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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.

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Digestive system
Digestive system organs

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:

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:

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:

When to Contact a Medical Professional

Call your health care provider if:

Prevention

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

Related Information

Malabsorption
Diarrhea

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. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: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.

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Review Date: 10/18/2019  

Reviewed By: Michael M. Phillips, MD, Clinical 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.

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