Sprue (afty tropical, white diarrhoea) is a chronic disease with symptoms resistant fermentation diarrhea, glossitis, anemia, General exhaustion and hypofunction of the endocrine glands.
The etiology is not installed. Some authors associate the disease with the development of intestinal yeast fungi, others with beriberi, hot climate and endocrine failure.
Epidemics is not observed; logged individual cases. Found in countries with tropical and subtropical climates; in the USSR - in the republics of Transcaucasia and Central Asia ("chillaxin"). Ill more often than pregnant women, lactating women and the elderly.
In the pathogenesis of the disease is set to the fermentation process in the intestine, developing as a result of lengthy carbohydrate diet, leading to the development of intestinal dysbacteriosis. Destructive catarrhal inflammation of the walls of the small intestine with the subsequent atrophy of the mucous membrane leads to malabsorption of nutrients, vitamins. Complex metabolic disorders, deficiency of protein and vitamins (especially b) lead to the development of hematological symptoms and endocrine failure.
The clinical picture. The disease begins gradually. Appear insignificant diarrhoea disorders, later repeated diarrhea, excessive discharge of gases, rumbling, and abdominal pain. Chair abundant, frothy, Malookhtinsky (white diarrhea). Belly swollen, visible reinforced intestinal peristalsis. The liver and spleen are not enlarged. Notes salivation. Language bright red, papillae atrophied, there are sores on the mucous membrane of the oral cavity, pharynx, esophagus. The temperature rises due to the development of complications. Often increases diuresis. In the study of Cala found yeast, undigested muscle fiber, and fat.
From the nervous system often observed polyneuritis, possible psychosis. In the blood - secondary anemia.
When deeply coming dystrophy occurs different degree of atrophy of the thyroid and parathyroid glands, and often sexual glands with the development of women amenorrhea, and men's impotence. Symptoms of addisonizme (hypotension, skin pigmentation, weakness) and hypophyseal insufficiency develops. Prolonged diarrhea leads to rapid dehydration, exhaustion, development of cachexia.
The diagnosis is based on clinical data.
Differentiating with pernicious anemia, pellagra, amebiasis, disease of the endocrine glands.
Forecast with modern methods of treatment often favorable.
Treatment. Used medicines and diet normalizes bowel function. Appoint PROTIVOPOZHARNOY protein-fat diet (proteins 140-160 g, fat 65-70 g), pomegranate juice, extract pomegranate peels, vitamins. Exclude flour dishes, milk, sugar, potatoes, fresh fruit. With the normalization of the chair is carefully inserted carbohydrates. At the same time, appoint folic acid (0.1 g 3 times a day for 2-3 weeks), vitamin B12 (100 - 200 in a day, 20 injections), a large number of vitamins B1, B2, B6, Niacin, ascorbic acid, vitamin a, calcium chloride intravenous 10 ml of 10% solution. Inside appoint gastric juice. In severe cases, use hormones, blood transfusions.
Persons who have had the disease it is recommended to change the climate is tropical countries abstained.