Ekibumba kyo kitundu kya mubiri ekyewuunyisa. Akola amazzi agayitibwa ‘bile’ agatuyamba okugaaya emmere erimu amasavu gye tulya. Naye mu muntu alina obulwadde obuyitibwa Primary Biliary Cholangitis (PBC), emikutu emigonvu egitambuza omusulo guno gyonooneka. Kino kireetera omusulo obutakulukuta bulungi ne guzibikira munda mu kibumba. Ekiseera bwe kigenda kiyitawo, omusulo guno oguzibiddwa gusobola okukaluba ne gufuuka amayinja ne guleeta yinfekisoni. Oluvannyuma entuuyo eno edda emabega n’ereeta enkovu munda mu kibumba. Buno bwe butonde obusookerwako obwa PBC.
Naye teweeraliikiriranga. Waliwo eddagala eddungi eriyinza okuyamba okuggya entuuyo mu kibumba n’okukendeeza ku kutondebwa kw’enkovu zino. Wabula singa tojjanjaba bulungi PBC, oba obulwadde bweyongera katono, ebizibu ebimu biyinza okubaawo. Leero, tugenda kwogera ku bizibu ebisinga okuva mu PBC n’engeri y’okubiddukanyaamu.
Cirrhosis, embeera ey’amaanyi
Obulwadde bwa Cirrhosis bwe buba obutoffaali obulamu mu kibumba kyo bwe bukyusibwa ne bufuulibwa ebitundu by’enkovu. Mu ngeri ennyangu, ekibumba kikaluba mpolampola ne kifuuka ejjinja. Embeera eno ebaawo mu mitendera egy’enkomerero egya PBC. Mu kiseera kino ekibumba kyayonooneka dda nnyo.
Obulwadde bwa Cirrhosis mbeera ya maanyi gye tulina okumanya, kuba eyinza okuvaako embeera ez’amaanyi ng’ekibumba okulemererwa ne kookolo w’ekibumba.
Edda, PBC yayitibwanga ‘primary biliary cirrhosis’. Kino kiva ku ngeri obuzibu bw’obulwadde bwa cirrhosis gye bukwataganamu ennyo n’obulwadde buno.
Kino kikwatibwa kitya?
Omusawo ajja kukuwa eddagala okufuga embeera eno.
- Ebiseera ebisinga, obujjanjabi obusooka buba ddagala eriyitibwa ursodeoxycholic acid (Ursodiol) . Kino kikola nga kiggya entuuyo mu kibumba n’okukendeeza ku kwonooneka kw’ekibumba.
- Bw’oba towulira bulungi nnyo ng’okozesa eddagala lino lyokka, omusawo ayinza okukuwa amagezi okumira eddagala eriyitibwa obeticholic acid (Ocaliva) ng’oggyeko.
- Ng’oggyeeko ekyo, eddagala eppya nga elafibranor (Iqirvo) ne seladelpar (Livdelzi) kati likkirizibwa okukozesebwa ne ursodeoxycholic acid.
- Ekirala eky'okukola ye kiraasi y'eddagala eriyitibwa fibrates . Wadde nga mu butuufu bino bikkirizibwa okukendeeza amasavu mu musaayi (lipids), kizuuliddwa nti bikola bulungi nnyo mu balwadde ba PBC abataddamu bulungi asidi wa ursodeoxycholic. Mu ngeri eno, omusawo bw’akozesa eddagala ku mbeera endala okuggyako eyo gye lyakkirizibwa, tuliyita ‘off-label’ use.
Wabula ne bw’okozesa bujjanjabi ki, singa enkovu mu kibumba ziyitiridde ate ekibumba ne kitasobola kukola, eky’okugonjoola ekibumba kyokka kwe kukyusa ekibumba.Okka. Ky’okola eyo kwe kuggyawo ekibumba kyo ekyonoonese n’okisimbuliza n’ekibumba okuva ku muntu omulamu.
Puleesa okweyongera mu musuwa mu kibumba (Portal Hypertension) .
Kino kizibu ekirala eky’amaanyi. Kino katukitegeere. Tulina omusuwa omukulu oguleeta omusaayi mu kibumba kyaffe. Kino kye tuyita ‘omusuwa gw’omulyango’.
Kati, ebitundu by’enkovu bwe bikola munda mu kibumba olw’embeera y’obulwadde bwa cirrhosis gye twayogeddeko emabegako, okutambula kw’omusaayi okuyita mu ‘portal vein’ eno kuziyizibwa. Okufaananako n’akalippagano k’ebidduka ku luguudo, omusaayi tegusobola kutambula bulungi ne gusibira munda mu musuwa ogwo. Omusaayi bwe gukuŋŋaanyizibwa bwe guti, puleesa eri munda mu musuwa ogwo yeeyongera mpolampola. Abasawo embeera eno bagiyita portal hypertension .
Lwaki kino kya bulabe? Puleesa eno eyinza okuleetera emisuwa emigonvu egy’omusaayi munda mu mubiri okukutuka, ne kivaako okuvaamu omusaayi munda . N’olwekyo, kikulu nnyo kino okukijjanjaba amangu.
Ka tutegeere ebizibu bino ebibiri okuva ku kipande wansi.
| Okuzibuwalirwa | Mu ngeri ennyangu... | Obulabe Obukulu |
|---|---|---|
| Obulwadde bwa Cirrhosis | Okutondebwa kw’ebitundu by’enkovu mu kifo ky’ebitundu by’ekibumba ebiramu (amayinja g’ekibumba). | Okulemererwa kw’ekibumba ne kookolo w’ekibumba. |
| Puleesa ya Portal | Obulwadde bwa Cirrhosis buleetera emisuwa egireeta omusaayi mu kibumba okuzibikira, ne kyongera puleesa eyo. | Okuvaamu omusaayi munda. |
Bujjanjabi ki obukolebwa ku kino?
Omusawo ayinza okukuwa eddagala, gamba nga beta-blockers, okukendeeza ku puleesa mu ‘omusuwa guno ogw’omulyango.’ Bino bisobola okufuga puleesa yo okumala akaseera.
Naye jjukira nti obujjanjabi bwokka era obusinga okuba obw’olubeerera obuyinza okukomya ddala puleesa y’omulyango (portal hypertension) kwe kusimbuliza ekibumba.Okka. Kubanga ekikolo ekivaako kino kwe kwonooneka kw’ekibumba olw’obulwadde bwa cirrhosis. Olw’okuba okwonooneka okwo tekuyinza kuddabirizibwa, ekisembayo kwe kuggyawo ekibumba ekyonoonese n’okizzaamu ekipya.
PBC bulwadde obusobola okufugibwa obulungi ng’ofunye obujjanjabi obutuufu n’okubuulirirwa. N’olwekyo, bw’oba olina obulwadde buno, tosattira, sigala ng’okwatagana n’omusawo wo buli kiseera, era ogoberere ddala obujjanjabi obukuweereddwa. Eyo y’engeri esinga obulungi ey’okusigala nga tolina bulabe ku bizibu ng’ebyo.
Obubaka Obutwala Awaka
- Primary Biliary Cholangitis (PBC) bulwadde obwonoona emikutu emigonvu mu kibumba egitambuza entuuyo.
- Singa obulwadde buno tebujjanjabwa bulungi, ebizibu eby’amaanyi nga cirrhosis ne portal hypertension bisobola okubaawo.
- Obulwadde bwa Cirrhosis mbeera ng’enkovu zikuŋŋaana mu kibumba, ekivaako ekibumba okulemererwa n’okutuuka ku kookolo.
- Puleesa y’omubiri (portal hypertension) kweyongera mu puleesa mu musuwa ogutwala omusaayi mu kibumba. Kino kiyinza okuvaako omusaayi okuva munda mu mubiri.
- Bw’oba olina PBC, bulijjo yogerako n’omusawo wo ku kintu kyonna ekikweraliikiriza . Kikulu nnyo okumira eddagala lyo ddala nga bwe likulagidde n’okugoberera ebiragiro by’omusawo.
- Emirundi mingi, ekisembayo okugonjoola ekibumba kiyinza okuba eky’okusimbuliza ekibumba.
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