Ingaba umntwana wakho une-Short Bowel Syndrome (SBS)? Makhe sithethe ngayo ngokulula.

Ngaba umntwana wakho omncinci uhlala egula? Ngaba uyancipha emzimbeni engazi nokuba uthini, nokuba sele esele ubisi okanye etye? Ngaba akatyebi konke konke? Njengomzali, kuyinto eqhelekileyo ukuziva usoyika kwaye ukhathazekile xa ubona izinto ezinje. Ngamanye amaxesha, kunokubakho imeko yezonyango emva kwezi mpawu esingazivanga kangako ngazo. Namhlanje siza kuthetha ngenye yeemeko ezinjalo, "iShort Bowel Syndrome".

Yintoni i-Short Bowel Syndrome (SBS)?

Ngamafutshane, i-Short Bowel Syndrome (SBS) yimeko apho umzimba womntwana wakho ungakwazi ukufunxa izondlo kunye nolwelo olwaneleyo. Oku kungenxa yokuba inxalenye yamathumbu amancinci omntwana ayikho okanye ayisebenzi kakuhle. Ngokuchanekileyo, amathumbu awade ngokwaneleyo. Le meko inokubakho ekuzalweni, okanye inokwenzeka emva kokuba inxalenye enkulu yamathumbu amancinci isusiwe ngotyando ngenxa yesinye isifo.

Ukuze sikuqonde oku, masiqale sijonge okwenzekayo emathunjini ethu amancinci.

Indima yamathumbu ethu amancinci

Cinga ngamathumbu amancinci njengomgca omde, 'wokucubungula' kwifektri. Ukutya esikutyayo kugaywa kancinci esiswini kuze kungene emathunjini amancinci. Emva koko, njengoko kuhamba ngeli thumbu lide, yonke into ebalulekileyo emzimbeni kuloo kutya - oko kukuthi, iiproteni, iicarbohydrate (isitatshi kunye neswekile), amafutha, iivithamini, iiminerali ezifana nesinyithi, icalcium - ifunxwa emzimbeni. Inkunkuma eseleyo ikhutshwa ngethumbu elikhulu njengendle.

Kukho iindawo ezintathu eziphambili zamathumbu ethu amancinci:

• I-Duodenum: Eyona ndawo imfutshane emva kwesisu.
• IJejunum: Inxalenye ephakathi.
• Ileum: Eyona ndawo inde kakhulu yamathumbu amakhulu.

Kwimeko ye-SBS, lo 'mgca wokucubungula' awude ngokwaneleyo. Khawucinge nje, bekuya kwenzeka ntoni ukuba indlela ende ngekhilomitha ingasetyenziselwa ukufunxa izondlo, ize loo ndlela ifinyezwe ngequbuliso? Isithuthi esibizwa ngokuba kukutya besihamba ngesantya esikhulu kuloo ndlela imfutshane kwaye singabi naxesha lokukhulula yonke imithwalo (izondlo) equletheyo. Kwenzeka into efanayo kwi-SBS. Ngenxa yokuba amathumbu mafutshane, ukutya kuyaphuma emzimbeni ngaphambi kokuba kugaywe kakuhle kwaye izondlo zifunxwe ngumzimba. Esi sisifo esibi kakhulu esinokuchaphazela nobomi bomntwana ukuba asinyangwa.

Uyazi njani ukuba umntwana une-SBS? Zithini iimpawu?

Umntwana one-SBS unokufumana enye okanye ngaphezulu kwezi mpawu. Uphawu oluqhelekileyo, ingakumbi kwiintsana nakubantwana abancinci, lurhudo oluphuma emanzini.

Kutheni umntwana efumana i-Short Bowel Syndrome?

Kukho iindidi ezimbini eziphambili zezizathu zoku.

1. Izizathu zokuzalwa: Abanye abantwana banokuzalwa benomathumbu amancinci amafutshane. Okanye basenokungabi nanxalenye yamathumbu, okanye amathumbu asenokungakhuli ngokupheleleyo ngelixa ekhula esibelekweni sikanina. Le meko ibizwa ngokuba yi-`(Intestinal Atresia)`.

2. Njengesiphumo esingesihle sotyando: Abanye abantwana kufuneka basuswe inxalenye yamathumbu abo amancinci ngenxa yezinye iimeko zonyango. Ezinye zezizathu eziqhelekileyo zolu hlobo lotyando zezi:

• I-necrotizing enterocolitis: Usulelo olubi kakhulu, ingakumbi kwiintsana ezizelwe ngaphambi kwexesha, apho iindawo zamathumbu ziyafa ngenxa yokuncipha kokuhamba kwegazi.
• I-Gastroschisis: Imeko apho amathumbu aphuma ngaphandle komzimba ngelixa umntwana ekhula esibelekweni.
• I-Volvulus: Imeko apho amathumbu ajika kunye aze alahlekelwe kukuhamba kwegazi.
• Isifo sikaCrohn:Imeko yokudumba kwenkqubo yokugaya ukutya ixesha elide.
• I-Intussusception: Imeko apho inxalenye yamathumbu ivaleleka kwenye inxalenye.

Ziziphi iingxaki ezinokubakho ngenxa ye-SBS?

I-SBS ayisiyonto ilula. Ukuba ayiphathwa kakuhle, umntwana unokufumana iingxaki ezahlukeneyo.

• Ukuphelelwa ngamanzi emzimbeni: Umzimba ungagcina amanzi rhoqo kuba awukwazi ukufunxa ulwelo olufunekayo.
• Ukungondleki: Ukunciphisa umzimba kunye nokukhula okukhawulezileyo ngenxa yokunqongophala kokutya okufunekayo.
• Ukunqongophala kweevithamini kunye neeminerali: Ukunqongophala kweevithamini ezibalulekileyo (A, D, E, K, B12) kunye neeminerali (calcium, magnesium, zinc) emzimbeni.
• Ukuqhambuka okukhulu kwe-diaper: Ukuhlala une-asidi efunekayo rhoqo kunokubangela ukuba ulusu olukwindawo ye-diaper lube bomvu kakhulu kwaye lube buhlungu.
• Isifo sesibindi: Isibindi sinokuchaphazeleka, ingakumbi ukuba ufumana isondlo se-parenteral (TPN) ixesha elide.
• Amatye ezintso: Ngenxa yokungalingani kokufunxwa kwezinto ezifana ne-calcium.
• Ukukhula kakhulu kweebhaktheriya emathunjini amancinci: Ukusebenza kakuhle kwamathumbu kunokukhokelela ekukhuleni kakhulu kweebhaktheriya eziyingozi.

Ngoko ke, ukuba umntwana wakho uneempawu ze-SBS, ingakumbi emva kotyando lwamathumbu, kubaluleke kakhulu ukubona ugqirha wakho ngoko nangoko .

Ziziphi iindlela zonyango ze-SBS?

Ukunyanga umntwana one-SBS ngumzamo weqela. Abantu abaninzi, kuquka oogqirha babantwana, oogqirha botyando, kunye neengcali zesondlo, basebenzisana ukuphuhlisa isicwangciso sonyango esingcono kakhulu somntwana wakho. Injongo ephambili yonyango kukulawula iimpawu ngelixa unika umntwana ukutya okufunekayo.

1. Utshintsho kwiSondlo

Le yeyona nxalenye ibalulekileyo yonyango.

• Isondlo Esipheleleyo Somzali Okhulelweyo (TPN): Emva kotyando lwamathumbu okanye xa amathumbu engakwazi ukufunxa izondlo kwaphela, zonke izondlo umntwana azidingayo (iiproteni, amafutha, iicarbohydrate, iivithamini, kunye neeminerali) zinikwa umntwana ngolwelo olukhethekileyo, olufana netyuwa, ngomthambo. Oku kuyayigqitha inkqubo yokugaya ukutya ngokupheleleyo kwaye kongeze izondlo ngqo egazini. Olu lunyango olusindisa ubomi bomntwana.
• Ukutya Okunesondlo/Ukutya Ngetyhubhu:Ukuba amathumbu omntwana asebenza kakuhle, ukutya okukhethekileyo okumanzi kunikwa ngetyhubhu efakwe ngempumlo iye esiswini okanye ngetyhubhu eqhagamshelwe ngqo esiswini ngotyando. Oku kunokunika umntwana izondlo ezongezelelweyo ukongeza kokutya akutya ngomlomo.
• Utshintsho kwindlela yokutya: Njengoko umntwana eqala ukutya ngomlomo kancinci kancinci, ugqirha kunye nengcali yesondlo baya kubonelela ngesicwangciso esikhethekileyo sokudla.
• Kancinci kancinci, baya kukucela ukuba ubaphe ukutya izihlandlo ezininzi ngemini.
• Ithi nciphisa ukutya okunamafutha amaninzi, iswekile kunye nefayibha.
• Ithi inika ukutya okutyebileyo kwiproteni kunye neecarbohydrate.
• Kucetyiswa ukuba unike iivithamini kunye neeminerali ezifunekayo njengezongezo.

2. Amayeza

Amayeza ahlukeneyo asetyenziswa ukulawula iimpawu kunye nokuphucula ukufunxwa kwezondlo.

• Amayeza anciphisa i-asidi yesisu (`i-Proton pump inhibitors`).
• Ii-antibiotics zilawula ukukhula kweebhaktheriya emathunjini.
• Amayeza anciphisa urhudo kwaye anciphise isantya sokuhamba kokutya emathunjini.
• Iintlobo zeehomoni eziphucula ukufunxwa kwezondlo.

3. Utyando

Kwezinye iimeko ezinzima kakhulu, kunokufuneka utyando olongezelelweyo ukuphucula ukusebenza kwamathumbu omntwana. Umzekelo, kukho iinkqubo zokwandisa amathumbu. Kwiimeko ezinzima kakhulu, apho kungekho nyango lusebenzayo, ukufakelwa amathumbu kunokufuneka.

Ithemba eliqinisekileyo lokuziqhelanisa namathumbu

Eli lelona themba likhulu kubantwana nakubazali abane-SBS. Imizimba yethu iyamangalisa. Emva kokuba icandelo lamathumbu lisusiwe, inxalenye eseleyo yamathumbu iqala ukutshintsha ngokuhamba kwexesha. Oku kubizwa ngokuba yi-'Intestinal Adaptation'.

Nantsi into eyenzekayo:

• Ummandla wodonga lwangaphakathi lwamathumbu aseleyo uyanda.
• Iindawo ezincinci ezifana neminwe (villi) ezifunxa izondlo ziyanda kwaye zijiye.
• Ububanzi bamathumbu buyakhula.
• Isantya sokuhamba kokutya siyehla, nto leyo enika ixesha elingakumbi lokuba izondlo zifunxwe.

Ngenxa yale nkqubo yokuziqhelanisa, abantwana abaninzi bayakwazi ukutshintsha kancinci kancinci ukusuka kwisondlo se-parenteral (TPN) ukuya ekutyeni ngomlomo. Amayeza amatsha, anjenge-teduglutide, ngoku afumanekayo anokukhawulezisa olu hlengahlengiso.

I-SBS luhambo olunzima. Kodwa ngonyango olufanelekileyo, ulawulo olufanelekileyo lwesondlo, kunye nothando nokuzinikela kwabazali, aba bantwana banokuphila ubomi obuhle nobonwabisayo. Kubaluleke kakhulu ukuhlala unxibelelana nogqirha wakho kunye neqela lezonyango kwaye ulandele iingcebiso zabo.