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Tropical sprue


Tropical sprue is a condition that occurs in people who live in or visit tropical areas. It impairs nutrients from being absorbed from the intestines. This causes malabsorption.

This disease is caused by inflammation of, and damage to the small intestine. It comes from having too much of certain types of bacteria in the intestines.

Risk factors are:

  • Living in the tropics
  • Long periods of travel to tropical destinations



  • Abdominal cramps
  • Diarrhea, worse on high-fat diet
  • Excessive gas (flatus)
  • Indigestion
  • Irritability
  • Muscle cramps
  • Numbness
  • Paleness
  • Weight loss


Exams and Tests


  • Bone density test
  • Complete blood count (CBC)
  • Comprehensive metabolic panel
  • Enteroscopy
  • Folate level (serum)
  • Iron level (serum)
  • Stool examination for bacteria and parasites
  • Upper endoscopy
  • Upper GI series
  • Vitamin B12 level (serum)
  • Vitamin D level




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 Bactrim is typically given for 3 to 6 months.

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.


Outlook (Prognosis)


The outcome is good with treatment.


Possible Complications


Vitamin and mineral deficiencies are common.

In children, sprue leads to:

  • Delay in the maturing of bones (skeletal maturation)
  • Growth failure


When to Contact a Medical Professional


Call your health care provider if:

  • Tropical sprue symptoms get worse or do not improve with treatment
  • You develop new symptoms
  • You have diarrhea or other symptoms of this disorder for a long period of time, especially after spending time in the tropics




Other than avoiding living in or traveling to tropical climates, there is no known prevention for tropical sprue.




Semrad CE. Approach to the patient with diarrhea and malabsorption. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 142.

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    Tests for Tropical sprue


      Review Date: 2/10/2014

      Reviewed By: Todd Eisner, MD, private practice specializing in gastroenterology, Boca Raton, FL. Affiliate Assistant Professor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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