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Celiac Sprue Vs Tropical Sprue Vs Whipple Disease

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The other day I was reading an article regarding these three diseases that can be confused especially celiac and tropical sprue, all of them cause malabsortion and therefore similar symptoms, this is what I understood:

Celiac sprue (disease): Positive antigladin, endomysial and transglutaminase antibodies, biopsy shows villi blunting, histology (villi) and symptoms improve with a gluten free diet.

Tropical sprue: Negative antigladin, endomysial and transglutaminase antibodies, biospy shows villi blunting, histology (villi) and symptoms don't improve with a gluten free diet. The disease is though to be cause by an infectious agent wich can be treated with some antibiotics for 6 months. Maybe this could be the reason why some people have villi blunting, negative antibodies and their symptoms don't improve with the gluten free diet, in fact, they can be cured with a antibiotics.

Whipple disease: Malbasortion syndrome caused by Tropheryma Whippleii wich obstucts lymphatics in the intestine which in turn cause malabsortion. I understand it doesn't present with villi blunting. It can be treated with antibiotics and can be cured. It doesn't improve with a gluten free diet.

I hope it helps. :D

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Tropical Sprue is regional and treatable and not an autoimmune response.:


[edit] Cause

The cause of tropical sprue is not known.[1] It has been suggested that it is caused by bacterial, viral, amoebal, or parasitic infection. Folic acid deficiency and rancid fat have also been suggested as possible causes. In a condition called coeliac (also: celiac) disease (also known as coeliac sprue), which has similar symptoms to non tropical sprue, the flattening of the villi and small intestine inflammation is caused by an autoimmune disorder.

[edit] Affected Regions

The disease was first described by William Hillary[2] in 1759 in Barbados. Tropical sprue is endemic to India and southeast Asia, Central and South America, and the Caribbean.

[edit] Treatment

Once diagnosed, tropical sprue can be treated by a course of the antibiotic tetracycline(Doxycycline) or Sulfamethoxazole/Trimethoprim(Co-trimoxazole) and vitamins B12 and folic acid for at least 6 months.

[edit] Prevention

Preventive measures include drinking only bottled water, brushing teeth, washing food, avoiding fruits washed with tap water (or consuming only peeled fruits, such as bananas and oranges), and altogether avoidance of travel to the affected regions.

[edit] Prognosis

The prognosis for tropical sprue is excellent. It usually does not recur in patients who get it during travel to affected regions. The recurrence rate for natives is about 20%.

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I don't know but I have also a "gut feeling" (ironic) that one person can have celiac and tropical sprue or whipple disease at the same time, though the chances would be pretty slim, it would be worth that every and each of these disease be ruled out by the GI doctor to be completley sure, also, pancreatic deficiency can cause the same malabsortion symtoms but I have read that one has to have a trypsin digestive and a secretin blood workup. Carbohydrite malabsortion can cause GI symptoms as well. Good luck to those having problems with the correct diagnosis.

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Interesting... I have seen improvements avoiding gluten but not all completely since I know there are other health problems that I have. I now also will avoid yeast, which I'm also seeing many improvements. Next doctor visit I'll see about getting my thyroids check, since I have all those symptoms plus more.... and think it's only a logical move. If results for thyroid conclude that there is something wrong I will suspect they will start checking for other health issues. Tropical and Whipple are two I will keep in mind, maybe they will come across it. Though I'm sure if I get a thyroid test with conclusion there is a health problem, a biopsy may also be done ( to thyroid and/ or intestine near stomach), maybe?

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