SPRUE SYNDROME (Tropical Sprue)


Tropical Sprue is a rare digestive diseasein 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.

Essentials of Diagnosis:-

• Pale, bulky, greasy, frothy, foul smelling stool with increased faecal fat on chemical analysis.
• Weight loss and multiple vitamin deficiency.
• Impaired intestinal absorption of glucose, vitamins and fat.
• Hypochromic or megaloblastic anaemia. X-ray-her-ring bone appearance.

• Skin pigmentation.


-Complete rest in severe cases and restriction of activity in mild case.
-Diet: High protein, low carbohydrate and low fat diet.
-Folic acid 10 to 20 mg daily orally or intramus- cularly for a few weeks corrects diarrhoea, ano- rexia, weight loss, glossitis and anaemia. Once acute symptoms subside patient can be maintained on Folic acid 5 mg daily.
-Antibiotics: Broad spectrum antibiotic 250 mg 6 hourly for few days.
-Cap Minicycline 100 mg twice daily.

-Prednisolone: 50 mg daily for first few days and then maintained on 15 mg daily. It increases absorp- tion of nitrogen, fat and has a nonspecific effect in producing euphoria and increase appetite. For malabsorption and steatorrhoea-Pancreatic enzy- mes-Merckenzyme tabs 2 with meals.


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