Ese amara yawe yabyimbye gutya? Reka twige kuri Pseudomembranous Colitis!

Ese ubabara cyane mu gifu no guhitwa inshuro nyinshi ku munsi? Wenda nawe wumva ufite isesemi hamwe n'umuriro? Cyane cyane, ese ibi bimenyetso byagaragaye nyuma yo gufata imiti yica udukoko mu gihe uherutse gufata? Niba ari byo, iki ni ikintu gishobora kuba ingenzi kuri wewe. Uyu munsi turaganira ku ndwara yitwa 'Pseudomembranous Colitis'. Ntugahangayike, niba ubibwiwe neza, ushobora kuvurwa ugakira vuba.

Igisebe cya Pseudomembranous Colitis ni iki?

Mu magambo make, 'Pseudomembranous Colitis' ni indwara ikomeye yo kubyimba igaragara mu mara yacu manini, cyangwa mu mara. Muri ibi, kubera impamvu runaka (ishobora kuba bagiteri, uburozi, cyangwa indi ndwara), urukuta rw'imbere rw'amara yawe manini, cyangwa mucosa (`mucosa`), rurangirika. Uku kwangirika gutuma habaho uduce tw'umuhondo-umweru, twinshi, kandi dufite ubukonje mu bice byangiritse. Abaganga babyita 'pseudomembrane'.

"Pseudomembranes" ni iki?

Pseudomembrane ni byo bikora iyo uturemangingo turi mu mwenge w'amara manini, nk'umwenge w'amara manini, dupfuye. Tekereza kuri ubu buryo: iyo habayeho igikomere, ubudahangarwa bwacu bw'umubiri bwohereza uturemangingo tw'amaraso umweru aho twakorewe. Mu buryo nk'ubwo, aha na ho, uduce tw'uturemangingo twapfuye twifatanya n'uturemangingo tw'amaraso umweru (cyane cyane neutrophils) tugakora uturemangingo tw'amaraso. Utwo turemangingo dufite ubugari bwa santimetero 2, dufite umuhondo n'umweru, kandi dufite imiterere y'uturemangingo tuzamuka gato hejuru.

Ni ibihe bimenyetso by'iyi ndwara?

Umuntu urwaye indwara ya pseudomembranous colitis ashobora kugira ibimenyetso nk'ibi bikurikira:

• Kubabara cyane mu nda.
• Impiswi. Ibi bishobora kubaho inshuro nyinshi ku munsi, rimwe na rimwe nk'amazi.
• Umuriro.
• Isesemi.
• Hari igihe ushobora kubona amaraso cyangwa amabyi biva mu mwanda wawe, ariko ibi ntibibaho kuri buri wese.

Ni iki gitera indwara ya Pseudomembranous Colitis?

Impamvu nyamukuru kandi ikunze gutera ibi ni ukwandura bagiteri `C. diff` (Clostridioides difficile). Uburozi bukorwa n'iyi bagiteri bwangiza igice cyo hejuru cy'amara manini. Hafi 10% by'ubwandu bwa `C. diff` bushobora kugera ku ndwara ikomeye cyane yitwa `pseudomembranous colitis`. Mu by'ukuri, 90% by'izi ndwara ziterwa na bagiteri `C. diff`. Ariko, izindi ndwara zo kubyimba amara nazo zishobora gutera ubu bwoko bw'ibyago.

Bagiteri ya C. difficile igira izihe ngaruka kuri ibi?

Bagiteri C. difficile ikora uburozi busenya uturemangingo two mu mara manini. Ubu bwandu bushobora gukwirakwira vuba kandi bukabije kurusha uko wabitekereza.

Akenshi, urwara indwara ya C. diff kuko ufite indi ndwara.Nyuma yo gukoresha imiti yica udukoko. Tekereza nawe, iyo ufashe imiti yica udukoko, izindi bagiteri "nziza" ziri mu mara yacu zidufasha gupfa. Ariko, imiti myinshi ishobora kwica iyi bagiteri ya "C. diff". Rero, iyo iyo mikorobe nziza igiye, bagiteri ya "C. diff" igira amahirwe yo gukura no gukwirakwira nta mbogamizi, igatera ibi bibazo nta rushanwa.

Ni iyihe miti irwanya udukoko ikora neza cyane muri iki kibazo?

Mu by’ukuri, antibiyotike iyo ari yo yose yica bagiteri nziza mu mara yacu kandi ntigire ingaruka ku bagiteri ya C. diff ishobora gutera ubwandu bwa C. diff ndetse n’indwara ya pseudomembranous colitis. Ariko, zimwe muri antibiyotike zifatwa nk’izitera ibyago byinshi. Zimwe muri zo ni:

• Clindamycin
• Ubwoko bw'imiti ya Cephalosporin
• Itsinda ry'imiti ya Penicilline
• Fluoroquinolone
• Aztreonamu
• Karubapenemu

Icy'ingenzi: Ibi ntibivuze ko izi antibiyotike ari mbi. Iyo muganga azihaye amabwiriza, zigomba gukoreshwa uko bikenewe. Ariko, gukoresha antibiyotike bitari ngombwa bishobora guteza ibyago nk'ibi.

Hari izindi mpamvu?

Indwara ya Pseudomembranous colitis ishobora no kubaho iyo kubyimba kw'amara gutewe n'izindi mpamvu, uretse C. diff. Dore ingero nke:

• Ubwandu bwa Staphylococcus aureus
• Ubwandu bwa E. coli `(ubwandu bwa E. coli)`
• Ubwandu bwa Cytomegalovirus
• Uturemangingo tw’indwara ya mikorosikopi
• Indwara ya Behçet
• Ischemic colitis (kubyimba guterwa no kugabanuka kw'amaraso ajya mu mara)
• Imiti irwanya kanseri `(Imiti ivura kanseri)`
• Gukoresha kokayine
• Vasculitis (kubyimba kw'imitsi y'amaraso)
• Uburozi bw'ibyuma biremereye

Muri ibyo bihe, iyi ndwara iba ikomeye cyangwa igoye kurusha indwara isanzwe ya colitis. Hari igihe amaraso atembera mu rukuta rw'imbere rw'amara agabanuka (ischemia), urupfu rw'ingingo (necrosis) rukabaho, hanyuma hakavuka uduce tw'amaraso. Nanone, indwara zari zisanzweho nka Inflammatory Arrow Disease (IBD) zishobora gutuma amara arushaho kwibasirwa n'iyi ndwara.

Ni nde uri mu kaga gakomeye ko kurwara iyi ndwara?

Ufite amahirwe menshi yo kurwara indwara ya pseudomembranous colitis niba:

• Niba uri mu bitaro.
• Niba uherutse gukoresha imiti igabanya ubukana bw'ibiyobyabwenge.
• Niba uherutse kubagwa.
• Niba umuntu acumbitse mu kigo cyita ku bageze mu za bukuru.
• Niba ufite imyaka irenga 65.
• Niba ufite indwara y’ubwiyongere bw’umubiri.
• Niba ubudahangarwa bw'umubiri bwawe bufite intege nke.
• Niba waramaze kugira ubwandu bwa C. diff.

Ni izihe ngorane zishobora guterwa na Pseudomembranous Colitis?

Iyo iki kibazo kibaye gikomeye kandi kikagorana kugikemura, hashobora kubaho ingorane zimwe na zimwe. Bityo rero ni ngombwa kubimenya.

• Kubura amazi mu mubiri no gutakaza electrolyte: Mu ndwara ikomeye ya pseudomembranous colitis, impiswi ishobora kubaho inshuro zigera kuri 10-15 ku munsi. Ibi bishobora gutera umwuma no gutakaza electrolyte. Ibi bishobora gutera indwara zikomeye nko kugabanuka k'amaraso, umuvuduko muke w'amaraso, no kunanirwa kw'impyiko.
• Gusohoka kw'amazi: Amazi ashobora kuva mu rukuta rw'amara manini rwangiritse akagera mu nda, bigatuma inda ibyimba. Ibi byitwa ascites. Poroteyine nka albumin nazo zishobora gusohoka mu mara manini. Iyo albumin ari nke, amazi ava mu miyoboro y'amaraso, bigatera kubyimba mu ngingo (edema).
• Megacolon y’uburozi: Ububyimbirwe bukomeye bw’amara bushobora gutuma amara abyimba cyane kandi agahagarika gukora. Mu ntangiriro, imitsi yo mu mara irahagarara, ikabuza inzira y’umwanda. Uko amara akomeje kubyimba, inkuta zayo zishobora gucika, bigatuma ibirimo bisohoka mu nda. Ibi byitwa peritonitis. Ibi bishobora gushyira ubuzima mu kaga.
• Gutobora amara: Umwobo mu rukuta rw'amara manini ushobora kubaho nta megacolon y'uburozi. Ibi bishobora kubaho iyo ibisebe bitangiye mu mara manini bikanyura mu rukuta, cyangwa niba hari urupfu rukabije rw'ingingo (necrosis) mu rukuta rw'amara manini. Iyo bagiteri zo mu mara manini zishotse mu nda (peritonitis), zishobora gukwirakwira mu maraso (septicemia).
• Sepsis: Sepsis ni indwara iterwa no kwirundanya kwa bagiteri mu maraso (septicemia). Sepsis ni indwara ikomeye kandi ishobora gushyira ubuzima mu kaga ikwirakwira mu mubiri wose. Ibi bishobora gutera septic shock, gucika intege kw'ingingo nyinshi, ndetse no gupfa.

Izi ngorane zishobora gutera ubwoba kumva. Ariko ibuka ko atari buri wese uzirwaye. Gusuzuma indwara hakiri kare no kuyivura neza bishobora gukumira izi ndwara zikomeye.

Ni gute wasuzuma iyi ndwara?

Muganga azabanza kukubaza ibimenyetso byawe n'amateka y'ubuzima bwawe. Hanyuma, bashobora gutumiza ibizamini bitandukanye kugira ngo bamenye icyateye ibimenyetso byawe. Urugero, bashobora gutumiza ibizamini by'amaraso, ibizamini byo gufata amashusho nka scan, n'ibizamini by'imyanda. Ibi bizamini bireba ubwandu, ububyimbirwe, n'ibindi bintu bishobora gutera ibyago.

Ikizamini cy'umwanda wawe kizasuzuma by'umwihariko ubwandu bwa C. diff. Nikiboneka, ubuvuzi buzahita butangira. Niba nta ngorane ufite kandi ukaba witabira neza ubuvuzi, nta mpamvu yihariye ishobora kubaho yo kureba mu mara yawe manini niba nta ngirabuzimafatizo zigaragara.

Hari igihe ibizamini byo gufata amashusho (nk'isuzuma rya CT) bishobora kugaragaza ibimenyetso bya colitis y’ubwoko bwa pseudomembranous. Iyo urukuta rw’amara rubyimbye (bisa n'ikimenyetso cy'igikumwe cyangwa "ikimenyetso cya accordion"), muganga ashobora gufata icyemezo cyo gukora ibindi bizamini.

Hanyuma, kugira ngo urebe neza, ugomba gukora ikizamini kireba imbere mu mara manini. Byitwa colonoscopy. Muri ibi, umuyoboro ufite kamera ukoreshwa mu kureba imbere mu mara manini. Iyo ubonye icyo bita 'pseudomembrane', agace gato k'urugingo (biopsy) karakurwamo kakoherezwa muri laboratwari kugira ngo hemezwe indwara.

Ni ubuhe buryo bwo kuvura?

Uburyo bwo kuvura buterwa n'icyateye iyi ndwara.

• Niba ari indwara ya bagiteri nka C. diff, uzakenera gutanga imiti yihariye ivura indwara.
• Niba iyi ndwara iterwa cyangwa irushaho gukomera bitewe n'indi miti urimo gufata, iyo miti ishobora gukenera guhagarikwa cyangwa guhindurwa.
• Mu bihe bimwe na bimwe, imiti ishobora gutangwa kugira ngo igabanye ububyimbirwe mu mara manini.

Hari abantu bakeneye ubufasha gusa. Urugero, amazi yo mu mitsi (IV fluids) kugira ngo afashe mu kubika amazi, cyangwa indyo yuzuye mu mara kugira ngo afashe amara kuruhuka. Abandi bashobora gukenera kuvurwa kubera ingorane, wenda mu cyumba cy’indembe. Hari abantu bafite indwara ya colitis ikomeye cyane cyangwa ingorane bashobora gukenera kubagwa (colectomy) kugira ngo bakureho igice cyangiritse cy’amara).

Ni iyihe miti y'ingenzi itangwa iyo itewe na `C. diff`?

Niba impamvu ya colitis ya pseudomembranous ari ubwandu bwa C. diff, hari imiti myinshi ihari yo kuyivura. Muganga wawe azaguhitiramo ikubereye. Imiti itangwa ku bwandu bwa C. diff ni iyi:

• Metronidazole
• Vancomycin
• Fidaxomicin

Ese indwara ya Pseudomembranous Colitis ishobora kwirindwa?

Uburyo bw'ingenzi bwo kwirinda iyi ndwara ni ukurwanya ikwirakwira rya bagiteri za C. diff mu duce twibasiwe cyane (cyane cyane mu bitaro no mu bigo byita ku bageze mu za bukuru). Abantu bo muri ibyo bice bashobora kwandura no kugira ibimenyetso bikomeye nka pseudomembranous colitis.

Bityo rero, abakozi bo mu bigo nk'ibi bafata ingamba zidasanzwe zo kurwanya ubwandu bwa C. diff:

• Kwishyira mu kato: Abantu banduye C. diff bashyirwa mu cyumba cyihariye, cyangwa mu cyumba gihuriweho n'abandi bantu banduye gusa. Uturindantoki dukoreshwa mu gihe binjira mu cyumba.
• Gukaraba intoki: Gukaraba intoki zawe kenshi n'isabune n'amazi ashyushye ni bwo buryo bwiza bwo kwirinda C. diff. Iyi bagiteri irwanya imiti isukura intoki. Ni ngombwa cyane cyane gukaraba intoki zawe mbere yo gufata ibiryo.
• Gukuraho udukoko: Imiti isanzwe yica udukoko ntishobora kwica C. diff. Ariko, imiti ikomoka kuri chlorine irashobora. Ni ngombwa gusukura neza ahantu hose umuntu wanduye yahuye na ho.

Ese iyi ndwara ishobora gukira burundu? Igipimo cy'impfu ni ikihe?

Yego, indwara ya colitis iterwa n'udukoko ishobora gukira burundu iyo ivuwe. Akenshi, ibimenyetso birashira vuba. Ariko, hari abantu bashobora gukenera kuvurwa cyane no kumara igihe kirekire kurusha abandi. Niba ufite ubwandu bwa C. diff bukomeje kandi bugoye kugenzura, ushobora kubagwa gato kugira ngo ubuvure. Hari n'igihe biba ngombwa ko ubagwa.

Ku bijyanye n'impfu, 2% gusa by'abarwayi barwaye indwara ya pseudomembranous colitis ni bo bapfa. Ariko, ku bantu bitabwaho igihe kirekire kandi bafite ubudahangarwa bw'umubiri budakomeye, iki gipimo gishobora kugera kuri 15%. Iyo habayeho ikibazo cyavuzwe haruguru cyitwa megacolon y'uburozi, igipimo cy'impfu gishobora kwiyongera kikagera kuri 35%. Niyo mpamvu ubuvuzi bwihuse ari ingenzi.

Ni ryari ukwiye kujya kwa muganga?

Niba ufite kimwe muri ibi bimenyetso, shaka ubufasha bwa muganga ako kanya:

• Kubabara cyane mu gifu cyangwa kubyimba inda.
• Niba ufite impiswi inshuro zirenga eshanu ku munsi.
• Niba hari amaraso mu gitereko.
• Niba umaze iminsi itatu utajya mu mara.
• Niba umaze umunsi utanyoye inkari, cyangwa inkari zawe zifite ibara ryijimye.
• Niba ufite umuriro urenze dogere selisiyusi 39 (dogere selisiyusi 102 Fahrenheit) mu gihe cy'iminsi itatu.

Amaherezo, ibintu byo kwibuka

Indwara za bagiteri zitera indwara ya colitis zirakunze kugaragara, kandi akenshi ntabwo ziba zikomeye. Si abantu bose barwara C. diff bazarwara indwara ya colitis yitwa pseudomembranous. Ariko, iyo ubikoze, bishobora gutera ubwoba. Kumenya ko amara yawe arimo kwangirika imbere bishobora gutera ubwoba, hamwe n'ibimenyetso nko kubabara no kuva amaraso.

Iyo ugaragaje ibimenyetso nk'ibi, ushobora gukenera ubuvuzi bwihariye. Ariko wibuke ko iyo uvuwe neza, amara yawe ashobora gukira.Uduce tw’umura, kimwe n’agace k’umura wacu, dukira neza iyo tutangiritse. Niba wumva ibimenyetso bya colitis yawe bitaragenda bigabanuka, vugana na muganga. Ashobora kugufasha kumenya icyateye iyo ndwara, agakora ibishoboka byose kugira ngo ayihagarike, kandi agaha umura wawe ikiruhuko gikenewe. Icy'ingenzi ni ukudatinya no gushaka inama z'abaganga vuba.

` Pseudomembranous Colitis, C. diff, impiswi, kubabara mu gifu, colitis, imiti yica udukoko