Tropical sprue history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History and Symptoms
| Symptom | Explanation |
|---|---|
| Diarrhea | Malabsorbed nutrients with osmotic diarrhea;colonic water secretion due to unabsorbed fatty acids. |
| Pale, bulky foul-smelling stool | Fat malabsorption |
| Borborygmi, abdominal fullness, indigestion | Carbohydrate malabsorption |
| Pedal edema, skin changes | Hypoproteinemia secondary to loss of mucosal surface, protein loss and pancreatic insufficiency. |
| Pallor | Vitamin B12 and folate deficiency, rarely Iron deficiency. |
| Angular stomatitis, glossitis | Vitamin B deficiency |
| Night blindness, corneal xerosis, Bitot's spots, hyperkeratosis or skin scales | Vitamin A deficiency |
| bruises | Vitamin K deficiency |
| spasm, bone pain, numbness and tingling sensation | Vitamin D and calcium deficiencies |
| Muscle weakness | Hypophosphataemia,hypokalemia,hypomagnesaemia |
| Weight loss, lassitude, cachexia, fatigue | Anorexia, malabsorption, malnutrition |
The symptoms of tropical sprue are:
- Diarrhoea with passage of 3-20 loose stools per day, sometimes associated with blood and mucus, accompanied by nausea, anorexia, a feeling of fullness in the abdomen, loud borborygmi and occasionally severe vomiting.
- Nausea and vomiting diminishes with time but anorexia and abdominal distension persists over time.
- In about a quarter of patients, the onset of diarrhea is preceded for 1 or 2 days by fever, malaise.
- Vague abdominal discomfort with occasional colicky abdominal pain is usually present.
- Symptomatically, the course of the disease is frequently characterized by remissions and relapses. Periods of diarrhea with watery stools are often interspersed with periods of normal stools.
Signs
Diagnosis of tropical sprue can be complicated because many diseases have similar symptoms. Your doctor would look for the following signs:
- Abnormal flattening of villi and inflammation of the lining of the small intestine, observed during an endoscopic procedure.
- Presence of inflammatory cell 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).
Tropical sprue is largely limited to within about 30 degrees north and south of the equator. Therefore, if one resides outside of that geographical region, recent travel to the region is a key factor in diagnosing this disease.