author={Gordon C. Cook},
  journal={The Lancet},
  • G. Cook
  • Published 31 March 1984
  • Medicine
  • The Lancet

Tropical sprue and subclinical enteropathy: a vision for the nineties.

There is a group of gastrointestinal disorders mainly affecting the small intestine of individuals predominantly living in and less often visiting or returning from the Third World, usually the tropics, and ranging from asymptomatic structural and/or functional abnormalities of the gastrointestinal mucosa to a fully symptomatic condition highlighted by malabsorption of nutrients.

Tropical Sprue: Revisiting an Underrecognized Disease

Histologic findings suggesting tropical sprue in the appropriate clinical context include incomplete duodenal villous blunting without development of flat mucosa, frequent involvement of the terminal ileum with more marked inflammation and villousBlunting than in the duodenum, and a conspicuous eosinophil infiltrate in the lamina propria.

Leadling artile-Tropical infection ofthe gastrointestinal tract and liver series Persisting diarrhoea and malabsorption

  • Medicine
This review does not deal specifically with causes of chronic diarrhoeal disease in the indigenous populations of tropical and subtropical countries; these include ileocaecal tuberculosis, Mediterranean and Burkitt's lymphomas, Kala-azar, chronic calcific pancreatitis, chronic liver disease, severe protein malnutrition, and pellagra.

Tropical malabsorption

The management of tropical sprue is reviewed and an algorithm for its investigation and management is presented, finding that investigations to exclude specific infective, immunological or inflammatory causes are important before considering Tropical sprue as a diagnosis.

Post-infective malabsorption in the temperate zone.

Infective gastroenteritis and its relationship to reduced gastric acidity.

  • G. Cook
  • Medicine
    Scandinavian journal of gastroenterology. Supplement
  • 1985
The best evidence for increased incidence of specific bacterial infection in the presence of achlorhydria relates to the nontyphoid salmonelloses and among parasitic infections, the most impressive evidence relates to giardiasis and strongyloidiasis.

[Tropical sprue in an expatriate].

What is tropical sprue?

  • M. Walker
  • Medicine
    Journal of gastroenterology and hepatology
  • 2003
It is shown that aerobic bacteria contaminate the small bowel in patients with TS and that these patients have a prolonged orocecal transit time (OCTT) compared with healthy control subjects and more studies are needed to unravel the nature of the enterocyte response in this spectrum of enteropathies resulting from antigen or pathogen insult.

The pathology of malabsorption: current concepts

Intestinal malabsorption results from a wide variety of causes, which can most easily be organized into three groups:munocompromised patients, mucosal and mural causes, and microbial causes.

'The tropics in our bathroom': chronic diarrhoea after return from the tropics.

The classification of chronic diarrhoea following a visit to the tropics is essentially the same as that for acute diarrhoeas, but malabsorption is an important feature of chronic diarrhea.



Morphologic effects of folic acid and vitamin B12 on the jejunal lesion of tropical sprue.

A group of previously untreated patients was subjected to a controlled series of observations to determine how the jejunum responds to folate-B12 therapy, finding it unlikely that the primary or sole cause of tropical sprue is folate -B12 deficiency.

Malabsorption in Africa.

  • G. Cook
  • Medicine
    Transactions of the Royal Society of Tropical Medicine and Hygiene
  • 1974

The Aetiology and Mechanism of Steatorrhoea

Steatorrhoea, often associated with generalized malnutrition and avitaminosis, is observed in coeliac disease, tropical and non-tropical sprue, gastro-jejuno-colic fistula, gastrectomy, pancreatitis

Military tropical sprue from South-east Asia.

British Servicemen and their families in South-east Asia form a relatively homogeneous group in whom tropical sprue is seen with some frequency, and is unlikely to be malnourished.

Enterotoxigenic intestinal bacteria in tropical sprue. IV. Effect of linoleic acid on growth interrelationships of Lactobacillus acidophilus and Klebsiella pneumoniae

Observations indicate that, under the conditions of the chemostat, gram-positive enteric bacteria suppress coliform growth and that this effect is reversible by the presence of linoleic acid.

Enterotoxigenic intestinal bacteria in tropical sprue.

Abstract Bacterial growth was seen in cultures of fasting or postprandial midjejunal aspirates from 10 of 11 patients with tropical sprue; 2 of 4 healthy North Americans; and 7 of 9 Puerto Rican co...

Effect of the Normal Microbial Flora on the Resistance of the Small Intestine to Infection

It is concluded from data, as well as from preliminary dye studies of intestinal motility, that the normal flora does not influence mucosal resistance directly, but may alter enteric infection by affecting intestinal emptying.

Gut hormones in tropical malabsorption.

The measurement of gut hormones, each of which has a specific site and function, throws new light on the pathophysiology of tropical malabsorption and may suggest approaches of treatment.

Tropical Sprue: A Review

  • W. O'brien
  • Medicine
    Journal of the Royal Society of Medicine
  • 1979
Sprue was also prevalent in Puerto Rico (Ashford 1913)where Rhoads & Miller (1934), using massive doses of parenteral liver extract, obtained not only a complete haematological remission in 4 apparently moribund patients, but also a remission of the gastrointestinal symptoms.