Ingabe kufanele sifunde ngezilonda zomlomo/zesisu (i-mucositis) ezihambisana nokwelashwa komdlavuza?

Uma welashwa umdlavuza, ngezinye izikhathi uthola izilonda ezibuhlungu ezingabekezeleleki emlonyeni nasemphinjeni, akunjalo? Kunezikhathi lapho ungakwazi ngisho nokudla noma ukuphuza, futhi kunzima ukukhuluma. Yileso simo esizokhuluma ngaso namuhla, esibizwa ngokuthi i-mucositis . Ungakhathazeki, lokhu kuyinto eyenzeka kubantu abaningi, futhi kunezindlela zokuyiphatha. Ake sihlolisise.

Kuyini i-Mucositis? Kalula nje...

I-Mucositis ukuvuvukala nokulimala kolwelwesi lomgudu wethu wokugaya ukudla (GI) , noma i-mucosa . Cabanga ngayo njengolwelwesi olumanzi, olubushelelezi, olupinki lomlomo wethu. Yilolo lwelwesi olumboza wonke umgudu wethu wokugaya ukudla. Yilokho okusivikela kumagciwane kanye namakhemikhali anamandla ekudleni kwethu.

Kodwa-ke, ezinye izindlela zokwelapha umdlavuza, ikakhulukazi i-chemotherapy , ukwelashwa ngemisebe , noma ukufakelwa amaseli e-stem , njengokufakelwa umnkantsha wamathambo , kungalimaza lolu lwelwesi olubucayi. Yilapho kuvela khona i-mucositis. Lesi simo sivame ukubonakala emlonyeni njenge-oral mucositis .

Lesi sifo sithinta kanjani imizimba yethu?

Manje, bheka, amangqamuzana omdlavuza awuhlobo lweseli elihlukana ngokushesha kakhulu. Ngakho-ke, ukwelashwa okunikezwayo komdlavuza kuklanyelwe ukubhubhisa lawo maseli ahlukana ngokushesha. Kodwa inkinga iwukuthi, amangqamuzana asezinhlakeni zethu zangaphakathi nawo awuhlobo lweseli elihlukana futhi livuseleleke ngokushesha kakhulu. Ngakho-ke, ukwelashwa komdlavuza akukwazi ukuhlukanisa phakathi kwalokhu okubili. Ngakho-ke, kanye namangqamuzana omdlavuza, amangqamuzana asezinhlakeni zethu ezivikelayo nawo alimele.

Ngokuvamile, lolu hlobo lwe-mucous membrane lusivikela ngoba luvuselela ngokushesha. Ngisho nesilonda esincane siphola ngokushesha. Kodwa ku-mucositis, akuwona nje kuphela amaseli akulolu hlobo lwe-membrane alimele, kodwa nekhono lalawo maseli lokuvuselela nokwelapha amanxeba nalo liyancishiswa. Kwenzekani-ke? Lolu hlobo lwe-membrane luqala ukulimala kakhulu ngemisebenzi evamile njengokudla nokukhuluma. Akukhona lokho kuphela, kodwa nengozi yokutheleleka nayo iyanda kakhulu.

Ku-oral mucositis, ingaphakathi lomlomo liba bomvu, licwebezele, livuvuke, bese kuvela izilonda . Ngezinye izikhathi , amabala amhlophe obovu angavela emlonyeni. Abanye abantu bangase bazizwe ubuhlungu obuncane, kodwa abanye bangase babe nobuhlungu obungabekezeleleki. Odokotela bahlukanise lobu buhlungu ngamazinga. Amazinga 1 no-2 aphansi kakhulu, kodwa amazinga 3 no-4 abuhlungu obukhulu. Kulezi zimo ezinzima, ungase ungakwazi ukudla noma ukuphuza, futhi ngisho nokwelashwa komdlavuza kungadingeka kuncishiswe.

Abanye abantu bangase babe nesifo sohudo esiswini, hhayi emlonyeni kuphela, kodwa nasemathunjini. Lokhu kungabangela izimpawu ezifana nobuhlungu besisu, isicanucanu, nokuhlanza . Uma kuseduze nesisu, lezi zimpawu zingase zivele. Uma kukhona ukuvuvukala emathunjini, ungase ube nesifo sohudo noma ubuhlungu ngesikhathi sokuhamba kwamathumbu.

Ubani onamathuba amaningi okuthola i-mucositis?

I-mucositis ikhula cishe kubantu abangu-50% abathola ukwelashwa ngamakhemikhali, kanye nabantu abaphakathi kuka-80% no-100% abathola ukwelashwa ngemisebe noma ukufakelwa amaseli e-stem. Lokhu kusho ukuthi ivame kakhulu.

Futhi, ungase ube sengozini enkulu yokuthuthukisa noma yokwenza lesi simo sibe sibi kakhulu ngezizathu ezifana nalezi:

• Uma ubhema noma uhlafuna ugwayi .
• Uma usebenzisa utshwala ngokweqile.
• Uma umzimba uphelelwe amanzi emzimbeni .
• Uma kukhona ukuntuleka kwamaprotheni .
• Uma inkomba yakho yesisindo somzimba (i-BMI) iphansi .
• Uma unezifakelo zamazinyo noma usebenzisa amazinyo okufakelwa .
• Uma unesifo sezinsini .
• Uma unesifo sezinso .
• Uma unesifo sikashukela .
• Uma unegciwane le-HIV .

Ziyini izimpawu ze-Mucositis?

Uma kwenzeka ukuvuvukala, kuvame ukubangela ukubomvu, ubuhlungu, ukushisa, nokuvuvukala . Kanye nalokhu, kungabonisa nezimpawu eziqondene nendawo ngayinye.

Izimpawu ze-oral mucositis:

• Ingaphakathi lomlomo nezinsini liba bomvu, licwebezele, futhi livuvuke .
• Umlomo owomile .
• Amathe ajiyile kakhulu .
• Izilonda zomlomo .
• Amabala amhlophe athambile obovu .
• Ubunzima bokugwinya, ukukhuluma, ukudla, nokuphuza .
• Ukopha .
• Uqweqwe olumhlophe lwamafinyila emlonyeni omhlophe .

Izimpawu ze-mucositis yesisu:

• Ukubomvu kwe-mucous membrane (i-erythematous mucosa) .
• Ubuhlungu besisu .
• Isicanucanu nokuhlanza .
• Uhudo .
• Igazi noma i-mucus endle yakho .
• Ukunyakaza kwamathumbu okubuhlungu .

Yiziphi izimbangela eziyinhloko ze-mucositis?

Uma odokotela bekhuluma nge-mucositis, bavame ukubhekisela ekuvuvukeni kolwelwesi lomlomo kanye nomgudu wokugaya ukudla okubangelwa ukwelashwa komdlavuza. Njengoba sesixoxile, lokhu kwelashwa kulimaza amangqamuzana ahlukana ngokushesha, okuhlanganisa namangqamuzana asezinhlakeni zethu zama-mucous. Umlomo noma isisu kungathinteka ngale ndlela ngemisebe ephezulu noma i-chemotherapy enikezwa umzimba wonke, noma ngemithi ephansi enikezwa endaweni ethile kuphela.

Ngezinye izikhathi, ukuvuvukala kwe-mucous membranes kungenzeka nezinye izimo, njengokutheleleka. Kodwa-ke zibizwa ngamanye amagama aqondile. Isibonelo, ukuvuvukala emlonyeni kubizwa ngokuthi i-stomatitis , kanti ukuvuvukala emlonyeni okubangelwa ukutheleleka kubizwa ngokuthi i-gingivostomatitis .

Yiziphi izinkinga ezingaba khona ze-Mucositis?

Lokhu kuyinto okufanele uyiqaphele kancane.

• Ukungondleki kahle: Ubuhlungu emlonyeni, emphinjeni, emqaleni, noma esiswini bungenza kube nzima ukudla noma ukuphuza. Lokhu kungaba kubi nakakhulu kubantu abanomdlavuza, asebevele benezinkinga zokudla kanye nokwehla kwesisindo. Kubalulekile ukubanikeza ukudla okunempilo. Cishe abantu abangu-70% bangadinga ukulaliswa esibhedlela ukuze bancelise ngepayipi.
• Uhudo olungapheli: Uma unesifo sohudo esiqhubekayo, noma uma unegazi esithweni sakho sangasese, kungadingeka ukuthi ulaliswe esibhedlela futhi uqashwe ukuze uvimbele ukuphelelwa amanzi emzimbeni noma i-anemia.
• Ukutheleleka: Uma ulwelwesi lwamafinyila lonakele, esinye sezivikelo ezibaluleke kakhulu emzimbeni wethu siyalahleka. Abantu abanomdlavuza banenani eliphansi lamangqamuzana amhlophe egazi, okusho ukuthi amasosha abo omzimba nawo abuthakathaka. Lapho kuvela amanxeba ngenxa ye-mucositis, amagciwane avame ukungena egazini. Abantu abane-mucositis, abenza i-chemotherapy, kanye nabanenani eliphansi lamangqamuzana amhlophe egazi (i-neutropenia) basengozini enkulu yokuthola ukutheleleka kwegazi okukhulu (i-septicemia).
• Ukuncipha kokwelashwa komdlavuza: Ezimweni ze-mucositis enzima, ezinye iziguli zomdlavuza kufanele zihlehlise noma zinciphise ukwelashwa kwazo. Lokhu kungenye ingozi empilweni yazo. Kuthiwa iziguli ezingaphezu kuka-30% ziyayeka ukwelashwa ngenxa yalesi simo.

I-Mucositis itholakala kanjani?

I-Mucositis ingumphumela ovamile wezokwelapha umdlavuza . Ingatholakala kalula ngokubheka izimpawu zakho, umlando wakho wezokwelapha, kanye nezindawo zokuvuvukala. Uma une-mucositis yesisu, bheka izivivinyo zezithombe.Kuzodingeka ube nayo. Futhi, udokotela wakho angase afune ukuhlola ukuthi unazo yini izifo ezibangelwa amagciwane noma isikhunta. Lokhu kungenziwa ngokuhlolwa kwegazi okulula.

Yiziphi izindlela zokwelapha i-Mucositis?

I-Mucositis ivame ukuphela yodwa ngemva kokuphela kokwelashwa komdlavuza. Uma uphathwa i-chemotherapy, i-mucositis izovela zingakapheli isonto noma amabili kusukela ekuqaleni kokwelashwa futhi izophela zingakapheli isonto elilodwa kuya kwayisithupha. Uma uphathwa ngemisebe, i-mucositis izovela zingakapheli amasonto amabili kuya kwamathathu kusukela ekuqaleni kokwelashwa futhi izophela zingakapheli amasonto amabili kuya kwamane kusukela ekugcineni kokwelashwa. Isikhathi esithathayo ukuze ululame singahluka kuye ngokuthi sibi kangakanani nokuthi usinakekela kahle kangakanani ukuze singabi sibi kakhulu. Ngenkathi ululama, uzodinga okulandelayo:

Ukuphathwa kobuhlungu

Ubuhlungu buyinkinga enkulu kakhulu nge-mucositis, ikakhulukazi uma kwenzeka emlonyeni. Izinto ezisetshenziswayo zingase zingahlali isikhathi eside noma zingafinyeleli kuzo zonke izindawo. Kungase kudingeke usebenzise inhlanganisela yezindlela zokulawula ubuhlungu bakho. Ungadinga izihlanzi zomlomo, iziqeda-buhlungu ezitholakala ngaphandle kwemithi kadokotela, ngisho nama-opioid kadokotela. Ungabubekezeleli ubuhlungu. Udinga ukwazi ukudla nokuphuza kahle ukuze ululame. Khuluma nodokotela wakho mayelana nokulawula ubuhlungu ngesikhathi sokwelashwa komdlavuza.

Ezinye izindlela zokwelapha ubuhlungu be-mucositis:

• Izibulala-zinhlungu zesikhumba: Lokhu kufaka phakathi izinto ezifana ne-'lidocaine', 'benzocaine', 'dyclonine hydrochloride (HCl)' kanye ne-'Ulcerease® (0.6% phenol)'.
• "I-Magic mouthwash": Lena ingxube ye-'lidocaine', i-'diphenhydramine', kanye ne-'Maalox®'.
• Imithi yokulwa nokuvuvukala: Isibonelo, i-prednisone.
• "I-cocktail ye-GI": Lena ingxube ye-`Maalox®`, `Nystatin®` kanye ne-`Hurricane Liquid®`.
• I-Acetaminophen: Ifana ne-`Tylenol®`.
• Imithi yobuhlungu edakayo kadokotela: Le mithi kufanele ithathwe nezithambisi zendle ukuze kuvinjelwe ukuqunjelwa.

Ukunakekelwa komlomo

Uma une-oral mucositis, udinga ukunakekela umlomo wakho ngokukhethekile. Lokhu ngeke nje kunciphise ubuhlungu, kodwa futhi kuvikele ekulimaleni nasekuthelelekeni okwengeziwe. Ngisho nezinto ezilula njengokudla, ukukhuluma, nokugwinya kungalimaza ulwelwesi lwakho olubuthakathaka lwama-mucous. Lokhu kusho ukukhetha ukudla okuthambile nezinto ezingagcina umlomo wakho nomphimbo wakho umanzi futhi uvikelekile. Njengoba ulwelwesi lwakho olubuthakathaka lwama-mucous lusengozini enkulu yokutheleleka, ukuhlanzeka nakho kubaluleke kakhulu .

Ukwelashwa kwe-oral mucositis:

• Hlanza amazinyo akho kakhudlwana – kodwa ngobumnene: Okungenani kathathu kuya kane ngosuku. Sebenzisa ibhulashi lamazinyo elithambile kanye ne-toothpaste ethambile ene-fluoride. Gwema izinto zokwenza mhlophe. Uma i-toothpaste icasula umlomo wakho, sebenzisa i-paste kasawoti kanye ne-baking soda. Hlanza amazinyo kancane . Hlanza amazinyo okufakelwa nsuku zonke.
• Ukuhlanza umlomo: Hlanza umlomo wakho ngamanzi anosawoti noma isisombululo sikasawoti kanye ne-baking soda izikhathi ezinhlanu kuya kweziyisithupha ngosuku. Lena yindlela emnene nephumelela kakhulu yokuhlanza izilonda zomlomo nokubulala amagciwane. Ungasebenzisa futhi izihlanzi zomlomo ezingenayo i-alcohol antiseptic.
• Ukudla: Ukudla kwakho kufanele kube okuthambile futhi kungabi namakhaza kakhulu . Gwema ukudla okune-asidi, okunokhaza kanye nokuqhekeka. Gwema ushukela notshwala. Lokhu kungalimaza ulwelwesi futhi kukhuthaze ukukhula kwamagciwane kanye nesikhunta. Ama-protein shakes angumqondo omuhle wokwandisa ukudla okunomsoco kanye nokumanzisa.
• Ukumanzisa: Kungase kudingeke uphuze uketshezi oluningi ukuze ulungise umlomo wakho owomile kanye nomswakama onciphile endleleni yakho yokugaya ukudla. Ungase ufune ukuzama umkhiqizo wamathe wokwenziwa osekelwe kuma-enzyme njenge-Oral Balance®. Abanye abantu bathola ukuthi ukumunca ama-ice chips kusiza ekumanziseni nasekuthobiseni umlomo wabo. Ungase ufune nokuvikela izindebe zakho ngokusebenzisa ama-lip balm.

Ukwelapha izinkinga

Uma uphelelwe amanzi emzimbeni kakhulu, ungondlekile kahle, noma unegciwane, ungadinga:

• Ukudla okunempilo
• Ukunikeza usawoti (uketshezi lwe-IV)
• Ama-antibiotic

Yini okufanele ngiyidle futhi ngiyiphuze kuze kube yilapho i-mucositis iphola?

Izinto ezinhle zokudla:

• Ukudla okunamaphrotheni amaningi
• Ama-shake okudla okunempilo
• Ukudla okuthambile
• Ama-popsicle angenashukela

Izinto okungafanele zidliwe:

• Ukudla okunongwe
• Ukudla okune-asidi
• Ukudla okunamafutha noma okuthosiwe
• Ukudla okunoshukela omningi

Izinto ezinhle zokuphuza:

• Itiye le-Chamomile
• Amanzi amaningi

Izinto ezingalungile ukuziphuza:

• Iziphuzo ezine-carbon
• Utshwala

Ingabe i-Mucositis ingavinjelwa?

Okwamanje akukho okuningi esingakwenza ukuvimbela i-mucositis ekwelashweni komdlavuza, kodwa odokotela bayacwaninga ngayo. Kusahlolwa imithi eminingana engasiza ekunciphiseni ubukhali nobude balesi simo kwabanye abantu. Eminye yayo ihlanganisa:

• Ukwelashwa nge-Cryotherapy: Ukumunca ama-ice cubes ngaphambi nangesikhathi sokwelashwa ngamakhemikhali kungasiza ekuvikeleni i-oral mucositis.
• I-Palifermin: Lolu uhlobo lokwenziwa lwento ekhiqizwa yimizimba yethu ebizwa ngokuthi i-keratinocyte growth factor (KGF). I-KGF isebenza ukuvikela nokulungisa amaseli emlonyeni nasemgudwini wokugaya ukudla. Kuye kwabonakala ukuthi kusiza ekunciphiseni ubukhali kanye nobude be-mucositis kubantu abanomdlavuza wegazi kanye nalabo abaye bafakelwa umnkantsha noma amaseli e-stem.
• Izinto ezisetshenziswa esikhumbeni: I-Gelclair® ne-Zilactin® ziboniswe ukuthi zinciphisa i-mucositis yomlomo ngokumboza nokuvikela i-mucosa ngaphambi kokwelashwa ngemisebe.
• I-Amifostine: Lo muthi unganciphisa ubukhali be-oral mucositis kubantu abathola ukwelashwa ngemisebe ekhanda nasentanyeni. Kodwa-ke, isicanucanu singaba umphumela omubi.

Uma nginalesi simo, yini okufanele ngiyilindele?

Lokhu kuvame ukuphela ngokwakho ngemva kokuqeda ukwelashwa komdlavuza, kodwa kungathatha amasonto amabili kuya kwayisithupha. Kungase kudingeke uphuze imithi yokwelapha ubuhlungu enqunywe udokotela wakho ukuze akusize ubhekane nalesi sikhathi. Ukunakekela umlomo wakho kakhulu nokuwugcina uhlanzekile ukuze uvimbele ukutheleleka kungasiza ukuthi ululame ngokushesha. Uma uthola ukutheleleka noma unenkinga yokudla noma ukuphuza, qiniseka ukuthi ufuna iseluleko sezokwelapha.

Kufanele ngimbone nini udokotela wami?

Uma ubona lezi zimpawu, funa iseluleko sezokwelapha ngokushesha:

• Lapho kuvela izimpawu zokuqala ze-mucositis .
• Uma unezimpawu zokutheleleka, njengomkhuhlane .
• Uma unenkinga yokudla nokuphuza .
• Uma wehlisa isisindo .
• Uma unesifo sohudo esiqhubekayo .
• Uma uvame ukuphuma igazi emlonyeni wakho noma ngendle yakho.

I-Mucositis ingenye yemiphumela emibi evame kakhulu futhi enzima yokwelashwa komdlavuza. Ukuthi imbi kangakanani kuncike ezintweni eziningi, okuhlanganisa impilo yakho iyonke, uhlobo lokwelashwa olutholayo, nokuthi uzinakekela kahle kangakanani ngemva kokwelashwa.

Okokugcina, khumbula lokhu (Umyalezo Wokuya Ekhaya)

I-Mucositis ingeyesikhashana, kodwa akudingeki ibe umthwalo, futhi kukhona usizo olutholakalayo. Amaviki ambalwa okuqala ngemva kokwelashwa komdlavuza abalulekile ekululameni kwakho. Kukhona ingozi yangempela yokungondleki kahle noma ukutheleleka phakathi nalesi sikhathi. Kokubili ukuzinakekela kanye nokunakekelwa kwezokwelapha kubalulekile uma une-mucositis. Ungesabi ukukhuluma nodokotela wakho futhi uthole usizo oludingayo. Awuwedwa!

I- Mucositis, ukwelashwa komdlavuza, izilonda zomlomo, ukuvuvukala kwesisu, imiphumela emibi ye-chemotherapy, imiphumela emibi yokwelashwa ngemisebe, ukunakekelwa komlomo