Tropical Sprue

National Organization for Rare Disorders, Inc.

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It is possible that the main title of the report Tropical Sprue is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.


  • Hill Diarrhea
  • Tropical Diarrhea

Disorder Subdivisions

  • None

General Discussion

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.

Affected Populations

Tropical Sprue is a rare disorder in temperate regions. It occurs mainly in the tropical regions of the Caribbean, India, South Africa, and Southeast Asia. Transients, tourists and visitors to these areas can be affected.

Standard Therapies

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.

Investigational Therapies

Information on current clinical trials is posted on the Internet at All studies receiving U.S. Government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222

TTY: (866) 411-1010


For information about clinical trials sponsored by private sources, contact:



Cecil Textbook of Medicine, 20th Ed.: J. C. Bennett & F. Plum, Editors; W.B. Saunders Co., 1996. Pp. 705-06.

The Merck Manual, 17th Ed.: Mark H. Beers and Robert Berkow , Eds.; Merck Research Laboratories, 1999. Pp. 300-01.

Mayo Clinic Family Health Book, 2nd Ed., David E. Larson, Ed. William Morrow and Company, Inc., 1996, P. 971.


Persistent Diarrhea in the Returned Traveler. N. M. Thielman et al., Infect Dis Clin North Am. (Jun 1998, 12 (2)), Pp. 489-501.

Tropical Sprue and Subclinical Enteropathy: A Vision for the Nineties.

P Haghighi et al., Crit Rev Clin Lab Sci. (Aug1997, 34 (4)), Pp. 313-41.



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