Ðe nènye amesi wowɔ dɔ na wò dɔgbo kple dɔgbo bliboa le atikewɔwɔ ƒe nɔnɔme aɖe ta eye wowɔ ‘ileal pouch’ ɖe eteƒea? Ne nenemae la, àte ŋu akpɔ vevesese aɖewo hã le kotoku sia ŋu ɣeaɖewoɣi. Kuxi siwo ate ŋu ado mo ɖa wu dometɔ ɖekae nye nusi ŋu míele nu ƒom tsoe egbea, ‘Pouchetis’. Mègavɔ̃ ne èse nya sia o. Mina míaƒo nu tso nusianu ŋu eme nakɔ eye wòanɔ bɔbɔe.
Nukae nye Pouchetis? Mina míase egɔme bɔbɔe.
Gbã la, mina míalé ŋku ɖe nusi ‘ileal pouch’ sia nye ŋu. Ne woɖe wò dɔgbo kple dɔgboa ɖa keŋkeŋ (total proctocolectomy) vɔ la, èhiã mɔnu yeye aɖe si dzi nàto aɖe wò aɖuɖɔ le wò ŋutilã me. Ema gbɔ kpɔnu ɖekae nye amekoko le ileal pouch me. Nusi dzɔna le afisia enye be amekolawo zãa wò dɔgbo sue (ileum) ƒe akpa mamlɛtɔ tsɔ wɔa nu sue aɖe si le abe kotoku ene.
Eyata nusi wò dɔgbo gã la wɔna tsã, si nyea aɖuɖɔ nu ƒu hena ɣeyiɣi aɖe hedzrana ɖo hafi dzona la, kotoku mae wɔe fifia. Ne míagblɔe bubui la, wò dɔgbo suea ƒe akpa aɖe wɔa dɔ abe dɔgbo gã ene fifia.
Pouchitis nye ne kotokua vuvu alo vuvu tso eme. Enye dɔléle si sɔ kple dɔgbo ƒe dɔléle (dɔgbo ƒe dɔdzẽ) alo proctitis (dɔgbo ƒe dɔdzẽ). Esia nye nɔnɔme si bɔ na amesi si kotoku le.
Le ame akpa gãtɔ gome la, esia nyea ɣeyiɣi kpui aɖe ƒe dɔléle (acute pouchitis), gake le ame aɖewo gome la, ate ŋu anye nɔnɔme si nɔa anyi ɖaa (couchitis si nɔa anyi didi) alo esi gbugbɔna.
Nukae nye pouchitis ƒe dzesiwo?
Ne pouchitis le ŋuwò la, àte ŋu akpɔ dzesi siawo dometɔ ɖeka alo esi wu nenema. Ele vevie be nànɔ ŋudzɔ ɖe wo ŋu.
| Dzesi si dzena | Nuɖᴐɖᴐ |
|---|---|
| Ƒodo ƒe vevesese kple lãmetutudɔ | Vevesese wɔnuku aɖe le ƒodo ƒe akpa si le anyime alo seselelãme be wolé ye hetrɔe. |
| Ehiã be woayi nugododeƒe enuenu kple zi ɖeka | Ehiã be nàyi nugododeƒe zi geɖe wu alesi nèwɔnɛ ɖaa, eye kasia nèsena le ɖokuiwò me be yehiã be yeayi nugododeƒe si màte ŋu ado dzi atsɔ o. |
| Nugododeƒe yiyi le zã me | Ele be nànyɔ ayi nugododeƒe. |
| Aɖuɖɔtoe dzi ɖuɖu sesẽ (aɖuɖɔtoememaɖumaɖu) . | Aɖuɖɔ sue aɖe toto evɔ womenya o. |
| Aɖuɖɔtoewo toto sesẽ | Tsitretsitsi be woaɖe aɖuɖɔ ne wole nugododeƒe yim (dyschezia). |
| Seselelãme si nye be yemate ŋu akɔ nugododeƒea keŋkeŋ le nugododeƒe yiyi vɔ megbe o | Sese le ɖokuiwò me be yeƒe aɖuɖɔ gakpɔtɔ le dodom le aɖuɖɔtoe (tenesmus) megbe gɔ̃ hã. |
| Ʋu vi aɖe le aɖuɖɔ me | Ʋu ƒe fliwo kpɔkpɔ le aɖuɖɔ me. |
| Asrã alo vuvɔ | Asrã alo ʋuʋudedi ƒe seselelãme. |
Nukatae Pouchetis dzɔna?
Womenya nusi tututu gbɔ esia tso haɖe o 100% o, gake nukpɔsusu vevitɔe nye be dɔlékui ƒomevi siwo nɔa kotokua me la meda sɔ o.
Bu eŋu kpɔ, ne wò dɔgbo sue ƒe akpa aɖe le dɔ wɔm abe dɔgbo gã ene fifia la, dɔlékui ƒomevi yeyewo gena ɖe eme.‘Aʋa’ vi aɖe le dɔlékui yeye kple xoxo siawo dome. Tɔtrɔ sia ate ŋu ana ŋutilãa ƒe dɔlélenutsiŋutete nasusu be dɔlékui aɖe le afima. Eyata le ema ta la, dɔdzẽ dzɔna, si fia be kotokua vuvu.
Ɣeaɖewoɣi la, dɔlékui siwo hea dɔlékuiwo ate ŋu adzi ɖe edzi akpa eye woahe dɔlékui vɛ. Dɔlékuiwo ƒe dadasɔ sia trɔna le amekoko vɔ megbe, si wɔnɛ be mɔnukpɔkpɔ geɖe wu sua dɔlékui siwo gblẽa nu le ame ŋu be woatsi.
Ebɔ be aklãdɔ nadze ame dzi le amekoko vɔ megbe kpuie. Zi geɖe la, woate ŋu atsɔ dɔlékuiwutikewo ada esia. Ke hã, le ame aɖewo gome la, ate ŋu agadzɔ ake.
Nu bubu siwo hea pouchitis si nɔa anyi ɖaa vɛ
Le ame aɖewo gome la, pouchitis nɔa anyi alo mewɔa nu nyuie ne wowɔ atike nɛ o. Esia ate ŋu atso nu bubuwo gbɔ.
- Atikewɔwɔ me nɔnɔme siwo nɔ anyi do ŋgɔ (IBD): Ne eva hiã be woaɖe wò dɔgboa le dɔgbo ƒe dɔléle si naa dɔgboa (IBD) abe Ulcerative Colitis alo Crohn ƒe dɔléle ene ta la, ke àte ŋu axɔ pouchitis. Esia le alea elabena mɔnu si le ete si he dɔléle ma vɛ la ke ate ŋu agblẽ nu le kotokua hã ŋu.
- Dɔlékui siwo te ŋu nɔa te ɖe dɔlékuiwutikewo nu: Esesẽna be woatsɔ dɔlékuiwutikewo aɖu dɔlékui aɖewo abe C. difficile ene dzi. Azɔ hã, ne woyi edzi le dɔlékuiwutikewo zãm la, dɔlékui aɖewo te ŋu nɔa te ɖe wo nu. Esia ate ŋu ana dɔlékuiwo ƒe dadasɔmakpɔmakpɔ le kotokua me hã nadzi ɖe edzi.
- Dɔlékui bubuwo: Ɣeaɖewoɣi la, dɔlékui (cytomegalovirus) alo fungi (candidiasis) dɔlékuiwo hã ate ŋu atso kotokua ƒe dɔdzẽ gbɔ.
- Dɔlélenutsiŋutete ƒe gbɔdzɔgbɔdzɔ: Ne wò ŋutilã ƒe dɔlélenutsiŋutete gbɔdzɔ le atikewɔwɔ ƒe nɔnɔme bubuwo alo atike aɖewo ta la, wò ŋutete be nàwɔ avu kple dɔlékuiwo dzi ɖena kpɔtɔna.
- Vevesesenutsitikewo zazã (NSAIDs): Vevesesenutsitikewo abe ibuprofen kple aspirin (Nonsteroidal anti-inflammatory drugs - NSAIDs) zazã ɣeyiɣi didi kple esi gbɔ eme ate ŋu agblẽ nu le kotokua ƒe akpa si le eme ŋu.
- Ʋu ƒe sisi dzi ɖena kpɔtɔna (Ischemia): Togbɔ be ƒã ŋutɔ hã la, abi ate ŋu adzɔ le ʋu si yia kotokua me ƒe xexe ta.
- PSC dɔléle: `(Primary sclerosing cholangitis - PSC)` nye dɔléle si nana aklã ƒe ʋumenugbagbeviɣiwo xɔa abi. Amesiwo ŋu dɔléle sia le la le afɔku me be woaxɔ pouchitis.
Kuxi kawoe ate ŋu ado tso pouchitis me?
Ƒã hafi pouchitis hena ɣeyiɣi aɖe hea kuxi gãwo vɛ, gake ne dɔlélea gakpɔtɔ li alo mewɔ dɔ ɖe atikewɔwɔ dzi o la, ate ŋu ahe kuxi aɖewo vɛ.
| Kuxi si dona tso eme | Nuɖᴐɖᴐ |
|---|---|
| Tɔtrɔ le dɔgbo ƒe nɔnɔmewo ŋu | Akploa ƒe dɔdzẽ ate ŋu ahe kuxi siwo anɔ anyi ɣeyiɣi didi vɛ, abe aɖuɖɔ léle sesẽ alo aɖuɖɔ me toto sesẽ le esi wòvuvu ta ene. |
| Agbenɔnɔ ƒe dzidzenu si le to yim | Nugododeƒe yiyi enuenu ƒe fuɖename ate ŋu ahe kuxiwo abe nuteɖeamedzi kple hadomekadodowo dzi ɖeɖe kpɔtɔ vɛ. |
| Akploa ƒe ʋuʋu (Stricture) . | Dzoxɔxɔ ɣeyiɣi didi ate ŋu ana abi nanɔ kotokua ŋu, si ana eƒe ʋuʋu natsi. |
| Aɖuɖɔtoewo | Dzoxɔxɔ ate ŋu ana kotokua ƒe akpa si le eme nado dziku eye ʋu nado. |
| Nunyiame ƒe veve | Ne nu gblẽ le kotokua ƒe akpa si le eme ŋu la, ate ŋu ana nunyiame siwo le nuɖuɖu me ƒe xɔxlɔ̃ dzi naɖe akpɔtɔ (nuɖuɖu maxɔmaxɔ nyuie), si ana nunyuimakpɔɖu nasu ame si. |
| Pouch ƒe Dodokpɔ | Ƒã ŋutɔ hafi kuxi siwo nɔa anyi ɖaa ate ŋu ana womate ŋu azã kotokua o, si abia be woaɖee ɖa eye woawɔ dɔ bubuwo abe ileostomy ene. |
Aleke nàwɔ anya nenye be pouchitis le ŋuwò?
Ne wò ɖɔkta ɖo to wò dzesiwo vɔ la, awɔ dodokpɔ geɖe atsɔ aɖo kpe dɔlélea dzi. Dodokpɔ vevitɔ kekeakee nye kotoku me nukpɔkpɔ (endoscopy) .
Esia bia be nàde mɔ̃ si le tsɛ ŋutɔ si me fotoɖemɔ̃ aɖe le to wò akɔta me eye nàlé ŋku ɖe kotokua ƒe eme ŋu. Emegbe ɖɔkta ate ŋu akpɔe ɖa be abi alo abi aɖeke le kotokua me hã. Le ɣeyiɣi ma ke me la, woate ŋu atsɔ lãkusi sue aɖe (biopsy) atsɔ adoe kpɔ.
Tsɔ kpe ɖe eŋu la, woate ŋu awɔ dodokpɔ siwo gbɔna atsɔ akpɔ alesi kotokua kple xɔtunu siwo ƒo xlãe le:
- Vovototodedeameme Pouchography `(pouchogram)`
- `CT scan`
- `MRI`
Nukawoe nye atike siwo wozãna na pouchitis?
Atikewɔwɔ ƒe tiatia nɔ te ɖe pouchitis ƒomevi si le ŋuwò dzi.
Atikewɔwɔ na Acute Pouchetis
Atikewɔwɔ gbãtɔe nye dɔlékuiwutikewo zazã kwasiɖa eve. Le ame geɖe gome la, esia aɖe woƒe dzesiwo ɖa keŋkeŋ kloe. Ne wò dzesiwo nyo ɖe edzi hã la, ele vevie be nàno atike siwo ɖɔkta ŋlɔ na wò la katã.
Atikewɔwɔ na Pouchitis si gbugbɔna
Ne pouchitis gadze le atikewɔwɔ vɔ megbe la, anɔ eme be ɖɔktaa aŋlɔ dɔlékuiwutike mawo ke na wò. Gake ne edzɔ wu zi etɔ̃ le ƒea me la, wobua eŋu be enye dɔléle si nɔa anyi didi eye woate ŋu adze atikewɔwɔ si woatsɔ alé be nɛ gɔme be wòagadzɔ ake o. Le esia ta la, .
- Dɔlékuiwutikewo nana ɣeyiɣi didi le agbɔsɔsɔ sue aɖe me.
- Probiotics Zazã: Probiotics, siwo me dɔlékui nyuiwo le ate ŋu akpe ɖe ame ŋu be dɔlékuiwo nagada asɔ le kotokua me.
Pouchitis si mewɔa dɔ ɖe dɔlékuiwutikewo ŋu o (CARP) dada .
Ne dɔlékuiwutikewo mekpena ɖe ame ŋu o, alo ne wokpe ɖe eŋu do ŋgɔ la, woyɔa nɔnɔmea be ``Chronic antibiotic-resistant pouchitis (CARP)''. Le afisia la, ɖɔkta la adi nu bubu siwo gbɔ wòtso eye wòatso nya me le atikewɔwɔ ŋu le esia nu. Atikewɔwɔ vovovowo li na esia.
- Enemas siwo me atikewo abe `Mesalamine` alo `Bismut` le
- Corticosteroids, siwo ɖea dɔdzẽ dzi kpɔtɔna
- Dɔlélenutsiŋutete ƒe atike siwo kpɔa dɔlélenutsiŋutete ƒe dɔwɔwɔ dzi
- Egbegbe atikewo abe `Biologics` ene
- Atikewɔwɔ tɔxɛwo abe `Fecal microbiota transplant (FMT)`
Nu vevitɔe nye be wò ɖɔkta natso nya me le atikewɔwɔ si anyo na wò ŋu. Eyata ne dzesiwo le ŋuwò la, di atikewɔlawo ƒe aɖaŋuɖoɖo enumake.
Ðe woate ŋu atsɔ nuɖuɖu kple nunono aɖu pouchitis dzia?
Ẽ, anya wɔ vaseɖe afi aɖe. Wò nuɖuɖu ate ŋu akpe ɖe ŋuwò nàxe mɔ ɖe pouchitis ƒe dzɔdzɔ nu eye wòakpe ɖe ŋuwò hã be nàɖu dzesiawo dzi ne wodo mo ɖa.
| Nuɖuɖu siwo kpena ɖe ame ŋu be woaxe mɔ ɖe pouchitis (nuɖuɖu siwo me antioxidant sɔ gbɔ ɖo) nu . | Nuɖuɖu siwo nana pouchitis ƒe dzesiwo nu sẽna ɖe edzi (wodzudzɔna hena ɣeyiɣi aɖe) . |
|---|---|
De atikutsetse kple amagbe siwo me antioxidants sɔ gbɔ ɖo siwo ɖea dɔdzẽ dzi kpɔtɔna le wò nuɖuɖu me.
| Ne dzesiwo dze la, woate ŋu akpɔ gbɔdzɔe to nuɖuɖu aɖewo siwo doa ŋusẽ dɔgbo me dɔlékuiwo eye wo ɖuɖu sesẽna dzi ɖeɖe kpɔtɔ hena ɣeyiɣi aɖe (Low FODMAP Diet).
|
Vevietɔ: Nuɖuɖu si me FODMAP mesɔ gbɔ ɖo o menye nusi dzi wòle be nàwɔ ɖo tegbee o. Enye nusi dzi wòle be nàzɔ ɖo hena ɣeyiɣi kpui aɖe, ne dzesiwo le ŋuwò, le ɖɔkta alo nuɖuɖuŋutinunyala ƒe mɔfiafia te.
Togbɔ be agbea nɔa bɔbɔe wu le ileal pouch dɔwɔwɔ vɔ megbe hã la, esɔ be nàtsi dzimaɖi ne kuxiwo abe pouchitis ene do mo ɖa. Gake ɖo ŋku edzi be esia nye dɔléle si woate ŋu ada, si dzea ame geɖe dzi. Àte ŋu awɔ dɔ kple wò ɖɔkta akpɔ egbɔkpɔnu nyuitɔ kekeake na wò.
Gbedasi si Wotsɔ Yi Aƒeme
- Pouchitis nye kotoku me dɔdzẽ si bɔ ɖe amesiwo wowɔ dɔ na le kotoku me le ileal me dome.
- Ne èkpɔ dzesiwo abe ƒodo ƒe vevesese, nugododeƒe yiyi enuenu, alo ʋu le wò aɖuɖɔ me ene la, lé ŋku ɖe wo ŋu.
- Woate ŋu atsɔ dɔlékuiwutikewo ada pouchitis ƒe akpa gãtɔ dzidzedzetɔe.
- Mègaŋe aɖaba ƒu dzesiawo dzi o. Kpɔ wò ɖɔkta kaba ale si nàte ŋui be nàɖo aɖaŋu na wò.
- Nuɖuɖu si da sɔ kple ɖewohĩ probiotics ate ŋu akpe ɖe kotokua ƒe lãmesẽ ŋu.
- Pouchitis ƒe nɔnɔme siwo nɔa anyi ɖaa (siwo nɔa anyi didi) ate ŋu abia be woawɔ atike na ame aɖe koŋ, eye wò ɖɔkta ana atikewɔwɔ ƒe ɖoɖo si sɔ wu la wò.
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