Gastrointestinal tuberculosis: 8-year experience from a tertiary care hospital in North India

Authors

Brij Sharma, Professor, Department of Gastroenterology,; Indira Gandhi Medical College and Hospital, Shimla,Himachal Pradesh, India.
Rajesh Sharma, Associate Professor, Department of Gastroenterology, Indira Gandhi Medical College and Hospital, Shimla,Himachal Pradesh, India.
Vineeta Sharma, Assistant Professor, Department of Microbiology, Indira Gandhi Medical College and Hospital, Shimla,Himachal Pradesh, India.
Vishal Bodh, Assistant Professor, Department of Gastroenterology, Indira Gandhi Medical College and Hospital, Shimla,Himachal Pradesh, India, Corresponding Author.
Rajesh Kumar, Senior Resident, Department of Gastroenterology, Indira Gandhi Medical College and Hospital, Shimla,Himachal Pradesh, India.
Neetu Sharma, Medical Officer, Department of Physiology, Indira Gandhi Medical College and Hospital, Shimla,Himachal Pradesh, India.
Arunima Sharma, Resident, Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, Illinois, United States.Follow

Recommended Citation

Sharma B, Sharma R, Sharma V, et al. Gastrointestinal Tuberculosis: 8-year Experience from a Tertiary Care Hospital in North India. J Assoc Physicians India. 2024;72(11):63-67. doi:10.59556/japi.72.0725

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Introduction: Tuberculosis (TB) represents a significant communicable disease on a global scale. The clinical manifestations of abdominal TB frequently resemble those of various gastrointestinal disorders, potentially leading to delays in accurate diagnosis.

Materials and methods: From January 2012 to December 2019, consecutive patients aged 12 years and older, diagnosed with gastrointestinal TB at a tertiary care center in North India, were enrolled. Demographic and clinical data, radiological imaging findings, gastrointestinal endoscopy results, and histopathological findings were meticulously recorded. Antitubercular treatment was administered, and gastrointestinal endoscopy was performed upon the completion of treatment.

Results: During the study period, 234 patients with gastrointestinal tuberculosis were enrolled, of which 151 (64.5%) were male and 83 (35.5%) were female. The most common presenting symptoms included weight loss (94.9%), abdominal pain (85.9%), fever (51.7%), and diarrhea (30.8%). The ileocecal region was the most frequently affected site (76.1%), followed by segmental colonic TB (17.1%). The most common finding on computed tomography (CT) of abdomen was thickening of the bowel wall with/without local or mesenteric lymphadenopathy. The most common endoscopic lesions were ulcerations (82.0%) followed by nodularity (73.9%), deformed cecum and ileocecal valve (41.9%) and strictures (11.1%). Histopathological examination of endoscopic biopsy revealed, well-formed granulomas in 94 (40.2%), collection of epithelioid cells with Langhans giant cells in 66 (28.2%), and chronic nonspecific inflammatory changes in 74 (31.6%). All patients responded to the antitubercular treatment. Follow-up colonoscopy in 171 (73.1%) patients showed regression of lesions.

Conclusion: Gastrointestinal tuberculosis (GiTb) presents with nonspecific symptoms such as weight loss, fever, and abdominal pain, with ileocecal region being most commonly involved. Gastrointestinal endoscopy shows ulceration, nodularity, and strictures as prominent findings. Histopathology and culture were helpful for making diagnosis in almost half of the patients with GiTb. Majority of the patients responded well to antitubercular treatment.

Type

Article

PubMed ID

39563119