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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 28, 2008; 14(32): 5051-5058
Published online Aug 28, 2008. doi: 10.3748/wjg.14.5051
Colonoscopy evaluation after short-term anti-tuberculosis treatment in nonspecific ulcers on the ileocecal area
Young Sook Park, Dae Won Jun, Seong Hwan Kim, Han Hyo Lee, Yun Ju Jo, Moon Hee Song, Nam In Kim, Jun Seok Lee
Young Sook Park, Dae Won Jun, Seong Hwan Kim, Han Hyo Lee, Yun Ju Jo, Moon Hee Song, Nam In Kim, Jun Seok Lee, Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul 139-711, South Korea
Author contributions: Park YS, Kim SH, Lee HH, Jo YJ, and Song MH designed and performed research; Park YS, Jun DW, Kim NI, and Lee JS analyzed data; and Park YS wrote the paper.
Correspondence to: Young Sook Park, MD, PhD, Director of Internal Medicine and Gastroenterology, Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, 280-1, Hagye 1 dong, Nowon-Gu, Seoul 139-711, South Korea. pys1109@eulji.ac.kr
Telephone: +82-2-9708207 Fax: +82-2-9708621
Received: March 23, 2008
Revised: August 6, 2008
Accepted: August 15, 2008
Published online: August 28, 2008
Abstract

AIM: To evaluate the efficacy of colonoscopy follow-up after short-term anti-tuberculosis treatment in patients with nonspecific ulcers on ileocecal areas being suspicious of tuberculous colitis.

METHODS: We prospectively analyzed the colonoscopic findings before and after short term anti-tuberculosis treatment in 18 patients with nonspecific ulcers on the ileocecal area and compared them with 7 patients of confirmed tuberculous colitis by acid-fast bacilli or caseating granuloma on colonic biopsy.

RESULTS: Mean duration for short-term follow-up was 107.3 d with combined chemotherapy containing isoniazid, rifampicin, ethambutol and pyrazinamide. Seven patients with tuberculous colitis showed complete healing of active ulcers after short-term medication. After short-term anti-tuberculosis treatment, follow-up colonoscopy findings divided 18 patients with nonspecific ulcers into two groups by ulcer state. One is the “suspicious tuberculous colitis group” showing healing of ulcers and erosions and another is the “suspicious inflammatory bowel disease group” showing active ulcers with or without aggravation of the lesion. Finally, all 9 of the “suspicious tuberculous colitis group” were diagnosed as tuberculous colitis showing no recurrence of ulcers after termination of 9 mo of anti-tuberculosis medication. Patients of the “suspicious inflammatory bowel disease group” were finally diagnosed as Crohn’s disease or nonspecific colonic ulcers during long-term follow up.

CONCLUSION: Follow-up colonoscopy shows a healing stage ulcer or scarring change without an active ulcer with just 2 mo to 3 mo of medication in patients with tuberculous colitis. Colonoscopy follow-up after short term anti-tuberculosis trial in patients with nonspecific ulcers on the ileocecal area is valuable in making early differential diagnosis of tuberculous colitis.

Keywords: Colonoscopy; Short-term; Anti-tuberculosis medication; Tuberculous colitis; Ileocecal ulcer