Ingestion of the tuberculous germ by drinking unpasteurised milk of a cow infected with TB is one of the mechanisms of abdominal TB.

Abdominal TB can also occur by spread of the TB bacillus from the lungs to the intestines by the blood stream.

In 2/3 rd of children, there is predominant involvement of the digestive system. Involvement of the abdominal cavity (peritoneum) occurs in remaining of the patients. Involvement of only the lymph glands in the abdomen is rare.

Clinical feature of abdominal tuberculosis is varied. The most common symptoms are pain in the abdomen, loss of weight, anorexia, recurrent diarrhea, low grade fever, cough and distension of abdomen.

The doctor on examination may feel a lump, fluid in the abdomen or a doughy feel of the abdomen. Also there may be enlarged lymph glands elsewhere in the body.

Diagnosis can be confirmed by isolating the TB germ from the digestive system by either a biopsy or endoscopy. However, other supportive tests that may be done are the Mantoux test, Chest X-Ray, Abdominal X-Rays (with or without barium) and scans such as ultrasound and CT scan.

Untreated TB of the intestine may lead to intestinal obstruction, fistula or even abscess and perforation with resultant peritonitis.

Abdominal TB needs to be treated with at least 3-4 anti TB drugs for the initial 2 months and subsequently 2 anti TB drugs for at least 7-10 months.

The commonly used drugs during the initial 2 months therapy (intensification phase) are Isoniazid (INH), Rifampicin, Ethambutol and Pyrazinamide. During the next 7-10 months (continuation phase) 2 the drugs commonly used are INH and Rifampicin.

Surgery is required whenever there is perforation, abscess or fistula formation.