Wakambovhiyiwa ne'ileal pouch' here, kana kuti pamwe unoziva mumwe munhu akavhiyiwa? Kune vamwe, nzira iyi inogona kutungamira kuchirwere chinozivikanwa se'Pouchitis.' Kunyange zvazvo ichigona kunetsa zvikuru, hapana chikonzero chekuvhunduka. KuNirogi Lanka, tinoda kukubatsira kunzwisisa chirwere ichi nemashoko ari nyore uye akajeka.
Chii chinonzi Pouchitis?
Zvichitaurwa zviri nyore, Pouchitis kuzvimba kuri mukati mebhegi rako remaleum. Kuti tinzwisise izvi, ngatitarisei kuti chii chinonzi bhegi remaleum. Kune vamwe varwere, matambudziko makuru emudumbu anoda kubviswa kweura hwese nerectum, nzira inonzi 'total proctocolectomy.' Mushure mekuvhiyiwa uku, muviri unoda nzira itsva yekuchengetedza nekubvisa tsvina. Ndipo panopinda 'bhegi remaleum'.
Vanachiremba vanogadzira chikwama ichi—chinonyanya kuva dhaka diki remukati—vachishandisa mugumo weura hwako hudiki, 'ileum.' Chinotevedzera mashandiro eura hwako hwepakutanga nerectum nekuchengeta tsvina kusvika wagadzirira kuiburitsa. Chikwama chacho chinobva chabatanidzwa kune anus yako, kazhinji kacho chakaita sechikwama 'J' kana 'S', kana mune dzimwe nguva, chakabatana neburi rekuvhiya riri mudumbu rinozivikanwa se'stoma' (K-pouch). Chaizvoizvo, chikamu cheura hwako hudiki chiri kuita basa reura hwako.
Pouchitis yakafanana ne'colitis' (kuzvimba kweura) kana 'proctitis' (kuzvimba kwerectum), asi inonyanya kuitika kune avo vane chikwama cheleal. Zviratidzo zvacho zvakafanana, zvinosanganisira kurwadziwa mudumbu uye kuda kushandisa chimbuzi kamwe kamwe. Vanhu vazhinji vanowana 'acute pouchitis,' inova kuzvimba kwenguva pfupi kunopera. Zvisinei, kune vamwe, inogona kuva chirwere chinogara kwenguva refu kana chinodzokororwa chinozivikanwa se'chronic pouchitis.'
Chirwere chePouchitis chakajairika zvakadii?
Zvinofungidzirwa kuti 25% kusvika 45% yevanhu vanovhiyiwa bhegi remapundu reial vachasangana nePouchitis pane imwe nguva muhupenyu hwavo. Vanenge 40% yevarwere vanogona kuibata mukati megore rekutanga, uye 10% kusvika 20% vanosangana nezviitiko zvinogara zvichiitika.
Ndezvipi zviratidzo zvePouchitis?
Kana uine Pouchitis , unogona kuona zviratidzo zvinotevera:
- Kurwadziwa kwemudumbu uye kurwadziwa kwemudumbu.
- Kuda kamwe kamwe kushandisa chimbuzi nguva nenguva.
- Kumuka husiku kuti ubvise tsvina.
- Kuomerwa nekudzora kufamba kwedumbu (kusazvidzora ura) kana kubuda kwemvura kudiki.
- Kuomerwa nekubvisa tsvina kana kukwenya (dyschezia).
- Kunzwa kwekubuda usina kukwana kana kuda kuenda nguva dzose (tenesmus).
- Ropa riri mutsvina yako.
- Fivha kana kutonhora.
Chii chinokonzera chirwere chePouchitis?
Nyanzvi dzezvekurapa dzinotenda kuti chirwere chePouchitis chinonyanya kukonzerwa nekuchinja kwehuremu hwemabhakitiriya ari mudumbu mako. Sezvo chikamu cheura hwako diki chava kushanda semudumbu, chinosangana nemhando dzakasiyana dzemabhakitiriya. Mabhakitiriya matsva aya anogona kukwikwidzana nearipo, zvichiita kuti dziviriro yemuviri wako itange kuzvimba, zvichiita kuti kuchinja uku kuve hutachiona.
Muzvimwe zviitiko, hutachiona hwechokwadi hunogona kuitika. Mamwe mabhakitiriya anokonzera zvirwere anowanzogara mudumbu ari mashoma, anodzorwa anogona kutanga kukura zvakanyanya kana kuenzana kwacho kwakanganiswa mushure mekuvhiyiwa. Izvi zvinoita kuti mabhakitiriya 'akaipa' abudirire, zvichikonzera kuzvimba.
Kutanga kwepouchitis, kunoitika nguva pfupi mushure mekuvhiyiwa, kunoonekwa semhedzisiro yakajairika mushure mekuvhiyiwa uye kazhinji kunopindura zvakanaka kumishonga inorwisa mabhakitiriya. Zvisinei, inogona kudzoka. Kana ikaramba ichidzoka, kazhinji imhaka yekuti mamwe mabhakitiriya anoramba aripo. Kunyange hazvo vanhu vazhinji vachibudirira kubata 'pouchitis yakaoma' nekutora mishonga mipfupi, mamiriro acho ezvinhu anova akaoma kana zvikaitika kakawanda pagore. Vamwe varwere vanotanga kuvimba nemishonga inorwisa mabhakitiriya, chirwere chinozivikanwa se'Chronic Antibiotic-Dependent Pouchitis' (CADP). Vamwe vanogona kuona kuti mishonga inorwisa mabhakitiriya inomira kushanda, iyo inonzi 'Chronic Antibiotic-Resistant Pouchitis' (CARP).
Zvinhu zvinokonzera chirwere chePouchitis Chisingaperi, Chisingaurayiwi nemishonga inorwisa mabhakitiriya (CARP):
Zvinhu zvakawanda zvinogona kubatsira mukusimudzirwa kwe 'CARP'. Pakati peizvi ndeizvi:
- Chirwere cheInflammatory Bowel ( IBD ): Kana wakavhiyiwa proctocolectomy kuti urapwe zvirwere zvakaita seUlcerative Colitis kana chirwere cheCrohn , uri panjodzi huru yekubatwa ne pouchitis. Zvinhu zvakakonzera chirwere chako chepakutanga zvinogona kukanganisa hutano hwepakeji yako.
- Mabhakitiriya asingaurayiwi nemishonga inorwisa mabhakitiriya : Mamwe mabhakitiriya , akadai seaya anokonzerwa ne 'C. difficile,' haaurayiwi nemishonga inorwisa mabhakitiriya yakajairika. Kushandisa mishonga inorwisa mabhakitiriya kwenguva refu kunogona kubvumira mabhakitiriya asingaurayiwi kuti arambe achirwisa mabhakitiriya, zvichikanganisa kuenzana kwemabhakitiriya ari muhomwe yako.
- Zvimwe zvirwere: Dzimwe nguva, kuzvimba kuri muhomwe yako kunogona kukonzerwa nehutachiona hwakaita seCytomegalovirus kana hutachiona hwefungus hwakaita seCandidiasis.
- Kudzvinyirirwa kweMadziviriro Emuviri: Kana masoja emuviri wako asina simba nekuda kwezvirwere zvagara zviripo kana mimwe mishonga, simba remuviri wako rekudzivirira hutachiona rinogona kukanganiswa.
- Kushandisa NSAID kwenguva refu: Kushandisa mishonga isingashandisi masteroidal anti-inflammatory (NSAIDs) yakadai seAspirin kana Ibuprofen kakawanda kana zvakanyanya kunogona kukuvadza jira rinodzivirira remudumbu mako, kusanganisira jira riri muhomwe yako.
- Ischemia (Kuderera kweropa): Kunyange zvazvo zvisingawanzoitiki, kuzvimba kunogona kuitika kana ropa richienda kunzvimbo yakati rikasafambiswa zvakanaka, kazhinji nekuda kwekuvharika kwetsinga dzeropa dzinoendesa ropa kunzvimbo iyoyo.
- Primary Sclerosing Cholangitis (PSC): Ichi chirwere chinokonzerwa ne autoimmune system apo masoja emuviri wako anorwisa masero ako ane hutano, zvichikonzera kuzvimba kwenguva refu kwe biliary ducts. Kufanana neIBD, nzira dzemuviri dzinokonzera kuzvimba uku kwenguva refu dzinogonawo kukanganisa pouchitis yako, zvichiwedzera njodzi yako yekubatwa ne pouchitis.
Ndezvipi zvinetso zvinogona kuitika nekuda kwe pouchitis?
Kurwara nechirwere chepouchitis kashoma kanowanzo kukonzera matambudziko makuru. Zvisinei, chirwere chepouchitis chinogara kwenguva refu kana chisingarapike chinogona kukonzera matambudziko. Matambudziko anogona kuitika anosanganisira:
- Kuchinja kwemaitiro ekubvisa ura: Kuzvimba kuri mubhegi kunogona kuita kuti zviome kudzora kufamba kweura, nepo kuzvimba kunogona kuita kuti zviomere kubvisa ura zvakanaka, zvichikanganisa mabasa ako ezuva nezuva.
- Kusagadzikana kwehupenyu: Kurarama nedambudziko rematumbu kwenguva refu kunogona kunetsa muviri nepfungwa, zvichikanganisa hupenyu hwako pamwe nekugara zvakanaka.
- Kuoma kwebhegi:Kuzvimba kwenguva refu kunogona kukonzera mavanga, izvo zvinogona kukonzera kuti pombi iite diki. Izvi zvinogonawo kukanganisa kufamba kweropa munzvimbo iyi, zvichikanganisa kupora kwechisikigo.
- Kuputsika kwejira remukati: Kuzvimba kwenguva refu kunogona kukanganisa jira remukati mebhegi, zvichikonzera maronda anogona kubuda ropa. Mabhakitiriya anokonzera utachiona anogona kukuvadza madziro emudumbu zvakanyanya.
- Kusanyungudika kwemuviri uye kushaya chikafu: Kana chikwama chako chakakuvara, kugona kwemuviri wako kupinza zvinovaka muviri kubva muchikafu kunoderera, izvo zvinogona kukonzera kushaya chikafu.
- Kukundikana kwechikwama: Muzviitiko zvakakomba, zvinogara kwenguva refu apo kurapwa kusingashande, chikwama chingasashande. Izvi zvingada kuvhiyiwa kwakawedzerwa kubvisa chikwama uye kutungamira ura kuburikidza ne ileostomy.
Pouchitis inoonekwa sei?
Kuongorora chirwere kunotanga nekukurukura zvakadzama zviratidzo zvako nenhoroondo yezvekurapa. Chiremba wako angangotarisa mukati mebhegi rako achishandisa endoscope —chubhu yakatetepa, inochinjika ine kamera diki. Izvi zvinovabvumira kuona kuzvimba kana chero chimwe chinhu chisina kunaka. Munguva iyi, vanogonawo kuita biopsy (kuunganidza sampuli diki yenyama) kuti vaone chikonzero chezviratidzo zvako.
Chiremba wako anogona kushandisawo bvunzo dzemifananidzo kuti aongorore chimiro chekunze chebhegi nenzvimbo dzakapoteredza, izvo zvinobatsira kubvisa zvimwe zvirwere zviripo pamwe chete.
Mimwe miedzo yekuongorora chirwere inogona kusanganisira:
- Kuenzanisa pouchography (pouchogram): X-ray chaiyo apo mvura inosiyanisa inoshandiswa kuratidza pouch zvakajeka, zvakafanana ne barium enema, asi kunyanya pouch ye ileal.
- Kuongororwa kweCT.
- Kuongororwa kweMRI.
Pouchitis inorapwa sei?
Kurapa kwekutanga kwe acute pouchitis imishonga inorwisa mabhakitiriya inotorwa kwemavhiki maviri , iyo inogadzirisa zviratidzo zvevarwere vazhinji. Kana mamiriro ako asina kunaka, chiremba wako anogona kugadzirisa mishonga yako, kusanganisa mishonga inorwisa mabhakitiriya yakasiyana, kana kuwedzera nguva yekurapwa. Kana zviratidzo zvikaramba zvichiitika kupfuura mavhiki mana, unogona kuonekwa uine pouchitis isingarwi nemishonga inorwisa mabhakitiriya, zvichida kuongororwa kwakawanda kuti uone nzira yakanakisisa yekufambira mberi.
Zvakadini nekudzoka kwechirwere chepouchitis?
Kana ukapora kubva pakurwara nechirwere chepouchitis asi zviratidzo zvikadzoka, chiremba wako angangodzokorora kurapwa kwekutanga kunoshanda. Chero bedzi kurapwa kwacho kuchishanda uye kurwara kusingawanzoitiki, nzira iyi inoramba iriyo yakajairika. Zvisinei, kana ukasangana nezviitiko zvinopfuura zvitatu pagore, inoiswa muchikamu che 'chronic antibiotic-dependent pouchitis,' uye chiremba wako achashandisa kurapwa kwenguva refu kudzivirira kurwara kunowedzera.
Kurapa kwekuchengetedza kunogona kusanganisira:
- Mishonga Inorwisa Mabhakitiriya: Kushandisa mishonga inorwisa mabhakitiriya kwenguva refu kunogona kubatsira kuchengetedza chikwama chine hutano uye kudzivirira kudzoka kwacho.
- MaProbiotics: Aya ndiwo manyuko ekuwedzera ane mabhakitiriya anobatsira anobatsira kudzorera hutano hwakanaka mubhegi rako uye kurwisa mabhakitiriya anokonzera hutachiona.
Ndeipi mishonga yekurapa chirwere chepouchitis chisingarapiki nemishonga inorwisa mabhakitiriya (CARP)?
Kana pouchitis yako isati yambopindura mishonga inorwisa mabhakitiriya, kana kuti yakambopindura asi isingachapinduri, vanachiremba vanodana izvi kuti Chronic Antibiotic-Resistant Pouchitis (CARP) . Muzviitiko zvakadaro, chiremba wako achatanga aongorora zvinhu zviri pasi pako zvaungave usina kuona, zvakaita sehutachiona hwechipiri, chirwere che autoimmune, kana dambudziko remaumbirwo epabhegi. Kana pasina chikonzero chakajeka chakawanikwa, vachabata pouchitis yenguva refu nenzira yatinobata nayo Inflammatory Bowel Disease (IBD).
Dzimwe nzira dzekurapa dzinosanganisira:
- Mesalamine enemas:Mesalamine, kana kuti 5-aminosalicylic acid (5-ASA), mushonga wekutanga wekurapa chirwere chemudumbu chinonzi ulcerative colitis. Inouya muchimiro che enema, chaunogona kuisa zvakananga muhomwe yako.
- Bismuth enemas: Bismuth subsalicylate, chinhu chinoshanda muPepto-Bismol®, chinowanikwa sefoam enema (bismuth carbomer), iyo inogona kubatsira kudzikamisa zviratidzo zvako.
- Corticosteroids: Iyi mishonga inoderedza kuzvimba inoshandiswa kurapa kuzvimba kwenguva refu.
- Mishonga inodzvinyirira muviri: Mishonga iyi inoderedza simba remuviri wako, iro vanachiremba vanokupa kana muviri wako uchikonzera kuzvimba kwenguva refu.
- Ma antibodies eMonoclonal (Biologics): Aya mapuroteni akagadzirwa nevanhu anoshanda sema antibodies emuviri wako, achisimudzira simba remuviri wako rekudzivirira chirwere chemuviri kurwisa kuzvimba.
- Mamorekuru madiki: Iyi mishonga mitsva, yakagadzirwa inoshanda zvakafanana nema antibodies e monoclonal.
- Kudyara Fecal Microbiota (FMT): Kunyange zvazvo yakatenderwa neUS FDA kurapa hutachiona hweC. diff husingaurayiwi nemishonga inorwisa mabhakitiriya, dzimwe nguva inoshandiswa isina zita rekuti pouchitis isingaurayiwi nemishonga inorwisa mabhakitiriya kubatsira kudzorera hutachiona hwemudumbu hune hutano.
Zvinotora nguva yakareba sei kuti pouchitis ipore?
Zviratidzo zve acute pouchitis zvinowanzotanga kudzikira mukati memazuva mashoma mushure mekutanga kushandisa mishonga inorwisa mabhakitiriya. Zvisinei, kunyangwe uchinzwa zviri nani, zvakakosha kuti upedze mavhiki maviri ese ekushandisa mishonga inorwisa mabhakitiriya.
Unofanira kubvunza chiremba wako mushure mekupedza kurapwa. Vangangoda kuongororwa ne endoscopic yebhegi rako kuti vaone kuti kuzvimba kwapera zvachose.
Pouchitis inogona kudzivirirwa here?
Humwe humbowo hunoratidza kuti mishonga inorwisa mabhakitiriya inogona kubatsira kudzivirira kutanga kwechirwere chepouchitis mushure mekuvhiyiwa kana kudzivirira kudzoka kwacho mushure mekurapwa kwakabudirira. Kunyange zvazvo isingashande kune wese munhu, inogona kukubatsira. Dzimwe nguva vanachiremba vanokupa musanganiswa wemishonga inorwisa mabhakitiriya (semuenzaniso, fomura yeDeSimone). Nekuti mhando chaiyo yemishonga inokosha, zvakakosha kukurukura izvi nachiremba wako.
Chii chaungatarisira kana ukaita chirwere chepouchitis?
Kana ukaita pouchitis mushure mekuvhiyiwa kweleal pouch yako—kunyangwe zvikaitika kakawanda—pane mukana mukuru wekuti ichapindura zvinobudirira kumaantibiotics. Vamwe vanhu vangada kurapwa kwenguva refu kupfuura vamwe. Kana ukasangana nekudzoka kwechirwere ichi kakawanda, ungangoda kurapwa kwenguva refu nemishonga inorwisa mabhakitiriya kana probiotics. Kune vanhu vashoma vane pouchitis, kurapwa uku kungasashanda.
Kana ukaramba uchirwara nechirwere chepouchitis chisingapindure mishonga inorwisa mabhakitiriya, chiremba wako achaongorora zvikonzero zvakavanzika zvekuzvimba, zvakaita se ischemia, kushandiswa kweNSAID, kana chirwere che autoimmune chiripo. Kana pasina chikonzero chechipiri chakawanikwa, chichaiswa muchikamu cheCARP. Vanachiremba vachakurudzira nzira dzakasiyana dzekurapa dzeCARP, vachishanda pamwe chete newe kuti vawane chinonyatsoshanda kune nyaya yako chaiyo.
Mune mamwe mamiriro ezvinhu, kana mutoro wekutarisira bhegi uchipfuura mabhenefiti, unogona kusarudza kubvisa bhegi kuti urarame usina zviratidzo. Iyoyo isarudzo inoshandawo.
Kudya kunokanganisa pouchitis here?
Ehe, zvinogona kuita basa.
Humwe humbowo hunoratidza kuti kana kudya kwako kusina ma antioxidants akawanda, njodzi yako yekubatwa ne pouchitis inogona kuwedzera. Ma antioxidants, anowanikwa mumichero nemiriwo yakawanda, anobatsira kuderedza makemikari mumuviri wako anonzi 'free radicals.' Kana ma free radicals akaungana, anogona kukuvadza masero uye kukonzera kuzvimba. Ma antioxidants anobva muchikafu anoshanda zvakanyanya kupfuura anobva mu supplements.
Kune rumwe rutivi, kana uri kutambura nezviratidzo zve pouchitis parizvino, kuderedza fiber mukudya kunogona kubatsira. Vanachiremba vanowanzokurudzira kudya kusina FODMAP yakawanda.Izvi zvinoderedza zvimwe zvekudya—kusanganisira fibers chaiyo—izvo mabhakitiriya emudumbu mako anofarira kuvirisa. Kuderedza zvekudya izvi kwenguva pfupi kunogona kubatsira kuderedza zviratidzo zvemudumbu mako. Zvisinei, kwenguva refu, unofanira kuvavarira kudzoreredza zvishoma nezvishoma zvakasiyana-siyana zvekudya.
Zvekudya zvinogona kubatsira kuchengetedza hutano hwebhegi rako:
Iva nechokwadi chekuti uri kuwana mishonga inorwisa mabhakitiriya yakakwana nekudya michero nemiriwo yakasiyana-siyana. Nzvimbo dzakanaka dzinosanganisira:
- Maapuro
- Mabheri (semuenzaniso, mastrawberry, mablueberries)
- Mazambiringa
- Mapuruni
- Bhinzi
- Artichokes
- Mbatatisi dzeRusset
- Miriwo yakasviba ine mashizha (semuenzaniso sipinachi)
Kuisa chikafu chose, kunyanya chikafu chezvirimwa, mukudya kwako inzira huru yekurarama hupenyu husina kuzvimba. Maantioxidant ndeimwe yezvikonzero nei.
Zvekudya zvekudzivirira panguva yekubuda kwepouchitis (kuderedza zviratidzo):
Kuti zvikubatsire kugadzirisa zviratidzo zvako, vanachiremba vanogona kukurudzira kudya kweFODMAP shoma, kusvika waona kuti ndeapi maFODMAP anokonzera matambudziko ako chaiwo. MaFODMAP anowanzo sanganisira:
- Fructose (shuga yemichero)
- Lactose (shuga yemukaka)
- Hanyanisi
- Garlic
- Bhinzi
- Gorosi
Kudya kusina FODMAP yakawanda inzira yekubvisa chikafu kwenguva pfupi. Unobvisa mamwe mapoka ezvekudya kwenguva pfupi kuti uone zvinokonzera chirwere chako uye wobva watangazve kudya uchishandisa nhungamiro yechiremba.
Kutora Kwekupedzisira
Kana uine chikwama cheial, zvinokwanisika kuti unogona kusangana ne pouchitis pane imwe nguva. Kunyange zvazvo isingakanganisi munhu wese, avo vanoiwana vanogona kusangana nezviitiko zvinogara zvichiitika. Zvinonzwisisika kunzwa kusafara kana matambudziko ekugaya aramba aripo kunyangwe mushure mekunge ura hwako hwabviswa. Zvisinei, mashoko akanaka ndeekuti kune vanhu vazhinji, pouchitis idambudziko rinowanzova nyore kubata naro kupfuura matambudziko emudumbu asingaperi awakasangana nawo kare.
Chirwere chepouchitis chisingarapiki nemishonga inorwisa mabhakitiriya (CARP) chinobvumwa kuti chakaoma zvikuru. Mune zvimwe zviitiko, chinogona kunge chakabatana nechirwere chako chemudumbu chisingaperi, zvichiita kuti nzira yekurapa ive yakaoma. Kunyange zvakadaro, nekurapwa nguva dzose uye nzira yakagadzirirwa, timu yako yezvekurapa inogona kuwana musanganiswa unoshanda wekurapa unoshanda kwauri.
Ndapota yeukai kuti hamusi mega parwendo urwu. Tinokukurudzirai kuti mutaure pachena nachiremba wenyu uye mubvunze chero mibvunzo yamungave nayo. Nekutungamirirwa kwakakodzera uye kurapwa, Nirogi Lanka iripo kuti ikubatsirei kuchengetedza hupenyu hwepamusoro.
