Tuberculosis in ulcerative colitis: bird in the bush

Records of one hundred and two patients with idiopathic ulcerative colitis were retrospectively studied to estimate the prevalence of associated tuberculosis. There were 49 males and 53 females with a mean age of 33 +/- 13 years. Seven patients (3 pulmonary and 4 intestinal) had associated tuberculosis. All patients with intestinal tuberculosis were females and had small bowel involvement. Patients with co-existing tuberculosis were on steroids at the time of presentation and responded well to anti tubercular treatment with gradual weight gain and remission of diarrhoea and fever. We conclude that in India, the prevalence of tuberculosis is high in patients with idiopathic ulcerative colitis on steroids and a high degree of suspicion is required to detect these cases.