Clinicocolonoscopic profile of colonic tuberculosis

Colonic tuberculosis is common in developing countries. However, its diagnosis is difficult. Nevertheless, colonoscopy and biopsy examination have shown promising results.

We evaluated the clinical spectrum and colonoscopic features of 62 patients with colonic tuberculosis.

Abdominal pain, fever, anorexia, weight loss, and change in bowel habit were seen in more than 50% of the patients. Massive rectal bleeding was frequently (13%) observed. Colonoscopy revealed strictures in 17, deformed ileocecal valve in 34, ulcers in 52, nodules in 49, polypoidal lesions in three, and fibrous bands in five patients. Segmental tuberculosis, lesions mimicking carcinoma, and multiple site involvement were observed in 19%, 20%, and 50% of the patients, respectively. Histopathologically, well formed granulomas were seen in 27, collections of epithelioid cells in 18, and chronic, nonspecific inflammatory changes in 17 of the cases. Acid-fast bacilli could not be isolated from any of the patients. All of the patients responded to the anti-tubercular treatment. Follow-up colonoscopy in 22 patients demonstrated regression of lesions.

Colonic tuberculosis is common in India. Our findings indicate that colonoscopy is useful for its diagnosis. However, histopathology many not always be helpful. Therefore, in a given clinical and colonosopic setting, a therapeutic trial may be indicated.