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Tropical sprue (TS) is a cause of chronic diarrhea and malabsorption syndrome and was commonly described from tropical countries including India.1 Patients with chronic small bowel diarrhea with demonstration of malabsorption of two unrelated substances, abnormal small intestinal histology, exclusion of other known causes of malabsorption and persistent response to treatment with tetracycline and folate were diagnosed as TS.2 The disease was described commonly in the sporadic form and even as epidemics from India in the past.3-5 It was also reported in epidemic form among soldiers and prisoners of war in the Indo-Burma region during the Second World War,6 in American military personnel serving in the Philippines,7 and in Bangladesh.8 This condition was also reported sporadically from temperate countries where it was named ‘temperate sprue’.9 In the recent years, there has been declined in publication on TS. Hence, some physicians started believing and even propagating that TS does not occur anymore! Some skeptics feel that in the era of evidence-based medicine, lack of published evidence can be used as an evidence of negating occurrence of that phenomenon.
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