Tuberculosis Treatment: Insights from Dr. Ko in Taiwan

Taiwan e-Hospital - Internal Medicine / Dr. Ke

Dear Dr.
Ke Cheng-Chang,
I apologize for reaching out via email; I should have visited you in person, but my work schedule during the day makes it inconvenient.
I hope you can understand.
My father is Mr.
Wang Jin-Can, and I believe you are familiar with him.
My younger sister's nickname is Song-Yun.
We are very grateful for your long-term care of our father.
He often speaks of your kindness and humor, and we truly appreciate it.
I must tell you that it is thanks to your relaxed approach to medicine that our father has been able to slightly overcome his previous reluctance to see a doctor.
My father mentioned that after your diagnosis, he has tuberculosis.
The uncertainty in our hearts made us anxious for a while, but after looking at the pamphlet sent by Miss Wang from the health center, we learned that as long as he takes his medication for six months, he should be fine.
This has eased our worries a bit.
I would like to ask you a few questions:
Q1: During the treatment process for tuberculosis, can taking medication cause side effects? For example, skin allergies, nausea, upset stomach, vomiting, and other uncomfortable symptoms.
Are there any other medications that can help alleviate these symptoms?
Q2: My father mentioned that you instructed him to temporarily stop taking his medication, but he has been experiencing severe itching lately and often needs to soak in vinegar to feel better.
What should we do? Are there other ways to help him?
Q3: During the period when he is not taking medication, will his tuberculosis condition worsen? Are there alternative treatment methods that can be used in conjunction?
I appreciate your time in addressing these three questions.
Thank you very much! My email is: [email protected].
Wishing you all the best.
Sincerely,
Song-Yun
January 20, 2003

song-uing, 20~29 year old female. Ask Date: 2003/01/20

Dr. Ke Zhengchang reply Internal Medicine

1.
Tuberculosis medications may cause nausea, liver function abnormalities, and skin allergies, so liver function monitoring is necessary.
If any discomfort occurs, the medication must be stopped immediately or switched to another drug.
2.
If there is severe itching, the medication can be paused for a few days, and antihistamines can be administered, with follow-up for liver function in the outpatient clinic.
3.
Pausing the medication for a few days will not adversely affect mild tuberculosis, and different classes of antitubercular drugs will be provided for treatment.

Reply Date: 2003/01/20

More Info

Dear Song-Yun,
Thank you for reaching out with your questions regarding your father's tuberculosis (TB) treatment. It's understandable to feel anxious about a diagnosis like this, but it's great to hear that your father is under the care of Dr. Ko, who seems to have a positive rapport with your family. Let’s address your questions one by one.

Q1: Side Effects of TB Medication
Yes, it is true that TB medications can cause side effects. Common side effects include skin rashes, nausea, vomiting, and gastrointestinal discomfort. These reactions can vary from mild to severe, and while some patients tolerate the medications well, others may experience significant discomfort.
If your father is experiencing side effects, it’s essential to communicate this with Dr. Ko. There are alternative medications and adjunct therapies that can help manage these symptoms. For instance, anti-nausea medications like ondansetron or metoclopramide can be prescribed to alleviate nausea and vomiting. Additionally, antihistamines may help with skin reactions, but it’s crucial to consult with the physician before making any changes to his medication regimen.

Q2: Managing Skin Itching
If your father is experiencing severe itching, it’s important to address this promptly. While soaking in vinegar may provide temporary relief, it’s not a long-term solution. There are topical treatments, such as hydrocortisone cream, that can help reduce inflammation and itching. Oral antihistamines like cetirizine or loratadine may also be beneficial in managing allergic reactions or itching. Again, please ensure that any new treatment is discussed with Dr. Ko to avoid any potential interactions with his TB medications.

Q3: Risks of Stopping Medication
Regarding the concern about stopping medication, it is critical to understand that discontinuing TB treatment can lead to the worsening of the disease. TB is a serious infection that requires consistent and prolonged treatment, typically lasting at least six months. Interrupting the treatment can allow the bacteria to multiply, potentially leading to more severe disease or the development of drug-resistant TB.

If there are concerns about the effectiveness of the current treatment or if side effects are too severe, it’s vital to have a discussion with Dr. Ko about alternative treatment options or adjustments to the current regimen. There are also supportive therapies that can be used in conjunction with TB medications to help manage symptoms and improve overall well-being.

In summary, it’s essential to maintain open communication with Dr. Ko regarding your father’s treatment. Addressing side effects and ensuring adherence to the treatment plan are crucial for a successful outcome. TB is a treatable disease, and with the right support and management, your father can achieve a full recovery.

Thank you for your thoughtful questions, and I wish your father a smooth and successful treatment journey.

Best regards,
Doctor Q&A Teams

Similar Q&A

Managing Tuberculosis While Working Abroad: Treatment Options Explained

Hello, doctor. I am currently residing in Vietnam for work and return to Taiwan approximately every three months. I have been diagnosed with tuberculosis. Do I need to resign from my job and return to Taiwan for treatment, or can I continue taking my medication and return to Taiw...

Dr. Yang Wenda reply Pulmonology
Hello: The treatment for tuberculosis is becoming increasingly standardized worldwide. It is recommended that you do not need to resign from your job. Before returning to Taiwan, you can ask a local physician to provide a treatment record and a copy of your chest X-ray. Upon your...

Understanding Tuberculosis Prevention and Treatment: Key Insights

Hello: My husband was hospitalized at National Taiwan University Hospital earlier this year and was diagnosed with tuberculosis, which the doctor said has been present for over six months. I would like to ask: 1. At that time, I had an X-ray that did not show any signs of tubercu...

Dr. Guo Conghuai reply Internal Medicine
DEAR LISA: As long as your husband can take the medication for six months and achieve recovery, it is challenging to prevent further issues in daily life. He should focus on maintaining a balanced diet and engaging in regular exercise. Air purifiers do not provide 100% effectiven...

Understanding Tuberculosis Testing and Preventive Treatment for Young Children

Hello, Doctor. I would like to inquire about the tuberculosis (TB) testing and the use of preventive medication for young children. My child is currently 1 year and 4 months old, and we live in Australia. We returned to Taiwan from December 31 to February 4 last year. Last week, ...

Dr. Zhang Ziyan reply Pulmonology
Hello Ann, here are the answers to your questions: 1. Currently in Taiwan, only contacts of tuberculosis (TB) patients undergo the Tuberculin Skin Test (TST), unless there is a specific history of exposure or suspicion of active disease. 2. Clinically, a nine-month treatment reg...

Understanding Tuberculosis: Risks, Treatment, and Management for Patients

Hello, Doctor. A few days ago, my friend had a physical examination and found some abnormalities in his lungs. I will detail the X-ray findings for you: there are patchy, linear, and small nodular shadows visible in both upper lung fields, with some unclear margins. The cardiac s...

Dr. Yang Wenda reply Pulmonology
Dear Ms. Xiao Teng, I would like to respond to your inquiries as follows, hoping it will be helpful for you and your friends. 1. Your friend has a history of tuberculosis, and chest X-rays can show residual scars (calcifications and fibrotic lines). To determine if the findings...