Tropical sprue

Definition

Tropical sprue is a condition affecting the absorption of nutrients (malabsorption) that is common in the tropics and subtropics.

Causes, incidence, and risk factors

The cause of this disease is unknown, but it may be caused by an infection. The condition affects residents of or visitors to the tropics. 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

In children, sprue leads to:

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

Signs and tests

• CHEM 20
• Complete blood count (CBC)
• Enteroscopy
• Stool
• Upper endoscopy
• Upper GI series

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 is given at the beginning of treatment.

Oral tetracycline is usually not prescribed for children until after all permanent teeth have appeared. It can permanently discolor teeth that are still forming.

Expectations (prognosis)

The outcome is expected to be good with treatment.

Complications

Vitamin and mineral deficiencies are common complications.

Calling your health care provider

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.