Tropical Sprue Treatment & Management

Updated: Dec 15, 2014
  • Author: Rohan C Clarke, MD; Chief Editor: Julian Katz, MD  more...
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Treatment

Medical Care

See the list below:

  • Patients with tropical sprue rarely present to the ED with the following symptoms. Unless folate or vitamin B-12 deficiencies are noted, the diagnosis will probably be made later. The symptoms require urgent evaluation and initiation replacement of deficient nutrients, fluid, and electrolytes. Hospital admission is indicated in complicated cases. Symptoms include the following:

    • Acute diarrhea

    • Volume depletion

    • Electrolyte imbalance

    • Symptomatic anemia

  • Without treatment, tropical sprue runs a relapsing course and can result in severe malnutrition.

  • Useful therapeutic interventions involve antibiotics and replacement of nutrients (eg, folic acid, vitamin B-12, iron), deficient fluid, and sometimes blood. However, despite success reported in other regions, antibiotic therapy for tropical sprue is not useful in patient populations of southern India.

  • Generally, administer a combination of antibiotics and folic acid to patients for 3-6 months. Patients with symptoms persisting longer than 6 months may be administered the combination for as long as a year.

  • Assess patients' responses by improvement of symptoms, weight gain, and correction of anemia. The duration of treatment depends on the duration of symptoms.