Colonoscopy evaluation after short-term anti-tuberculosis treatment in nonspecific ulcers on the ileocecal area.
OBJECTIVE
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.


CONCLUSIONS
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.
Park
Young Sook
YS
Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center 280-1, Hagye 1 dong, Nowon-Gu, Seoul, South Korea. pys1109@eulji.ac.kr
Jun
Dae Won
DW
Kim
Seong Hwan
SH
Lee
Han Hyo
HH
Jo
Yun-Ju
YJ
Song
Moon Hee
MH
Kim
Nam In
NI
Lee
Jun Seok
JS