What are the symptoms of gastric tuberculosis?

Gastric tuberculosis is not a very common disease in life. It is generally caused by bacterial infection in the internal organs of the human body. Gastric tuberculosis is divided into mild or severe, and different degrees will present different symptoms. In general, gastric tuberculosis will easily lead to stomach pain, nausea and retching, etc., and it will also be easy to have symptoms such as acid reflux and abnormal hiccups.

Clinical manifestations of gastric tuberculosis

The clinical manifestations of gastric tuberculosis are very inconsistent. Some are asymptomatic or very mild, some are similar to chronic gastritis, gastric cancer, and most are similar to ulcer disease. Patients have upper abdominal discomfort or pain, often accompanied by acid reflux and belching, and the abdominal pain is unrelated to eating. The vomiting caused by pyloric obstruction is mostly severe in the afternoon and evening. The vomitus is the food eaten and does not contain bile. The occult blood may be negative, and the abdominal distension will be relieved after vomiting. In addition to gastric symptoms, systemic tuberculosis symptoms may also occur, such as fatigue, weight loss, afternoon fever, and night sweats. During physical examination of the upper abdomen, an irregular mass may be felt. When there is pyloric obstruction, the gastric shape and gastric peristalsis can be seen in the upper abdomen, and there will be gastric gurgling sounds.

examine

1. Laboratory examination

(1) Hematological examination often shows mild anemia, increased erythrocyte sedimentation rate, and tuberculosis antibodies can be detected in the serum.

(2) Fecal occult blood test may be positive.

(3) The tuberculin skin test is usually positive or strongly positive.

(4) Gastric juice analysis is often reduced, and some patients do not have achlorhydria.

(5) The acid-fast staining of the endoscopic biopsy section was positive, with caseous granulomas.

2. Other auxiliary examinations

(1) X-ray barium meal examination shows no specific signs of gastric tuberculosis, but may present as niche shadows, filling defects, stenosis and deformation of the gastric antrum, and often with signs of duodenal involvement and pyloric obstruction. The gastric mucosa is rough and the stomach wall is still soft, but there are also cases where the stomach wall is stiff, and a few even have leathery stomachs. These signs are difficult to distinguish from gastric ulcer, gastric cancer, gastric malignant lymphoma, etc.

(2) Gastroscopy is the main method for diagnosing gastric tuberculosis. It is still difficult to differentiate gastric tuberculosis lesions from gastric ulcer or gastric cancer by naked eye observation under gastroscopy. However, the following findings during biopsy are helpful for the diagnosis of tuberculosis: ① caseous granuloma; ② Mycobacterium tuberculosis is found by acid-fast staining of sections or culture of biopsy materials; ③ Mycobacterium tuberculosis DNA is positive by polymerase chain reaction test. If the lesion is located in the muscular layer without destroying the mucosa, it is easy to be misdiagnosed as a smooth muscle tumor during gastroscopy. For submucosal lesions, the result may be negative if the biopsy sample is taken too shallowly.

diagnosis

Gastric tuberculosis has no characteristic clinical manifestations, and X-ray and gastroscopy examinations have no specific signs, so clinical diagnosis is quite difficult. It is currently believed that histological and bacteriological examinations are the only methods for confirming gastric tuberculosis. Clinically, gastric tuberculosis should be considered when gastric lesions occur in young people who are refractory to regular anti-ulcer drug treatment and are accompanied by the following conditions: ① tuberculosis lesions in other parts of the body; ② a strongly positive tuberculin test without tuberculosis in other organs; ③ an abdominal mass is palpable; ④ X-ray shows fistulas or sinuses; ⑤ the stomach and duodenum are affected at the same time and the lesions are continuous.