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Tropical sprue
Tropical sprue is a condition that occurs in people who live in or visit tropical areas. It impairs nutrients from being absorbed from the intestines.
Tropical sprue (TS) is a syndrome characterized by acute or chronic diarrhea, weight loss, and malabsorption of nutrients.
Malabsorption
Malabsorption involves problems with the body's ability to take in nutrients from food.
Causes
This disease is caused by damage to the lining of the small intestine. It comes from having too much of certain types of bacteria in the intestines.
Risk factors are:
- Living in the tropics
- Long periods of travel to tropical destinations
Symptoms
Symptoms include:
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Abdominal cramps
Abdominal cramps
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
ImageRead Article Now Book Mark Article - Diarrhea, worse on a high-fat diet
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Excess gas (flatus)
Excess gas (flatus)
Gas is air in the intestine that is passed through the rectum. Air that moves from the digestive tract through the mouth is called belching. Gas is ...
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- Fever
- Leg swelling
-
Weight loss
Weight loss
Unexplained weight loss is a decrease in body weight, when you did not try to lose the weight on your own. Many people gain and lose weight. Uninten...
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Symptoms may not appear for up to 10 years after leaving the tropics.
Exams and Tests
There is no clear marker or test that clearly diagnoses this problem.
Certain tests help to confirm that poor absorption of nutrients is present:
- D-xylsoe is a lab test to see how well the intestines absorb a simple sugar
- Tests of the stool to see if fat is absorbed correctly
-
Blood tests to measure iron, folate,
vitamin B12
, or vitamin D.
Vitamin B12
The vitamin B12 level is a blood test that measures how much vitamin B12 is in your blood.
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Complete blood count (CBC)
Complete blood count (CBC)
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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Test that examine the small intestine may include:
-
Enteroscopy
Enteroscopy
Enteroscopy is a procedure used to examine the small intestine (small bowel).
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Upper endoscopy
Upper endoscopy
Endoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...
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Upper GI series
Upper GI series
An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine. Barium enema is a related test....
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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 Bactrim is typically given for 3 to 6 months.
In most cases, oral tetracycline is not prescribed for children until after all the permanent teeth have come in. This medicine can permanently discolor teeth that are still forming. However, other antibiotics can be used.
Outlook (Prognosis)
The outcome is good with treatment.
Possible Complications
Vitamin and mineral deficiencies are common.
In children, sprue leads to:
- Delay in the maturing of bones (skeletal maturation)
-
Growth failure
Growth failure
Failure to thrive refers to children whose current weight or rate of weight gain is much lower than that of other children of similar age and gender....
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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
Ramakrishna BS. Tropical diarrhea and malabsorption. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 108.
Semrad CE. Approach to the patient with diarrhea and malabsorption In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 140.
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Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
-
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
-
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
-
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
Review Date: 10/27/2015
Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
