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What is the treatment for abdominal tuberculosis?

Friday, 01 August 2003
Answered by: Irwin Ziment
Professor of Medicine
UCLA
USA
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Q. I am suffering from abdominal kochs for the last 1.5 years. The treatment(oral ATT) was stopped after a year. However the pain, and the original symptoms reappeared after 2 months. This time the treatment was the same, also the streptomycin injection was given for 60 days. There is a good recovery and the weight has picked up. However frequent motions continue. How long should the treatment continue? How do I know whether I have been completely cured?Should a CT scan/ultrasound be done again before stopping ATT?

A.  Usually, one year of treatment for abdominal tuberculosis is more than sufficient to cure the disease. Relapse is most likely to occur under four conditions: 1. The treatment was not taken reliably or correctly, in which case another 6-12 months of therapy with different drugs - including streptomycin - may be required. 2. The organism was resistant to one or more of the anti-tuberculosis drugs. Perhaps the organism was never isolated , and appropriate sensitivity tests were not accomplished. 3. There may be an associated disease, such as an abnormality of immunity or a condition such as colitis. 4. The original disease was not actually (just) tuberculosis., e.g adhesions, amoebiasis. In any case, ultrasound or even a CT scan may not be all that helpful, whereas a barium enema or swallow may be.

A.  Usually, one year of treatment for abdominal tuberculosis is more than sufficient to cure the disease. Relapse is most likely to occur under four conditions: 1. The treatment was not taken reliably or correctly, in which case another 6-12 months of therapy with different drugs - including streptomycin - may be required. 2. The organism was resistant to one or more of the anti-tuberculosis drugs. Perhaps the organism was never isolated , and appropriate sensitivity tests were not accomplished. 3. There may be an associated disease, such as an abnormality of immunity or a condition such as colitis. 4. The original disease was not actually (just) tuberculosis., e.g adhesions, amoebiasis. In any case, ultrasound or even a CT scan may not be all that helpful, whereas a barium enema or swallow may be.

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