Intestinal Tuberculosis Intestinal tuberculosis is a chronic specific infectious disease caused by the invasion of the intestinal tract by Mycobacterium tuberculosis. Pulmonary tuberculosis is a common primary lesion, mainly through oral infection, and can also be caused by hematogenous spread and direct extension. It manifests as abdominal pain, changes in bowel habits, fever, fatigue, etc. Early rational use of anti-tuberculosis drugs or surgical treatment is recommended, and the general prognosis is good.

Intestinal tuberculosis is a chronic specific infectious disease caused by the invasion of the intestinal tract by Mycobacterium tuberculosis. Pulmonary tuberculosis is a common primary lesion, mainly through oral infection, and can also be caused by hematogenous spread or direct extension. It presents with symptoms such as abdominal pain, changes in bowel habits, fever, and fatigue. Early rational use of anti-tuberculosis drugs or surgical treatment is recommended, with generally good prognosis.

Ulcerative intestinal tuberculosis

It develops along the transverse axis of the intestine, with the lesions starting from the intestinal wall lymphocytes and then progressing to caseous necrosis, leading to the shedding of the intestinal mucosa and the formation of ulcers. The edges of the ulcers are irregular, varying in depth, and can reach the subserosal layer.

Proliferative intestinal tuberculosis

The lesions are located in the cecum, sometimes involving the proximal segment of the ascending colon or the terminal ileum. There is a large amount of tuberculous granulomas and fibrous tissue proliferation in the submucosa, causing localized thickening and rigidity of the intestinal wall, with tumor-like masses protruding into the intestinal lumen, leading to narrowing of the intestinal lumen and easily causing obstruction.

Mixed type intestinal tuberculosis, ulcerative proliferative type intestinal tuberculosis

Both mixed and proliferative changes coexist.

Oral infection

Patients with pulmonary tuberculosis swallow sputum containing tubercle bacilli, drink unpasteurized milk or dairy products. Sharing utensils with open pulmonary tuberculosis patients, inadequate sterilization and disinfection can lead to intestinal tuberculosis infection.

Hematogenous spread

Common in miliary tuberculosis.

Direct extension

Due to adjacent tissue and organ tuberculosis lesions, such as mesenteric lymph node tuberculosis, tuberculous peritonitis, tuberculous pelvic inflammation, etc., causing intestinal tuberculosis through lymphatic or direct extension.

Abdominal pain

Mostly right lower abdominal pain, occasionally periumbilical or diffuse abdominal pain, dull or vague, aggravated after eating, and relieved after defecation.

Changes in bowel habits

Constipation is common in proliferative intestinal tuberculosis patients, while ulcerative intestinal tuberculosis patients mainly present with diarrhea, increased frequency of bowel movements, loose stools without pus or blood, and no tenesmus. Patients often experience alternating diarrhea and constipation.

Abdominal mass

The mass is located in the right lower abdomen, tender, and mostly seen in proliferative intestinal tuberculosis. When ulcerative intestinal tuberculosis is accompanied by localized peritonitis, the affected intestinal segment and tissue adhesion can also cause abdominal masses.

Tuberculous toxic symptoms

Common in ulcerative intestinal tuberculosis, with symptoms such as fever, fatigue, weight loss, anemia, and malnutrition. Proliferative intestinal tuberculosis generally does not present with tuberculous toxic symptoms due to its longer course.

Ensure good ventilation and maintain indoor air freshness, and keep the indoor environment quiet.

Monitor body temperature regularly, and use alcohol sponge baths to provide physical cooling when there is fever.

Diet

Have small, frequent meals, eat soft, easily digestible, nutritious, and energy-rich foods, mainly based on rice and flour, and supplement protein in moderation. Avoid hard nuts, peppers, and alcohol.

Exercise

Engage in appropriate activities such as walking, calisthenics, and tai chi.

Lifestyle

Maintain regular daily routines and ensure sufficient rest time, and live a disciplined life.

Emotional and psychological well-being

Enhance communication with the patient, continuously encourage the patient to accept treatment with an optimistic mindset, and strengthen the patient's confidence in overcoming the disease.

For treatment with anti-tuberculosis drugs, it is essential to take the medication on time and adhere to the full course of treatment.

In case of intestinal obstruction, fasting should be temporarily prohibited, and prompt medical attention should be sought.