Tuberculosis: Symptoms, Treatment, Dietary management

Tuberculosis

Tuberculosis is an infectious disease caused by the bacillus Mycobacterium Tuberculosis. It affects the lungs most often but may also be localised in other organs such as the lymph nodes, intestine, meninges, bones, joints and skin or it may be generalised.

In the 20th century, TB was a leading cause of death in the United States. Today, most cases are cured with antibiotics. But it takes a long time. You have to take meds for at least 6 to 9 months.

Clinical Features:

Pulmonary tuberculosis is accompanied by :

  • Wasting tissues
  • Exhausting
  • Cough
  • Expectoration (cough with respiratory secretions)
  • Fever

The acute phase resembles pneumonia, with high fever and increased circulation and respiration.

The chronic phase is accompanied by low grade fever though the metabolic rate is high, it is lower than in acute fever. Because of the protracted illness,wasting may be considerable.

As the disease progress the patient begins to exhibit.

  • Loss of appetite
  • Pain in chest
  • Fatigue
  • Weight loss
  • Night sweats and worsening cough

If a blood vessel is eroded in the bacilli may gain access to the blood and be transported to various parts of the body, establishing numerous secondary foci of infection in the lungs and other vital organs. Lymph Nodes and kidneys can also be affected. There is increased catabolism of tissue proteins and increased loss of water from body due to perspiration, increased loss of sodium chloride and potassium salt from body.

“24th MARCH IS WORLD TUBERCULOSIS DAY”

Dietary Principle:

High calorie, high proteins, high vitamin and minerals, high fluid soft diet is recommended.

Nutrition:

Energy: Since the metabolic rate is not as high as in other fevers, satisfactory weight can be maintained with 2500 to 3000. It is not desirable to gain more than 10 percent above the ideal weight. High calorie diet is prescribed. High calorie foods include:

Banana, cereal porridge, peanut chikki, wheat and ragi are quite beneficial for TB patients.

Protein: A protein intake somewhat in excess of normal requirements is necessary in tuberculosis, since the serum albumin value especially in advanced tuberculosis and in cases of long standing, may be low. The daily requirement may be from 80 to 120g. Protein rich foods include:

Egg, soya chunks, paneer. These foods can be absorbed easily by the body and can give you the required energy.

Minerals: The drug isoniazid interferes with vitamin D metabolism. This in turn can decrease absorption of calcium and phosphorous. Calcium should be provided liberally since it is also essential for healing tuberculosis lesions. Atleast 1 litre of milk should be taken daily. The iron needs may also be increased if there has been hemorrhage. Calcium, iron, phosphorous help in regeneration of cells, blood and fluids.

Nuts and seeds like sunflower seeds, flax seeds, chia seeds and pumpkin seeds.

Vitamins: Vitamin A,C and E should be given abundantly. The metabolism of vitamin a is adversely affected in tuberculosis.Carotene appears to be poorly converted to vitamin A so that the diet should be planned to provide vitamin A. The weekly inclusion of liver and dietary supplementation with vitamin A essential.

Ascorbic acid deficiency is present and increased amounts of orange juice is prescribed. Vitamin C is essential for regenerative purpose. Vitamin A, C & E rich foods :

Orange, mango, sweet pumpkin, carrots, guava, amla, tomato, nuts and seeds

B complex rich foods include: Cereals, nuts, seeds, fish and chicken

Treatment:

Rifampicin, Isoniazid, Pyrazinamide and Ethambutol are drugs used in combinations for treating tuberculosis. These drugs are supiled free to the patients through government hospitals and health centres and monitored the progress under the REVISED NATIONAL TB CONTROL PROGRAMME based on Directly Observed Treatment Short Course (DOTS)

Isoniazid is used as chemotherapeutic agent for tuberculosis is an antimetabolite to pyridoxine,preventing the formation of pyridoxal phosphate. Treatment with large doses, 50 to 100g daily of pyridoxine prevents this effect.


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