About Me

Welcome to my blog! I am a medical doctor currently in the role of a health entrepreneur and a health coach/consultant. My blogs are focused on using a holistic approach towards healthcare. I believe patients are not just diseases but humans as a whole. Therefore, conventional treatments should be combined with alternative/natural therapies. My blogs focus on providing guidance to fix the cause of conditions and not just reduce the symptoms.

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Whipple's Disease: Symptoms, Diagnosis, Treatment | Dealing With Weight Loss and Chronic Diarrhea?

  October 28, 2020    

 

Whipple's disease is commonly thought of as a digestive issue exclusively, which is not the case. Additionally, it is so rare that it is often misdiagnosed as other more common digestive conditions. 

Objectives of this article:

  •  What is Whipple's Disease?

  •  What are the Symptoms of Whipple's Disease?

  •  How is Whipple's Disease Diagnosed?

  •  How is Whipple's Disease Treated?

  •  Other Conditions Similar to Whipple's Disease


What is Whipple's Disease?

Whipple's disease (WD) is a rare but a chronic bacterial infection caused by a bacterium called Tropheryma whipplei. It interferes with the breakdown, digestion and absorption of food and vital nutrients that pass through the gut. 
While the bacterium predominantly affects the digestive system, it is not the only site of attack. Whipple's disease has debilitating effects on other organs such as the joints, heart, lungs, brain, eyes and skin, and therefore, produces specific symptoms accordingly. 

What are the Symptoms of Whipple's Disease?

  • Joint pain: not all joint pains are arthritis! WD is easily misdiagnosed as other forms of chronic inflammatory arthritis. The medications that the patients are mistreated with results in even a more severe, life-threatening form of WD.
  • Heart: the bacterium can invade the pericardium (outer covering of the heart), myocardium (the heart muscle) as well as the valves that the blood pumps through. This results in specific murmurs, particularly aortic and mitral valve insufficiency that has been noted in 25% of the cases, roughly. 
  • Lungs: WD can invade the pleurae (outer covering) of the lungs as well as the lung tissue, which produces symptoms that can be misdiagnosed as lung cancer such as chronic cough, weight loss, difficulty breathing, pleural effusion (build-up of excess fluid between the coverings of the lungs).  
  • Brain: Although very rare, WD can exclusively affect the CNS, without causing any gastrointestinal (GI) disturbances. Often without generating significant symptoms, CNS involvement results in worse outcomes with long-term effects such as cognitive impairment and dementia, so immediate tests and treatments are mandatory. 
  • Eyes: Involvement of the eyes in WD generally occurs with GI and CNS symptoms and causes inflammation, swelling, and hemorrhage, which can lead to blurred vision or loss of vision.
  • Skin: Skin manifestations primarily result from nutritional deficiencies due to malabsorption caused by WD. Hyperpigmentation results from Vitamin B3, B12 deficiency or low cortisol. Petechiae or purpura (red spots on skin) may appear due to Vitamin C or K deficiency. Also, swelling may result from increased protein loss from the GI tract.
  • GI and associated common symptoms: severe diarrhea leading to anemia, nutrient deficiencies, abdominal pain/discomfort, low-grade fever, headache, cough, weight loss and muscle waste.

 How is Whipple's Disease Diagnosed?

Endoscopic examination of the small intestines with a tissue biopsy is the initial step in diagnosis. Endoscopy characteristically reveals swollen, red tissue with whitish appearance. Close study of the tissue under a microscope confirms the diagnosis. Other organ tissues may also be sampled relevant to the presenting signs and symptoms.  Specific test names that you may across are Polymerase Chain Reaction, or PCR (tells about the amount of bacteria present), Periodic-Acid Schiff, or PAS (stains bacteria pink for better visualization), electronic microscopy (high resolution reveals the presence of bacteria).

How is Whipple's Disease Treated?

WD was potentially fatal before the administration of antibiotics. However, at current times, it is efficiently treatable with a good prognosis. General guidelines include the following treatment regimen: IV ceftriazone or IV Penicillin for 2-4 weeks followed by trimethoprim-sulfamethoxazole for an additional year. When treated effectively, the symptoms generally resolve within 2-3 months.

Other Conditions That Mimic Whipple's Disease:

  • Celiac Disease
  • Crohn's Disease
  • Irritable Bowel Syndrome (IBS)
  • Lactose Intolerance
  • Grain Allergy 

WD may be rare but it does exist and is very commonly misdiagnosed as other very different conditions but ones that produce similar symptoms. Immunocompromised middle-aged men in locations that lack proper sanitation and fresh water are at increased risk of contracting this illness. Fortunately, better diagnostic tests and the use of antibiotics can effectively treat this potentially chronic and fatal condition.


References:
 

 Puéchal X. Whipple disease and arthritis. Curr Opin Rheumatol. 2001;13(1):74.

Bai JC, Mazure RM, Vazquez H, et al. Whipple’s disease. Clin Gastroenterol Hepatol. 2004;2(10):849-860.

Ratnaike RN. Whipple’s disease. Postgrad Med J. 2000;76(902):760-766.

Scheld WM. Whipple disease of the central nervous system. J Infect Dis. 2003;188(6):797-800.

Savaryn B, Decker M, Ye C, Bacani J, Houston S. An atypical case of Whipple’s disease presenting as fever of unknown origin: A brief review. Off J Assoc Med Microbiol Infect Dis Can. 2019;4(4):241-247.

Dolmans RAV, Boel CHE, Lacle MM, Kusters JG. Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections. Clin Microbiol Rev. 2017;30(2):529-555.

  

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Blueberries Nutrition and Health Benefits

  October 04, 2020    

 

Photo by Joanna Kosinska on Unsplash

Blueberries are a very popular part of North American diet. One simple reason is because it tastes good. But are you aware of its nutritional facts and what the latest research indicate about this "super fruit"? 

In this article:

  • Blueberries benefits in brain health, diabetes and cardiovascular health

  • Latest trends in snacking

  • Blueberries nutrition facts

  • Ways to incorporate blueberries into daily diet


Blueberries Benefits in Brain Health:

  • Krikorian et al. 2020: Older subjects who were showing signs of memory impairment were enrolled in a study for 16 weeks where they consumed one serving of blueberries daily (1 cup). At the end of 16 weeks, significant improvement was noted in visual and spatial memory with increased memory processing speed. 
  • Miller et al. 2017: 13 healthy men and 24 healthy women between the ages of 60 and 75 were randomly selected to either receive daily supplementation of blueberries or a placebo for next 3 months. The group that received blueberry supplementation showed significant decline in making errors in their verbal memory. 

 

Blueberries Benefits in Diabetes:

  • Stull et al. 2010: The experimental group that received daily supplementation of blueberries for 6 weeks displayed significant improvement in insulin sensitivity.
  • Stote et al. 2020: Consumption of blueberries for 8 weeks resulted in significant reduction in type 2 diabetes risk factors and improvement in HbA1c levels in overweight men.

 

Blueberries Benefits in Cardiovascular Health:

  • Johnson et al. 2015: Blueberries consumption for 8 weeks lead to a 5-6% decrease in high blood pressure in post-menopausal women.
  • Curtis et al. 2019: One cup of blueberries intake daily for 6 weeks resulted in significant improvements in heart health measures in men and women with metabolic syndrome.

 

Latest Trends in Snacking:

According to a survey conducted by Information Resources Inc. & US Department of HHS, almost half of Americans consume 3+ snacks per day and one-third consume 4+ snacks per day, out of which 65-75% Americans want snack items that curb hunger, boost energy and provide nutrition. Snacking with nuts and fruits can help boost nutrition and provide additional health benefits as they increase the overall diet quality and provide essential nutrients to children.

 

Blueberries Nutrition and Benefits: Powerful Snacking Option

A handful of blueberries is roughly equal to a cup or one serving, which is equivalent to 80 calories. Four major nutrients that are packed in blueberries include: fiber (increases fullness, aids in digestion and regulates healthy cholesterol levels; 3.6g per serving), vitamin C (a strong antioxidant that improves immunity, stabilizes free radicals and prevents cellular damage, helps in collagen synthesis to support healing, increases iron absorption; 16% of daily requirement per serving), vitamin K (regulates blood clotting and metabolism; ~25% of daily requirement per serving), Manganese (aids in bone development and converts digested food into usable energy; ~25% of daily requirement per serving).

 

How to Incorporate Blueberries in Your Diet:

  • Blueberries provide complex carbohydrates in form of high dietary fiber. They are best paired with forms of proteins such as nuts, seeds, cheese, hummus, yogurt and eggs.
  • The sweetness of blueberries can be paired with savory items including various herbs, lemon, cheese, olives etc.
  • Bowls (with proteins, greens, fats and carbs) and smoothies (with greens and fruits)
  • Bento boxes: kids-friendly, well-balanced, varied nutrients in one meal.
Blueberries are one of those super fruits that are not only extremely satisfying to our taste but are equally nutritious as well. They can be easily incorporated into our diets in form of sustainable snack items. And, thanks to the versatility in their taste, they can deliciously be paired with savory items, and high-protein foods for a more nutritional balance.

 

 References:

1.Prior RL, Cao G, Martin A, et al. Antioxidant capacity as influenced by total phenolic and anthocyanin content, maturity, and variety of Vaccinium species. J Agric Food Chem. 1998;46(7):2686-2693.
 2.Joseph JA,Shukitt-Hale B, Denisova NA,et al. Reversals of age-related declines in neuronal signal transduction, cognitive, and motor behavioral deficits with blueberry, spinach, or strawberry dietary supplementation. J Neurosci. 1999;19(18):8114-8121. 
3.Krikorian R, Kalt W, McDonald JE, Shidler MD, Summer SS, Stein AL. Cognitive performance inrelation to urinary anthocyanins and their flavonoid-based products following blueberry supplementation in older adults at risk for dementia.J Funct Foods. 2020;64:103667. 
4.Miller MG, Hamilton DA, Joseph JA, Shukitt-Hale B. Dietary blueberry improves cognition among older adults in a randomized, double-blind, placebo-controlled trial.EurJ Nutr. 2017;57(3):1169-1180. 
5.Stull AJ, Cash KC, Johnson WD, Champagne CM, Cefalu WT.Bioactivesin blueberries improve insulinsensitivity in obese, insulin-resistantmen and women.JNutr.2010;140(10):1764-1768. 
6.Stote KS, Wilson MM, Hallenbeck D, et al. Effect of blueberry consumption on cardiometabolic health parameters in men with type 2 diabetes: an 8-week, double-blind, randomized, placebo-controlled trial. CurrDev Nutr. 2020;4(4):nzaa030.
 7.Johnson SA, Figueroa A, Navaei N, et al. Daily blueberry consumption improves blood pressure and arterial stiffness inpostmenopausal women with pre-and stage 1-hypertension:arandomized, double-blind, placebo-controlled clinical trial.JAcadNutrDiet. 2015;115(3):369-377. 
8.Curtis PJ,van der Velpen V, Berends L,et al. Blueberries improve biomarkers of cardiometabolic function in participants with metabolic syndrome —results from a 6-month, double-blind, randomized controlled trial.Am J Clin Nutr. 2019;109(6):1535-1545. 
9.IRI.How America eats:the state of the snacking industry. https://www.iriworldwide.com/IRI/media/Library/webinar/IRI-How-America-Eats_2019-State-of-Snack-Industry.pdf. Published April 9, 2019. 
10.US Department of Health and Human Services;US Department of Agriculture. 2015–2020Dietary Guidelines for Americans,8th Edition.https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/. Published January 7, 2016. 
11.Loth KA, Tate A, Trofholz A, Fisher JO, Neumark-Sztainer D, Berge JM.The contribution of snacking to overall diet Intake among an ethnically and racially diverse population of boys and girls. J Acad Nutr Diet. 2020;120(2):270-279. 
12.Barnes TL, French SA, Harnack LJ, Mitchell NR, Wolfson J. Snacking behaviors, diet quality, and body mass index in a community sample of working adults. J Acad Nutr Diet. 2015;115(7):1117-1123. 
13.U.S. Highbush Blueberry Council. 2019 U.S. Highbush BlueberryCouncil segmentation study. 
14.Moghaddam E, Vogt JA, Wolever TMS. The effects of fat and protein on glycemic responses in nondiabetic humans vary with waist circumference, fasting plasma insulin, and dietary fiber intake. J Nutr. 2006;136(10):2506-2511. 
15.Flavor pairings. U.S. Highbush Blueberry Council website. https://www.blueberrycouncil.org/blueberry-cooking-tips/flavor-pairings/.

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