Ingabe ungumuntu oye wahlinzwa ngokuhlinzwa wonke umphimbo wakho kanye ne-rectum ngenxa yesimo sezokwelapha kanye 'nesikhwama se-ileal' endaweni yaso? Uma kunjalo, ungase uzizwe ungakhululekile ngezinye izikhathi okuhlobene nalesi sikhwama. Enye yezinkinga ezivame kakhulu ezingavela yilokho esikhuluma ngakho namuhla, 'i-Pouchitis'. Ungesabi uma uzwa lokhu. Ake sixoxe ngakho konke ngokucacile nangokulula.
Kuyini i-Pouchitis? Ake sikuqonde kalula.
Okokuqala, ake sibheke ukuthi iyini le 'isikhwama se-ileal'. Ngemva kokuba ikholoni yakho kanye ne-rectum sekususiwe ngokuphelele (i-total proctocolectomy), udinga indlela entsha yokukhipha indle yakho emzimbeni wakho. Isixazululo esisodwa salokho ukuhlinzwa kwesikhwama se-ileal. Okwenzekayo lapha ukuthi odokotela abahlinzayo basebenzisa ingxenye yokugcina yamathumbu akho amancane (ileum) ukudala isakhiwo esincane esifana nesikhwama.
Ngakho-ke, lokho okwakusenziwa amathumbu akho amakhulu, okwakuwukuqoqa nokugcina indle okwesikhashana ngaphambi kokuba isuke, manje sekwenziwa yilelo sikhwama. Ngamanye amazwi, ingxenye yamathumbu akho amancane manje isebenza njengethumbu elikhulu.
I-Pouchitis yilapho isikhwama sivuvukala noma sivuvukala ngaphakathi. Kuyisimo esifana ne-colitis (ukuvuvukala kwekholoni) noma i-proctitis (ukuvuvukala kwe-rectum). Lesi yisimo esivamile kumuntu onesikhwama.
Kwabaningi, lokhu kungokwesikhashana (i-acute pouchitis), kodwa kwabanye abantu kungaba yisimo esiqhubekayo (i-chronic pouchitis) noma esiphindaphindayo.
Ziyini izimpawu ze-pouchitis?
Uma une-pouchitis, ungase ube nesinye noma ngaphezulu salezi zimpawu. Kubalulekile ukuzazi.
| Isibonakaliso | Incazelo |
|---|---|
| Ubuhlungu besisu esingezansi kanye nokuxhuga | Ubuhlungu obungavamile esiswini esingezansi noma umuzwa wokubanjwa nokuphendulwa. |
| Isidingo sokuya endlini yangasese njalo nangokungazelelwe | Udinga ukuya endlini yangasese kaningi kunokujwayelekile, bese uzizwa unesidingo esingabekezeleleki sokuya endlini yangasese. |
| Ukuya endlini yangasese ebusuku | Kuzomele ngivuke ngiye endlini yangasese. |
| Ubunzima bokulawula ukuhamba kwamathumbu (ukungakwazi ukuzibamba) | Ukuchitha indle encane ngaphandle kokuqaphela. |
| Ubunzima bokuchama indle | Ukuzikhandla ukuze ukhululeke uma uya endlini yangasese (i-dyschezia). |
| Umuzwa wokungakwazi ukukhipha konke endlini yangasese ngemva kokuya endlini yangasese | Ukuzizwa sengathi usakwazi ukuhlanza ngisho nangemva kokukhipha indle (tenesmus). |
| Igazi elincane esitulweni | Ukubona imivimbo yegazi esitulweni. |
| Umkhuhlane noma ukubanda | Ukuzizwa ushisa noma uthuthumela. |
Kungani kwenzeka i-Pouchitis?
Imbangela eqondile yalokhu ayaziwa ngokuphelele, kodwa inkolelo-mbono eyinhloko ukuthi kukhona ukungalingani ezinhlotsheni zamagciwane ahlala ngaphakathi kwesikhwama.
Cabanga nje, lapho ingxenye yamathumbu akho amancane manje isebenza njengethumbu elikhulu, kungena izinhlobo ezintsha zamagciwane. Kukhona 'impi' encane phakathi kwala magciwane amasha namadala. Lolu shintsho lungabangela ukuthi amasosha omzimba acabange ukuthi kukhona ukutheleleka lapho. Ngakho-ke ngenxa yalokho, kuvela ukuvuvukala, okusho ukuthi isikhwama siyavuvukala.
Ngezinye izikhathi, amabhaktheriya abangela izifo angakhula kakhulu futhi abangele ukutheleleka. Lokhu kulinganisela kwamabhaktheriya kuyashintsha ngemva kokuhlinzwa, okunikeza amabhaktheriya ayingozi ithuba elingcono lokukhula.
Kuvamile ukuba ne-pouchitis ngokushesha ngemva kokuhlinzwa. Lokhu kungelashwa ngama-antibiotic. Kodwa-ke, kwabanye abantu, kungaphinde kuvele.
Ezinye izinto ezibangela i-pouchitis eqhubekayo
Kwabanye abantu, i-pouchitis iyaqhubeka noma ayiphenduli kahle ekwelashweni. Lokhu kungaba ngenxa yezinye izici.
- Izimo zezokwelapha ezazikhona ngaphambili (IBD): Uma kwadingeka ukuthi ususwe ikholoni yakho ngenxa yesifo samathumbu esivuvukalayo (IBD) njenge-Ulcerative Colitis noma isifo sikaCrohn, usengozini enkulu yokuthola i-pouchitis. Lokhu kungenxa yokuthi indlela efanayo eyisisekelo eyabangela leso sifo ingathinta nesikhwama.
- Amabhaktheriya amelana nama-antibiotic: Amanye amabhaktheriya athelelekayo, njenge-C. difficile, kunzima ukuwalawula ngama-antibiotic. Futhi, ngokuqhubeka nokusebenzisa ama-antibiotic, amanye amabhaktheriya ayamelana nawo. Lokhu kungandisa nokungalingani kwamabhaktheriya esikhwameni.
- Ezinye izifo: Ngezinye izikhathi, ukuvuvukala kwesikhwama kungabangelwa nayizifo ezibangelwa amagciwane (i-cytomegalovirus) noma i-fungal (candidiasis).
- Ukuzivikela komzimba okubuthakathaka: Uma amasosha omzimba wakho ebuthakathaka ngenxa yezinye izimo zezokwelapha noma imithi ethile, ikhono lakho lokulwa nezifo liyancipha.
- Ukusetshenziswa kwemithi yobuhlungu (ama-NSAID): Ukusetshenziswa isikhathi eside futhi ngokweqile kwemithi yobuhlungu njenge-ibuprofen ne-aspirin (imithi elwa nokuvuvukala engeyona eye-steroidal - ama-NSAID) kungalimaza ungqimba lwangaphakathi lwesikhwama.
- Ukuncipha kokunikezwa kwegazi (ischemia): Nakuba kungavamile kakhulu, ukuvuvukala kungenzeka ngenxa yokuvaleka kokunikezwa kwegazi esikhwameni.
- Isifo se-PSC: `(I-Primary sclerosing cholangitis - PSC)` yisifo esibangela ukuvuvukala kwemisele ye-bile yesibindi. Abantu abanalesi simo basengozini enkulu yokuthola i-pouchitis.
Yiziphi izinkinga ezingaba khona ngenxa ye-pouchitis?
I-pouchitis yesikhashana ayivamile ukubangela izinkinga ezinkulu, kodwa uma lesi simo siqhubeka noma singaphenduli ekwelashweni, singabangela izinkinga ezithile.
| Inkinga | Incazelo |
|---|---|
| Ushintsho emikhubeni yokuzilungisa | Ukuvuvukala kwesikhwama kungabangela izinkinga zesikhathi eside, njengobunzima bokubamba indle noma ubunzima bokuphuma kwendle ngenxa yokuvuvukala. |
| Izinga lokuphila elinciphayo | Ukuphazamiseka kokuya endlini yangasese njalo kungaholela ezinkingeni ezifana nokucindezeleka kanye nokwehla kobudlelwano bomphakathi. |
| Ukuncishiswa kwesikhwama (i-Stricture) | Ukuvuvukala kwesikhathi eside kungabangela izibazi esikhwameni, kunciphise ukuvuleka kwaso. |
| Izilonda | Ukuvuvukala kungabangela ukuthi ungqimba lwangaphakathi lwesikhwama lucasuke futhi luphume igazi. |
| Ukuntuleka kokudla okunempilo | Ukulimala kwengqimba yangaphakathi yesikhwama kungaholela ekunciphiseni ukumuncwa kwezakhamzimba ekudleni (i-malabsorption), okuholela ekungondleki kahle. |
| Ukwehluleka Kwesikhwama | Akuvamile kakhulu ukuthi izinkinga eziqhubekayo zingenza isikhwama singasetshenziswa, okudinga ukususwa kwaso kanye nezinye izinqubo zokuhlinzwa, njenge-ileostomy. |
Wazi kanjani kahle ukuthi une-pouchitis?
Ngemva kokulalela izimpawu zakho, udokotela wakho uzokwenza izivivinyo eziningana ukuqinisekisa isimo. Ukuhlolwa okubaluleke kakhulu yi -pouchoscopy (endoscopy) .
Lokhu kuhilela ukufaka ipayipi elincane kakhulu elinekhamera exhunywe ngendunu yakho bese uhlola ingaphakathi lesikhwama. Udokotela angabe esehlola noma yikuphi ukuvuvukala noma izilonda ngaphakathi kwesikhwama. Ngesikhathi esifanayo, kungathathwa ingcezu encane yezicubu (i-biopsy) ukuze ihlolwe.
Ngaphezu kwalokho, kungenziwa izivivinyo ezilandelayo ukuhlola isimo sesikhwama kanye nezakhiwo ezizungezile:
- I-Contrast Pouchography `(i-pouchogram)`
- `I-CT scan`
- `I-MRI`
Yiziphi izindlela zokwelapha i-pouchitis?
Izinketho zokwelapha zincike ohlotsheni lwe-pouchitis onayo.
Ukwelashwa kwe-Acute Pouchitis
Ukwelashwa kokuqala yinkambo yama-antibiotic yamasonto amabili. Kubantu abaningi, lokhu kuzoziqeda ngokuphelele izimpawu zabo. Ngisho noma izimpawu zakho zithuthuka, kubalulekile ukuthatha yonke imithi oyinikezwe udokotela wakho.
Ukwelashwa kwe-Recurrent Pouchitis
Uma i-pouchitis iphinda ivele ngemva kokwelashwa, udokotela cishe uzonikeza ama-antibiotic afanayo. Kodwa-ke, uma kwenzeka izikhathi ezingaphezu kwezintathu ngonyaka, kubhekwa njengesifo esingamahlalakhona futhi ukwelashwa kokulungisa kungase kuqalwe ukuvimbela ukuphinda kuvele. Ngenxa yalokhu,
- Ukunikeza ama-antibiotic isikhathi eside ngemithamo ephansi.
- Ukusetshenziswa kwama-Probiotic: Ama-Probiotic, aqukethe amabhaktheriya awusizo, angasiza ekubuyiseleni ibhalansi yamabhaktheriya esikhwameni.
Ukwelashwa kwe-pouchitis engaphenduli kuma-antibiotic (i-CARP)
Uma ama-antibiotic engasizi, noma uma ayesiza ngaphambili, lesi simo sibizwa ngokuthi "i-pouchitis engamelana nama-antibiotic (CARP)". Lapha, udokotela uzofuna ezinye izimbangela bese enquma ukwelashwa ngokufanele. Kunezindlela ezahlukene zokwelapha lokhu.
- Ama-enema aqukethe imithi efana ne-'Mesalamine' noma i-'Bismuth'
- Ama-Corticosteroids, anciphisa ukuvuvukala
- Ama-immunosuppressants alawula ukusebenza kwesimiso somzimba sokuzivikela
- Imithi yesimanje efana ne-'Biologics'
- Izindlela zokwelapha ezikhethekile ezifana nokufakelwa kwe-Fecal microbiota (FMT)`
Into ebaluleke kakhulu ukuthi udokotela wakho kufanele anqume ukuthi yikuphi ukwelashwa okukulungele. Ngakho-ke uma unezimpawu, funa iseluleko sezokwelapha ngokushesha.
Ingabe i-pouchitis ingalawulwa ngokudla neziphuzo?
Yebo, ngezinga elithile kungenzeka. Ukudla kwakho kungasiza ekuvimbeleni i-pouchitis ukuthi ingaveli futhi kusize nasekulawuleni izimpawu lapho zivela.
| Ukudla okusiza ukuvimbela i-pouchitis (ukudla okucebile ngama-antioxidant) | Ukudla okwandisa izimpawu ze-pouchitis (yeka okwesikhashana) |
|---|---|
Faka izithelo nemifino ecebile ngama-antioxidants anciphisa ukuvuvukala ekudleni kwakho.
| Uma izimpawu zikhona, impumuzo ingatholakala ngokunciphisa okwesikhashana ukudla okuthile okuvuselela amabhaktheriya amathumbu futhi okunzima ukukugaya (Low FODMAP Diet).
|
Okubalulekile: Ukudla okuphansi kwe-FODMAP akuyona into okufanele uyilandele unomphela. Kuyinto okufanele uyilandele isikhathi esifushane, uma unezimpawu, ngaphansi kwesiqondiso sikadokotela noma isazi sokudla okunempilo.
Nakuba impilo ilula kakhulu ngemva kokuhlinzwa kwesikhwama se-ileal, kuvamile ukuzizwa ukhathazekile lapho kuvela izinkinga ezifana ne-pouchitis. Kodwa khumbula, lesi yisimo esingelapheka esithinta abantu abaningi. Ungasebenzisana nodokotela wakho ukuthola ikhambi elingcono kakhulu kuwe.
Umlayezo Wokuya Nawe Ekhaya
- I-Pouchitis ukuvuvukala kwesikhwama okuvamile kubantu abaye bahlinzwa ngesikhwama se-ileal.
- Uma uzwa izimpawu ezifana nobuhlungu besisu esingezansi, ukuya endlini yangasese njalo, noma igazi esitulweni sakho, ziqaphele.
- Iningi lamacala e-pouchitis angelashwa ngempumelelo ngama-antibiotic.
- Ungazinaki izimpawu. Bona udokotela wakho ngokushesha okukhulu ukuze uthole iseluleko.
- Ukudla okunomsoco kanye nama-probiotics kungasiza ekugcineni impilo yesikhwama.
- Izimo ze-pouchitis eziqhubekayo (ezingapheli) zingadinga ukwelashwa okukhethekile, futhi udokotela wakho uzokunikeza uhlelo lokwelashwa olufanele kakhulu.
💬 Comments (0)
Awekho amazwana athunyelwe okwamanje. Faka amazwana akho lapha okokuqala ngqa.
Engeza amazwana akho