Uri munhu akambobviswa ura hwako hwese nerectum nekuda kwechirwere uye 'ileal pouch' yakagadzirwa panzvimbo payo here? Kana zvakadaro, unogona zvakare kunzwa kusagadzikana kwakabatana nepachikwama ichi dzimwe nguva. Chimwe chezvinetso zvinowanzoitika ndechekuti tiri kutaura nezvazvo nhasi, 'Pouchitis'. Usatye kana ukanzwa izvi. Ngatitaure nezvese zvakajeka uye zviri nyore.
Chii chinonzi Pouchitis? Ngatichinzwisise zviri nyore.
Kutanga, ngatitarisei kuti iyi 'leal pouch' chii. Mushure mekunge ura hwako nerectum zvabviswa zvachose (total proctocolectomy), unoda nzira itsva yekubvisa tsvina yako mumuviri wako. Imwe mhinduro yeizvi ndeyekuvhiyiwa kweleal pouch. Chinoitika pano ndechekuti vanachiremba vanoshandisa chikamu chekupedzisira cheura hwako hudiki (ileum) kugadzira chimiro chidiki chakaita sehomwe.
Saka, zvaiitwa neura hwako hukuru, hwaiunganidza tsvina kwenguva pfupi uye husati hwabuda, zvino zvaitwa nepakeji iyoyo. Nemamwe mashoko, chikamu cheura hwako hudiki chava kushanda seura hukuru.
Pouchitis inyaya iyo chikwama chinozvimba kana kuzvimba kubva mukati. Idambudziko rakafanana necolitis (kuzvimba kweura) kana proctitis (kuzvimba kwerectum). Iri idambudziko rinowanzoitika kune munhu ane chikwama.
Kune vanhu vazhinji, izvi ndezvenguva pfupi (acute pouchitis), asi kune vamwe vanhu zvinogona kuva chirwere chinogara kwenguva refu (chronic pouchitis) kana kuti chinogara chichiitika.
Ndezvipi zviratidzo zve pouchitis?
Kana uine pouchitis, unogona kusangana nechimwe chezviratidzo izvi kana kupfuura. Zvakakosha kuziva nezvazvo.
| Chiratidzo | Tsananguro |
|---|---|
| Kurwadziwa kwemudumbu uye kukamhina | Kurwadziwa kusinganzwisisike mudumbu kana kunzwa sekunge wabatwa wopindurudzwa. |
| Kuda kuenda kuchimbuzi kakawanda uye kamwe kamwe | Unofanira kuenda kuchimbuzi kakawanda kupfuura zvawagara uchiita. Unobva wangoerekana wava nechido chisingatsungiririki chekuenda kuchimbuzi. |
| Kuenda kuchimbuzi husiku | Kumuka woenda kuchimbuzi. |
| Kuoma kudzora kufamba kwedumbu (kusazvidzora) | Kubvisa tsvina shoma usingazvizivi. |
| Kuomerwa nekubvisa tsvina | Kuedza kuita tsvina panguva yekuenda kuchimbuzi (dyschezia). |
| Kunzwa kwekusakwanisa kubvisa zvese zviri muchimbuzi mushure mekuenda kuchimbuzi | Kunzwa sekuti uchiri kuita tsvina kunyangwe mushure mekubvisa tsvina (tenesmus). |
| Ropa diki mutsvina | Kuona mitsetse yeropa mutsvina. |
| Fivha kana kutonhora | Kunzwa fivha kana kudedera. |
Sei chirwere chePouchitis chichiitika?
Chikonzero chaicho cheizvi hachisati chazivikanwa zvizere, asi dzidziso huru ndeyekuti pane kusaenzana kwemarudzi emabhakitiriya anogara mukati mebhegi.
Fungidzira, kana chikamu cheura hwako hudiki chava kushanda seura hukuru, mhando itsva dzebhakitiriya dzinopinda. Pane 'hondo' diki pakati pebhakitiriya idzva nerekare. Kuchinja uku kunogona kukonzera kuti masoja emuviri afunge kuti pane hutachiona ipapo. Saka nekudaro, kuzvimba kunoitika, zvichireva kuti chikwama chinozvimba.
Dzimwe nguva, mabhakitiriya anokonzera zvirwere anogona kukura zvakanyanya okonzera hutachiona. Kuenzana kwemabhakitiriya uku kunochinja mushure mekuvhiyiwa, zvichipa mabhakitiriya ane njodzi mukana uri nani wekukura.
Zvinowanzoitika kuti munhu awane pouchitis nguva pfupi mushure mekuvhiyiwa. Izvi zvinogona kurapwa nemishonga inorwisa mabhakitiriya. Zvisinei, mune vamwe vanhu, zvinogona kudzoka.
Zvimwe zvinhu zvinokonzera pouchitis inogara iripo
Kune vamwe vanhu, pouchitis inoramba iripo kana kuti haipinduri zvakanaka kana ikarapwa. Izvi zvinogona kukonzerwa nezvimwe zvinhu.
- Zvirwere zvakamboitika kare (IBD): Kana waifanira kubviswa ura hwako nekuda kwechirwere chemudumbu (IBD) chakadai seUlcerative Colitis kana chirwere cheCrohn, uri panjodzi huru yekubatwa ne pouchitis. Izvi zvinodaro nekuti nzira imwecheteyo yakakonzera chirwere ichocho inogonawo kukanganisa pouch.
- Mabhakitiriya asingaurayiwi nemishonga inorwisa mabhakitiriya: Mamwe mabhakitiriya, akadai seC. difficile, akaoma kudzora nemishonga inorwisa mabhakitiriya. Uyewo, kana ukaramba uchishandisa mishonga inorwisa mabhakitiriya, mamwe mabhakitiriya anoramba achirapwa nemishonga iyi. Izvi zvinogonawo kuwedzera kusawirirana kwemabhakitiriya mupaketi.
- Zvimwe zvirwere: Dzimwe nguva, kuzvimba kwepachikwama kunogonawo kukonzerwa nehutachiona (cytomegalovirus) kana fungus (candidiasis).
- Kusasimba kwedziviriro yemuviri: Kana dziviriro yemuviri wako ikasasimba nekuda kwezvimwe zvirwere kana mimwe mishonga, kugona kwako kurwisa hutachiona kunoderera.
- Kushandisa mishonga inoderedza marwadzo (NSAIDs): Kushandisa mishonga inoderedza marwadzo kwenguva refu uye zvakanyanya senge ibuprofen neaspirin (Nonsteroidal anti-inflammatory drugs - NSAIDs) kunogona kukuvadza chikamu chemukati chebhegi.
- Kuderera kweropa (ischemia): Kunyangwe zvisingawanzoitiki, kuzvimba kunogona kuitika nekuda kwekuvharika kweropa rinopinda mupaketi.
- Chirwere chePSC: `(Primary sclerosing cholangitis - PSC)` chirwere chinokonzera kuzvimba kwemutsinga dzeropa dzechiropa. Vanhu vane chirwere ichi vari panjodzi yakakura yekubatwa ne pouchitis.
Ndezvipi zvinetso zvinogona kuitika nekuda kwe pouchitis?
Kashoma pouchitis haiwanzo kukonzera matambudziko makuru, asi kana chirwere ichi chikaramba chiripo kana chikasapindura kana charapwa, chinogona kukonzera mamwe matambudziko.
| Dambudziko | Tsananguro |
|---|---|
| Kuchinja maitiro emudumbu | Kuzvimba kwebhegi kunogona kukonzera matambudziko kwenguva refu, akadai sekuoma kubata tsvina kana kuoma kubuda tsvina nekuda kwekuzvimba. |
| Kuderera kwemararamiro | Kusagadzikana kwekuenda kuchimbuzi nguva nenguva kunogona kukonzera matambudziko akadai sekushushikana uye kudzikira kwehukama hwevanhu. |
| Kutetepa kwehomwe (Stricture) | Kuzvimba kwenguva refu kunogona kukonzera mavanga epabhegi, zvichiita kuti muromo waro uve mutete. |
| Maronda | Kuzvimba kunogona kukonzera kuti chikamu chemukati chehomwe chitsamwe uye chibude ropa. |
| Kusakwana kwezvekudya zvinovaka muviri | Kukuvadzwa kwechikamu chemukati chehomwe kunogona kukonzera kushoma kwekunwa zvinovaka muviri kubva muchikafu (malabsorption), zvichikonzera kushaya chikafu zvakakwana. |
| Kukundikana Kwehomwe | Kashoma, matambudziko anoramba aripo anogona kuita kuti chikwama chisashande, zvichiita kuti chibviswe uye zvimwe zvirongwa zvekuvhiya, zvakaita se ileostomy. |
Unoziva sei kana uine pouchitis?
Mushure mekuteerera zviratidzo zvako, chiremba wako achaita bvunzo dzinoverengeka kuti asimbise chirwere chako. Muedzo unonyanya kukosha i pouchoscopy (endoscopy) .
Izvi zvinosanganisira kuisa chubhu yakatetepa ine kamera yakasungirirwa kuburikidza nepaburi remusana wako woongorora mukati mebhegi. Chiremba anogona kubva atarisa kana paine kuzvimba kana maronda ari mukati mebhegi. Panguva imwe chete, chidimbu chidiki chenyama (biopsy) chinogona kutorwa kuti chiongororwe.
Pamusoro pezvo, bvunzo dzinotevera dzinogona kuitwa kuti utarise mamiriro ehomwe yacho uye zvivakwa zvakaipoteredza:
- Kusiyana kwePouchography `(pouchography)`
- `CT scan`
- `MRI`
Ndeipi mishonga yekurapa pouchitis?
Nzira dzekurapa dzinoenderana nerudzi rwe pouchitis yaunayo.
Kurapa kweAcute Pouchitis
Kurapa kwekutanga kunotora mavhiki maviri emishonga inorwisa mabhakitiriya. Kune vanhu vazhinji, izvi zvinobvisa zviratidzo zvavo zvachose. Kunyangwe zviratidzo zvako zvikavandudzika, zvakakosha kuti utore mishonga yese yawakanyorerwa nachiremba wako.
Kurapa kweRecurrent Pouchitis
Kana pouchitis ikadzoka mushure mekurapwa, chiremba angangonyora mishonga inorwisa mabhakitiriya yakafanana. Zvisinei, kana ikaitika kanopfuura katatu pagore, inoonekwa sechirwere chisingaperi uye kurapwa kwekuchengetedza kunogona kutanga kudzivirira kudzokazve. Panyaya iyi,
- Kupa mishonga inorwisa mabhakitiriya kwenguva yakareba pamutengo mudiki.
- Kushandisa MaProbiotics: MaProbiotics, ane mabhakitiriya anobatsira, anogona kubatsira kudzorera kuenzana kwemabhakitiriya ari mubhegi.
Kurapa pouchitis isingapindure nemishonga inorwisa mabhakitiriya (CARP)
Kana mishonga inorwisa mabhakitiriya isingabatsire, kana kuti yakambobatsira kare, chirwere ichi chinonzi ``Chronic antibiotic-resistant pouchitis (CARP)''. Pano, chiremba achatsvaga zvimwe zvinokonzera uye achasarudza kurapwa zvinoenderana nazvo. Kune nzira dzakasiyana dzekurapa izvi.
- MaEnema ane mishonga yakaita se'Mesalamine' kana 'Bismuth'
- Corticosteroids, inoderedza kuzvimba
- Mishonga inodzvinyirira muviri inodzora mashandiro emuviri wemuviri
- Mishonga yemazuva ano yakaita se'Biologics'
- Kurapa kwakakosha kwakadai se `Fecal microbiota transplant (FMT)`
Chinhu chinonyanya kukosha ndechekuti chiremba wako ndiye anofanira kusarudza kuti ndeipi mishonga yakakunakira. Saka kana uine zviratidzo, tsvaga rubatsiro rwechiremba nekukasika.
Ko pouchitis inogona kudzorwa nechikafu nechinwiwa here?
Ehe, zvinokwanisika kusvika pamwero wakati. Kudya kwako kunogona kubatsira kudzivirira pouchitis kuti isatanga uye kubatsirawo kudzora zviratidzo kana zvikaitika.
| Zvikafu zvinobatsira kudzivirira pouchitis (chikafu chine antioxidant yakawanda) | Zvikafu zvinowedzera zviratidzo zve pouchitis (mira kwenguva pfupi) |
|---|---|
Isa michero nemiriwo yakapfuma mu antioxidants inoderedza kuzvimba mukudya kwako.
| Kana zviratidzo zvikaonekwa, zororo rinogona kuwanikwa nekuderedza kwechinguva zvimwe zvekudya zvinokurudzira mabhakitiriya emudumbu uye zvinonetsa kugaya (Low FODMAP Diet).
|
Zvakakosha: Kudya kushoma kweFODMAP hakusi chinhu chaunofanira kutevera nguva dzose. Chinhu chaunofanira kutevera kwenguva pfupi, kana uine zviratidzo, uchitungamirirwa nachiremba kana nyanzvi yezvekudya.
Kunyangwe hupenyu huri nyore mushure mekuvhiyiwa kwepachikwama cheial, zvakajairika kuti unzwe kunetseka kana matambudziko akaita sepouchitis amuka. Asi yeuka, ichi chirwere chinorapika chinokanganisa vanhu vazhinji. Unogona kushanda nachiremba wako kuti uwane mhinduro yakanakira iwe.
Mharidzo Yekuenda Nayo Kumba
- Pouchitis kuzvimba kwepachikwama kunowanzoitika kuvanhu vakavhiyiwa nepachikwama cheleal.
- Kana ukaona zviratidzo zvakaita sekurwadziwa mudumbu, kugara uchienda kuchimbuzi, kana ropa mutsvina yako, teerera.
- Zviitiko zvakawanda zve pouchitis zvinogona kurapwa zvinobudirira nemishonga inorwisa mabhakitiriya.
- Usaregeredza zviratidzo. Enda kuna chiremba wako nekukurumidza kuti akupe mazano.
- Kudya kwakaringana uye pamwe nema probiotics zvinogona kubatsira kuchengetedza hutano hwepaketi.
- Zvirwere zvepouchitis zvinogara kwenguva refu (zvisingaperi) zvinogona kuda kurapwa kwakananga, uye chiremba wako achakupa hurongwa hwakakodzera hwekurapa.
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