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    Tropical sprue

    Tropical sprue is a condition seen in residents of, or visitors to, tropical areas. It impairs the absorption of nutrients from the intestines, causing malabsorption.

    See also: Celiac disease - sprue

    Causes

    This disease is caused byinflammation of, and damage to the small intestine due to havingtoo much of certain types of bacteria in the intestines.

    Risk factors are:

    • Living in the tropics
    • Long periods of travel to tropical destinations

    Symptoms

    • Abdominal cramps
    • Diarrhea, worse on high-fat diet
    • Excessive gas (flatus)
    • Indigestion
    • Irritability
    • Muscle cramps
    • Numbness
    • Paleness
    • Weight loss

    Exams and Tests

    • Bone density test
    • Complete blood count (CBC)
    • Comprehensive metabolic panel
    • Enteroscopy
    • Folate level (serum)
    • Iron level (serum)
    • Stool examination for bacteria and parasites
    • Upper endoscopy
    • Upper GI series
    • Vitamin B12 level (serum)
    • Vitamin D level

    Treatment

    Treatment begins with plenty of fluids and electrolytes. Replacement of folate, iron, vitamin B12, and other nutrients may also be needed. Antibiotic therapy with tetracycline or another broad-spectrum antibiotic is given at the beginning of treatment.

    Oral tetracycline is usually not prescribed for children until after all of their permanent teeth have appeared, because it can permanently discolor teeth that are still forming. However, other antibiotics are available.

    Outlook (Prognosis)

    The outcome is good with treatment.

    Possible Complications

    Vitamin and mineral deficiencies are common complications.

    In children, sprue leads to:

    • Delay in the maturing of bones (skeletal maturation)
    • Growth failure

    When to Contact a Medical Professional

    Call your health care provider if:

    • Tropical sprue symptoms get worse or do not improve with treatment
    • You develop new symptoms
    • You have diarrhea or other symptoms of this disorder for a long period of time, especially after spending time in the tropics

    Prevention

    Other than avoiding living in or traveling to tropical climates, there is no known prevention for tropical sprue.

    References

    Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 142.

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    • Digestive system

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    • Digestive system organs

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      • Digestive system

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      • Digestive system organs

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      A Closer Look

        Tests for Tropical sprue

          Review Date: 2/19/2012

          Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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