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Intestinal tuberculosis: return of an old disease
1Department of Surgery, College of Physicians and Surgeons, Columbia University and Presbyterian Hospital, New York, New York, USA.
The American Journal of Gastroenterology
|June 13, 1998
Summary
Tuberculosis (TB) is resurging in the US, often affecting the intestines. Early diagnosis and a full course of chemotherapy are crucial for treating intestinal TB, even with unclear initial results.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Public Health
Background:
- Tuberculosis (TB) is no longer rare in the US, partly due to the AIDS epidemic.
- Nonspecific symptoms of intestinal TB necessitate a high index of suspicion for timely diagnosis.
Purpose of the Study:
- To review the history, epidemiology, pathophysiology, and treatment of intestinal tuberculosis (TB).
Main Methods:
- Literature review of global studies on intestinal TB.
Main Results:
- Active pulmonary TB occurs in only 20% of TB patients.
- The jejunoileum and ileocecum are the most common sites (>75%) for gastrointestinal TB.
- Diagnosis involves colonoscopy with biopsies; empiric treatment is recommended even with negative initial tests.
Conclusions:
- Increased awareness and knowledge of intestinal TB are vital for improving diagnosis and patient outcomes.
- A full course of antituberculous chemotherapy is the standard medical treatment.
- Surgery may be required for diagnostic uncertainty or complications like perforation or obstruction.