Frequently Asked Questions
Q1. What is abdominal tuberculosis?
A: Tuberculosis is a common problem which affects many people across the world. Although tuberculosis is commonly understood to affect the lungs, it is also known to involve virtually any organ of the body. Abdominal tuberculosis means to the involvement of organs inside the abdominal cavity by tuberculosis. Usually involvement of the urinary or the genital systems is considered a separate entity but may occur along abdominal tuberculosis.
Q2. Is abdominal tuberculosis a homogenous entity?
A: Not really ! Abdominal tuberculosis is a term which includes various distinctive entities like peritoneal tuberculosis, intestinal tuberculosis, involvement of the visceral organs are the abdominal lymph nodes.
Q3. How common is abdominal tuberculosis?
A: Abdominal TB is one of the common forms of extrapulmonary Tuberculosis (EPTB). In most of the reports it is said to account for more than 10% of the EPTB cases. Of all the EPTB cases, abdominal tuberculosis could be the third most common form after pleural effusion and lymph nodal disease.
Q4. What are the symptoms of abdominal tuberculosis?
A: Abdominal tuberculosis can have variable clinical manifestations.
Intestinal tuberculosis could have abdominal pain, diarrhoea, bleeding per rectum, intestinal obstruction, loss of appetite, loss of weight, fever etc.
Peritoneal tuberculosis could have abdominal distension because of formation of fluid inside the abdominal cavity, pain, fever, loss of weight or appetite etc.
Visceral involvement can include the involvement of the liver, pancreas, gallbladder or spleen and could have varied presentations.
Some of the patients suffering from abdominal tuberculosis could have very minimal symptoms and the disease is discovered incidentally for evaluation of some other complaints.
Q5. I have abdominal pain, do I abdominal tuberculosis?
A: Abdominal pain is a non-specific symptom which could occur because of hundreds of reasons. If you have if you have abdominal pain it is best to consult a physician for proper evaluation of the cause
Q6. Is abdominal tuberculosis treatable?
A: Like other forms of tuberculosis, abdominal tuberculosis is treatable and curable. the importance is to recognise it early and treat it early so as to prevent the troubling sequel.
Q7. How long do I need to take treatment of abdominal tuberculosis?
A: The usual duration of treatment for abdominal tuberculosis is 6 months. Occasionally, on the basis of your symptoms or extent of disease the physician may choose to provide you a longer duration of therapy.
In India, the treatment is provided free of cost by the government at various dots centres across the country.
Q8. What tests are need to diagnose abdominal tuberculosis?
A: You may need to undergo various imaging tests like ultrasound or computed tomographic scan for evaluation of your symptoms. Following this, tests to obtain tissue so as to have a sure diagnosis are needed. These may include endoscopy, Colonoscopy, aspiration of the fluid from the abdomen, fine needle aspiration from the lymph nodes etc. Further the samples so obtained undergo histological and microbiological test to arrive at a diagnosis.
Q9. What is peritoneal tuberculosis?
A: As mentioned above peritoneum is membrane which surrounds the organs in our abdomen. It could get involved in tuberculosis usually manifesting as fluid formation in the abdomen.
Q10. I have been told that I have fluid in my abdomen, could it be because of tuberculosis?
A: Tuberculosis is one of the main causes of formation of fluid in the abdomen. Other causes could be related to any underlying liver disease, malignancies, heart or Kidney Disease. To reach to the diagnosis it is important to test the fluid with other tests.
Q11. I have abdominal tuberculosis, should I get tested for HIV?
A: HIV infection increases the risk of acquisition of Tuberculosis. Also, HIV patients are more likely to have extra pulmonary tuberculosis. Therefore all patients diagnose to have tuberculosis should be tested for HIV. This testing is available free in India through the national AIDS control programme.
Q12. Is abdominal tuberculosis contagious?
Abdominal tuberculosis is not usually contagious. However, 10 to 30% of patients with abdominal tuberculosis may have pulmonary findings. Usually chest x ray is done to be sure if the lungs are involved or not. In case of associated active pulmonary disease, the disease could be contagious for the contacts.
Q13. What precautions should I take while I am getting treatment for abdominal tuberculosis?
A: It is important to take the medication properly and remain under follow up with the treating physician. The drug should be taken regularly. In case you feel that the drugs are causing some symptoms or problems, this must be brought to the notice of the treating physician so that appropriate adjustments can be made. It is also important to take healthy diet while on treatment.
Q14. I have abdominal tuberculosis, what kind of diet should I take?
A: Nutritional therapy is important in improving recovery in patients with tuberculosis. Usually high protein diet is recommended in these patients. This is especially true for those suffering from abdominal tuberculosis where malabsorption maybe clinically important.
Q15. . I have abdominal tuberculosis, should I take fibre in my diet or not?
A: Some of the patients of abdominal tuberculosis have underlying strictures which cause narrowing of the intestine. these strictures may respond to anti-tubercular therapy. Some of the time treatment of strictures needs endoscopic dilatation with balloons or may need surgery. if you have a stricturing disease the physician may advise you to avoid intake of fibres.
Q16. Do I need surgery for the treatment of abdominal tuberculosis?
A: Surgery may be required in a small subset of patients with abdominal tuberculosis. These are patients who have refractory stricturing disease which does not improve with antitubercular therapy or endoscopy dilatations. Sometimes, surgery may be needed for g i bleeding or intestinal obstruction or perforation. With availability of good medicines, the need for surgery has reduced.
Q17. I have taken full treatment for abdominal tuberculosis, how do I know if I am cured?
A: It is important to be on follow up while you are being treated for tuberculosis. the physician treating you may want to do certain tests like repeating a colonoscopy or ultrasound so as to be sure that the treatment is having the desired effect
Q18. I have taken full treatment for abdominal tuberculosis, can tuberculosis occur again?
A: Tuberculosis can recur in patients who have been treated for the disease in the past. Therefore it is important for such patients to maintain a healthy lifestyle, take a nutritious diet, avoid alcohol intake or smoking, and ensure that any underlying health conditions which predispose to tuberculosis are treated. These conditions could include diseases like HIV or Diabetes mellitus.
Q19. Where should I buy drugs? Are drugs from DOTS effective?
A: In India the national tuberculosis Control Programme provides access to free testing and treatment. The drugs provided under the program are of excellent quality and effective for treatment.
Q20. I was started on treatment for tuberculosis but my physician that he is unsure and I could have Crohn’s disease. What should I do?
A: A positive diagnosis of abdominal tuberculosis is possible in only a minority of cases. Crohn’s disease very closely mimics the clinical presentation of intestinal tuberculosis. Since in India both of these diseases are common, clinicians frequently encounter this scenario. It is ok to start treatment for tuberculosis in such situations because treatment for Crohn’s disease may worsen underlying tuberculosis. However, you need to be on close follow up and the physician may want to repeat a Colonoscopy to be sure that the treatment is having the desired effect.
If you have any other questions related to Abdominal tuberculosis you can ask us(link)
Vishal Sharma, Assistant Professor of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India