Tuberculosis Can Affect Your Gut Too: Symptoms, Causes and Treatment of Intestinal TB

Tuberculosis (TB) is commonly associated with the lungs, but the infection can affect other parts of the body, including the digestive system. Intestinal tuberculosis, also known as abdominal TB when it affects other abdominal organs, is a form of TB that can involve the intestines, particularly the small intestine and the area where the small and large intestines meet.

Intestinal TB can cause persistent abdominal pain, changes in bowel habits, loss of appetite, and unexplained weight loss. Since its symptoms can resemble those of other digestive disorders, including Crohn’s disease, it may be difficult to diagnose. Early detection and appropriate treatment are important to prevent complications.

What Is Intestinal Tuberculosis?

 

 

 

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Dr Neeraj Dhamija, Surgical Gastroenterologist at Sir Ganga Ram Hospital, New Delhi defines, “Intestinal TB is caused by Mycobacterium tuberculosis, the bacterium responsible for tuberculosis. It usually affects the ileum, the final part of the small intestine, and the caecum, the first part of the large intestine.”

The infection can develop when a person swallows TB bacteria, which may reach the digestive tract from infected respiratory secretions. It can also spread through the bloodstream or lymphatic system from another infected part of the body.

Although intestinal TB can occur without obvious lung symptoms, some people may have pulmonary TB at the same time. It is more common in regions where tuberculosis is prevalent, including India.

What Are the Symptoms of Intestinal TB?

According to a study published in the Journal of Clinical Medicine, the symptoms may develop gradually and vary depending on the part of the intestine affected. Common signs include:

• Persistent abdominal pain: Pain may occur around the navel or in the lower-right abdomen.
• Unexplained weight loss: Ongoing infection can reduce appetite and affect overall nutritional health.
• Loss of appetite and fatigue: A person may feel unusually tired, weak, or less interested in food.
• Fever and night sweats: Low-grade fever, particularly in the evening, and excessive sweating at night may occur.
• Changes in bowel habits: Some people experience diarrhoea, constipation, or alternating bowel patterns.
• Abdominal swelling or bloating: Inflammation or narrowing of the intestine can cause discomfort and distension.

Not everyone experiences all these symptoms. Some people may have symptoms for weeks or months before receiving a diagnosis. Severe abdominal pain, persistent vomiting, a swollen abdomen, or inability to pass stool or gas may indicate an intestinal obstruction and require urgent medical attention.

Also Read: Breathlessness Is Not Always Asthma: How ILD Differs From Asthma and COPD

Who Is at Risk of Intestinal TB?

Anyone can develop intestinal TB, but the risk is higher among people who have been exposed to tuberculosis or live in areas where it is common.

Other risk factors include a weakened immune system, HIV infection, malnutrition, and conditions or treatments that suppress immunity. People with a history of TB or close contact with someone who has infectious TB may also need assessment if they develop persistent symptoms.

Having abdominal symptoms does not automatically mean a person has intestinal TB. Medical evaluation is necessary to identify the underlying cause.

How Is Intestinal TB Diagnosed?

Diagnosing intestinal TB can be challenging because its symptoms overlap with those of inflammatory bowel diseases, particularly Crohn’s disease, as well as certain infections and cancers, according to a report published in the journal ‘Intestinal Research’.

Doctors may recommend a combination of tests, depending on the symptoms and clinical findings.

• Colonoscopy with biopsy: A thin, flexible tube with a camera is used to examine the colon and the end of the small intestine. Tissue samples may be collected to look for evidence of TB.
• Histopathology: Examining tissue under a microscope can help identify characteristic inflammation or granulomas associated with TB.
• Molecular tests and cultures: Tests on tissue or other samples can help detect TB bacteria. Molecular tests may also identify drug resistance, while cultures can take longer to provide results.
• Imaging: Ultrasound or CT scans may reveal thickening of the intestinal wall, enlarged abdominal lymph nodes, fluid accumulation, or complications.
• Other TB tests: Chest X-rays, sputum tests, and blood tests may be used to check for TB elsewhere in the body. A skin test or interferon-gamma release assay can indicate TB infection but cannot, by itself, confirm active intestinal TB.

No single test identifies every case. Doctors interpret the findings together to distinguish intestinal TB from other conditions and decide on the appropriate treatment.

How Is Intestinal TB Treated?

Intestinal TB is treatable with a combination of anti-tuberculosis medicines. Treatment usually involves several antibiotics taken over a period of months, depending on the patient's condition, drug-susceptibility results, and response to treatment.

• Patients must complete the prescribed course, even if their symptoms improve earlier. Stopping medicines without medical advice can lead to treatment failure, relapse, and drug resistance. Regular follow-ups help doctors monitor recovery and identify possible side effects.
• Nutritional support is also important, particularly for people who have lost weight or have poor appetite. A balanced diet with adequate protein, calories, vitamins, and minerals can support recovery. However, diet alone cannot cure intestinal TB.

Also Read: 6 Best Anti-Inflammatory Foods That You Should Eat

What Happens If Intestinal TB Is Left Untreated?

Without timely treatment, inflammation can damage the intestine and lead to serious complications. These include:

• Intestinal obstruction: Inflammation and scarring can narrow the intestine, blocking the passage of food and stool.
• Perforation: Severe damage may cause a hole in the intestinal wall, allowing its contents to leak into the abdominal cavity.
• Bleeding: Ulcers in the intestine may sometimes cause bleeding.
• Nutritional problems: Persistent symptoms can lead to poor food intake, weight loss, and nutritional deficiencies.

Some complications may require surgery alongside medical treatment.

Can Intestinal TB Be Prevented?

Preventing tuberculosis involves identifying and treating active TB promptly, reducing exposure to infectious TB, and following recommended public health measures. Since TB commonly spreads through the air, good ventilation and appropriate precautions around people with infectious pulmonary TB are important.

Intestinal TB is not usually spread directly from one person to another through ordinary contact. However, a person with intestinal TB who also has infectious pulmonary or laryngeal TB may spread the infection through the air.

Final Word

Persistent abdominal pain, unexplained weight loss, fever, or ongoing changes in bowel habits should not be ignored, particularly in regions where TB is common. Early medical assessment can help establish the diagnosis and prevent complications. With the right treatment and follow-up, intestinal TB can be cured.