Intestinal Tuberculosis

Intestinal TB is the most common digestive system TB, mostly secondary to extrapulmonary TB, especially cavitary pulmonary TB; 25-50% of pulmonary TB patients develop intestinal TB. It is mainly from ingesting bacilli-laden sputum, occasionally contaminated food, or hematogenous/direct spread from abdominal/pelvic organs. It affects young/middle-aged adults, female:male ~1.85:1. Pathologically it is ulcerative, hypertrophic, or mixed.

Common Symptoms

Ileocecal TB; irregular fever; remittent fever; borborygmus; cachectic facies; intestinal perforation; extrapulmonary TB; abdominal pain; constipation; black bloody stool

Causes and Pathogenesis

Bacilli enter the gut mainly orally. Patients often have open pulmonary TB and swallow their own bacillary sputum; or share meals with open cases without disinfection; rarely, unpasteurized bacillus-containing milk/dairy causes primary intestinal TB. Miliary TB hematogenously seeds the intestine; intra-abdominal foci (female genital, renal TB) directly spread. Infection alone is not sufficient; disease requires heavy virulent inoculum plus reduced immunity, bowel dysfunction, and local lowered resistance.

Treatment

Anti-tuberculous therapy, symptomatic treatment, supportive therapy, surgical treatment

Preventive Measures

Preventing pulmonary TB is fundamental; emphasize early diagnosis and active anti-TB treatment of pulmonary TB to sputum-conversion before bacilli-laden sputum is swallowed. Health education is essential.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.