Environmental enteropathy (EE or tropical enteropathy or environmental enteric dysfunction or EED) is an acquired small intestinal disorder characterized by gut inflammation, reduced absorptive surface area in small intestine, and disruption of intestinal barrier function.[2][3][1][4][5] EE is most common amongst children living in low-resource settings.[2][3][1] Acute symptoms are typically minimal or absent.[3] EE can lead to malnutrition, anemia (iron-deficiency anemia and anemia of chronic inflammation),[2]stunted growth, impaired brain development,[6][7][8] and impaired response to oral vaccinations.[9][10]
The cause of EE is multifactorial. Overall, exposure to contaminated food and water leads to a generalized state of intestinal inflammation.[2][3][1] The inflammatory response results in multiple pathological changes to the gastrointestinal tract: Smaller villi, larger crypts (called crypt hyperplasia), increased permeability, and inflammatory cell build-up within the intestines.[3][1][11] These changes result in poor absorption of food, vitamins and minerals.
Standardized, clinically practical diagnostic criteria do not exist. The most accurate diagnostic test is intestinal biopsy. However, this test is invasive and unnecessary for most patients.[2]
Prevention is the strongest and most reliable option for preventing EE and its effects. Therefore, prevention and treatment of EE are often discussed together.[11][12][13]
^Ngure FM, Reid BM, Humphrey JH, Mbuya MN, Pelto G, Stoltzfus RJ (January 2014). "Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links". Annals of the New York Academy of Sciences. 1308 (1): 118–128. Bibcode:2014NYASA1308..118N. doi:10.1111/nyas.12330. PMID24571214. S2CID21280033.