Since ancient times, mankind has been fighting withintestinal tuberculosis. This is a serious and dangerous disease that, if left untreated, can lead to death. Everyone should know how this disease manifests itself. So what is intestinal tuberculosis? What are the symptoms for it?
The essence of intestinal tuberculosis
Tuberculosis is a disease that everyone knows about.to people. Under this term, experts understand chronic infectious disease. Many people think that this disease is associated only with damage to the respiratory system. In fact, it is not. There are extrapulmonary types of the disease. One of them is intestinal tuberculosis. Occurs named disease due to mycobacteria. One of the sources of infection are patients who do not follow the rules of personal hygiene.
Such people secrete Mycobacterium tuberculosis(MBT) and infect several people in a year. Cattle are also sources of infection. Mycobacterium tuberculosis is highly resistant to environmental factors. At various effects, microorganisms can become ultrafine filtering particles or giant branching structures. In favorable conditions, the office takes on typical forms.
Forms of intestinal tuberculosis
The named disease is divided into primary andsecondary. Tuberculosis of the intestine is transmitted, because of what occurs? The answer to this question is to give. So, primary tuberculosis occurs for several reasons:
- Due to the use of unboiled milk of tuberculosis cows.
- When hematogenous dissemination of Mycobacterium tuberculosis from the primary focus in the lungs, lymph nodes.
- Because of the use of food from dishes that are infected with Mycobacterium tuberculosis, or a container that belongs to people with the disease.
The secondary form of the disease occurs in sick peopleaffected lungs due to ingestion of sputum and saliva. Mycobacterium tuberculosis in this way enter the intestine and infect its wall (affect mainly the ileum). As a result, fistula and ulceration occur. Is colon tuberculosis dangerous? Statistics show that the disease is usually a secondary process that occurs during progress pulmonary form. Much less often, intestinal tuberculosis is primary, developed due to nutritional infection.
Symptoms of the disease
With intestinal tuberculosis, people note the following suspicious signs:
- Symptoms of intoxication. Due to the disease, appetite is lost, body weight begins to decrease. Patients complain of night sweats, fever. In women, there may be no menstruation.
- Intestinal symptoms.At the onset of the disease, some people get constipated. After it should, as a rule, prolonged and debilitating diarrhea. Patients referring to specialists also complain of abdominal pain.
- The presence of education. On palpation of the abdomen a slightly painful tumor can be felt.
With ulcerative-destructive bowel diseaseSymptoms of peritoneal irritation occur. Patients with fever. Blood is visible in fecal masses or there are its components (erythrocytes, leukocytes), which are detected by specialists when conducting research using a microscope. Complications may be characteristic of the ulcerative-destructive process. Often there are bleeding, intestinal obstruction, a violation of the integrity of its wall.
Diagnosing Tuberculosis
The diagnosis of intestinal tuberculosis can be made by specialists after a comprehensive examination. It includes:
- tuberculin tests;
- X-ray;
- colonoscopy;
- irrigoscopy;
- laparoscopy with biopsy.
Quite informative methods arecomputed tomography and laparoscopy. In the course of applying these diagnostic methods, specialists often find calcified mesenteric lymph nodes and tuberculosis in patients. Informative and X-ray examination. Thanks to him, experts detect signs of intestinal tuberculosis (for example, barium retention in the cecum during the release of other departments).
The quantiferon test is modernlaboratory method to identify the infection. Lighting the diagnosis of tuberculosis, it is worth considering it. So, the essence of the test lies in the study of the patient's blood. It is taken in the morning on an empty stomach from a vein and placed in a special kit consisting of three test tubes. After blood sampling, experts conduct a study. A quantiferon test can give a positive, negative and questionable result:
- A positive result indicates infection with the Office.
- A negative result is received by healthy people.However, it is worth noting that with it one should not exclude infection with Mycobacterium tuberculosis. The result may be false negative. This happens in the early stages of infection, with immunodeficiency states.
- A dubious result is possible withindividual features of immunity, as well as in violation of pre-analytical requirements. For more information, doctors decide whether to collect new blood or order additional examinations.
Differential diagnosis
Those signs that are detected by experts inexamination of people with suspected intestinal tuberculosis may be characteristic of other inflammatory diseases. This ailment has a lot in common with ulcerative colitis, Crohn's disease, amoebic dysentery, and intestinal neoplasms. For the correct diagnosis requires differential diagnosis:
- To ensure the absence of amebic dysentery and tumors, histological examination should be carried out.
- Thanks to the endoscopic biopsy can besarcoid-like granulomas, consisting of lymphocytes, with large Pirogov-Langhans-type cells in the center were found. Such structures are characteristic of intestinal tuberculosis and Crohn's disease. These diseases can be distinguished from each other by the centers of caseous necrosis. They occur together with granulomas only in intestinal tuberculosis.
Treatment of the disease
With the diagnosis of "intestinal tuberculosis"treatment begins in specialized hospitals. Its goal is the persistent healing of foci of infection, the elimination of symptoms of the disease. Treatment of tuberculosis is quite long. Recovery on average occurs in a year. In some cases, it takes much longer to heal.
Intestinal tuberculosis requires complextreatment. Its main component is chemotherapy. Doctors choose specific drugs, determine their combinations, doses. At the beginning of intensive chemotherapy. It inhibits the reproduction of mycobacteria, helps to reduce their number. Regarding treatment regimens, it is worth noting that every day can be applied:
- "Isoniazid" and "Rifampicin";
- "Isoniazid" and "Ethambutol".
Первая комбинация препаратов назначается на a period of 9 to 12 months, and the second - by 18. Such long-term treatment is necessary due to the fact that mycobacteria multiply slowly and can remain inactive for a long time.
Если выявила туберкулез кишечника диагностика, то conservative treatment will not necessarily be prescribed. It is not in all cases able to give the expected result. Sometimes doctors prescribed surgical treatment. It is shown in the development of complications. For example, an operation can be assigned when there is a large amount of fluid in the abdominal cavity. Surgical intervention requires mechanical intestinal obstruction. The causes of its occurrence may lie in the remaining scars and adhesions between intestinal loops after treatment.
Treatment problems
The main problem associated with treatmentintestinal tuberculosis, is the indiscipline of sick people. Many patients do not follow the recommendations of specialists and interrupt the intake of tuberculostatic drugs. Due to the premature termination of chemotherapy, the process is sharpened. Another problem is that after taking the prescribed drugs, side effects may appear. The serious consequences of the toxic effects of drugs are:
- Hepatitis is an inflammatory disease of the liver.
- Thrombocytopenia is a condition in which there is a decrease in platelet count.
- Neuritis - inflammatory diseases of the nerves.
- Renal failure is a pathological condition characterized by a violation of all the functions of the kidneys.
Побочные эффекты появляются не так уж и часто.3-5% of people receiving Rifampicin and Isoniazid, and 1-2% of patients treated with Isoniazid and Ethambutol are confronted with them. With the appearance of side effects, the treatment program is changed.
The effects of intestinal tuberculosis
The prognosis of the disease depends onhow timely the specialists diagnosed the disease and prescribed therapy. In advanced cases and with destructive lesions of the small intestine, the prognosis is unfavorable due to recurrent intestinal obstruction and impaired absorption of useful substances. A less pessimistic prognosis is given when a large intestine is affected.
Prevention of disease
С целью предупреждения развития туберкулеза bowel therapy is carried out. In order to determine whether a particular person needs him, a preliminary formulation of tuberculin tests is performed. If the result is positive, then prophylactic 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 a disease such as intestinal tuberculosis. The reasons for its appointment may be as follows:
- The person is often in contact with persons who have active tuberculosis.
- The patient takes corticosteroid and immunosuppressive agents.
- A person suffers from immunodeficiency of various origins.
In conclusion, it is worth noting that whensuspicious symptoms characteristic of intestinal tuberculosis, you should immediately contact the clinic to the therapist. If a specialist suspects the disease, the patient will be referred to one of the specialized TB facilities.
