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.