Tuberculosis is a chronic multisystemic diseases caused by mycobacterium tuberculosis. It is spread by droplet infection. The World Health Organisation and various government and non-governmental agencies are trying to eradicate this disease. But due to the chronic nature, potential to contaminate others, long duration of treatment and social stigma attached, this seems a very difficult and herculean task.
Diagnosis of TB is made by clinical features and relevant tests. Following which treatment is given. Timely treatment leads to complete recovery and prevents tissue damage.. But if delayed or infection is severe, there can be chronic health problems.
Loss of appetite due to TB results in chronic malnutrition in the sufferer. Anti-TB medicines add to the nausea and loss of appetite. The result is that some of the persons continue to be very weak even after finishing the course of medicines.
There can be permanent damage in the part of lung affected. This affects lung’s ventillatory function. At times, pulmonary TB heals by fibrosis, whereas elastic tissue of lungs is replaced by fibrous bands, thus affecting lung capacity. The affected person suffers from breathlessness on exertion. Chronic cough and breathlessness can also develop due to permanent destruction of air tubes and air sacs. One also gets tired easily and is at risk of death due to sudden respiratory failure. Impairment of lung function is further aggravated by chronic exposure to smoke or dust.
A person with damaged lungs is more prone to develop recurrent respiratory tract infections, because the lungs can no longer effectively expel infectious germs.
Those suffering from tuberculosis of the intestines or peritoneal cavity are prone to chronic constipation and pain in abdomen even after completion of therapy because of adhesions formed around intestines.
One with TB of the spine can suffer from chronic backache even after finishing treatment. Affections of the brain can lead to permanent neurological problems.
A person who has finished full course of therapy for TB pericarditis (covering of the heart), may continue to suffer from cardiac failure because of the damage incurred to the heart, if treatment is delayed. Though very rare, but TB of genital parts can cause chronic genital swelling, lesions and even infertility.
The sequels of tuberculosis masquerade as reinfection or incompletely treated tuberculosis, thus at times making the person take another round of anti tubercular chemotherapy
Thus one has to be aware of tuberculosis and get tests done on the slightest suspicion. Because more is the delay in treatment, more is the risk of chronic problems.
Attention to nutrition is vital in a patient suffering from tuberculosis. In spite of anorexia, small frequent meals containing vital nutrients is necessary. Breathing exercises done regularly, help to rebuild the ability to ventilate in the damaged lung and enhance the function of the intact lung tissue. Developing pulmonary tuberculosis should be changing phase in the life of a smoker to quit smoking. Otherwise, one is bound to suffer from chronic cough, breathlessness and weakness.
In this era of effective chemotherapy, tuberculosis should not be a cause for chronic morbidity and poor health of a person. A person may acquire tuberculosis from any source but can lead a good quality normal life as before.
The only thing needed is to pay attention to good nutrition and other factors associated with the illness and treatment.
Dr. Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital