Ngaba umntwana wakho uhlala eneengxaki zesisu ezifana norhudo? Nokuba umnika ukutya okungakanani na, kubonakala ngathi akatyi ngokwaneleyo, kwaye akatyebi? Okanye ngaba ezi mpawu zivele emva kotyando lwamathumbu? Njengomama okanye utata, kuqhelekile ukuba uzive usoyika kwaye ukhathazekile xa ubona izinto ezinje. Namhlanje siza kuthetha ngeShort Bowel Syndrome (SBS), imeko enokubangela ezi mpawu, kodwa akuthethwa kakhulu ngayo.
Ngamafutshane, yintoni i-Short Bowel Syndrome (SBS)?
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.
Le meko inokubakho ukususela ekuzalweni. Kwakhona, ngamanye amaxesha i-SBS ingenzeka emva kokuba inxalenye enkulu yamathumbu amancinci isusiwe ngotyando ngenxa yesinye isifo. Oku kukwabizwa ngokuba yi-"Short gut syndrome".
Ngoko ke, yintoni indima yale mathumbu amancinci?
Ukuze sikuqonde ngcono oku, masiqale sifunde kancinci ngamathumbu amancinci, iqhawe lenkqubo yethu yokugaya ukutya. Cinga ngamathumbu amancinci njengebhanti elide lokuhambisa ukutya kumzi-mveliso. Ukutya esikutyayo kujika kube lulwelo esiswini kuze kuhambe ngale bhanti. Endleleni, iindonga zamathumbu, ezisebenza njengabasebenzi befektri, zahlula zonke izinto ezilungileyo kuloo kutya - oko kukuthi, izondlo ezibalulekileyo ezifana neeproteni, iicarbohydrate, amafutha, iivithamini, isinyithi, i-calcium, kunye nolwelo - kwaye zongeze egazini. Okuseleyo, okungaluncedo emzimbeni, kuya emathunjini amakhulu kwaye kukhutshwe njengendle.
Amathumbu amancinci anamalungu amathathu aphambili:
- I-Duodenum: Le yeyona ndawo imfutshane emva kwesisu.
- IJejunum: Le yinxalenye ephakathi.
- Ileum: Le yeyona ndawo inde. Iphelela emathunjini amakhulu.
I-SBS iyichaphazela njani ithumbu elincinci?
Khawucinge nje, bekuya kwenzeka ntoni ukuba besinokususa iqhekeza elikhulu kwibhanti yokuhambisa impahla kuloo mzi-mveliso sikhankanyileyo? Iimpahla (oko kukuthi ukutya) ziya kuphela ngokukhawuleza kwibhanti yokuhambisa impahla. Abasebenzi (udonga lwamathumbu) bebengenalo ixesha elaneleyo lokwahlula izinto ezilungileyo (isondlo) kwiimpahla. Kwenzeka into efanayo kwi-SBS.
Ngokwesiqhelo, umntwana uzalwa enesisu eside kancinci kunesiqhelo. Kufana nenxalenye eyongezelelweyo. Nokuba inxalenye encinci ye-duodenum kunye ne-jejunum isusiwe ngexesha lotyando, i-ileum ingathatha umsebenzi wamalungu omabini kwaye ilinganise ukufunxwa kwezondlo.
Nangona kunjalo, inxalenye enkulu kakhulu ye-jejunum okanye i-ileumUkuba isusiwe ngotyando, kuba nzima kakhulu ukuba umzimba ufumane izondlo ezaneleyo. Ngenxa yokuba ukutya kuhamba umgama omfutshane, ixesha ekufuneka kugaywe kwaye kufunxwe ngumzimba liyancipha kakhulu.
Ukuba le meko ayinyangwa, umntwana unokuba neemeko ezinzulu ezifana nokungondleki kakuhle aze ade abe yingozi ebomini.
Uyazi njani ukuba umntwana une-SBS? Zithini iimpawu?
Ukuba ukrokrela ukuba umntwana wakho unale meko, hlala ujonge ezi mpawu. Ukuba unenye okanye ngaphezulu kwezi mpawu zilandelelana, bonana nogqirha ngokukhawuleza.
| Uphawu | Ingcaciso elula |
|---|---|
| Urhudo | Urhudo oluhlala lumanzi. Olu lolona phawu luphambili noluqhelekileyo lwe-SBS. |
| Ukudumba | Uzive ngathi isisu sakho sigcwele umoya, isisu sakho sibonakala sidumbile. |
| Igesi egqithisileyo | Umoya omninzi kunesiqhelo. |
| Isihlalo esinuka kakubi | Amafutha angagaywanga abangela ivumba elibi kwindle. |
| Ukudinwa | Umntwana udla ngokuziva ediniwe kwaye elele ngenxa yokungondleki kakuhle. |
| Ukukhula okubi | Ukungatyebi nokuphakama ngendlela efanelekileyo ngokweminyaka. |
Kutheni abantwana benale meko?
Njengoko igama lisitsho, oyena nobangela woku kukuxinana kwamathumbu. Kukho iindidi ezimbini eziphambili zezizathu ezibangela oku:
1. Iingxaki zokuzalwa: Abanye abantwana bazalwa beneengxaki ezithile zamathumbu.
- Ukuncipha kobude bamathumbu ebuntwaneni.
- Ukuzalwa ngaphandle kwenxalenye yamathumbu.
- I-intestinal atresia ligama lezonyango elithetha ukungaphumeleli kwamathumbu ukukhula ngokupheleleyo esibelekweni.
2. Njengesiphumo esingesihle sotyando: Ezinye iimeko ezinzima zempilo zifuna ukususwa kwenxalenye yamathumbu amancinci omntwana ngotyando. I-SBS nayo inokubakho.
Ziziphi iimeko ezifuna ukususwa kwenxalenye yamathumbu ngotyando?
- I-necrotizing enterocolitis: Oku kwenzeka xa ukuhamba kwegazi ukuya eludongeni lwamathumbu kuncipha, nto leyo ebangela ukuba iindawo ezithile zamathumbu zife. Le meko ixhaphakile kwiintsana ezizelwe ngaphambi kwexesha.
- I-Gastroschisis: Oku kwenzeka xa amathumbu ephuma ngaphandle komzimba ngelixa umntwana esakhula esibelekweni.
- I-Volvulus: Ukujijeka kwamathumbu. Oku kunokuthintela ukuhamba kwegazi kwaye konakalise loo ndawo.
- Isifo sikaCrohn: Imeko yokudumba okungapheliyo kwenkqubo yokugaya ukutya.
- Ukungena ngaphakathi: Inxalenye enye yamathumbu ibanjwa ngaphakathi kwenye inxalenye.
Ziziphi iingxaki ezinokubakho ngenxa ye-SBS?
Ukuba i-SBS ayinyangwa kakuhle, umntwana unokufumana iingxaki ezahlukeneyo, ezinye zazo ezinokuba yingozi kakhulu.
- Ukuphelelwa ngamanzi emzimbeni: Ukugcina amanzi rhoqo emzimbeni kuba umzimba awukwazi ukufunxa ubungakanani obufunekayo bolwelo.
- Ukungondleki: Ukunciphisa umzimba kunye nokungakwazi ukutyeba ngenxa yokufunxwa kakuhle kwezondlo.
- Ukunqongophala kweevithamini kunye neeminerali: Ukunqongophala kweevithamini ezibalulekileyo (A, D, E, K, B12) kunye neeminerali (calcium, magnesium, zinc) emzimbeni.
- Ukurhawuzelela okukhulu kwe-diaper: Ukurhawuzelela okukhulu kwesikhumba okubangelwa kukuhamba rhoqo kwamathumbu kunye ne-asidi ephezulu yendle.
- Isifo sesibindi: Ukonakala kwesibindi okubangelwa kukutya okuhlala ixesha elide kwe-IV kunye nezinye izizathu.
- Amatye ezintso: Ngenxa yokungalingani kokufunxwa kwe-calcium kunye ne-oxalate.
- Ukukhula kakhulu kweebhaktheriya: Ukukhula kakhulu kweebhaktheriya eziyingozi emathunjini amancinci.
- Ukunganyamezelani nokutya: Umzekelo, ukungakwazi ukugaya iimveliso zobisi ezine-lactose.
Ngoko ke, kubaluleke kakhulu ukufuna iingcebiso zonyango ngokukhawuleza ukuba umntwana wakho uneempawu ze-SBS, ingakumbi emva kotyando lwamathumbu.
Oogqirha bayixilonga njani le sifo?
Xa usisa umntwana wakho kugqirha, uza kuqala abuze ngeempawu zomntwana kunye nembali yezonyango zosapho. Emva koko, umntwana uza kuhlolwa. Kunokwenziwa iimvavanyo ezininzi ukuqinisekisa ukuxilongwa kunye nokufumana unobangela ochanekileyo:
- Uvavanyo lwegazi: Jonga igazi lomntwana ukuze ubone izinto ezifana namanqanaba eevithamini kunye neeminerali, kunye ne-anemia.
- Uvavanyo lwamafutha endle: Lujonga ukuba angakanani amafutha angatyiwayo kwindle.
- Ii-X-reyi: Ukujonga imeko yamathumbu. Usenokunikwa ulwelo olukhethekileyo, olufana ne-barium, kwaye i-X-reyi ingathathwa.
- I-CT scan: Fumana umfanekiso ocacileyo wamathumbu kunye nezinye izitho zesisu.
Ziziphi iindlela zonyango ze-SBS?
Kukho iinjongo ezimbini eziphambili ekunyangeni umntwana one-SBS. Enye kukubonelela umntwana ngesondlo asidingayo ukuze akhule. Enye kukulawula iimpawu ezifana norhudo. Iindlela ezahlukeneyo zonyango zisetyenziswa kunye ukufezekisa oku.
1. Utshintsho lwesondlo
Le yeyona nxalenye ibalulekileyo. Ngokuxhomekeke kwimeko yomntwana, oogqirha kunye neengcali zesondlo basebenzisana ukwenza isicwangciso sesondlo esifanelekileyo somntwana.
- Utshintsho kwindlela yokutya: Ukuba umntwana wakho uyakwazi ukutya ngomlomo, ugqirha wakho unokumcebisa ukuba amnike ukutya okuncinci izihlandlo ezininzi ngemini . Banokumcebisa ukuba anciphise ukutya okunamafutha amaninzi, iiswekile ezilula, kunye nefayibha, endaweni yoko amnike ukutya okuneekhalori eziphezulu okutyebileyo kwiicarbohydrates kunye neeproteni.
- Isondlo Esipheleleyo Somzali Okhulelweyo (TPN): Oku kuquka ukunika zonke izondlo (ulwelo, iswekile, iiproteni, amafutha, iivithamini) ngqo emthanjeni njengolwelo, nto leyo ethintela inkqubo yokugaya yomntwana ngokupheleleyo. Le ndlela idla ngokusetyenziswa emva kotyando lwamathumbu okanye xa umntwana engakwazi ukutya ngomlomo.
- Isondlo Somzimba: Kule nto, kufakwa umbhobho oguquguqukayo ngempumlo okanye ngqo esiswini okanye emathunjini amancinci, kwaye kunikwa isondlo solwelo ngayo. Le ndlela inceda ekuboneleleni ngesondlo esongezelelekileyo ukongeza kubungakanani bokutya okutyiwayo ngomlomo.
2. Amayeza
Amayeza ahlukeneyo asetyenziswa ukulawula iimpawu kunye nokuphucula ukufunxwa kwezondlo.
- Ii-antibiotics: Lawula ukukhula okugqithisileyo kweebhaktheriya emathunjini.
- Amayeza okunciphisa i-asidi yesisu (i-proton pump inhibitors, i-H2 blockers): Ukunciphisa iingxaki ezibangelwa yi-asidi yesisu.
- Amayeza okulwa norhudo: Yehlisa isantya sokuhamba kokutya emathunjini, nto leyo evumela ixesha elingakumbi lokuba izondlo zifunxwe.
- Iihomoni zokukhula: Ziphucula ukufunxwa kwezondlo ngamathumbu.
3. Utyando
Abanye abantwana banokufuna utyando olongezelelweyo ukuphucula ukusebenza kwamathumbu. Oku kuquka:
- Ukwandisa ubude bamathumbu (ngokusebenzisa iindlela ezikhethekileyo zotyando).
- Ukucothisa isantya sokuhamba kokutya.
- Ukususa izinto ezithintela amathumbu.
Kwiimeko ezinzima kakhulu, umntwana unokufuna ukufakelwa isisu/isibindi.
Ithemba eliqinisekileyo lokuziqhelanisa namathumbu
Eli lelona themba likhulu kubazali babantwana abane-SBS. Ukuziqhelanisa namathumbu yinkqubo apho inxalenye eseleyo yamathumbu iphucula ukusebenza kwayo ngokuhamba kwexesha emva kokuba icandelo lamathumbu lisusiwe.
Kule nto, udonga lwangaphakathi lwamathumbu aseleyo luyaqina, kwaye izakhiwo ezifana neminwe ezibizwa ngokuba yi-villi ezifunxa izondlo ziba zinde kwaye zijiye. Oku kuvumela amathumbu amancinci aseleyo ukuba afunxe izondlo ngokufanelekileyo kunangaphambili. Le nkqubo yokuziqhelanisa inokuba nempumelelo enkulu, njengoko amathumbu abantwana abancinci eqhubeka ekhula ngokwendalo de bafikelele kwiminyaka yobudala.
Iigonyo ezisandula ukwaziswa ezifana ne-teduglutide ziyakhawulezisa le nkqubo yokuziqhelanisa kwaye zinceda ekukhupheni abantwana kwisondlo semithambo efana ne-TPN.
Ungenza ntoni njengomzali?
Nangona olu hambo lunzima, awuwedwa. Kukho iqela elihle lokukunceda ulawule imeko yempilo yomntwana wakho.
- Ugqirha wabantwana
- Ingcali yezifo zesisu zabantwana
- Ingcali yokutya kwabantwana
- Ugqirha wabantwana
Umsebenzi wakho ophambili kukulandela imiyalelo enikwe leli qela lezonyango ngokuchanekileyo. Kubalulekile ukuba ulumke kakhulu ekondleni umntwana, umnike amayeza ngexesha elifanelekileyo, kwaye ukuba usebenzisa unyango olufana ne-TPN, kubalulekile ukuba ulumke kakhulu ekumgcineni ecocekile.
Ukuba unemibuzo okanye izinto ezikuxhalabisayo, ungaze woyike ukubuza ugqirha wakho. Buza imibuzo efana nale, "Le yeza lini?", "Ngaba oku kutya kulungile kumntwana wam?", "Ndingalindela ntoni emva koko?" ukuze uphumle engqondweni yakho.
I-SBS inokuba yimeko yobomi bonke kwabanye abantwana. Nangona kunjalo, kwabanye abantwana, imeko iphucuka kakhulu ngokuhamba kwexesha. Ngonyango olufanelekileyo, ukutya okunempilo, kunye nokhathalelo olunothando, uninzi lwaba bantwana banokuphila ubomi obuqhelekileyo nobonwabisayo.
Umyalezo Wokuya Ekhaya
- I-Short Bowel Syndrome (SBS) yimeko apho umzimba ungakwazi ukufunxa izondlo ngenxa yesisu esincinci esifutshane okanye esingasebenzi kakuhle.
- Urhudo oluqhelekileyo kunye nokukhula kakubi zezona mpawu ziphambili.
- Injongo ephambili yonyango kukubonelela umntwana ngesondlo esifunekayo. Oku kungenziwa ngokutya okukhethekileyo, ukondla ngetyhubhu, okanye isondlo se-parenteral (TPN).
- Ekuhambeni kwexesha, inxalenye eseleyo yamathumbu omntwana iya kulungelelanisa imeko (ukulungiswa kwamathumbu). Olu luphawu oluhle kakhulu.
- Le yimeko elawulekayo. Ngoncedo lweqela lezonyango eliyingcali kunye nokuzinikela kwabazali, umntwana anganikwa ubomi obulungileyo.
- Ukuba umntwana wakho unezi mpawu, bonana nogqirha wabantwana ngokukhawuleza.
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