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Tropical Sprue: Causes, Symptoms and Treatments

Occurring in tropical and subtropical regions of the world, tropical sprue is a digestive disorder where nutrients—folic acid and vitamin B12 in particular—are not properly absorbed by the body.

Tropical Sprue Occurs Only in the Tropics
Tropical sprue really does occur only in tropical and subtropical regions of the world. Most cases occur within 30 degrees north and south of the equator. The disease occurs more frequently in certain countries, including:

Cuba
Dominican Republic
Haiti
India
Puerto Rico
Southeast Asia.

Oddly enough, other countries within the tropical and subtropical regions—namely the Bahamas, Jamaica, and countries on the African continent—report very few cases of tropical sprue.

People Affected by Tropical Sprue

Tropical sprue is not limited to natives of the tropics and subtropics or visitors. Tropical sprue can affect anyone, although short-term travelers have a smaller risk of acquiring the disease. Most travelers affected by tropical sprue usually have stayed for over six months.

Causes of Tropical Sprue

The cause of tropical sprue is unknown, though researchers believe the disease is caused by an infectious microbial organism, or by a combination of an infectious organism and poor nutrition.

Nutritional Deficiencies and Tropical Sprue
The small intestine is lined with villi, small finger-like projections that increase the surface area of the small intestine. These villi aid in the absorption of nutrients. In tropical sprue, the villi are flattened, significantly decreasing the surface area of the small intestine. With less surface area, fewer nutrients than is normal are absorbed.

Symptoms of Tropical Sprue

Since tropical sprue is a type of malabsorption syndrome, it shares many of the same symptoms as other malabsorption syndromes. Diarrhea, weight loss and a sore tongue are the primary symptoms of tropical sprue, but other symptoms may also appear, including:

nausea
gas/flatulence
abdominal cramping
irritability
fatigue
fever
indigestion.

Tropical Sprue Treatments

Treatment for tropical sprue is fairly simple: Patients affected with the disease are prescribed antibiotics (tetracycline or oxytetracycline) for three to six months. Folic acid and vitamin B12 supplements may also be given, depending on the doctor.

Resources

A.D.A.M., Inc. (updated 2002). Tropical sprue.

Adediji, O.S. (updated 2004). Sprue, tropical.

Aetna InteliHealth Inc. (updated 2003). Tropical sprue.

Beers, M.H. & Berkow, R. (ed). Tropical sprue. The Merck Manual of Diagnosis and Therapy, 17th Edition. Merck Research Laboratories, NJ, 1999.