Kodi pali vuto ndi njira zotulutsira ndulu m'chiwindi chanu? Tiyeni tiphunzire bwino za Primary Biliary Cholangitis (PBC)!

Kodi mumamvanso ngati mwatopa kwambiri, mwatopa ngakhale osachita chilichonse? Kapena nthawi zina mumamva ngati mukukanda khungu lanu popanda chifukwa? Nthawi zina, ngakhale sitisamala kwambiri ndi izi, zitha kukhala chizindikiro cha vuto la chiwindi, chimodzi mwa ziwalo zofunika kwambiri m'thupi lathu. Lero tikambirana za matenda otere omwe amakhudza chiwindi, ndipo ngakhale dzinalo lingawoneke lovuta pang'ono, n'losavuta kumva. Ndi (Primary Biliary Cholangitis) , yomwe imadziwikanso kuti (PBC) mwachidule.

Kodi Primary Biliary Cholangitis (PBC) ndi chiyani? Tiyeni timvetse mosavuta!

Chabwino, dzina ili likuoneka lalitali pang'ono, sichoncho? Tiyeni tiwone tanthauzo lake.

"Cholangitis" ndi kutupa kwa ducts za bile . Mukudziwa, madzi otchedwa bile, omwe amapangidwa m'chiwindi chathu, amayenda kudzera m'machubu ang'onoang'ono. Machubu amenewo amatchedwa ducts za bile. "Biliary" amatanthauzanso chinthu chogwirizana ndi ducts izi za bile. "Primary" amatanthauza "basic" kapena "start".

Kenako, mukaphatikiza zonsezi, Primary Biliary Cholangitis imatanthauza kuti, osati chifukwa cha matenda ena aliwonse, matenda, kapena kutsekeka, koma chifukwa cha matendawa, pali kutupa kwa ndulu mkati mwa chiwindi chanu . Popeza kutupa kumeneku sikumachitika chifukwa cha chilichonse, simukudziwa nthawi yomwe kudzasiya. Chifukwa chake ndi vuto lomwe likupita patsogolo pang'onopang'ono.

Matendawa kale ankatchedwa Primary Biliary Cirrhosis chifukwa amatha kupangitsa chiwindi kukhala cholimba komanso chotupa, zomwe zimapangitsa kuti munthu adwale matenda otchedwa cirrhosis .

Kodi (PBC) imakhudza bwanji thupi lathu?

Tangoganizirani, chimachitika ndi chiyani ngati gawo la thupi lathu likutupa nthawi zonse? Kawirikawiri, kutupa kwakanthawi ndi gawo la njira yochiritsira. Koma ngati kutupa kwamtunduwu kosatha kupitirira, m'malo mochira, derali limayamba kuvulala.

Ndicho chimene chimachitika ndi ducts za ndulu mkati mwa chiwindi chanu mu PBC. ducts izi zimakhala zochepa ndikutsekedwa ndi zipsera . Kenako ndulu yopangidwa ndi chiwindi singathe kuyenda bwino. ndulu iyi imayamba kubwerera m'chiwindi. ndulu iyi ikachulukana, imawononga maselo a chiwindi ndikuyambitsa kutupa m'chiwindi. Pakapita nthawi, minofu ya chiwindi yathanzi iyi imalowedwa m'malo ndi minofu ya zipsera. Pamapeto pake, chiwindi chimalephera kugwira ntchito bwino, zomwe tatchula kale (cirrhosis) .

Kodi PBC ndi vuto lalikulu?

Inde, Primary Biliary Cholangitis ndi matenda osatha komanso opitirira muyeso . Izi zikutanthauza kuti sikuti imangochira, imatha kuipiraipira pakapita nthawi. Siimaipiraipira nthawi imodzi, imaipiraipira pang'onopang'ono, kudzera m'magawo osiyanasiyana. Mwina simungakhale ndi zizindikiro zilizonse poyamba.

Komabe, chinthu choopsa kwambiri pa izi ndichakuti zimatha kupangitsa kuti chiwindi chisagwire bwino ntchito komanso kufa ngati sichinaikidwenso chiwindi .

Koma mwamwayi, pali mankhwala omwe angathandize kuchepetsa kufalikira kwa matendawa . Ndipo si aliyense amene amapita ku gawo lomalizali. Choncho musadandaule.

Kodi kusiyana pakati pa (PBC) ndi (PSC) ndi kotani?

Mwina munamvapo za matenda ena otchedwa Primary Sclerosing Cholangitis, kapena PSC. Matenda awiriwa ndi ofanana kwambiri, koma pali kusiyana kwakukulu.

• Mu PBC , njira za ndulu zomwe zili mkati mwa chiwindi chanu (intrahepatic bile ducts) zokha ndi zomwe zimakhudzidwa.
• Komabe, mu PSC, njira zotulutsira ndulu mkati mwa chiwindi komanso kunja kwa chiwindi (njira zotulutsira ndulu) zimakhudzidwa .
• Palinso kusiyana pang'ono pakati pa anthu omwe matenda awiriwa amapezeka kwambiri.
• Chofunika ndichakuti, ngakhale pali mankhwala ochiritsira (PBC), palibe chithandizo chothandiza chomwe chapezeka cha (PSC) .

Ndani amene ali ndi mwayi waukulu wopeza matendawa (PBC)?

Ngakhale izi zingawoneke zodabwitsa, akazi ali ndi mwayi wochuluka wopeza matenda a PBC kuposa amuna (10:1) . Malinga ndi ziwerengero ku United States, akazi pafupifupi 60 mwa 100,000 ali ndi matendawa, poyerekeza ndi amuna pafupifupi 15 mwa 100,000.

Anthu ambiri amapezeka ndi matendawa akakwanitsa zaka 40. Matendawa amapezeka kwambiri ku Scotland, mayiko a ku Scandinavia, komanso kumpoto chakum'mawa kwa England.

Komanso, ngati inu kapena wina m'banja mwanu muli ndi matenda ena odziteteza ku matenda a autoimmune, muli ndi mwayi waukulu wopeza matenda a PBC . Izi zikusonyeza kuti pakhoza kukhala kulumikizana kwa majini .

Kodi zizindikiro za matenda a (PBC) ndi ziti?

Anthu ambiri omwe ali ndi PBC samakhala ndi zizindikiro zilizonse kumayambiriro kwa matendawa. Koma matendawa akamakula m'pamene zizindikiro zokhudzana ndi ndulu zimayamba kuonekera. Zizindikiro zoyamba komanso zodziwika bwino zomwe zimapezeka mwa anthu omwe ali ndi PBC ndi izi:

• Kutopa kwambiri (pafupifupi 65% ya anthu)
• Khungu loyabwa (pafupifupi 55% ya anthu)

Zizindikiro zimenezi zimakhudza aliyense mosiyana. Anthu ena akhoza kukhala nazo msanga matendawa akangoyamba kumene, pomwe ena akhoza kukhala nazo pambuyo pake. Zingakhalenso zoopsa kwambiri pa gawo lililonse la matendawa. Zikuwoneka kuti palibe kugwirizana kwakukulu pakati pa kuopsa kwa zizindikiro zanu ndi kukula kwa matendawa. Komabe, kafukufuku wina akusonyeza kuti anthu omwe ali ndi zizindikiro zoopsa akangoyamba kumene matendawa amatha kukula mofulumira .

Kodi mavuto a matenda a ndulu ndi otani?

Poyamba, simungazindikire kuti muli ndi vuto ndi njira zanu zotulutsira ndulu. Koma matendawa akamakula, mavuto osiyanasiyana amayamba kuchitika. Ndudu yomwe singathe kuyenda bwino,Zimayamba kutuluka m'magazi, zomwe zimayambitsa matenda. Komanso, ngati ndulu singathe kufika m'thupi bwino, kugaya chakudya kumalephereka. Chifukwa ndulu ndi yofunika kwambiri pogaya chakudya.

Pambuyo pake, zipsera za chiwindi zimathanso kukhudza mitsempha yamagazi yomwe imadutsa m'chiwindi, zomwe zimapangitsa kuti munthu akhale ndi vuto lotchedwa portal hypertension , lomwe limatanthauza kuthamanga kwa magazi m'mitsempha imeneyo.

1. Kusayamwa mafuta

Ngati kugaya chakudya kwanu sikulandira ndulu yokwanira, sikungathe kusweka bwino ndikuyamwa mafuta omwe ali mu chakudya chanu. Kuchepa kwa kuyamwa mafuta kumeneku kungayambitse zotsatirazi:

• Cholesterol yambiri m'magazi .
• Mafuta amaikidwa pansi pa khungu .
• Matumbo onenepa kapena kutsegula m'mimba .
• Kuchepetsa thupi .
• Kuchepa kwa mavitamini osungunuka mafuta A, D, E, ndi K.
• Matenda a mafupa otchedwa osteoporosis ndi matenda ochepetsa mafupa omwe amayamba chifukwa cha kuchepa kwa kuyamwa kwa vitamini D wosungunuka m'mafuta.

2. Kuthamanga kwa magazi kwa portal

Pamene mitsempha yamagazi yomwe imadutsa m'chiwindi yatsekeka chifukwa cha zipsera, kuthamanga kwa magazi kwa portal komwe kwatchulidwa pamwambapa kumachitika, zomwe zikutanthauza kuti kuthamanga kwa magazi m'mitsempha imeneyo ndi mitsempha ina yolumikizidwa nayo kumawonjezeka. Kuthamanga kwa magazi kwa portal kumeneku kungayambitse matenda otsatirawa:

• Chiwindi chokulirapo .
• Nthata yokulirapo .
• Chimfine chobwerezabwereza ndi matenda ena (kuchepa kwa chitetezo chamthupi).
• Kutupa ndi kutuluka magazi mosavuta (ma platelet otsika m'magazi - (thrombocytopenia) ).
• Kuoneka kwa mitsempha yamagazi yofiira, yofanana ndi kangaude (spider angiomas) pamwamba pa khungu.
• Mitsempha yotupa kapena yoboola m'mimba ndi m'mimba (mitsempha yotupa - varices) .
• Kutuluka magazi m'mimba .
• Kuchulukana kwa madzi m'mimba (ascites) .
• Kutupa (edema) kwa thupi la pansi.
• Nthawi zina kusokonezeka maganizo kumachitika chifukwa cha kuchuluka kwa poizoni m'magazi.

Kodi zifukwa za (PBC) ndi ziti?

Mu PBC, chitetezo chanu chamthupi chimaukira maselo omwe ali mkati mwa ndulu ya chiwindi chanu . Zili ngati chitetezo chamthupi chimaona maselowa ngati olowa m'thupi. Ichi ndi chomwe timachitcha matenda odziteteza okha., kapena matenda odziteteza ku matenda a autoimmune. Pachifukwa chosadziwika bwino, chitetezo cha mthupi chimawononga maselo athanzi, ndipo palibe njira yochiletsa. Kutupa kumeneku komwe kukuchitika ndi komwe kumayambitsa zipsera.

Sitikudziwa bwino chifukwa chake matenda a autoimmune awa amakula. Komabe, zikuwoneka kuti pali chifukwa cha majini . Anthu ambiri omwe amadwala matenda a autoimmune amakhala ndi mbiri ya m'banja lawo ya matendawa, ndipo amatha kudwala mitundu ingapo ya matenda a autoimmune.

Zikuonekanso kuti pali chinthu china chomwe chimayambitsa matenda . Izi zikutanthauza kuti, mwina china chake m'chilengedwe chingayambitse matendawa. Chingakhale mankhwala omwe mumakhala nawo, kapena chingakhale matenda.

Kodi matenda a PBC amapezedwa bwanji?

Dokotala wanu adzakufunsani kaye za mbiri yanu yachipatala ndi zizindikiro zake, adzakuyesani thupi, kenako adzakuyesani magazi kuti aone ngati muli ndi PBC.

Mayeso a magazi amenewa makamaka amafufuza ma antibodies enaake okhudzana ndi PBC, makamaka antibody yotchedwa antimitochondrial antibody (AMA) . Amafufuzanso ma enzymes ambiri a chiwindi , makamaka alkaline phosphatase (ALP), omwe amasonyeza kuwonongeka kwa chiwindi.

Ngati zotsatira za mayeso anu zili ndi PBC, dokotala wanu adzafunanso kuwona zithunzi za chiwindi chanu ndi dongosolo lanu la biliary . Izi zingathandize kuchotsa zina zomwe zimayambitsa zizindikiro zanu ndikuwona momwe matendawa akulira. Nthawi zambiri, chinthu chosavuta monga ultrasound ya m'mimba chimachitika kaye. Koma nthawi zina, mayeso monga MRI (magnetic resonance imaging) angafunike kuti mupeze zithunzi zomveka bwino.

Pafupifupi 5% ya anthu omwe ali ndi PBC akhoza kukhala ndi mayeso a AMA omwe alibe, koma akhoza kukhala ndi zizindikiro zina. Ngati izi zitachitika, dokotala wanu angafunike kutenga chidutswa cha minofu kuchokera ku chiwindi chanu (biopsy ya chiwindi) kuti atsimikizire PBC. Izi nthawi zambiri zimachitika pambali pa bedi mwa kuyika singano mu chiwindi chanu. Chitsanzo chaching'ono cha minofu yotengedwa kuchokera ku singano chimatumizidwa ku labu kuti chikawunikidwe pansi pa maikulosikopu.

Kodi mankhwala a Primary Biliary Cholangitis ndi ati?

Madokotala amagwiritsa ntchito zotsatirazi pochiza matenda a PBC:

Mankhwala

Matenda a PBC sangachiritsidwe kwathunthu . Komabe, mankhwala amatha kuletsa kufalikira kwa matendawa ndikukonza thanzi lanu .

(Ursodeoxycholic acid - UDCA)Ndi mtundu wa asidi wa bile. Umathandiza kuchotsa ndulu m'chiwindi ndikuchepetsa kuwonongeka kwa chiwindi. Mankhwalawa amagwira ntchito bwino kwa pafupifupi theka la anthu omwe ali ndi PBC, makamaka kumayambiriro kwa matendawa. Kwa anthu omwe sayankha ku UDCA, madokotala nthawi zina amalimbikitsa mtundu wina wa asidi wa bile wotchedwa obeticholic acid .

Komanso, zizindikiro zanu zitha kuchiritsidwa ndi mankhwala osiyana.

• Pakhungu loyabwa: mankhwala oletsa kuyabwa (monga diphenhydramine - monga Benadryl®), chithandizo cha kuwala kwa ultraviolet, kapena mankhwala ochepetsa asidi a bile monga cholestyramine angaperekedwe.
• Pewani zotsatirapo zoyipa monga kusowa kwa mavitamini ndi kufooka kwa mafupa: Zakudya zowonjezera mavitamini zingathandize.
• Anthu ena omwe ali ndi kutopa angapindule ndi zinthu zolimbikitsa thupi monga modafinil.

Opaleshoni

Ngati vuto lanu silikuyenda bwino ndi mankhwala, ndipo ntchito ya chiwindi chanu ikupitirira kuchepa, dokotala wanu angakuikeni pamndandanda woyembekezera kuikidwa chiwindi . Anthu omwe ali ndi PBC amapeza zotsatira zabwino kwambiri ndi opaleshoni yoika chiwindi.

Monga matenda ena odziteteza ku matenda a autoimmune, matenda a PBC amatha kubwereranso munthu akangoikidwa chiwindi, koma kuchuluka kwa matendawa kumachepa kwambiri nthawi yachiwiri. Moyo wa munthu akaikidwa chiwindi ndi wabwinobwino.

Kodi muyenera kuyembekezera chiyani mukakhala ndi vutoli?

Nthawi zambiri, Primary Biliary Cholangitis imakula pang'onopang'ono . Kuzindikira msanga ndi kulandira chithandizo mwachangu kungalepheretse kapena kuchedwetsa magawo otsiriza a matendawa ndi zovuta zake.

Anthu ambiri amatha kuwongolera bwino zizindikiro zawo ndi mankhwala. Komabe, kuchiza kutopa komwe kumachitika ndi PBC kungakhale kovuta. Anthu ambiri amakhala zaka zambiri osasokoneza kwambiri moyo wawo watsiku ndi tsiku chifukwa cha PBC.

Komabe, si aliyense amene amapezeka ndi matenda a PBC akangoyamba kumene. Ndipo anthu ena amakhala ndi matenda oopsa kwambiri. Zizindikiro monga kutopa kwambiri komanso kuchuluka kwa bilirubin m'magazi zingasonyeze kuti matendawa amatha kupitirira msanga mpaka kulephera kwa chiwindi. Ngati mufika pamlingo umenewo, mudzafunika kuikidwa chiwindi kuti mukhale ndi moyo. Koma kwa iwo omwe ali ndi PBC omwe adayikidwa chiwindi bwino, chiyembekezo chake ndi chabwino kwambiri.

Kodi mungakhale ndi moyo wautali bwanji (PBC)?

Kawirikawiri zimatenga pakati pa zaka 15 ndi 20 kuti matendawa afike pachimake.

Gawo loyamba, zomwe zikutanthauza kuti ngakhale mutayesedwa ndikupezeka kuti muli ndi PBC, mungakhalebe opanda zizindikiro kwa nthawi yayitali. Pafupifupi theka la anthu adzayamba kukhala ndi zizindikiro mkati mwa zaka zisanu kapena khumi zikubwerazi.Mukayamba kuona zizindikiro, anthu ambiri amakhala ndi moyo zaka pafupifupi 10. 65% ya anthu omwe adapatsidwa chiwindi bwino amakhala ndi moyo zaka 10.

Kodi ndimadzisamalira bwanji ndikakhala ndi (PBC)?

Kudya zakudya zabwino komanso moyo wathanzi kudzakuthandizani kuti chiwindi chanu chikhale ndi thanzi kwa nthawi yayitali.

Mwachitsanzo:

• Siyani kusuta fodya, kumwa mowa, ndi kugwiritsa ntchito mankhwala osokoneza bongo ndi mankhwala molakwika kapena chifukwa chosangalala.
• Idyani zakudya zochepa zokonzedwa ndi zopakidwa m'matumba koma idyani zakudya zonse.
• Chepetsani mafuta okhuta ndipo idyani mafuta ambiri osakhuta omwe ali ndi thanzi labwino.
• Yendani mofulumira tsiku lililonse. Kuchita masewera olimbitsa thupi kungathandize kuti mafupa anu akhale olimba.

Anthu ambiri omwe ali ndi Primary Biliary Cholangitis amatha kukhala zaka zambiri popanda mavuto akulu. Komabe, kukhala ndi matenda opitilira patsogolo, nthawi zina oopsa kungakukhumudwitseni. Lankhulani ndi dokotala wanu za njira zochepetsera kupsinjika kwanu kwakuthupi, kwamaganizo, komanso kwamalingaliro . Komanso, funsani za maukonde othandizira omwe amathandiza anthu omwe ali ndi PBC. Kumbukirani, thanzi lanu lonse ndi lalikulu kwambiri kuposa matenda okha.

Uthenga Wopita Nawo Kunyumba

Matenda a Primary Biliary Cholangitis (PBC) ndi matenda osatha omwe amakhudza ducts ya ndulu ya chiwindi. Akuti amayamba chifukwa cha vuto la autoimmune . Ngakhale kuti zizindikiro sizingawonekere poyamba, zizindikiro monga kutopa ndi kuyabwa pakhungu zimatha kuyamba pakapita nthawi. Pamene matendawa akupita patsogolo , angayambitse matenda a cirrhosis ndi kulephera kwa chiwindi.

Komabe, matendawa akapezeka msanga komanso kugwiritsa ntchito mankhwala monga (UDCA), amatha kuthetsedwa . Anthu ena angafunike kuikidwa chiwindi.

Chofunika kwambiri ndikupempha upangiri kwa dokotala ndikukhala ndi moyo wathanzi ngati muli ndi zizindikiro izi. Simuli nokha, musaope kulankhula za izi ndikupeza thandizo.

Cholangitis Yoyamba ya Biliary, PBC, matenda a chiwindi, njira zotulutsira ndulu, cirrhosis, autoimmune