Sɔntɛnde wi kin fil taya fɔ natin, wi kin gɛt smɔl pen na di ɔp rayt say na wi bɛlɛ, ɔ sɔntɛm wi kin jɔs fil lɛk se wi de skrach wisɛf. Pan ɔl we wi nɔ kin pe atɛnshɔn tumɔs to dɛn tin ya na wi layf ɛvride, sɔntɛnde dɛn tin ya kin bi sayn fɔ se wi gɛt mɔ siriɔs sik insay wi bɔdi. Tide wi go tɔk bɔt wan kɔndishɔn we kɔmplikt smɔl, bɔt i rili impɔtant fɔ mek ɔlman no bɔt am. Dat na Primary Sclerosing Cholangitis , ɔ PSC fɔ shɔt tɛm.
Wetin na praymari sklɛrosin kɔlangitis (PSC)?
Fɔ tɔk am simpul wan, PSC na sik we kin apin na di bayl dakt dɛn na wi bɔdi. As yu go mɛmba, di bayl de kɔmɔt na di liva. Dis bayl de ɛp fɔ digest. So, wan sistεm de fכ sכm sכm tכb dεm we de kכri dis bayl frכm di liva to di intestכn dεm. Wi kin kɔl dɛn tiub dɛn de di bayl dakt dɛn.
insay PSC, kr כnik inflameshn , כ swel de de na dεn bayl dakt dεm ya. Dɔktɔ dɛn kin kɔl dis bak cholangitis . we dis inflameshn de kכntinyu fכ l כng tεm, ska de bigin fכ fכ m na di bayl dakt dεm. dis skata de mek di bayl dakt dεm at εn sכmtεm. Dɛn kɔl dis sik we dɛn kɔl sklɛrosis .
Imajin se wata paip we dɔn ful-ɔp wit dɔti ɛn we de smɔl, we de mek i nɔ izi fɔ mek wata pas, nɔto so? Semweso, we di bayl dakt dεm sכmtεm, di bayl dεm de fכ fכlכ. Dɛn kɔl dis biliary stricture . So, we di bayl nɔ ebul fɔ flɔ fayn, i kin bigin fɔ bak ɔp insay di liva. dis akyumuleshכn fכ bayl na di liva (cholestasis) de pwεl di liva sכmtεm.
Dis PSC situeshɔn siriɔs?
Yɛs, PSC na rili siriɔs sik . Yu nɔr kin gɛt ɛni sayn na di fɔs tɛm. Bɔt na sik we de go bifo. we di bayl blok na di bayl dakt dεm (cholestasis), sכm pan di tכxin dεm na di bayl kin bכku insay di bכdi. Dɔn yu kin bigin fɔ fil bad. Dɔn bak, dis kin mek di liva de pwɛl ɔltɛm.
Tipikli, dis damej kin mek di liva fεl kכmplit afta lεk 10 to 15 ia. As yu no, wi nɔ go ebul fɔ liv if wi nɔ gɛt liva. Pan ɔl we di tritmɛnt dɛn we dɛn de gi naw kin kɔntrol di sik dɛn, dɛn stil nɔ gɛt ɛni mɛrɛsin fɔ PSC. Di wangren tin we go sɔlv di prɔblɛm na fɔ transplant di liva .
Wetin na di difrɛns bitwin praymari ɛn sɛkɔndari sklɛrosin kɔlangitis?
di wכd "primary" ya min se di sik na di praymar kכz f כ di inflameshn εn ska na di bayl dakt dεm. Dat min se na dis sik nɔmɔ kin kam wit dis sik, ɛn nɔ gɛt ɛni ɔda tin.
Bɔt,insay wan kכndyushכn we dεn kכl sεkכnd sklεrosing kכlangyt, di inflameshn (cholangitis) εn ska (sklεrosis) na di bayl dakt dεm kin apin as a rizulεt f כ כda kכz. Dat min se, na ɔda sik ɔr tin we kin apin kin mek i gɛt dis sik. Na sɔm ɛgzampul dɛn ya:
- di injuri na di bayl dakt dεm (fכ egzampl, we dεn de du di כpεrayshכn).
- Infεkshכn dεm na di bayl dakt dεm.
- Anti-kansa tritmɛnt (Kɛmotɛrapi).
- Galston dɛn we de blok di bayl dakt dɛn.
- Pankrias we de kam bak.
Wetin na di difrɛns bitwin praymari biliary cirrhosis (PBC) ɛn PSC?
Di sik we dɛn bin de kɔl Praymari Bilari Sirosis, naw dɛn kɔl am Praymari Bilari Kɔlangitis (PBC) .
כl tu di PBC εn PSC na sik dεm we de go bifo we de afekt di liva, we de afekt di bayl dakt dεm. Di sayn dɛm ɛn di ifɛkt dɛm wae dɛn tu kin gɛt kin rili fiba. Dɛn tu sik ya kin mek di bayl dakt dɛn wik smɔl smɔl. we di bayl dakt dεm dכn pwεl, skata, εn sכmtεm sכmtεm, di bayl fכ fכlכ de blok. Dɔn di bayl de bak ɔp insay di liva, ɛn dis kin pwɛl di liva mɔ. Dis kin mek di liva gɛt skata ɛn leta di liva gɛt sirosis .
Bɔt sɔm impɔtant tin dɛn de we difrɛn bitwin dɛn tu sik ya:
- PBC de afekt di bayl dakt dεm we de insay di liva (intrahεpatik). PSC kin afekt כl tu di bayl dakt dεm insay di liva εn di bayl dakt dεm we de na do na di liva (εkstrahεpatik).
- PBC kin kכmכn mכr pan uman dεm (10:1 rεshכ), we PSC kin kכmכn mכr pan man dεm (2: 1 rεshכ).
- Na lɛk 80% pan di PSC pasɛnt dɛn gɛt inflammatory bowel disease (IBD) we bin dɔn de bifo, mɔ di ɔlsɛrativ kɔlayt . Bɔt dis nɔto impɔtant tin we gɛt fɔ du wit PBC.
- Risk de fɔ gɛt bayl dakt kansa wit PSC. Nɔr kayn ay risk nɔr de wit PBC.
- Ursodeoxycholic acid (UDCA) dεn de yuz fכ trit PBC, bכt naw nכ spεshal tritmεnt de fכ PSC.
Aw kכmכn dεn kכl dis kכndyushכn PSC? Udat kin gɛt am?
PSC na sik we nɔ kin bɔku . Ɔlsay na di wɔl, dɛn se na wan pan ɛvri tɛn tawzin pipul dɛn nɔmɔ gɛt dis sik.
Dis sik kin bɔku pan man dɛn tu tɛm pas uman dɛn. Dɛn kin no dis sik arawnd di ej 40. Na lɛk 80% pan di pipul dɛm wae gɛt PSC kin gɛt IBD (Inflammatory Bowel Disease) bak , mɔr lɛk Ulcerative Colitis . If pɔsin na di famili gɛt dis sik, ɔda pipul dɛn kin gɛt dis sik bak.
Wetin kin mek PSC?
Dɛn nɔ no yet di rayt tin we kin mek pɔsin gɛt PSC, bɔt dɛn tink se na wan kɔmbayn tin dɛn kin mek i apin. Dɛn tin ya na:
- Jɛnɛtiks
- Di tin dɛn we de apin na di envayrɔmɛnt
- Imyun sɛl dɛn
Dɔktɔ dɛn tink se PSC kin bi wan kayn sik we pɔsin kin gɛt we i de fɛt insɛf . Dis min se wi bɔdi in yon difens sistɛm, di sojaman dɛn we dɛn se fɔ protɛkt wi frɔm sik, kin mistek bigin fɔ atak wi yon wɛlbɔdi sɛl dɛn. Inflameshɔn na wan pan di wɛpɔn dɛn we wi imyun sistɛm de yuz. I kin bi fɔ sɔm tɛm, i kin akt agens pɔsin we invayd. Bɔt if inflamɛns kin kam fɔ lɔng tɛm, i kin bi sayn fɔ sik.
Dɔktɔ dɛn dɔn si bak se pipul dɛn we gɛt PSC kin gɛt ɔda sik dɛn we dɛn kin gɛt we dɛn de fɛt dɛnsɛf. Fɔ ɛgzampul:
- Inflammatory bowel diseases we kin mek pɔsin gɛt bɔdi
- Siliak sik we dɛn kin gɛt
- Tayrɔyd sik
- Tayp 1 dayabitis
- Autoimyun epataytis we pɔsin kin gɛt
- Ɔtoimyun pankrɛaytis
dεn tink se dis kayn כtoimyun rεspכns kin apin we pipul dεm we gεt sכm jεnεtik trayt dεm de εkspos to sכm envayroment fכktכ dεm (e.g., we dεn de εkspos to tכxik kεmikכl dεm).
Wetin na di sayn dɛm fɔ PSC?
As PSC de go bifo, di sayn dɛm kin chenj. Na lɛk 50% pan pipul dɛm nɔr kin gɛt ɛni sayn at ɔl wae dɛn no bɔt dis sik. Bɔku tɛm dɛn kin no PSC bay we dɛn de du tɛst fɔ ɔda kɔndishɔn. Bɔrku tɛm, di fɔs sayn dɛm nɔr kin rili klia. Dɛn tin ya na:
- Taya
- Ɔpa rayt kwadrant bɛlɛ pen
- Skin we de it (pruritus) .
Di sayn dɛm wae kin apun as de sik de go bifo na:
- Di bɛlɛ we dɔn swel
- Liva we dɔn big
- Spleen we dɔn big
- Jaundice - Dis min se di wayt dεm na di yay εn di skin de yכlכ.
- Fiva
- We yu nɔ bin want fɔ lɔs yu wet
Wetin na di kɔmplikeshɔn dɛm wae kin kam wit siriɔs PSC?
Praymari sklerosing cholangitis na sik we de go bifo smɔl smɔl, bɔt as yu bayl dakt ɛn liva de gɛt skata ɛn dɛn de wok fayn, difrɛn prɔblɛm dɛn kin apin.
Di sik dɛn we kin mek pɔsin gɛt bɔdi
if yu bayl dakt dεm blכk bכku bכku wan, dεn nכ kin pכmp bayl fayn fayn wan insay yu sכmכl intestin. Bayl impɔtant fɔ digest it, mɔ di fat, ɛn fɔ tek di vaytamɛn dɛn we kin sɔlv di fat (A, D, E, ɛn K). If yu nɔ gɛt bayl, yu dijestiv sistɛm nɔ go ebul fɔ prosɛs di fat fayn fayn wan, ɛn i nɔ go ebul fɔ tek dɛn impɔtant vaytamɛn ya frɔm it. Dis kin mek yu gɛt ɔda prɔblɛm dɛn:
- Fat stɔl ɛn dayarɛa
- Malabsorption ɛn malnutrishɔn
- I izi fɔ mek yu brus ɛn blɔd (bikɔs yu nɔ gɛt vaytamɛn K) .
- di bon dεm we de wik - כstiomalasia εn כstioporosis (biכs fכ di vaytam in D dεficienshכn) .
- Nɔr de si fayn na nɛt (bikɔs yu nɔ gɛt vaytamɛn A) .
Pɔtal haypatɛnshɔn
As sirosis de go bifo, di blɔd we de pas na di liva de go dɔŋ. dis de mek di prεshכn na di pכtal vein we de rכn tru yu dijestiv sistεm. dis prεshכn kin mek כda vein dεm na yu εsophagus εn bεlε big εn bכst. Dis kin mek yu blɔd kɔmɔt insay yu bɔdi .
Infεkshכn dεm
Bɔku tɛm di bayl dakt dɛn we dɔn blok kin gɛt di sik, we kin mek pɔsin gɛt tin dɛn lɛk fiva, bɛlɛ pen, ɛn blɔd pɔyzin (sepsis).
Kansa
As PSC de kam tranga, di risk fɔ gɛt sɔm kayn kansa de go ɔp:
- di bayl dakt kεnsar (cholangiocarcinoma) - Risk bitwin 5% εn 20%.
- Kansa na di gal blad
- Kansa na di liva (hepatoma) .
- Kolorektal kansa - if yu gɛt IBD bak.
Aw dɛn kin no bɔt PSC?
Bɔrku tɛm, dɛn kin no dis sik bay chans, wae dɛn de tɛst fɔ ɔda tin. Na lɛk 50% pan pipul dɛm nɔr kin gɛt ɛni sayn wae dɛn no bɔt dis sik. Yu kin si di fɔs sayn dɛm fɔ dis sik wit blɔd tɛst ɔr imej tɛst. skan dεm fכ di bayl dakt dεm wit PSC de sho spεshal fכm dεm. If blɔd tɛst sho se wan ɛnzaym we dɛn kɔl alkaline phosphatase , gɛt ay levul, ɔ if sɔm antibodi dɛn de we de sho se di imyun rεspכns to di bayl dakt dεm, i kin bi sayn fɔ PSC. We di wayt blɔd sɛl dɛn bɔku, na sayn fɔ se pɔsin gɛt infɛkshɔn na di liva.
Fɔ mek yu no se yu gɛt di sik, yu dɔktɔ kin tɛl yu fɔ du sɔm ɔda patikyula tɛst dɛn:
- Tɛst fɔ di wok we di liva de du (LFT) .: dis bכdi tεst dεm de luk fכ εlevεt lεvεl dεm fכ spεshal εnzym dεm na di liva. di εlevεt lεvεl dεm fכ alkaline phosphatase kin sho PSC.
- Magnεtik rεsכnans kolεnjכpankrεatografi (MRCP) : Dis na MRI (Magnetic Resonance Imaging) skan. I kin tek ditayla pikchɔ dɛm fɔ yu biliary system (liva, galbladder, ɛn bayl dakt dɛm). Dis na di fɔs skan fɔ no PSC. Dis na bikɔs i nɔ de invayd ɛn i nɔ de involv fɔ gɛt raytin. Bɔt sɔntɛnde, if di sik bigin ɔ i nɔ rili bad, i nɔ kin ebul fɔ no am kɔrɛkt wan. Dɔn dɛn go nid fɔ skan ɔda skan.
Aw dɛn kin trit PSC?
Naw, no tritmɛnt nɔ de we go ebul fɔ stɔp ɔ rivɛns di prɔgrɛs fɔ praymari sklɛrosing kɔlangitis. Bɔt, dɛn kin trit di sik ɛn prɔblɛm dɛn dairekt wan. Fɔ ɛgzampul, yu dɔktɔ kin gi yu tin dɛn lɛk:
- Mɛrɛsin fɔ mɛn di skin we de it (pruritus) .
- Sɔplɛnt fɔ trit di vaytamɛn dɛn we nɔ gɛt bɛtɛ vaytamɛn
- Antibayɔtik fɔ trit infɛkshɔn
Yu dɔktɔ go de wach yu liva ɛn di bayl dakt dɛn gud gud wan. As di sik de go bifo, wan wan tɛm dɛn kin opin wan bayl dakt we dɔn blok. dis kin bi tru wan tεst we dεn kכ l ERCP (endoscopic retrograde cholangiopancreatography) . Dis na wan we we de mek yu ebul fɔ si insay yu bayl dakt dɛn we yu nɔ gɛt ɔpreshɔn.
ERCP na wan kayn ɛndoskopi . I min se yu fɔ chɛk yu ɔgan dɛn bay we yu yuz ɛndoskɔp, we na wan lɔng tiub we kin chenj ɛn we gɛt smɔl kamɛra ɛn layt pan am. Afta dɛn dɔn anestez yu, yu dɔktɔ go put dis tiub dɔŋ yu trot ɛn insay yu bɛlɛ. yu kin pas sכm sכm instrכmεnt dεm tru dis tכb fכ trit yu bayl dakt dεm. Di tɛknishian kin yuz balyɔn fɔ mek yu bayl dakt big, ɔ put stent fɔ mek i opin. if ERCP nכ ebul fכ rich di blכk, sכmtεm dεn kin yuz wan prכsidכs we dεn kכl `pεrkyutan trans-hεpatik cholangiography (PTHC)'.
Bɔt dis na jɔs fɔ sɔlv di prɔblɛm fɔ sɔm tɛm. Insay 10 to 20 ia, praymari sklɛros kɔlangitis kin wɔs smɔl smɔl, di liva sik kin wɔs, ɛn leta di liva kin pwɛl. Yu dɔktɔ go wach aw yu liva dɔn pwɛl ɛn disayd ustɛm fɔ tink bɔt fɔ transplant yu liva . Yu nid fɔ mit sɔm krayteria bak fɔ de pan di wet list fɔ mek dɛn transplant yu liva.
Aw lɔŋ yu kin liv wit PSC?
We dɛn dɔn no se i gɛt dis sik, di avɛrej layf we pɔsin kin liv kin difrɛn bitwin 10 ɛn 20 ia. If pɔsin transplant di liva, i kin gi nyu layf. Bɔt insay 15% to 20% pan di kes dɛm, PSC kin kam bak ivin afta dɛn dɔn transplant di liva. If dat apin, di nyu liva kin pwɛl bak. Insay dɛn kayn tin ya, di avɛrej layf we pɔsin kin liv na lɛk nayn mɔnt.
Wan ɔda tin we kin afɛkt di we aw pɔsin de liv lɔng na kansa. If yu gɛt kansa as kɔmplikeshɔn fɔ PSC, yu nɔ kin bi gud kandidet fɔ gɛt liva transplant. Insay kes dɛn we dɛn tek tɛm pik, dɔktɔ dɛn kin fɔs trit di kansa wit redyushɔn ɔ kemotɛrapi, dɔn dɛn kin tray fɔ transplant di liva.
Aw a fɔ tek kia ɔf misɛf if a gɛt dis sik?
If yu chenj yu layf, dat kin ɛp fɔ mɛn di taya we kin apin to PSC ɛn mek yu nɔ gɛt mɔ liva damej. Fɔ ɛgzampul:
- Nɔ drink rɔm kpatakpata.
- I nɔ it bɔku tin dɛn we dɛn dɔn prosɛs ɛn it mɔ tin dɛn we ful-ɔp.
- Kɔntrol strɛs.
- Slip fayn fayn wan.
- Du sɔm ɛksesaiz ɛvride.
Primary sclerosing cholangitis na wan sik wae nɔr kin bɔrku, wae nɔr kin no, ɛn wae pɔrsin kin ebul fɔ avɔyd. I kin go bifo smɔl smɔl, ɛn bɔku tɛm i nɔ kin gɛt ɛni sayn we i de bigin. Bɔt if yu go to yu dɔktɔ ɔltɛm ɛn gɛt fɔ chɛk yu ɔltɛm, dɛn kin no di sik bifo i bigin fɔ afɛkt yu layf. Na da tɛm de yu kin chenj yu layf we go ɛp fɔ mek yu liva gɛt wɛlbɔdi fɔ lɔng tɛm. Dɛn go rifer yu bak fɔ lɔng tɛm mɛdikal kia, we min se dɛn kin chɛk yu ɔltɛm ɛn du tin fɔ ɛp yu if nid de.
Fɔ dɔn, tin dɛn we wi fɔ mɛmba
Okay, so a op se wetin wi don tok abaut PSC don helep yu fo memba som of di most impotant tins. Na smɔl kɔmplikɛt tin, bɔt i rili impɔtant fɔ no bɔt am.
- PSC na sik we de afɛkt di bayl dakt ɛn i kin wɔs as tɛm de go. I kin pwɛl di liva.
- Nɔr sayn nɔr kin de na di fɔs stej, so i impɔtant fɔ mek yu de chɛk yu dɔktɔ ɔltɛm.
- Naw, no mɛrɛsin nɔr de fɔ dis sik, bɔt tritmɛnt de fɔ kɔntrol di sayn dɛm ɛn fɔ mek yu layf bɛtɛ.
- Liva transplant na di men sɔlv we dɛn gɛt siriɔs kes dɛm.
- Fɔ fala wɛlbɔdi layf, i kin ɛp fɔ protɛkt di liva.
If yu gɛt ɛni ɔda kwɛstyɔn bɔt PSC, ɔ if yu tink se yu gɛt ɛni wan pan dɛn sik ya, mek shɔ se yu go to dɔktɔ fɔ advays . Nɔ wɔri, tin dɛn de we yu kin du fɔ manej am if dɛn kech am kwik.
` Praymari Sklerosing Cholangitis, PSC, Bayl Dakt Disiz, Liva Sik, Jandis, Bɛlɛ Pen, Praymari Sklerosing Cholangitis
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