Tropical Sprue

Tropical Sprue

    * Introduction
    * Symptoms and Diagnosis
    * Treatment
Tropical Sprue is a syndrome characterized by acute or chronic diarrhea, weight loss and malabsorption. Appears to residents or visitors tropical and subtropical areas. The definition was expanded to include malabsorption of two different substances when other causes are excluded.
The exact cause is necunoascuta, but is considered guilty of an intestinal microbial infection. Infection caused damage to enterocytes, intestinal stasis and bacterial overpopulation. Destruction and malabsorption of nutrients demonstrated viloasa appear in varying degrees. Are the most common deficiencies of folate, vitamin B12 and iron.
Tropical Sprue occurs in epidemic and endemic forms especially in South Asia and the Caribbean. The current prevalence of endemic form is difficult to estimate, but reported rates exceeding 8% in Puerto Rico. An unusual feature is that tropical sprue appears to be limited to certain geographical areas, even in the tropics.
Form complicated by acute shortages of fluids and electrolytes is rarely fatal. The frequency of these complications is unknown but appears to be declining. Chronic disease with severe malabsorption and anemia can also lead to death, but it occurs mostly in people with comorbidities.
Without treatment for tropical sprue shows relapse leading to severe malabsorption. Useful therapies consist of antibiotics and replacement of nutrients, fluid deficits and sometimes blood. Generally manages a combination of antibiotics and folic acid plus vitamin B 12 for six months.
Pathogenesis
The precise role of microbial agents in the initiation and spread of the disease is misunderstood. One theory is that according to which an acute intestinal infection leading to jejunal and ileal mucosa injury, and bacterial overpopulation and increased plasma enteroglucagonul cause slowed intestinal transit. An important place is occupied in this process that folate deficiency contributes to the destruction of the mucosa.
Enteroglucagonul and motilin levels are elevated in patients with tropical sprue. Damage to enterocytes may cause. Enteroclucagonul cause intestinal stasis, but motilinei role is not yet clear.
The small intestine is predominantly affected, yet because it is a progressive and continuous, and small intestine may be affected until the distal ileum. Pathological changes are rarely demonstrated in stomach and colon. Coliform bacteria are isolated and are organismjele usually associated with tropical sprue.