Nontropical sprue can be fatal, particularly if growth abnormalities are ignored or unrecognized. It is not known if scrupulous adherence to a gluten-free diet in this disease decreases the likelihood of intestinal lymphoma, but the deletion of gluten from the diet and the intake of vitamin, mineral, and hematinic supplements facilitate remission. Steroid treatments are often used if a gluten-free diet is ineffective; if steroid treatment is ineffective the prognosis is not good.
The symptoms of both types of sprue are generally the same: diarrhea with bulky, frothy, foul-smelling stools containing large amounts of fatty acids and soaps, and later weight loss, anemia, and other symptoms related to malabsorption of vitamins. X-ray examination of the small intestine revealing dilation, segmentation, and other typical changes is used in diagnosis.
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