Ramakrishna B S, Venkataraman S, Mukhopadhya A
Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Postgrad Med J. 2006 Dec;82(974):779-87. doi: 10.1136/pgmj.2006.048579.
Malabsorption is an important clinical problem both in visitors to the tropics and in native residents of tropical countries. Infections of the small intestine are the most important cause of tropical malabsorption. Protozoal infections cause malabsorption in immunocompetent hosts, but do so more commonly in the setting of immune deficiency. Helminth infections occasionally cause malabsorption or protein-losing enteropathy. Intestinal tuberculosis, chronic pancreatitis and small-bowel bacterial overgrowth are important causes of tropical malabsorption. In recent years, inflammatory bowel disease and coeliac disease have become major causes of malabsorption in the tropics. Sporadic tropical sprue is still an important cause of malabsorption in adults and in children in South Asia. Investigations to exclude specific infective, immunological or inflammatory causes are important before considering tropical sprue as a diagnosis. This article briefly reviews the management of tropical sprue and presents an algorithm for its investigation and management.
吸收不良在前往热带地区的游客以及热带国家的本地居民中都是一个重要的临床问题。小肠感染是热带地区吸收不良的最重要原因。原生动物感染可导致免疫功能正常宿主出现吸收不良，但在免疫缺陷情况下更为常见。蠕虫感染偶尔会导致吸收不良或蛋白丢失性肠病。肠结核、慢性胰腺炎和小肠细菌过度生长是热带地区吸收不良的重要原因。近年来，炎症性肠病和乳糜泻已成为热带地区吸收不良的主要原因。散发性热带口炎性腹泻仍是南亚成人和儿童吸收不良的重要原因。在将热带口炎性腹泻作为诊断考虑之前，排除特定感染性、免疫性或炎症性原因的检查很重要。本文简要回顾了热带口炎性腹泻的管理，并提出了其检查和管理的算法。
