Tuberculosis of the intestine: causes, symptoms, diagnosis and treatment

Since ancient times, mankind has been struggling with intestinal tuberculosis. This is a serious and dangerous disease, which, if untreated, can lead to death. Every person should know how this ailment manifests. So, what is intestinal tuberculosis? What are the symptoms for him?

The essence of intestinal tuberculosis

Tuberculosis is an ailment known to all people. Under this term, specialists understand chronic infectious disease. Many people think that this disease is associated only with the defeat of the respiratory system. In fact, this is not so. There are extrapulmonary varieties of the disease. One of them is intestinal tuberculosis. There is a named disease because of mycobacteria. One source of infection is patients who do not comply with the rules of personal hygiene.

Such people secrete mycobacterium tuberculosis (MBT) and infect several people a year. The sources of infection include cattle. Mycobacterium tuberculosis is very resistant to environmental factors. With different effects, microorganisms can become ultra-small filter particles or giant branched structures. In favorable conditions, the Office takes on typical forms.

Forms of intestinal tuberculosis

The disease is divided into primary and secondary. Tuberculosis of the intestine as transmitted, because of what arises? The answer to this question is worth giving. So, primary tuberculosis occurs for several reasons:

• Due to the use of unboiled milk from tuberculosis cows.
• With hematogenous dissemination of Mycobacterium tuberculosis from the primary focus in the lungs, lymph nodes.
• Because of the consumption of food from dishes that are infected with mycobacteria tuberculosis, or a container that belongs to people who have this disease.

The secondary form of the disease occurs in sick people with injured lungs due to swallowing sputum and saliva. Mycobacterium tuberculosis in this way enter the intestine and infect its wall (affecting mainly the ileum). As a result, fistulas and ulceration occur. Is tuberculosis of the intestines dangerous to others? легочной формы. Statistics show that the disease is usually a secondary process that occurs during the progress of the pulmonary form. Much less often, intestinal tuberculosis proves to be the primary one, which developed because of an alimentary infection.

Symptoms of the disease

At a tuberculosis of an intestine people note at themselves the following suspicious signs:

1. Symptoms of intoxication. Because of illness, appetite is lost, body weight begins to decrease. Patients complain of night sweats, fever. Women may not have menstruation.
2. Intestinal symptoms. At the onset of the disease, some people develop constipation. After it follows, as a rule, a prolonged and debilitating diarrhea. Patients referring to specialists also complain of pain in the abdomen.
3. The presence of education. When palpating the abdomen, a painless tumor can be palpated.

With ulcerative-destructive lesion of the intestine, symptoms of irritation of the peritoneum appear. In patients, the temperature rises. In fecal masses, blood is visible or there are components of it (red blood cells, leukocytes) that are detected by specialists during a microscope study. For ulcerative-destructive process complications can be characteristic. Often there are bleeding, intestinal obstruction, a violation of the integrity of its walls.

Diagnosis of tuberculosis

The diagnosis of "intestinal tuberculosis" can be diagnosed by specialists after a comprehensive examination. It includes:

• Tuberculin tests;
• Radiography;
• Colonoscopy;
• Irrigoscopy;
• Laparoscopy with biopsy.

Quite informative methods are computed tomography and laparoscopy. During the application of these methods of diagnosis, specialists often find patients with calcified mesenteric lymph nodes, tuberculous tubercles. Informative and X-ray study. Thanks to him, specialists detect signs of intestinal tuberculosis (for example, the delay of barium in the caecum with the release of other departments).

A quantified test is a modern laboratory method that can detect an infection. When illuminating the diagnosis of tuberculosis, it is worth considering it. So, the essence of the test is to examine the patient's blood. She surrenders in the morning on an empty stomach from a vein and is placed in a special kit consisting of three test tubes. After blood sampling, specialists conduct a study. A quantified test can give a positive, negative and questionable result:

1. A positive result indicates infection with the Office.
2. Healthy people get a negative result. However, it should be noted that with him, it is not necessary to exclude infection with mycobacteria tuberculosis. The result can be false-negative. This happens in the early stages of infection, with immunodeficiency states.
3. A doubtful result is possible with individual immunity characteristics, as well as in violation of preanalytical requirements. For more information, doctors decide whether to take new blood or to schedule additional examinations.

Differential diagnosis

Those signs that are revealed by experts in the course of examination of people with suspicions of intestinal tuberculosis may be characteristic of other inflammatory diseases. Much in common, this disease has ulcerative colitis, Crohn's disease, amoebic dysentery, and bowel neoplasms. To establish the correct diagnosis, differential diagnosis is necessary:

1. To verify the absence of amoebic dysentery and neoplasms, a histological examination should be performed.
2. Due to endoscopic biopsy, sarcoid granulomas consisting of lymphocytes with large cells of the Pirogov-Langhans type can be found in the center. Such structures are characteristic for intestinal tuberculosis and Crohn's disease. It is possible to distinguish these diseases from each other along the foci of caseous necrosis. They occur together with granulomas only with intestinal tuberculosis.

Treatment of the disease

With the diagnosis "intestinal tuberculosis", treatment begins in specialized hospitals. Its goal is to permanently heal foci of infection, eliminate symptoms of the disease. The treatment of tuberculosis is quite long. Recovery on average comes in a year. In some cases, much more time is needed to heal.

With intestinal tuberculosis, complex treatment is necessary. Its main component is chemotherapy. Doctors choose specific drugs, determine their combinations, doses. At the beginning of intensive chemotherapy. It suppresses the reproduction of mycobacteria, contributes to a decrease in their number. Regarding treatment regimens, it should be noted that every day can be used:

• Isoniazid and Rifampicin;
• Isoniazid and Etambutol.

The first combination of drugs is prescribed for a period of 9 to 12 months, and the second - at 18. Such long-term treatment is necessary due to the fact that mycobacteria slowly multiply and can stay inactive for a long time.

If tuberculosis of the intestinal tract is diagnosed, then conservative treatment will not necessarily be prescribed. It is not always able to give the expected result in all cases. Sometimes doctors prescribe surgical treatment. It is indicated in the development of complications. For example, surgery can be prescribed if there is a large amount of fluid in the abdominal cavity. Surgical intervention requires mechanical intestinal obstruction. The causes of its occurrence may be in the cicatrices left behind after healing and the adhesions between the loops of the intestine.

Problems associated with treatment

The main problem associated with the treatment of intestinal tuberculosis is the lack of discipline of sick people. Many patients do not follow the recommendations of specialists and interrupt the use of tuberculostatic drugs. Because of the premature cessation of chemotherapy, the process becomes aggravated. Another problem is that after taking prescribed medications, side effects may appear. Serious consequences of toxic effects of drugs are:

1. Hepatitis is an inflammatory disease of the liver.
2. Thrombocytopenia is a condition characterized by a decrease in the number of platelets.
3. Neuritis - inflammatory diseases of nerves.
4. Renal failure is a pathological condition characterized by impaired renal function.

Side effects do not appear so often. 3-5% of people receiving Rifampicin and Isoniazid face them, and 1-2% of patients treated with Isoniazid and Etambutol. When there are side effects, the treatment program changes.

Consequences of intestinal tuberculosis

The prognosis for the disease depends on how timely the specialists diagnosed the disease and prescribed therapy. In neglected cases and with destructive lesions of the small intestine, the prognosis is unfavorable because of recurrences of intestinal obstruction and a violation of the assimilation of nutrients. A less pessimistic prognosis is given with a lesion of the large intestine.

Prevention of disease

To prevent the development of intestinal tuberculosis, preventive treatment is carried out. In order to determine whether a particular person needs it, perform a preliminary setting of tuberculin samples. If the result is positive, then preventive treatment is prescribed. It consists in carrying out chemoprophylaxis with Isoniazid for 1 year. Prevention is carried out not only with a positive tuberculin test to avoid such a disease as intestinal tuberculosis. The reasons for its appointment can be as follows:

• A person often contacts people who have active tuberculosis.
• The patient takes corticosteroid and immunosuppressive drugs.
• A person suffers from immunodeficiencies of various origins.

In conclusion, it should be noted that when there are suspicious symptoms characteristic of intestinal tuberculosis, it is worth immediately contacting the clinic with the therapist. If the specialist suspects the named disease, the patient will be referred to one of the specialized anti-tuberculosis institutions.