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The Effect of Folic Acid on the Steatorrhea of Tropical Sprue and Other Tests for Intestinal Absorption^*

R. Rodriguez-Molina, Marta Cancio AND Conrado F. Asenjo

1. Twelve fat-balance studies were performed in ten documented sprue patients before and during the administration of 15 mg folic acid given orally and daily over a period ranging from 9 to 44 days, with an average of 23 days for the twelve cases. All patients showed steatorrhea during a period of observation before treatment.

2. Other tests for intestinal absorption such as glucose tolerance, D-xylose excretion, and vitamin A absorption were carried out prior to and after treatment in some cases.

3. Steatorrhea was significantly reduced during treatment in two patients, and it was increased in two other cases. In the remaining eight, folic acid did not produce any significant changes in the steatorrhea.

4. Vitamin A absorption improved in four cases and glucose tolerance in two cases. Results of other tests for intestinal absorption (glucose tolerance, D-xylose excretion and vitamin A absorption), though slightly improved, remained below normal values in other patients.

5. Under folic acid therapy all but one patient showed improvement in general condition, in glossitis, in weight, and in red cells and hemoglobin. The hematologic response to the drug, however, was inadequate in all cases.

6. Probable factors responsible for the poor effect of folic acid on the blood, on steatorrhea and on the malabsorption of glucose, D-xylose and vitamin A are discussed.

^* This investigation was carried out as a cooperative project under a grant from the U. S. Public Health Service, National Institutes of Health, Research Project A-889.

General Medical Research Laboratory, Veterans Administration San Patricio Hospital, and School of Medicine and School of Tropical Medicine, University of Puerto Rico.

General Medical Research Laboratory, Veterans Administration San Patricio Hospital.

Department of Biochemistry and Nutrition, School of Medicine and School of Tropical Medicine, University of Puerto Rico.