Distinguishing intestinal tuberculosis from Crohn's disease

We read with keen interest the extensive review by Rupa Banerjee and colleagues 1 Banerjee R Pal P Mak JWY Ng SC Challenges in the diagnosis and management of inflammatory bowel disease in resource-limited settings in Asia. Lancet Gastroenterol Hepatol. 2020; 5: 1076-1088 Summary Full Text Full Text PDF PubMed Scopus (5) Google Scholar regarding the challenges and management strategies of Crohn's disease in low-income, tuberculosis endemic countries. The differential diagnosis between intestinal tuberculosis and Crohn's disease has always been an important concern in Asia. Challenges in the diagnosis and management of inflammatory bowel disease in resource-limited settings in AsiaInflammatory bowel disease (IBD) is increasing in prevalence in resource-limited settings in Asia. Although the prevalence of IBD is lower in these settings than in high-income countries, the high disease burden due to large population size is projected to overtake that of high-income countries in the near future. Unique challenges exist for diagnosing and managing IBD in Asia. On one hand, the inadequate disease awareness in physicians and the general population, the scarcity of diagnostic services, the infectious mimics of IBD (specifically intestinal tuberculosis), and the widespread use of empirical antibiotics and antitubercular therapy pose diagnostic challenges. Full-Text PDF Distinguishing intestinal tuberculosis from Crohn's disease – Authors' replyWe thank Anuraag Jena and colleagues for their interest in our review.1 They suggest that a colonoscopy after 2 months should be standard strategy for patients taking empirical antitubercular therapy, irrespective of improvement of the symptoms. Full-Text PDF