Ulcerative Colitis
Umxholo
Yintoni
I-ulcerative colitis yisifo sesibindi esivuthayo (IBD), igama eliqhelekileyo lezifo ezibangela ukuvuvukala emathunjini amancinci kunye nekholoni. Kunokuba nzima ukufumanisa isifo kuba iimpawu zayo ziyafana nezinye iingxaki zamathumbu kunye nolunye uhlobo lwe-IBD olubizwa ngokuba sisifo sikaCrohn. Isifo sikaCrohn sihluke ngenxa yokuba sibangela ukuvuvukala okunzulu ngaphakathi kwodonga lwamathumbu kwaye kunokwenzeka kwezinye iindawo zenkqubo yokutya kuquka amathumbu amancinci, umlomo, isisu kunye nesisu.
I-ulcerative colitis inokwenzeka kubantu bayo nayiphi na iminyaka, kodwa ihlala iqala phakathi kweminyaka eyi-15 ukuya kwengama-30, kwaye iphantsi rhoqo phakathi kweminyaka engama-50 nengama-70 ubudala. Ichaphazela amadoda nabasetyhini ngokulinganayo kwaye ibonakala ibaleka kwiintsapho, ineengxelo ukuya kuthi ga kwiipesenti ezingama-20 zabantu abane-ulcerative colitis enelungu losapho okanye isihlobo esine-ulcerative colitis okanye isifo sikaCrohn. Isigameko esiphakamileyo sesifo sokudumba okwenziwa sisilonda sikabhobhosi siyabonakala kwabaMhlophe nakubantu abangamaYuda.
Iimpawu
Ezona mpawu zixhaphakileyo ze-ulcerative colitis ziintlungu zesisu kunye norhudo olunegazi. Izigulana zikwanamava
- Ukunqongophala kwegazi
- Ukudinwa
- Ukuhla ukusinda
- Ukuphelelwa ngumdla wokutya
- Ukopha ngokufihlakeleyo
- Ukuphulukana nolwelo lomzimba kunye nezondlo
- Izilonda zolusu
- Intlungu edibeneyo
- Ukusilela kokukhula (ngokukodwa ebantwaneni)
Phantse isiqingatha sabantu abafunyaniswe ukuba unesifo sezilonda ezenziwa sisilonda sikabhobhosi, baneempawu ezibuthathaka. Abanye banefiva rhoqo, urhudo olunegazi, isicaphucaphu, kunye neempawu ezinzima zesisu esiswini. I-ulcerative colitis inokubangela iingxaki ezifana nesifo samathambo, ukudumba kwamehlo, isifo sesibindi, kunye ne-osteoporosis. Ayaziwa ukuba kutheni le ngxaki zivela ngaphandle kwekholoni. Oososayensi bacinga ukuba ezi ngxaki zinokuba sisiphumo sokudumba okubangelwe ngamajoni omzimba. Ezinye zeengxaki ziyahamba xa unyango lwe-colitis lunyangwa.
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Oonobangela
Kukho iithiyori ezininzi malunga nokuba yintoni ebangela ukudumba kwesilonda esiswini. Abantu abane-ulcerative colitis banokungahambi kakuhle kwamajoni omzimba, kodwa oogqirha abazi ukuba oku kungahambi kakuhle kungunobangela okanye sisiphumo sesifo. Amajoni omzimba akholelwa ekubeni asabela ngendlela engaqhelekanga kwiibhaktiriya ezikwindlela yokugaya ukutya.
I-ulcerative colitis ayibangelwa luxinzelelo lweemvakalelo okanye uvakalelo kukutya okuthile okanye iimveliso zokutya, kodwa ezi zinto zinokubangela iimpawu kwabanye abantu. Uxinzelelo lokuhlala nesifo sezilonda esibuhlungu sinokubangela ukwanda kweempawu.
Uxilongo
Iimvavanyo ezininzi zisetyenziselwa ukufumanisa isifo se-ulcerative colitis. Uvavanyo lomzimba kunye nembali yonyango ngokuqhelekileyo linyathelo lokuqala.
Uvavanyo lwegazi lunokwenziwa ukujonga i-anemia, enokuthi ibonise ukopha kwikholoni okanye kwi-rectum, okanye banokufumanisa inani eliphezulu leeseli ezimhlophe zegazi, oluphawu lokudumba kwindawo ethile emzimbeni.
Isampulu yendlu inokuveza iiseli ezimhlophe zegazi, ubukho bayo bubonisa ulcerative colitis okanye isifo sokudumba. Ukongeza, isampuli yestool ivumela ugqirha ukuba abone ukopha okanye usulelo kwikholoni okanye kwi-rectum ebangelwa ziintsholongwane, intsholongwane, okanye iiparasites.
I-colonoscopy okanye i-sigmoidoscopy zezona ndlela zichanekileyo zokwenza isifo se-ulcerative colitis kunye nokulawula ezinye iimeko ezinokwenzeka, ezinjengesifo sikaCrohn, isifo se-diverticular, okanye umhlaza. Kuzo zombini iimvavanyo, ugqirha ufaka i-endoscope-ityhubhu ende, eguqukayo, ekhanyisiweyo edityaniswe kwikhompyuter kunye nokubeka esweni i-TV-kwi-anus ukubona ngaphakathi kwikholoni kunye ne-rectum. Ugqirha uya kuba nakho ukubona nakuphi na ukudumba, ukopha, okanye izilonda kudonga lwekholoni. Ngexesha loviwo, ugqirha unokwenza i-biopsy, ebandakanya ukuthatha isampulu yethishu kuludwe lwekholoni ukujonga ngemicroscope.
Ngamanye amaxesha ii-x-reyi ezifana ne-barium enema okanye i-CT scans nazo zisetyenziselwa ukuxilonga isifo se-ulcerative colitis okanye iingxaki zaso.
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Unyango
Unyango lwe-ulcerative colitis luxhomekeke kubunzima besi sifo. Umntu ngamnye ufumana ulcerative colitis ngokwahlukileyo, ke unyango luhlengahlengiswa umntu ngamnye.
Unyango lweziyobisi
Injongo yonyango lweziyobisi kukunyanzelisa kunye nokugcina uxolelo, kunye nokuphucula umgangatho wobomi kubantu abane-ulcerative colitis. Ziliqela iintlobo zamachiza akhoyo.
- Aminosalicylates, iziyobisi eziqukethe i-5-aminosalicyclic acid (5-ASA), inceda ukulawula ukudumba. I-Sulfasalazine yindibaniselwano ye-sulfapyridine kunye ne-5-ASA. Icandelo le-sulfapyridine lithwala i-5-ASA echasene nokudumba ukuya emathunjini. Nangona kunjalo, i-sulfapyridine inokukhokelela kwimiphumo emibi efana ne-nausea, ukuhlanza, i-heartburn, isifo sohudo kunye nentloko. Ezinye ii-arhente ze-5-ASA, ezinje nge-olsalazine, i-mesalamine, kunye ne-balsalazide, zinesiphatho esahlukileyo, iziphumo ebezingalindelekanga ezimbalwa, kwaye zinokusetyenziswa ngabantu abangakwaziyo ukuthatha i-sulfasalazine. I-5-ASAs zinikezelwa ngomlomo, nge-enema, okanye kwindawo yokugcina izinto, kuxhomekeke kwindawo yokuvuvukala kwikholoni. Uninzi lwabantu abane-ulcerative colitis emnene okanye ephakathi bayanyangwa ngeli qela lamachiza kuqala. Eli klasi leziyobisi lisetyenziswa nakwimeko zokubuyela umva.
- ICorticosteroids Njenge-prednisone, methylprednisone, kunye ne-hydrocortisone nayo inciphisa ukudumba. Zingasetyenziselwa ngabantu abanokulinganisela kwi-ulcerative colitis okanye abangaphenduliyo kumachiza ama-5-ASA. I-Corticosteroids, ekwabizwa ngokuba yi-steroids, inokunikwa ngomlomo, ngaphakathi, nge-enema, okanye kwindawo yokugcina izinto, kuxhomekeke kwindawo yokuvuvukala. La machiza anokubangela iziphumo ebezingalindelekanga ezifana nokuzuza ubunzima, amaqhakuva, iinwele zobuso, uxinzelelo lwegazi, isifo seswekile, ukuguquka kwemizwelo, ukuncipha kwamathambo, kunye nokwanda komngcipheko wosulelo. Ngesi sizathu, azikhuthazwa ukuba zisetyenziswe ixesha elide, nangona zithathwa njengezisebenza kakuhle xa kumiselwe ukusetyenziswa kwexesha elifutshane.
- Amagciwane njenge-azathioprine kunye ne-6-mercapto-purine (6-MP) ukunciphisa ukudumba ngokuchaphazela amajoni omzimba. Ezi ziyobisi zisetyenziselwa izigulane ezingakhange ziphendule kwi-5-ASAs okanye i-corticosteroids okanye ezixhomekeke kwi-corticosteroids. Ii-Immunomodulators zilawulwa ngomlomo, nangona kunjalo, zisebenza kancinci kwaye zingathatha ukuya kwiinyanga ezi-6 ngaphambi kokuba inzuzo epheleleyo ivakale. Izigulana ezithatha la machiza zijongwa njengeengxaki ezibandakanya i-pancreatitis, i-hepatitis, ukunciphisa ukubalwa kweeseli ezimhlophe, kunye nomngcipheko owandayo wosulelo. ICyclosporine A inokusetyenziswa kunye ne-6-MP okanye i-azathioprine ukunyanga isifo sokuqina kwesilonda esibi kubantu abangaphenduliyo kwi-corticosteroids efakwa ngaphakathi.
Amanye amachiza anokunikwa ukuphumza isigulana okanye ukuphelisa iintlungu, urhudo, okanye usulelo.
Ngamanye amaxesha, iimpawu ziba nzima kangangokuba umntu kufuneka alaliswe esibhedlele. Umzekelo, umntu unokuba nokopha kakhulu okanye urhudo oluqatha olubangela ukomisa. Kwiimeko ezinjalo ugqirha uzakuzama ukunqanda urhudo kunye nokulahleka kwegazi, ulwelo, kunye neetyiwa zetyuwa. Umguli usenokufuna ukutya okukhethekileyo, ukondla ngomthambo, amayeza, okanye ngamanye amaxesha utyando.
Ugqirha
Malunga neepesenti ezingama-25 ukuya kwezingama-40 zezigulana ezinesifo sokudumba okwenziwa sisilonda sikabhobhosi kufuneka ekugqibeleni zisuswe iikholoni ngenxa yokopha kakhulu, ukugula kakhulu, ukugqabhuka kwekholon, okanye umngcipheko womhlaza. Ngamanye amaxesha ugqirha uya kuncoma ukuba asuse ikholoni ukuba unyango aluphumeleli okanye ukuba iziphumo ebezingalindelekanga ze-corticosteroids okanye ezinye iziyobisi zisongela impilo yesigulana.
Utyando lokususa ikholoni kunye ne-rectum, eyaziwa ngokuba yi-proctocolectomy, ilandelwa yenye yezi zilandelayo:
- Ileostomy, apho ugqirha wotyando enza uvulo oluncinci esiswini, olubizwa ngokuba yi-stoma, kwaye ancamathele esiphelweni sethumbu elincinci, elibizwa ngokuba yiileum, kuso. Inkunkuma iya kuhamba emathunjini amancinci kwaye iphume emzimbeni ngestoma. I-stoma imalunga nobungakanani bekota kwaye ihlala ikwindawo esezantsi ngasekunene kwesisu kufutshane nebhanti. Ingxowa inxitywe ngaphezulu komngxunya wokuqokelela inkunkuma, kwaye isigulana siyikhuphela kwisingxobo njengoko kufuneka njalo.
- I-Ileoanal anastomosis, okanye utsalo-ngomsebenzi, ovumela isigulane ukuba sibe nezibilini eziqhelekileyo ngenxa yokuba igcina inxalenye ye-anus. Kulo msebenzi, ugqirha ususa ikholoni kunye nengaphakathi le-rectum, eshiya imisipha yangaphandle ye-rectum. Ugqirha ke emva koko uncamathisela i-ileum ngaphakathi kwi-rectum kunye ne-anus, esenza isingxobo. Inkunkuma igcinwa engxoweni kwaye idlula kwi-anus ngendlela yesiqhelo. Ukuhamba kwamathumbu kusenokuba rhoqo kwaye kunamanzi kunangaphambi kwenkqubo. Ukudumba kwengxowa (pouchitis) yinto enokwenzeka.
Iingxaki ze-ulcerative colitis
Malunga neepesenti ezi-5 zabantu abane-ulcerative colitis bahlakulela umhlaza wekoloni. Umngcipheko womhlaza uyanda kunye nobude besifo kunye nokuba ikholoni yonakaliswe kangakanani. Ngokomzekelo, ukuba kuphela ikholoni esezantsi kunye ne-rectum echaphazelekayo, umngcipheko womhlaza awukho ngaphezu kwesiqhelo. Nangona kunjalo, ukuba ikholoni yonke ibandakanyeka, umngcipheko womhlaza unokuba ngokuphindwe ngama-32 kunomlinganiselo oqhelekileyo.
Ngamanye amaxesha utshintsho olwenzeka kwangaphambili lusenzeka kwiiseli ezikwelekholoni. Olu tshintsho lubizwa ngokuba yi "dysplasia." Abantu abane-dysplasia kunokwenzeka ukuba babe nomhlaza kunabo bangenayo. Oogqirha bajonga iimpawu ze-dysplasia xa besenza i-colonoscopy okanye i-sigmoidoscopy kwaye xa behlola izicubu ezisusiweyo ngexesha lovavanyo.