It is common in the tropics but also occurs in temperate countries, where it is known as idiopathic or nontropical sprue. There are many disorders that may cause sprue. The disorders include celiac disease in infants and pancreatitis, in which there is an insufficient secretion of the pancreatic enzymes that chemically break down food. Sprue may be caused by any condition that interferes with normal intestinal cell activity, for example, the metabolic disorder amyloidosis. Sprue may also develop following irradiation treatment, worm infections, blockage of the lymphatic system from heart failure, or an operation in which part of the stomach or small intestine has been removed.
Tropical sprue is thought to be caused by infection.
The patient usually appears unwell, is underweight, and has a dry, pale skin. The abdomen may also swell. The patient may complain of weakness, fatigue, and frequent muscle cramps. Bruising may occur easily, and diarrhea, with large, pale, fatty stools that float, may be present. Treatment depends on the cause.