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</div><div><span>Tropical sprue</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Tropical sprue</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>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.</p><p>Tropical sprue (TS) is a syndrome characterized by acute or chronic diarrhea, weight loss, and <a test="test" href="./000299.htm">malabsorption</a> of nutrients.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>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.</p><p>Risk factors are:</p><ul><li>Living in the tropics</li><li>Long periods of travel to tropical destinations </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms include:</p><ul><li><a test="test" href="./003120.htm">Abdominal cramps</a></li><li>Diarrhea, worse on a high-fat diet</li><li><a test="test" href="./003124.htm">Excess gas (flatus)</a></li><li>Fatigue</li><li>Fever</li><li>Leg swelling</li><li><a test="test" href="./003107.htm">Weight loss</a></li></ul><p>Symptoms may not appear for up to 10 years after leaving the tropics.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>There is no clear marker or test that clearly diagnoses this problem.</p><p>Certain tests help to confirm that poor absorption of nutrients is present:</p><ul><li>D-xylose test to see how well the intestines absorb a simple sugar</li><li>Tests of the stool to see if fat is absorbed correctly</li><li>Blood tests to measure iron, folate, <a test="test" href="./003705.htm">vitamin B12</a>, or vitamin D</li><li><a test="test" href="./003642.htm">Complete blood count </a>(CBC)
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</li></ul><p>Tests that examine the small intestine may include:</p><ul><li><a test="test" href="./003889.htm">Enteroscopy</a></li><li><a test="test" href="./003338.htm">Upper endoscopy</a></li><li>Biopsy of the small intestine</li><li><a test="test" href="./003816.htm">Upper GI series</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>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 trimethoprim with sulfamethoxazole is typically given for 3 to 6 months.</p><p>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.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>The outcome is good with treatment.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Vitamin and mineral deficiencies are common.</p><p>In children, sprue leads to:</p><ul><li><div>Delay in the maturing of bones (skeletal maturation)</div></li><li><div><a test="test" href="./000991.htm">Growth failure</a></div></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your health care provider if:</p><ul><li>Tropical sprue symptoms get worse or do not improve with treatment.</li><li>You develop new symptoms.</li><li>You have diarrhea or other symptoms of this disorder for a long period of time, especially after spending time in the tropics. </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Other than avoiding living in or traveling to tropical climates, there is no known prevention for tropical sprue.</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1090t.jpg" alt="Digestive system" title="Digestive system" class="side-img"/><a href="../imagepages/1090.htm">Digestive system</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Ramakrishna BS. Tropical diarrhea and malabsorption. In: Feldman M, Friedman LS, Brandt LJ, eds. <em>Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management</em>. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 108.</p><p>Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Cooney KA, eds. <em>Goldman-Cecil Medicine</em>. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 126.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 12/31/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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