Gastrointestinal Tuberculosis

Gastrointestinal tuberculosis (GI TB) is a type of tuberculosis that affects the digestive system, including the stomach and intestines. It’s caused by the bacteria Mycobacterium tuberculosis, the same bacteria that cause pulmonary tuberculosis, but it affects the digestive tract instead. Understanding GI TB, its symptoms, causes, diagnosis, and treatment is essential for early detection and effective management.

Types of Gastrointestinal Tuberculosis:

  1. Intestinal Tuberculosis: Affects the intestines, including the small intestine and colon.
  2. Peritoneal Tuberculosis: Involves the lining of the abdominal cavity, called the peritoneum.
  3. Tuberculous Colitis: Specifically affects the colon.
  4. Tuberculous Enteritis: Affects the small intestine.

Causes of Gastrointestinal Tuberculosis:

  1. Infection with Mycobacterium tuberculosis bacteria through contaminated food or water.
  2. Weakened immune system, such as in HIV/AIDS or due to certain medications.
  3. Close contact with individuals infected with tuberculosis.
  4. Poor living conditions and overcrowding.
  5. Malnutrition and poor dietary habits.
  6. Smoking and substance abuse, which weaken the immune system.
  7. Chronic diseases like diabetes or kidney disease.
  8. Travel to regions with high tuberculosis prevalence.
  9. Lack of access to healthcare and preventive measures.
  10. Occupational exposure in healthcare settings.
  11. Alcohol abuse, which weakens the immune system.
  12. Age, as older adults are more susceptible to infections.
  13. Genetic predisposition to tuberculosis.
  14. Previous history of tuberculosis infection.
  15. Immunosuppressive therapies, such as for organ transplants.
  16. Poor hygiene practices.
  17. Underlying lung diseases.
  18. Crowded living conditions.
  19. Poverty and socioeconomic factors.
  20. Drug-resistant strains of tuberculosis.

Symptoms of Gastrointestinal Tuberculosis:

  1. Abdominal pain, especially in the lower abdomen.
  2. Persistent diarrhea or changes in bowel habits.
  3. Rectal bleeding or blood in stool.
  4. Unintentional weight loss.
  5. Loss of appetite and decreased food intake.
  6. Fatigue and weakness.
  7. Fever and night sweats.
  8. Nausea and vomiting, sometimes with blood.
  9. Abdominal swelling or distension.
  10. Constipation or difficulty passing stool.
  11. Anemia due to blood loss.
  12. Abdominal tenderness or discomfort.
  13. Swollen lymph nodes in the abdomen.
  14. Malabsorption of nutrients leading to deficiencies.
  15. Joint pain and stiffness.
  16. Difficulty swallowing (dysphagia).
  17. Persistent cough, especially if accompanied by blood.
  18. Formation of abscesses or fistulas in the abdomen.
  19. Difficulty breathing or shortness of breath.
  20. Generalized weakness and lethargy.

Diagnostic Tests for Gastrointestinal Tuberculosis:

  1. Tuberculin skin test (TST) or Mantoux test to check for exposure to tuberculosis.
  2. Chest X-ray to detect signs of tuberculosis in the lungs.
  3. Blood tests, such as interferon-gamma release assays (IGRAs) to detect tuberculosis infection.
  4. Stool examination for presence of Mycobacterium tuberculosis bacteria.
  5. Endoscopy and colonoscopy to visualize the digestive tract and take biopsies.
  6. Polymerase chain reaction (PCR) test to identify tuberculosis DNA in samples.
  7. Imaging studies like CT scan or MRI to assess the extent of disease.
  8. Sputum culture to grow and identify tuberculosis bacteria.
  9. Fine needle aspiration (FNA) biopsy of abdominal masses or lymph nodes.
  10. Ascitic fluid analysis to detect tuberculosis infection in peritoneal fluid.
  11. Ultrasound to evaluate abdominal organs for signs of tuberculosis.
  12. Barium swallow or barium enema to visualize the digestive tract.
  13. Serological tests to detect antibodies against tuberculosis.
  14. Tuberculin lymphocyte proliferation assay (TLPA) to assess immune response.
  15. Pleural fluid analysis if there are signs of pleural involvement.
  16. Gastric aspirate for acid-fast bacilli (AFB) smear microscopy.
  17. Magnetic resonance enterography (MRE) for detailed imaging of the intestines.
  18. Laparoscopy for direct visualization and biopsy of abdominal organs.
  19. PET scan to detect areas of increased metabolic activity.
  20. Histopathological examination of tissue samples for characteristic changes of tuberculosis.

Non-Pharmacological Treatments for Gastrointestinal Tuberculosis:

  1. Adequate nutrition with a balanced diet rich in vitamins and minerals.
  2. Rest and avoidance of strenuous activities to conserve energy.
  3. Hydration with plenty of fluids to prevent dehydration.
  4. Regular exercise within individual limitations to maintain strength and mobility.
  5. Psychological support and counseling to cope with the stress of illness.
  6. Smoking cessation and avoidance of alcohol to promote healing.
  7. Proper hygiene practices, including handwashing, to prevent spread of infection.
  8. Dietary modifications to manage gastrointestinal symptoms, such as avoiding spicy or fatty foods.
  9. Small, frequent meals to aid digestion and prevent discomfort.
  10. Supportive care for complications like malnutrition or anemia.
  11. Education about tuberculosis prevention and management.
  12. Social support from family and friends to encourage adherence to treatment.
  13. Monitoring of symptoms and response to treatment by healthcare providers.
  14. Wound care for skin lesions or surgical incisions.
  15. Use of heating pads or warm compresses for abdominal pain relief.
  16. Mobility aids if weakness or joint pain is present.
  17. Occupational therapy to regain skills for daily activities.
  18. Counseling for smoking cessation or substance abuse issues.
  19. Assistive devices for mobility if needed.
  20. Nutritional supplements if malnutrition is severe.
  21. Collaboration with a registered dietitian for personalized dietary recommendations.
  22. Complementary therapies such as acupuncture or massage for symptom relief.
  23. Peer support groups for emotional support and shared experiences.
  24. Stress management techniques like deep breathing or meditation.
  25. Home modifications for safety and accessibility.
  26. Regular follow-up appointments with healthcare providers.
  27. Education about medication management and potential side effects.
  28. Family planning counseling for individuals of childbearing age.
  29. Referral to specialists for management of specific complications.
  30. Advance care planning for individuals with advanced disease.

Drugs Used in the Treatment of Gastrointestinal Tuberculosis:

  1. Isoniazid (INH): Kills tuberculosis bacteria by inhibiting cell wall synthesis.
  2. Rifampicin (RIF): Targets tuberculosis bacteria by inhibiting RNA synthesis.
  3. Pyrazinamide (PZA): Kills tuberculosis bacteria in acidic environments like those found in the intestines.
  4. Ethambutol (EMB): Inhibits cell wall synthesis in tuberculosis bacteria.
  5. Streptomycin: A bactericidal antibiotic effective against tuberculosis.
  6. Levofloxacin: A fluoroquinolone antibiotic used in drug-resistant tuberculosis.
  7. Moxifloxacin: Another fluoroquinolone antibiotic with activity against tuberculosis.
  8. Bedaquiline: A newer medication used in multidrug-resistant tuberculosis.
  9. Delamanid: Another newer medication for multidrug-resistant tuberculosis.
  10. Clofazimine: A medication used in combination therapy for tuberculosis.
  11. Linezolid: An antibiotic used in drug-resistant tuberculosis.
  12. Ethionamide: Inhibits tuberculosis bacterial growth by interfering with metabolism.
  13. Cycloserine: Blocks cell wall synthesis in tuberculosis bacteria.
  14. Para-aminosalicylic acid (PAS): Inhibits folate synthesis in tuberculosis bacteria.
  15. Capreomycin: A bactericidal antibiotic used in multidrug-resistant tuberculosis.
  16. Amikacin: An aminoglycoside antibiotic effective against tuberculosis.
  17. Kanamycin: Another aminoglycoside antibiotic used in tuberculosis.
  18. Rifabutin: A rifamycin antibiotic used in tuberculosis treatment.
  19. Thioacetazone: Inhibits cell wall synthesis in tuberculosis bacteria.
  20. Terizidone: Another medication used in multidrug-resistant tuberculosis.

Surgeries for Gastrointestinal Tuberculosis:

  1. Bowel resection: Removal of a portion of the diseased intestine.
  2. Peritoneal biopsy: Removal of a tissue sample for examination.
  3. Drainage of abscesses: Surgical removal of pus-filled pockets.
  4. Fistula repair: Closure of abnormal connections between organs.
  5. Strictureplasty: Surgical widening of narrowed intestinal segments.
  6. Laparotomy: Surgical exploration of the abdomen.
  7. Colectomy: Surgical removal of part or all of the colon.
  8. Ileostomy or colostomy: Creation of an opening in the abdomen for stool diversion.
  9. Lymph node biopsy: Removal of enlarged lymph nodes for testing.
  10. Exploratory laparoscopy: Minimally invasive surgical procedure to examine abdominal organs.

Preventive Measures for Gastrointestinal Tuberculosis:

  1. Vaccination with the Bacillus Calmette-Guérin (BCG) vaccine in regions with high tuberculosis prevalence.
  2. Screening for tuberculosis in high-risk populations, such as healthcare workers or those living in crowded conditions.
  3. Treatment of latent tuberculosis infection to prevent progression to active disease.
  4. Education about tuberculosis transmission and prevention measures.
  5. Promotion of good hygiene practices, including handwashing and respiratory etiquette.
  6. Improving living conditions and access to healthcare in high-risk communities.
  7. Early detection and treatment of tuberculosis cases to reduce transmission.
  8. Use of personal protective equipment in healthcare settings when caring for tuberculosis patients.
  9. Contact tracing and screening of close contacts of individuals with tuberculosis.
  10. Collaboration between healthcare providers, public health agencies, and community organizations to address tuberculosis prevention and control.

When to See a Doctor:

If you experience any of the following symptoms or risk factors, it’s important to see a doctor:

  1. Persistent abdominal pain or discomfort.
  2. Unexplained weight loss or appetite changes.
  3. Blood in stool or rectal bleeding.
  4. Persistent diarrhea or changes in bowel habits.
  5. Fever, night sweats, or fatigue.
  6. History of tuberculosis exposure or infection.
  7. Known risk factors for tuberculosis, such as HIV/AIDS or immunosuppressive medications.
  8. Recent travel to regions with high tuberculosis prevalence.
  9. Close contact with individuals diagnosed with tuberculosis.
  10. Any other concerning symptoms or health issues.


Gastrointestinal tuberculosis is a serious condition that requires prompt diagnosis and treatment. By understanding the symptoms, causes, diagnostic tests, and treatment options, individuals can take proactive steps to protect their health and well-being. Early detection and management are key to preventing complications and improving outcomes for individuals affected by this disease. If you have any concerns about gastrointestinal tuberculosis or experience symptoms suggestive of the condition, don’t hesitate to seek medical attention for evaluation and care.


Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. Thank you for giving your valuable time to read the article.