Ingabe wena noma othile emndenini wakho, ikakhulukazi ingane, nivame ukuba nobuhlungu besisu? Wake waphawula igazi elincane esitulweni sakho? Noma uzizwa ukhathele futhi ukhathele? Sivame ukunganaki lezi zimpawu njengobuhlungu besisu noma ukungabekezelelani nokudla. Kodwa-ke, ngezinye izikhathi lezi zimpawu zingabangelwa yisimo esingakazwa kakhulu ngaso, kodwa kufanele nakanjani siqaphele. Namuhla sizokhuluma ngesinye sezimo ezinjalo, i-Juvenile Polyposis Syndrome (JPS).
Iyini ngempela i-JPS?
Kalula nje, i-Juvenile Polyposis Syndrome (JPS) yisimo sofuzo lapho kwakheka khona ukukhula okungavamile ezindongeni zangaphakathi zesimiso sethu sokugaya ukudla (isisu - i-GI tract). Ngokwezokwelapha sibiza lokhu kukhula ngokuthi ama-polyp . Cabanga ngeqhubu elincane elifana negilebhisi elilenga esiqwini ngaphakathi kwamathumbu ethu. Yileyo ndlela la ma-polyp akhiwa ngayo.
La ma-polyp angakheka noma kuphi ohlelweni lwethu lokugaya ukudla.
- Isisu
- Emathunjini amancane
- Emathunjini amakhulu (ikholoni)
- I-Rectum
Kodwa zivame ukutholakala emathunjini amakhulu kanye nase-rectum. Umuntu one-JPS angaba nala ma-polyp ambalwa kuya kwamakhulu.
Manje ungase ucabange ukuthi ngenxa yokuthi inegama elithi "juvenile" kuyo, lesi yisifo esithinta izingane ezincane kuphela. Akunjalo ngempela. Igama elithi "juvenile" lapha alibhekiseli eminyakeni lapho lesi sifo siqala khona. Libhekisela emvelweni wamaseli abonakala lapho i-polyp ithathwa futhi ihlolwa ngaphansi kwe-microscope. Kodwa-ke, isikhathi esiningi, izimpawu zalesi sifo ziqala ukuvela ebuntwaneni noma ebusheni , ngokuvamile ngaphambi kweminyaka engama-20.
Ingabe zikhona izinhlobo eziyinhloko ze-JPS?
Yebo, i-JPS ingahlukaniswa ngezinhlobo ezintathu eziyinhloko. Lokhu kuhlukaniswa kusekelwe kusayizi wama-polyp akhayo kanye nendawo yawo.
| Uhlobo lwe-JPS | Incazelo elula |
|---|---|
| I-polyposis yezingane ezincane (JPI) | Lolu uhlobo lwe-JPS olubi kakhulu nolubi kakhulu. Luvela ezinsaneni nasezinganeni ezincane. Izimpawu zingavela ngokushesha okukhulu. |
| I-polyposis evamile yentsha | Lolu uhlobo oluvame kakhulu lwe-JPS. Ama-polyp angakhula noma kuphi kulo lonke umgudu wokugaya ukudla, okuhlanganisa isisu, amathumbu amancane, kanye namathumbu amakhulu. |
| I-Juvenile polyposis coli | Kulolu hlobo, ama-polyp akheka kuphela emathunjini. Lokhu kuncane kakhulu uma kuqhathaniswa nezinye izinhlobo ezimbili. |
Ubani othola lesi simo? Ingabe siwufuzo?
I-JPS ibangelwa ukuguquka kwezakhi zofuzo, ngakho-ke noma ubani angayithola. Kuyisimo esingavamile kakhulu. Emhlabeni wonke, ukwenzeka kwalesi sifo kucishe kube yinye kwabayikhulu abayizinkulungwane .
Yebo, lesi sifo singazuzwa njengefa . I-JPS yilokho esikubiza ngokwezokwelapha ngokuthi isimo "esiphezulu se-autosomal". Lokhu kusho ukuthi noma ingane izuza ikhophi eyodwa yesakhi sofuzo esiguquliwe salesi sifo kumama noma kuyise, kwanele ukuthi ingane ithole lesi sifo.
- Cishe ama-75% eziguli ze-JPS athola lesi simo njengefa kubazali bazo.
- Ezimweni ezingama-25% ezisele, lesi sifo singabangelwa ukuguquka okuzenzakalelayo emzimbeni wengane, yize abazali bengenalo lolu guquko lwezakhi zofuzo.
Ziyini izimpawu ze-JPS?
Uphawu oluyinhloko lwalesi sifo ukwakheka kwama-polyp, esikhulume ngawo ngaphambili, emathunjini. Njengoba lawa akheka ngaphakathi emzimbeni, asikwazi ukuwabona ngaphandle. Ezimweni eziningi, ama-polyp angase angakhombisi zimpawu aze abe makhudlwana noma inani lawo landa. Kodwa uma izimpawu ziqala ukubonakala, zingabonakala kanje.
| Isibonakaliso | Incazelo |
|---|---|
| Ukopha kwegazi endulo | Lolu uphawu oluvame kakhulu nolokuqala ukuvela. Ungase ubone igazi elibomvu elikhanyayo esitulweni sakho. |
| Ubuhlungu besisu noma ubuhlungu | Ungase uzwe ubuhlungu obungavamile, obufana nobuhlungu esiswini sakho. |
| Uhudo | Uhudo oluhlala isikhathi eside lungase luvele. |
| Ukuqunjelwa | Abanye abantu bangase babe nokuqunjelwa esikhundleni sohudo. |
| I-anemia | Njengoba igazi liqhubeka nokugeleza, inani legazi emzimbeni lingancipha, okuholela ekulahlekelweni yigazi. Lokhu kungakwenza uzizwe ukhathele, uphaphathekile futhi ubuthakathaka ngaso sonke isikhathi. |
| Ukwehlisa isisindo | Uma uqhubeka nokunciphisa isisindo ngaphandle kwesizathu, lokho kungaba uphawu. |
Ezinye izici ezingabonakala ekuzalweni
Cishe iziguli ze-JPS ezingama-15% zinezinye izinkinga zomzimba lapho zizalwa ngaphezu kwama-intestinal polyps.
- Umlomo oqhekekile nolwanga
- Ukuba neminwe noma izinzwane ezengeziwe (i-Polydactyly)
- Ukukhubazeka kokukhula kobuchopho, inhliziyo, noma uhlelo lomchamo
- Ukusonta kwamathumbu (i-Malrotation)
Ingabe kukhona ukuxhumana phakathi kwe-JPS nengozi yomdlavuza?
Lokhu kuyinto ebaluleke kakhulu okufanele uyazi ngalesi sifo. Ama-polyp aqala ngenxa ye-JPS awabi nomdlavuza ekuqaleni (angabi yingozi). Angama-tumors ajwayelekile. Kodwa-ke, ngokuhamba kwesikhathi, kunengozi enkulu kakhulu yokuthi la ma-polyp aguquke abe umdlavuza.
Umuntu one-JPS usengozini yokuphila kwakhe konke yokuba nomdlavuza wesistimu yokugaya ukudla ophakathi kuka-30% no-50%.
Ngakho-ke, umuntu one-JPS usengozini enkulu yokuthola izinhlobo ezilandelayo zomdlavuza:
- Umdlavuza we-Colorectal
- Umdlavuza wesisu
- Umdlavuza wamathumbu amancane
- Umdlavuza we-pancreatic
Ungesabi lokhu. Lokhu akusho ukuthi wonke umuntu uzothola umdlavuza. Kodwa kusho ukuthi ingozi inkulu. Yingakho kubaluleke kakhulu ukuxilonga lesi sifo ngesikhathi esifanele futhi uhlolwe ngezikhathi ezifanele njengoba kunconywe udokotela wakho.
Iyini imbangela eqondile ye-JPS?
Njengoba sixoxile ngaphambili, lesi yisimo sofuzo. I-JPS ibangelwa kakhulu izinguquko ezakhiweni ezimbili zomzimba wethu ezibizwa ngokuthi i-BMPR1A kanye ne-SMAD4 .
Ukuze siqonde lokhu, ake sisebenzise isibonelo esilula. Cabanga ukuthi amangqamuzana emzimbeni wethu afana nezimoto emgwaqweni. Izakhi zofuzo ezimbili ezibizwa nge-BMPR1A kanye ne-SMAD4 zifana namaphoyisa omgwaqo. Zilawula ukukhula nokuhlukana kwamangqamuzana, zinikeza izimpawu ezithi "Kulungile, hlukana manje" kanye nokuthi "Kulungile, yeka manje."
Uma la ma-gene amabili eshintshashintsha, njengalapho lawo maphoyisa omgwaqo engasekho, amaseli alahlekelwa ukulawula. Aqala ukuhlukana nganoma iyiphi indlela ayifunayo, futhi ngesivinini esikhulu. Yileyo ndlela la maseli ahlukanisayo angalawuleki ahlangana ngayo futhi akhe la mathumba abizwa ngokuthi ama-polyps.
Ngaphezu kwe-JPS, abantu abanezinguquko ku-SMAD4 gene basengozini yokuthola esinye isimo sofuzo esibizwa ngokuthi i-hereditary hemorrhagic telangiectasia (HHT).
Ungasithola kanjani lesi sifo?
Uma utshela udokotela wakho ngezimpawu zakho, uzokuxilonga futhi akubuze ngomlando wezokwelapha womndeni wakho. Ukuze uxilonge i-JPS, kumele okungenani ube nokukodwa kwalokhu okulandelayo:
- Ukuba nama-polyp amahlanu noma ngaphezulu emathunjini amakhulu kanye/noma e-rectum.
- Ukuba khona kwama-polyp kwenye indawo ohlelweni lokugaya ukudla.
- Ukuba ne-polyp okungenani eyodwa kanye nomlando womndeni we-JPS.
Kunezivivinyo ezimbili eziyinhloko zokuqinisekisa lesi sifo.
1. Ukuhlolwa kwe-Endoscopic / Colonoscopy: Lokhu kuhilela ukufaka ithubhu elincane neliguquguqukayo elinekhamera kanye nokukhanya okudlula endunu ukuhlola ingaphakathi lonke lamathumbu amakhulu kanye nomgudu wokugaya ukudla. Lokhu kungasiza ekuboneni ukuthi kukhona ama-polyp, ukuthi mangaki, nokuthi akuphi. Ngesikhathi sokuhlolwa, ama-polyp amancane angasuswa bese kuthathwa isampula yezicubu (i-biopsy) ukuze ihlolwe.
2. Ukuhlolwa kwegazi ngofuzo: Kuthathwa isampula yegazi bese kuhlolwa ukuguqulwa kwezakhi zofuzo ze-BMPR1A noma ze-SMAD4 okubangela i-JPS. Lokhu kungaqinisekisa lesi sifo isikhathi esingu-100%.
Yiziphi izindlela zokwelapha i-JPS?
Umgomo oyinhloko wokwelapha i-JPS ukususa ama-polyp.Lokhu kungalawula izimpawu futhi kunciphise ingozi yokuba nomdlavuza esikhathini esizayo. Udokotela wakho uzonquma ukwelashwa okungcono kakhulu kuwe ngokusekelwe eminyakeni yakho, impilo, inani lama-polyp, kanye nendawo akuyo.
Kunezindlela eziningana zokwelapha:
- Ukususa ama-polyp ngesikhathi se-colonoscopy: Uma ama-polyp ambalwa futhi amancane ngobukhulu, anganqunywa futhi asuswe ngethuluzi elifanayo elisetshenziselwa ukwenza ukuhlolwa.
- Ukususwa kwama-polyp ngokuhlinzwa: Uma ama-polyp amakhulu noma esendaweni okunzima ukuyifinyelela nge-colonoscope, kungase kudingeke ukuhlinzwa.
- Ukususwa kwengxenye yekholoni ngokuhlinzwa: Uma inani elikhulu lama-polyp lisakazeke endaweni eyodwa, odokotela bangase banqume ukususa yonke leyo ngxenye yekholoni ngokuhlinzwa.
Uma izingane ezincane zine-polyp eyodwa kuphela, ivame ukususwa ngesikhathi sokuhlolwa kwe-colonoscopy. Ukuhlinzwa akuvamile ukwenziwa ezinganeni.
Indlela yokuphatha lesi sifo ngemva kokuxilongwa?
I-JPS yisimo esidinga ukuphathwa isikhathi eside. Ngemva kokwelashwa nokususwa kwama-polyp, sidinga ukubhekwa njalo ukuze sibone ukuthi ayakhula yini noma amasha ayavela. Yingakho senza ukuhlolwa .
Udokotela wakho uzokutshela ukuthi wenze lezi zivivinyo ngesheduli ehleliwe.
- Ukuhlolwa kwegazi
- I-Colonoscopy
- I-endoscopy ephezulu
Ukuhlolwa kokuqala kuvame ukwenziwa ngokushesha nje lapho kuvela izimpawu noma ngaphambi kweminyaka engu-15. Uma imiphumela yokuhlolwa imihle, uzocelwa ukuthi uphinde ukuhlolwa njalo eminyakeni emi-3. Kodwa-ke, uma unama-polyp futhi esesusiwe, kungadingeka ukuthi uhlolwe njalo ngonyaka . Uma ama-polyp engabuyi, isikhathi esiphakathi kokuhlolwa singandiswa sibe iminyaka emi-3.
Ukulandela lolu hlelo kubaluleke kakhulu empilweni yakho nasempilweni yakho. Kungakusiza ukuthi uthole futhi uvimbele izingozi zomdlavuza kusenesikhathi.
Kunini lapho udinga ukubonana nodokotela?
Uma unezinye zezimpawu esixoxe ngazo, ikakhulukazi igazi elisesitulweni sakho , ungalokothi uzishaye indiva. Kungaba yi-hemorrhoid elula, noma kungaba uphawu lwesimo esibucayi njenge-JPS. Ngakho-ke, bona udokotela wakho ngokushesha.
Futhi, uma othile emndenini wakho eke waba ne-JPS ngaphambili, noma uma uke waba nomdlavuza wamathumbu usemncane, kuwukuhlakanipha ukukhuluma nodokotela wakho ngakho futhi uthole ukuhlolwa kofuzo uma kudingeka, noma ngabe awunazo izimpawu.
Umlayezo Wokuya Nawe Ekhaya
- I-Juvenile Polyposis Syndrome (JPS) yisifo sofuzo esibangela ukukhula okungavamile (ama-polyp) emathunjini. Igama elithi 'Juvenile' libhekisela esimweni se-polyp, hhayi ubudala.
- Ungalokothi ungazinaki izimpawu ezifana negazi esitulweni, ubuhlungu besisu obuhlala isikhathi eside, noma ukwehla kwesisindo. Funa iseluleko sikadokotela ngokushesha.
- I-JPS yandisa ingozi yokuba nomdlavuza esikhathini esizayo. Ngakho-ke, kubalulekile ukwenza ukuhlolwa okunconywe udokotela wakho ngesikhathi.
- Nakuba kungekho ikhambi eliphelele lalesi sifo, singaphathwa ngempumelelo futhi impilo enempilo ingaphilwa ngokususa ama-polyp nokuhlolwa njalo.
- Uma unomlando womndeni we-JPS noma umdlavuza wamathumbu, khuluma nodokotela wakho ngakho bese ucabanga ngokwelulekwa nokuhlolwa kwezakhi zofuzo.
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