TB is generally recognized for affecting lung infection, however, it is can also seen in various organs including the GI tube. Gastrointestinal tuberculosis or GI TB is an extensive form of TB that affects the gastrointestinal tract and may present with several manifestations that are difficult to diagnose and control. This article will overview the meaning of gastrointestinal tuberculosis, its symptoms, causes, diagnosis, and available treatment options.
What is gastrointestinal tuberculosis?
Gastrointestinal tuberculosis is one of the forms of tuberculosis that affects organs other than lungs. They are located within digestive tract and usually involve the intestines, stomach, esophagus, and some of the neighboring lymph nodes.
The ileocecal region, the area where ileum of the small intestine joins the colon of the large intestine, is most often involved. Despite the fact that GI TB is less common than PTB it is rather dangerous disease, especially to regions with high level of TB spread.
Symptoms of gastrointestinal tuberculosis
Gastrointestinal TB can be difficult to diagnose because its symptoms often overlap with other GI disorders. Symptoms of gastrointestinal tuberculosis can vary depending on the specific part of the digestive system affected but generally include:
- Abdominal Pain: A widely experienced symptom, abdominal pain is always on the right lower quadrant if the disease is involving the ileocecal region.
- Diarrhea or Constipation: Some patients may present with both diarrhoea and constipation; this is effectively the patient presents with IBS.
- Weight Loss: As with other forms of tuberculosis, weight loss is common in patients with GI TB and may be of sufficient magnitude without clear explanation.
- Loss of Appetite: Less food intake is equally a factor for weight loss as well as malnutrition.
- Fever: Most patients develop a low-grade fever that is chronic and may include night sweats.
Causes and risk factors
The primary causes of gastrointestinal tuberculosis are the bacteria Mycobacterium tuberculosis. While the infection typically begins in the lungs, it can spread to other parts of the body, including the GI tract, via the bloodstream or lymphatic system.
Several factors increase the risk of developing GI TB:
- Weakened Immune System: Individuals with compromised immune systems, such as those with HIV/AIDS, are at higher risk of developing extrapulmonary TB, including GI TB.
- Endemic Regions: People in regions with high rates of TB, such as parts of Asia and Africa, have a greater chance of exposure.
- History of Pulmonary TB: Those with a history of pulmonary tuberculosis are at higher risk for GI TB if the infection spreads.
- Poor Nutrition: Malnutrition weakens the immune system, making the body more susceptible to TB infections.
Diagnosis of gastrointestinal tuberculosis
Diagnosis of gastrointestinal tuberculosis can be challenging due to its nonspecific symptoms and similarity to other GI conditions like Crohn’s disease, ulcerative colitis, and cancers of the digestive tract. Therefore, a thorough evaluation and multiple diagnostic tests are usually required.
- Medical History and Physical Examination: The doctor will take a complete medical history, focusing on any past history of TB or exposure to TB patients. A physical examination can reveal abdominal tenderness or swelling.
- Laboratory Tests:
- Blood Tests: Routine blood tests may show signs of infection, such as elevated white blood cells and inflammatory markers, but they are not specific to TB.
- Tuberculin Skin Test (TST): A skin test can indicate TB infection but cannot confirm GI TB on its own.
- Interferon-Gamma Release Assays (IGRA): Blood tests like the IGRA are more specific than the TST and can suggest TB infection.
- Imaging Studies:
- Abdominal X-Ray or CT Scan: These imaging techniques can detect abnormalities like thickening of the intestinal wall, lymph node enlargement, or intestinal obstruction, all of which are indicative of GI TB.
- Ultrasound: Abdominal ultrasound may reveal enlarged lymph nodes or fluid buildup.
- Endoscopy and Biopsy:
- Colonoscopy: Allows the doctor to directly visualize the inner lining of the intestines. Suspicious lesions can be biopsied for further testing.
- Biopsy: A tissue sample taken from the affected area is analyzed in a lab for signs of Mycobacterium tuberculosis.
Treatment options for gastrointestinal tuberculosis
Treatment for gastrointestinal TB is similar to pulmonary TB and primarily involves a combination of antibiotics over an extended period and proper prevention and care. The goal is to eliminate the bacteria, reduce symptoms, and prevent complications.
- Antibiotic Therapy:
- First-Line Drugs: The standard treatment regimen includes four antibiotics: isoniazid, rifampicin, ethambutol, and pyrazinamide. This regimen typically lasts for at least six months.
- Duration: Patients must follow the prescribed course for the entire duration, even if symptoms improve early on, to ensure all bacteria are eradicated.
- Drug Resistance: In cases of multidrug-resistant TB (MDR-TB), additional or alternative antibiotics may be necessary, and treatment duration may extend to 18-24 months.
- Nutritional Support: Many patients with GI TB suffer from malnutrition due to loss of appetite, weight loss, and digestive issues. Nutritional supplements and a balanced diet can support recovery and enhance the immune system.
- Surgical Intervention: In severe cases where there are complications such as intestinal obstruction, perforation, or abscess formation, surgery may be necessary. Surgical options can involve removing part of the intestine, draining abscesses, or repairing perforations.
Conclusion
Gastrointestinal tuberculosis is a challenging yet treatable condition that requires early diagnosis and adherence to a comprehensive treatment plan. With prompt medical attention and appropriate care, patients can recover and prevent severe complications. If you or someone you know is experiencing symptoms of gastrointestinal TB, it’s essential to seek medical advice from a healthcare provider experienced in TB care.
Look for gastroenterologist today to ensure your digestive health is in the best hands.