I pouch-ah pawh harsatna i nei em? Pouchetis chungchang hi han sawi ila! (Pouchetis) a ni.

Damdawi lam harsatna avanga i colon leh rectum zawng zawng surgery hmanga lakchhuah a, a aiah ‘ileal pouch’ siam tawh mi i ni em? Chutiang a nih chuan he pouch nena inzawm hian a chang chuan harsatna engemaw zat i nei thei bawk. Harsatna lo awm thei tam ber pakhat chu tunlaia kan sawi tak, ‘Pouchetis’ hi a ni. He thu i hriat hian hlau suh. Engkim hi chiang tak leh awlsam takin sawi ila.

Pouchetis tih hi eng nge ni? A awlsam zawngin i hrethiam ang u.

A hmasain he ‘ileal pouch’ hi eng nge a nih i en ang u. I colon leh rectum a chhuah vek hnuah (total proctocolectomy) i taksa atanga i bawlhhlawh chhuah tir dan thar i mamawh a ni. Chumi chinfelna pakhat chu ileal pouch surgery hi a ni. Heta thil thleng chu surgeon-te chuan i small intestine (ileum) tawp ber chu pouch ang chi structure te tak te siam nan an hmang thin.

Chuvangin, i intestine lian takin a tih thin, a chhuah hmaa hun engemaw chen atana bawlhhlawh khawlkhawm leh dahkhawm thin kha tunah chuan chu pouch chuan a ti ta a ni. Phên dangin sawi ila, tunah chuan i intestine te tak te thenkhat chu intestine lian tak angin a thawk ta a ni.

Pouchetis chu pouch chhung atanga a hring emaw, a hring emaw a nih chuan a ni. Colitis (colon inflammation) emaw proctitis (rectum inflammation) ang chi a ni. Hei hi pouch nei tan chuan a awm fo thin.

Mi tam zawk tan chuan hei hi hun eng emaw chen atan (acute pouchitis) a ni a, mahse mi thenkhat tan chuan a awm reng (chronic pouchitis) emaw, a lo lang leh thei bawk.

Pouchetis natna lan chhuahna chu engte nge ni?

Pouchetis i neih chuan heng symptoms zinga pakhat emaw a aia tam emaw i nei thei. Anmahni hriat chian a pawimawh.

Engvangin nge Pouchetis hi a lo awm?

Hei hi a chhan dik tak hi 100% in hriat a la ni lo a, mahse a theory ber chu pouch chhunga bacteria chi hrang hrang awmte hi a inthlau hle tih hi a ni.

Ngaihtuah teh, tunah chuan i intestine te tak te thenkhat chu intestine lian ang maia a thawh lai hian bacteria chi thar a rawn lut a, heng bacteria thar leh hlui inkarah hian ‘indona’ tlem a awm thin. Hetianga inthlak danglamna hian taksa immune system chu chutah chuan infection a awm tih a ngaihtuah tir thei a ni. Chuvangin chutiang chhanna atan chuan inflammation a awm a, chu chu pouch chu a lo hring tihna a ni.

A chang chuan natna thlentu bacteria te hi an lo thang lian lutuk a, natna hrik a thlen thei bawk. He bacteria balance hi operation hnuah a danglam a, bacteria hlauhawm tak takte chu an thanlen theihna chance tha zawk a pe a ni.

Persistent pouchitis thlentu thil dangte

Mi thenkhat tan chuan pouchitis hi a awm reng emaw, enkawlna a dawng tha lo emaw a ni. Hei hi thil dang vang pawh a ni thei.

• Pre-existing medical conditions (IBD): Inflammatory bowel disease (IBD) Ulcerative Colitis emaw Crohn’s disease emaw avanga i colon lakchhuah a ngai a nih chuan pouchitis vei theihna a sang zawk. Hei hi a chhan chu chu natna thlentu underlying mechanism ang chiah chuan pouch pawh a nghawng thei a ni.
• Antibiotic-resistant bacteria: Bacteria infection thenkhat, C. difficile te hi antibiotics hmanga control a harsa hle. Tin, antibiotics hman chhunzawm zel chuan bacteria thenkhat chu an do thei ta a ni. Hei hian pouch chhunga bacteria imbalance a tipung thei bawk.
• Infection dang: A chang chuan pouch inflammation hi viral (cytomegalovirus) emaw fungal (candidiasis) infection vang pawh a ni thei.
• Immuity chak lo: Damdawi dang emaw, damdawi thenkhat emaw avanga i taksa immune system a chak lo a nih chuan infection i do theihna a tlahniam a ni.
• Painkillers (NSAIDs) hman dan): Hun rei tak leh a tam lutuk hian painkiller ibuprofen leh aspirin (Nonsteroidal anti-inflammatory drugs - NSAIDs) te hi pouch chhung lam layer a tichhe thei a ni.
• Thisen pek tlem (ischemia): A tlem hle nachungin, pouch-a thisen kalna a block avangin inflammation a awm thei.
• PSC natna: `(Primary sclerosing cholangitis - PSC)` hi thin (liver) a bile ducts a inflammation thlentu a ni. Hetiang natna vei te hi pouchitis vei theihna a sang hle.

Pouchetis avanga harsatna awm thei te chu engte nge ni?

Temporary pouchitis hian harsatna lian tham a thlen tam lo hle a, mahse he natna hi a awm reng emaw, enkawlna a dawng lo emaw a nih chuan harsatna engemaw zat a thlen thei a ni.

Engtin nge pouchitis i vei tih chiang taka i hriat theih ang?

I natna lan chhuah dan a ngaihthlak hnuah i doctor chuan test eng emaw zat a nei ang a, i natna chu a finfiah ang. Test pawimawh ber chu pouchoscopy (endoscopy) a ni.

Hei hian i hnute kal tlanga camera dahna tur tube te tak te dah luh a, pouch chhung lam enfiah a huam a ni. Chumi hnuah doctor chuan pouch chhunga inflammation emaw lesion emaw a awm leh awm loh a enfiah thei ang. Chutih rual chuan tissue te tak te (biopsy) chu enfiah turin lak theih a ni bawk.

Chu bakah, pouch leh a chhehvela thil awmte dinhmun enfiah nan a hnuaia test te hi tih theih a ni bawk:

• A rilru a buai em em a, a rilru a hah em em bawk a. `(pouchogram)`
• `CT scan` tih a ni
• `MRI` tih a ni

Pouchetis enkawlna tur engte nge ni?

Enkawl dan tur chu pouchitis i neih chi hrang hrangah a innghat.

Acute Pouchetis enkawl dan tur

Enkawlna hmasa ber chu kar hnih chhung antibiotics pek a ni. Mi tam tak tan chuan hei hian an natna lan chhuah dan chu a tifai vek tawh mai ang. I natna lan chhuah dan a tha zawk a nih pawhin doctor-in damdawi a pek zawng zawng ei a pawimawh.

Recurrent Pouchetis enkawl dan tur

Enkawlna hnua pouchitis a lo awm leh chuan doctor chuan antibiotics ang chiah hi a pe ngei ang. Mahse, kum khatah vawi thum aia tam a awm chuan natna khirh tak anga ngaih a ni a, a lo lang leh tur ven nan maintenance therapy tan theih a ni. Chumi atan chuan, .

• Antibiotics rei tak pek hi a tlem berah pek thin.
• Probiotics hman dan: Probiotics hian bacteria tha tak tak a pai a, pouch chhunga bacteria balance awm chu a siam tha thei a ni.

Antibiotics (CARP) ei lo pouchitis enkawl dan .

Antibiotics hian a puih loh chuan, a nih loh leh a hmaa a puih a nih chuan, chu natna chu ``Chronic antibiotic-resistant pouchitis (CARP)'' an ti a ni. Hetah hian doctor chuan a chhan dang a zawng ang a, chumi ang chuan enkawl dan tur a rel ang. Hei hi enkawl dan hrang hrang a awm a.

• Enemas-ah hian ruihhlo `Mesalamine` emaw `Bismuth` emaw a awm
• Corticosteroids, inflammation tihziaawmna
• Immunosuppressants te hian immune system hnathawh dan a thunun a ni
• Tunlai damdawi `Biologics` ang chi te
• Damdawi bik, `Fecal microbiota transplant (FMT)` tih ang chi te

Ei leh in hmangin pouchitis hi control theih a ni em?

Ni e, eng emaw chen chu a theih a ni. I ei leh in hian pouchitis a lo awm loh nan a pui thei a, symptoms a lo awm hunah pawh a enkawl thei bawk.

Pawimawh: FODMAP hniam ei leh in hi a nghet taka zawm tur a ni lo. Hun rei lote chhung, symptom i neih hunah, doctor emaw nutritionist emaw kaihhruaina hnuaia i zawm tur thil a ni.

Ileal pouch surgery hnuah nun hi a awlsam zawk hle nachungin, pouchitis ang chi harsatna a awm chuan lungkhamna hi thil pangngai a ni. Mahse, hei hi enkawl theih, mi tam tak tuar thei a ni tih hre reng ang che. I doctor nen thawk hovin i tana solution tha ber i zawng thei ang.