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==Overview==
==Overview==
Ts should be considered in individuals with a compatible history, malabsorption, and chronic diarrhea. It may occur in either epidemic or endemic forms and can be preceded by acute gastroenteritis.
Patients with [[tropical sprue]] present with [[diarrhea]], [[bloating]], [[flatulence]], [[fever]] and [[myalgias]] in the acute phase. Patients in the chronic phase present with features of [[malabsorption]].


==History and Symptoms==
==History==
{| border="1"
Obtaining [[History and Physical examination|history]] gives important information in making a [[diagnosis]] of tropical sprue. It provides an insight into the cause, precipitating factors, and associated [[comorbid]] conditions. A complete [[History and Physical examination|history]] will help determine the correct [[therapy]] and helps in determining the [[prognosis]]. The areas of focus should be on onset, duration, and progression of [[symptoms]] such as:
!colspan="1" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Symptom}}
*[[Fever]]
!!colspan="1" style="background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Explanation}}
*[[Abdominal pain]]
|-
*Changes in [[appetite]]
|align=center|Diarrhea
*[[Bowel movement|Bowel movements]]
|Malabsorbed nutrients with '''osmotic''' diarrhea;colonic water secretion due to unabsorbed fatty acids.
*[[Weight loss]]
|-
*[[Leg swelling]]
|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 (physical)|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.


 
==Symptoms==
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.
Common symptoms in patients with acute phase of tropical sprue present with the following symptoms: <ref name="pmid12859716">{{cite journal| author=Walker MM| title=What is tropical sprue? | journal=J Gastroenterol Hepatol | year= 2003 | volume= 18 | issue= 8 | pages= 887-90 | pmid=12859716 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12859716  }} </ref>
*[[Diarrhea]]<ref name="pmid17089618">{{cite journal| author=Thakur B, Mishra P, Desai N, Thakur S, Alexander J, Sawant P| title=Profile of chronic small-bowel diarrhea in adults in Western India: a hospital-based study. | journal=Trop Gastroenterol | year= 2006 | volume= 27 | issue= 2 | pages= 84-6 | pmid=17089618 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17089618  }} </ref>
*[[Anorexia]]
*Abdominal [[bloating]]
*[[Flatulence]]
*[[Myalgia]]
*[[Fever]]
Common symptoms in patients with chronic phase of [[tropical sprue]] present with the following symptoms:<ref name="pmid24441659">{{cite journal| author=Brown IS, Bettington A, Bettington M, Rosty C| title=Tropical sprue: revisiting an underrecognized disease. | journal=Am J Surg Pathol | year= 2014 | volume= 38 | issue= 5 | pages= 666-72 | pmid=24441659 | doi=10.1097/PAS.0000000000000153 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24441659  }} </ref>
*[[Weight loss]]
*[[Malnutrition]]
*[[Anemia]]
*[[Fatigue]]
*[[Neuropathy]]
*[[Bone pain]] due to calcium and [[vitamin D]] [[malabsorption]]
*Weakness in combing hair and getting up from the chair are suggestive of [[Muscle weakness|proximal muscle weakness]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Gastroenterology]]


{{WS}}
{{WS}}
{{WH}}
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[[Category:Emergency mdicine]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Gastroenterology]]

Latest revision as of 00:30, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]

Overview

Patients with tropical sprue present with diarrhea, bloating, flatulence, fever and myalgias in the acute phase. Patients in the chronic phase present with features of malabsorption.

History

Obtaining history gives important information in making a diagnosis of tropical sprue. It provides an insight into the cause, precipitating factors, and associated comorbid conditions. A complete history will help determine the correct therapy and helps in determining the prognosis. The areas of focus should be on onset, duration, and progression of symptoms such as:

Symptoms

Common symptoms in patients with acute phase of tropical sprue present with the following symptoms: [1]

Common symptoms in patients with chronic phase of tropical sprue present with the following symptoms:[3]

References

  1. Walker MM (2003). "What is tropical sprue?". J Gastroenterol Hepatol. 18 (8): 887–90. PMID 12859716.
  2. Thakur B, Mishra P, Desai N, Thakur S, Alexander J, Sawant P (2006). "Profile of chronic small-bowel diarrhea in adults in Western India: a hospital-based study". Trop Gastroenterol. 27 (2): 84–6. PMID 17089618.
  3. Brown IS, Bettington A, Bettington M, Rosty C (2014). "Tropical sprue: revisiting an underrecognized disease". Am J Surg Pathol. 38 (5): 666–72. doi:10.1097/PAS.0000000000000153. PMID 24441659.

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