How to distinguish celiac sprue and tropical sprue??

Infection vs allergy: Celiac sprue occurs when your body develops IGA antibodies to a components of wheat (gluten,gliaden). These antibodies then attack your intestinal absorptive surfaces and injure them.Poor nutrient absorption then occurs, and continues to occur as long as your diet includes the foods that contain gluten.Tropical sprue describes the same poor absorption, but the cause is an infection of the bowel.

Hard: On biopsy they would be the same. Therefore if the clinical picture is symptoms are related to recent travel, or recent onset of symptoms (especially with an exposure) then tropical sprue would be more likely. If chronic, then Celiac more likely. Tropical should get better with time.