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$Title{Tropical Sprue}
$Subject{Tropical Sprue Hill Diarrhea Tropical Diarrhea }
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Copyright (C) 1986, 1989 National Organization for Rare Disorders, Inc.

89:
Tropical Sprue

** IMPORTANT **
It is possible that the main title of the article (Tropical Sprue) is not
the name you expected.  Please check the SYNONYM listing to find alternate
names and disorder subdivisions covered by the article.

Synonyms

     Hill Diarrhea
     Tropical Diarrhea

General Discussion

** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only.  It should not be used for diagnostic or treatment
purposes.  If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.

Malabsorption, multiple nutritional deficiencies, and abnormalities in
the small bowel mucosa are the chief characteristics in Tropical Sprue, a
disorder of unknown cause.  The disease is acquired and appears to be related
to environmental and nutritional conditions.  It is most prevalent in the
Caribbean, south India, and southeast Asia.

Symptoms

Symptoms of Tropical Sprue may include fatigue, diarrhea with stools that are
copious, pale and malodorous, anorexia, loss of weight, asthenia (loss of
strength and energy) and general weakness.

The onset of the disorder may be acute.  There may be fever and an
inflammation of the mouth and tongue.  The skin may be dry and there may be
scaling apparent on the lips and at the angles of the mouth.  Some patients
may experience mental depression.

Some patients experience spontaneous remission.  Treatment of the
disorder in its early stages may result in rapid and complete recovery.  The
restoration of normal intestinal structure and function may be slower if
treatment is begun later in the course of the disease.  Tropical Sprue may
become chronic with frequent relapses.

Malabsorption of fats and xylose, reduction in the absorption of iron,
vitamin B12, and folate, and megaloblastic anemia are common findings.

Causes

Tropical Sprue is a disease of unknown cause.  It is an acquired disorder
which appears to be related to environmental and nutritional conditions.  The
disease may be related to an infectious organism (either viral or bacterial),
dietary toxin, parasitic infestation, or a nutritional deficiency such as
folic acid.  Damage to intestinal mucosa which results in an impairment of
the absorption of foods, minerals, and water may be produced by these agents.

Affected Population

Tropical Sprue occurs chiefly in the Caribbean area, south India, and
southeast Asia.  Both residents of the area and visitors can be affected.

Therapies:  Standard

Treatment for Tropical Sprue includes the use of folic acid and tetracycline
or oxytetracycline or ampicillin.  The dosage depends on the severity of the
disorder as well as how the patient responds to the therapy.  Other
replacement therapy is given as needed (e.g., iron, vitamin B12).  Diarrhea
may be controlled with Lomotil or Imodium.

Therapies:  Investigational

This disease entry is based upon medical information available through
September 1989.  Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate.  Please check with the agencies listed in the Resources section for
the most current information about this disorder.

Resources

For more information on Tropical Sprue, please contact:

     National Organization for Rare Disorders (NORD)
     P.O. Box 8923
     New Fairfield, CT  06812-1783
     (203) 746-6518

     National Digestive Diseases Information Clearinghouse
     Box NDIC
     Bethesda, MD  20892
     (301) 468-2162

     Centers for Disease Control (CDC)
     1600 Clifton Road, NE
     Atlanta, GA  30333
     (404) 639-3534

References

CECIL TEXTBOOK OF MEDICINE, 18th ed.:  James B. Wyngaarden, and Lloyd H.
Smith, Jr., Eds.:  W. B. Saunders Co., 1988.  P. 743.

THE MERCK MANUAL 15th ed:  R. Berkow, et al:  eds; Merck, Sharp & Dohme
Research Laboratories, 1987.  P. 794.