Koj puas yog ib tug neeg uas tau phais tshem tag nrho koj txoj hnyuv loj thiab lub qhov quav vim muaj mob thiab muaj 'lub hnab ileal' tsim los rau hauv nws qhov chaw? Yog tias yog, koj kuj yuav muaj qee qhov tsis xis nyob ntsig txog lub hnab no qee zaum. Ib qho ntawm cov teeb meem feem ntau uas tuaj yeem tshwm sim yog qhov peb tab tom tham txog hnub no, 'Pouchitis'. Tsis txhob ntshai thaum koj hnov qhov no. Cia peb tham txog txhua yam kom meej thiab yooj yim.
Kab mob Pouchitis yog dab tsi? Cia peb nkag siab yooj yim.
Ua ntej, cia peb saib seb qhov 'ileal pouch' no yog dab tsi. Tom qab koj txoj hnyuv loj thiab lub qhov quav raug tshem tawm tag nrho (total proctocolectomy), koj xav tau txoj hauv kev tshiab los tshem koj cov quav tawm ntawm koj lub cev. Ib qho kev daws teeb meem rau qhov ntawd yog kev phais mob ileal pouch. Qhov tshwm sim ntawm no yog tias cov kws phais siv qhov kawg ntawm koj txoj hnyuv me (ileum) los tsim ib lub hnab me me zoo li lub hnab.
Yog li, yam uas koj txoj hnyuv loj ua yav dhau los, uas yog ib qho chaw khaws thiab khaws cov quav ib ntus ua ntej nws tawm mus, tam sim no ua los ntawm lub hnab ntawd. Hauv lwm lo lus, ib feem ntawm koj txoj hnyuv me tam sim no ua haujlwm zoo li txoj hnyuv loj.
Mob plab yog thaum lub hnab hnyuv o los yog o los ntawm sab hauv. Nws yog ib qho mob zoo ib yam li mob colitis (mob plab hnyuv loj) lossis mob proctitis (mob plab hnyuv). Qhov no yog ib qho mob uas ib tus neeg uas muaj lub hnab hnyuv feem ntau mob.
Rau cov neeg feem coob, qhov no yog ib ntus xwb (mob ntsws mob hnyav), tab sis rau qee tus neeg nws tuaj yeem yog ib qho mob uas kav ntev (mob ntsws mob ntev) lossis rov tshwm sim dua.
Cov tsos mob ntawm tus mob pouchitis yog dab tsi?
Yog tias koj muaj mob pouchitis, koj yuav muaj ib lossis ntau yam ntawm cov tsos mob no. Nws yog ib qho tseem ceeb uas yuav tsum paub txog lawv.
| Cov tsos mob | Kev piav qhia |
|---|---|
| Mob plab qis thiab mob ceg | Mob txawv txawv hauv qab plab los yog xav tias raug tuav thiab tig rov qab. |
| Yuav tsum mus rau chav dej ntau zaus thiab tam sim ntawd | Koj yuav tsum mus rau chav dej ntau zaus dua li niaj zaus, thiab koj mam li xav tias koj yuav tsum mus rau chav dej tsis tau. |
| Mus rau chav dej thaum hmo ntuj | Yuav tsum sawv thiab mus rau chav dej. |
| Nyuaj tswj kev txav mus los ntawm txoj hnyuv (incontinence) | Tso zis me me yam tsis paub txog. |
| Nyuaj siab tso quav | Siv zog tso quav thaum mus rau chav dej (dyschezia). |
| Qhov kev xav tias tsis muaj peev xwm nchuav tag nrho cov quav tom qab mus rau chav dej | Zoo li koj tseem tso quav tau txawm tias koj tso quav tas lawm (tenesmus). |
| Ntshav me ntsis hauv cov quav | Pom cov ntshav ntws hauv cov quav. |
| Kub taub hau los yog mob khaub thuas | Hnov mob kub taub hau los yog tshee hnyo. |
Vim li cas thiaj muaj mob Pouchitis?
Qhov ua rau qhov no tseem tsis tau paub 100%, tab sis lub tswv yim tseem ceeb yog tias muaj qhov tsis sib npaug ntawm cov kab mob uas nyob hauv lub hnab.
Xav txog, thaum ib feem ntawm koj txoj hnyuv me ua haujlwm zoo li txoj hnyuv loj, cov kab mob tshiab tuaj. Muaj kev sib ntaus sib tua me ntsis ntawm cov kab mob tshiab thiab cov kab mob qub no. Qhov kev hloov pauv no tuaj yeem ua rau lub cev tiv thaiv kab mob xav tias muaj kev kis kab mob nyob ntawd. Yog li ntawd, kev o tuaj, txhais tau tias lub hnab o.
Qee zaum, cov kab mob pathogenic tuaj yeem loj hlob ntau dhau thiab ua rau muaj kev kis kab mob. Qhov sib npaug ntawm cov kab mob no hloov pauv tom qab phais, ua rau cov kab mob phem muaj lub sijhawm zoo dua los loj hlob.
Nws yog ib qho uas feem ntau yuav mob pouchitis tsis ntev tom qab phais. Qhov no feem ntau tuaj yeem kho nrog cov tshuaj tua kab mob. Txawm li cas los xij, rau qee tus neeg, nws tuaj yeem rov qab tshwm sim.
Lwm yam tseem ceeb uas ua rau mob pouchitis tas li
Rau qee tus neeg, mob pouchitis tseem muaj lossis tsis teb zoo rau kev kho mob. Qhov no tuaj yeem yog vim muaj lwm yam.
- Cov mob uas twb muaj lawm (IBD): Yog tias koj yuav tsum tau tshem koj txoj hnyuv loj vim yog tus kab mob inflammatory bowel disease (IBD) xws li Ulcerative Colitis lossis Crohn's disease, koj muaj feem yuav mob pouchitis ntau dua. Qhov no yog vim tib lub hauv paus uas ua rau muaj tus kab mob ntawd kuj tuaj yeem cuam tshuam rau lub hnab.
- Cov kab mob uas tiv taus tshuaj tua kab mob: Qee cov kab mob uas kis tau los ntawm cov kab mob, xws li C. difficile, nyuaj rau tswj nrog cov tshuaj tua kab mob. Tsis tas li ntawd, nrog kev siv cov tshuaj tua kab mob tas li, qee cov kab mob yuav tiv taus lawv. Qhov no kuj tseem tuaj yeem ua rau cov kab mob tsis sib npaug hauv lub hnab.
- Lwm yam kev kis kab mob: Qee zaum, o ntawm lub hnab kuj tseem tuaj yeem tshwm sim los ntawm kev kis kab mob viral (cytomegalovirus) lossis fungal (candidiasis).
- Kev tiv thaiv kab mob tsis muaj zog: Yog tias koj lub cev tiv thaiv kab mob tsis muaj zog vim yog lwm yam mob lossis qee yam tshuaj, koj lub peev xwm los tawm tsam kev kis kab mob yuav txo qis.
- Siv cov tshuaj tua kab mob (NSAIDs): Siv cov tshuaj tua kab mob xws li ibuprofen thiab aspirin (Cov tshuaj tsis yog steroidal anti-inflammatory - NSAIDs) mus sij hawm ntev thiab ntau dhau tuaj yeem ua rau lub hnab sab hauv puas tsuaj.
- Txo cov ntshav tsis txaus (Ischemia): Txawm hais tias tsis tshua muaj, qhov o tuaj yeem tshwm sim vim yog kev thaiv cov ntshav mus rau lub hnab.
- Kab mob PSC: `(Primary sclerosing cholangitis - PSC)` yog ib yam kab mob uas ua rau cov hlab ntsha hauv lub siab o. Cov neeg uas muaj tus mob no muaj feem yuav mob pouchitis ntau dua.
Cov teeb meem uas yuav tshwm sim ntawm mob pouchitis yog dab tsi?
Mob pouchitis ib ntus tsis tshua ua rau muaj teeb meem loj, tab sis yog tias qhov mob tseem muaj lossis tsis teb rau kev kho mob, nws tuaj yeem ua rau muaj teeb meem.
| Kev nyuaj siab | Kev piav qhia |
|---|---|
| Kev hloov pauv ntawm kev quav | Qhov o ntawm lub hnab tuaj yeem ua rau muaj teeb meem mus sij hawm ntev, xws li nyuaj tuav quav lossis nyuaj tso quav vim o. |
| Kev ua neej nyob poob qis | Qhov tsis yooj yim ntawm kev mus rau chav dej ntau zaus tuaj yeem ua rau muaj teeb meem xws li kev ntxhov siab thiab kev sib raug zoo hauv zej zog tsawg dua. |
| Kev Narrowing ntawm lub hnab (Stricture) | Kev o ntev tuaj yeem ua rau lub hnab caws pliav, ua rau nws qhov qhib nqaim. |
| Mob qog | Kev o tuaj yeem ua rau txheej sab hauv ntawm lub hnab khaus thiab los ntshav. |
| Kev tsis txaus noj haus | Kev puas tsuaj rau sab hauv ntawm lub hnab tuaj yeem ua rau kev nqus cov as-ham los ntawm cov khoom noj tsawg dua (malabsorption), ua rau tsis muaj zaub mov zoo. |
| Lub Hnab Tsis Ua Haujlwm | Tsis tshua muaj, cov teeb meem uas kav ntev yuav ua rau lub hnab tsis siv tau, yuav tsum tau tshem nws tawm thiab lwm yam kev phais, xws li ileostomy. |
Koj paub tseeb li cas yog tias koj muaj mob pouchitis?
Tom qab mloog koj cov tsos mob, koj tus kws kho mob yuav ua ntau yam kev kuaj mob kom paub meej tias koj muaj mob. Qhov kev kuaj mob tseem ceeb tshaj plaws yog kev siv lub tshuab tsom iav (endoscopy) .
Qhov no suav nrog kev ntxig ib lub raj nyias nyias uas muaj lub koob yees duab txuas rau hauv koj lub qhov quav thiab kuaj xyuas sab hauv ntawm lub hnab. Tus kws kho mob mam li kuaj xyuas seb puas muaj qhov o lossis qhov txhab hauv lub hnab. Tib lub sijhawm, ib daim ntaub me me (biopsy) yuav raug coj mus kuaj.
Ntxiv rau, cov kev ntsuam xyuas hauv qab no yuav raug ua los xyuas seb lub hnab thiab cov qauv ib puag ncig puas zoo:
- Kev ntsuas hnab sib piv `(pouchogram)`
- 'CT scan'
- MRI
Cov kev kho mob rau pouchitis yog dab tsi?
Cov kev xaiv kho mob nyob ntawm seb hom mob pouchitis koj muaj.
Kev Kho Mob Rau Mob Pouchitis Mob Hnyav
Kev kho mob thawj zaug yog siv tshuaj tua kab mob ob lub lis piam. Rau ntau tus neeg, qhov no yuav luag tshem tawm lawv cov tsos mob tag nrho. Txawm tias koj cov tsos mob zoo dua los xij, nws yog ib qho tseem ceeb uas yuav tsum noj tshuaj tag nrho raws li koj tus kws kho mob tau sau tseg.
Kev Kho Mob Rau Cov Mob Pouchitis Rov Qab Los
Yog tias mob pouchitis rov qab los tom qab kho mob, tus kws kho mob yuav sau cov tshuaj tua kab mob tib yam. Txawm li cas los xij, yog tias nws tshwm sim ntau dua peb zaug hauv ib xyoos, nws suav hais tias yog mob ntev thiab kev kho mob txij nkawm yuav pib los tiv thaiv kev rov qab los. Rau qhov no,
- Muab tshuaj tua kab mob ntev ntev nrog cov koob tshuaj tsawg.
- Kev Siv Probiotics: Probiotics, uas muaj cov kab mob zoo, tuaj yeem pab kho qhov sib npaug ntawm cov kab mob hauv lub hnab.
Kev kho mob ntawm cov kab mob pouchitis uas tsis teb rau cov tshuaj tua kab mob (CARP)
Yog tias cov tshuaj tua kab mob tsis pab, lossis yog tias lawv tau pab ua ntej, qhov mob no hu ua "Chronic antibiotic-resistant pouchitis (CARP)". Hauv qhov no, tus kws kho mob yuav nrhiav lwm yam ua rau thiab txiav txim siab kho raws li qhov tsim nyog. Muaj ntau txoj kev kho rau qhov no.
- Cov tshuaj Enema uas muaj cov tshuaj xws li 'Mesalamine' lossis 'Bismuth'
- Cov tshuaj Corticosteroids, uas txo qhov o
- Cov tshuaj tiv thaiv kab mob uas tswj kev ua haujlwm ntawm lub cev tiv thaiv kab mob
- Cov tshuaj niaj hnub zoo li 'Biologics'
- Kev kho mob tshwj xeeb xws li 'Fecal microbiota transplant (FMT)'
Qhov tseem ceeb tshaj plaws yog koj tus kws kho mob yuav tsum txiav txim siab seb kev kho mob twg zoo tshaj plaws rau koj. Yog li ntawd, yog tias koj muaj cov tsos mob, nrhiav kev pab kho mob tam sim ntawd.
Puas tswj tau tus mob pouchitis los ntawm kev noj mov thiab haus dej?
Yog, qee qhov nws ua tau. Koj cov zaub mov noj tuaj yeem pab tiv thaiv kom tsis txhob muaj mob pouchitis thiab pab tswj cov tsos mob thaum lawv tshwm sim.
| Cov khoom noj uas pab tiv thaiv kab mob pouchitis (cov khoom noj uas muaj antioxidant ntau) | Cov khoom noj uas ua rau cov tsos mob ntawm tus mob pouchitis hnyav zuj zus (tsis txhob noj ib ntus) |
|---|---|
Muab cov txiv hmab txiv ntoo thiab zaub uas muaj cov tshuaj antioxidants uas txo qhov o rau hauv koj cov zaub mov noj.
| Thaum muaj cov tsos mob, kev pab yuav tau los ntawm kev txo qee yam khoom noj uas ua rau cov kab mob hauv plab zom mov thiab nyuaj rau zom (Kev Noj Zaub Mov Qis FODMAP).
|
Tseem Ceeb: Kev noj zaub mov FODMAP qis tsis yog ib yam dab tsi uas koj yuav tsum ua raws li tas mus li. Nws yog ib yam dab tsi uas koj yuav tsum ua raws li lub sijhawm luv luv, thaum koj muaj cov tsos mob, nyob rau hauv kev taw qhia ntawm tus kws kho mob lossis tus kws noj haus.
Txawm hais tias lub neej yooj yim dua tom qab phais mob ileal pouch, nws yog ib qho ib txwm muaj kev ntxhov siab thaum muaj teeb meem xws li pouchitis tshwm sim. Tab sis nco ntsoov, qhov no yog ib qho mob uas kho tau uas cuam tshuam rau ntau tus neeg. Koj tuaj yeem ua haujlwm nrog koj tus kws kho mob kom nrhiav tau qhov kev daws teeb meem zoo tshaj plaws rau koj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kab mob Pouchitis yog ib qho mob o ntawm lub hnab uas feem ntau tshwm sim ntawm cov neeg uas tau phais lub hnab ileal.
- Yog tias koj muaj cov tsos mob xws li mob plab qis, mus rau chav dej ntau zaus, lossis muaj ntshav hauv koj cov quav, ua tib zoo saib xyuas lawv.
- Feem ntau cov mob pouchitis tuaj yeem kho tau zoo nrog cov tshuaj tua kab mob.
- Tsis txhob tso tseg cov tsos mob. Mus ntsib koj tus kws kho mob sai li sai tau kom tau txais kev qhia.
- Kev noj zaub mov kom sib npaug thiab tej zaum probiotics tuaj yeem pab tswj kev noj qab haus huv ntawm lub hnab.
- Cov mob pouchitis uas mob mus ntev (mob ntev) yuav xav tau kev kho mob tshwj xeeb, thiab koj tus kws kho mob yuav muab txoj kev npaj kho mob zoo tshaj plaws rau koj.
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