Answers
What is abdominal (intestinal) tuberculosis?
Short answer
Tuberculosis (TB) can affect the intestines, the lining of the abdomen (causing fluid), and lymph nodes in the belly. It is common in India. It causes weight loss, fever, night sweats, belly pain and changes in bowel habit. It can be cured with a full course of TB medicines, which are free under the national TB programme, but the diagnosis should be confirmed first.
Symptoms
- Weight loss, loss of appetite and tiredness
- Low-grade fever and night sweats
- Belly pain, often around the lower right side
- Loose motions or constipation, or episodes of blockage with vomiting and swelling
- A swollen belly from fluid (peritoneal TB)
How it is diagnosed
- Colonoscopy with biopsies from the lower small intestine and colon, tested for TB germs (including GeneXpert), culture and the typical microscopic changes
- CT scan of the abdomen
- Testing the belly fluid (including ADA) when there is ascites
- Chest X-ray, as TB may also be in the lungs
TB or Crohn's disease?
Intestinal TB and Crohn's disease can look very similar on colonoscopy and scans. The treatments are very different, and the wrong one can cause harm: steroids and immune medicines for Crohn's can make TB worse. So doctors try hard to confirm the diagnosis before starting treatment, and sometimes follow up closely after a trial of TB medicines.
Treatment
Never stop TB medicines early because you feel better. Incomplete treatment can lead to drug-resistant TB.
- A full course of TB medicines, usually for at least six months, taken every day without gaps
- Treatment is free under the National TB Elimination Programme (Ni-kshay), and patients also receive nutrition support
- Regular follow-up to check the response and watch for side effects, especially on the liver
- Surgery only for complications such as severe narrowing or perforation
Diet during TB treatment
Eat more
- Energy and protein at every meal: dal, chana, rajma, soya, paneer, milk, curd, eggs, fish or chicken
- Small, frequent meals if appetite is poor
- Soft, low-fibre food (khichdi, dalia, curd rice) if the bowel is narrowed, as advised
Cut down
- Alcohol and tobacco, completely
- Large chunks of fibrous food, such as whole corn, seeds and tough peels, if there is narrowing
- Skipping meals because of nausea; tell your doctor instead
Good to know
- Under the Ni-kshay Poshan Yojana, people with TB receive monthly nutrition support during treatment.
- Weight gain during treatment is a good sign that TB is responding.
Common questions
Is abdominal TB contagious?
Usually not, unless the lungs are also affected. A chest X-ray checks this, and family members with a cough should be tested.
Can abdominal TB come back?
It is uncommon after a full course of treatment. Missing doses or stopping early raises the risk of return and of drug-resistant TB.
Will I need surgery?
Most people do not. Medicines cure the infection. Surgery or endoscopic dilatation is needed only for complications such as a tight narrowing.