Article Text

Download PDFPDF
Tropical malabsorption
  1. B S Ramakrishna1,
  2. S Venkataraman1,
  3. A Mukhopadhya2
  1. 1Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
  2. 2St George’s Hospital, University of London, London, UK
  1. Correspondence to:
 B S Ramakrishna
 The Wellcome Trust Research Laboratory, Department of Gastrointestinal Sciences, Christian Medical College, Ida Scudder Road, Vellore 632004, Tamil Nadu, India; rama{at}


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.

  • IPSID, immunoproliferative small intestinal disease
  • enteropathy
  • malabsorption
  • parasites
  • sprue
  • tropical

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: None declared.