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Tropical sprue

Tropical sprue is a condition that occurs in people who live in or visit tropical areas for extended periods of time. 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.

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:

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-xylose 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
  • Complete blood count (CBC)

Tests that examine the small intestine may include:

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

When to Contact a Medical Professional

Contact 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.

Review Date: 10/25/2021

Reviewed By

Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Ramakrishna BS. Tropical diarrhea and malabsorption. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 108.

Semrad SE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 131.

Disclaimer

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. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Digestive system - Illustration Thumbnail

Digestive system

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.

Illustration

Digestive system organs - Illustration Thumbnail

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