tropical sprue a chronic disease affecting the digestive system, marked by imperfect absorption of food elements, especially fat, xylose, and vitamin B
12, from the small intestine. It is closely related to
celiac disease and may be identical to it.
The name sprue derives from a Dutch word describing inflammation of the mouth, which is a frequent symptom. The disease has been recognized for more than 2000 years. It occurs mostly, but not exclusively, in the tropics.
Symptoms and Treatment. Symptoms are loss of appetite, flatulence, anemia, diarrhea, stomach cramps, and extreme loss of weight. Stools are usually pale, greasy, unformed, and foul-smelling, but at times become watery. If a deficiency of vitamin B complex is also present, cracks develop at the corners of the mouth and the tongue becomes smooth, glossy, and bright red.
Treatment consists of a special diet of foods that are low in fat and high in protein. Diets free of gluten, a viscid grain protein, may be prescribed. Liver preparations, folic acid, calcium lactate tablets, vitamin B12, and iron supplements to provide food elements that are not absorbed, as well as skim milk and ripe bananas, have produced favorable results. Antibiotics have proved temporarily successful, but their prolonged use is not recommended.
Cases of sprue that are recognized early respond better to treatment than do cases of long standing. Appetite and weight return rapidly. The time required for complete recovery is prolonged, however, especially in extreme cases.