Ngaba ungumntu oye wasuswa i-colon kunye ne-rectum yakho yonke ngotyando ngenxa yemeko yempilo kwaye kwenziwa 'i-ileal pouch' endaweni yayo? Ukuba kunjalo, unokufumana ukungakhululeki okunxulumene nale ngxowa ngamanye amaxesha. Enye yezona ngxaki zixhaphakileyo ezinokuvela yile nto sithetha ngayo namhlanje, 'iPouchitis'. Musa ukoyika xa usiva oku. Masithethe ngayo yonke into ngokucacileyo nangokulula.
Yintoni iPouchitis? Masiyiqonde ngokulula.
Okokuqala, makhe sijonge ukuba yintoni le 'ingxowa ye-ileal'. Emva kokuba ikholoni yakho kunye ne-rectum zisusiwe ngokupheleleyo (i-total proctocolectomy), udinga indlela entsha yokukhupha indle yakho emzimbeni wakho. Esinye isisombululo saloo nto lutyando lwengxowa ye-ileal. Okwenzekayo apha kukuba oogqirha basebenzisa inxalenye yokugqibela yamathumbu akho amancinci (ileum) ukwenza isakhiwo esincinci esifana nengxowa.
Ngoko ke, into eyayisenziwa ngamathumbu akho amakhulu, eyayikukuqokelela nokugcina indle okwethutyana ngaphambi kokuba ihambe, ngoku yenziwa yiloo ngxowa. Ngamanye amazwi, inxalenye yamathumbu akho amancinci ngoku isebenza njengethumbu elikhulu.
I-Pouchitis kuxa ingxowa idumba okanye ivuvukala ngaphakathi. Yimeko efana ne-colitis (ukudumba kwamathumbu amakhulu) okanye i-proctitis (ukudumba kwe-rectum). Le yimeko eqhelekileyo kumntu onengxowa.
Kwabaninzi abantu, oku kwenzeka okwexeshana (i-acute pouchitis), kodwa kwabanye abantu kunokuba yimeko eqhubekayo (i-chronic pouchitis) okanye imeko ephindaphindayo.
Zithini iimpawu ze-pouchitis?
Ukuba une-pouchitis, usenokuba nenye okanye ngaphezulu kwezi mpawu. Kubalulekile ukuba uzazi.
| Uphawu | Inkcazo |
|---|---|
| Intlungu yesisu esisezantsi kunye nokuqhwalela | Intlungu engaqhelekanga esiswini esisezantsi okanye ukuziva ubanjwe kwaye ujike. |
| Ukufuna ukuya kwindlu yangasese rhoqo nangesiquphe | Kufuneka uye kwindlu yangasese rhoqo kunesiqhelo. Ukwaba nesidingo esinganyamezelekiyo sokuya kwindlu yangasese. |
| Ukuya kwindlu yangasese ebusuku | Kufuneka ndivuke ndiye kwindlu yangasese. |
| Ubunzima bokulawula ukuhamba kwamathumbu (ukungakwazi ukuzibamba) | Ukuchitha isitulo esincinci ungaqondanga. |
| Ubunzima bokuchama | Ukuzilolonga ukuze ukhululeke xa usiya kwindlu yangasese (i-dyschezia). |
| Ukuziva ungakwazi ukukhupha yonke into endlwini yangasese emva kokungena endlwini yangasese | Ukuziva ngathi usenesisu esiphumayo nangona sele uphume indle (tenesmus). |
| Igazi elincinci esitulweni | Ukubona imicu yegazi esitulweni. |
| Umkhuhlane okanye ukubanda | Ukuziva ushushu okanye uqhaqhazela. |
Kutheni iPouchitis isenzeka?
Isizathu esichanekileyo soku asikaziwa ngokupheleleyo, kodwa ingcamango ephambili kukuba kukho ukungalingani kwiintlobo zeebhaktheriya ezihlala ngaphakathi kwesi sikhwama.
Khawucinge nje, xa inxalenye yamathumbu akho amancinci ngoku isebenza njengethumbu elikhulu, kungena iintlobo ezintsha zeebhaktheriya. Kukho 'imfazwe' encinci phakathi kwezi bhaktheriya zintsha nezindala. Olu tshintsho lunokubangela ukuba inkqubo yomzimba yokuzikhusela icinge ukuba kukho usulelo apho. Ngoko ke, ngenxa yoko, kuvela ukudumba, nto leyo ethetha ukuba isikhwama siyadumba.
Ngamanye amaxesha, iintsholongwane ezibangela izifo zinokukhula zize zibangele usulelo. Olu lungelelwaniso lweentsholongwane luyatshintsha emva kotyando, nto leyo enika iintsholongwane eziyingozi ithuba elingcono lokukhula.
Kuqhelekile ukuba ne-pouchitis emva nje kotyando. Oku kunokunyangwa rhoqo ngamayeza okubulala iintsholongwane. Nangona kunjalo, kwabanye abantu, inokuphinda ivele.
Ezinye izinto ezibangela i-pouchitis engapheliyo
Kwabanye abantu, i-pouchitis iyaqhubeka okanye ayiphenduli kakuhle kunyango. Oku kunokubangelwa zezinye izinto.
- Iimeko zonyango ezazikho ngaphambili (IBD): Ukuba bekufuneka ususwe ikholoni yakho ngenxa yesifo samathumbu esibangelwa kukudumba (IBD) esifana ne-Ulcerative Colitis okanye isifo sikaCrohn, usemngciphekweni omkhulu wokuba ne-pouchitis. Oku kungenxa yokuba indlela efanayo ebangela eso sifo inokuchaphazela ne-pouch.
- Iibhaktheriya ezimelana neentsholongwane: Ezinye izifo zebhaktheriya, ezifana ne-C. difficile, kunzima ukuzilawula ngee-antibiotics. Kwakhona, ngokuqhubeka nokusebenzisa ii-antibiotics, ezinye iibhaktheriya ziyamelana nazo. Oku kunokunyusa ukungalingani kweebhaktheriya kwisingxobo.
- Ezinye izifo: Ngamanye amaxesha, ukudumba kwesingxobo kunokubangelwa zizifo ezibangelwa yintsholongwane (cytomegalovirus) okanye izifo ezibangelwa yifungus (candidiasis).
- Ubuthathaka bomzimba: Ukuba umzimba wakho ubuthathaka ngenxa yezinye iimeko zonyango okanye amayeza athile, amandla akho okulwa nosulelo ayancitshiswa.
- Ukusetyenziswa kwee-painkillers (NSAIDs): Ukusetyenziswa ixesha elide nangokugqithisileyo kwee-painkillers ezifana ne-ibuprofen kunye ne-aspirin (i-Nonsteroidal anti-inflammatory drugs - NSAIDs) kunokonakalisa umaleko ongaphakathi wesikhwama.
- Ukuncipha kokunikezelwa kwegazi (ischemia): Nangona kunqabile kakhulu, ukudumba kunokwenzeka ngenxa yokuvaleka kokunikezelwa kwegazi kwisingxobo.
- Isifo se-PSC: `(I-Primary sclerosing cholangitis - PSC)` sisifo esibangela ukudumba kwe-bile ducts yesibindi. Abantu abanale meko basengozini enkulu yokufumana i-pouchitis.
Ziziphi iingxaki ezinokubakho ngenxa ye-pouchitis?
I-pouchitis yexeshana ayisoloko ibangela iingxaki ezinkulu, kodwa ukuba imeko iyaqhubeka okanye ayiphenduli kunyango, inokubangela iingxaki ezithile.
| Ingxaki | Inkcazo |
|---|---|
| Utshintsho kwimikhwa yamathumbu | Ukudumba kwesingxobo kunokubangela iingxaki ezihlala ixesha elide, ezinje ngokuba nzima ukubamba isitulo okanye ubunzima bokuphuma kwesitulo ngenxa yokudumba. |
| Ukwehla komgangatho wokuphila | Ubunzima bokuya kwindlu yangasese rhoqo bunokubangela iingxaki ezifana noxinzelelo kunye nokuncipha kobudlelwane bentlalo. |
| Ukuncitshiswa kwengxowa (iStricture) | Ukudumba ixesha elide kunokubangela ukuba ingxowa ibe namanxeba, nto leyo enciphisa ukuvuleka kwayo. |
| Izilonda | Ukudumba kunokubangela ukuba umaleko ongaphakathi wesingxobo ucaphuke kwaye wophe igazi. |
| Ukunqongophala kwesondlo | Ukonakala komaleko ongaphakathi wesingxobo kunokukhokelela ekuncipheni kokufunxwa kwezondlo ekutyeni (i-malabsorption), okukhokelela ekungondlekini kakuhle. |
| Ukusilela Kwesikhwama | Amaxesha amaninzi, iingxaki ezingapheliyo zinokwenza isikhwama singasetyenziswa, nto leyo edinga ukuba sisuswe kwaye kufuneke ukuba sithathwe nezinye iindlela zotyando, ezifana ne-ileostomy. |
Uyazi njani ukuba une-pouchitis?
Emva kokumamela iimpawu zakho, ugqirha wakho uza kwenza iimvavanyo ezininzi ukuqinisekisa imeko. Olona vavanyo lubalulekileyo yi -pouchoscopy (endoscopy) .
Oku kuquka ukufaka ityhubhu encinci kakhulu enekhamera eqhotyoshelwe kwi-anus yakho uze uhlole ingaphakathi lesikhwama. Ugqirha angajonga ukuba akukho nakuphi na ukudumba okanye izilonda ngaphakathi kwesikhwama. Kwangaxeshanye, iqhekeza elincinci lesicwili (i-biopsy) linokuthathwa ukuze lihlolwe.
Ukongeza, ezi mvavanyo zilandelayo zingenziwa ukujonga imeko yesingxobo kunye nezakhiwo ezisingqongileyo:
- I-Contrast Pouchography `(i-pouchogram)`
- `Iskeni ye-CT`
- `I-MRI`
Ziziphi iindlela zonyango lwe-pouchitis?
Iindlela zonyango zixhomekeke kuhlobo lwe-pouchitis onayo.
Unyango lwe-Acute Pouchitis
Unyango lokuqala lunyango lwee-antibiotics lweeveki ezimbini. Kubantu abaninzi, oku kuya kuzicima ngokupheleleyo iimpawu zabo. Nokuba iimpawu zakho ziyaphucuka, kubalulekile ukuthatha yonke ikhosi yamayeza achazwe ngugqirha wakho.
Unyango lwePouchitis ePhindaphindayo
Ukuba i-pouchitis iphinda ivele emva konyango, ugqirha usenokunika amayeza afanayo okubulala iintsholongwane. Nangona kunjalo, ukuba iyenzeka ngaphezu kwezihlandlo ezithathu ngonyaka, ithathwa njengesifo esingapheliyo kwaye unyango lokugcina lunokuqaliswa ukuthintela ukuphinda kwenzeke. Ngenxa yoku,
- Ukunika amayeza okubulala iintsholongwane ixesha elide ngeedosi eziphantsi.
- Ukusetyenziswa kweeProbiotics: IiProbiotics, eziqulethe iintsholongwane eziluncedo, zinokunceda ukubuyisela ibhalansi yeentsholongwane kwisingxobo.
Unyango lwe-pouchitis engaphenduliyo kwii-antibiotics (CARP)
Ukuba ii-antibiotics azincedi, okanye ukuba bezinceda ngaphambili, imeko ibizwa ngokuba yi-"Chronic antibiotic-resistant pouchitis (CARP)". Apha, ugqirha uza kukhangela ezinye izizathu aze agqibe ngonyango ngokufanelekileyo. Kukho iindlela ezahlukeneyo zonyango zoku.
- Ii-enema eziqulethe amayeza afana ne-'Mesalamine' okanye i-'Bismuth'
- Ii-Corticosteroids, ezinciphisa ukudumba
- Ii-immunosuppressants ezilawula ukusebenza kwenkqubo yomzimba yokuzikhusela
- Amayeza anamhlanje afana ne-'Biologics'
- Unyango olukhethekileyo olufana nokufakelwa kwe-fecal microbiota (FMT)`
Eyona nto ibalulekileyo kukuba ugqirha wakho agqibe ukuba loluphi unyango olukulungeleyo. Ngoko ke ukuba uneempawu, funa ingcebiso kagqirha ngokukhawuleza.
Ngaba i-pouchitis ingalawulwa ngokutya nokusela?
Ewe, ngandlela ithile kunokwenzeka. Ukutya kwakho kunokunceda ukuthintela ukuvela kwe-pouchitis kwaye kuncede nokulawula iimpawu xa zivela.
| Ukutya okunceda ukuthintela i-pouchitis (ukutya okutyebileyo kwi-antioxidant) | Ukutya okwandisa iimpawu ze-pouchitis (yeka okwethutyana) |
|---|---|
Faka iziqhamo kunye nemifuno etyebileyo kwii-antioxidants ezinciphisa ukudumba ekutyeni kwakho.
| Xa kukho iimpawu, isiqabu sinokufunyanwa ngokunciphisa okwethutyana ukutya okuthile okuvuselela iintsholongwane zamathumbu kwaye kunzima ukukugaya (Low FODMAP Diet).
|
Kubalulekile: Ukutya okune-FODMAP ephantsi akuyonto omele uyilandele ngokusisigxina. Yinto omele uyilandele ixesha elifutshane, xa uneempawu, phantsi kwesikhokelo sikagqirha okanye ingcali yesondlo.
Nangona ubomi bulula kakhulu emva kotyando lwe-ileal pouch, kuqhelekile ukuba uzive uxhalabile xa kuvela iingxaki ezifana ne-pouchitis. Kodwa khumbula, le yimeko enyangekayo echaphazela abantu abaninzi. Ungasebenzisana nogqirha wakho ukuze ufumane isisombululo esifanelekileyo kuwe.
Umyalezo Wokuya Ekhaya
- I-Pouchitis kukudumba kwesingxobo okuxhaphakileyo kubantu abaye benza utyando lwe-ileal pouch.
- Ukuba ufumana iimpawu ezifana neentlungu zesisu esisezantsi, ukuya rhoqo kwindlu yangasese, okanye igazi eliphuma kwindle yakho, ziqaphele.
- Uninzi lweemeko ze-pouchitis zinokunyangwa ngempumelelo ngamayeza okubulala iintsholongwane.
- Musa ukuyityeshela le mpawu. Bonana nogqirha wakho ngokukhawuleza ukuze akunike icebiso.
- Ukutya okunesondlo kunye neeprobiotics kunokunceda ukugcina impilo yesingxobo.
- Iimeko ze-pouchitis ezingapheliyo (ezingapheliyo) zinokufuna unyango oluthile, kwaye ugqirha wakho uya kukunika isicwangciso sonyango esifanelekileyo.
💬 Comments (0)
No comments yet. Be the first to share your thoughts here.
Add Your Comment