Ingaba isibindi sakho sinamafutha amaninzi? Masifunde ngegama elitsha lesifo sesibindi esinamafutha (iSteatotic Liver Disease)!

“Owu, gqirha, ndinamanqatha esibindini sam…” Ngaba ukhe wayiva into efana nale? Okanye nawe unayo le meko? Ungakhathazeki. Namhlanje sithetha ngesi sifo sokunamatha esibindini, okanye ngamanye amazwi, iSteatotic Liver Disease. Ngaphambili, besibiza esi “sisibindi esinamafutha.” Yintoni kanye kanye le? Kutheni sanikwa igama elitsha? Masithethe ngayo yonke le nto ngokulula.

Kutheni igama elithi "Fatty Liver" litshintshile?

Sasibiza le meko ngokuthi “isifo sesibindi esityebileyo.” Kodwa ngo-2023, iingcali zonyango zagqiba ekubeni zitshintshe igama zibe “sisifo sesibindi esityebileyo.” Zimbini izizathu eziphambili zoku. Esinye kukuba igama elitsha lichaza ngokuchanekileyo izizathu zeso sifo. Umzekelo, nangona ukutyeba kakhulu kuyimbangela enye, kukho ezinye izinto ezinobungozi ezingenanto yakwenza nobunzima. Esinye isizathu kukuba igama elithi “isibindi esityebileyo” ngamanye amaxesha linokuba yintloni kwaye libeke ibala kubantu abanesifo, ngoko ke ukutshintsha igama kwanceda ekungagxininiseni oko. Ngamafutshane, “i-steatosis” ligama elisetyenziswa ngoogqirha ukuchaza ukuqokelelwa kwamafutha kwilungu (ngokuqhelekileyo isibindi). Isibindi esisempilweni nesisebenza kakuhle sinamafutha amancinci. Oku kuqokelelwa kwamafutha kuba yingxaki ukuba kudlula i-5% yobunzima besibindi.

Ziziphi iintlobo zesifo sesibindi esinamafutha (SLD)?

Oogqirha bahlulahlula i-SLD ngokwezizathu zayo kunye neemeko ezinxulumene nayo. Makhe sijonge iintlobo eziphambili.

1. Isifo sesibindi esinxulumene notywala (ALD)

Kwenzeka ntoni kukuba ukuba usela utywala kakhulu, amafutha ayaqokelelana esibindini sakho. Cinga ngako, xa usela utywala, isibindi sakho yiso esibuhluzayo. Kule nkqubo, ezinye iiseli zesibindi ziyafa. Ngokwesiqhelo, isibindi sinokwenza iiseli ezintsha ezithatha indawo yezo zilahlekileyo. Kodwa ukuba uqhubeka usela utywala kakhulu, isibindi asikwazi ukwenza lo msebenzi ngokufanelekileyo. Kulapho ke amafutha aqala ukuqokelelana esibindini sakho, imeko ebizwa ngokuba yi-steatosis .

2. Isifo sesibindi se-steatotic esinxulumene nokungasebenzi kakuhle kwe-metabolic (MASLD)

Oku kwakubizwa ngokuba sisifo sesibindi esinamafutha esinganxilisiyo (i-NAFLD). Oku kungenxa yokuba amafutha asesibindini awabangelwa kukusebenzisa utywala kakhulu. Igama elitsha lithi izinto eziphambili ezinegalelo ekuphuhlisweni kwesibindi esinamafutha zizinto ezibangela umngcipheko wentliziyo kunye ne-metabolic . Ngamafutshane, kubangelwa ziimeko ezithile kunye neempawu ezichaphazela impilo yentliziyo yakho.

Izinto eziphambili ezibangela umngcipheko wokuphuhlisa i-MASLD zezi:

• Ukutyeba kakhulu
• Uhlobo lwesibini lwesifo seswekile
• Igazi elonyukayo
• Ukungalungelelani kwamafutha egazini – Oku kukungalingani kwamafutha egazini lakho, njenge-cholesterol kunye ne-triglycerides.

Nokuba usela utywala obuncinci ngeveki, oko kukuthi, ngaphantsi kweegremu ezili-140 ngeveki kwabasetyhini kunye nangaphantsi kweegremu ezingama-210 ngeveki kwamadoda, usenokuthathwa njengeMASLD. (Umzekelo, eMelika, ibhotile yebhiya eqhelekileyo ene-ounce ezili-12 iqulethe malunga neegremu ezili-14 zotywala.)

3. Ukugcwala kwamafutha kunye nokudumba esibindini ngenxa yokungasebenzi kakuhle kwe-metabolism (i-steatohepatitis enxulumene ne-metabolic - MASH)

I-MASH luhlobo olubi kakhulu lwe-MASLD. Kule meko, isibindi siyadumba kwaye sivuvuke ngenxa yokuqokelelwa kwamafutha esibindini. Emva koko, izicubu zesibindi zonakele kwaye ziqale ukuba namanxeba (fibrosis) . Ngaphambili, oku kwakubizwa ngokuba yi-steatohepatitis engeyo-alcoholic (NASH).

4. I-MASLD kunye nokusetyenziswa kotywala ngokugqithisileyo (i-MetalALD)

Ukuba uneMetalALD, oko kuthetha ukuba zombini izinto ezibangela umngcipheko we-metabolic kunye nokusetyenziswa kotywala ziye zanegalelo ekuqokeleleni kwamafutha esibindini sakho. Kwimeko enjalo, unezinto ezibangela umngcipheko wentliziyo kunye ne-metabolic, kwaye usela ngaphezulu kwe-140 grams yotywala ngeveki kubasetyhini kunye nangaphezulu kwe-210 grams kumadoda.

Nokuba utywala okanye izinto ezibangela umngcipheko wokusetyenziswa kwe-metabolic zinokubangela ukuba amafutha aqokeleleke esibindini zinokwahluka kumntu nomntu.

5. Ezinye iintlobo ze-SLD

I-SLD inokwenzeka ngaphandle kokusetyenziswa kotywala okanye izinto ezinokubangela umngcipheko we-metabolic. Umzekelo, amanye amayeza kunye nezinye izifo zinokubangela ukuba amafutha aqokeleleke esibindini. Ngamanye amaxesha oogqirha abakwazi ukufumana unobangela ocacileyo. I-SLD engenasizathu sicacileyo ibizwa ngokuba yi -cryptogenic SLD .

Ngaba isifo sesibindi esinamafutha (SLD) singxaki enkulu?

Kwiimeko ezininzi, ukugcinwa kwamafutha esibindini akubangeli ngxaki zinkulu okanye kuphazamise ukusebenza kakuhle kwesibindi. Nangona kunjalo, ngamanye amaxesha le meko inokuba mandundu kancinci kancinci ize ikhule ibe sisifo sesibindi. Oku kwenzeka ngezigaba ezahlukeneyo:

• IHepatitis : Isibindi, esizaliswa ngamafutha ekuqaleni, siyadumba size sivuvuke. Oku kuvutha konakalisa izicubu zesibindi. Le meko ibizwa ngokuba yi-steatohepatitis. Umzekelo, i-MASLD iba yi-MASH ngolu hlobo lulandelayo.
• I-Fibrosis: Izicubu ezibuhlungu ziqala ukwakheka kwiindawo apho isibindi sonakaliswe khona kukudumba. Oku kubangela ukuba isibindi sibe lukhuni kancinci. Le nkqubo ibizwa ngokuba yi-fibrosis .
• Isifo sokuqaqamba kwesibindi: Kulapho izicubu zesibindi ezisempilweni zithathelwa indawo ziinkozo ezininzi. Kulapho ke sibiza ngokuba yi -cirrhosis yesibindi . Ukuba ayinyangwa kakuhle, isifo sokuqaqamba kwesibindi sinokukhokelela kwiimeko ezisongela ubomi ezifana nokungasebenzi kwesibindi kunye nomhlaza wesibindi. Umzekelo, malunga nama-90% abantu abafumana i-hepatocellular carcinoma (HCC) , uhlobo lomhlaza wesibindi, bane-cirrhosis.

Zithini iimpawu zesifo sesibindi esinamafutha (SLD)?

Ayingabo bonke abantu abane-SLD abaya kuba neempawu. Ngamanye amaxesha, ukuba iimpawu ziyenzeka, zingabandakanya:

• Intlungu yesisu okanye ukuziva ugcwele kwinxalenye ephezulu ngasekunene yesisu.
• Ukuziva udiniwe kakhulu okanye ubuthathaka (ukudinwa).

Nangona kunjalo, uninzi lwabantu lubona iimpawu kuphela emva kokuba isifo sesibindi sidlulele ekubeni sisifo sesibindi . Xa isifo sesibindi siqala, iimpawu ezifana nezi:

• Isicaphucaphu.
• Ukutya akunancasa.
• Ukuba mncane ngaphandle kwesizathu.
• Ukutyheli kwesikhumba kunye namhlophe emehlweni (i-jaundice).
• Ii-Ascites – Oku kuthetha ukuba isisu sizaliswe lulwelo.
• Ukudumba (ukudumba) kwemilenze, iingalo, okanye amaqatha.
• Ukopha (ugqirha angakubona oku kwisisu sakho, esiswini, okanye kwi-rectum).

Zithini izizathu zesifo sesibindi esinamafutha (SLD)?

Kukho izizathu ezahlukeneyo zokuba i-SLD inokukhula. Nangona kunjalo, ukuba unezinto ezinobungozi kwintliziyo nakwimetabolism , ukuba usebenzisa utywala ngendlela engafanelekanga, okanye ukuba unazo zombini ezi zinto, unamathuba amaninzi okuba ne-SLD.

Usemngciphekweni omkhulu wokufumana i-SLD ukuba unezi zinto zilandelayo:

• Ingxaki yokusebenzisa utywala – oko kukuthi, ukusela utywala rhoqo okanye ngokugqithisileyo.
• I-Metabolic syndrome - Oku kuquka ukuxhathisa i-insulin, uxinzelelo lwegazi oluphezulu, i-cholesterol ephezulu, kunye namanqanaba aphezulu e-triglyceride.
• Uhlobo lwesibini lweswekile.
• Ubunzima obugqithisileyo – Oku kuthetha ukuba i-body mass index yakho (BMI) iphakathi kwama-25 nama-29.9 kg/m2.
• Ukutyeba kakhulu – I-BMI yi-30 kg/m2 okanye ngaphezulu.
• I-Polycystic ovary syndrome (i-PCOS).
• Ukuphazamiseka kokulala.
• I-Hypothyroidism.
• Ukwehla kwamanqanaba e-pituitary hormone (i-Hypopituitarism).
• Ukuncipha kweehomoni zesini (i-Hypogonadism).
• Ukuqhubeka nokusebenzisa amayeza athile. Umzekelo, i-Amiodarone (Amiodarone – Cordarone®), i-Diltiazem (Diltiazem – Cardizem®), i-Tamoxifen (Tamoxifen – Nolvadex®) okanye ii-steroids. (Amanye amayeza anokubangela ukuba amafutha aqokeleleke esibindini njengesiphumo esibi.)

Ziziphi iingxaki ezinokubakho ze-SLD?

Ukuba ayinyangwa, isibindi esibizwa ngokuba yi-steatotic liver sinokuqhubekela kwi- cirrhosis , nto leyo enokubangela ukungasebenzi kakuhle kwesibindi, umhlaza wesibindi, kunye neminye imidlaza engaphandle kwesibindi. Abantu abane-MASLD basengozini enkulu yesifo sentliziyo. Kubalulekile ukukhumbula ukuba isifo sentliziyo, kungekhona isifo sesibindi, sesona sizathu siphambili sokufa phakathi kwabantu abane-MASLD.

Isifo sesibindi esinamafutha (SLD) sifunyanwa njani?

Ngenxa yokuba i-SLD idla ngokungabi nazimpawu, ugqirha wakho usenokuba ngowokuqala ukuqaphela ingxaki. Ukuba ii-enzymes zesibindi sakho ziphezulu ngexesha lovavanyo lwegazi kwezinye iimeko, oko kungaba luphawu lwesilumkiso. Ii-enzymes zesibindi eziphakamileyo zinokuthetha ukuba isibindi sakho sonakele.

Ukuze axilonge, ugqirha wakho angenza oku kulandelayo:

• Imbali yezonyango: Ukubuza ngeemeko zakho zempilo, ukuba usela utywala obungakanani, kunye namayeza owasebenzisayo.
• Uvavanyo lomzimba: Jonga iimpawu zesifo sokuqina kwesibindi, ezinje ngesibindi esikhulu kunye ne-jaundice .
• Iinkqubo zokuthatha imifanekiso: Uvavanyo olufana ne -ultrasound , i-CT scan (i-Computed Tomography scan) , okanye i-MRI (i-Magnetic Resonance Imaging) lusetyenziselwa ukukhangela ukudumba kunye namanxeba esibindini. Uvavanyo olukhethekileyo lwe-ultrasound olubizwa ngokuba yi -FibroScan® lunokusetyenziswa ukufumanisa ubungakanani bamafutha kunye nezicubu zamanxeba esibindini.
• Uvavanyo lwesibindi: Olu vavanyo lwenziwa ukuze kuqinisekiswe ukuba isifo sesibindi sihambe kangakanani na. Eyona ndlela yokwahlula ngokuchanekileyo phakathi kwe-MASLD kunye ne-MASH kukwenza uvavanyo lwesibindi .

Iphathwa njani isifo sesibindi esinamafutha (SLD)?

Akukho nyango okanye amayeza athile ale meko. Endaweni yoko, oogqirha bagxila ekukuncedeni ukulawula izinto ezibangela umngcipheko kule meko. Oku kuquka ukwenza utshintsho kwindlela ophila ngayo olunokuphucula impilo yakho.

Ugqirha wakho unokucebisa oku kulandelayo:

• Yeka ukusela utywala ngokupheleleyo: Nokuba i-SLD yakho ayibangelwanga kukusebenzisa utywala, yiphephe ngokupheleleyo.
• Ukunciphisa umzimba: Ukuzilolonga, utshintsho kwindlela yokutya phantsi kweliso lengcali yesondlo, kunye namayeza athile, anjenge- GLP-1RA, anokukunceda unciphise umzimba. Ungacinga nangotyando lokunciphisa umzimba.(utyando lweBariatric) nabo banokufaneleka.
• Sela amayeza okulawula iimeko zemetabolism: Sela amayeza akho owanikwe ngugqirha ukulawula isifo seswekile, i-cholesterol, kunye namafutha egazini (ii-triglycerides). Kwezinye iimeko, unokufuna ukuthatha i-vitamin E kunye ne -thiazolidinediones (amayeza esifo seswekile afana ne -Actos® kunye ne -Avandia® ).
• Gonyelwa iHepatitis A kunye neHepatitis B : Ezi ntsholongwane ziyingozi kakhulu ukuba sele unesifo sesibindi.

Ukuba iyeza olisebenzisayo libangela ukuba amafutha aqokeleleke esibindini sakho, ugqirha wakho unokutshintsha umyalelo wakho.

Ungayithintela njani isifo sesibindi esinamafutha (SLD)?

Eyona ndlela ilungileyo yokuphepha i-SLD kukugcina impilo yakho iyonke:

• Zilolonge rhoqo.
• Nciphisa ukusela kwakho utywala.
• Gcina ubunzima bakho busempilweni.
• Ukuba unesifo seswekile sohlobo lwesibini okanye isifo se-metabolic syndrome, thatha amayeza akho owanikwe ngugqirha njengoko uyalelwe.

Ngaba isifo sesibindi esinamafutha (SLD) siyanyangeka?

Ngokuxhomekeke kubunzima bemeko yakho, i-SLD inokuguqulwa kwaye ezinye izibazi zinokulungiswa. Isibindi sakho sinamandla amangalisayo okuziphilisa. Ukuba ulandela isicwangciso sonyango sikagqirha wakho ngokuchanekileyo, unganciphisa inani lamafutha kunye nokudumba kwisibindi sakho. Ungathintela umonakalo ukuba ube mbi ngakumbi, kwaye kwezinye iimeko, ubuyisele umonakalo wesibindi kwangoko.

Ngaba i-SLD ingabangela ukufa?

Kubantu abaninzi, i-SLD ayibangeli iingxaki ezinkulu ngaphandle kokuba iqhubekela phambili kwi -cirrhosis . Abantu abaninzi abane-SLD baphila ubomi obuqhelekileyo.

Nangona kunjalo, isifo sesibindi esinganyangwanga singakhokelela ekusileleni kwesibindi okanye kumhlaza wesibindi. Isibindi sisitho esibalulekileyo kuwe. Yiyo loo nto kubaluleke kakhulu ukukhusela isibindi sakho ukuba ufumanisa ukuba une-SLD.

Ithini indlela yokutya efanelekileyo kumntu one-SLD?

Ukuba i-SLD yakho inxulunyaniswa nokutyeba, landela ukutya okunesondlo ukuze wehlise umzimba kancinci kodwa ngokuthe chu. Oogqirha badla ngokucebisa ukuba baphephe ukutya okuneswekile. Bakwacebisa ukuba uzame ukutya kwaseMedithera . Kutyebile kwimifuno, iziqhamo, kunye namafutha alungileyo. Kwakhona, izinto ezifana namandongomane, iimbotyi, iinkozo ezipheleleyo, intlanzi kunye nenkukhu zizinto ezilungileyo zokutya kubantu abane-SLD. Kubaluleke kakhulu ukuphepha ukutya inyama ebomvu kakhulu nokusela iziselo ezineswekile.

Imibuzo Ebuzwa Rhoqo (Imibuzo Ebuzwa Rhoqo)

Umbuzo: Ingakanani ingozi eyenzekileyo kwisibindi sam?

Impendulo: Ugqirha wakho angakuxelela ngokuqinisekileyo. Uza kwenza uvavanyo lwegazi, ahlole (i-Ultrasound, i-FibroScan) ukujonga ukuba ingakanani na i-fat esibindini sakho kunye nokuba kukho na amanxeba. Emva koko uza kukuchazela imeko.

Umbuzo: Kuthatha ixesha elingakanani ukuba umonakalo wesibindi ubuyele esiqhelweni?

Impendulo:Kuxhomekeke kakhulu kwimeko yakho kunye nemizamo yakho. Ukuba kusekuqaleni, ukuba ulawula ukutya kwakho kwaye wehlise umzimba, ungabona utshintsho oluhle kwiinyanga ezimbalwa. Ukuba inzima, njenge-cirrhosis, kunzima ukuyinyanga ngokupheleleyo, kodwa ungayinqanda ukuba ibe mandundu.

Umbuzo: Ngaba amayeza endiwasebenzisayo ayayichaphazela i-SLD?

Impendulo: Ewe, inokwenzeka. Amanye amayeza, umzekelo, i-Amiodarone kunye ne-Diltiazem, anokuchaphazela isibindi. Yiyo loo nto kufuneka uxelele ugqirha wakho ngawo onke amayeza owasebenzisayo. Uya kujonga ukuba kukho ingxaki na ngaloo mayeza.

Umbuzo: Yintoni ubunzima obusempilweni kum?

Impendulo: Kuxhomekeke kubude bakho kunye nobudala bakho. Ngokuqhelekileyo kungcono ukugcina i-BMI yakho ingaphantsi kwama-25. Kodwa eyona nto ilungileyo onokuyenza kukubuza ugqirha wakho okanye ingcali yesondlo malunga nobunzima obufanelekileyo kuwe. Nokuba unciphise ubunzima obuncinci kunokuba luncedo kakhulu kwisibindi sakho.

Umbuzo: Ndingadibana nengcali yesondlo ukuze ndifunde ngokutya okunempilo?

Impendulo: Inene! Yiyo loo nto ilungileyo onokuyenza. Ingcali yesondlo ingakunceda wenze uluhlu lokutya okufanelekileyo kuwe. Bangakuxelela ngezinto ezifana nokutya kwaseMedithera kunye nokutya okulula ukukulungisa. Ukuba ubuza ugqirha wakho, angakuthumela.

Umbuzo: Ndingalufumana njani unyango lwengxaki yokusebenzisa utywala?

Impendulo: Ukuba unengxaki yokuyeka ukusela utywala, musa ukuba neentloni. Yinto eqhelekileyo leyo. Eyona nto ingcono onokuyenza kukuthetha nogqirha wakho ngayo. Angakunceda, kwaye ukuba kuyimfuneko, akuthumele kwinkonzo yokunika iingcebiso okanye kwingcali. Khumbula, ukuhlala kude notywala kubalulekile ukuze usindise isibindi sakho.