Tropical Sprue
Tropical sprue is a disorder of unknown cause affecting people living in tropical and subtropical areas who develop abnormalities of the lining of the small intestine, leading to malabsorption and deficiencies of many nutrients.
Tropical sprue occurs chiefly in the Caribbean, southern India, and Southeast Asia. Both natives and visitors may be affected, but children are rarely affected. The cause is unknown, but available evidence suggests an infectious cause.
Symptoms and Diagnosis
Light-colored stools, chronic diarrhea, and weight loss are typical symptoms of tropical sprue. Other symptoms of malabsorption of specific nutrients may also develop. A sore tongue develops from vitamin B2 deficiency. A deficiency of prothrombin, which is important in blood clotting, leads to easy bruising and prolonged bleeding after an injury. Anemia usually develops as a result of iron, vitamin B12, or folic acid deficiency, causing fatigue and weakness.
A doctor considers the diagnosis of tropical sprue in a person with anemia and symptoms of malabsorption who lives in or has recently visited one of the areas in which the disorder commonly occurs. X-rays of the small intestine may or may not be abnormal. An endoscopic biopsy (in which a tissue sample is obtained through a flexible tube and examined microscopically) of the small intestine can show some characteristic but not specific abnormalities. A stool sample may be analyzed to exclude parasites or bacteria as a cause.
Treatment
A person suspected of having tropical sprue is treated with an antibiotic. Either tetracycline or oxytetracycline is given over several months. Nutritional supplements, especially folic acid and vitamin B12, are given as needed. Treatment usually results in a full recovery.
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