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Tropical sprue: a forgotten entity
1Institute of Gastroenterology, Hepatobiliary Science and Liver Transplantation, SRM Institutes for Medical Science, Vadapalani, Chennai, India.
Current Opinion in Infectious Diseases
|August 11, 2026
Summary
Tropical sprue, a malabsorption syndrome, is increasingly difficult to diagnose due to its rarity. This review highlights its overlap with postinfectious irritable bowel syndrome and suggests coronaviruses as a potential cause.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Malabsorption Syndromes
Background:
- Tropical sprue is a malabsorption syndrome with declining prevalence.
- Its rarity and lack of specific diagnostic tests lead to delayed or missed diagnoses.
- There is a notable overlap between tropical sprue and postinfectious irritable bowel syndrome.
Purpose of the Study:
- To re-emphasize the importance of diagnosing tropical sprue.
- To explore the connection between tropical sprue and postinfectious irritable bowel syndrome.
- To discuss evolving diagnostic criteria for tropical sprue.
Main Methods:
- Review of sporadic case reports and recent findings.
- Analysis of post-COVID-19 gastrointestinal symptoms.
- Evaluation of modified diagnostic criteria for malabsorption.
Main Results:
- Tropical sprue continues to occur in endemic areas and among travelers.
- Post-COVID-19 gastrointestinal symptoms and malnutrition warrant investigation for tropical sprue.
- Coronaviruses are proposed as a potential cause of tropical sprue.
- Modified diagnostic criteria are needed due to limited access to absorption tests.
Conclusions:
- Tropical sprue should be considered in the differential diagnosis of malabsorption.
- Non-celiac enteropathy responding to antibiotics suggests tropical sprue.
- Further investigation into potential causes like coronaviruses is recommended.
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