Tropical Sprue

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 an infection.

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 feces

Patients with tropical sprue may also experience symptoms of vitamin-deficiencies, such as:

  • Scaling of the skin or hyperkeratosis, caused by vitamin A deficiency
  • 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 sprue:

  • Travel history
    A key part in diagnosing tropical sprue is to determine whether you have visited the tropics, where this disease is commonly found.

  • Endoscopy
    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
  • Africa
  • 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 are:

  • Bacteria
  • Viruses
  • Amoebas
  • Parasites
  • 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 tap water.

  • 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

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