Scan Report Shows Enlarged Mesenteric Lymphadenopathy Terminal Ileum Cecum And Proximal Ascending Colon. Is This Koch's Disease?

Posted on Wed, 13 Nov 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 13 Nov 2013 Answered on

Mon, 9 Dec 2013 Last reviewed on

Question : Hi sir ,I'm from India working in u.k having abdominal pain with gas in right quadrant have been diagnosed with colon tb infection 6 months ago, Doctor has done blood test (quantiferon gold)which was positive /ultrasound scan was showing diffuse wall thickening with surrounding fat stranding and enlarged mesenteric lymphadenopathy terminal ileum cecum and proximal ascending colon suspecting Koch's disease colonoscopy report was thickend edematous ulcerated mucosa ascending colon with luminal narrowing Scope unable to negotiate beyond. Histopatholgy report was graulomatous disease and was not sure koach/ chron as well but the tube was not going further and he was suspecting it must either Koach or chron disease.doctor prescribed 6 months course forecox/benadon/rabiuim dsr for first 2 months and r cinex/benadon rest of 4 months. I'm about to finish my 6 month course in 2 weeks time. Still I get a random pain with gas in the same region after the gas releases from mouth pain will be disappeared and will be comfort and I'm getting pain in my foot heels for 10 minutes while walking after wake up from bed or after sitting long time what is the the reason for this how do I know my present tb is cured or not and is it a chron or a Kox disease. I'm worried lot about this can you please advice me, thanks reddy

Answered by Dr. Dr. Klerida Shehu (55 minutes later)

Brief Answer: please refer to the following answer.. Detailed Answer: Hi, I have read your medical history carefully and could say as following: - the pain and gas you feel would be related to the tbc damages of the colon. - at the end of your treatment, you will repeat the serological tests for tbc (tuberculosis) to understand if it is cured or not. Usually, tbc gets well after therapy. You can take serological test about Crohn's disease like ACSA(Anti-Saccharomyces cerevisiae XXXXXXX Antibodies), it is specific for it. - according to your biopsy and colonoscopy results, it is noted a granulomatous lesion similar to the Crohn's disease. To my opinion, it might be related to both Crohn's disease and tbc of the lower part of the colon. Non-caseating granulomas is a typical biopsy finding for Koch infection. At the end, I'd suggest to redo the testing and check-ups after finishing the current therapy you are taking. Then, based on the results you should do regular follow-ups. Hope it answered to your questions! If you have more concerns, do not hesitate to write me back! I'd be happy to assist you further! Dr.Klerida

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Klerida Shehu (2 hours later)

Hi, Is this Colon tb /chron diesese infectious? After finishing course we are planning for baby,Can you please advice. Thanks

Answered by Dr. Dr. Klerida Shehu (15 hours later)

Brief Answer: please refer to the following answer... Detailed Answer: Hi, Thank you for writing back. Crohn's disease is not infectious, while TBC is an infectious disease. To plan for the baby, I'd suggest to wait until the results of serological tests at the end of the therapy. If they are all OK, you can start planning for a baby. However, I strongly advise to keep in touch with your caring doctor. Wish you fast recovery and lots of babies! Dr.Klerida

Above answer was peer-reviewed by : Dr. Shanthi.E