TUBERCULOSIS: Complication, Diet & Prevention

Tuberculosis (TB) is an air-borne infectious disease caused by bacteria - Mycobacterium tuberculosis. World Health Organization (WHO) stated that it is one of the top ten causes of death across the globe. In 2016, WHO gave a statistics of 2.79 million cases of TB for India. Although TB primarily affects lungs but it can occur in almost any part of the body.

Tuberculosis is majorly of two types - an Active TB Disease and Latent TB Infection.

Active TB Disease - In this illness, TB bacteria multiply at a very fast rate and invades other organs of the body. Person suffering from active TB disease may spread TB bacterias to others by airborne infection via cough and sneeze. Typical symptoms of active TB disease are chest congestion, chest pain, weakness, cough, phlegm, chronic fever, chills, night sweats and weakness. Person infected should take active care as the disease is contagious. If not treated, it may prove fatal.

Miliary TB - This is a form of active TB in which bacterias enter the blood circulation and spread infection to other parts of the body. Apart from lungs, miliary TB may damage liver, spleen, kidneys, brain, spinal cord and heart. Symptoms can be vague and hard to discern.

Latent TB Infection - People suffering from latent TB infection have bacterias in their body but they are present in very small numbers. Due to this reason, the infection is kept under control by our immune system and do not cause any symptoms. Latent TB infection is not infectious and it can not be passed to others but people suffering from latent TB infection may develop active TB disease in the future.

 COMPLICATIONS OF TUBERCULOSIS

Complications of TB are numerous and they may vary from person to person in terms of stages when they appear and severity. Let’s understand some of them in brief-

  1. Haemoptysis - This term refers to coughing out blood. It may occur due to erosion or rupture of a blood vessel located around lung. At times massive haemoptysis, which implies coughing approx. 100-600 ml in 24 hours, may require blood transfusion.
  2. Pleural Effusion - Simply refers to accumulation of fluid around the lungs. Computed tomography or ultrasound-guided pleural biopsies are usually implied for the examination of pleural effusions.
  3. Tuberculosis Pericarditis - This is another important complication of TB affecting heart. There is inflammation of tissues surrounding the heart and common symptoms includes cardiomegaly (enlarged heart), tachycardia (increased heart rate), cough, dyspnea (shortness of breath), chest pain, night sweats, oedema, fever and weight loss.
  4. Pneumothorax - It refers to leaking of air in between the lung and chest. Sometimes, this complication is also referred as collapsed lung. This puts pressure on our lungs, making them unable to expand as much as they normally do when we breathe.
  5. Cor Pulmonale - This complication affects the structure and function of right ventricle of our heart. There are changes in the small blood vessels of right side of lungs which exerts a pressure on the right ventricle. There is development of high blood pressure in the arteries of lungs commonly known as pulmonary hypertension. 
  6. Dysphagia and Dysphonia - Sometimes TB results in ulceration making it difficult for the person to swallow referred as dysphagia. Person might also find it hard to speak as there is imbalance in the coordination of voice muscles. This variance is called as dysphonia.

 Studies have shown that TB complications might also expand their wings leading to cancer, gastrointestinal disturbances, hearing loss, lesions in kidneys and spondylitis affecting spine. 

DIETARY MANAGEMENT OF TUBERCULOSIS

 

 Along with proper rest, treatment and antibiotic therapy, dietary management is also necessary to provide recovery from Tuberculosis.

Although there is no specific food which is required by a person suffering from TB, but it is important to have a well-balanced diet. Meals should be simple, soft and easily digestible. Depending upon the associated complications, food options might vary from person to person but usually diet prescribed should be -

  • Calorie dense to meet daily energy needs and to prevent further weight loss.
  • Consume plenty of whole grain cereals, pastas and breads.
  • Increased protein needs to prevent muscle loss and maintain serum albumin levels should be met by including protein rich foods like eggs, paneer, soybean, pulses, milk and milk products.
  • Diet should be rich in micronutrients especially vitamin A, C and E. Rich food sources are orange, mango, pumpkin, sweet potato, papaya, amla, kiwi, sweet lime, nuts and seeds. These are antioxidant rich and prevents free radical damage of cells and tissues.
  • Rich sources of calcium and iron should also be liberally included in the diet like dark green leafy vegetables, ragi and dates.
  • Too much fat should be avoided as it can lead to gastric upset. Prefer unsaturated fats like olive oil and vegetable oils, instead of saturated ones like butter and cream.
  • Avoid high fat, junk foods, fried foods, ready to eat and processed foods.
  • Avoid alcohol and tobacco consumption.
  • Limit the intake of carbonated and caffeinated beverages and foods like tea, sodas and coffee.
  • Always keep body hydrated to flush out toxins.
  • Prefer clear soups over creamy ones.
  • Have small frequent meals and avoid forced feeding.
  • Avoid excess of spices and salt.
  • It is advisable to avoid intake of refined based carbohydrates.

PREVENTION OF TUBERCULOSIS

It is very well said that “prevention is better than cure”. On World Tuberculosis Day, let us pledge to practise some of these measures that can prevent the spreading of this disease.

  1. Get yourself vaccinated by BCG (Bacille Calmette-Guérin) which is a vaccine against tuberculosis.
  2. Maintain proper personal hygiene and keep surroundings clean.
  3. Cover yourself while coughing or sneezing to prevent spreading of TB bacteria.
  4. Have a strong immune system.
  5. People who frequently comes in contact with TB patients like in clinics and hospitals, should regularly monitor themselves medically.
  6. Improve room air ventilation.
  7. In case any symptom appear, consult a physician and begin with the treatment to avoid further progressing of TB.

REFERENCES

 http://bmi.icmr.org.in/itrc/index.php

 https://www.who.int/news-room/fact-sheets/detail/tuberculosis

 https://www.cdc.gov/features/tbsymptoms/index.html

 https://www.tbfacts.org/tb-statistics-india/

 https://www.nationaljewish.org/conditions/tuberculosis-tb/types

 https://www.researchgate.net/publication/256297424_Complications_of_Tuberculosis

 https://academic.oup.com/cid/article/33/7/954/432366

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