Tropical Enteropathy (Environmental Enteropathy) in Early Childhood: a Syndrome Caused by Contaminated Environment

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Abstract
Summary Tropical Enteropathy has been described in children and adults that live in developing countries. This disease may or may not be symptomatic. We studied 112 patients with Tropical Enteropathy for their nutritional status and intestinal function. The following tests were performed: D-xylose absorption, triglyceride load, carbohydrate load (lactose, sucrose, glucose), bile salts assay of jejunal juice and small bowel biopsy; follow-up of the nutritional status revealed that 107 (95.5 per cent) had presented with malnutrition. Xylose absorption revealed levels of 25.00±12.3 mg per cent and 23.70±ll.l at 1 and 2 hours, with controls of, 46.0±13.9 and 40.7±12.3 mg per cent (p<0.001). The mean plasma triglyceride increase after a margarine load was 32.80±19.30 mg per cent, with the control group 96.54±49.59 mg per cent (p< 0.001). Carbohydrate load tests revealed 48.8 per cent lactose malabsorption, 30.04 per cent sucrose malabsorption and 5 per cent glucose malabsorption. Bile salts determination showed 44.8 per cent conjugated/55.2 per cent unconjugated. Small bowel biopsy showed partial villous atrophy in 94 per cent of samples studied. These children constitute a homogenous group representative of the majority of the population of the Third World and call the attention for the necessity of planning a more efficient health care system and adequate sanitary conditions.

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