GI Tuberculosis

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Each year, tuberculosis (TB) results in the death of 3 million people globally. In 2000-2020, an estimated 1 billion people will be infected, 200 million people will become sick, and 35 million will die from TB, if control is not strengthened.

Overall, one third of the world's population is infected with the TB bacillus, but not all infected individuals have clinical disease. The bacteria cause the disease when the immune system is weakened, as in older patients and in patients who are HIV positive. The control of TB has been challenging because of the natural history of the disease and the varying pattern in which it manifests in different groups.

GI TB is a major health problem in many underdeveloped countries. A recent significant increase has occurred in developed countries, especially in association with HIV infection. Autopsies of patients with pulmonary TB before the era of effective treatment demonstrated intestinal involvement in 55-90% of fatal cases. The previously noted frequent association between pulmonary TB and intestinal TB no longer prevails, and only a minority of patients (< 50%) with abdominal TB now have abnormal chest radiographic findings. However, approximately 20-25% of patients with GI TB have pulmonary TB. Any part of the GI system may be infected, although the ileum and colon are common sites.

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