Ake sifunde "ngokugcinwa kwe-bile" noma i-cholestasis.

Wake wezwa “ngokuvinjelwa kwenyongo” noma “amatshe enyongo”? Kungenzeka ukuthi wake wababona abanye abantu abanamehlo nesikhumba sabo esiphenduka sibe phuzi. Wake wazibuza ukuthi ziyini ngempela lezi zinto nokuthi kungani zenzeka? Namuhla sizokhuluma ngesimo esinjalo. Ngokwezokwelapha sibizwa ngokuthi i-cholestasis. Ungakhathazeki, ake sikuchaze kalula.

Kuyini i-Cholestasis?

Kalula nje, i-cholestasis yilapho ukugeleza kwe-bile kusuka esibindini sakho kunciphisa noma kuyeka ngokuphelele. Cabanga ngakho njengefektri encane emzimbeni wethu. Ikhiqiza into ebizwa ngokuthi i-bile . Le bile isisiza ukugaya ukudla esikudlayo, ikakhulukazi ukudla okunamafutha.

Isibindi sikhiqiza le nyongo bese siyithumela ohlelweni lwethu lokugaya ukudla ngenethiwekhi yamapayipi amancane abizwa ngokuthi ama-bile ducts . Amanye ala ma-bile ducts angaphakathi kwesibindi (imigudu ye-intrahepatic) kanti amanye angaphandle kwesibindi (imigudu ye-extrahepatic). Lolu hlelo lwama-ducts luxhumanisa isibindi, i-gallbladder, i-pancreas , kanye namathumbu amancane. Uma zihlangene, lezi zakha uhlelo lwenyongo .

Ake ucabange nje, kwenzekani uma kukhona ukuvaleka noma ukuvaleka endaweni ethile kulesi simiso se-bile duct? Kufana nombhobho wamanzi ovalekile. I-bile ayikwazi ukugeleza kahle. Bese le bile iqala ukuqongelela emigudwini ye-bile nasezithweni ezihlobene nayo njengesibindi. Lokhu kungalimaza lezo zicubu futhi kuphazamise ukusebenza kwazo. Akukhona lokho kuphela, kodwa le bile eqongelelene kancane kancane iqala ukuvuza egazini. Lokhu kuyingozi futhi kuyingozi emzimbeni. Lokhu kungabangela izimpawu ezingakhululekile futhi, ngokuhamba kwesikhathi, kungaholela ezifweni ezahlukahlukene. I-Cholestasis ngezinye izikhathi ingaba yinkinga yesikhashana, noma ingaba yinkinga ekhula kancane kancane futhi eqhubekayo.

Lokhu kuthinta kanjani umzimba wakho?

I-Cholestasis ingathinta umzimba wakho ngezindlela ezahlukene.

Imiphumela yesikhashana:

Into yokuqala ethintekayo yizitho ezisesimisweni sakho senyongo. Ukuqongelela kwenyongo kungabangela ukuthi isibindi, inyongo, i-pancreas, noma imisele yenyongo ivuvuke futhi ivuvuke . Lokhu kungabangela izimpawu ezifana nobuhlungu besisu kanye nesicanucanu. Kuphinde kwandise ingozi yokutheleleka.

Futhi, ngenxa yokuthi amathumbu amancane awatholi inyongo eyanele, amafutha ekudleni okudlayo awagaywa kahle. Lokhu kungabangela ukuqunjelwa, ukungagaywa kahle kokudla, kanye nesifo sohudo.

Imiphumela yesikhathi eside:

Uma lesi simo siqhubeka, kungase kuvele izinkinga ezengeziwe.

• Ukuqongelela kwenyongo egazini kungabangela i-jaundice , okuwukuphuzi kwamehlo nesikhumba, kanye nomchamo omnyama.
• Abanye abantu bangase babe nokulunywa okukhulu (pruritus) . Lokhu kungenxa yokuthi usawoti we-bile egazini uvuselela imizwa.
• Ukuvuvukala isikhathi eside kwezitho zomzimba njengesibindi kungaholela ezibazini nasekulahlekelweni ukusebenza unomphela. Lokhu kubizwa nangokuthi i-cirrhosis .
• Amavithamini ancibilika emafutheni, njengevithamini A , D, E, kanye ne-K , awamuncwa kahle ngumzimba. Lokhu kungaholela ekungondleki kahle. Lokhu kungaba yimbangela yokukhula okulimele, ikakhulukazi ezinganeni ezincane.

Khumbula ikakhulukazi!

I-obstetric cholestasis ngesikhathi sokukhulelwa yandisa ingozi yezinkinga ezisongela impilo kumama kanye nosana. Lokhu kufaka phakathi i-preeclampsia, ukuzalwa ngaphambi kwesikhathi, kanye nokuzalwa kwengane isishonile. Ngakho-ke, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha uma uhlangabezana nalezi zimpawu ngesikhathi sokukhulelwa.

Yiziphi izizathu eziyinhloko zalokhu?

Kunezimbangela eziningi ze-cholestasis. Ngokuvamile, kunezinhlobo ezimbili zezinkinga:

Ziyini izimpawu ze-cholestasis?

Kunezimpawu eziningana ezivame ukubonakala kulesi simo:

• I-Jaundice: Ukuphuzi kwesikhumba sakho kanye nokumhlophe kwamehlo akho kuvame ukuba uphawu lokuqala lokuthi isibindi sakho asisebenzi kahle. Lokhu kubangelwa ukunqwabelana kwe-bile egazini. Ngokukhethekile, umbala obizwa ngokuthi i-bilirubin e-bile unesibopho salo mbala ophuzi. Ngezinye izikhathi, i-bilirubin nayo ikhishwa emchameni, okungenza umchamo ube nombala ophuzi/onsundu omnyama.
• Indle enombala okhanyayo: Lokhu kungenxa yokuthi indle ayihambi kahle emathunjini, okungabangela izinguquko endle. Uma indle ingatholakali ukugaya amafutha, amafutha akhishwa kanye nendle. Lolu hlobo lwendle lumhlophe, lunombala wobumba. Futhi, lo mbala okhanyayo ubangelwa ukuntuleka kwe-bilirubin (ngokuvamile, indle inombala onsundu ngenxa ye-bilirubin). Lokhu kungase kuntante emanzini futhi kube nephunga elinamandla.
• Ukuqubuka: Lesi esinye isibonakaliso esivamile esibonakala ku-cholestasis. Ukuluma okuhlobene ne-bile kwenzeka lapho usawoti we-bile noma ama-bile acid eqoqana egazini futhi kuvuselele imizwa yesimiso sezinzwa esingaphandle. Lokhu kuluma akubanga ukuqubuka. Abanye abantu bazwela kakhulu kulawa sawoti we-bile. Abanye abantu banokuluma okuncane, kanti abanye banako okuningi. Ukuluma kungase kube kakhulu ezintendeni zezandla, ezinyaweni, nasemalungeni, futhi umzimba wonke ungase ukuluma.

Ngaphezu kwalezi zimpawu eziyinhloko, ezinye izimpawu zingase zivele kuye ngokuthi imbangela ye-cholestasis ibangelwa yini.

• Ubuhlungu besisu
• Isicanucanu nokuhlanza
• Ukukhathala

Ukubona kanjani lokhu?

Uma unezimpawu ze-cholestasis, into yokuqala udokotela angayenza ukuhlola isampula yegazi lakho.

• Ukuhlolwa kwegazi:Lokhu kuhlola amazinga aphezulu e-bilirubin kanye nosawoti we-bile. Kuhlola futhi i-cholesterol ephezulu kanye nama-enzyme athile esibindi, njenge-gamma-glutamyl transferase (GGT) kanye ne-alkaline phosphatase (ALP). Lokhu kunganikeza umbono othile ngembangela yalesi sifo.
• Ukuhlolwa kwezithombe: Uma ukuhlolwa kwegazi kubonisa isifo, isinyathelo esilandelayo ukuba nokuhlolwa kwezithombe ukuze kubhekwe uhlelo lwakho lwe-biliary. Lokhu kungaqala ngokuhlolwa okulula, okungangenisi ukutheleleka njenge-ultrasound yesisu noma i-CT scan yesisu. Lokhu kungabheka ukuvaleka okubonakalayo emigudwini ye-bile kanye nokuvuvukala kwezitho zomzimba.
• Ukuhlolwa kokuhlola: Ezinye izimbangela ze-cholestasis zidinga ukuhlolwa kwangaphakathi ukuthola nokwelapha imbangela. Udokotela kungadingeka ahlole imigudu ye-bile noma athathe ingxenye encane yezicubu esibindini (i-biopsy yesibindi) ukuze ihlolwe elebhu. Ngesikhathi se -ERCP (Endoscopic Retrograde Cholangiopancreatography) , odokotela bangabheka futhi baphathe izinkinga ngemigudu ye-bile.

Iphathwa kanjani?

Ukwelashwa kwe-cholestasis kuncike embangela eyinhloko.

• Izimbangela ezibukhali: Ezinye izimbangela zingelashwa kalula. Imithi ebangela inkinga ingashintshwa ngeminye imithi. Ama-antibiotic noma ama-antiviral anganikezwa ukutheleleka. Ukuvinjelwa kwe-bile duct kungasuswa ngezinqubo ze-endoscopic njenge-ERCP.
• Izimbangela Ezingapheli: Izimbangela Ezingapheli zesifo sesibindi zingaba nzima ukuzelapha. Ezinye izifo azinawo umuthi ohlala njalo, futhi izibazi zesibindi (i-cirrhosis) azikwazi ukuguqulwa. Kodwa-ke, izinguquko zendlela yokuphila njengokudla, ukuzivocavoca umzimba, nokugwema utshwala kungasiza ekulawuleni ukuqhubeka kwezifo eziningi zesibindi. Okwamanje, udokotela wakho uzogxila ekwelapheni imiphumela emibi yesimo sakho.

Ukwelashwa kungafaka:

• Ukudla Okunomsoco: Ukushintsha kokudla kanye nezithako zokudla kungasiza ekuvimbeleni ukungondleki kahle kanye nokuntuleka kwamavithamini.
• I-Ursodeoxycholic acid:Lo muthi uvame ukusetshenziselwa ukuncibilikisa amatshe enyongo, kodwa ngezinye izikhathi ungasiza nge-cholestasis ngokwandisa ukukhiqizwa kwenyongo nokunciphisa imiphumela yosawoti wenyongo obuningi egazini.
• I-Naltrexone: Lo mphikisi we-opioid ngezinye izikhathi usetshenziselwa ukwelapha ukulunywa okukhulu. Isebenza ngokuvimba izindlela zemizwa ezivuselelwa yi-bile acid egazini.
• I-Cholestyramine: Lo muthi onciphisa i-cholesterol ubopha i-cholesterol nosawoti we-bile emathunjini, okuvumela ukuthi ikhishwe kakhulu esitulweni.