Tropical sprue overview: Difference between revisions
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===History and Symptoms=== | ===History and Symptoms=== | ||
TS has been defined as malabsorption of two or more substances(Carbohydrate,fat,vitamin B12) in people from the tropics when other known causes have been excluded. Klipstein characterized tropical sprue as jejunal morphologic abnormalities accompanied by malabsorption of two distinct substances, and having the following distinct features: 1) gastrointestinal symptoms | |||
2) relentless worsening unless treatment is instituted; | |||
3) nutritional deficiency in all patients with advanced disease, regardless of dietary intake; | |||
4) failure of the morphologic abnormalities to improve with emigration to a temperate zone; and | |||
5) consistent response to folic acid and/or tetracycline. | |||
===Physical Examination=== | ===Physical Examination=== | ||
Revision as of 15:40, 22 February 2017
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Tropical sprue Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Tropical sprue overview On the Web |
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American Roentgen Ray Society Images of Tropical sprue overview |
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Risk calculators and risk factors for Tropical sprue overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]
Synonyms and keywords: Chronic diarrhea, Intestinal malabsorption, Tropical malabsorption, Postinfective tropical malabsorption, Postinfective malabsorption, Tropical enteropathy, Tropical diarrhea, Military diarrhea, Cachectic diarrhea, Psilosis, Aphthae tropical, Chronic traveller's diarrhea, Tropical steatorrhea, Chronic malabsorption.
Overview
Tropical sprue is an acquired malabsorption disease of unknown etiology commonly found in the tropical regions, marked with abnormal flattening of the villi and inflammation of the lining of the small intestine. Ghoshal et al. defined a group of patients with TS by strict clinical and pathological criteria and show that aerobic bacteria contaminate the small bowel in patients with TS and that these patients have a prolonged orocecal transit time (OCTT) compared with healthy control subjects. It differs significantly from coeliac sprue.
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Tropical sprue overview from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Exclusion of other diarrheal etiologies is required for the diagnosis of TS.
Diagnostic Criteria
Tropical sprue is a diagnosis of exclusion, it is usually considered in returning traveller's presenting with persistent diarrhea. Following signs may be indicative of TS:
- Abnormal flattening of the villi and inflammation of the lining of the small intestine, observed during an endoscopic procedure.
- Presence of inflammatory cells in the biopsy of small intestine tissue.
- Low levels of vitamins A, B12, E, D, and K, as well as serum albumin, calcium, and folate, revealed by a blood test.
- Excess fat in the feces (steatorrhoea).
History and Symptoms
TS has been defined as malabsorption of two or more substances(Carbohydrate,fat,vitamin B12) in people from the tropics when other known causes have been excluded. Klipstein characterized tropical sprue as jejunal morphologic abnormalities accompanied by malabsorption of two distinct substances, and having the following distinct features: 1) gastrointestinal symptoms 2) relentless worsening unless treatment is instituted; 3) nutritional deficiency in all patients with advanced disease, regardless of dietary intake; 4) failure of the morphologic abnormalities to improve with emigration to a temperate zone; and 5) consistent response to folic acid and/or tetracycline.