When tuberculosis is mentioned, most people tend to have a negative perception, viewing it as a disgusting and dangerous contagious disease. In reality, this is only half true. Tuberculosis is indeed a dangerous contagious disease, but it is not a dirty or disgusting disease because it is a common local disease found throughout Thailand. It is a disease that anyone can get, but it can also be cured.
To confirm and help everyone understand that tuberculosis can truly be cured, today we will talk with Dr. Winai Boveja, a respiratory specialist, about tuberculosis treatment and the process and methods involved in curing it.
Before treatment, a clear diagnosis must be made to confirm it is tuberculosis
The first step in tuberculosis treatment begins with diagnosis. When a patient visits the doctor, the doctor will start by taking a medical history and performing a physical examination. The next step is a “chest X-ray,” which can give an indication of how severe the tuberculosis is. After the X-ray, if tuberculosis is suspected, the next step is “sputum collection” to test and confirm whether it is tuberculosis or not. However, there are often cases where symptoms and X-rays suggest tuberculosis, but sputum tests do not find any indicators of tuberculosis, which is a major problem because even if it looks like tuberculosis, if the test does not detect it, a definitive diagnosis cannot be made.
Therefore, nowadays, if sputum tests cannot clearly confirm tuberculosis, a new technique called “molecular biology” testing is used on the sputum. Although this method is more expensive, it provides a more accurate and certain diagnosis, allowing for faster and more timely treatment. However, if sputum tests still cannot provide a clear diagnosis, the last resort is a bronchoscopy with a biopsy, which is the most definitive diagnostic method but also the most costly.
Just taking medicine can cure tuberculosis
The current approach to tuberculosis treatment is “medication only,” using tablets. Treatment is divided into two phases. For pulmonary tuberculosis, medication must be taken for about 6 months. For extrapulmonary tuberculosis, such as tuberculosis of the pleura, bones, lymph nodes, etc., medication must be taken for about 9-12 months or as determined by the doctor. If tuberculosis affects the brain, treatment must last at least 12 months, but it can still be cured.
4+2 regimen and get ready to celebrate: the medication formula that clears tuberculosis within 6 months
Before starting medication, it is essential to evaluate liver function, kidney function, diabetes status, and the overall condition of the patient to ensure they can tolerate the medication. If ready, the first set of medication will be given immediately. Tuberculosis treatment is divided into two phases: the first 2 months is the intensive phase, where 4 groups of drugs are given, excluding other vitamins. After the first 2 months, tuberculosis gradually subsides, and the treatment enters the second phase with less intensive medication, using only 2 groups of drugs for about 4 more months. After that, it depends on the doctor’s judgment whether to continue medication, but most patients are cured within 6 months.
Is tuberculosis 100% curable? It depends 100% on the patient
During medication, patients must strictly follow the doctor’s instructions regarding medication intake and lifestyle behaviors, such as absolutely no alcohol consumption because tuberculosis drugs affect the liver. Drinking alcohol can harm the liver and cause complications. Patients who take traditional medicine, herbal medicine, or self-purchased medication for treatment or health maintenance must consult their doctor if they want to be completely cured of tuberculosis. Tuberculosis is 100% curable, but patients must not be resistant, must take medication regularly, and follow the doctor’s orders.
Side effects to be aware of during tuberculosis treatment
While taking tuberculosis medication, the patient’s urine may turn dark yellow to orange, similar to orange Fanta. Nausea, vomiting, or itchy rashes on the body may also occur. Mild symptoms are normal and not worrisome. However, if there are widespread rashes, swelling of the lips or eyes, high fever, abdominal pain, jaundice (yellowing of the skin and eyes), loss of appetite, vomiting, etc., these are abnormal symptoms and the patient should see a doctor immediately.
No cough? Don’t be complacent. You might have tuberculosis without knowing it
Finally, the doctor wants to emphasize that annual health check-ups help screen and protect us from tuberculosis. Tuberculosis does not always show symptoms; there is a form that is asymptomatic, which is now quite common. Patients may not cough, have fever, or any symptoms but still have tuberculosis in their lungs. This form is not only dangerous to the patient but also makes them unknowingly a source of infection to others. Although tuberculosis is curable, if left untreated and undiagnosed, it will spread, making tuberculosis control much more difficult. Therefore, health check-ups and chest X-rays should not be overlooked because if tuberculosis is detected early, treatment can be started promptly, preventing harm to close family members and helping control the spread of tuberculosis in society and the country.
Dr. Winai Boveja
Internal Medicine Specialist, Pulmonary Clinic
Phyathai 3 Hospital