Clinical Study of Intestinal Tuberculosis and its Response to Short Course Anti-Tuberculosis Therapy

Objective: Intestinal tuberculosis (ITB) is an important form of extrapulmonary TB that often mimics other gastrointestinal diseases, making early diagnosis and management challenging. This study aimed to assess the clinical features, diagnostic approaches and treatment response of patients with ITB who received short-course anti-tuberculosis therapy (ATT). Methods: A prospective study was conducted on 48 patients with clinical, radiological, endoscopic and histopathological evidence of ITB at a tertiary care hospital between March 2023 and March 2024. Patients underwent diagnostic tests including the Mantoux test, abdominal ultrasonography, barium studies and colonoscopy with biopsy. All patients were treated with a standard 6-month ATT regimen and their clinical response was evaluated at 2 months and 6 months. Results: The most common symptoms were abdominal pain (89.6%), weight loss (81.3%) and fever (77.1%). The Mantoux test was positive in 69% of cases and elevated ESR was found in 91.7% of patients. Imaging and endoscopy showed frequent findings such as ulcers (85.4%) and ileocecal involvement (75%). After 2 months of ATT, 56.25% of patients showed significant clinical improvement, which increased to 89.6% after completing 6 months of therapy (p<0.001). However, 8 patients were later diagnosed with Crohn’s disease instead of ITB. Conclusions: Most patients with ITB showed marked improvement with a 6-month ATT regimen, highlighting the effectiveness of this treatment approach. However, diagnosing ITB remains challenging because it shares symptoms with Crohn’s disease. This study underscores the need for careful evaluation and follow-up to help doctors diagnose intestinal TB accurately and provide timely, effective treatment.