NONTROPICAL sprue (idiopathic steatorrhea) may be defined as a disease of unknown etiology without specific anatomicopathologic changes1occurring in adults living in temperate climates in which absorption from and motility of the small bowel are impaired. Nontropical sprue includes celiac disease (with which it is apparently identical) when it persists into adult life. It does not include sprue syndromes arising secondary to diseases characterized by specific pathologic abnormalities. Impairment of absorption in nontropical sprue, contrary to early beliefs, affects all nutrients, including fat, protein, carbohydrates, vitamins, minerals, and even water. Although steatorrhea is an easily recognized and characteristic feature of this disease, the fecal content of nutrients other than fat is also increased. For this reason the terms "idiopathic steatorrhea" and "steatorrhea syndrome" are not satisfactory designations for nontropical sprue. Impaired absorption leads to diarrhea with loss of weight, hypoproteinemia with edema and ascites, osteomalacia with hypocalcemia and tetany,