THE ‘SILENT’ RISE OF ABDOMINAL TB
Women mostly in the age group of 20-40 yrs have this condition
Malnutrition, immunesuppression, diabetes, chemotherapy, improper drug compliance and monotherapy are some of the reasons for the occurance of abdominal tuberculosis (TB), which accounts for 11 per cent of the cases of extra-pulmonary TB. Abdominal TB is an infection of the abdominal organs such as the intestines, the liver, pancreas, and adrenal glands, with mycobacterium tuberculosis.
Dr Mohammed Saaduddin Azmi, a senior consultant gastroenterologist, says, “In the past 10 years we have observed an increase in the prevalence of the disease due to the availability of better diagnostic techniques. Children, immunecompromised persons, patients undergoing chemotherapy, malnourished persons, pregnant women, and those living in areas inhabited by TB patients, are the most vulnerable. We have seen women in the age-group of 20 to 40 years suffering from this condition.”
Experts say that the symptoms of abdominal TB are confusing, which is why it is often mistaken for a disease of the gastrointestinal tract. Symptoms include recurrent abdominal pain, fever, weight loss, diarrhoea, obstruction in the intestine, vomiting, and the accumulation of fluid in the abdomen.
The condition is largely under-diagnosed as its presentation is very subtle. Dr G. Ramesh, a senior gastroenterologist, says, “The suspicion that a condition is tuberculosis arises last, after other gastrointestinal diseases such as irritable bowel syndrome and Crohn’s disease have been ruled out. Patience is required on the part of the patients. Diagnosis may be a challenge in the initial stages, but if the condition is not treated properly, it could result in complications such as bleeding, ulceration, and intestinal obstruction. In its most severe form, the TB can affect multiple organs.”
A high index of suspicion is required for early diagnoses; this usually arises in the cases of immuno-compromised patients and those suffering from cancer. A standard six-month anti-TB therapy is the first line of treatment, and it has proven to be quite successful.