Ua pehu anei kou kolona penei? E aʻo kākou e pili ana i ka Pseudomembranous Colitis!

Loaʻa iā ʻoe ka ʻeha nui o ka ʻōpū a me ka maʻi kahe i nā manawa he nui i ka lā? Malia paha ua manaʻo ʻoe i ka luaʻi me ke kuni? ʻOi loa aku, ua ʻike ʻia kēia mau hōʻailona ma hope o kou lawe ʻana i nā lāʻau antibiotic no kekahi maʻi? Inā pēlā, he mea nui paha kēia iā ʻoe. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi i kapa ʻia ʻo 'Pseudomembranous Colitis'. Mai hopohopo, inā ua ʻike pono ʻia ʻoe e pili ana i kēia, hiki iā ʻoe ke loaʻa ka lāʻau a hoʻōla koke.

He aha ka Pseudomembranous Colitis?

I ka ʻōlelo maʻalahi, ʻo ka 'Pseudomembranous Colitis' kahi maʻi mumū koʻikoʻi e kū mai ana i loko o ko kākou ʻōpū nui, a i ʻole colon. I loko o kēia, no kekahi kumu (hiki ke lilo i bacteria, kahi toxin, a i ʻole kekahi maʻi ʻē aʻe), ua hōʻino ʻia ka paia o loko o kou ʻōpū nui, a i ʻole ka membrane mucous (`mucosa`). ʻO kēia hōʻino ke kumu o nā plaques melemele-keʻokeʻo, mānoanoa, a ʻōpala e hana i nā wahi i hōʻino ʻia. Ua kapa nā kauka i kēia mau 'pseudomembranes'.

He aha nā 'pseudomembranes'?

ʻO nā pseudomembranes ka mea e hana ʻia i ka wā e make ai nā pūnaewele i loko o ka ʻili o ka ʻōpū nui, e like me ka ʻili o ka ʻōpū nui. E noʻonoʻo i kēia ʻano: i ka wā e loaʻa ai kahi ʻeha, hoʻouna kā mākou ʻōnaehana pale i nā keʻena koko keʻokeʻo i kahi. Pēlā nō hoʻi, ma ʻaneʻi, hui pū nā ʻāpana kelepona make me nā keʻena koko keʻokeʻo (ʻoi aku ka neutrophils) e hana i nā pseudomembranes. He 2 kenimika ka laulā o kēia mau mea, he melemele-keʻokeʻo, a he mau papa i hāpai iki ʻia ma luna o ka ʻili.

He aha nā hōʻailona o kēia maʻi?

Hiki i kekahi kanaka me ka pseudomembranous colitis ke ʻike i nā hōʻailona e like me:

• ʻEha nui o ka ʻōpū.
• Ka maʻi kahe. Hiki ke hana kēia i nā manawa he nui i ka lā, i kekahi manawa ma ke ʻano he wai.
• Kuni.
• Ka luaʻi.
• I kekahi manawa, ʻike paha ʻoe i ke koko a i ʻole ka pus e puka mai ana mai loko mai o kou ʻōpala, akā ʻaʻole kēia e hana i nā mea āpau.

He aha ke kumu o ka Pseudomembranous Colitis?

ʻO ke kumu nui a maʻamau o kēia, ʻo ia ka maʻi me ka bacteria `C. diff` (Clostridioides difficile). ʻO nā mea ʻawahia i hana ʻia e kēia bacteria e hōʻino i ka uhi o ka ʻōpū nui. Ma kahi o 10% o nā maʻi `C. diff` hiki ke holomua i kahi kūlana koʻikoʻi i kapa ʻia ʻo `pseudomembranous colitis.` ʻO ka ʻoiaʻiʻo, 90% o kēia mau hihia i hoʻokumu ʻia e ka bacteria `C. diff`. Eia nō naʻe, hiki i nā maʻi ʻōpū mumū ʻē aʻe ke hana i kēia ʻano hōʻino.

Pehea ka hopena o ka bacteria C. difficile i kēia?

Hoʻopuka ka bacteria C. difficile i nā mea ʻawahia e luku ai i nā pūnaewele e uhi ana i ko kākou ʻōpū nui. Hiki i kēia maʻi ke laha wikiwiki a koʻikoʻi ma mua o kou manaʻo.

ʻO ka hapa nui o ka manawa, loaʻa iā ʻoe kahi maʻi C. diff no ka mea he maʻi ʻē aʻe kāu.Ma hope o ka hoʻohana ʻana i nā lāʻau antibiotic. E noʻonoʻo e pili ana i ia mea, ke lawe ʻoe i nā lāʻau antibiotic, ʻo nā bacteria "maikaʻi" ʻē aʻe i loko o ko kākou ʻōpū e kōkua iā kākou e make. Eia naʻe, ʻaʻole hiki i ka hapa nui o nā lāʻau antibiotic ke pepehi i kēia bacteria 'C. diff'. No laila, i ka pau ʻana o kēlā mau bacteria maikaʻi, loaʻa i ka bacteria 'C. diff' ka manawa kūpono e ulu a laha me ka nānā ʻole ʻia, e hana ana i kēia mau pilikia me ka ʻole o ka hoʻokūkū.

He aha nā antibiotics e kūpono loa i kēia maʻi?

ʻO kaʻoiaʻiʻo, ʻo kēlā me kēia antibiotic e pepehi ana i nā bacteria maikaʻi i loko o ko kākou ʻōpū a ʻaʻole hoʻi e hoʻopilikia i ka bacteria C. diff hiki ke hana i kahi maʻi C. diff a me ka hopena o ka colitis pseudomembranous. Eia nō naʻe, ua manaʻo ʻia kekahi mau antibiotics e hoʻoweliweli nui aʻe. ʻO kekahi o lākou:

• ʻO Clindamycin
• ʻO ka papa lāʻau lapaʻau Cephalosporin
• ʻO ka hui o nā lāʻau penicillin
• Nā Fluoroquinolones
• ʻAsetereonama
• Nā Carbapenems

He mea nui: ʻAʻole kēia e ʻōlelo he maikaʻi ʻole kēia mau lāʻau antibiotic. Inā kuhikuhi ke kauka iā lākou, pono e hoʻohana ʻia e like me ka mea e pono ai. Eia nō naʻe, ʻo ka hoʻohana ʻana i nā lāʻau antibiotic me ke kumu ʻole hiki ke alakaʻi i nā pilikia e like me kēia.

Aia kekahi mau kumu ʻē aʻe?

Hiki ke loaʻa ka pseudomembranous colitis ke loaʻa ka mumū o ka colon i hoʻokumu ʻia e nā kumu ʻē aʻe, koe wale nō ʻo C. diff. Eia kekahi mau laʻana:

• Ka maʻi Staphylococcus aureus
• ʻO ka maʻi E. coli `(ʻO ka maʻi E. coli)`
• ʻO ka maʻi Cytomegalovirus
• ʻO ka colitis microscopic
• ʻO ka maʻi o Behçet
• ʻO ka colitis Ischemic (ka mumū i hoʻokumu ʻia e ka emi ʻana o ke kahe koko i ka kolone)
• Nā lāʻau lapaʻau anti-cancer (nā lāʻau Chemotherapy)
• Ka hoʻohana ʻana i ka cocaine
• ʻO ka Vasculitis (ka mumū o nā kīʻaha koko)
• Ka lāʻau make metala kaumaha

I ia mau hihia, ʻoi aku ka ʻino a paʻakikī paha o ka maʻi ma mua o ka colitis maʻamau. I kekahi manawa, ua emi ke kahe o ke koko i ka paia o loko o ka colon (ischemia), make nā ʻiʻo (necrosis), a ulu nā pseudomembranes. Eia kekahi, ʻo nā maʻi i loaʻa mua e like me ka Inflammatory Bowel Disease (IBD) hiki ke hoʻolilo i ka colon i mea maʻalahi i kēia ʻano.

ʻO wai ka mea i ʻoi aku ka pilikia o ka loaʻa ʻana o kēia maʻi?

ʻOi aku ka nui o kou loaʻa ʻana i ka colitis pseudomembranous inā ʻoe:

• Inā ua hoʻokomo ʻia ʻoe i ka haukapila.
• Inā ua hoʻohana koke ʻoe i nā antibiotics.
• Inā ua hana ʻia ʻoe i ke ʻoki kino i hala koke nei.
• Inā noho kekahi ma ka hale mālama.
• Inā ʻoe ma luna o 65 mau makahiki.
• Inā loaʻa iā ʻoe kahi maʻi autoimmune.
• Inā nāwaliwali kou ʻōnaehana pale maʻi.
• Inā ua loaʻa mua iā ʻoe kahi maʻi C. diff.

He aha nā pilikia e hiki ke loaʻa mai ka Pseudomembranous colitis?

Inā lilo kēia kūlana i mea koʻikoʻi a paʻakikī ke kāohi, hiki ke loaʻa kekahi mau pilikia weliweli. No laila he mea nui e makaʻala i kēia.

• Ka maloʻo ʻana o ka wai a me ka nalowale o nā electrolyte: I ka colitis pseudomembranous koʻikoʻi, hiki ke loaʻa ka maʻi diarrhea a hiki i 10-15 mau manawa i ka lā. Hiki i kēia ke alakaʻi i ka maloʻo ʻana o ka wai a me ka nalowale o nā electrolyte. Hiki i kēia ke alakaʻi i nā kūlana weliweli e like me ka haʻahaʻa o ke koko, ke koko haʻahaʻa, a me ka hāʻule ʻana o nā puʻupaʻa.
• Ka liki ʻana o ka wai: Hiki i ka wai ke liki mai ka paia i hōʻino ʻia o ka ʻōpū nui i loko o ka lua ʻōpū, e hoʻoulu ai i ka pehu ʻana o ka ʻōpū. Ua kapa ʻia kēia he ascites. Hiki ke nalowale nā ​​​​protein e like me ka albumin mai ka ʻōpū nui. Ke haʻahaʻa ka albumin, liki ka wai mai loko mai o nā kīʻaha koko, e hoʻoulu ai i ka pehu ʻana o nā lālā (edema).
• Megacolon ʻawahia: He mumū koʻikoʻi a kaohi ʻole ʻia o ka kolone e hiki ai ke hoʻoulu i ka pehu nui ʻana o ke kolone a hoʻōki i ka hana. I ka wā mua, hoʻōki nā ʻiʻo o ke kolone i ka ʻaelike ʻana, e ālai ana i ke ala o ka ʻōpala. Ke hoʻomau nei ka pehu ʻana o ke kolone, hiki i kona mau paia ke haki, e ʻae ana i nā mea o loko e kahe i loko o ka lua ʻōpū. Ua kapa ʻia kēia he peritonitis. Hiki i kēia ke hoʻoweliweli i ke ola.
• ʻO ka perforation o ka ʻōpū: Hiki ke loaʻa kahi lua ma ka paia o ka ʻōpū nui me ka ʻole o ka megacolon ʻawahia. Hiki ke hana ʻia kēia inā ulu nā ʻeha ma ka ʻōpū nui a hele ma waena o ka paia, a inā he make nui o nā ʻiʻo (necrosis) ma ka paia o ka ʻōpū nui. Ke kahe ka bacteria i loko o ka ʻōpū nui i loko o ka lua ʻōpū (peritonitis), hiki iā lākou ke laha i loko o ke kahe koko (septicemia).
• Sepsis: ʻO Sepsis kahi maʻi i hoʻokumu ʻia e ka hōʻiliʻili ʻana o nā bacteria i loko o ke koko (septicemia). He maʻi koʻikoʻi ka Sepsis a hoʻoweliweli i ke ola e laha ana ma ke kino holoʻokoʻa. Hiki i kēia ke alakaʻi i ka septic shock, ka hāʻule ʻana o nā ʻōkana he nui, a me ka make.

Hiki ke hopohopo kēia mau pilikia ke lohe ʻia. Akā e hoʻomanaʻo, ʻaʻole lākou e hana i nā mea āpau. ʻO ka ʻike mua ʻana a me ka mālama kūpono e hiki ke pale i kēia mau maʻi koʻikoʻi.

Pehea e ʻike ai i kēia maʻi?

E nīnau mua ke kauka iā ʻoe e pili ana i kāu mau hōʻailona a me kou mōʻaukala olakino. A laila, hiki iā lākou ke kauoha i nā hoʻokolohua like ʻole e ʻike i ke kumu o kāu mau hōʻailona. No ka laʻana, hiki iā lākou ke kauoha i nā hoʻokolohua koko, nā hoʻokolohua kiʻi e like me nā scans, a me nā hoʻokolohua poop. Ke nānā nei kēia mau hoʻokolohua i ka maʻi, ka mumū, a me nā mea pilikia ʻē aʻe.

E nānā pono kāu hoʻāʻo ʻana i ka ʻōpala no ka maʻi C. diff. Inā loaʻa, e hoʻomaka koke ka lāʻau lapaʻau. Inā ʻaʻohe ou pilikia a ke pane maikaʻi nei i ka lāʻau lapaʻau, ʻaʻohe kumu kikoʻī e nānā ai i loko o kou ʻōpū nui no nā pseudomembranes.

I kekahi manawa, hiki i nā hoʻokolohua kiʻi (e like me ka CT scan) ke hōʻike i nā hōʻailona o ka colitis pseudomembranous. Inā mānoanoa ka paia o ka colon (like me ka "thumbprint sign" a i ʻole "accordion sign"), hiki i ke kauka ke hoʻoholo e hana i nā hoʻokolohua hou aʻe.

ʻO ka mea aʻe, no ka nānā hohonu ʻana, pono ʻoe e hana i kahi hoʻokolohua e nānā ana i loko o ka ʻōpū nui. Ua kapa ʻia ʻo ia he colonoscopy. Ma kēia, hoʻohana ʻia kahi ʻōmole me kahi kāmela e nānā i loko o ka ʻōpū nui. Inā ʻike ʻoe i ka mea i kapa ʻia ʻo 'pseudomembrane', lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo (he biopsy) mai ia mea a hoʻouna ʻia i kahi keʻena hoʻokolohua e hōʻoia i ka maʻi.

He aha nā lāʻau lapaʻau?

ʻO ke ʻano o ka lāʻau lapaʻau e pili ana i ke kumu o kēia maʻi.

• Inā he maʻi bacteria e like me C. diff, pono ʻoe e hāʻawi i nā lāʻau antibiotic kikoʻī e hana ana no ia.
• Inā hoʻokumu ʻia kēia kūlana a i ʻole e hoʻonui ʻia e kekahi lāʻau lapaʻau ʻē aʻe āu e lawe nei, pono paha e hoʻōki a hoʻololi paha i kēlā lāʻau lapaʻau.
• I kekahi mau hihia, hiki ke kuhikuhi ʻia nā lāʻau lapaʻau e hōʻemi i ka mumū i loko o ka ʻōpū nui.

Pono kekahi poʻe i ka mālama kākoʻo wale nō. No ka laʻana, nā wai intravenous (nā wai IV) e kōkua i ka paʻa ʻana o ka wai, a i ʻole ka meaʻai IV e kōkua i ka hoʻomaha ʻana o ka colon. Pono paha kekahi e mālama ʻia no nā pilikia, malia paha i loko o kahi keʻena mālama koʻikoʻi. Pono paha kekahi poʻe me ka colitis koʻikoʻi a i ʻole nā ​​​​pilikia e loaʻa i kahi colectomy (ʻoki ʻana e wehe i ka ʻāpana i hōʻino ʻia o ka colon).

He aha nā lāʻau lapaʻau nui i hāʻawi ʻia inā ua hoʻokumu ʻia e ka `C. diff`?

Inā he maʻi C. diff ke kumu o ka pseudomembranous colitis, aia kekahi mau lāʻau lapaʻau e loaʻa ana no ka mālama ʻana. E koho kāu kauka i ka mea kūpono loa iā ʻoe. ʻO nā lāʻau lapaʻau i hāʻawi ʻia no ka maʻi C. diff:

• Metronidazole
• Vancomycin
• ʻO Fidaxomicin

Hiki ke pale ʻia ka Pseudomembranous colitis?

ʻO ke ala koʻikoʻi loa e pale aku ai i kēia maʻi, ʻo ia ke kāohi ʻana i ka laha ʻana o ka bacteria C. diff ma nā kaiāulu pilikia kiʻekiʻe (ʻoi aku hoʻi nā haukapila a me nā hale mālama maʻi). ʻOi aku ka nui o ka poʻe ma kēia mau wahi e loaʻa i ka maʻi a loaʻa nā hōʻailona koʻikoʻi e like me ka pseudomembranous colitis.

No laila, hana nā limahana mālama ola ma kēia ʻano ʻoihana i nā hana kūikawā e kāohi ai i ka maʻi C. diff:

• Hoʻokaʻawale: Hoʻonoho ʻia ka poʻe i loaʻa i ka maʻi C. diff i loko o kahi lumi ʻokoʻa, a i ʻole i loko o kahi lumi i kaʻana like ʻia me nā poʻe ʻē aʻe i loaʻa i ka maʻi. Hoʻohana ʻia nā mīkina lima hoʻolei i ka wā e komo ai i loko o ka lumi.
• Holoi lima: ʻO ka holoi pinepine ʻana i kou mau lima me ke kopa a me ka wai mahana ke ala maikaʻi loa e pale aku ai iā ʻoe iho mai C. diff. Kūʻē kēia bacteria i nā mea hoʻomaʻemaʻe lima. He mea nui loa ka holoi ʻana i kou mau lima ma mua o ka lawelawe ʻana i ka meaʻai.
• Hoʻomaʻemaʻe: ʻAʻole hiki i nā mea hoʻomaʻemaʻe maʻamau ke pepehi iā C. diff. Eia nō naʻe, hiki i nā huahana i hana ʻia me ka chlorine. He mea nui e hoʻomaʻemaʻe pono i nā ʻili āpau a ka mea i loaʻa i ka maʻi i hoʻopili aku ai.

Hiki ke ho'ōla loa ʻia kēia maʻi? He aha ka nui o ka make?

ʻAe, hiki ke ho'ōla loa ʻia ka pseudomembranous colitis me ka lāʻau lapaʻau. I ka hapanui o nā hihia, e nalo koke nā hōʻailona. Eia nō naʻe, pono paha kekahi poʻe i ka lāʻau lapaʻau hou aʻe a me nā manawa lōʻihi ma mua o nā poʻe ʻē aʻe. Inā loaʻa iā ʻoe kahi maʻi C. diff mau loa a paʻakikī ke kāohi, pono paha ʻoe e hana i kahi ʻoki liʻiliʻi e mālama ai. I kekahi mau hihia, pono paha ke ʻoki ʻana.

Ma ke ʻano o ka make ʻana, 2% wale nō o nā maʻi me ka pseudomembranous colitis e make ana. Eia nō naʻe, i nā poʻe me ka mālama lōʻihi a me nā ʻōnaehana pale nāwaliwali, hiki i kēia helu ke piʻi a hiki i ka 15%. Inā loaʻa ka pilikia i ʻōlelo ʻia ma mua i kapa ʻia ʻo toxic megacolon, hiki ke piʻi ka helu make i 35%. ʻO ia ke kumu he mea nui ka mālama koke ʻana.

Āhea ʻoe e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e ʻimi koke i ke kōkua lapaʻau:

• ʻEha nui o ka ʻōpū a i ʻole ka pehu ʻana.
• Inā loaʻa iā ʻoe ka maʻi diarrhea ma mua o ʻelima mau manawa i ka lā.
• Inā he koko i loko o ka ʻōpala.
• Inā ʻaʻole ʻoe i loaʻa i kahi neʻe ʻōpū no nā lā ʻekolu.
• Inā ʻaʻole ʻoe i mimi no hoʻokahi lā, a inā he ʻeleʻele ke kala o kou mimi.
• Inā loaʻa iā ʻoe ke kuni ma luna o 39 kekelē Celsius (102 kekelē Fahrenheit) no nā lā ʻekolu.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

He mea maʻamau nā maʻi bacteria e hoʻoulu ai i ka colitis, a ʻo ka hapa nui o ka manawa ʻaʻole lākou he mea koʻikoʻi. ʻAʻole nā ​​​​mea a pau i loaʻa iā C. diff e loaʻa i ka colitis pseudomembranous. Eia naʻe, inā hana ʻoe, hiki ke hopohopo iki. ʻO ka ʻike ʻana ua hōʻino ʻia kou colon mai loko mai hiki ke hopohopo, me nā hōʻailona e like me ka ʻeha a me ke kahe ʻana o ke koko.

Inā loaʻa iā ʻoe nā hōʻailona e like me kēia, pono paha ʻoe i ke kōkua lapaʻau kūikawā. Akā e hoʻomanaʻo, me ka mālama kūpono, hiki i kou kolona ke ho'ōla.ʻO nā membrane mucous, e like me ka uhi o ko kākou colon, e ola maikaʻi ke ʻole lākou i hōʻino ʻia. Inā manaʻo ʻoe ʻaʻole e hoʻomaikaʻi ana kou mau hōʻailona colitis, e kamaʻilio me ke kauka. Hiki iā ia ke kōkua iā ʻoe e ʻike i ke kumu o kou kūlana, e hana i ka mea e pono ai e hoʻōki iā ia, a hāʻawi i kou colon i ke koena e pono ai. ʻO ka mea nui loa, ʻaʻole e hopohopo a ʻimi koke i ke aʻo lapaʻau.

ʻO ka Pseudomembranous Colitis, C. diff, ka maʻi pākī, ʻeha ʻōpū, colitis, nā lāʻau antibiotic