Ggwe oba omuntu mu maka go naddala omwana atera okulumwa olubuto? Wali olabyeko omusaayi omutono mu musulo gwo? Oba owulira ng’okooye era ng’okooye? Tutera okugoba obubonero buno nga tugamba nti obulumi mu lubuto mu ngeri ennyangu oba obutagumira mmere. Wabula oluusi obubonero buno buyinza okuva ku mbeera gye tutawuliddeko nnyo, naye nga ddala tusaanidde okugimanya. Leero tugenda kwogera ku mbeera emu ng’ezo, Juvenile Polyposis Syndrome (JPS).
Ddala JPS kye ki?
Mu ngeri ennyangu, Juvenile Polyposis Syndrome (JPS) mbeera ya buzaale nga okukula okutali kwa bulijjo kutondebwa ku bisenge eby’omunda eby’enkola yaffe ey’okugaaya emmere (gastrointestinal - GI tract). Mu by'obusawo ebikula bino tubiyita polyps . Teebereza akatundu akatono akalinga emizabbibu nga kawanikiddwa ku kikolo munda mu byenda byaffe. Bw’etyo ebiwuka bino ebiyitibwa polyps bwe bikola.
Ebirungo bino ebiyitibwa polyps bisobola okutondebwa wonna mu nkola yaffe ey’okugaaya emmere.
- Olubuto
- Mu kyenda ekitono
- Mu kyenda ekinene (colon) .
- Enseke z’omumwa gwa nnabaana
Naye zisinga kusangibwa mu kyenda ekinene ne mu nseke. Omuntu alina JPS ayinza okuba n’ebirungo bino okuva ku bitono okutuuka ku bikumi n’ebikumi.
Kati oyinza okulowooza nti olw'okuba gulimu ekigambo "juvenile", buno bulwadde bukwata abaana abato bokka. Si ddala. Ekigambo "omuto" wano tekitegeeza myaka obulwadde gye bukula. Kitegeeza obutonde bw’obutoffaali obulabibwa nga ekiwujjo kitwaliddwa ne kikeberebwa wansi wa microscope. Kyokka ebiseera ebisinga, obubonero bw’obulwadde buno butandika okulabika mu buto oba mu myaka gy’obutiini , ebiseera ebisinga nga tebannaweza myaka 20.
Waliwo ebika bya JPS ebikulu?
Yee, JPS esobola okwawulwamu ebika bisatu ebikulu. Ensengeka zino zeesigamiziddwa ku bunene bwa polipu ezikola n’ekifo we ziri.
| Ekika kya JPS | Ennyinyonnyola ennyangu |
|---|---|
| Obulwadde bwa polyposis mu baana abawere (JPI) . | Eno y’engeri esinga okuba ey’amaanyi era ey’amaanyi eya JPS. Bubeera mu baana abawere n’abaana abato. Obubonero busobola okulabika amangu ddala. |
| Obulwadde bwa polyposis bw’abaana abato mu ngeri ey’enjawulo | Kino kye kika kya JPS ekisinga okukozesebwa. Polyps zisobola okukula wonna mu nkola yonna ey’okugaaya emmere, omuli olubuto, ekyenda ekitono n’ekyenda ekinene. |
| Obulwadde bwa polyposis coli obw’abaana abato | Mu kika kino, ebiwuka ebiyitibwa polyps bikolebwa mu kyenda kyokka. Kino kikoma katono bw’ogeraageranya n’ebika ebirala ebibiri. |
Ani afuna embeera eno? Kiba kya nsikirano?
JPS eva ku nkyukakyuka mu buzaale, n’olwekyo omuntu yenna asobola okugifuna. Embeera etatera kubaawo nnyo. Mu nsi yonna, obulwadde buno buba nga kimu ku buli lukumi .
Yee, obulwadde buno busobola okusikira . JPS y’embeera gye tuyita mu by’obusawo ``autosomal dominant``. Kino kitegeeza butegeeza nti omwana ne bw’asikira kkopi emu ey’obuzaale obukyusiddwa olw’obulwadde buno okuva ku maama oba taata, kiba kimala omwana okufuna obulwadde buno.
- Abalwadde ba JPS nga 75% basikira embeera eno okuva mu bazadde baabwe.
- Mu bitundu 25% ebisigadde, obulwadde buno busobola okubaawo olw’enkyukakyuka eyeetongodde mu mubiri gw’omwana, wadde ng’abazadde tebalina nkyukakyuka eno ey’obuzaale.
Bubonero ki obwa JPS?
Akabonero akakulu ak’obulwadde buno kwe kutondebwa kw’ebiwuka ebiyitibwa polyps, bye twayogeddeko emabegako, mu byenda. Okuva bwe kiri nti bino bitondebwa munda mu mubiri, tetusobola kubiraba okuva ebweru. Emirundi egisinga, ebiwuka ebiyitibwa polyps biyinza obutalaga bubonero bwonna okutuusa nga binene katono oba omuwendo gwabyo gweyongedde. Naye obubonero bwe butandika okulabika, busobola okulabika bwe buti.
| Obubonero | Okunnyonnyola |
|---|---|
| Okuvaamu omusaayi mu nseke | Kano ke kabonero akasinga okulabika era akasooka okulabika. Oyinza okulaba omusaayi omumyufu omutangaavu mu musulo gwo. |
| Okulumwa olubuto oba okulumwa | Oyinza okufuna obulumi obw’ekyewuunyo obulinga obw’okuzimba mu lubuto. |
| Embiro | Ekiddukano okumala ebbanga eddene kiyinza okubaawo. |
| Obuteeyabya | Abantu abamu bayinza n’okuziyira mu kifo ky’okuziyira. |
| Okukendeera kw’omusaayi | Omusaayi bwe gweyongera okukulukuta, omuwendo gw’omusaayi mu mubiri guyinza okukendeera ekivaako okukendeeza ku musaayi. Kino kiyinza okukuleetera okuwulira ng’okooye, ng’oli muddugavu, era ng’oli munafu buli kiseera. |
| Okugejja | Singa weeyongera okugejja awatali nsonga, ekyo nakyo kiyinza okuba akabonero. |
Engeri endala eziyinza okulabibwa ng’azaalibwa
Abalwadde ba JPS nga 15% balina obuzibu obulala mu mubiri nga bazaalibwa ng’oggyeeko ebizimba by’ekyenda.
- Emimwa n’ennyindo byakutuse
- Okubeera n’engalo oba engalo ez’enjawulo (Polydactyly) .
- Obutabeera bulungi mu nkula y’obwongo, omutima oba enkola y’omusulo
- Okukyusakyusa ebyenda (Malrotation) .
Waliwo akakwate wakati wa JPS n’obulabe bwa kookolo?
Kino kye kisinga obukulu okumanya ku bulwadde buno. Polyps ezikula olw’obulwadde bwa JPS mu kusooka teziba za kookolo (benign). Zino bizimba bya bulijjo. Wabula ekiseera bwe kigenda kiyitawo, waliwo akabi kanene nnyo ak’ebiwuka bino okukyuka ne bifuuka kookolo.
Omuntu alina JPS alina akabi ak’obulamu bwe bwonna ak’okufuna kookolo w’enkola y’okugaaya emmere wakati wa bitundu 30% ne 50%.
N’olwekyo, omuntu alina JPS abeera mu bulabe obw’okufuna ebika bya kookolo bino wammanga:
- Kookolo w’olubuto n’omumwa gwa nnabaana
- Kookolo w’olubuto
- Kookolo w’ekyenda ekitono
- Kookolo w’olubuto
Kino tokitya. Kino tekitegeeza nti buli muntu ajja kufuna kookolo. Naye kitegeeza nti akabi kali waggulu. Y’ensonga lwaki kikulu nnyo okuzuula obulwadde buno mu kiseera ekituufu n’okukeberebwa mu biseera ebituufu ng’omusawo bw’akulagidde.
Kiki ekituufu ekivaako JPS?
Nga bwe twayogeddeko emabegako, eno mbeera ya buzaale. JPS esinga kuva ku nkyukakyuka mu buzaale bubiri mu mubiri gwaffe obuyitibwa BMPR1A ne SMAD4 .
Okusobola okutegeera kino, ka tukozese ekyokulabirako eky’enjawulo. Kuba akafaananyi ng’obutoffaali obuli mu mubiri gwaffe bulinga mmotoka eziri ku luguudo. Ensengekera z’obuzaale bbiri eziyitibwa BMPR1A ne SMAD4 ziringa abaserikale ba poliisi y’ebidduka. Zifuga okukula n'okugabanya kw'obutoffaali, ne ziwa obubonero "OK, divide now" ne "OK, stop now."
Obuzaale buno obubiri bwe bukyuka, okufaananako ng’abaserikale abo ab’ebidduka tebakyaliwo, obutoffaali bubulwa obuyinza. Batandika okwawukana mu ngeri yonna gye baagala, era ku sipiidi ya mangu. Bw’etyo obutoffaali buno obw’enjawulo obutafugibwa bwe bukwatagana ne bukola ebizimba bino ebiyitibwa polyps.
Ng’oggyeeko JPS, abantu abalina enkyukakyuka mu buzaale bwa SMAD4 bali mu bulabe bw’okufuna embeera endala ey’obuzaale eyitibwa hereditary hemorrhagic telangiectasia (HHT).
Osobola otya okuzuula obulwadde buno?
Bw’obuulira omusawo wo ku bubonero bwo, ajja kukukebera era akubuuze ku byafaayo by’obujjanjabi bw’amaka go. Okuzuula JPS, olina okuba n’ekimu ku bino wammanga:
- Okubeera ne polyps ttaano oba okusingawo mu kyenda ekinene ne/oba rectum.
- Okubeerawo kwa polyps awalala mu nkola y’okugaaya emmere.
- Okubeera ne polyp waakiri emu n’ebyafaayo by’amaka ebya JPS.
Waliwo ebikulu bibiri ebikeberebwa okukakasa obulwadde buno.
1. Endoscopic exam / Colonoscopy: Kino kizingiramu okuyingiza ekyuma ekigonvu ekigonvu nga kiriko camera n’ekitangaala okuyita mu nseke okwekenneenya munda yonna ey’ekyenda ekinene n’enkola y’okugaaya emmere. Kino kiyinza okuyamba okulaba oba waliwo ebiwuka ebiyitibwa polyps, bimeka, ne gye biri. Mu kiseera ky’okukebera, obuwuzi obutonotono busobola okuggyibwamu ne basobola okuggyibwako ebitundu by’omubiri (biopsy) okukeberebwa.
2. Okukebera omusaayi gw’obuzaale: Omusaayi guggyibwa ne gukeberebwa okuzuula enkyukakyuka mu buzaale bwa BMPR1A oba SMAD4 ezireeta JPS. Kino kiyinza okukakasa obulwadde buno 100% of the time.
Bujjanjabi ki obuweebwa JPS?
Ekigendererwa ekikulu eky’okujjanjaba JPS kwe kuggyawo obuwuka obuyitibwa polyps.Kino kisobola okufuga obubonero n’okukendeeza ku bulabe bw’okukwatibwa kookolo mu biseera eby’omu maaso. Omusawo wo ajja kukusalirawo obujjanjabi obusinga obulungi okusinziira ku myaka gyo, obulamu bwo, omuwendo gw’ebirungo ebiyitibwa polyps, n’ekifo we biri.
Waliwo enkola eziwerako ez’obujjanjabi:
- Okuggyawo ebiwuka ebiyitibwa polyps mu kiseera ky’okukebera ekyenda ekinene: Singa ebiwuka biba bitono mu muwendo ate nga bitono mu sayizi, osobola okubisala ne biggyibwamu n’ekintu kye kimu ekikozesebwa okukola okukebera.
- Okulongoosa okuggyawo ebiwuka ebiyitibwa polyps: Singa ebiwuka biba binene oba nga biba mu kifo ekizibu okutuukako n’ekyuma ekikebera ekyenda ekinene, kiyinza okwetaagisa okulongoosebwa.
- Okulongoosa okuggya ekitundu ky’ekyenda ekinene: Singa ebiwuka ebiyitibwa polyps bingi bisaasaanidde mu kitundu ekimu, abasawo bayinza okusalawo okulongoosa ekitundu ekyo kyonna eky’ekyenda ekinene.
Singa abaana abato baba n’ekirungo kya ‘polyp’ kimu kyokka, kitera okuggyibwamu nga bakeberebwa ekyenda ekinene. Okulongoosa tekutera kukolebwa ku baana.
Obulwadde buno obuddukanya otya oluvannyuma lw’okuzuulibwa?
JPS mbeera eyeetaaga okuddukanyizibwa okumala ebbanga eddene. Oluvannyuma lw’okujjanjaba n’okuggyawo ebiwuka ebiyitibwa polyps, twetaaga okulondoolebwa buli kiseera okulaba oba biddamu okukula oba ebipya bitondebwawo. Y'ensonga lwaki tukola screenings .
Omusawo ajja kukugamba okukeberebwa kuno ku nteekateeka etegekeddwa.
- Okukebera omusaayi
- Okukebera ekibumba
- Okukebera endoscopy eya waggulu
Okukebera okusooka kutera okukolebwa amangu ddala ng’obubonero bulabika oba nga tonnaweza myaka 15. Singa ebyava mu kukeberebwa biba birungi, ojja kusabibwa okuddamu okukebera buli luvannyuma lwa myaka 3. Wabula bw’oba olina ebiwuka ebiyitibwa polyps era nga biggyiddwamu, oyinza okwetaaga okukeberebwa buli mwaka . Singa ebiwuka ebiyitibwa polyps tebidda, ebbanga wakati w’okukeberebwa liyinza okwongerwako okutuuka ku myaka 3.
Okugoberera enteekateeka eno ddala kikulu nnyo eri obulamu bwo n’obulamu bwo. Kiyinza okukuyamba okuzuula n’okuziyiza obulabe bwa kookolo nga bukyali.
Ddi lwe weetaaga okulaba omusawo?
Bw’oba olina obubonero bwonna bwe twogeddeko naddala omusaayi mu musulo gwo , tobuusa maaso. Kiyinza okuba nga kyangu, oba kiyinza okuba akabonero k’embeera ey’amaanyi ennyo nga JPS. Kale, laba omusawo wo amangu ago.
Ekirala, singa omuntu mu maka go abaddeko ne JPS emabegako, oba bw’oba obadde ne kookolo w’ekyenda ng’okyali muto, kiba kya magezi okwogera n’omusawo wo ku nsonga eno n’okukeberebwa obuzaale bwe kiba kyetaagisa, ne bw’oba tolina bubonero bwonna.
Obubaka Obutwala Awaka
- Obulwadde bwa Juvenile Polyposis Syndrome (JPS) bulwadde bwa buzaale obuleetera okukula okutali kwa bulijjo (polyps) okukola mu byenda. ‘Juvenile’ kitegeeza obutonde bwa polyp, so si myaka.
- Tobuusa maaso bubonero ng’omusaayi mu musulo, okulumwa olubuto okumala ebbanga oba okugejja. Noonya abasawo amagezi mu bwangu.
- JPS eyongera obulabe bw’okukwatibwa kookolo mu biseera eby’omu maaso. N’olwekyo, kyetaagisa nnyo okwekebejjebwa omusawo w’akulagidde mu budde.
- Wadde nga tewali ddagala lyonna eriwonya bulwadde buno, busobola okuddukanyizibwa obulungi era obulamu obulungi busobola okubeerawo ng’oggyawo ebiwuka ebiyitibwa polyps n’okwekebejjebwa buli kiseera.
- Bw’oba olina ebyafaayo by’amaka ga JPS oba kookolo w’ekyenda, yogerako n’omusawo wo ku nsonga eno era olowooze ku kubudaabudibwa n’okukeberebwa obuzaale.
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