Ese ufite ububyimbirwe mu 'mufuka' wawe? Reka tuvuge kuri pouchitis!

Ese wigeze kubagwa mu mufuka w'inyuma? Cyangwa hari umuntu uzi wigeze abagwa? Abantu babagwa mu mufuka w'inyuma rimwe na rimwe bashobora kurwara indwara yitwa pouchitis. Nubwo ishobora kubabaza gato, nta mpungenge ifite. Reka tubiganireho mu buryo bworoshye ushobora gusobanukirwa.

Pouchitis ni iki mu by'ukuri?

Mu magambo make, pouchitis ni ukubyimba k'agapfunyika kawe k'inyuma . Reka turebe icyo agapfunyika kawe k'inyuma ari cyo. Urugero, hari abantu bafite ikibazo gikomeye cy'amara gisaba gukuraho akara kose n'agapfunyika. Uku kubagwa twita proctocolectomy yuzuye. Hanyuma, bagomba guhanga uburyo bushya bwo gusohora imyanda, cyangwa umwanda mu mubiri wabo. Aho niho agapfunyika kawe kinjiye. Abaganga b'inzobere mu kubaga bakoresha impera y'amara yawe mato, ileum, kugira ngo bakore aka gapfunyika, kameze nk'agapfunyika gato. Aka ni agapfunyika kawe k'inyuma n'agapfunyika kakuweho, bivuze ko gafatana kandi kagafata umwanda igihe gito. Aka gapfunyika gahuzwa n'aho umwanda usohoka. Hari igihe gahuzwa n'agapfunyika kawe k'inyuma, haba nk'agapfunyika ka J cyangwa agapfunyika ka S, cyangwa nk'agapfunyika ka K, gahuzwa n'umwobo wihariye mu nda yawe, witwa stoma. Mu yandi magambo, igice cy'amara yawe mato ubu gikora nk'agapfunyika kawe k'inyuma. Rero, pouchitis ni kimwe na colitis - kubyimba kw'amara - cyangwa proctitis - kubyimba kw'amara - ariko bibaho ku bantu bafite agapfunyika k'ikiziba. Ibimenyetso birasa cyane. Ibimenyetso bishobora kuba birimo kubabara mu gifu no gukenera kujya mu bwiherero vuba kandi kenshi. Abantu benshi barwara 'acute pouchitis', ari byo kubyimba biza bikongera bikagenda igihe gito. Ariko, kuri bamwe, bishobora kuba indwara yitwa 'chronic pouchitis', ikomeza cyangwa ikagenda.

Pouchitis ikunze kugaragara gute?

Bivugwa ko hagati ya 25% na 45% by'abantu babazwe ikiyiko cy'umufuka bazagira ikiyiko cy'umufuka mu gihe runaka mu buzima bwabo . Abantu bagera kuri 40% bazayirwara bwa mbere buri mwaka. Nanone, hagati ya 10% na 20% bazongera kuyirwara.

Ni ibihe bimenyetso bya Pouchitis?

Niba ufite pouchitis, ushobora kugira ibimenyetso nk'ibi.

• Kubabara mu nda yo hasi no gucumbagira.
• Gukenera kujya mu bwiherero vuba kandi kenshi.
• Kubyuka kugira ngo ujye mu bwiherero nijoro.
• Kugorwa no kugenzura inzira zo mu nda (kwirinda kwifata), bivuze ko hari amazi make.
• Kugorwa no kwituma mu myanya ndangagitsina, kwihuta cyane (dyschezia).
• Kumva ukeneye kujya mu bwiherero, ariko ntubishobore (tenesmus).
• Amaraso make mu ntebe.
• Kurya umuriro cyangwa kumva urimo gukonja.

Ni izihe mpamvu zitera pouchitis?

Abaganga batekereza ko impamvu nyamukuru ya pouchitis ari impinduka mu bwoko bwa bagiteri zo mu mara ziba mu gakapu kawe. Tekereza nawe, iyo igice cy'amara yawe mato gitangiye gukora nk'amara manini, kiba kigaragaramo ubwoko bushya bwa bagiteri. Izi bagiteri nshya zihangana na bagiteri zari zihari mbere. Ibi bituma ubudahangarwa bw'umubiri wawe butekereza buti, "Oh, hari ubwandu hano," hanyuma bugatera ububyimbirwe. Hari abantu bafite ubwandu. Hari ubwoko bwa bagiteri mu mara yacu, iyo buhawe amahirwe, bugerageza kugenzura izindi maze bukaba umwami. Izi zitwa "bagiteri zitera indwara." Ubusanzwe, kugira bake muri izi bagiteri mu mara yacu ni byiza, kuko izindi bagiteri nziza zituma zibugenzura. Ariko nyuma yo kubagwa mu gakapu ka ileal, iri hinduka, kandi izo bagiteri "mbi" zigira amahirwe mashya yo gukwirakwiza imbaraga zazo. Ni ibisanzwe ko pouchitis irwara igihe gito nyuma yo kubagwa mu gakapu ka ileal. Ibi byitwa pouchitis itangira hakiri kare, kandi bifatwa nk'ingaruka mbi zo kubagwa. Akenshi igenda irushaho koroha hamwe na antibiyotike. Ariko ishobora kugaruka. Kuri bamwe, ikomeza kugaruka. Ibi biterwa nuko ubwoko bumwe na bumwe bwa bagiteri bukomeza kwigarurira izindi. Ushobora kugira ibihe byinshi bya pouchitis ikaze, kandi buri gihe ushobora gukira ukoresheje antibiyotike. Ikibazo kiba ingorabahizi gato iyo urwaye inshuro zirenze nke mu mwaka. Hari abantu batangira kwishingikiriza kuri antibiyotike - ibi byitwa pouchitis idakira ishingiye kuri antibiyotike (CADP). Ku bandi, antibiyotike zigenda zihagarara gukora buhoro buhoro. Ibi byitwa Pouchitis idakira irwanya antibiyotike (CARP).

Ni ibihe bintu bigira ingaruka ku ndwara ya pouchitis idakira kandi idafata imiti irwanya udukoko (CARP)?

Hari impamvu nyinshi zishobora gutuma habaho iyi ndwara ya 'CARP'. Zimwe muri zo ni izi:

• Indwara y'amara abyimba ( IBD ): Abantu bakorewe proctocolectomy kubera IBD, nka ulcerative colitis cyangwa indwara ya Crohn, bafite ibyago byinshi byo kurwara pouchitis. Ibintu bimwe na bimwe byateye indwara yabo ya mbere bishobora kugira ingaruka ku gakapu.
• Bagiteri zirwanya imiti irwanya udukoko: Zimwe muri zoIndwara za bagiteri , nka C. difficile, ntizirwanya imiti yica udukoko. Iyo ukomeje gukoresha imiti yica udukoko, bagiteri ubusanzwe zidatera indwara zishobora kurwanya imiti yica udukoko. Ibi bishobora kandi gutera ubusumbane bwa bagiteri mu gakapu.
• Izindi ndwara: Hari igihe indwara ya virusi, nka cytomegalovirus, cyangwa indwara y’ibihumyo, nka candidiasis, nabyo bishobora gutera ububyimbirwe bw’agapfunyika.
• Kugabanya ubudahangarwa bw'umubiri: Ubudahangarwa bw'umubiri bwawe bushobora kugabanuka bitewe n'indwara zimwe na zimwe cyangwa imiti ufata, bigatuma udashobora kurwanya indwara.
• Gukomeza gukoresha imiti igabanya ububabare yitwa 'NSAIDs' (imiti igabanya ububabare idakoresha steroide) nka 'Aspirin' na ' Ibuprofen ' kenshi kandi bikabije bishobora kwangiza igice cy'amara yawe n'igice cy'amara.
• Kugabanuka kw'amaraso (Ischemia): Nubwo bidakunze kubaho, kubyimba bishobora no kubaho bitewe no kugabanuka kw'amaraso ajya mu gice cy'umubiri. Ibi bishobora guterwa no kuziba kw'imitsi ijyana amaraso.
• Indwara ya Sclerosing Cholangitis y’ibanze (PSC): Iyi ni indwara iterwa n’ubwiyongere bw’umubiri, bivuze ko ubudahangarwa bw’umubiri bwibasira uturemangingo twawo. Itera ububyimbirwe budakira mu nzira y’umuyoboro w’inkari. Kimwe na IBD, uburyo butera ubu bubyimbirwe budakira bushobora no kugira ingaruka ku gapfunyika. Abantu bafite iyi ndwara bafite ibyago byinshi byo kurwara pouchitis.

Ni izihe ngorane zishobora guterwa na pouchitis?

Pouchitis ikabije ntabwo ikunze gutera ingorane zikomeye. Ariko, pouchitis idakira kandi itavuwe ishobora gutera ibibazo. Ibi bishobora kuba birimo:

• Impinduka mu mikorere y'amara: Kubyimba k'agafuka bishobora gutuma umwanda ugorwa no kuwubikamo, naho kubyimba bishobora gutuma umwanda ugorwa no kuwusohora. Ibi bishobora kugira ingaruka ku mikorere y'amara yawe igihe kirekire.
• Kugabanuka k'ubuzima: Kugira ibibazo byo kujya mu bwiherero buri gihe bishobora kugorana kubaho. Bishobora gutera imihangayiko y'umubiri n'iy'ubwonko, kandi bishobora kubangamira kwishimira ubuzima bwo gusabana n'abandi.
• Uburyo bwo gufunga ipaki:Ububyimbirwe buhoraho bushobora gutera inkovu ku gafuka. Ubu bubyimbirwe bushobora kugabanya umwanya w'agafuka. Bushobora kandi kugabanya amaraso atembera mu gafuka, bikabangamira gukira.
• Gushwanyagurika: Kubyimba igihe kirekire bishobora gutuma igice cy'umufuka gishwanyagurika, bigatera ibisebe. Ibi bisebe bishobora no kuva amaraso. Hari ubwoko bumwe na bumwe bwa bagiteri zishobora kwangiza urukuta rw'amara.
• Kudafata neza no kurya nabi: Iyo igice cy'imbere cy'agafuka cyangiritse, ubushobozi bwo kwinjiza intungamubiri mu biribwa biri imbere buragabanuka (malabsorption), ibyo bikaba byatera imirire mibi.
• Kunanirwa k'umufuka: Iyo ibibazo by'umufuka bikomeje, amaherezo ushobora kureka gukoreshwa. Ibi bishobora gusaba kubagwa kugira ngo umufuka ukurweho maze amara ahindukire mu ijosi rya ileostomy.

Pouchitis ipimwa ite?

Gusuzuma pouchitis bitangirana no kuvuga ibimenyetso byawe n'amateka y'ubuzima bwawe. Hanyuma, muganga wawe azareba mu gakapu kawe. Azakoresha igikoresho cyitwa endoscope . Aka ni agace gato gafite kamera ntoya gafatanye nako. Bazagacisha mu gakapu kugira ngo barebe niba hari ububyimbirwe cyangwa ibindi bintu bidasanzwe. Bazafata kandi icyitegererezo cy'ingingo (biopsy) binyuze muri endoscope maze bakisuzume kugira ngo bamenye icyaba gitera iyo ndwara. Muganga wawe ashobora kandi gukoresha ibindi bizamini byo gupima kugira ngo arebe inyuma y'agakapu n'imiterere ijyanye nako. Ibi bikorwa kugira ngo bamenye niba hari izindi ndwara zishobora kuba zitera iyo ndwara. Ibindi bizamini bishobora gukorwa birimo:

• Gupima itandukaniro ry'imitsi (pouchogram): Ubu ni ubwoko bwa X-ray. Umutsi unyuranyije n'imitsi ushyirwa mu gikapu kugira ngo ugaragare neza. Bisa na barium enema, ariko ibi bikorwa ku gikapu cya ileal.
• Isuzuma rya CT.
• Gupima MRI (MRI).

Ni gute wakira pouchitis?

Uburyo bwa mbere bwo kuvura pouchitis ikabije ni imiti igabanya ubukana bw'indwara mu gihe cy'ibyumweru bibiri . Abantu benshi bakira iyo ndwara. Iyo utakize, muganga wawe azagerageza indi miti igabanya ubukana bw'indwara, cyangwa imiti ivanze n'indi miti, igihe kirekire. Niba ugifite ibimenyetso nyuma y'ibyumweru bine, ushobora kuba ufite pouchitis idakira imiti. Hanyuma muganga wawe azakenera gukora ibizamini byinshi kugira ngo ashake izindi mpamvu zishobora gutera mbere yo guhitamo uburyo bwiza bwo kuvura.

Ni ubuhe buryo bwo kuvura pouchitis isubira inyuma?

Iyo indwara ya pouchitis ikemutse nyuma yo kuvurwa hanyuma ikongera ikagaruka, muganga wawe azakomeza kuyivura. Iyo ubuvuzi bukora kandi ibimenyetso ntibisubire kugaruka kenshi, hakoreshwa ubuvuzi bumwe. Ariko, iyo igarutse inshuro zirenga eshatu mu mwaka, abaganga bayifata nk'indwara idakira iterwa na antibiyotike. Ivurwa n'ubuvuzi bw'igihe kirekire kugira ngo hirindwe ko yongera kugaruka. Ubuvuzi bw'ubuvuzi bushobora kuba burimo:

• Antibiyotike: Gufata antibiyotike ku rugero ruto bishobora gufasha kwirinda kongera kurwara.
• Probiotics: Izi ni inyongeramusaruro zirimo bagiteri z'ingirakamaro ziba mu mara yacu. Zishobora gufasha kugarura uburinganire bwa bagiteri mu gafuka no kurwanya bagiteri zitera indwara.

Ni ubuhe buryo bwo kuvura indwara ya pouchitis idakira kandi idafata imiti irwanya udukoko (CARP)?

Niba pouchitis yawe itigeze ikira neza ukoresheje imiti yica udukoko, cyangwa niba yarakize mu bihe byashize ariko ikaba itarakira ubu, abaganga bayita pouchitis idakira antibiyotike (CARP). Muri iki gihe, muganga azabanza kureba impamvu iyo ari yo yose itera, nko kwandura ubwandu bwa kabiri, indwara y’ubwiyongere bw’umubiri, cyangwa inenge iri mu gikapu. Niba nta mpamvu igaragara ihari, bazavura pouchitis idakira nk’uko bavura indwara y’ububyimbirwe bw’amara (IBD). Dore uburyo bumwe na bumwe bwo kuvura:

• Enema ya Mesalamine: Mesalamine, izwi kandi nka aside 5-aminosalicylic (5-ASA), ni umuti wa mbere uvura indwara ya kanseri y'ibisebe. Uza nk'umuti ushyirwa mu gafuka.
• Bismuth enema: Bismuth subsalicylate, ikora muri Pepto Bismol®, nayo iza nk'ifuro ry'ibinure (bismuth carbomer). Ibi bishobora kugabanya ibimenyetso by'indwara.
• Corticosteroids: Iyi ni ubwoko bw'imiti igabanya ubushyuhe ikoreshwa mu kuvura ubushyuhe budakira.
• Imiti igabanya ubudahangarwa bw'umubiri: Iyi miti igabanya uburyo ubudahangarwa bw'umubiri bwawe bukora. Abaganga bayitanga iyo ubudahangarwa bw'umubiri bwawe butera ububyimbirwe budakira.
• Antibodies za monoclonal (biologics): Antibodies za monoclonal ni poroteyine zakozwe n'abantu zikora nk'antibodies z'abantu, zikongera ubushobozi bw'umubiri wawe bwo kurwanya indwara.
• Molekile nto: Iyi ni imiti mishya ikora nk'uturemangingo tw'umubiri tw'abantu, ariko ikorwa mu buryo bw'ubuhanga.
• Gutera mikorobe zo mu mara: Ubu buryo bwemewe n'Ikigo gishinzwe ibiribwa n'imiti muri Amerika (FDA) kugira ngo buvure C. diff idapfa imiti. Ariko, bushobora no gukoreshwa mu kuvura pouchitis idapfa imiti, nubwo idaterwa na C. diff. Bifasha kugarura mikorobe zo mu mara zimeze neza.

Bifata igihe kingana iki kugira ngo pouchitis ikire?

Ibimenyetso bya pouchitis ikabije bikunze gutangira kumera neza mu minsi mike uhereye igihe utangiye kuvurwa na antibiyotike. Ariko, ni ngombwa kurangiza imiti yose ya antibiyotike mu byumweru bibiri, nubwo waba wumva umeze neza. Ugomba kujya kwa muganga nyuma y’uko imiti irangiye. Bazashaka kongera kureba mu gakapu kawe kugira ngo barebe neza ko ububyimbirwe bwashize burundu.

Ese indwara ya Pouchitis ishobora kwirindwa?

Hari ibimenyetso bigaragaza ko imiti ya probiotic ishobora gufasha gukumira pouchitis kuva nyuma yo kubagwa cyangwa kugaruka nyuma yo kuvurwa neza. Ishobora kuba idakora buri gihe, ariko ishobora kugukorera. Hari igihe abaganga baguha uruvange rwihariye rwa probiotic (nk'umuti wa DeSimone). Ubwoko bwa probiotic ufata ni ingenzi, bityo ni ngombwa kuvugana na muganga wawe.

Ni iki wakwitega mu gihe urwaye pouchitis?

Iyo urwaye pouchitis nyuma yo kubagwa mu mufuka w’ikiyiko – nubwo byaba bibaye inshuro nke – hari amahirwe menshi ko izavurwa neza hifashishijwe antibiyotike. Hari abantu bashobora gukenera imiti myinshi kurusha abandi. Niba urwaye indwara nyinshi, ushobora gukenera kuvurwa igihe kirekire hifashishijwe antibiyotike cyangwa probiotics. Ku bantu bake barwaye pouchitis, nta na kimwe muri ubu buryo gishobora gukora. Niba ukomeje kugira pouchitis kandi ntisubize imiti ya antibiyotike, muganga wawe azashakisha impamvu zitera ububyimbirwe, nko kubura amaraso, gukoresha NSAID, cyangwa indwara y’umubiri. Niba badashobora kubona indi mpamvu, bazayisuzuma nk’indwara idakira ya pouchitis (CARP). Abaganga bazagutanga inama zitandukanye zo kuvura CARP. Bazakorana nawe kugira ngo babone iyikubereye.

Hari igihe, niba ibibazo biri kuri iyo paki biruta inyungu, ushobora gufata icyemezo cyo kuyikuramo kugira ngo ubeho ubuzima buzira indwara. Ibyo kandi ni amahitamo.

Ese ibiryo n'ibinyobwa bigira ingaruka ku ndwara ya pouchitis?

Yego, ku rugero runaka. Hari ibimenyetso bigaragaza ko niba indyo yawe ifite antioxydants nke, ushobora kuba ufite ibyago byinshi byo kurwara pouchitis. Antioxydants ziboneka mu mbuto n'imboga nyinshi. Izi mvange zifasha mu kugabanya imiti mu mibiri yacu yitwa free radicals. Iyo free radicals zikusanyije mu mubiri, zishobora kwangiza uturemangingo no kugira uruhare mu kubyimba. Antioxydants ziva mu biribwa zigira akamaro kurusha inyongeramusaruro. Ku rundi ruhande, niba ufite ibimenyetso bya pouchitis, kugabanya fibre mu mirire yawe bishobora gufasha. Abaganga bakugira inama yo kurya indyo nkeya ya FODMAP . Ibi bigabanya ingano y'ibiribwa bagiteri zo mu mara zikunda kurya, harimo na fibre. Kureka ibi biribwa by'igihe gito bishobora kugufasha kugabanya ibimenyetso by'amara. Ariko amaherezo, ugomba kugerageza kongeramo ubwoko butandukanye bw'ibiribwa mu mirire yawe.

Ibiribwa bifasha mu kwirinda pouchitis:

Menya neza ko ubona antioxydants zihagije. Ushobora kuzibona urya imbuto n'imboga zitandukanye. Bimwe mu biribwa byiza birimo antioxydants nyinshi ni ibi bikurikira:

• Pome
• Imbuto (nk'inkeri, imboga zo mu bwoko bwa blueberries)
• Inzabibu
• Plums zumye (Prunes)
• Ubwoko bw'ibishyimbo
• Artichokes
• Ibirayi bya Russet
• Imboga z'icyatsi kibisi (nk'epinari, kale)

Kongera ibiribwa byuzuye mu mirire yawe, cyane cyane ibikomoka ku bimera, ni ihame ry'ingenzi mu mirire irwanya ububyimbirwe. Antioxydants ni imwe mu mpamvu.

Ibiryo utagomba kurya iyo ufite pouchitis (kugira ngo ugabanye ibimenyetso):

Kugira ngo bagabanye ibimenyetso bya pouchitis, abaganga bakugira inama yo kurya indyo idafite FODMAP nyinshi, nibura kugeza igihe umenye FODMAP uterwa na zo. FODMAP zisanzwe zirimo:

• Fructose (isukari iri mu mbuto)
• Lactose (isukari iri mu mata)
• Igitunguru
• Igitunguru cy'umweru
• Ubwoko bw'ibishyimbo
• Ingano

Indyo idafite FODMAP nyinshi ni indyo igabanya ubukana bw'igihe gito. Ukuraho ibiryo bimwe na bimwe mu mirire yawe, ukamenya icyabitera, hanyuma ukabigarura buhoro buhoro uyobowe na muganga.

Amaherezo, ubutumwa bwo kujyana mu rugo

Niba ufite agapfunyika k'iileal, ushobora kurwara pouchitis mu gihe runaka. Si buri wese uyibona, ariko abayirwara bashobora kuyirwara inshuro zirenze imwe. Bishobora kubabaza kugira ibibazo bikomeza mu mara ndetse no nyuma yo gukurwaho igice kinini cy'amara. Inkuru nziza ni uko ku bantu benshi, pouchitis ari ikibazo gikunze kubaho rimwe na rimwe, kandi biroroshye cyane kuvura kuruta indwara zidakira bashobora kuba bararwaye mbere. Pouchitis idakira imiti yica udukoko (CARP) iragoye gato. Hari igihe ishobora kuba ifitanye isano n'indwara idakira yari isanzweho. Kuyivura bishobora kugorana. Ariko hamwe no kugerageza gato, ushobora kubona uburyo butandukanye bwo kuvura bukorera abantu benshi. Wibuke ko utari wenyine. Vugana na muganga wawe mu buryo bweruye kandi ubaze ibibazo ufite byose. Ukoresheje ubuyobozi n'ubuvuzi bukwiye, ushobora kubaho neza n'iyi ndwara.