Ungase uhlupheke kakhulu ngenxa yesimo sesikhathi eside emathunjini akho. Mhlawumbe, ngisho nangemithi, lesi simo kunzima ukusilawula. Esimweni esinjalo, udokotela angase asikisele ikhambi lokuthi ukhiphe amathumbu amakhulu agulayo ngokuhlinzwa bese udala isikhwama esikhethekile emzimbeni esingaqoqa imfucuza. Yilokho esikubiza ngokuthi isikhwama se-ileal. Ake sixoxe ngakho konke ngamagama alula.
Kalula nje, siyini isikhwama se-ileal?
Cabanga ukuthi wonke amathumbu akho amakhulu (ikholoni) kanye ne-rectum kususwa ngokuhlinzwa ngenxa yesifo esithile. Lokhu kuhlinzwa kubizwa ngokuthi "i-Total Proctocolectomy". Ngakho-ke ngemva kokususwa, udinga indawo yokuqoqa nokugcina imfucuza (indle) eyakheka ngemva kokugaya ukudla ngaphambi kokuba iphume emzimbeni.
Yilapho odokotela abahlinzayo besebenzisa khona isiphetho samathumbu akho amancane (i-ileum) ukudala isikhwama esincane emzimbeni wakho. Lokhu kubizwa ngokuthi isikhwama se-ileal .
Inzuzo enkulu yalokhu ukuthi awudingi ukugqoka isikhwama/isikhwama sangaphandle ukuze uqoqe imfucuza ngaphandle kwesisu sakho. Ungagcina ukulawula amathumbu njengokujwayelekile.
Kukuziphi izinhlobo zezimo zezokwelapha lapho lokhu kuhlinzwa kudingeka kwenziwe khona?
Akuwona wonke umuntu ohlinzwa ngale ndlela. Odokotela bacabangela le ndlela ikakhulukazi lapho izimo ezithile zezokwelapha zingenakulawuleka ngemithi. Lokhu kuhlinzwa, okubizwa ngokuthi `(Ileal Pouch-Anal Anastomosis - IPAA)`, kuvame ukusetshenziswa ezimweni ezilandelayo:
- I-Ulcerative Colitis: Lesi yisimo esibangela ukuvuvukala nokuvuvukala isikhathi eside emathunjini amakhulu. Lena inketho engcono kakhulu uma imithi ingasebenzi.
- I-Familial Adenomatous Polyposis (FAP): Lesi yisifo esidluliselwa ngofuzo esibangela amakhulu ezimila ezincane (ama-polyp) emathunjini angakhula abe umdlavuza.
- Umdlavuza we-Colorectal/Colon: Kwezinye izimo zomdlavuza.
- Umdlavuza Wezinqe: Kweminye imidlavuza eyenzeka engxenyeni engenhla ye-rectum, kunokuba ibe yingxenye engezansi.
Zingaki izinhlobo zalezi zikhwama ezikhona?
Yebo, kunezinhlobo ezintathu eziyinhloko zalezi zikhwama zangaphakathi ezidalwe odokotela abahlinzayo.
| Uhlobo Lwesikhwama | Incazelo elula |
|---|---|
| Isikhwama se-J | Lolu uhlobo oluvame ukusetshenziswa kakhulu . Isikhwama sakhiwa ngokugoqa amathumbu amancane abe ngesimo senhlamvu ethi 'J'. Sixhunywe ngqo endunu, ukuze ukwazi ukuzikhulula ngendlela evamile. |
| Isikhwama se-S | Lokhu kwenziwa ngesimo sencwadi ethi 'S'. Kufana kakhulu nesikhwama se-J. Kuxhunywe ne-anus. |
| Isikhwama se-Kock / isikhwama se-K | Lolu uhlobo olungavamile kakhulu . Lwenzelwa abantu abangakwazi ukuba nezinye izinhlobo ezimbili. Lapha, isikhwama sixhunywe embotsheni (stoma) eyenziwe esikhumbeni sesisu. |
Ngakho-ke lo kuhlinzwa ufanelekela bani futhi ubani ongafaneleki?
Ukuze lokhu kuhlinzwa kuphumelele, izingxenye ezithile zomzimba wakho kudingeka zisebenze kahle. Futhi, kungase kungafaneleki kubantu abanezimo ezithile zezokwelapha.
| Abantu Abahle Abazongenela Lo Mhlinzo | Labo abanganconywa ukuhlinzwa (Kungenzeka Bangafaneleki) |
|---|---|
| Labo abanezingxenye ezisele zesimiso sokugaya ukudla ezisebenza kahle. | Abantu abanesifo sikaCrohn (njengoba lesi sifo singathinta nesikhwama esisanda kwakheka). |
| Abantu abanemisipha ye-anal sphincter esebenza kahle kanye nekhono lokulawula ukunyakaza kwamathumbu abo. | Abantu asebevele bengakwazi ukuzibamba indle . |
| Abantu abangazange balimele imizwa ye-pelvic. | Abantu abanokukhuluphala okukhulu (ukukhuluphala kwesigaba sesi-3) . |
| Imiphumela iphumelela kakhulu kubantu abaneminyaka ephakathi kuka-20 no-50. Kodwa abantu abanempilo abaneminyaka engaphezu kuka-50 nabo bangakwenza lokhu. | Abantu abanomdlavuza ophansi we-rectal. |
Yini ongayilindela ngemva kokuhlinzwa?
Lokhu akusikho ukuhlinzwa okukodwa. Ngokuvamile kwenziwa ngezigaba ezimbili noma ezintathu . Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela cishe isonto lonke.
Ekuqaleni, isikhwama sesikhashana sizobekwa ngaphandle kwesisu sakho ngenkathi isikhwama esisanda kudalwa sisaphola. Lokhu kungahlala izinyanga ezintathu kuya kweziyisithupha. Ngemuva kwalokho, kuzokwenziwa ukuhlinzwa okuncane ukuze kususwe futhi kuvunyelwe isikhwama sangaphakathi ukuthi siqale ukusebenza. Phakathi nalesi sikhathi, ithimba lezokwelapha lizokunakekela kahle kakhulu. Ungesabi ukukhuluma nabo uma unemibuzo.
Kuphumelela kangakanani lokhu? Ingabe zikhona izingozi?
Lokhu ukuhlinzwa okuphumelele kakhulu. Izinga lempumelelo licishe libe ngu-95% . Ngokuhamba kwesikhathi, izinga lempilo yakho lizothuthuka kakhulu. Isibonelo, umuntu owayene-`(Ulcerative Colitis)` ngeke esakwazi ukuba nesifiso sokuya endlini yangasese esasikhona.
Ngokwesilinganiso, udinga ukuzikhulula cishe izikhathi eziyisikhombisa ngosuku. Kodwa into ebaluleke kakhulu ukukwazi ukuyilawula ngaphandle kokuphuthuma lapho kuphakama isidingo.
Kodwa-ke, njengazo zonke izinhlobo zokuhlinzwa okukhulu, kunezingozi nezinkinga.
- I-Pouchitis: Lena inkinga evame kakhulu. Kuwukuvuvukala noma ukutheleleka kwesikhwama esisanda kudalwa.
- Ezinye izinkinga:
- Ukuvuza okuvela esikhwameni ngemuva kokuhlinzwa.
- Ukuvaleka kwamathumbu amancane.
- Ukuqhekeka kwegazi noma ukuphuma kwegazi.
- Ukwakheka kokuxhumana okungavamile (i-fistula) phakathi kwesikhwama nesinye isitho.
- Ukungakhululeki esikhumbeni esizungeze indunu ngenxa yokuhamba njalo kwamathumbu.
Ingozi yalezi zinkinga iphakathi kuka-5% no-10%. Uma lokhu kwenzeka, kungadingeka ukuthi uphinde uhlinzwe noma uthole i-stoma ehlala njalo. Ngakho-ke, kubalulekile ukuxoxa ngakho konke lokhu nodokotela wakho.
Kufanele ubonane nini nodokotela ngokushesha?
Kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezintsha noma ezingavamile ngemva kokuhlinzwa. Uma unezinye zalezi zimpawu, tshela udokotela wakho ngokushesha.
| Izimpawu okufanele uziqaphele |
|---|
| Ukuvuvukala kwesisu noma izinhlungu zesisu ezithatha amahora angaphezu kwamabili kuya kwamathathu. |
| Ukopha. |
| (Uma kukhona isikhwama sesikhashana) ushintsho noma ukulimala kwe-stoma. |
| Ubunzima bokukhipha indle. |
| Ukuvuza okukhulu. |
| Ubuhlungu obukhulu. |
| Ukucanuzela okukhulu, ukuhlanza, noma uhudo. |
Kuzothatha isikhathi esingakanani ukubuyela empilweni evamile? Kuthiwani ngokudla neziphuzo?
Ngokuvamile ungabuyela emsebenzini nasemisebenzini yakho zingakapheli amasonto amane kuya kwayisishiyagalombili . Ngemva kokuba usululame, udokotela wakho uzokwenza i-pouchoscopy (ikhamera encane ebheka ngaphakathi kwesikhwama) njalo ngonyaka noma emibili ukuqinisekisa ukuthi konke kuhamba kahle.
Uma kukhulunywa ngokudla , kungadingeka wenze izinguquko ezithile ekudleni kwakho ukuze uvumelane nohlelo lwakho olusha lokugaya ukudla ekuqaleni. Kungcono ukubonisana nochwepheshe wezokudla ukuze uthole iseluleko. Kodwa abantu abaningi ekugcineni bazokwazi ukudla noma yini abayifunayo.
Ngokuphathelene nokukhulelwa , lokhu kuhlinzwa akuvamile ukuthinta ikhono lakho lokuthola abantwana. Kodwa-ke, ukuze ugweme ukulimala kwemisipha ye-rectum ngesikhathi sokubeletha, udokotela wakho angase akuncomele ukuhlinzwa .
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlinzwa kwesikhwama se-Ileal kuyithuba elihle kulabo abahlushwa yizifo zamathumbu amakhulu ukuze baphile impilo evamile ngaphandle kwesikhwama esiswini sabo.
- Lolu ukuhlinzwa olunezinga eliphezulu kakhulu lempumelelo (95%) futhi oluthuthukisa kakhulu ikhwalithi yokuphila.
- Kodwa-ke, lokhu kuyindlela enkulu yokuhlinzwa engenazo izingozi nezinkinga. Inkinga evame kakhulu yisimo esibizwa ngokuthi i-pouchitis.
- Kuthatha isikhathi ukululama ngemva kokuhlinzwa, futhi ukuhlolwa njalo nodokotela wakho kubalulekile empilweni yesikhathi eside.
- Uma unemibuzo ngalokhu, ungesabi ukubuza udokotela wakho.
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