Wakambovhiyiwa pouch yeial here? Kana kuti pane mumwe munhu waunoziva akambovhiyiwa? Vanhu vane pouch yeial pouch dzimwe nguva vanogona kuva nechirwere chinonzi pouchitis. Kunyangwe zvichigona kunetsa zvishoma, hazvina basa. Ngatitaurei nezvazvo nenzira iri nyore yaunogona kunzwisisa.

Chii chinonzi Pouchitis?

Zvichitaurwa zviri nyore, pouchitis kuzvimba kwepaketi yako yeleal . Ngatitarisei kuti ipaketi yeleal chii. Semuenzaniso, vamwe vanhu vane dambudziko guru remudumbu rinoda kubviswa kweura hwavo hwese nerectum. Tinodana kuvhiyiwa uku kuti kuvhiyiwa kweproctocolectomy yakakwana. Zvadaro, vanofanirwa kugadzira nzira itsva yekuti tsvina, kana tsvina, ibude mumuviri wavo. Ndipo panopinda pepaketi yeleal. Vanachiremba vanoshandisa mugumo weura hwako hudiki, ileum, kugadzira pepaketi iyi, yakaita sebhegi diki. Iri ndiro dumbu rako rakabviswa nerectum, zvinoreva kuti rinounganidza uye rinochengeta tsvina kwenguva yakati. Peketi iyi inobva yabatanidzwa panobuda tsvina. Dzimwe nguva yakabatana neanus yako, kungave seJ-pouch kana S-pouch, kana seK-pouch, iyo yakabatana neburi rakakosha mudumbu mako, rinonzi stoma. Nemamwe mashoko, chikamu cheura hwako hudiki ikozvino chiri kushanda sekoloni yako. Saka, pouchitis yakafanana necolitis - kuzvimba kwemudumbu - kana proctitis - kuzvimba kwerectum - asi kunoitika kuvanhu vane chikwama cheleal. Zviratidzo zvacho zvakafanana zvikuru. Zviratidzo zvinogona kusanganisira kurwadziwa mudumbu uye kuda kuenda kuchimbuzi nekukurumidza uye kakawanda. Vanhu vazhinji vanotanga 'acute pouchitis', inova kuzvimba kunouya uye kunopera kwenguva pfupi. Zvisinei, kune vamwe, inogona kuva chirwere chinonzi 'chronic pouchitis', chinogara chiripo kana chinouya uye chichienda.

Pouchitis yakajairika zvakadii?

Zvinofungidzirwa kuti pakati pe25% ne45% yevanhu vakambovhiyiwa muromo weial pouch vacharwara nechirwere chepouchitis pane imwe nguva muhupenyu hwavo . Vanhu vanosvika 40% vacharwara kekutanga gore rega rega. Uyewo, pakati pe10% ne20% vacharwara zvakare.

Ndezvipi zviratidzo zvePouchitis?

Kana uine pouchitis, unogona kuona zviratidzo zvakaita seizvi.

• Kurwadziwa kwemudumbu uye kukamhina.
• Kuda kuenda kuchimbuzi nekukurumidza uye nguva nenguva.
• Kumuka kuti ndiende kuchimbuzi husiku.
• Kuoma kudzora kufamba kwedumbu (kusazvidzora ura), zvinoreva kubuda kwemvura zvishoma.
• Kuomerwa nekubvisa tsvina, kukwenya (dyschezia).
• Kunzwa sekunge unoda kuenda kuchimbuzi, asi usingakwanise kuenda (tenesmus).
• Ropa diki mutsvina.
• Kunzwa fivha kana kutonhora.

Ndezvipi zvinokonzera pouchitis?

Vanachiremba vanofunga kuti chikonzero chikuru che pouchitis kuchinja kwemarudzi emabhakitiriya emudumbu anogara muhomwe yako. Funga nezvazvo, kana chikamu cheura hwako diki chava kushanda seura hukuru, chinosangana nemhando itsva dzemabhakitiriya. Mabhakitiriya matsva aya anokwikwidzana nemabhakitiriya aimbovapo kare. Izvi zvinoita kuti immune system yako ifunge kuti, "Oh, pane hutachiona pano," uye zvinozoita kuti zvikonzere kuzvimba. Vamwe vanhu vane hutachiona. Mamwe marudzi emabhakitiriya muura hwedu, kana akapihwa mukana, edza kudzora mamwe uye uve mambo. Aya anonzi "mabhakitiriya anouraya." Kazhinji, kuva nemamwe emabhakitiriya aya muura hwedu kwakanaka, nekuti mamwe mabhakitiriya akanaka anoachengetedza. Asi mushure mekuvhiyiwa kwebhokisi re ileal, chiyero ichi chinochinja, uye mabhakitiriya "akaipa" iwayo ane mukana mutsva wekuparadzira simba rawo. Zvakajairika kuti pouchitis iite kwenguva pfupi mushure mekuvhiyiwa kwebhokisi re ileal. Izvi zvinonzi pouchitis yekutanga, uye inoonekwa semhedzisiro yekuvhiyiwa. Inowanzova nani nemishonga inorwisa mabhakitiriya. Asi inogona kudzoka. Kune vamwe vanhu, inoramba ichidzoka. Izvi zvinodaro nekuti mamwe marudzi emabhakitiriya anoramba achitonga mamwe. Ungave uine zviitiko zvakawanda zve acute pouchitis, uye nguva imwe neimwe unogona kuva nani nemishonga inorwisa mabhakitiriya. Dambudziko racho rinova rakaoma zvishoma kana uine zviitiko zvinopfuura zvishoma pagore. Vamwe vanhu vanotanga kuvimba nemishonga inorwisa mabhakitiriya - izvi zvinonzi chronic antibiotic-dependent pouchitis (CADP). Kune vamwe, mishonga inorwisa mabhakitiriya inomira kushanda zvishoma nezvishoma. Izvi zvinonzi Chronic Antibiotic-Resistant Pouchitis (CARP).

Ndezvipi zvinhu zvinopesvedzera chirwere chepouchitis chisingarapiki nemishonga inorwisa mabhakitiriya (CARP) chisingaperi?

Pane zvikonzero zvakawanda zvinogona kukonzera chirwere ichi che'CARP'. Zvimwe zvacho ndeizvi:

• Chirwere cheIBD ( IBD ): Vanhu vakavhiyiwa proctocolectomy yeIBD, yakadai seulcerative colitis kana chirwere cheCrohn, vari panjodzi huru yekubatwa ne pouchitis. Zvinhu zvakafanana zvakakonzera chirwere chavo chepakutanga zvinogona kukanganisa pouchitis.
• Mabhakitiriya asingaurayiwi nemishonga inorwisa mabhakitiriya : MamweUtachiona hwemabhakitiriya , hwakadai seC. difficile, hahuna simba rekurwisa mabhakitiriya. Kana ukashandisa maantibiotic nguva dzose, mabhakitiriya asingawanzo kukonzera chirwere anogona kuramba simba rekurwisa mabhakitiriya. Izvi zvinogonawo kukonzera kusaenzana kwemabhakitiriya ari mubhegi.
• Zvimwe zvirwere: Dzimwe nguva utachiona, hwakadai se cytomegalovirus, kana hutachiona hwefungus, hwakadai se candidiasis, hunogonawo kukonzera kuzvimba kwepachikwama.
• Kudzvinyirirwa kweMadziviriro Emuviri: Masoja emuviri wako anogona kunge asina simba nekuda kwemamwe mamiriro ezvinhu awakambosangana nawo kana mishonga yaunotora, zvichiita kuti usakwanise kurwisa hutachiona.
• Kuramba uchishandisa NSAIDs : Kunwa mishonga inoderedza marwadzo inonzi 'NSAIDs' (mishonga isingarwisi kuzvimba) yakaita se'Aspirin' ne'Ibuprofen ' kakawanda uye zvakanyanyisa kunogona kukuvadza muura hwako nemukati me'pouch'.
• Kuderera kweropa (Ischemia): Kunyangwe zvisingawanzoitiki, kuzvimba kunogonawo kuitika nekuda kwekudzikira kweropa rinoenda kunhengo yemuviri. Izvi zvinogona kunge zvichikonzerwa nekuvharika kwetsinga dzeropa dzinopa ropa.
• Primary Sclerosing Cholangitis (PSC): Ichi chirwere chinokonzerwa ne autoimmune system, zvichireva kuti masoja emuviri anorwisa masero awo. Chinokonzera kuzvimba kusingaperi mu duct yako ye nyongo. Kufanana ne IBD, nzira dzinokonzera kuzvimba uku kusingaperi dzinogonawo kukanganisa pouchitis. Vanhu vane chirwere ichi vari panjodzi huru yekubatwa ne pouchitis.

Ndezvipi zvinetso zvinogona kuitika nekuda kwe pouchitis?

Kurwara nechirwere chepouchitis kashoma kukonzera matambudziko makuru. Zvisinei, chirwere chepouchitis chisingaperi, chisina kurapwa chinogona kukonzera matambudziko. Izvi zvinogona kusanganisira:

• Kuchinja kwemaitiro ekubvisa tsvina: Kuzvimba kwepachikwama kunogona kuita kuti zviome kubata tsvina, uye kuzvimba kunogona kuita kuti zviome kubvisa tsvina. Izvi zvinogona kukanganisa maitiro ako ekubvisa tsvina kwenguva refu.
• Kuderera kwehupenyu: Kuva nematambudziko ekuenda kuchimbuzi nguva dzose kunogona kuoma kurarama nawo. Zvinogona kukonzera kushushikana mumuviri nepfungwa, uye zvinogona kukanganisa kunakidzwa nehupenyu hwevanhu.
• Kuoma kwebhegi:Kuzvimba kwenguva refu kunogona kukonzera mavanga pabhegi. Mavanga aya anogona kuvharika. Zvinogonawo kuderedza kuyerera kweropa mubhegi, zvichikanganisa kupora.
• Kukukurwa kwevhu: Kuzvimba kwenguva refu kunogona kukonzera kuti jira repabhegi rikurwe, zvoita maronda. Maronda aya anogonawo kubuda ropa. Mamwe marudzi ebhakitiriya anokonzera zvirwere anogonawo kukuvadza madziro emudumbu.
• Kusanyungudika kwemuviri uye kushaya chikafu: Kana chikamu chemukati chebhegi chikakuvara, kugona kupinza zvinovaka muviri kubva muchikafu chiri mukati maro kunoderera (malabsorption), izvo zvinogona kukonzera kushaya chikafu.
• Kusashanda zvakanaka kwebhegi: Kana matambudziko ebhegi akaramba aripo, rinogona kupedzisira risisashande. Izvi zvingada kuvhiyiwa kubvisa bhegi uye kupinza ura mu ileostomy.

Pouchitis inoonekwa sei?

Kuongorora chirwere chepouchitis kunotanga nekutaura nezvezviratidzo zvako uye nhoroondo yehutano hwako. Zvadaro, chiremba wako achatarisa mukati mebhegi rako. Vachashandisa chishandiso chinonzi endoscope . Iri ichubhu diki rine kamera diki yakabatanidzwa pariri. Vacharipfuudza nepabhegi kuti vaone kana paine kuzvimba kana zvimwe zvisina kunaka. Vachatorawo sampuli yenyama (biopsy) kuburikidza ne endoscope voiongorora kuti vaone kuti chii chingave chiri kukonzera chirwere ichi. Chiremba wako anogona zvakare kushandisa mimwe miedzo yekufungidzira kuti aone kunze kwebhegi uye maumbirwo aro. Izvi zvinoitwa kuti vaone kana paine zvimwe zvirwere zvinogona kunge zvichiri kukonzera. Mimwe miedzo inogona kuitwa inosanganisira:

• Kuenzanisa pouchography (pouchogram): Iyi imhando yeX-ray. Mvura inosiyana inopinzwa mupouch kuti ionekwe zviri nani. Yakafanana nebarium enema, asi izvi zvinoitwa papouch yeileal.
• Kuongororwa kweCT.
• Kuongororwa kweMRI (MRI).

Nzira yekurapa pouchitis?

Kurapa kwekutanga kwechirwere chepouchitis chinouraya utachiona (acute pouchitis) kunotora mavhiki maviri ekurapwa nemishonga inorwisa mabhakitiriya . Vanhu vazhinji vanopora neizvi. Kana ukasapora neizvi, chiremba wako achaedza mushonga unorwisa mabhakitiriya wakasiyana, kana musanganiswa wemishonga inorwisa mabhakitiriya, kwenguva yakareba. Kana uchiri nezviratidzo mushure memavhiki mana, unogona kunge uine pouchitis isingaurayiwi nemishonga inorwisa mabhakitiriya. Chiremba wako achafanira kuita bvunzo dzakawanda kuti atsvage zvimwe zvinokonzera asati asarudza mushonga wakanakisa.

Ndeipi mishonga yekurapa pouchitis inodzokororwa?

Kana chirwere chepouchitis chikapera nekurapwa uye chobva chadzoka, chiremba wako acharamba achirapa zvakafanana. Kana kurapwa kwacho kuchishanda uye zviratidzo zvisingadzokeri kakawanda, mushonga mumwe chete unoshandiswa. Zvisinei, kana chikadzoka kanopfuura katatu pagore, vanachiremba vanochiona sechirwere chepouchitis chisingaperi chinokonzerwa nemishonga inorwisa mabhakitiriya. Chinorapwa nekurapwa kwenguva refu kuti chisadzoke zvakare. Kurapa kwekuchengetedza kunogona kusanganisira:

• Mishonga inorwisa mabhakitiriya: Kutora mishonga inorwisa mabhakitiriya padanho diki kunogona kubatsira kudzivirira kudzoka kwechirwere.
• Mapurobiotic: Aya ndiwo manyuko emuviri ane mabhakitiriya anobatsira anogara muura hwedu. Anogona kubatsira kudzoreredza kuenzana kwemabhakitiriya ari mupaketi uye kurwisa mabhakitiriya anokonzera zvirwere.

Ndeipi mishonga yekurapa chirwere chepouchitis chisingarapiki nemishonga inorwisa mabhakitiriya (CARP)?

Kana chirwere chako chepouchitis chisina kumbobvira chava nani nemishonga inorwisa mabhakitiriya, kana kuti chakambova nani kare asi chisiri kuva nani pari zvino, vanachiremba vanoti chirwere ichi hachirambirwi nemishonga inorwisa mabhakitiriya (CARP). Muchiitiko ichi, chiremba achatanga atarisa chero zvikonzero zviri pachena, zvakaita sehutachiona hwechipiri, chirwere che autoimmune, kana kuti chikanganiso chiri mupaketi. Kana pasina chikonzero chakajeka chingawanikwa, vacharapa chirwere chepouchitis chisingaperi nenzira imwecheteyo yavanorapa nayo chirwere che inflammatory bowel (IBD). Heano mamwe marapirwo anogona kuitwa:

• Mesalamine enemas: Mesalamine, inozivikanwawo se5-aminosalicylic acid (5-ASA), mushonga wekutanga wekurapa ulcerative colitis. Inouya se enema yaunoisa muhomwe.
• Bismuth enemas: Bismuth subsalicylate, chinhu chinoshanda muPepto Bismol®, chinouyawo sefoam enema (bismuth carbomer). Izvi zvinogona kubatsira kuderedza zviratidzo zvechirwere chako.
• Corticosteroids: Iyi imhando yemishonga inoderedza kuzvimba inoshandiswa kurapa kuzvimba kwenguva refu.
• Mishonga inodzvinyirira muviri: Mishonga iyi inoderedza kushanda kwemuviri wako. Vanachiremba vanokupa mishonga iyi kana muviri wako wemuviri uchikonzera kuzvimba kwenguva refu.
• Ma antibodies eMonoclonal (biologics): Ma antibodies eMonoclonal mapuroteni akagadzirwa nevanhu anoshanda sema antibodies evanhu, achisimudzira simba remuviri wako rekudzivirira zvirwere.
• Mamorekuru madiki: Aya mishonga mitsva inoshanda sema antibodies e monoclonal, asi akagadzirwa nemakemikari.
• Kuisirwa kwe microbiota yetsvina: Kurapa uku kwakatenderwa neUS Food and Drug Administration (FDA) kurapa C. diff isingaurayiwi nemishonga inorwisa mabhakitiriya. Zvisinei, inogona kushandiswawo isina zita rayo kurapa pouchitis isingaurayiwi nemishonga inorwisa mabhakitiriya, kunyangwe isina kukonzerwa neC. diff. Inobatsira kudzorera microbiome yemudumbu ine hutano.

Zvinotora nguva yakareba sei kuti pouchitis ipore?

Zviratidzo zve acute pouchitis zvinowanzotanga kuvandudzika mukati memazuva mashoma ekutanga kurapwa nemishonga inorwisa mabhakitiriya. Zvisinei, zvakakosha kuti upedze mushonga wemavhiki maviri wemishonga inorwisa mabhakitiriya, kunyangwe uchinzwa zviri nani. Unofanira kuona chiremba wako mushure mekunge mushonga wapera. Vachada kutarisa mukati mebhegi rako zvakare kuti vaone kuti kuzvimba kwapera zvachose.

Pouchitis inogona kudzivirirwa here?

Humwe humbowo hunoratidza kuti mishonga yeprobiotic inogona kubatsira kudzivirira pouchitis kuti isakure mushure mekuvhiyiwa kana kuti isadzoke mushure mekurapwa kwakabudirira. Inogona kusashanda nguva dzose, asi inogona kushanda kwauri. Dzimwe nguva vanachiremba vanokupa mushonga weprobiotic wakakosha (wakadai seDeSimone formula). Rudzi rwemishonga yeprobiotic yaunotora rwakakosha, saka zvakakosha kutaura nachiremba wako.

Chii chaungatarisira kana ukaita pouchitis?

Kana ukaita pouchitis mushure mekuvhiyiwa kweleal pouch - kunyangwe zvikaitika kashoma - pane mukana wekuti icharapwa zvinobudirira nemishonga inorwisa mabhakitiriya. Vamwe vanhu vangada kurapwa kwenguva refu kupfuura vamwe. Kana ukagara uchirwara, ungangoda kurapwa kwenguva refu nemishonga inorwisa mabhakitiriya kana probiotics. Kune vanhu vashoma vane pouchitis, hapana imwe yemishonga iyi ingashanda. Kana ukaramba uine pouchitis uye isingapindure pakurapwa nemishonga inorwisa mabhakitiriya, chiremba wako achatsvaga zvikonzero zvekuzvimba, zvakaita se ischemia, kushandiswa kweNSAID, kana chirwere che autoimmune. Kana vasingakwanise kuwana chimwe chikonzero, vachachiongorora se chronic antibiotic-resistant pouchitis (CARP). Vanachiremba vachakurudzira nzira dzakasiyana dzekurapa dzeCARP. Vachashanda newe kuti vawane yakakunakira.

Dzimwe nguva, kana matambudziko ebhegi racho achipfuura zvakanakira, unogona kusarudza kubvisa bhegi racho kuti urarame hupenyu husina zvirwere. Ndiyo imwe sarudzo zvakare.

Ko chikafu nechinwiwa chinokanganisa pouchitis here?

Ehe, kusvika pamwero wakati. Humwe humbowo hunoratidza kuti kana kudya kwako kusina ma antioxidants akawanda , unogona kunge uri panjodzi yakakura yekurwara ne pouchitis. Ma antioxidants anowanikwa mumichero nemiriwo yakawanda. Makemikari aya anobatsira kuderedza makemikari mumiviri yedu anonzi ma free radicals. Kana ma free radicals akaungana mumuviri, anogona kukuvadza masero uye kukonzera kuzvimba. Ma antioxidants anobva muchikafu anoshanda kupfuura zvinovaka muviri. Kune rumwe rutivi, kana uri kutambura nezviratidzo zve pouchitis, kuderedza huwandu hwe fiber mukudya kwako kunogona kubatsira. Vanachiremba vanokurudzira kudya kusina FODMAP yakawanda . Izvi zvinoderedza huwandu hwezvikafu zvinodyiwa nemabhakitiriya ako emudumbu, kusanganisira fiber. Kurega kudya uku kwenguva pfupi kunogona kubatsira kuderedza zviratidzo zvemudumbu mako. Asi nekufamba kwenguva, unofanira kuedza kuwedzera zvekudya zvakasiyana-siyana mukudya kwako.

Zvekudya zvinobatsira kudzivirira pouchitis:

Iva nechokwadi chekuti uri kuwana ma antioxidants akakwana. Unogona kuwana izvi nekudya michero nemiriwo yakasiyana-siyana. Zvimwe zvezvikafu zvakanakisa zvine ma antioxidants akawanda ndeizvi:

• Apuro
• Mabheri (senge mastrawberry, mablueberries)
• Mazambiringa
• Mapurumu akaomeswa (Prunes)
• Mhando dzebhinzi
• Artichokes
• Mbatatisi dzeRusset
• Muriwo une mashizha matema (senge sipinachi, kale)

Kuwedzera chikafu chose mukudya kwako, kunyanya chikafu chezvirimwa, ndiyo musimboti mukuru wekudya kunorwisa kuzvimba. Maantioxidant ndeimwe yezvikonzero.

Zvekudya zvisingafaniri kudyiwa kana uine pouchitis (kuderedza zviratidzo):

Kuti vaderedze zviratidzo zve pouchitis, vanachiremba vanokurudzira kudya kudya kushoma kweFODMAP, kusvika waziva kuti ndeapi maFODMAP aune allergy nawo. MaFODMAP akajairika anosanganisira:

• Fructose (shuga iri mumuchero)
• Lactose (shuga mumukaka)
• Hanyanisi
• Hanyanisi chena
• Mhando dzebhinzi
• Gorosi

Kudya kushoma kweFODMAP kudya kunotora nguva pfupi. Unobvisa zvimwe zvekudya kubva mukudya kwako, wobva waona zvinokonzera, wozozvidzosera zvishoma nezvishoma uchitungamirirwa nachiremba.

Pakupedzisira, meseji yekudzokera nayo kumba

Kana uine chikwama cheial, unogona kusangana ne pouchitis pane imwe nguva. Havasi vese vanochiwana, asi avo vanochiwana vanogona kuchiwana kanopfuura kamwe chete. Zvinogona kunetsa kuva nematambudziko emudumbu anoramba aripo kunyangwe mushure mekubviswa kwemudumbu wavo. Mashoko akanaka ndeekuti kune vanhu vazhinji, pouchitis idambudziko rinowanzoitika, uye zviri nyore kurapa kupfuura matambudziko emudumbu asingaperi avangadaro vakambosangana nawo kare. Pouchitis isingarapike nemishonga inorwisa mabhakitiriya (CARP) inonetsa zvishoma. Dzimwe nguva, inogona kunge yakabatana nedambudziko remudumbu risingaperi. Kurapa kunogona kunge kwakaomawo. Asi nekuyedza zvishoma, unogona kuwana musanganiswa wemishonga inoshanda kune vazhinji. Yeuka, hausi wega. Taura pachena nachiremba wako uye bvunza chero mibvunzo yaunayo. Nekutungamirirwa kwakakodzera uye kurapwa, unogona kurarama zvakanaka nechirwere ichi.