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Suffering from severe back pain. MRI showing spine tuberculosis. Complete bed rest and unable to take high dosage. Advise?

DOCTOR OF THE MONTH - Jul 2013
Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
Question
hi,

My mother is suffering from severe back pain from past few days. In her MRI reports, spine tuberculosis is detected. She is 56 years old. I am working in Bangalore right now. My mother is in Dehradun. She is in complete bed rest. My father has consulted a doctor in Delhi. He suggested following medicines:

1. RCinex 600mg
2. Pzide 750mg
3. Combutol 1000mg
4. Oflox 400mg
5. Benadon

But she was able to take them only for 1 day. The very next day she started vomiting and was not able to sleep. She is unable to take such a high dosage.
Please suggest what to do??
Posted Mon, 21 Oct 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. K. Naga Ravi Prasad 34 minutes later
Brief Answer:
She has to take the medications.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

The above mentioned drugs are all appropriate adult dosages for the treatment of Caries spine (TB spine).

They may cause a little bit of Gastric upset (resulting in nausea & vomiting)initially which can be effectively countered by taking a PPI (proton pump inhibitor) like Omeprazole, Rabeprazole, Pantoprazole etc along with Domperidone. Gradually, patients will become tolerant to the dosages and feel comfortable.

There is no other alternative but to use the medications for atleast 6-8 months regularly.

Hope I have addressed your query. Happy to help further

Regards
Above answer was peer-reviewed by
 
Follow-up: Suffering from severe back pain. MRI showing spine tuberculosis. Complete bed rest and unable to take high dosage. Advise? 21 minutes later
Till how many months she has to be in complete bed sheet? and at what stage her spinal tubercluosis has reached (I have attached MRI report) ? And what is the cause of extreme back pain? Is that due to some spinal nerve compression?


Also, apart from medication is there any specific diet that can help her in recovering.
 
 
Answered by Dr. K. Naga Ravi Prasad 23 minutes later
Brief Answer:
Bed rest untill resolution of Acute pain.

Detailed Answer:
Hi, Nice to hear from you. I have gone through all the attached documents.

Strict bed rest is needed up untill the acute pain is subsided, which may take around a week. After that period, she can move around by wearing a Lumbosacral support or corset.

As your mother has no signs or symptoms of neurological deficits in the legs, this stage of the disease is manageable with medical treatment alone.

The extreme back pain is due to the discitis and neural compression (as per the MRI report).

A diet for tuberculosis should not include foods that are tough to digest as they can cause acidity and aggravate respiratory irritation. It is recommended that TB patients should consume a balanced diet that should include at least two cups of fruits and two and a half cups of vegetables a day.

Foods that can help the body fight the TB infection include milk, fruits and vegetables. Green leafy vegetables, legumes and starchy vegetables including bitter gourd, drumsticks, spinach and broccoli can help the body in its fight against the tuberculosis bacillus.

Fruit juices that are XXXXXXX in antioxidants and vitamins are advised. Orange juice is XXXXXXX in vitamin C, a powerful antioxidant that can help the body in its fight against the tuberculosis bacillus. Other juices that are beneficial include carrot, tomato, gooseberry and pineapple juice.

Recommended fruits for tuberculosis patients include strawberries and custard apples. Strawberries are high in potassium, vitamins, and minerals that help boost the immune system and help fight the disease. Custard apples are often used as a home remedy for tuberculosis by boiling the pulp with water and consuming the reduction daily.

Hope I have justified your query.
Above answer was peer-reviewed by
 
Follow-up: Suffering from severe back pain. MRI showing spine tuberculosis. Complete bed rest and unable to take high dosage. Advise? 16 minutes later
Thanks doctor for such nice answers. I am quite satisfied now. My last question to you is that whether PPI has to be taken after taking anti tb drugs or before that..?? Also with what all drugs it is required..??
 
 
Answered by Dr. K. Naga Ravi Prasad 7 hours later
Brief Answer:
PPI is to be taken before breakfast.

Detailed Answer:
Hi, the PPI is to be taken daily, one hour before breakfast. It's only one tablet per day. And this will take care of your mother's Nausea,vomiting and Gastric upset for the whole day.

Hope I made it clear. Good day
Above answer was peer-reviewed by
 
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