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Colonic tuberculosis: clinical features, endoscopic appearance and management
S P Misra1, V Misra, M Dwivedi
1Department of Gastroenterology, Moti Lal Nehru Medical College, Allahabad, India. spmisra@nde.vsnl.net.in
Journal of Gastroenterology and Hepatology
|August 10, 1999
Summary
Colonoscopy is a valuable tool for diagnosing colonic tuberculosis, especially when combined with biopsies showing specific or non-specific inflammatory changes. A trial of anti-tuberculous therapy is recommended if findings are suggestive of the disease.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Endoscopy
Background:
- Colonic tuberculosis is uncommon in Western countries but prevalent in developing nations.
- Clinical and radiological signs of colonic tuberculosis are often non-specific.
- Colonoscopy has emerged as a key diagnostic method for colonic tuberculosis.
Purpose of the Study:
- To evaluate the utility of colonoscopy in diagnosing colonic tuberculosis.
- To correlate colonoscopic findings with histological results and treatment response.
Main Methods:
- A study involving 50 patients diagnosed with colonic tuberculosis.
- Recording of clinical features, colonoscopic findings, and histology.
- Assessment of treatment response to anti-tuberculous therapy.
Main Results:
- Common symptoms included abdominal pain, fever, weight loss, and diarrhea.
- Colonoscopic findings revealed ulcers (92%), nodules (88%), and deformed ileocecal regions (42%).
- Histology showed non-caseating granulomas (18%), epithelioid cells (40%), and non-specific inflammation (42%).
Conclusions:
- Colonoscopy is a highly useful diagnostic modality for colonic tuberculosis.
- A therapeutic trial of anti-tuberculous drugs is recommended for suspected cases, even with non-specific biopsy findings.
- Positive clinical response to treatment supports the diagnosis of colonic tuberculosis.