I colon hi hetiang hian a inflamed em? Pseudomembranous Colitis chungchang hi i zir dawn nia!

Ni khatah vawi tam tak pum na leh luak chhuak nasa tak i nei em? Khawsik rualin i rilru a na ve bawk mai thei em? A bik takin, tun hnaia natna engemaw avanga antibiotics i ei hnuah heng symptoms te hi a lo lang em? Chutiang a nih chuan hei hi i tan thil pawimawh tak a ni mai thei. Vawiin hian ‘Pseudomembranous Colitis’ tih natna pakhat kan sawi dawn a ni. Lungngai suh, hemi chungchang hi uluk taka hriattir i nih chuan inenkawlna i hmu thei a, i dam thuai thei bawk.

Pseudomembranous Colitis hi eng nge ni?

A awlsam zawngin sawi ila, ‘Pseudomembranous Colitis’ hi kan intestine lian, a nih loh leh kan colon-a awm thin, inflammatory condition na tak a ni. Hetah hian eng emaw chhan vangin (bacteria, toxin emaw, natna dang emaw pawh a ni thei), i intestine lian chhungril bang, emaw, mucous membrane (`mucosa`) chu a chhe ta a ni. Hetianga chhiatna hian a chhiatna hmunah chuan yellowish-white, thick, crusty plaques a siam thin. Doctor-te chuan hengte hi ‘pseudomembrane’ an ti a.

‘Pseudomembrane’ tih hi eng nge ni?

Pseudomembrane hi intestine lian lining-a cell, intestine lian lining ang chi te an thih hian a lo awm thin a ni. Hetiang hian han ngaihtuah teh: hliam a awm chuan kan taksa hriselna (immune system) hian thisen var (white blood cells) chu chu hmunah chuan a thawn chhuak thin. Chutiang bawkin hetah pawh hian cell thi chi hrang hrangte chu thisen var (a bik takin neutrophils) nen an inzawm khawm a, pseudomembrane an siam a ni. Chungte chu centimetre 2 vel a zau, yellowish-white, a chung lamah chuan a sang deuh deuh a ni.

Hetiang natna lan chhuah dan hi engte nge ni?

Pseudomembranous colitis vei chuan a natna lan chhuahna a nei thei a, chungte chu:

• Pum natna nasa tak.
• Kawthalo. Hei hi ni khatah vawi tam tak a thleng thei a, a chang chuan tui angin a thleng thei bawk.
• Khawsik.
• Luhai.
• A chang chuan, i ek atanga thisen emaw, hnim emaw lo chhuak i hmu thei a, mahse hetiang hi mi zawng zawngah a thleng lo.

Eng thilin nge Pseudomembranous Colitis hi a thlen?

Chumi chhan ber leh langsar ber chu bacteria `C. diff` (Clostridioides difficile) tih a ni. He bacteria atanga toxins siam hian intestine lian lining a tichhia a ni. 10% vel chu `C. diff` infection te hi natna khirh zawk `pseudomembranous colitis` an tih thlengin a kal thei a ni. Dik tak chuan heng zinga 90% hi `C. diff` bacteria te an ni. Mahse, inflammatory bowel condition dang pawh hian hetiang chhiatna hi a thlen thei bawk.

Engtin nge C. difficile bacteria hian hei hi a nghawng?

Bacteria C. difficile hian toxin a siam a, chu chuan kan intestine lian tak chhunga cell awmte a tichhia a ni. He natna hi i ngaihtuah aia rang zawk leh nasa zawkin a darh thei a ni.

A tam zawkah chuan natna dang i neih avangin C. diff infection i nei thin.Antibiotics hman hnuah. Ngaihtuah teh, antibiotics i ei hian kan gut chhunga bacteria "tha" dang, thihna tura min puitu te hi a ni. Mahse, antibiotics tam zawk chuan he `C. diff` bacteria te an ni. Chuvangin, chu bacteria tha tak takte chu a bo tawh chuan, `C. diff` bacteria hian venhim loha thang leh darh theihna hun remchang a nei a, inelna awm lovin heng harsatnate hi a thlen thin.

Hetiang dinhmunah hian eng antibiotics nge a hlawk ber?

Dik tak chuan kan rilru chhunga bacteria tha tak tak thattu leh C. diff bacteria tichhe lo antibiotic eng pawh hian C. diff infection a thlen thei a, chu chuan pseudomembranous colitis a thlen thei bawk. Mahse, antibiotics thenkhat chuan a hlauhawm zawk nia ngaih a ni. Chung zinga ṭhenkhat chu:

• Clindamycin hmanga siam a ni
• Cephalosporin class hmanga siam damdawi a ni
• Penicillin group hmanga damdawi hman thin
• Fluoroquinolones a awm bawk
• Aztreonam tih a ni
• Carbapenems a awm bawk

Pawimawh: Hei hian heng antibiotics te hi a tha lo tihna a ni lo. Doctor-in a pek chuan a tul anga hman tur a ni. Mahse, a tul lo taka antibiotics hman hian heng ang hlauhawmna hi a thlen thei a ni.

Chhan dang a awm em?

Pseudomembranous colitis hi thil dang avanga colon inflammation a awm pawhin a awm thei a, C. diff tih loh chu. Entirna tlemte chu hetiang hi a ni:

• Staphylococcus aureus natna vei a ni
• E. coli hri kai `(E. coli kai)`
• Cytomegalovirus hrik kai a ni
• Microscopic colitis a awm thei
• Behçet natna a ni
• Ischemic colitis (colon-a thisen kal tlem avanga natna lo awm) .
• Cancer dona damdawi `(Chemotherapy damdawi)`
• Cocaine hman dan
• Vasculitis (thisen kalna kawng a na) .
• Heavy metal hmanga rimchhia a awm

Chutiang hunah chuan natna chu colitis pangngai aiin a na zawk emaw, a buaithlak zawk emaw a ni. A châng chuan, colon chhungril bang lama thisen kal chu a tlahniam (ischemia), tissue thihna (necrosis) a awm a, pseudomembrane a lo awm bawk. Tin, natna awm tawh, Inflammatory Bowel Disease (IBD) te pawhin colon hi he natna hi a vei awlsam zawk thei bawk.

He natna hi tute nge vei theihna chance sang zawk?

Pseudomembranous colitis i vei theihna a sang zawk a, chu chu:

• Damdawi inah i awm a nih chuan.
• Tun hnaia antibiotics i hman tawh chuan.
• Tun hnaia operation i neih tawh chuan.
• Mi pakhat chu nursing home-ah a awm a nih chuan.
• Kum 65 chunglam i nih chuan.
• Autoimmune natna i neih chuan.
• I immune system a chak loh chuan.
• C. diff infection i neih tawh chuan.

Pseudomembranous Colitis natna avanga harsatna awm thei te chu engte nge ni?

Hetiang dinhmun hi a nasat a, thunun harsa tak a nih chuan harsatna hlauhawm tak tak a awm thei a ni. Chuvangin hei pawh hi hriat a pawimawh hle.

• Dehydration leh electrolyte hloh: Pseudomembranous colitis na tak ah chuan ni khatah vawi 10-15 thleng riltam a awm thei. Hei hian tui tlakchhamna leh electrolyte hlohna a thlen thei a ni. Hei hian natna hlauhawm tak tak, thisen volume hniam, thisen sang hniam, kal (kidney failure) te a thlen thei a ni.
• Fluid leakage: Intestine lian bang chhia atang hian pum chhungah tui a luang lut thei a, chu chuan pum a ti na a ni. Hei hi ascites an ti a. Albumin ang chi protein te pawh hi intestine lian atang hian a bo thei bawk. Albumin a tlem chuan thisen kalna kawng atang hian tui a chhuak a, chu chuan taksa peng hrang hrangah a hring (edema) a siam thin.
• Toxic megacolon: Colon natna nasa tak, thunun theih loh, colon a hring lutuk a, hna a thawk tawh lo thei. A tirah chuan colon chhunga thau te chu an inzawm khawm tawh lo va, bawlhhlawh kalna tur a tikhawlo thin. Colon a lo hring chhunzawm zel chuan a bangte chu a chhe thei a, chu chuan a chhunga thil awmte chu pum chhungah a luang lut thei a ni. Hei hi peritonitis an ti a. Hei hian nunna a tichhe thei a ni.
• Gastrointestinal perforation: Intestine lian bangah khur a awm thei a, toxic megacolon tel lovin a awm thei. Hei hi intestine lianah ulcer a lo awm a, wall kaltlangin a awm thei a, a nih loh leh intestine wall-ah tissue thihna nasa tak (necrosis) a awm chuan a thleng thei bawk. Intestine lian chhunga bacteria leak in abdominal cavity (peritonitis) chuan thisenah a darh thei (septicemia).
• Sepsis: Sepsis hi thisenah bacteria awm khawm (septicemia) avanga lo awm a ni. Sepsis hi natna khirh tak, nunna atana hlauhawm tak a ni a, taksa pum puiah a darh zel a ni. Hei hian septic shock, multiple organ failure, thihna thlengin a thlen thei a ni.

Heng harsatnate hi hriat a hlauhawm thei hle. Mahse, mi zawng zawng chungah a thleng lo tih hre reng ang che. A hmaa hriatchhuah leh enkawl dan dik chuan heng natna khirh tak takte hi a veng thei a ni.

He natna hi engtin nge kan hriat theih ang?

Doctor chuan i natna lan chhuah dan leh i hriselna chanchin a zawt hmasa ang che. Tichuan, i natna lan chhuah chhan hriat tumin test hrang hrang an ti thei ang. Entirnan, thisen test te, scan ang chi imaging test te, poop test te an order thei bawk. Heng test te hian infection, inflammation leh risk factor dangte an zawng thin.

I stool test hian C. diff infection a awm leh awm loh chiang takin a enfiah ang. Hmuh a nih chuan enkawl tan nghal a ni ang. Complication i neih loh a, enkawlna i dawng tha a nih chuan i intestine lian chhungah pseudomembrane en tur chhan chiang tak a awm lo mai thei.

A châng chuan imaging test (CT scan ang chi)-ah hian pseudomembranous colitis chhinchhiahna a lang thei bawk. Colon wall a thim ("thumbprint sign" emaw "accordion sign" emaw ang chi) a nih chuan doctor chuan test dang tih belh a rel thei ang.

A dawtah chuan thuk zawka en tur chuan intestine lian chhung lam en thei test i tih a ngai a ni. Colonoscopy an ti a. Hemiah hian camera nei tube hmangin intestine lian chhung chu an en thin. ‘Pseudomembrane’ an tih hi i hmuh chuan, chuta tang chuan tissue te tak te (biopsy) la chhuakin laboratory-ah an thawn a, natna a finfiah thin.

Enkawlnate chu engte nge ni?

Enkawlna chu he natna thlentuah a innghat a ni.

• C. diff ang chi bacteria infection a nih chuan a tana thawk thei antibiotics bik i pek a ngai ang.
• Hetiang dinhmun hi damdawi dang i ei avanga lo awm emaw, a zual emaw a nih chuan, chu damdawi chu tihtawp emaw, thlak emaw a ngai mai thei.
• A then phei chuan intestine lianah inflammation tihziaawmna turin damdawi an pe thei bawk.

Mi thenkhat chuan supportive care chauh an mamawh. Entirnan, intravenous fluids (IV fluids) te chu fluid retention-a pui turin emaw, IV nutrition hmangin colon chawlh hahdamna tur a ni. Mi dangte chu harsatna an neih chuan enkawl an ngai mai thei a, intensive care unit-ah pawh enkawl an ngai thei bawk. Mi thenkhat, colitis na tak tak emaw, harsatna nei emaw chuan colectomy (colon chhia tihbo nan surgery) an neih a ngai mai thei.

`C. diff`?

Pseudomembranous colitis thlentu chu C. diff infection a nih chuan a enkawlna tur damdawi engemaw zat a awm a. I doctor chuan i tana tha ber tur a thlang ang. C. diff infection damdawi pek thinte chu:

• Metronidazole a ni
• Vancomycin hmanga siam a ni
• Fidaxomicin hmanga siam a ni

Pseudomembranous Colitis hi ven theih a ni em?

He natna laka invenna kawng pawimawh ber chu C. diff bacteria darh zel tur ven hi high-risk community (a bik takin damdawi in leh nursing home) ah te a ni. Heng setting-a awmte hi an kai tam zawk a, pseudomembranous colitis ang chi symptom na tak tak an nei tam zawk bawk.

Chuvangin, heng institution chi hrang hranga healthcare worker te hian C. diff infection control nan hmalakna bik an nei thin:

• Isolation: C. diff vei te chu pindan hranah dah an ni a, a nih loh leh hri kai dangte chauh awmna room-ah dah an ni bawk. Room chhunga luh dawnin disposable gloves hman a ni.
• Kut sil: Sahbawn leh tui lum hmanga kut sil fo hi C. diff laka invenna tha ber a ni. He bacteria hi hand sanitizer lakah a do thei a ni. A bik takin chaw kan khawih hmaa kut sil hi a pawimawh hle.
• Disinfection: Disinfectant pangngai hian C. diff a that thei lo. Mahse, chlorine hmanga siam thilte chuan. Hri kai miin a lo tawn tawhna hmun zawng zawng chu uluk taka disinfect vek a pawimawh.

He natna hi a dam kim thei ang em? Thihna hi engzat nge ni?

Ni e, pseudomembranous colitis hi enkawlna hmangin a dam vek thei a ni. A tam zawkah chuan symptoms chu a reh thuai ang. Mahse, mi thenkhat chuan mi dangte aiin enkawlna tam zawk leh hun rei zawk an mamawh mai thei. C. diff infection awm reng, control harsa tak i neih chuan enkawl nan operation tenau i neih a ngai mai thei. A \henah chuan zai a ngai mai thei.

Thihna lam hawi chuan pseudomembranous colitis vei zinga 2% chauh an thi. Mahse, hun rei tak enkawl tawh leh taksa hriselna chak lote tan chuan he rate hi 15% vel a ni thei. A hmaa kan sawi tawh ang khan toxic megacolon an tih complication hi a lo awm a nih chuan thihna rate hi 35% ah a kai chho thei a ni. Chuvang chuan enkawl vat a pawimawh a ni.

Engtikah nge doctor i hmuh ang?

Heng symptoms te hi i neih chuan doctor rawn la nghal rawh:

• Pum natna nasa tak emaw, pum na emaw.
• Ni khatah vawi nga aia tam riltam i neih chuan.
• Thluak chhungah thisen a awm chuan.
• Ni thum chhung zet i ril i la chhuak lo a nih chuan.
• Ni khat chhung i zun loh chuan, a nih loh leh i zun rawng a dum a nih chuan.
• Ni thum chhung khawsik 39 degree Celsius (102 degree Fahrenheit) aia sang i neih chuan.

A tawp berah chuan thil hriat reng tur

Colitis thlentu bacteria infection hi a tam hle a, a tam zawkah chuan a na lo hle. C. diff vei zawng zawng hian pseudomembranous colitis an vei vek dawn lo. Mahse, i tih chuan a hlauhawm deuh thei. I colon chhungril atanga a chhiat tih hriat hi a hlauhawm thei a, natna leh thisen chhuah ang chi symptoms a awm thei bawk.

Hetiang symptoms i neih chuan damdawi lam enkawlna bik i mamawh mai thei. Mahse, enkawl dan dik tak chuan i colon chu a dam thei tih hre reng ang che.Mucous membrane te hi kan colon lining ang bawkin a chhiat loh chuan a dam tha hle. I colitis symptoms a reh lo nia i hriat chuan doctor nen inbia ang che. I natna chhan zawng chhuak turin a pui thei che a, tihtawp nan a tul angin a ti thei che a, i colon chu a mamawh chawlhna a pe thei bawk. A pawimawh ber chu hlauthawng lo tur leh damdawi lam thurawn lak vat hi a ni.

` Pseudomembranous Colitis, C. diff, ril\am, pum na, ril\am, antibiotics