Tuberculosis (TB) is a devastating infectious disease caused by a bacteria called Mycobacterium tuberculosis, which kills over 4,000 people every day globally. Unlike other infections, TB bacteria affect our body slowly over a prolonged period, causing symptoms for months to years.
How can you get tuberculosis?
TB bacteria spread through droplets from the cough or sneeze of one person to another. However, not all people exposed to these droplets develop TB. The bacteria affects only vulnerable people with weakened immune systems, chronic liver disease, HIV, uncontrolled diabetes, nutritional issues and slightly older people.
On the other hand, some people might have TB in their bodies in an inactive form. This kind of inactive TB becomes active or reactive when the person’s immune system weakens.
What is abdominal tuberculosis?
Most people know TB as an infection that affects the lungs. But not many know that TB bacteria can also affect other body parts, including the digestive system. Many gastroenterologists come across cases of TB involving the digestive system, called abdominal TB. It can affect the food pipe or oesophagus, stomach, small intestine, and large intestine. It is unique because it is not easy to detect and produces non-specific symptoms depending on the part it affects.
TB affecting the intestines is more common than TB affecting the food pipe or stomach. It mainly affects the part of the intestines called the ileocaecal junction, where the small intestine meets with the large intestine. The concentration of the lymphoid tissue and the mixing of the contents of small and large intestines in this area make it favourable for the growth and multiplication of TB bacteria.
Is abdominal tuberculosis contagious?
Abdominal TB does not pass from one person to another unless the patient also has a TB infection in the lungs.
What are the symptoms of abdominal tuberculosis?
- TB affecting the food pipe causes difficulty swallowing.
- TB affecting the stomach causes symptoms similar to peptic ulcers, like a burning sensation or abdominal discomfort.
- TB affecting the small intestine causes narrowing of the intestines due to repeated inflammation and swelling. This narrowing could lead to other symptoms like feeling full after meals and abdominal discomfort that could continue for hours. It can also interfere with the absorption of essential nutrients leading to malnutrition.
- TB affecting the large intestine causes multiple problems, including a growth that could blockage leading to difficulty passing stools, severe constipation, and multiple ulcers in the lining leading to diarrhoea.
- TB can also affect organs outside the gut, like the liver and peritoneum, causing inflammation. Inflamed peritoneum could cause a low-grade fever, abdominal pain, and build-up of fluids in the peritoneum.
What are the non-specific symptoms of abdominal tuberculosis?
The following symptoms can make it challenging to diagnose abdominal TB, as some other digestive conditions can also produce similar symptoms.
- Fever - Patients report a low-grade fever and a bit of cold, especially toward the end of the day.
- Changes in bowel habits - These changes could be constipation from intestinal blockage or diarrhoea from extensive ulcers.
- Nausea or vomiting - People can constantly feel nauseous or suffer from intermittent vomiting.
- Loss of appetite - Constant nausea can lead to loss of appetite.
- Blood loss - Extensive ulcers in the gut could cause internal bleeding and blood loss, which can be seen as black stools or bright red blood in the stools. It gradually increases, leading to a drop in blood cell counts.
- Weight loss - It can be so profound that some patients can lose 20% of their body weight, causing severe malnutrition.
Why is abdominal tuberculosis called a "great mimicker"?
Abdominal TB can mimic other conditions like peptic ulcers, colorectal cancer, inflammatory bowel disease called Crohn’s disease, certain chronic infections or inflammatory conditions. These reasons make abdominal TB a great mimicker.
What are the complications of abdominal tuberculosis?
Abdominal TB should be promptly diagnosed and treated, as it could cause the following complications.
- Gastrointestinal bleeding - Bleeding inside the gut from ulcers can cause bright red blood in stools or black stools.
- Obstruction - Abdominal TB can cause growths in the intestine leading to narrowing of the way or complete blockage, stopping the movement of food or waste matter. It can cause distended abdomen and abdominal discomfort, necessitating emergency surgery to remove the obstruction.
- Stricture - Repeated inflammation, swelling, and scarring inside the intestines could cause permanent narrowing of the intestines. Strictures can affect the movement of food through the intestines.
- Fistula - They are abnormal openings in between two parts of the intestine or intestine and adjacent organs. Fistulas can cause infections, inflammation, and malnutrition
- Malnutrition and weight loss - Abdominal TB affects multiple areas of the intestines, causing problems in the body's ability to absorb nutrients from food. It leads to multiple vitamin and mineral deficiencies, low blood count, and feeling of being unwell.
- Perforation - Sometimes, the ulcers in the intestinal walls could be so deep to cause perforation in the wall, through which the stools and digested food could leak. It can cause infection and irritation in the abdomen requiring emergency surgery to fix the perforation.
How to diagnose abdominal tuberculosis?
The diagnosis of abdominal TB often gets delayed as its symptoms are confused with other gastrointestinal issues. People with abdominal TB symptoms should seek help from a medical gastroenterologist, who will perform a series of tests to diagnose it.
How to treat abdominal tuberculosis?
- Catching abdominal TB early can help provide the proper treatment promptly in the form of 6-month or 9-month anti-TB medication courses that can completely cure abdominal TB.
- Surgery may be needed in some patients in emergencies.
Takeaway points
- TB is an infectious disease which is preventable and curable.
- It can also affect body parts other than the lungs, and the TB of the digestive system is called the abdominal TB.
- Symptoms of abdominal TB are similar to the symptoms of other gastrointestinal disorders, causing difficulties in its diagnosis.
- Catching it early and starting prompt anti-TB treatment can help in a complete cure.
How can Bangalore Gastro Centre help you?
Bangalore Gastro Centre Hospitals in HSR Layout houses top gastroenterologists highly experienced in rightly diagnosing and managing abdominal TB. The best gastro doctors at this facility also offer endoscopy and colonoscopy tests to track the disease activity and treat the infection accordingly.
