There is a tendency to depression and irritability.
The period during which sprue runs its course is very variable. Some cases drag on for ten or twelve years while others may be subacute in type, death ensuing within a year or two.
In addition to the typical or complete sprue described above Bahr would add: (1) Incomplete sprue, in which with typical stools there is no abnormal appearance of the tongue, and (2) Tongue sprue, in which with characteristic mouth involvement there is absence of the sprue stool.
Symptoms in Detail
The Stomatitis.—At first we have a disagreeable bitter taste in an unusually sensitive mouth. Later there develop superficial ulcers along the sides and frenum of the tongue, which subsequently involve the buccal mucosa. The gums may be quite tender and saliva dribble from the mouth.
In the later stages the tongue becomes bare, red, fissured and glazed.
The Stools.—Commencing as early morning diarrhoea, with at times alternating constipation, there gradually sets in that which makes for a diagnosis of sprue—putty-colored, fermenting, offensive stools which are extraordinarily copious.
They are also very fatty and of acid reaction. They show a proteid loss as well as lack of fat absorption.
The Blood Findings.—There is a marked secondary anaemia with great reduction in red cells and Hb. percentage.