Brief Article
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World J Gastroenterol. May 7, 2014; 20(17): 5017-5024
Published online May 7, 2014. doi: 10.3748/wjg.v20.i17.5017
Routine diagnosis of intestinal tuberculosis and Crohn's disease in Southern India
Geir Larsson, Thrivikrama Shenoy, Ramalingom Ramasubramanian, Leena Kondarappassery Balakumaran, Milada Cvancarova Småstuen, Gunnar Aksel Bjune, Bjørn Allan Moum
Geir Larsson, Department of Medicine, Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, NO-0440 Oslo, Norway
Thrivikrama Shenoy, Population Health and Research Institute, Medical College PO, Trivandrum 695011, Kerala, India
Ramalingom Ramasubramanian, Thoothukudi Government Medical College, Thoothukudi 628002, Tamil Nadu, India
Leena Kondarappassery Balakumaran, Population Health and Research Institute, Medical College PO, Trivandrum 695011, Kerala, India
Milada Cvancarova Småstuen, Department of Biostatistics, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, NO-0318 Oslo, Norway
Gunnar Aksel Bjune, Institute of Health and Society, Faculty of Medicine, University of Oslo, NO-0318 Oslo, Norway
Bjørn Allan Moum, Department of Gastroenterology and Hepatology, Institute of Clinical Medicine, Oslo University Hospital Ullevål, NO-0424 Oslo, Norway
Author contributions: Larsson G designed and performed the research and wrote the paper; Shenoy T designed the research, advised on the research methods, served as a centre investigator and edited the paper; Ramasubramanian R served as a centre investigator and edited the paper; Balakumaran LK organised the research and sample collection and edited the paper; Småstuen MC supervised on the statistical analyses and edited the paper; Bjune GA advised on tuberculosis aspects and edited the paper; Moum BA advised on the research design, methods and gastroenterological aspects and edited the paper.
Supported by The South-Eastern Norwegian Regional Health Authority, No. 2011132, Lovisenberg Diaconal Hospital’s Research Fund and The Unger-Vetlesen Medical Fund
Correspondence to: Dr. Geir Larsson, Department of Medicine, Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, NO-0440 Oslo, Norway. larsson.geir@gmail.com
Telephone: +47-23-225140 Fax: +47-23-225139
Received: October 11, 2013
Revised: December 31, 2013
Accepted: March 5, 2014
Published online: May 7, 2014
Core Tip

Core tip: Intestinal tuberculosis (ITB) and Crohn’s disease (CD) may easily be confused with one another in terms of clinical, laboratory, endoscopic and histopathological features. In this prospective multi-centre study from Southern India, we found weight loss and mucosal nodularity were associated with ITB. Furthermore, right lower abdominal pain and multi-segment intestinal involvement were associated with CD. The random inclusion of as many CD as ITB patients suggests that CD may be increasing in the region. Current diagnostic modalities for differentiating ITB from CD are imperfect and simple inexpensive tools for diagnosis are needed.