Tropical Sprue is a rare digestive disease in which the small intestine's ability to absorb nutrients is impaired (malabsorption). Consequently, nutritional deficiencies and abnormalities in the mucous lining of the small intestine may be present. The exact cause of this disorder is not known, however it may be related to environmental and nutritional conditions in the tropical regions where it is most prevalent.

The symptoms of Tropical Sprue may include Fatigue and Diarrhea with stools that are abundant, pale and foul-smelling. People with this disorder may also experience a profound loss of appetite (anorexia), a sore tongue, night blindness, Weight loss, a loss of strength and energy (asthenia) and general Weakness.

The onset of Tropical Sprue may be sudden. Individuals may have an abnormally high Fever, inflammation of the mouth and tongue, experience dry skin, a scaly appearance on the lips and at the angles of the mouth. Sometimes mental depression may occur.

For some people with Tropical Sprue, symptoms cease as suddenly as they may have begun (spontaneous remission). Treatment of the disorder in its early stages may result in rapid and complete recovery. The return to normal intestinal structure and function may be slower if treatment is begun later in the course of the disease. In some cases, Tropical Sprue may become chronic with frequent relapses.

People with this disorder may develop Anemia characterized by the presence of abnormally enlarged blood cells (megaloblastic) in the bone marrow. (For more information on this disorder, choose “Megaloblastic Anemia” as your search term in the Rare Disease Database.)

The exact cause of Tropical Sprue is not known. It is an acquired disorder that may be related to environmental and nutritional factors, or Tropical Sprue may be related to an infectious organism (either viral or bacterial), dietary toxin, parasitic infestation, or a nutritional deficiency such as folic acid. Tropical Sprue causes damage to the mucosal lining of the intestine resulting the impaired absorption of food, minerals, and water.

Treatment for Tropical Sprue includes the use of folic acid, cobalamin, and antibiotics such as tetracycline, oxytetracycline, or ampicillin. The dosage of these medications depends on the severity of the disorder as well as how the patient responds to the therapy. Combined therapy with folic acid and tetracycline seems to rapidly reduce the severity of the symptoms and also heal unhealthy tissue in the small intestine. Other nutrients may be given as needed (i.e., iron, vitamin B12). Diarrhea associated with this disorder may be controlled with anti-diarrhea agents.

Tropical sprue is a disorder that affects persons who spend long periods of time in tropical settings. It reduces nutrition absorption from the intestines. TS is a condition marked by chronic or acute diarrhea, weight loss, and nutritional malabsorption. Injury to the intestinal wall causes this condition. It is caused by an overabundance of certain kinds of bacteria in the intestines.

The following are risk factors:

• Being a tropical resident
• Traveling to tropical locations for extended periods of time
• People residing in or are immigrants from endemic tropical sprue areas are more at risk of becoming infected; immigrants might catch tropical sprue after leaving a risk area.
• Expatriates who have resided in an endemic region for more than 6 months are most at risk for tropical sprue, while the disease has been reported in travelers who have only been in a risk area for 2 to 4 weeks.
• Tropical sprue has been reported in US military personnel serving in the Philippines and Vietnam, as well as Peace Corps volunteers.
• Individuals with intestinal immunological abnormalities, such as a lack of secretory immunoglobulin A, may be at a higher risk. This shows additional factors outside an infectious etiology, but it also restricts the likelihood that overall starvation predisposes people to tropical sprue.
• Another feature that distinguishes tropical sprue from gluten-sensitive enteropathy is the lack of a genetic predisposition (celiac sprue).

Conditions
Deficits in vitamins and minerals are prevalent,In children, sprue causes Bone maturation is slowed (skeletal maturation),Failure to Grow
Drugs
Folic acid,Cobalamin,Tetracycline,Oxytetracycline,Ampicillin
Symptoms
Abdominal cramps,Diarrhea, worse on a high-fat diet,Excess gas (flatus),Fatigue,Fever,Leg swelling,Weight loss

Tropical sprue is a disease of malabsorption. There is no definitive evidence that proves of specific cause. Bacterial and viral infections, deficiency, and exposure to toxins such as rancid fats have been hypothesized to cause the disease.

Treatment

• The disease is commonly diagnosed in travelers to tropical areas, affects the small intestine, and causes chronic diarrhea, weight loss, and multiple nutritional malabsorptions of vitamins, especially B12 and folate. The disease is most prevalent in countries that are in tropical regions.
• Mineral and vitamin supplementation is the primary course of treatment.
• Initiation of fluid and electrolyte replacement is the immediate course of treatment provided to patients who present to the emergency department with severe dehydration and weight loss.
• The treatment includes antibiotics, parenteral vitamin supplementation, and fluid and electrolyte replacement.
• Some patients with blood count-related deficiencies require a blood transfusion.
• Combination therapy: It involves the administration of antibiotic tetracycline at the dose of 250 mg four times a day and 5 mg of folic acid, for 3 to 6 months.
• Anti-diarrheal drugs help control diarrhea associated with the disease.
• Premature termination of the therapy results in a relapse of the disease.

Conditions
Deficits in vitamins and minerals are prevalent,In children, sprue causes Bone maturation is slowed (skeletal maturation),Failure to Grow
Drugs
Folic acid,Cobalamin,Tetracycline,Oxytetracycline,Ampicillin
Symptoms
Abdominal cramps,Diarrhea, worse on a high-fat diet,Excess gas (flatus),Fatigue,Fever,Leg swelling,Weight loss