Ingaba ikholoni yakho ivuvukele ngolu hlobo? Masifunde ngePseudomembranous Colitis!

Ngaba unentlungu ebuhlungu esiswini kunye norhudo izihlandlo ezininzi ngemini? Mhlawumbi uziva unesicaphucaphu kunye nomkhuhlane? Ingakumbi, ngaba ezi mpawu zavela emva kokuba usandul' ukuthatha amayeza okubulala iintsholongwane ngenxa yesifo esithile? Ukuba kunjalo, le yinto enokuba yinto ebalulekileyo kuwe. Namhlanje siza kuthetha ngemeko ebizwa ngokuba yi-'Pseudomembranous Colitis'. Ungakhathazeki, ukuba unolwazi olufanelekileyo ngale nto, ungafumana unyango kwaye uphile ngokukhawuleza.

Yintoni iPseudomembranous Colitis?

Ngamafutshane, 'i-Pseudomembranous Colitis' yimeko yokudumba okukhulu eyenzeka emathunjini ethu amakhulu, okanye emathunjini amakhulu. Kule meko, ngesizathu esithile (isenokuba yibhaktheriya, ityhefu, okanye esinye isifo), udonga lwangaphakathi lwamathumbu akho amakhulu, okanye i-mucous membrane ('mucosa'), lonakala. Lo monakalo ubangela ukuba kubekho iiplaque ezimhlophe-ezimthubi, ezityebileyo, nezirhabaxa kwiindawo ezonakeleyo. Oogqirha babiza ezi 'pseudomembrane'.

Zithini 'ii-pseudomembrane'?

Ii-pseudomembranes zezona zinto zenzeka xa iiseli ezikwilweyini yamathumbu amakhulu, njengelweyini yamathumbu amakhulu, zisifa. Cinga ngale ndlela: xa kukho ukwenzakala, inkqubo yethu yokuzikhusela komzimba ithumela iiseli ezimhlophe zegazi kwindawo leyo. Ngokufanayo, nalapha, iziqwenga zeeseli ezifileyo zidibana neeseli ezimhlophe zegazi (ingakumbi ii-neutrophils) ukuze zenze ii-pseudomembranes. Ezi zimalunga neesentimitha ezi-2 ububanzi, zimhlophe tyheli, kwaye ziphakame kancinci phezu komhlaba.

Zithini iimpawu zale meko?

Umntu one-pseudomembranous colitis unokufumana iimpawu ezifana nezi:

• Intlungu ebuhlungu esiswini.
• Urhudo. Oku kunokwenzeka amaxesha amaninzi ngemini, ngamanye amaxesha njengolwelo.
• Ifiva.
• Isicaphucaphu.
• Ngamanye amaxesha, unokubona igazi okanye ubomvu buphuma kwindle yakho, kodwa oku akwenzeki kuwo wonke umntu.

Yintoni ebangela i-Pseudomembranous Colitis?

Eyona nto iphambili neyona ixhaphakileyo yoku kusulelwa yintsholongwane ethi `C. diff` (Clostridioides difficile). Iityhefu eziveliswa yile ntsholongwane zonakalisa ulwelo lwamathumbu amakhulu. Malunga ne-10% yosulelo lwe-`C. diff` lunokuqhubela phambili luye kwimeko embi kakhulu ebizwa ngokuba yi-`pseudomembranous colitis.` Enyanisweni, i-90% yale meko ibangelwa yintsholongwane ethi `C. diff`. Nangona kunjalo, ezinye iimeko zamathumbu ezivuthayo nazo zinokubangela olu hlobo lomonakalo.

Intsholongwane ye-C. difficile iyichaphazela njani le nto?

Ibhaktheriya i-C. difficile ivelisa iityhefu ezitshabalalisa iiseli ezikwi-intestine yethu enkulu. Olu sulelo lunokusasazeka ngokukhawuleza nangokubi kunokuba ucinga.

Ixesha elininzi, ufumana usulelo lwe-C. diff kuba unesinye isifo.Emva kokusebenzisa ii-antibiotics. Cinga ngayo, xa uthatha ii-antibiotics, ezinye iintsholongwane "ezilungileyo" emathunjini ethu ezisinceda sife. Nangona kunjalo, uninzi lwee-antibiotics alunakubulala ezi ntsholongwane 'ze-C. diff'. Ngoko ke, xa ezo ntsholongwane zilungileyo zingasekho, iintsholongwane ze-'C. diff' zinethuba lokukhula nokusasazeka ngaphandle kokulawulwa, nto leyo ebangela ezi ngxaki ngaphandle kokhuphiswano.

Ngawaphi amayeza okubulala iintsholongwane asebenza kakhulu kule meko?

Enyanisweni, nayiphi na i-antibiotic ebulala iintsholongwane ezilungileyo emathunjini ethu kwaye ingachaphazeli iintsholongwane ze-C. diff inokubangela usulelo lwe-C. diff kunye ne-pseudomembranous colitis ephumela kuyo. Nangona kunjalo, ezinye ii-antibiotics zicingelwa ukuba zibeka umngcipheko omkhulu. Ezinye zazo zezi:

• I-Clindamycin
• Udidi lweziyobisi zeCephalosporin
• Iqela leziyobisi zePenicillin
• IiFluoroquinolones
• I-Aztreonam
• IiCarbapenems

Kubalulekile: Oku akuthethi ukuba la mayeza okubulala iintsholongwane alungile. Ukuba ugqirha uyawanika imiyalelo, kufuneka asetyenziswe njengoko kufuneka. Nangona kunjalo, ukusebenzisa amayeza okubulala iintsholongwane ngokungeyomfuneko kunokukhokelela kwiingozi ezifana nezi.

Ngaba zikho ezinye izizathu?

I-Pseudomembranous colitis inokwenzeka naxa ukudumba kwekholoni kubangelwa zezinye izizathu, ngaphandle kwe-C. diff. Nazi imizekelo embalwa:

• usulelo lweStaphylococcus aureus
• Usulelo lwe-E. coli `(Usulelo lwe-E. coli)`
• Usulelo lweCytomegalovirus
• I-Microscopic colitis
• Isifo sikaBehçet
• I-Ischemic colitis (ukudumba okubangelwa kukuncipha kokunikezelwa kwegazi kumathumbu amakhulu)
• Amayeza okulwa nomhlaza `(amayeza e-chemotherapy)`
• Ukusetyenziswa kwe-cocaine
• I-Vasculitis (ukudumba kwemithambo yegazi)
• Ityhefu yesinyithi esinzima

Kwiimeko ezinjalo, esi sifo sinzima okanye siyinkimbinkimbi kune-colitis eqhelekileyo. Ngamanye amaxesha, ukuhamba kwegazi eludongeni lwangaphakathi lwe-colon kuyancipha (ischemia), ukufa kwezicubu (necrosis) kwenzeka, kwaye kuvela ii-pseudomembranes. Kwakhona, izifo esele zikhona njenge-Inflammatory Bowel Disease (IBD) nazo zinokwenza i-colon ibe sesichengeni ngakumbi kule meko.

Ngubani osengozini enkulu yokuhlaselwa yile meko?

Unamathuba amaninzi okuba ne-pseudomembrane colitis ukuba:

• Ukuba ulaliswe esibhedlele.
• Ukuba usandul' ukusebenzisa amayeza okubulala iintsholongwane.
• Ukuba usandul' ukwenziwa utyando.
• Ukuba umntu uhlala kwikhaya labalupheleyo.
• Ukuba uneminyaka engaphezu kwama-65 ubudala.
• Ukuba unesifo sokuzikhusela komzimba.
• Ukuba inkqubo yakho yomzimba yokuzikhusela ibuthathaka.
• Ukuba sele unosulelo lwe-C. diff.

Ziziphi iingxaki ezinokubakho zePseudomembranous Colitis?

Ukuba le meko iba nzima kwaye kunzima ukuyilawula, kunokubakho iingxaki ezinobungozi. Ngoko ke kubalulekile ukuba uqaphele oku.

• Ukuphelelwa ngamanzi emzimbeni kunye nokulahleka kwe-electrolyte: Kwi-pseudomembranous colitis enzima, urhudo lunokwenzeka ukuya kuthi ga kwi-10-15 ngemini. Oku kunokukhokelela ekuphelelweni ngamanzi emzimbeni kunye nokulahleka kwe-electrolyte. Oku kunokukhokelela kwiimeko eziyingozi ezifana nomthamo wegazi ophantsi, uxinzelelo lwegazi oluphantsi, kunye nokungasebenzi kakuhle kwezintso.
• Ukuvuza kolwelo: Ulwelo lunokuvuza lusuka eludongeni olonakeleyo lwamathumbu amakhulu luye kwisisu, nto leyo ebangela ukuba isisu sidumbe. Oku kubizwa ngokuba yi-ascites. Iiproteni ezifana ne-albumin nazo zinokulahleka kumathumbu amakhulu. Xa i-albumin iphantsi, ulwelo luphuma kwimithambo yegazi, nto leyo ebangela ukudumba kwamalungu (i-edema).
• I-megacolon enetyhefu: Ukudumba okukhulu okungalawulekiyo kwekholoni okunokubangela ukuba ikholoni idumbe kakhulu ize iyeke ukusebenza. Ekuqaleni, izihlunu ezikwikholoni ziyayeka ukufinyela, zivale indlela yokuhamba kwendle. Njengoko ikholoni iqhubeka idumba, iindonga zayo zinokuqhekeka, zivumele umxholo ukuba uvuzele esiswini. Oku kubizwa ngokuba yi-peritonitis. Oku kunokuba yingozi ebomini.
• Ukugqobhoka kwamathumbu: Umngxuma eludongeni lwamathumbu amakhulu unokwenzeka ngaphandle kwe-megacolon enetyhefu. Oku kunokwenzeka ukuba izilonda zikhula emathunjini amakhulu zize zidlule eludongeni, okanye ukuba kukho ukufa okukhulu kwezicubu (necrosis) eludongeni lwamathumbu amakhulu. Xa iintsholongwane emathunjini amakhulu zivuza zingene kwisisu (peritonitis), zinokusasazeka ziye egazini (septicemia).
• I-Sepsis: I-Sepsis yimeko ebangelwa kukuqokelelana kweebhaktheriya egazini (i-septicemia). I-Sepsis lusulelo olunzima nolusongela ubomi olusasazeka emzimbeni wonke. Oku kunokukhokelela ekuhlaselweni yi-septic shock, ukungasebenzi kakuhle kwamalungu amaninzi omzimba, kwanokufa.

Ezi ngxaki zinokuba yinto eyoyikisayo ukuva ngazo. Kodwa khumbula, azenzeki kuwo wonke umntu. Ukuxilongwa kwangoko kunye nonyango olufanelekileyo kunokuthintela ezi meko zinzima.

Indlela yokuxilonga esi sifo?

Ugqirha uza kuqala akubuze ngeempawu zakho kunye nembali yakho yempilo. Emva koko, banokuyalela iimvavanyo ezahlukeneyo ukuze bafumane unobangela weempawu zakho. Umzekelo, banokuyalela uvavanyo lwegazi, iimvavanyo zomfanekiso ezifana neeskeni, kunye novavanyo lwendle. Ezi mvavanyo zijonga usulelo, ukudumba, kunye nezinye izinto ezinobungozi.

Uvavanyo lwakho lwesitulo luza kujonga ngokukodwa usulelo lwe-C. diff. Ukuba lufunyenwe, unyango luza kuqala ngoko nangoko. Ukuba awunazo iingxaki kwaye usabela kakuhle kunyango, kusenokubakho sizathu sithile sokujonga ngaphakathi emathunjini akho amakhulu ii-pseudomembranes.

Ngamanye amaxesha, iimvavanyo zokujonga imifanekiso (ezifana ne-CT scan) zinokubonisa iimpawu ze-pseudomembranous colitis. Ukuba udonga lwamathumbu amakhulu lujiyile (njengophawu "lwesithupha" okanye "uphawu lwe-accordion"), ugqirha unokugqiba ekubeni enze olunye uvavanyo.

Okulandelayo, ukuze ujonge nzulu, kufuneka wenze uvavanyo olujonga ngaphakathi kwamathumbu amakhulu. Lubizwa ngokuba yi-colonoscopy. Kule nto, ityhubhu enekhamera isetyenziselwa ukujonga ngaphakathi kwamathumbu amakhulu. Ukuba ubona into ebizwa ngokuba yi-'pseudomembrane', kuthathwa iqhekeza elincinci lesicubu (i-biopsy) kulo lize lithunyelwe kwilebhu ukuqinisekisa isifo.

Zithini iindlela zonyango?

Unyango luxhomekeke kwisizathu sesi sifo.

• Ukuba sisifo sebhaktiriya esifana ne-C. diff, kuya kufuneka unike amayeza athile okubulala iintsholongwane asebenzayo kuso.
• Ukuba le meko ibangelwa okanye iba mandundu ngenxa yelinye iyeza olisebenzisayo, elo yeza linokufuneka limiswe okanye litshintshwe.
• Kwezinye iimeko, amayeza anokumiselwa ukunciphisa ukudumba emathunjini amakhulu.

Abanye abantu bafuna uncedo oluxhasayo kuphela. Umzekelo, ulwelo olufakwa kwimithambo yegazi (ii-IV fluids) ukunceda ukugcina ulwelo, okanye isondlo se-IV ukunceda i-colon iphumle. Abanye banokufuna unyango lweengxaki, mhlawumbi kwiyunithi yokhathalelo olunzulu. Abanye abantu abane-colitis enzima kakhulu okanye iingxaki banokufuna ukuba kwenziwe i-colectomy (utyando lokususa inxalenye eyonakeleyo ye-colon).

Ngawaphi amayeza aphambili anikwayo ukuba abangelwa yi-`C. diff`?

Ukuba unobangela we-pseudomembranous colitis yintsholongwane ye-C. diff, kukho amayeza aliqela afumanekayo okunyanga. Ugqirha wakho uza kukhetha elungele wena. Amayeza anikwayo osulelo lwe-C. diff ngala:

• I-Metronidazole
• I-Vancomycin
• I-Fidaxomicin

Ngaba i-Pseudomembranous Colitis ingathintelwa?

Eyona ndlela ibalulekileyo yokuthintela esi sifo kukulawula ukusasazeka kwebhaktheriya ye-C. diff kwiindawo ezisengozini enkulu (ingakumbi izibhedlele kunye namakhaya abantu abadala). Abantu abakwezi ndawo banamathuba amaninzi okufumana usulelo kwaye babe neempawu ezinzima ezifana ne-pseudomembranous colitis.

Ngoko ke, abasebenzi bezempilo kwezi ntlobo zeziko bathatha amanyathelo akhethekileyo okulawula usulelo lwe-C. diff:

• Ukuzahlula: Abantu abosulelwe yi-C. diff bafakwa kwigumbi elahlukileyo, okanye kwigumbi elisetyenziswa nabanye abantu abosulelweyo kuphela. Iiglavu ezilahlwayo zisetyenziswa xa kungena kwigumbi.
• Ukuhlamba izandla: Ukuhlamba izandla zakho rhoqo ngesepha namanzi afudumeleyo yeyona ndlela ilungileyo yokuzikhusela kwi-C. diff. Le ntsholongwane ayixhathisi kwii-sanitizer zezandla. Kubaluleke kakhulu ukuhlamba izandla zakho ngaphambi kokuphatha ukutya.
• Ukubulala iintsholongwane: Iintsholongwane eziqhelekileyo azinakubulala i-C. diff. Nangona kunjalo, iimveliso ezisekwe kwi-chlorine ziyakwazi. Kubalulekile ukubulala iintsholongwane ngokupheleleyo kuzo zonke iindawo umntu osulelekileyo athe wadibana nazo.

Ngaba esi sifo singanyangeka ngokupheleleyo? Lingakanani izinga lokufa kwabantu?

Ewe, i-pseudomembranous colitis inokunyangeka ngokupheleleyo ngonyango. Kwiimeko ezininzi, iimpawu ziya kuphela ngokukhawuleza. Nangona kunjalo, abanye abantu banokufuna unyango olungakumbi kunye nexesha elide kunabanye. Ukuba unosulelo lwe-C. diff oluqhubekayo nolunzima ukululawula, unokufuna utyando oluncinci ukuze ulunyange. Kwezinye iimeko, utyando lunokufuneka.

Ngokuphathelele ukufa, yi-2% kuphela yezigulane ezine-pseudomembranous colitis ezifayo. Nangona kunjalo, kubantu abakhathalelwa ixesha elide kunye namajoni omzimba abuthathaka, eli zinga linokuba phezulu ukuya kwi-15%. Ukuba ingxaki ekhankanyiweyo ngaphambili ebizwa ngokuba yi-megacolon enobuthi iyenzeka, izinga lokufa linokunyuka liye kwi-35%. Yiyo loo nto unyango olukhawulezileyo lubalulekile.

Ufanele uye nini kugqirha?

Ukuba unayo nayiphi na kwezi mpawu, funa ingcebiso kagqirha ngokukhawuleza:

• Intlungu ebuhlungu yesisu okanye ukudumba.
• Ukuba unesifo sohudo ngaphezu kwezihlandlo ezihlanu ngemini.
• Ukuba kukho igazi esitulweni.
• Ukuba awukayifumani intshukumo yokuhambisa isisu kangangeentsuku ezintathu.
• Ukuba awukachami usuku lonke, okanye ukuba umchamo wakho umnyama ngombala.
• Ukuba unomkhuhlane ongaphezulu kwama-39 degrees Celsius (102 degrees Fahrenheit) kangangeentsuku ezintathu.

Okokugqibela, izinto ekufuneka uzikhumbule

Iintsholongwane ezibangela i-colitis zixhaphakile, kwaye uninzi lwexesha azibi zibi kakhulu. Ayingabo bonke abantu abafumana i-C. diff abaya kuba ne-pseudomembranous colitis. Nangona kunjalo, ukuba uyayenza, inokuba yinto eyoyikisayo. Ukwazi ukuba ikholoni yakho yonakele ngaphakathi kunokuba yinto eyoyikisayo, kunye neempawu ezifana neentlungu kunye nokopha.

Ukuba ubonakalisa iimpawu ezinje, ungadinga unyango olukhethekileyo. Kodwa khumbula, ngonyango olufanelekileyo, ikholoni yakho ingaphola.Iinwebu ze-mucous, njenge-inclusion ye-colon yethu, ziyaphola kakuhle xa zingonakalanga. Ukuba uziva ngathi iimpawu zakho ze-colitis aziphucuki, thetha nogqirha. Angakunceda ufumane unobangela wemeko yakho, enze oko kuyimfuneko ukuyimisa, kwaye anike i-colon yakho ukuphumla ekudingayo. Eyona nto ibalulekileyo kukungaphazami kwaye ufune iingcebiso zonyango ngokukhawuleza.

I- Pseudomembranous Colitis, i-C. diff, urhudo, iintlungu zesisu, i-colitis, ii-antibiotics