Ðe kuxiwo le fu ɖem na wò le wò ƒunukpeƒewo kple dɔgbowo ŋua? Mina míaƒo nu tso Enteropathic Arthritis ŋu!

Ðe wòsena le ɖokuiwò me alea ɣeaɖewoɣia? Ne èfɔ le ŋdi me la, wò ƒunukpeƒewo vea wò eye nèsena le ɖokuiwò me be yevuvu... Tsɔ kpe ɖe ema ŋu la, dɔgbo le fu ɖem na wò eye wòhiã be nàyi nugododeƒe zi geɖe gbesiagbe. Ne dzesi siawo evea siaa le ŋuwò le ɣeyiɣi ɖeka me la, ahiã be nànya dɔléle aɖe si woyɔna be ƒunukpeƒetetedɔ.

Nukae Nye Ƒunukpeƒetetedɔ?

Kpuie ko la, ƒunukpeƒetetedɔ nye dɔléle si nana wò ƒunukpeƒewo sea veve eye wòvuvu (ƒunukpeƒetetedɔ) tsɔ kpe ɖe abi si le wò nuɖuɖumeŋusẽ, alo dɔgbowo me ŋu (Inflammatory Bowel Disease - IBD) . Tsɔe be kuxi aɖe do mo ɖa le wo ame evea siaa ŋu zi ɖeka. Ame aɖewo yɔa esia be ƒunukpeƒetetedɔ, alo ƒunukpeƒetetedɔ si do ƒome kple IBD.

Azɔ kpɔ ɖa, ne míegblɔ be ƒunukpeƒetetedɔ la, mí katã míenya be enye dɔléle si nana ƒunukpeƒewo vuvuna, eye wòsea veve, eye ate ŋu anɔ anyi didi . Le go bubu me la, ne míegblɔ be IBD la, efia be abi alo abi si nɔa anyi didi si dzɔna le wò nuɖuɖumeŋusẽ ƒe akpa aɖe alo katã, vevietɔ wò dɔgbowo, li. Eyata ne EnA le ŋuwò la, veve kple vuvu le ƒunukpeƒe siawo ŋu, gake dɔdzẽ le wò dɔgbowo hã me.

EnA le dɔléle siwo gblẽa nu le ƒunukpeƒewo ŋu ƒe hatsotso gã aɖe me. Woyɔa esia be spondyloarthropathy. Enye ŋkɔ si gɔme sese sesẽ, gake efia ƒunukpeƒewo ƒe dɔléle si nɔa anyi didi. Nɔnɔme sia ate ŋu anye mɔxenu vie na wò agbenɔnɔ si sɔ , gake nya nyuiae nye be atikewo li na esia.

Nukae nye ƒunukpeƒetetedɔ (EnA) ƒe dzesiwo?

Le amesi ŋu EnA le gome la, nusiwo wògblẽna koŋue nyea wò ƒunukpeƒewo kple nuɖuɖumeŋusẽ (Gastrointestinal - GI system).

Dzesi siwo do ƒome kple ƒunukpeƒewo:

Zi geɖe la, esiawo gblẽa nu le wò asiwo kple afɔ ƒe ƒunukpeƒewo ŋu wu, gake ɣeaɖewoɣi la, vevesese kple vevesese siawo ate ŋu adzɔ le wò akɔta hã .

• Tɔtrɔ siwo vaa ƒunukpeƒewo ƒe nɔnɔme me: Le kpɔɖeŋu me, adze abe asibidɛawo he ɖe gota ene, alo adze abe ɖe wole ƒoƒom ene.
• Ŋutilã ƒe amadede ƒe tɔtrɔ: Ŋutilã si le ƒunukpeƒea tame ate ŋu azu dzĩ eye eƒe amadede atrɔ.
• Vevesese: Esiae nye dzesi vevitɔ.
• Ƒunukpeƒewo ƒe sesẽ/sesẽ: Ne èfɔ le ŋdi me la, ate ŋu asesẽ na wò be nàbɔbɔ alo akeke wò ƒunukpeƒewo hena ɣeyiɣi aɖe.
• Vuvu: Edzena abe ƒunukpeƒewo vuvu eye wololo ene.
• Vevesese: Vevesese ne èka asi ƒunukpeƒea ŋu alo le edzi tem .
• Dzoxɔxɔ le ƒunukpeƒewo: Teƒe si ƒunukpeƒea le la sena le eɖokui me be dzoxɔxɔ le eme wu teƒe bubuwo.

Dzesi siwo do ƒome kple nuɖuɖumeŋusẽ (GI system):

• Dɔgbo ƒe veve: Dɔgbo ƒe veve enuenu.
• Ʋu si dona le aɖuɖɔ me ne èle nugododeƒe yim: Esia nye dzesi si ŋu wòle be nàtsi dzi ɖo vevie.
• Aɖuɖɔtoe enuenu: Tsileƒe yiyi zi geɖe gbesiagbe.
• Lolo dzi ɖeɖe kpɔtɔ le manyamanya me: Menye ɖe nèle agbagba dzem vevie be yeaɖe lolo dzi akpɔtɔ o, ke boŋ ɖeko nèle lolo dzi ɖem kpɔtɔ.

Ame aɖewo ate ŋu akpɔ GI ƒe dzesiwo gbã, emegbe ƒunukpeƒewo ƒe dzesiwo . Alo ate ŋu anye nusi to vovo na ema. Eyae nye be ƒunukpeƒewo dzea veve gɔme gbã, emegbe dɔgbo ƒe nyawo dzea egɔme. Ɣeaɖewoɣi la, dzesi eveawo siaa ate ŋu ado mo ɖa le ɣeyiɣi ɖeka me.

Nukatae ƒunukpeƒetetedɔ (EnA) dzea ame dzi? Nukawoe gbɔ wòtsona?

Le nyateƒe me la, dzɔdzɔmeŋutinunyalawo mekpɔ nya nusi tututu hea EnA vɛ haɖe o . Gake wosusu be protein aɖe si woyɔna be HLA-B27 , si le míaƒe ʋumenugbagbevi ɣiwo ƒe anyime lae le eme.

Bu eŋu ale, le `HLA-B27` protein sia ta la, míaƒe ŋutilã ƒe dɔlélenutsiŋutete dzea mía ŋutɔwo ƒe lãmenugbagbevi siwo le lãmesẽ me dzi dzedze gɔme vodadatɔe ɣeaɖewoɣi, vevietɔ lãmenugbagbevi siwo le míaƒe ƒunukpeƒewo . Ele abe mía ŋutɔwo ƒe aʋakɔ si le eɖokui dzi dzem ene.

Gake nu bubu aɖe hã le afisia. `HLA-B27` sia menye dɔléle sia ɖeɖeko tɔ o. Eyae nye be menye amesiame si ŋu `HLA-B27` le lae axɔ ƒunukpeƒetetedɔ o. Ame aɖewo siwo le lãmesẽ me hã ate ŋu akpɔ dzidzɔ ɖe eŋu. Eyata togbɔ be esia ate ŋu anye nusi gbɔ wòtso hã la, eganye nusi gakpɔtɔ le numekuku ƒe afɔɖeɖea me .

Amekawoe le afɔku gã me be woaxɔ ƒunukpeƒetetedɔ (EnA)?

Wobu akɔnta be amesiwo ade ɖeka le atɔ̃ ɖesiaɖe me si ŋu dɔgbo ƒe dɔléle (IBD) le la axɔ ƒunukpeƒetetedɔ si nye enteropathic arthritis. Nɔnɔmewo abe dɔdzẽ si me abi le kple Crohn ƒe dɔléle ene koŋue le IBD me .

Tsɔ kpe ɖe eŋu la, woate ŋu atsɔ EnA asɔ kple nɔnɔme bubu siwo gblẽa nu le wò dɔgbo suea ŋu . Le kpɔɖeŋu me:

• Celiac dɔléle: Esia hã nye dɔléle si dɔlélenutsiŋutete ŋutɔ wɔna. Esia fia be ŋutilãa ƒe dɔlélenutsiŋutete dzea eya ŋutɔ ƒe lãmenugbagbeviwo dzi.
• Dzoxɔxɔ si dzɔna le dɔlékuiwo ƒe dɔléle abe Salmonella kple Shigella ene megbe. Dɔlékui aɖewo hã ate ŋu ana dɔgbowo naxɔ abi, si ate ŋu ahe ƒunukpeƒewo ƒe kuxiwo vɛ.
• Dɔgbo ƒe amekoko aɖewo (dɔgbomeʋuʋu ƒe amekoko).
• Whipple dɔléle: Esia nye dɔlékuiwo ƒe dɔléle si mebɔ kura o.

Aleke ɖɔktawo dea dzesi esiae?

Ne èyi ɖɔkta gbɔ kple dzesi siawo la, nu gbãtɔ si wòawɔe nye be wòado wò ŋutilã kpɔ bliboe.. Emegbe, woalé ŋku ɖe wò ŋutɔ wò lãmesẽ ŋutinya ŋu tsitotsito . Woabia nya geɖe wò hã tso wò dzesiwo ŋu. Vevietɔ la, woabia nya wò tso alesi wò ƒunukpeƒeveame trɔna le ŋkekea me katã ŋu, abe nenye be egblẽna ɖe edzi le ŋdi alo zã me ene .

Woabia nya tso wò nuɖuɖumeŋusẽ (GI) ƒe dzesiwo hã ŋu , abe tɔtrɔ le dɔgbo ƒe nɔnɔmewo me kple nuɖuɖu ƒe dzodzro ƒe vɔvɔ ene.

Tsɔ kpe ɖe eŋu la, ele vevie be nànya wò ƒomea ƒe atikewɔwɔ ŋutinya , vevietɔ ne wò ƒomea me tɔ aɖe xɔ IBD alo ƒunukpeƒetetedɔ kpɔ.

Dodokpɔ kawoe wozãna tsɔ dea dzesi ƒunukpeƒetetedɔ (EnA)?

Dodokpɔ aɖeke koŋ meli si woatsɔ anya EnA o. Gake wò ɖɔkta ate ŋu aɖe gbe be woawɔ dodokpɔ geɖe atsɔ aɖo kpe edzi be IBD kple ƒunukpeƒetetedɔ siaa le ŋuwò, alo be wòagbe nu bubu siwo gbɔ wò dzesiawo tso. Dodokpɔ siawo ate ŋu anye:

• Arthrocentesis: Esia bia be nàɖe tsi sue aɖe si woyɔna be synovial fluid tso wò ƒunukpeƒe eye nàdoe kpɔ . Esia ate ŋu ana nyatakaka ku ɖe dɔdzẽ si le ƒunukpeƒea ŋu.
• Wò aɖuɖɔ ƒe kpɔɖeŋu aɖe ɖeɖe kple dɔlékuiwo ƒe dekɔnu dodokpɔ wɔwɔ.
• Biopsy nye dodokpɔ si me woɖea lãkusi aɖe le nuɖuɖumeŋusẽ me.
• Ʋudodokpɔ siwo ɖea dɔdzẽ fiana: Le kpɔɖeŋu me, ʋumenugbagbeviɣidɔ ƒe dodokpɔ (ESR) alo C-reactive protein (CRP) dodokpɔ. Esiawo ate ŋu ana woakpɔe ɖa be vuvu alo abi le ŋutilãa ƒe akpa aɖe hã.
• Ʋudodokpɔ hena `HLA-B27` .
• Colonoscopy: Esia nye dodokpɔ si me wozãa mɔ̃ si me fotoɖemɔ̃ le tsɔ doa dɔgbo gã la kpɔna.
• X-ray siwo woɖena tso ƒunukpeƒe siwo le veve sem alo le veve sem ne woka asi wo ŋu.

Aleke wodaa ƒunukpeƒetetedɔ (EnA)?

Taɖodzinu vevitɔ si le ƒunukpeƒetetedɔ dada ŋue nye be wòaɖe vevesese si le wò nuɖuɖumeŋusẽ me dzi akpɔtɔ eye wòaɖe vevesese si le wò ƒunukpeƒewo hã dzi akpɔtɔ . Ele vevie hã be woaxe mɔ ɖe nu bubu siwo agblẽ le ƒunukpeƒewo ŋu nu .

Woate ŋu azã esiawo abe atikewɔwɔ ƒe tiatia ene:

• Glucocorticoids dodo: Esiawo kpena ɖe ame ŋu be vevesese kple vuvu dzi ɖena kpɔtɔna. Woate ŋu ado wo ɖe ƒunukpeƒea hã tẽ.
• Atike siwo trɔa asi le dɔléle ŋu (DMARDs): Atike siawo trɔa alesi wò dɔlélenutsiŋutete wɔa dɔe eye woɖea dɔlélea ƒe ŋgɔyiyi blewu. Kpɔɖeŋu aɖewoe nye methotrexate , sulfasalazine , .Atikewo abe Hydroxychloroquine kple Leflunomide ene .
• Tumor necrosis factor-alpha inhibitors (TNF-alpha inhibitors): Esia nye atike sẽŋu bubu si kpɔa ŋusẽ ɖe dɔlélenutsiŋutete dzi. Kpɔɖeŋu aɖee nye Infliximab .
• Lãmesẽfefewɔwɔ: Esia kpena ɖe ame ŋu ŋutɔ le ƒunukpeƒewo ƒe dɔwɔwɔ nyuie me léle ɖe asi kple mɔxexe ɖe ƒunukpeƒewo ƒe gbegblẽ kple woƒe nɔnɔme madeamedzi nu.
• Amekoko: Le nɔnɔme sesẽ aɖewo me, vevietɔ ne akɔta ƒe kuxiwo le eŋu la, ate ŋu ahiã be woawɔ dɔ nɛ.
• Agbenɔnɔ ƒe tɔtrɔ: Ele vevie ŋutɔ be nàɖɔ ŋu ɖo, vevietɔ le nusiwo nèɖuna kple nusiwo nènona (nuɖuɖu) ŋu .

Aleke mawɔ akpɔ nye lãmesẽ dzi kple ƒunukpeƒetetedɔ (EnA)?

Togbɔ be EnA ate ŋu akpɔ ŋusẽ ɖe wò gbesiagbegbenɔnɔ dzi hã la, mɔ geɖe li siwo dzi nàto akpe ɖe ŋuwò nàse le ɖokuiwò me be yeƒe lãme sẽ eye nàwɔ dɔ nyuie wu :

• Dzoxɔxɔ dede ƒunukpeƒe siwo le veve sem ate ŋu akpe ɖe lãmekawo ŋu woaɖe dzi ɖi. Nenema ke vuvɔ sisi ate ŋu akpe ɖe ame ŋu be ƒunukpeƒeveame dzi naɖe akpɔtɔ. Ame aɖewo kpɔnɛ be dzoxɔxɔ kpena ɖe ame ŋu, gake ame bubuwo ya kpɔnɛ be vuvɔ kpena ɖe ame ŋu. Kpɔ nusi awɔ dɔ na wò nyuie wu ɖa.
• Tia nuɖuɖu kple nunono siwo tsia dzodzodzoetsitsi nu. Ema fia be nàɖe nuɖuɖu siwo me nu ʋeʋĩwo le kple esiwo me ami le dzi akpɔtɔ eye nàtsɔ amagbewo, atikutsetsewo, kple gbetikewo akpe ɖe wò nuɖuɖu ŋu.
• Srɔ̃ alesi nànɔ nɔnɔme nyui me. Eyae nye be, tsi tre dzɔdzɔe ne èbɔbɔ nɔ anyi hele tsitrenu.
• Gomekpɔkpɔ le kpekpeɖeŋunahawo me. Nuƒoƒo na ame bubu siwo ŋu nɔnɔmewo abe ƒunukpeƒetetedɔ alo IBD ene le ate ŋu anye ŋusẽ kple nyatakakatsoƒe gã aɖe.
• Ne ènoa atama alo zãa atamanuwo la, dzudzɔ. Esiawo ate ŋu ana dzesiawo nagagblẽ ɖe edzi.
• Keke ɖokuiwò eye nàde kame edziedzi. Bia wò ɖɔkta be kamedede kawoe sɔ na wò eye nàwɔ wo.
• Te atikewɔmɔnu siwo kpe ɖe eŋu, abe asisisi , ŋugbledede , abɔtasisi , nɔnɔmetata siwo wofia mɔe, kple ɖiɖiɖememɔnu ene kpɔ . Gake anyo be nàƒo nu kple wò ɖɔkta hafi ate esiawo kpɔ.

Nya kawoe wòle be mabia nye ɖɔkta?

Ne èyi ɖɔkta gbɔ la, aɖe vi na wò be nàbia nya siawo abe esiawo ene:

• Atikewɔwɔ ka ƒomevie nèkafu nam?
• Ðe nuɖuɖu tɔxɛ aɖewo li siwo mele be maɖu oa?
• Nukae mate ŋu awɔ be woaxe mɔ ɖe dzobibi nu?
• Ðe vinyewo hã ate ŋu axɔ nɔnɔme siaa? (Eyae nye be, domenyiŋusẽfianue wònyea?)

Ðe woate ŋu axe mɔ ɖe ƒunukpeƒetetedɔ (EnA) nua?

Esi dzɔdzɔmeŋutinunyalawo mese nusi hea ƒunukpeƒetetedɔ vɛ gɔme bliboe haɖe o ta la, mɔ aɖeke meli si dzi woato axe mɔ ɖe dɔlélea nu keŋkeŋ o . Gake mɔ aɖewo li siwo dzi nàto akpe ɖe ŋuwò nàxe mɔ ɖe dzesiawo ƒe ʋuʋu nu .

Àte ŋu alé fɔ ɖe nuɖuɖu si naa lãmesẽ ƒe ɖoɖo si me amagbe kple atikutsetse yeye gbogbo aɖewo le ŋu . Dze agbagba nàde kame vie gbesiagbe. Ne ènoa atama la, ke dzudzɔ godoo . Ƒo nu kple wò ɖɔkta tso mɔ bubu siwo dzi nàto aɖe dzesi siawo ƒe dzidziɖedzi dzi akpɔtɔ ŋu.

Nukae nye ŋgɔdonya na amesi ŋu ƒunukpeƒetetedɔ (EnA) le?

Dɔlélea ƒe zɔzɔme le amesi ŋu EnA le ŋu ate ŋu ato vovo ŋutɔ tso ame ɖeka gbɔ yi bubu gbɔ . Dzesiawo ate ŋu anɔ anyi ɖaa alo woava yi eye woadzo . Dzoxɔxɔ ate ŋu anye fuɖename sue aɖe na ame aɖewo, evɔ le ame bubuwo gome la, ate ŋu asẽ ale gbegbe be wòagblẽ woƒe ŋkekea me.

Gake, nu vevitɔ kekeakee nye be ame geɖe siwo ŋu ƒunukpeƒetetedɔ le la nɔa agbe si sɔ, si tsea ku eye wonɔa agbe si sɔ .

Menye ɖeko ƒunukpeƒewo le veve sem na wò ko o, ke fifia dɔgbo me nyawo hã le ŋuwòa? Enteropathic arthritis ate ŋu anye dɔléle si vea ame ŋutɔŋutɔ, si ate ŋu ade ame ƒe agbe afɔku me. Dzesiawo ate ŋu ato vovo, gake ne nɔnɔmea nu sẽ la, ate ŋu agblẽ nu le wò ŋkeke bliboa ŋu. Dzɔgbenyuietɔe la, atikewɔwɔmɔnu aɖewo li siwo li . Ke hã, ate ŋu axɔ ɣeyiɣi aɖe hafi woakpɔ atike si sɔ na wò. Wòe nye ame tɔxɛ, eyata ɖewohĩ wò dzesiwo manyo ɖe edzi abe alesi ame bubu ƒe dzesiwo nyona ɖe edzi ene o. Ƒo nu kple wò ɖɔkta. Ate ŋu akpe ɖe ŋuwò nàwɔ atikewɔwɔ ƒe ɖoɖo si awɔ dɔ na wò wu.

Nusiwo dzi wòle be míaɖo ŋkui tso ŋutinya sia me (Take-Home Message) .

Enyo, eyata mina míalé ŋku ɖe nu bɔbɔe aɖewo siwo dzi míaɖo ŋkui tso ƒunukpeƒetetedɔ si ŋu míeƒo nu tsoe ŋu:

• EnA nye nɔnɔme aɖe si dzɔna kpe ɖe ƒunukpeƒetetedɔ kple dɔgbo ƒe dɔléle si naa dɔgbo ƒe dɔléle (IBD) ŋu .
• Dzesiawo ate ŋu anye ƒunukpeƒewo ƒe vevesese, ʋuʋudedi, kple ʋuʋudedi, kpakple dɔgbo ƒe ʋuʋu, aɖuɖɔtoe, kple ʋu si le aɖuɖɔ me .
• Womekpɔ nusi tututu gbɔ esia tso haɖe o , gake domenyiŋusẽfianu abe `HLA-B27` ate ŋu awɔ akpa aɖe.
• Amesiwo ŋu IBD le (vevietɔ Crohn ƒe dɔlélea kple abi ƒe dɔdzẽ) le afɔku gã aɖe me be woaxɔe.
• Wozãa dodokpɔ vovovowo (ʋu, aɖuɖɔ, dɔgbomekpɔkpɔ, X-ray) tsɔ dea dzesi dɔlélea.
• Dɔdamɔnuawo dometɔ aɖewoe nye atikewo, kamedede, kple agbenɔnɔ ƒe tɔtrɔ.Ele vevie ŋutɔ.
• Togbɔ be womate ŋu axe mɔ ɖe dɔlélea nu keŋkeŋ o hã la, woate ŋu aɖu dzesiawo dzi ahanɔ agbe nyui .
• Nu vevitɔ kekeake menye be nàtsi dzodzodzoe o, ke boŋ be nàƒo nu kple wò ɖɔkta eye nàxɔ atike kple aɖaŋuɖoɖo si nyo na wò.

Ne dzesi siawo le ŋuwò la, mègakpe fu wò ɖeka o, di atikewɔlawo ƒe aɖaŋuɖoɖo enumake. Ekema àte ŋu akpɔ gbɔdzɔe kaba.

` Enteropathic arthritis, ƒunukpeƒetetedɔ, dɔgbo ƒe dɔléle, nuɖuɖumeŋusẽ, ƒunukpeƒeveame, IBD, Crohn ƒe dɔléle