Kodi inunso muli ndi vuto ndi thumba lanu? Tiyeni tikambirane za Pouchitis! (Pouchitis)

Kodi ndinu munthu amene mwachitidwa opaleshoni ya m'matumbo ndi m'matumbo chifukwa cha matenda ena ndipo m'malo mwake mwapangidwa 'thumba la ileal'? Ngati ndi choncho, nthawi zina mungakumane ndi kusasangalala kokhudzana ndi thumba ili. Limodzi mwa mavuto omwe angabwere ndi lomwe tikulankhula lero, 'Pouchitis'. Musachite mantha mukamva izi. Tiyeni tikambirane zonse momveka bwino komanso mosavuta.

Kodi matenda a Pouchitis ndi chiyani? Tiyeni timvetse mosavuta.

Choyamba, tiyeni tiwone chomwe 'thumba la ileal' ili lili. Pambuyo poti m'mimba mwanu ndi m'matumbo mwachotsedwa kwathunthu (kuchotsa kwathunthu kwa proctocolectomy), muyenera njira yatsopano yotulutsira ndowe zanu m'thupi lanu. Njira imodzi yothetsera vutoli ndi opaleshoni ya thumba la ileal. Chomwe chimachitika apa ndi chakuti madokotala amagwiritsa ntchito gawo lomaliza la matumbo anu ang'onoang'ono (ileum) kuti apange kapangidwe kakang'ono kofanana ndi thumba.

Kotero, zomwe matumbo anu akuluakulu ankachita, zomwe zinali kusonkhanitsa ndi kusunga ndowe kwakanthawi asanachoke, tsopano zachitika ndi thumba limenelo. Mwa kuyankhula kwina, gawo la matumbo anu ang'onoang'ono tsopano limagwira ntchito ngati matumbo akulu.

Pouchitis ndi pamene thumba limatupa kapena kutupa kuchokera mkati. Ndi matenda ofanana ndi colitis (kutupa kwa m'matumbo) kapena proctitis (kutupa kwa rectum). Imeneyi ndi matenda ofala kwa munthu amene ali ndi thumba.

Kwa anthu ambiri, izi ndi zakanthawi kochepa (acute pouchitis), koma kwa anthu ena zimatha kukhala matenda osatha (chronic pouchitis) kapena matenda obwerezabwereza.

Kodi zizindikiro za pouchitis ndi ziti?

Ngati muli ndi pouchitis, mutha kukhala ndi chimodzi kapena zingapo mwa zizindikiro izi. Ndikofunikira kuzidziwa.

Nchifukwa chiyani Pouchitis imachitika?

Choyambitsa chenicheni cha izi sichikudziwika 100%, koma lingaliro lalikulu ndilakuti pali kusalingana kwa mitundu ya mabakiteriya omwe amakhala mkati mwa thumba.

Tangoganizirani, pamene gawo la m'mimba mwanu laling'ono likugwira ntchito ngati matumbo akuluakulu, mitundu yatsopano ya mabakiteriya imabwera. Pali 'nkhondo' pang'ono pakati pa mabakiteriya atsopano ndi akale awa. Kusintha kumeneku kungapangitse chitetezo cha mthupi kuganiza kuti pali matenda pamenepo. Chifukwa chake, kutupa kumachitika, kutanthauza kuti thumba limatupa.

Nthawi zina, mabakiteriya oyambitsa matenda amatha kukula kwambiri ndikuyambitsa matenda. Kulinganiza kwa mabakiteriya kumeneku kumasintha pambuyo pa opaleshoni, zomwe zimapangitsa kuti mabakiteriya owopsa azitha kukula bwino.

Zinthu zina zomwe zimapangitsa kuti pakhale pouchitis yosatha

Kwa anthu ena, pouchitis imapitirira kapena siigwira bwino chithandizo. Izi zitha kuchitika chifukwa cha zinthu zina.

• Matenda omwe analipo kale (IBD): Ngati munayenera kuchotsedwa m'matumbo chifukwa cha matenda otupa m'matumbo (IBD) monga Ulcerative Colitis kapena matenda a Crohn, muli pachiwopsezo chachikulu chotenga pouchitis. Izi zili choncho chifukwa njira yomweyi yomwe idayambitsa matendawa ingakhudzenso thumba.
• Mabakiteriya osagwira maantibayotiki: Matenda ena a bakiteriya, monga C. difficile, ndi ovuta kuwathetsa ndi maantibayotiki. Komanso, mukapitiriza kugwiritsa ntchito maantibayotiki, mabakiteriya ena amakhala osagwira nawo ntchito. Izi zingapangitsenso kuti mabakiteriya asagwire bwino ntchito m'thumba.
• Matenda ena: Nthawi zina, kutupa kwa thumba kungayambitsidwenso ndi matenda a mavairasi (cytomegalovirus) kapena fungal (candidiasis).
• Chitetezo chamthupi chofooka: Ngati chitetezo chamthupi lanu chafooka chifukwa cha matenda ena kapena mankhwala ena, mphamvu yanu yolimbana ndi matenda imachepa.
• Kugwiritsa ntchito mankhwala ochepetsa ululu (NSAIDs): Kugwiritsa ntchito mankhwala ochepetsa ululu kwa nthawi yayitali komanso mopitirira muyeso monga ibuprofen ndi aspirin (mankhwala osapweteka a steroidal - NSAIDs) kungawononge mkati mwa thumba.
• Kuchepa kwa magazi (ischemia): Ngakhale kuti sizichitika kawirikawiri, kutupa kungachitike chifukwa cha kutsekeka kwa magazi kupita ku thumba.
• Matenda a PSC: `(Primary sclerosing cholangitis - PSC)` ndi matenda omwe amayambitsa kutupa kwa ndulu ya chiwindi. Anthu omwe ali ndi vutoli ali pachiwopsezo chachikulu chotenga pouchitis.

Kodi mavuto omwe angakhalepo chifukwa cha pouchitis ndi ati?

Pouchitis yachikhalire nthawi zambiri imayambitsa mavuto akulu, koma ngati vutoli likupitirira kapena silikuyankha chithandizo, lingayambitse mavuto ena.

Kodi mungadziwe bwanji ngati muli ndi pouchitis?

Dokotala wanu akamaliza kumvetsera zizindikiro zanu, adzakuyesani kangapo kuti atsimikizire vutoli. Chofunikira kwambiri ndi pouchoscopy (endoscopy) .

Izi zimaphatikizapo kulowetsa chubu choonda kwambiri chokhala ndi kamera yolumikizidwa kudzera mu anus yanu ndikuyang'ana mkati mwa thumba. Dokotala amatha kuwona ngati pali kutupa kapena zilonda mkati mwa thumba. Nthawi yomweyo, chidutswa chaching'ono cha minofu (biopsy) chingatengedwe kuti chikaunikidwe.

Kuphatikiza apo, mayeso otsatirawa angachitike kuti awone momwe thumba ndi zomangira zake zilili:

• Kusiyanitsa Pouchography `(pouchogram)`
• `CT scan`
• `MRI`

Kodi mankhwala a pouchitis ndi otani?

Njira zochiritsira zimadalira mtundu wa pouchitis womwe muli nawo.

Chithandizo cha Acute Pouchitis

Chithandizo choyamba ndi kumwa mankhwala opha maantibayotiki kwa milungu iwiri. Kwa anthu ambiri, izi zidzathetsa zizindikiro zawo kwathunthu. Ngakhale zizindikiro zanu zitapita bwino, ndikofunikira kumwa mankhwala onse omwe dokotala wanu wakupatsani.

Chithandizo cha Pouchitis Yobwerezabwereza

Ngati pouchitis ibwereranso pambuyo pa chithandizo, dokotala angakupatseni mankhwala omwewo a maantibayotiki. Komabe, ngati ichitika katatu pachaka, imaonedwa ngati matenda osatha ndipo chithandizo chosamalira chikhoza kuyambitsidwa kuti chisabwererenso. Pachifukwa ichi,

• Kupereka mankhwala opha maantibayotiki kwa nthawi yayitali pa mlingo wochepa.
• Kugwiritsa Ntchito Ma Probiotics: Ma Probiotics, omwe ali ndi mabakiteriya opindulitsa, angathandize kubwezeretsa bwino mabakiteriya omwe ali m'thumba.

Chithandizo cha pouchitis chomwe sichiyankha mankhwala opha tizilombo (CARP)

Ngati maantibayotiki sathandiza, kapena ngati adathandiza kale, vutoli limatchedwa ``Chronic antibiotic-resistant pouchitis (CARP)''. Pano, dokotala adzafufuza zifukwa zina ndikusankha chithandizo moyenerera. Pali njira zosiyanasiyana zochiritsira izi.

• Ma enema okhala ndi mankhwala monga `Mesalamine` kapena `Bismuth`
• Corticosteroids, yomwe imachepetsa kutupa
• Mankhwala oletsa chitetezo chamthupi omwe amawongolera magwiridwe antchito a chitetezo chamthupi
• Mankhwala amakono monga `Biologics`
• Mankhwala apadera monga `Fecal microbiota transplant (FMT)`

Kodi pouchitis ingathetsedwe ndi chakudya ndi zakumwa?

Inde, mpaka pamlingo winawake n'zotheka. Zakudya zanu zingathandize kupewa matenda a pouchitis komanso zimathandiza kuthana ndi zizindikiro zikachitika.

Chofunika: Zakudya zochepa za FODMAP si chinthu chomwe muyenera kutsatira nthawi zonse. Ndi chinthu chomwe muyenera kutsatira kwa kanthawi kochepa, mukakhala ndi zizindikiro, motsogozedwa ndi dokotala kapena katswiri wa zakudya.

Ngakhale moyo umakhala wosavuta mukachita opaleshoni ya thumba la ileal, ndikwachibadwa kukhala ndi nkhawa mavuto monga pouchitis akabuka. Koma kumbukirani, iyi ndi vuto lochiritsika lomwe limakhudza anthu ambiri. Mutha kugwira ntchito ndi dokotala wanu kuti mupeze yankho labwino kwambiri kwa inu.