Tropical sprue is an infectious disease commonly
found in the tropics that cause the finger-like projections in
the lining of the small intestine called villi
to become flattened and inflamed.
Because villi increase the total surface area of the small intestine
and help it absorb nutrients, patients with tropical sprue may
suffer from nutrient- and vitamin-deficiencies
and become malnourished.
In a similar condition called celiac
disease, the body’s immune system mistakenly
attack a protein from grain called gluten. In
this process, the villi become flattened and the small intestine
lining becomes inflamed. The key difference between celiac disease
(also called non-tropical sprue) and tropical sprue is that the
first is an autoimmune disorder whereas the latter is caused by
Symptoms of Tropical Sprue
The symptoms of tropical sprue are:
- Chronic diarrhea
- Excess gas or flatulence
- Sore tongue
- Weight loss and malnutrition
- Chronic fatigue or weakness
- Steatorrhea or particularly foul-smelling
Patients with tropical sprue may also experience symptoms of
vitamin-deficiencies, such as:
- Scaling of the skin or hyperkeratosis, caused by vitamin
- Muscle spasm, bone pain, numbness and tingling sensation,
caused by vitamin D and calcium deficiencies
- Bruising and blood in urine, caused by vitamin K deficiency
How is Tropical Sprue Diagnosed?
Your doctor would perform the following tests to diagnose tropical
- Travel history
A key part in diagnosing tropical sprue is to determine whether
you have visited the tropics, where this disease is commonly
An endoscope or a flexible tube with camera and lights attached
is carefully threaded into the small intestine to see the flattening
of the villi. Tissue sample or biopsy is also taken at this
point to detect the presence of inflammatory cells.
Where is Tropical Sprue Commonly Found?
Tropical sprue is commonly found in:
- The Caribbean, Cuba, and Puerto Rico
- India and Southeast Asia
- Central and South America
Both natives and visitors to these places are often affected.
Causes of Tropical Sprue
The exact cause of tropical sprue is not known. Possible culprits
- Folic acid deficiency
- Toxins in spoiled food.
Prevention of Tropical Sprue
When you are traveling in tropical regions:
- Drink bottled water and sodas from trusted sources. Be aware
that in some poor regions bottled water may be re-filled with
tap water and resold.
- Use bottled water to brush your teeth.
- Wash fruits well with bottled water, or limit yourself only
to fruits that you can peel such as oranges and bananas.
- Avoid ice which may be made from tap water.
- Avoid vegetables and salads, which may be washed only with
- Do not eat foods sold by street vendors.
Treatment for Tropical Sprue?
Your doctor may prescribe the following:
- Antibiotic medications, such as tetracycline or sulfa drugs
- Vitamin supplements, such as vitamin B12 and folic acid supplements