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Suggest diet chart for a patient on ATT

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Posted on Wed, 13 May 2015
Question: hi doc i have put up on ATT, wht can be my possible diet
doctor
Answered by Dr. Richa Agarwal (22 minutes later)
Brief Answer:
High protein, low fat and carbohydrate diet.

Detailed Answer:
Hello dear,

Thanks for trusting us about your health care.

I can understand your concern here.

Here are the diet chart for a patient on ATT-

-You should consume a balanced diet rich in protein, low in fat and carbohydrate.
-You should take total 2000 calories.
-You should consume 3 serving of whole grains in your diet.
- 2-3 serving of fruits and green leafy vegetables in your diet.
- 3-4 serving of low skimmed milk in your diet.
-Consume cod liver oil, micronutrients and liver 52 in your diet.
- Take a diet which protect your liver because antitubercular drugs affect liver function.

Hope it is useful, feefeel free to discuss more.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Richa Agarwal (3 hours later)
i have been put on empirical att post cesaearan for last 18 days. (cesaran nov 14). as there was a soft tissue track and ultrasound reported of hypoechoic avascular track.0f 14mm.pls guide me is it safe to take att post op as i have taken lots of antibiotics on and off for last 5 months..there might hav3 been some devlopment of fibrosis and adhesions also,.does att help in that even if there is some kind of intestinal blockage

.plsprovide me how to counter the side effects of these medicines in liver eyes etc with diet to be taken and name of probiotic supplements that i can take to maintain the healthy gut flora ..
also is there any blood test to confirm whether the antibiotics of atti m taking have become resistant as its been 18 days and sometimes o feel the problem is still same,that is heaviness and sweelling of lower abdomen with pain sometimes..have a history of allergic asthma also


mantoux tsets reding was 11 mm at 72 hour
tb platinum gamma interfereo positive 0.81
chest x ray negative
usg suggestive of avascular hypoechoic track ist 27 mm then 14 mm from properitonial upto skin in anterior abdominal wall
ist mri suggestive of adhesions and soft tissue track ii suggestive of possibilty of pelvoc infllamtory disease
can this be tuberculosis(as they say it has originated from uterus and went upto skin

pls guide in a detailed manner

has this been converted into cancerous or tumour as there was a delay in nproper diagnosis.is there any blood work to confirm that if the track has become cancerous

also can att be given through iv to show more effects as i m afraid tht it might have making its place further as my hands becom numb with too much pain in my lower back with same discomfory of abdomen ..difficilty in passing stools too..

taking akt 4 bevon folvite sorbilin rabicip l and sofetron z.pls guide
doctor
Answered by Dr. Richa Agarwal (11 hours later)
Brief Answer:
You should continue your treatment for at least 4-6 months.

Detailed Answer:
Hi dear,

Sorry for the long delay in my response.

Yes, you should continue your ATT treatment atleast for 6 months because your test are positive for tuberculosis.

Yes, ATT is effective in case of fibrosis and adhesion.Adhesion and intestinal obstruction can be corrected only surgically.

You are on ATT from last 18 days so it is too early too say whether drug resistance is thete or not.

Diet as we discuss before is helpful in counteract the side effect of ATT and you can take probiotics which contains lactobacillus ( darolac sachet) in it.

In diet you can add yougurt and cereals which contains probiotics in it.

Pelvic inflammatory disease can be due to tuberculosis.

Cancer can be rule out with biopsy taken from affected area and send for histopathology, no blood test detect cancer( as you are not having severe weight loss or any other symptom and you are young these symptoms can be most probably due to tuberculosis).

So please continue your ATT drugs for 6 months to see the results and if any side effects occurs due to ATT treat accordingly.

Hope I have given all the answers but if you are having any further doubt please ask me further.

Good luck.
Regards


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Richa Agarwal (11 hours later)
thanks doc

1got an ada done tday in blood sample...value is 9.2..is this a reilable indicator of pelvoc or abdominal tb
2
i m taking serriatopeptidase.,can i continue tht with att.also taken for 1 month earlier before at
3
how is att taken simulataneoulsy or with different meals..
4
i m attaching my medicines taken so far..pls see if my tb has become mdr
5
for how long darolac can be taken..i took it for 1 month wen i was on antibiotics..is it safe to take if i m having constipation

right now i m takung
akt 4,bevon ,folvite,cipzen forte bd softeron z and duphalac..soventis c syrup for cough as i have dry cough also

mam is this actually tb or the bulge and discomfort is because of fibrosis ,incisional hernia
and adhesions.my abdominal strenght has become very loose.till tne time motions or flatus are not passed i have a very rhythmatic heart beat..kind of fast and numbness and tingling in my hands as if some nerve is compreesed..once the motions are passed thebulge that arises in lower abdomen above scar area settles for some time..i got a very discofrt feeling whilecoughing sneezing or laughing too.

.consulted a surgeon also ,he asked for diagnostic laproscopy,but my concern is is it safe if i have tubercular soft track as my immunity is also low and had a history of gerd and allrrgic asthma

can that soft tissue trackbecome necrotic as there was a delay in doagosis and treatment of tb(Because it was considered as a part of healing earlier,..why do i feel heaviness amd as if someting os stuck in my lower abdomen
pls guide in detailed manner
doctor
Answered by Dr. Richa Agarwal (12 hours later)
Brief Answer:
Continue your ATT treatment.

Detailed Answer:
Hello dear,

Regretful for the long delay in my response.

I have worked through your investigation reports and drugs in detail and following are my opinion.

-Your ADA level is less than 10( cut off is 40-50IU/l, it signifies that you are not having any active load of TB.B.

- For pelvic and abdominal TB ADA measured in ascitic or pelvic fluid( in my view).

- In your instance, diagnostic laparoscopy and tissue taken from the affected site and culture for Mycobacterium tuberculosis is most diagnostic tool.

- Yes, you can wait for laproscopy if your treating doctor think so.

-Do not take serratiopeptidase so long, please discontinue its usage.

- AKT - 4 kit taken once in the morning with empty stomach ( 4 tablets simultaneously).

- No your drug chart is not supported MDR, you were mostly on antibiotics.

- Darolac you can take freely, but give a gap of 7- 14 days in between.

- Constipation can be due to cough syp. also.

- To relieve constipation, you should choose a high fibre diet, drink a lot of water and more types of fruits and vegetables and whole grain diet rather depends upon
stool softener.

- Your symptoms are mostly due to mechanical obstruction cause by fibrosis, adhesion not due to TB.

- In my opinion it is better to consult a surgeon because may be these adhesion and fibrosis may be due to TB but these mechanical obstruction and your symptoms only relieve by surgery.

Hope I am able to help you some of your issue and my opinion is helpful for your future outcome.

If you are not satisfied and want to ask further and need more clarification, I am always here to assist you.

Good luck.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Richa Agarwal (1 hour later)
thanks mam

sorry but i got confused with the answer

do u want to say that it is not tb,but then y i had positive mantoux and igra test..is ada a more relable test and does that rule out tuberculosis and if it is this sho7ld i continue taking att..my doc has tokd me to take rifampicin before breakfast and rest of three cap post breakfast..which method is right..taking so many antibiotics for last five months and now att , i feel thenatural gut flora of my body has lost

will i be a right candidate for laproscopy is it safe to get it done after five months of lscs and at the same time if the infction is tubercular or my weak abdominal strength and immunity

..i m having warm feeling daily ie kind of feverish and loads of bodyache with blurred vision while taking att..does that happen with everyone

mam is it possible tht my baby would have this infection if it is tb and it originated feom uterus..the peadiatrician has asked for chest x ray mantoux and cbc for my five month old baby..i m not feeding him right now..should i keep him away from me..can i cuddle him..or will i spread infction in him

pls guide
doctor
Answered by Dr. Richa Agarwal (3 hours later)
Brief Answer:
You should continue your ATT treatment.

Detailed Answer:
Hello dear,

Sorry if you get confused because of my discussion.

Please do not get confused, as your test results are positive for TB and you are having symptoms also, in my opinion also you are having TB and you should continue your antitubercular treatment.

Maybe I got confused, as per my knowledge ADA is an enzyme and in short it is very important for normal activity of lymphocyte and its levels increases in pleural and ascitic fluid if person is diagnosed for TB.

And blood test for ADA is to see whether this enzyme sufficient or not.( so can you please upload your ADA report to clear my doubt).

You can take AKT kit as your doctor advised( only rifampcin should be taken an empty stomach).

Let your surgeon decide whether you are a right candidate for laproscopy or not.

You should consult your treating doctor because blurred vision is a side effect of ATT.

If you are having active infection during pregnancy than chances of your baby get infected by you.

As TB is not transmitted through touch you can cuddle your baby but precautions should be taken that she should not be in touch of your body secretion, so you should wear a mask and do not feed your baby.

Hope it is clear your doubt, feel free to discuss more.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Richa Agarwal (2 days later)
Mam pls let me know if that problem is because of soft tissue track( which may or
May not be tubercular) , it att effective in that preoblem also


Isnt serriaptopeptidse helpful in that dead tossue removal

Is diagnostic laproscopy a safe and eoutine practice post cesarean if thrre is tb inside

Can I take some ayuevedic supplements like herbocalcium immunocare and liv plus with att
doctor
Answered by Dr. Richa Agarwal (1 hour later)
Brief Answer:
Most probably due to soft tissue tract.

Detailed Answer:
Hello dear,

Nice to hear from you once again.

Yes, most probably your symptoms are due to soft tissue tract.

If soft tissue tract is due to TB, antitubercular are effective in that case.

No, serratiopeptidase is not advisable for so long, so please do not go for it.

In my opinion you can go for laproscopy to find out the cause because at this point diagnosis is very important to treat your symptoms.

I am not suggesting so many drugs whether they are auyrvedic or allopathic, you can take liv- 52 which is good for your liver.

Hope it is useful.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Richa Agarwal (2 days later)
ñ Thanls mam
Based on igra usg and mrithat was doubtful of pid i have been put on empirical att for last 25days.


Doc i have also taken tayo 60 k once weekly six times till now,but while taking this att medicines i feel very weak tired and feverish during the day as if so eone has extracted all my power.is it common,with ceackling sounds feom my bones and body and headache too withblurred visison

mam how long does att take time to show its effects,right now i m given akt 4 witbevon folvite sorbilin and hifinac p or xinase d sos and rabonik plus or pan d softeron z and montair lc and soventis dc
I weigh 66 kg ..i take rifampicin beforebreakfast and rest of medic8nes post breakfast
Do theyneed to be taken same time exact daily or theybecome drug resistant
Is tht so..u have also seen the attached list of medicines taken by me sofar have my become drug resostant

if i have the soft tossue track,lesion or adhesion (whether tubercular or not as i m still confused )will att work on that.or will that track needs to be excsied sugically..if a surgical intervention is neccesary am i the right candidate for rhat ,(given a history of lscs 5 months back,allergic asthma,weak abominal wall strength,low immunity,malnutrotion and if there is tb infection inside).WILL IT BE SAFE TO GET DIAGNOSTIC LAPRPSCOPYDONE and will it help in tht track removal or ,may be it will settle from att.my surgeon says to wait for 6 weeks then will get a cect done and then will decide..isnt that will cause more adhesions (dig lap)


.can u suggest me some iron and calcium supplement that can be taken with att
i have difficulty passing motions too..what should i do

Mam pls guide i m very scared
doctor
Answered by Dr. Richa Agarwal (16 hours later)
Brief Answer:
Wait for 6 weeks as your surgeon advice.

Detailed Answer:
Hello dear,

Sorry for the long delay in my response ( our network are not working properly due to earthquake ).

So I am so sorry for the delay ( I think you will understand my situation ).

First and foremost important thing for you please do not take any stress because it will further decrease your immunity and ATT will take some time to see its response, so as per your doctor suggestion, we should wait for at least 6 weeks.

First we should go for CECT than we can plan for laproscopy or surgical removal of the tract.

Whether the tract is tubercular or not if it is necrosed than nothing will work over it and surgical removal is the better option.

You should take ferium- xt for iron and shelcal500 mg for calcium supplementation.

But iron will further causes constipation.

You can take isabgol husk with warm milk in night to relieve constipation and simultaneously take high fibre diet and drink a lot of water.

All the symptoms are due to TB or due to ATT side effects and it will resolve in few weeks.

You can take them simultaneously or as you had, it will not cause any resistance.

Hope it is useful, feel free to take further questions.

Regards
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Dr. Richa Agarwal

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Practicing since :1999

Answered : 3828 Questions

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Suggest diet chart for a patient on ATT

Brief Answer: High protein, low fat and carbohydrate diet. Detailed Answer: Hello dear, Thanks for trusting us about your health care. I can understand your concern here. Here are the diet chart for a patient on ATT- -You should consume a balanced diet rich in protein, low in fat and carbohydrate. -You should take total 2000 calories. -You should consume 3 serving of whole grains in your diet. - 2-3 serving of fruits and green leafy vegetables in your diet. - 3-4 serving of low skimmed milk in your diet. -Consume cod liver oil, micronutrients and liver 52 in your diet. - Take a diet which protect your liver because antitubercular drugs affect liver function. Hope it is useful, feefeel free to discuss more. Regards