Brief Answer: No weight gain does not mean active disease Detailed Answer: Namasthe Welcome to Healthcare-Magic Greetings of the day Dear Mr XXXXXXX Intestinal Tuberculosis usually presents with features of 1. Obstruction 2. Malabsorption 3. Consitutional symptoms like Fever, loss of appetite and weight loss Anti tuberculosis treatment is very effective in curing Tuberculosis, with efficacy almost approaching 100% if patient complaince is maintained. Improvement in disease and response to treatment is assessed by 1. Improvement in abdominal symptoms 2. Absence of fever 3. Feeling of positive energy Initially there may bedrug induced gastritis and once tolerance develops to it, there is improvement in appetite which denotes clinical improvement. Weight gain is usually seen after 5 to 6 months of starting of treatment. No weight gain does not mean active disease. If your previous symptoms which you had are improving it denotes trend towards cure. If your appetite is good and you eat a well balanced nutritional diet the weight gain will occur. Do write to me if you need any further assistance, will be glad to assist you. Take Care Best Regards DR Deepak Kishore MBBS,MS,MCH Consultant Surgeon

---

Brief Answer: Histopathology will differentiate Detailed Answer: Namasthe Many of the times its very difficult to differentiate TB from Crohn's disease. The diagnostic features are 1. Histopathological examination of the Ulcer in Illeocecal region 2. PCR For TB 3. Therapeutic trail: If the symptoms respond to antitubercular treatment its likely to be TB In my clinical practice, I take the biopsy of the lesion. In majority of the cases its TB. If your symptoms have resolved with anti Tubercular treatment , its likey to be TB. Majority of case of Intestinal TB are caused by Mycobacterium Tuberculosis(Human starin). There is decline in cases caused by Mycobacterium Bovis( Strain present in cow). The commercial milk available is pasteurized and is free from M Bovis. so there is no cause for concern. I would advise you the following diet 1. Consume plenty of oral fluids: 2 to 3 liter per day 2. High fiber diet: 2 servings of vegetable salad, two serving of fruit and one serving should be citrus food. 3. Eggs: Boiled eggs are preferable 4. Wheat porridge/ dalia/lapsi for breakfast: especially made with jaggery and desi ghee 5. Green leafy vegetable: especially palak and pethi 6. Chicken soup 7. Include Yoghurt / curd in diet 8. Avoid junk foods One of the recipe which i advise the patient for breakfast is as follows Add 2 spoon of desi ghee in frying pan, add 2 spoons of whole wheat flour and cook it till its golden brown in clour. Add 2 cups of water. Boil it on slow flame. To it add a mixture of grinded Almonds+ Pista+ Khajur(dried dates) approximately 1 cup. Make a paste like consistency. you can have it for breakfast thrice a week along with lassi and a serving of fruit. Khajur is calorigenic and will help buid up weight. Egg being a first class protein , its important to supplement your breakfast with one boiled egg everyday. I hope it helped. D get back to me if you need any further assistance, will be glad to assist you. Take Care Best Regards DR Deepak

---

Brief Answer: TB is 100 percent curable Detailed Answer: Namasthe Dear Brother Intestinal TB is completely curable. The efficacy of anti-tubercular treatment is nearly 100 percent. Mild pain is acceptable., there is no cause for concern. Infection with TB provides a long immunity and is unlikely to recur. TB and Crohns have different etiology, Tb will not get converted in crohn's disease. If its intestinal TB there is no need for milk restriction. Milk and eggs have good firts class proteins and are wholesome food. Milk restriction may be necessary in crohn's disease but nit in TB. Consuming pasteurized milk, re boiling it again at home is safe and will not cause recurrence. Having Intestinal Tb is much better than Crohn's , TB is 100 percent curable with the anti TB chemotherapeutic agents available. Some Physician recommend anti TB drugs for as long as one year, ideally 6 months is sufficient. Do write to me anytime you need any further clarification. Take Care Regards Deepak

---

Brief Answer: No cause for concern Detailed Answer: Namasthe Dear Mr XXXXXXX Let me first reassure you, there are no major side effects by TB treamtment. Most common side effect is drug induced Hepatitis and is very rare. So do not be worried about side effects. Having two bowel motion per day is absolutely fine, there is no cause for concern Every individual have their own bowel habits and things cannot be generalized. I would also suggest you to have a course of deworming, as worm infestation could be the cause of underlying pain in abdomen. Many of my patients have benefited. Tablet Mebendazole 100 mg twice a day for three deals is recommended dosage. Also would suggest you to keep taking Tablet Pantoprozole once a day early morning. As i have mentioned, if your appetite is good and your oral intake is good then dont be worried about weight gain. Absence of fever, good appetite , positive feeling are all positive signs. If your others previous complaints have resolved after starting anti TB treatment, it implies you are on path of recovery. Do write to me brother if you have any other query. Regards Deepak

---