Up to 25% of patients with TB of the lymph nodes (TB lymphadenitis) will get worse on treatment before they get better and this usually happens in the first few months of treatment. [ citation needed ] A few weeks after starting treatment, lymph nodes often start to enlarge, and previously solid lymph nodes may soften and develop into tuberculous cervical lymphadenitis . This should not be interpreted as failure of therapy and is a common reason for patients (and their physicians) to panic unnecessarily. With patience, two to three months into treatment the lymph nodes start to shrink again and re-aspiration or re-biopsy of the lymph nodes is unnecessary: if repeat microbiological studies are ordered, they will show the continued presence of viable bacteria with the same sensitivity pattern, which further adds to the confusion: physicians inexperienced in the treatment of TB will then often add second-line drugs in the belief that the treatment is not working. In these situations, all that is required is re-assurance. Steroids may be useful in resolving the swelling, especially if it is painful, but they are unnecessary. Additional antibiotics are unnecessary and the treatment regimen does not need to be lengthened. [ citation needed ]
Information from the National Library of Medicine
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Courtesy Amber Vesey Despite her healthy lifestyle, Amber still needs to prepare for sudden flare-ups, particularly when she goes on vacations. “It can be scary. There are lots of what ifs,” she says. “I worry, what if I can’t leave the hotel? I pack my medication, but also IBS-friendly snacks, laxatives, and pain meds, just in case. That keeps me calm in the knowledge that no matter what, IBS-C won’t stop me. I do extreme sports. I can do whatever I want. IBS-C limits me, only when I let it limit me.”