CLINICOCOLONOSCOPIC PROFILE OF COLONIC TUBERCULOSIS

Background: Colonic tuberculosis is common in developing countries. Ho wever, its diagnosis is difficult. Nevertheless, colonoscopy and biops y examination have shown promising results. Methods: We evaluated the clinical spectrum and colonoscopic features of 62 patients with coloni c tuberculosis. Results: Abdominal pain, fever, anorexia, weight loss, and change in bowel habit were seen in more than 50% of the patients. Massive rectal bleeding was frequently (13%) observed. Colonoscopy re vealed strictures in 17, deformed ileocecal valve in 34, ulcers in 52, nodules in 49, polypoidal lesions in three, and fibrous bands in five patients. Segmental tuberculosis, lesions mimicking carcinoma, and mu ltiple site involvement were observed in 19%, 20%, and 50% of the pati ents, respectively. Histopathologically, well formed granulomas were s een in 27, collections of epithelioid cells in 18, and chronic, nonspe cific inflammatory changes in 17 of the cases. Acid-fast bacilli could not be isolated from any of the patients. All of the patients respond ed to the anti-tubercular treatment. Follow-up colonoscopy in 22 patie nts demonstrated regression of lesions. Conclusions: Colonic tuberculo sis is common in India. Our findings indicate that colonoscopy is usef ul for its diagnosis. However, histopathology may not always be helpfu l. Therefore, in a given clinical and colonosopic setting, a therapeut ic trial may be indicated.