then ends. Usually, the return of the illness comes along not within three or four months after the previous diarrhea. However, in the case of Whipple's disease, the matter becomes a serious situation, whereas the patient begins to feel awful of diarrhea almost regularly within the first two months of the development of the disease. (b) abdominal cramping: this may happen due to the stressed status of the small intestines. Besides that, diarrhea itself could cause the pain, especially if the situation keeps on recurring between shorter times of relapse. (c)Fast Wight Loss: Because of constant diarrhea along with the maldistribution of the nutrients to the body, the weight of the patient is likely to drop from normal to state of malnutrition. (d) Weakness and Lack of Self Concentration: a person with Whipple's disease would likely become more concerned with eating food to replace the weight that has been lost However, even though the patient may opt to do this, the continuous weakness of the body would occur as the nutrients of whatever is eaten is already not properly distributed to the different parts of the body. Then again, when the body weakens, the brain system also drowns down. Thinking would not be easy as one considers the state mentioned herein. (e) Loss of Appetite : although the need to eat might be know to the patient, the push to do so may not be that strong enough to say that the patient would have fine eating habits. Because of being weak from the loose bowel movement happening a patient may feel to exhausted to even consider eating any meal at all. (f) Joint inflammation: As the body weakens and the nutrients of the body not being well distributed in the body, inflammation of the joint occurs. With this particular situation, a patient becomes overly stressed to even stand up and work or so, making the joints become inflamed hence making it harder for the patient to even move. It should be noted though upon knowing these symptoms that the situation occurs in a much longer developmental time. Hence, it may not be that easy to identify if the symptom is actually pointing out to Whipple disease as it is. For this particular reason it is important that the symptoms be immediately brought to an expert, especially if they are already observed to have a prolonged effect on the patient. Diagnosis of the disease could only be assured with the use of the different tests that are made to search the intestine's status within. Upon discovering that the disease is indeed Whipple's disease, immediate attention should be given to the patient. Hence, to assure that the treatment to be given to a certain patient suffering from the said disease would be ample and applicable for the situation being solved, the medical diagnosis set as follows are being given careful analysis: D-xylose test: Absorption test, this test aims to measure the level of absorption that the body responds to, in terms of accepting sugar and other nutrients from food sources. Hydrogen breath test: a clinical medical method that is used to check the status of the body systems of those who are experiencing bowel irritability, as well as some food intolerance among several patients. Imaging studies of small intestine and pancreas: Seeing through lenses or radiological tools to see within the intestines and be able to observe the malfunctioning problems of the said systems in the body. Qualitative stool fat test: a checking method on the quality of the stool. Quantitative stool fat test: Measure or observatory test on how many times a person experience loose bowel movement and how much does he particularly excrete every time he does. Schilling test for vitamin B12: A stool and urine test for deciphering the level of vitamin B12 excreted from the body through waste [both liquid based or solid waste] Secretin stimulation test: This test particularly determines the physiological responsive ability of the pancreas to the released secretin being the hormone given by the small intestine when partially undigested food is passed through it from the stomach. Normally, released secretin causes the pancreas to produce a high concentration of bicarbonate fluid acting as an antacid to counteract the acid from the stomach contained in the passed food so that the enzymes in the small intestine can properly digest and absorb the food. Small bowel biopsy: This medical diagnostic procedure is done through examining the tissue samples taken from the lining of small intestine from the result of endoscopy. Samples are obtained through the use of EGD (esophagogastroduodenoscopy) or other endoscopy devices which are inserted through the nose or mouth and through the gastrointestinal tract. Tissues sample taken from the use of the device are then examined in the laboratory to determine significant information about the health condition. Stool culture or culture of small intestine aspirate: This diagnostic procedure is mainly done to examine the condition of the fecal waste sample for detecting parasite and germ infestation and even toxic chemical presence causing infection and problems. This medical examination is applied through culturing stool sample in a clean container maintained under sustainable condition for the bacteria in it to grow which is then used as the basis for observation noting their microscopic characteristics and condition. These tests are rather expected to at least be able to identify if a patient is already suffering from Whipple's disease. Likely, the said tests may be taken together or alternately until the desired sure results are garnered for the sake of giving ample medical assistance to any body affected by the said disease. Compliance to these tests may make the process of healing much possibly easier and faster to complete. Hence, if a patient is to be subjected to these tests, cooperation is primarily required. It may not be that easy for the medical experts to release immediate diagnosis after a single test, but it must be kept in mind that an assured test is much better than that of a non or wrong resulting health examinations. 3. AGENT-HOST-ENVIRONMENT The known bacteria for this particular disease is that of the Tropheryma Whipplei. The said bacteria has been observed to have been developing among patients who are give some specific medical treatment for a long time. Most of these patients are given regular antibiotic treatments. The bacteria grows in a polymicrobial community whereas the patient's body begins to stop responding to the medicine and the bacteria becomes cultured resulting to destructive effects on the different parts of the human body. So far, from the studies handled to understand this particular disease, researches bear a fact that the said disease only occurs on humans. Animals who were detected to have experienced the same symptoms as to humans already suffering from the Whipple disease were diagnosed to be under other health cases. Moreover, human-to-human transfer of the disease has not been proven yet. IV. MODE OF TRANSMISSION (ACQUSITION) As mentioned earlier, the transmission of the disease has not been well identified yet through research, It could be observed that it is only the prolonged use of antibiotics among patients and other individuals that usually result to this imbalance of nutrient distribution in the body. No other process of transmission had been yet detected hence it is believed that the problem could still be strongly controlled and is a non-epidemic scare matter at present yet. V. DESCRIPTIVE STUDIES Most of the patients who were found prone to the disease are that of the male Caucasians who are under the age bracket ranging from 40 towards 50 years of age. Mostly, the cases pertain to male population. In recent studies, there had also been some discoveries that Malaysian farmers also experience the same symptoms that characterize the existence of the Whipple Disease in an individual. It has also been noted that among those detected with the disease work as farmers. Others with other occupation come in a lot smaller number of population. Hence, the said situation is still subject to study and further research at present. VI. ANALYTIC STUDIES Today, the analytic studies released to help experts and health professionals understand the situation better are simply aimed in identifying further points of consideration needed to be realized so as to increase the level of concentration of treatment given to the patients diagnosed to have the Whipple disease. Moreover, such researches are also focused in understanding the different causes of the disease so as to help in the process of implicating possible prevention especially among those who are already taking certain medical assistance involving antibiotics, which are noted as primary agents of the disease among the first diagnosed patients on the record. VII. TREATMENT There are numerous treatments that could be applied among patients experiencing Whipple disease symptoms depending on the concentration of the disease on a particular individual. Undeniably, through the said treatments, Whipple's disease is expected to be cured. However, the recurrence of the disease is also expected after two years of successful treatment. Considerably, with these facts in focus, it should be noted that the patient that has been treated for the cure of the disease should constantly be under medication even after the given therapy, as the recurrence of the disease is even more fatal than that of the previous health illness that has occurred. Usually, the treatments vary from the level of doses that are given to the patients. These doses are actually given accordingly to the level of seriousness of the disease that one that is needed to be cured in a patient. It could be observed that the success of the treatment goes strongly dependent on the level of accuracy that the diagnosis has in accordance with the kinds of medical treatments that are to be offered for the patient to undergo. With these epidemiological report on Whipple's disease, it could be certainly agreed that the role of the small intestines in the body is indeed vital hence, should be well protected with a balanced diet and a healthy lifestyle that would better cause one a better and healthy living. VIII. PREVENTION Today, since the main causes of the disease has not been well identified yet, the only possible prevention that has been realized by experts to protect patients from the said disease is the process of immunization. Besides that, immediate response to the symptoms is also suggested especially that pertaining to excessive diarrhea and physical weakness. IX. FUTURE TREAD The Canadian intervention procedures have naturally gained much understanding regarding the most effective process to be applied in treating the Whipple disease through the researches one. Undeniably though, the researches still need better refurnishing and investigation so as to be fully applicable in the process of curing patients who are likely to develop, and even those who have already developed the disease upon themselves. Doing so shall also prevent the disease from developing into a more serious matter that is most refractive on the life of the population living within the human society that the disease primarily affects. References: Puchal X (2002). "Whipple's disease". Joint Bone Spine 69 (2): 133-40. Whipple GH (1907). "A hitherto undescribed disease characterized anatomically by deposits of fat and fatty acid in the intestinal and mesenteric lymphatic tissues". Bull Johns Hopkins Hosp 18: 382-93. Bai J, Mazure R, Vazquez H, Niveloni S, Smecuol E, Pedreira S, Maurio E (2004). "Whipple's disease". Clin Gastroenterol Hepatol 2 (10): 849-60 Fenollar F, Puchal X, Raoult D (2007). "Whipple's disease". N Engl J Med 356 (1): 55-66. Schwartz MA, Selhorst JB, Ochs AL, et al (1986). "Oculomasticatory myorhythmia: a unique movement disorder occurring in Whipple's disease". Ann. Neurol. 20 (6): 677-83. Read More