Ingabe unezinkinga ngamalunga akho namathumbu? Ake sixoxe nge-Enteropathic Arthritis!

Ingabe ngezinye izikhathi uzizwa kanje? Uma uvuka ekuseni, amalunga akho ayabuhlungu futhi azizwe evuvukele... Kanye nalokho, unesisu esibuhlungu futhi udinga ukuya endlini yangasese izikhathi eziningana ngosuku. Uma unazo zombili lezi zimpawu ngesikhathi esisodwa, kungadingeka uqaphele isimo esibizwa ngokuthi i-enteropathic arthritis.

Kuyini i-Enteropathy Arthritis?

Kalula nje, i-enteropathic arthritis yisimo esibangela ubuhlungu nokuvuvukala emalungeni akho (i-arthritis) kanye nokuvuvukala ohlelweni lwakho lokugaya ukudla, noma emathunjini (I-Inflammatory Bowel Disease - IBD) . Cabanga unenkinga ngakho kokubili ngesikhathi esisodwa. Abanye abantu bakubiza lokhu ngokuthi i-enteropathic arthropathy, noma i-IBD-related arthropathy.

Manje, bheka, uma sithi isifo samathambo, sonke siyazi ukuthi yisimo esibangela ukuvuvukala kwamalunga, ubuhlungu, futhi singaba yisifo esingamahlalakhona . Ngakolunye uhlangothi, uma sithi i-IBD, kusho ukuthi kukhona ukuvuvukala noma ukulimala kwesikhathi eside okwenzeka engxenyeni noma kuyo yonke indlela yakho yokugaya ukudla, ikakhulukazi amathumbu akho. Ngakho-ke, uma une-EnA, unobuhlungu nokuvuvukala kula malunga, kodwa futhi nokuvuvukala kwamathumbu akho.

I-EnA ingelinye lamaqembu amakhulu ezifo ezithinta amalunga. Ibizwa ngokuthi i-spondyloarthropathy. Igama eliyinkimbinkimbi, kodwa libhekisela esifweni sesikhathi eside samalunga. Lesi simo singaba yisithiyo empilweni yakho evamile , kodwa izindaba ezinhle ukuthi kukhona ukwelashwa kwaso.

Ziyini izimpawu ze-arthritis ye-enteropathic (i-EnA)?

Kumuntu one-EnA, imiphumela eyinhloko isemalungeni akho kanye nohlelo lokugaya ukudla (Uhlelo lwesisu - GI).

Izimpawu ezihlobene namalunga:

Lokhu kuvame ukuthinta kakhulu amalunga ezandleni nasezinyaweni zakho, kodwa ngezinye izikhathi lobu buhlungu nokungakhululeki kungavela nasemhlane wakho .

• Izinguquko esimweni samalunga: Isibonelo, iminwe ingase ibonakale sengathi idonswe ngaphandle, noma ingase ibonakale sengathi igobile.
• Ukushintsha kombala wesikhumba: Isikhumba esingaphezulu kwelunga singase sibe bomvu futhi sishintshe umbala.
• Ubuhlungu: Lolu uphawu oluyinhloko.
• Ukuqina/ukuqina kwamalunga: Lapho uvuka ekuseni, ungase uzizwe unzima ukugoba noma ukwelula amalunga akho isikhashana.
• Ukuvuvukala: Amalunga abonakala evuvukele futhi ekhulisiwe.
• Ubuhlungu: Ubuhlungu lapho uthinta noma ucindezela ilunga.
• Ukufudumala kwamalunga: Indawo lapho ilunga likhona izwakala ifudumele kunezinye izindawo.

Izimpawu ezihlobene nohlelo lokugaya ukudla (uhlelo lwe-GI):

• Ubuhlungu besisu: Ubuhlungu besisu obuvamile.
• Igazi esitulweni lapho uya endlini yangasese: Lolu uphawu okufanele ukhathazeke kakhulu ngalo.
• Uhudo oluvamile: Ukuya endlini yangasese izikhathi eziningana ngosuku.
• Ukwehlisa isisindo ngokungenhloso: Akukhona ukuthi uzama kanzima ukwehlisa isisindo, kodwa ukuthi nje unciphisa isisindo.

Abanye abantu bangase babe nezimpawu ze-GI kuqala, bese kuba nezimpawu zamalunga . Noma kungaba ngenye indlela. Okusho ukuthi, amalunga aqala ukubuhlungu kuqala, bese kuqala izinkinga zesisu. Ngezinye izikhathi zombili izimpawu zingavela ngesikhathi esisodwa.

Kungani kuvela isifo samathambo esibizwa ngokuthi i-enteropathic arthritis (EnA)? Ziyini izimbangela?

Eqinisweni, ososayensi abakakatholi ukuthi yini ngempela ebangela i-EnA . Kodwa basola ukuthi kuhileleke iphrotheni ebizwa ngokuthi i-HLA-B27 , etholakala ebusweni bamaseli ethu amhlophe egazi.

Cabanga ngale ndlela, ngenxa yale phrotheni ethi 'HLA-B27', amasosha omzimba wethu ngezinye izikhathi aqala ngephutha ukuhlasela amangqamuzana ethu aphilile, ikakhulukazi amangqamuzana asemalungeni ethu . Kufana nebutho lethu elizihlasela lona.

Kodwa kukhona okunye lapha. Le `HLA-B27` ayiyona into eyingqayizivele kulesi sifo. Okusho ukuthi, akuwona wonke umuntu one-`HLA-B27` ozoba ne-arthritis ye-enteropathic. Abanye abantu abaphilile nabo bangaba ne-positive ngayo. Ngakho-ke, nakuba lokhu kungaba yimbangela, kuseyinto esesesigabeni socwaningo .

Ubani osengozini enkulu yokuthola isifo samathambo esibizwa ngokuthi i-enteropathic arthritis (EnA)?

Kulinganiselwa ukuthi cishe umuntu oyedwa kwabahlanu onesifo samathumbu esivuvukalayo (i-IBD) uzoba nesifo samathambo esibizwa ngokuthi i-enteropathic arthritis. I-IBD ihlanganisa ikakhulukazi izimo ezifana ne -ulcerative colitis kanye nesifo sikaCrohn .

Ngaphezu kwalokho, i-EnA ingahlotshaniswa nezinye izimo ezithinta amathumbu akho amancane . Isibonelo:

• Isifo se-Celiac: Lesi futhi yisimo sokuzivikela komzimba. Lokhu kusho ukuthi amasosha omzimba ahlasela amangqamuzana awo.
• Ukuvuvukala okwenzeka ngemva kokutheleleka ngamagciwane njengeSalmonella neShigella. Ezinye izifo ezibangelwa amagciwane zingabangela nokuvuvukala kwamathumbu, okungaholela ezinkingeni zamalunga.
• Ukuhlinzwa kwamathumbu (ukuhlinzwa kwe-intestinal bypass).
• Isifo se-Whipple: Lokhu ukutheleleka okungavamile kwamagciwane.

Odokotela bakuthola kanjani lokhu?

Uma uya kudokotela onalezi zimpawu, into yokuqala azokwenza ukukuhlola ngokuphelele ngokomzimba.Ngemuva kwalokho, bazobheka umlando wakho wezempilo ngokuningiliziwe. Bazokubuza nemibuzo eminingi mayelana nezimpawu zakho. Ikakhulukazi, bazokubuza imibuzo mayelana nokuthi ubuhlungu bamalunga akho bushintsha kanjani phakathi nosuku, njengokuthi bube bubi kakhulu ekuseni noma ebusuku .

Bazobuza nangezimpawu zesistimu yakho yokugaya ukudla (GI) , njengokushintsha kwemikhuba yamathumbu kanye nokulahlekelwa yisifiso sokudla.

Ngaphezu kwalokho, kubalulekile ukwazi umlando wezokwelapha womndeni wakho, ikakhulukazi uma kukhona umuntu emndenini wakho oke waba ne-IBD noma i-arthritis.

Yiziphi izivivinyo ezisetshenziswa ukuxilonga i-enteropathic arthritis (i-EnA)?

Akukho ukuhlolwa okuqondile kokuxilonga i-EnA. Kodwa-ke, udokotela wakho angayala ukuhlolwa okuningana ukuqinisekisa ukuthi une-IBD kanye ne-arthritis, noma ukuqeda ezinye izimbangela zezimpawu zakho. Lokhu kuhlolwa kungafaka:

• I-Arthroscopy: Lokhu kuhilela ukuthatha isampula encane yoketshezi olubizwa ngokuthi i-synovial fluid esilungwini sakho bese uluhlola . Lokhu kungakunikeza ulwazi mayelana nokuvuvukala esilungwini.
• Ukuthatha isampula yendle yakho nokwenza ukuhlolwa kokukhula kwamagciwane.
• I-biopsy ukuhlolwa okuhilela ukuthatha ingxenye yezicubu ohlelweni lokugaya ukudla.
• Ukuhlolwa kwegazi okubonisa ukuvuvukala: Isibonelo, izinga lokuncipha kwe-erythrocyte sedimentation (ESR) noma ukuhlolwa kwe -C-reactive protein (CRP) . Lokhu kunganikeza umbono wokuthi kukhona ukuvuvukala noma ukuvuvukala endaweni ethile emzimbeni.
• Ukuhlolwa kwegazi kwe -'HLA-B27' .
• I-Colonoscopy: Lolu uhlobo lokuhlola amathumbu amakhulu kusetshenziswa ipayipi elinekhamera.
• Ama-X-ray amalunga abuhlungu noma athambile uma ethintwa.

Iphathwa kanjani i-arthritis ye-enteropathic (i-EnA)?

Umgomo oyinhloko wokwelashwa kwe-arthritis ye-enteropathic ukunciphisa ukungakhululeki ohlelweni lwakho lokugaya ukudla kanye nokungakhululeki emalungeni akho . Kubalulekile futhi ukuvimbela ukulimala okwengeziwe emalungeni .

Okulandelayo kungasetshenziswa njengezinketho zokwelapha:

• Imijovo ye-Glucocorticoids: Lokhu kusiza ekunciphiseni ubuhlungu nokuvuvukala. Kungafakwa futhi ngqo emalungeni.
• Imithi yokwelapha isifo samathambo (i-DMARD): Le mithi ishintsha indlela amasosha omzimba wakho asebenza ngayo futhi yehlisa ijubane lokuqhubeka kwesifo. Izibonelo zifaka phakathi i-methotrexate , i-sulfasalazine ,Imithi efana ne-Hydroxychloroquine kanye ne -Leflunomide .
• Ama-tumor necrosis factor-alpha inhibitors (ama-TNF-alpha inhibitors): Lolu olunye uhlobo lwemithi enamandla oluthinta isimiso somzimba sokuzivikela. Isibonelo yi- Infliximab .
• Ukwelashwa ngokomzimba: Lokhu kusiza kakhulu ekugcineni ukusebenza kahle kwamalunga nokuvimbela ukulimala nokukhubazeka kwamalunga.
• Ukuhlinzwa: Kwezinye izimo ezinzima, ikakhulukazi uma kunezinkinga zomgogodla, ukuhlinzwa kungadingeka.
• Izinguquko endleleni yokuphila: Kubaluleke kakhulu ukuqaphela, ikakhulukazi ngalokho okudlayo nokuphuzayo (ukudla okudlayo) .

Ngingayinakekela kanjani impilo yami nge-arthritis ye-enteropathic (i-EnA)?

Nakuba i-EnA ingathinta impilo yakho yansuku zonke, kunezindlela eziningana zokukusiza uzizwe ungcono futhi usebenze kangcono :

• Ukufaka ukushisa emalungeni abuhlungu kungasiza ekuphumzeni imisipha. Ngokufanayo, ukufaka umkhuhlane kungasiza ekunciphiseni ubuhlungu bamalunga. Abanye abantu bathola ukushisa kuwusizo, kanti abanye bathola ukubanda kuwusizo. Thola ukuthi yini ekusebenzela kahle.
• Khetha ukudla neziphuzo ezilwa nokuvuvukala. Lokho kusho ukunciphisa ukudla okubabayo nokunamafutha bese ufaka imifino, izithelo, namakhambi amaningi ekudleni kwakho.
• Prakthiza ukuma kahle. Okusho ukuthi, sukuma uqonde lapho uhleli nalapho umi.
• Bamba iqhaza emaqenjini okusekelana. Ukukhuluma nabanye abanezimo ezifana ne-arthritis noma i-IBD kungaba umthombo omkhulu wamandla nolwazi.
• Uma ubhema noma usebenzisa imikhiqizo kagwayi, yeka. Lokhu kungenza izimpawu zibe zimbi kakhulu.
• Zelule futhi wenze umsebenzi womzimba njalo. Buza udokotela wakho ukuthi yiziphi izivivinyo ezifanele wena bese uzenza.
• Zama izindlela zokwelapha ezihambisanayo, njengokubhucunga, ukuzindla , ukutshopa , izithombe eziqondiswayo , kanye namasu okuphumula . Kodwa kuwumqondo omuhle ukukhuluma nodokotela wakho ngaphambi kokuzama lokhu.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma uya kudokotela, kuzokusiza ukubuza imibuzo efana nale:

• Hlobo luni lokwelashwa olungincomayo?
• Ingabe kukhona ukudla okukhethekile okungafanele ngikudle?
• Yini engingayenza ukuze ngivimbele ukuqubuka kwesikhumba?
• Ingabe izingane zami nazo zingayithola le nkinga? (Okungukuthi, ingabe iwufuzo?)

Ingabe isifo samathambo esibangelwa yi-enteropathic (EnA) singavinjelwa?

Ngenxa yokuthi ososayensi abakaqondi ngokugcwele ukuthi yini ebangela i-enteropathic arthropathy, ayikho indlela yokuvimbela lesi sifo ngokuphelele . Kodwa-ke, kunezindlela ongasiza ngazo ekuvimbeleni ukuqubuka kwezimpawu .

Ungagxila ohlelweni lokudla okunempilo oluhlanganisa imifino nezithelo eziningi ezintsha . Zama ukwenza umsebenzi womzimba nsuku zonke. Uma ubhema, yeka nakanjani . Khuluma nodokotela wakho ngezinye izindlela onganciphisa ngazo ukuvama kwalezi zimpawu.

Iyini i-prognosis yomuntu onesifo samathambo esibizwa ngokuthi i-enteropathic arthritis (EnA)?

Indlela lesi sifo esiqhubeka ngayo kumuntu one-EnA ingahluka kakhulu kuye ngomuntu . Izimpawu zingase zibe njalo noma zifike zidlule . Ukuvuvukala kungaba yinto encane ecasulayo kwabanye abantu, kanti kwabanye kungaba kubi ngokwanele ukuphazamisa usuku lwabo.

Kodwa, into ebaluleke kakhulu ukuthi abantu abaningi abane-arthritis ye-enteropathic baphila impilo evamile, ekhiqizayo futhi baphile impilo ejwayelekile .

Akukhona nje ukuthi unezinhlungu zamalunga, kodwa manje usunezinkinga zamathumbu? I-arthritis ye-enteropathic ingaba yisimo esibuhlungu kakhulu nesisongela impilo. Izimpawu zingahluka, kodwa uma isimo sibi kakhulu, singathinta usuku lwakho lonke. Ngenhlanhla, kunezindlela zokwelapha ezitholakalayo . Kodwa-ke, kungathatha isikhathi ukuthola ukwelashwa okufanele. Uhlukile, ngakho izimpawu zakho zingase zingathuthuki ngendlela efanayo naleyo izimpawu zomunye umuntu ezithuthuka ngayo. Khuluma nodokotela wakho. Angakusiza ukuthi wakhe uhlelo lokwelashwa olusebenza kahle kuwe.

Izinto okufanele sizikhumbule kule ndaba (Umyalezo Ohamba Nawo Ekhaya)

Kulungile, ake sibheke izinto ezilula okufanele sizikhumbule ngesifo samathambo esibizwa ngokuthi i-enteropathic arthritis:

• I-EnA yisimo esenzeka kanye nesifo samathambo kanye nesifo samathumbu esivuvukalayo (IBD) .
• Izimpawu zingase zihlanganise ubuhlungu bamalunga, ukuvuvukala, nokuqina, kanye nobuhlungu besisu, uhudo, kanye negazi esitulweni .
• Imbangela yangempela yalokhu ayikatholakali okwamanje , kodwa izici zofuzo ezifana ne-'HLA-B27' zingase zibe nendima.
• Abantu abane-IBD (ikakhulukazi isifo sikaCrohn kanye nesifo sofuba esiswini) basengozini enkulu yokuba naso.
• Ukuhlolwa okuhlukahlukene (igazi, indle, i-colonoscopy, i-X-ray) kusetshenziswa ukuthola lesi sifo.
• Ukwelashwa kuhlanganisa imithi, ukwelashwa ngokomzimba, kanye nokushintsha indlela yokuphila.Kubalulekile.
• Nakuba lesi sifo singenakuvinjelwa ngokuphelele, kungenzeka ukulawula izimpawu futhi uphile impilo enhle .
• Into ebaluleke kakhulu ukungesabi, kodwa ukukhuluma nodokotela wakho bese uthola ukwelashwa neseluleko esikufanele kakhulu.

Uma unalezi zimpawu, ungahlupheki wedwa, kodwa funa iseluleko sezokwelapha ngokushesha okukhulu. Ngemuva kwalokho ungathola impumuzo ngokushesha.

I - arthritis ye-enteropathic, i-arthritis, isifo samathumbu, indlela yokugaya ukudla, ubuhlungu bamalunga, i-IBD, isifo sikaCrohn