Ingabe ikhona inkinga ngemibhobho yenyongo yesibindi sakho? Ake sifunde ngqo nge-Primary Biliary Cholangitis (PBC)!

O, uzizwa sengathi ukhathele kakhulu, ukhathele ngisho noma ungenzi lutho? Noma ngezinye izikhathi uzizwa sengathi uklwebha isikhumba sakho ngaphandle kwesizathu? Ngezinye izikhathi, nakuba singazinaki kakhulu lezi, zingaba uphawu lwenkinga yesibindi, esinye sezitho ezibaluleke kakhulu emzimbeni wethu. Namuhla sizokhuluma ngesifo esinjalo esithinta isibindi, futhi nakuba igama lingase libonakale liyinkimbinkimbi kancane, kulula ukuliqonda. Lokho kusho ukuthi (i-Primary Biliary Cholangitis) , eyaziwa nangokuthi (PBC) ngamafuphi.

Kuyini i-Primary Biliary Cholangitis (PBC)? Masiqonde kalula!

Kulungile, leli gama libonakala lide kancane, akunjalo? Ake sibone ukuthi lisho ukuthini.

I-"Cholangitis" ukuvuvukala kwemigudu yakho ye-bile . Uyazi, uketshezi olubizwa ngokuthi i-bile, olukhiqizwa esibindini sethu, luhamba ohlelweni lwamapayipi amancane. Lawo mapayipi abizwa ngokuthi amapayipi e-bile. Igama elithi "Biliary" lisho nokuthile okuhlobene nala mapayipi e-bile. Igama elithi "Primary" lisho "okuyisisekelo" noma "okuqalwa."

Uma uhlanganisa konke lokhu, i-Primary Biliary Cholangitis isho ukuthi, hhayi ngenxa yanoma yisiphi esinye isifo, ukutheleleka, noma ukuvaleka, kodwa ngenxa yalesi sifo, kukhona ukuvuvukala kwemigudu yenyongo esibindini sakho . Njengoba lokhu kuvuvukala kungenzeki ngenxa yanoma yini, awazi ukuthi kuzophela nini. Ngakho-ke kuyisimo esiqhubeka kancane kancane.

Lesi sifo sasibizwa ngokuthi i-Primary Biliary Cirrhosis ngoba ekugcineni singabangela ukuthi isibindi sibe lukhuni futhi sibe nezibazi, okuholela esimweni esibizwa ngokuthi i-cirrhosis .

I-(PBC) iyithinta kanjani imizimba yethu?

Cabanga nje, kwenzekani uma ingxenye yomzimba wethu ivuvukala njalo? Ngokuvamile, ukuvuvukala kwesikhashana kuyingxenye yenqubo yokuphulukisa. Kodwa uma lolu hlobo lokuvuvukala okungapheli luqhubeka, esikhundleni sokuphulukiswa, indawo iqala ukuba nezibazi.

Yilokho okwenzekayo emigudwini yenyongo engaphakathi kwesibindi sakho ku-PBC. Le migudwini iyancishiswa futhi ivinjwe yizibazi . Bese inyongo ekhiqizwa yisibindi ayikwazi ukugeleza kahle. Lenyongo iqala ukubuyela emuva ngaphakathi kwesibindi. Lapho lenyongo inqwabelana, ilimaza amangqamuzana esibindi futhi ibangele ukuvuvukala esibindini. Ngokuhamba kwesikhathi, le ngxube yesibindi enempilo ithathelwa indawo yizicubu zesibazi. Ekugcineni, isibindi asisakwazi ukusebenza kahle, okuyilokho esikushilo ngaphambilini (i-cirrhosis) .

Ingabe i-PBC iyisimo esibucayi?

Yebo, i-Primary Biliary Cholangitis iyisifo esingamahlalakhona nesiqhubekayo . Lokhu kusho ukuthi ayigcini nje ngokuba ngcono, ingaba yimbi kakhulu ngokuhamba kwesikhathi. Ayibi yimbi kakhulu ngesikhathi esisodwa, iba yimbi kancane kancane, ngezigaba ezahlukene. Ungase ungabi nazimpawu ekuqaleni.

Kodwa-ke, into eyingozi kakhulu ngalokhu ukuthi kungagcina kuholele ekuhlulekeni kwesibindi ngokuphelele ngisho nokufa uma ukufakelwa isibindi kungenziwa.

Kodwa, ngenhlanhla, kunemithi engasiza ekunciphiseni ukuqhubeka kwalesi sifo . Futhi akuwona wonke umuntu ofinyelela kulesi sigaba sokugcina. Ngakho ungakhathazeki.

Uyini umehluko phakathi kwe-(PBC) kanye ne-(PSC)?

Kungenzeka ukuthi uke wezwa ngesinye isimo esibizwa ngokuthi i-Primary Sclerosing Cholangitis, noma i-PSC. Lezi zibili zifana kakhulu, kodwa kunezimo ezimbalwa ezihlukile.

• Ku-PBC , kuthinteka kuphela imigudu ye-bile engaphakathi kwesibindi sakho (imigudu ye-bile engaphakathi kwesisu) .
• Kodwa-ke, ku-PSC, imibhobho ye-bile ngaphakathi kwesibindi kanye nangaphandle kwesibindi (imibhobho yangaphandle kwesibindi) iyathinteka .
• Kukhona futhi umehluko othile emiphakathini lapho lezi zifo ezimbili zivame kakhulu khona.
• Into ebalulekile ukuthi, nakuba kunemithi yokwelapha (i-PBC), akukho ukwelashwa okuphumelelayo okutholakale okwamanje (i-PSC) .

Ubani okungenzeka kakhulu ukuthi athole lesi sifo (PBC)?

Nakuba lokhu kungase kubonakale kumangalisa, abesifazane banamathuba aphindwe kayishumi okuthola i-PBC kunabesilisa (10:1) . Ngokwezibalo e-United States, cishe abesifazane abangu-60 kwabangu-100,000 banalesi sifo, uma kuqhathaniswa nabesilisa abangaba ngu-15 kwabangu-100,000.

Iningi labantu litholakala linalesi sifo ngemva kweminyaka engama-40. Lesi sifo sivame kakhulu eScotland, emazweni aseScandinavia, nasenyakatho-mpumalanga yeNgilandi.

Futhi, uma wena noma othile emndenini wakho enesinye isifo sokuzivikela komzimba, kungenzeka kakhulu ukuthi ube ne-PBC . Lokhu kusikisela ukuthi kungase kube nokuxhumana kwezakhi zofuzo .

Ziyini izimpawu zesifo (i-PBC)?

Abantu abaningi abane-PBC abanazo izimpawu ezigabeni zokuqala. Kuphela lapho lesi sifo siqhubeka lapho izimpawu ezihlobene nemigudu yenyongo ziqala ukuvela. Izimpawu zokuqala nezivame kakhulu ezibonakala kubantu abane-PBC yilezi:

• Ukukhathala okukhulu (cishe abantu abangu-65%)
• Isikhumba esilumayo (cishe abantu abangu-55%)

Lezi zimpawu zithinta wonke umuntu ngendlela ehlukile. Abanye abantu bangase babe nazo ekuqaleni kwalesi sifo, kanti abanye bangase babe nazo kamuva. Zingaba zimbi kakhulu kunoma yisiphi isigaba salesi sifo. Kubonakala sengathi akukho ukuxhumana okukhulu phakathi kokuthi izimpawu zakho zimbi kangakanani nokuthi lesi sifo siqhubeke kangakanani. Kodwa-ke, ucwaningo oluthile lusikisela ukuthi abantu abanezimpawu ezinzima ekuqaleni bangase babe nokuqhubeka ngokushesha kwalesi sifo .

Yiziphi izinkinga zezifo ze-bile duct?

Ezigabeni zokuqala, ungase ungaboni ukuthi unenkinga ngemigudu yakho ye-bile. Kodwa njengoba isifo siqhubeka, kuvela izinkinga ezahlukahlukene. I-bile engakwazi ukugeleza kahle,Iqala ukuvuza egazini, okubangela izifo. Futhi, lapho inyongo ingakwazi ukufinyelela ohlelweni lokugaya ukudla kahle, ukugaya ukudla nakho kuyaphazamiseka. Ngoba inyongo ibalulekile ekugayeni ukudla.

Kamuva, ukusha kwesibindi kungathinta nemithambo yegazi edlula esibindini, okuholela esimweni esibizwa ngokuthi i-portal hypertension , okusho umfutho wegazi ophezulu kuleyo mithambo.

1. Ukumuncwa kwamafutha

Uma uhlelo lwakho lokugaya ukudla lungatholi inyongo eyanele, alukwazi ukuwohloka kahle futhi lumunce amafutha ekudleni kwakho. Lokhu kuncipha kokumuncwa kwamafutha kungabangela okulandelayo:

• I-cholesterol ephezulu egazini .
• Amafutha ahlala ngaphansi kwesikhumba .
• Indle enamafutha noma isifo sohudo .
• Ukwehlisa isisindo .
• Ukwehla kwamazinga amavithamini A, D, E, kanye no-K ancibilika emafutheni.
• I-Osteoporosis yisifo sokuncipha kwamathambo esibangelwa ukuncipha kokumuncwa kwevithamini D encibilikayo emafutheni.

2. Umfutho wegazi ophezulu we-portal

Uma imithambo yegazi edlula esibindini ivalekile ngenxa yezibazi, kuvela umfutho wegazi ophezulu we-portal okukhulunywe ngawo ngenhla, okusho ukuthi umfutho wegazi kuleyo mithambo neminye imithambo exhunywe kuyo uyakhuphuka. Lo mfutho wegazi ophezulu we-portal ungabangela lezi zimo ezilandelayo:

• Isibindi esikhulu .
• Ubende obukhulu .
• Umkhuhlane ovamile kanye nezinye izifo (ukuncipha kokuzivikela komzimba).
• Ukuphuka kalula nokopha (ama-platelet aphansi egazi - (thrombocytopenia) ).
• Ukuvela kwemithambo yegazi ebomvu efana nesicabucabu (spider angiomas) ebusweni besikhumba.
• Imithambo evuvukile noma enamafindo emgogodleni nasesiswini (imithambo evuvukile - ama-varice) .
• Ukopha kwamathumbu .
• Ukuqongelela koketshezi esiswini (ama-ascites) .
• Ukuvuvukala (i-edema) komzimba ongezansi.
• Ngezinye izikhathi ukudideka kwengqondo kwenzeka ngenxa yokuqongelela kobuthi egazini.

Yiziphi izimbangela ze-(PBC)?

Ku-PBC, amasosha omzimba wakho ahlasela amangqamuzana azungeze imisele ye-bile yesibindi sakho . Kunjengokungathi amasosha omzimba abona lawa maseli njengabahlaseli bangaphandle. Lokhu yilokho esikubiza ngokuthi isifo sokuzivikela komzimba., noma izifo ezihlasela amasosha omzimba. Ngaphandle kwesizathu esibonakalayo, amasosha omzimba abhubhisa amangqamuzana anempilo, futhi akukho ukulawula ukukuvimba. Lokhu kuvuvukala okuqhubekayo yikona okubangela izibazi.

Asazi ngempela ukuthi kungani lezi zifo zokuzivikela komzimba zikhula. Kodwa-ke, kubonakala sengathi kukhona isici sofuzo . Abantu abaningi abathola izifo zokuzivikela komzimba banomlando womndeni walesi sifo, futhi bangahlakulela izinhlobo ezingaphezu kweyodwa zezifo zokuzivikela komzimba.

Kubonakala sengathi kukhona nesici semvelo . Okusho ukuthi, mhlawumbe okuthile endaweni ezungezile kungabangela lesi sifo. Kungaba yikhemikhali obhekene nayo, noma kungaba ukutheleleka.

I-PBC itholakala kanjani?

Udokotela wakho uzoqala ngokukubuza ngomlando wakho wezokwelapha kanye nezimpawu, enze ukuhlolwa ngokomzimba, bese ethatha isampula yegazi ukuze ahlole i-PBC.

Lokhu kuhlolwa kwegazi kubheka kakhulu ama-antibodies athile ahlobene ne-PBC, ikakhulukazi i-antibody ebizwa ngokuthi i-antimitochondrial antibody (AMA) . Kubheka nama-enzyme esibindi aphezulu, ikakhulukazi i-alkaline phosphatase (ALP), abonisa ukulimala kwesibindi.

Uma imiphumela yokuhlolwa kwakho ikhombisa ukuthi une-PBC, udokotela wakho uzofuna ukubheka izithombe zesibindi sakho kanye nohlelo lwe-biliary . Lokhu kungasiza ekususeni ezinye izimbangela zezimpawu zakho futhi abone ukuthi lesi sifo siqhubeke kangakanani. Ngokuvamile, into elula njenge- ultrasound yesisu yenziwa kuqala. Kodwa ngezinye izikhathi, kungase kudingeke ukuhlolwa okufana ne-MRI (magnetic resonance imaging) ukuze kutholakale izithombe ezicacile.

Cishe abantu abangu-5% abane-PBC bangase babe nokuhlolwa kwe-AMA okungekuhle, kodwa bangase babe nezinye izimpawu. Uma lokhu kwenzeka, udokotela wakho kungadingeka athathe ingxenye encane yezicubu esibindini sakho (i-biopsy yesibindi) ukuqinisekisa ukuthi une-PBC. Lokhu kuvame ukwenziwa eceleni kombhede, ngenaliti efakwe esibindini sakho. Isampula encane yezicubu ezithathwe enalitini ithunyelwa elabhorethri ukuze ihlolwe ngaphansi kwe-microscope.

Yiziphi izindlela zokwelapha i-Primary Biliary Cholangitis?

Odokotela basebenzisa okulandelayo ukwelapha i-PBC:

Imithi

I-PBC ayikwazi ukwelapheka ngokuphelele . Kodwa-ke, imithi ingalawula ukuqhubeka kwesifo futhi ithuthukise isimo sakho .

(I-Ursodeoxycholic acid - UDCA)Luhlobo lwe-bile acid. Lusiza ekususeni i-bile esibindini futhi lunciphise ukulimala kwesibindi. Lo muthi usebenza kahle cishe kubantu abane-PBC, ikakhulukazi ezigabeni zokuqala zesifo. Kubantu abangaphenduli ku-UDCA, odokotela ngezinye izikhathi batusa olunye uhlobo lwe-bile acid olubizwa ngokuthi i-obeticholic acid .

Futhi, izimpawu zakho zomuntu ngamunye zingelashwa ngemithi ehlukile.

• Ngesikhumba esilumayo: ama-antihistamine (isb., i-diphenhydramine - njenge-Benadryl®), ukwelashwa ngokukhanya kwe-ultraviolet, noma ama-sequestrant e-bile acid njenge-cholestyramine anganikezwa.
• Vimbela imiphumela emibi njengokuntuleka kwamavithamini kanye ne-osteoporosis: Izithasiselo zamavithamini zingasiza.
• Abanye abantu abakhathele bangase bazuze ezintweni ezivuselelayo ezifana ne-modafinil.

Ukuhlinzwa

Uma isimo sakho singathuthuki ngemithi, futhi ukusebenza kwesibindi sakho kuqhubeka nokwehla, udokotela wakho angakubeka ohlwini lokulinda ukufakelwa isibindi . Abantu abane-PBC bathola imiphumela emihle kakhulu ngokuhlinzwa kokufakelwa isibindi.

Njengezinye izifo ezihlasela amasosha omzimba, i-PBC ingaphinde ivele ngemva kokufakelwa isibindi, kodwa izinga lokuqhubeka kwalesi sifo lihamba kancane kakhulu ngokwesibili. Isikhathi sokuphila ngemva kokufakelwa isibindi sivamile.

Yini okufanele uyilindele uma uphila nalesi simo?

Ezimweni eziningi, i-Primary Biliary Cholangitis iqhubeka kancane . Ukutholwa kusenesikhathi kanye nokwelashwa okusheshayo kungavimbela noma okungenani kubambezele izigaba zakamuva zesifo kanye nezinkinga zaso.

Iningi labantu lingazilawula kahle izimpawu zabo ngemithi. Kodwa-ke, ukwelapha ukukhathala okwenzeka nge-PBC kungaba yinselele. Abantu abaningi baphila iminyaka eminingi ngaphandle kokuphazamiseka okukhulu empilweni yabo yansuku zonke ngenxa ye-PBC.

Kodwa-ke, akubona bonke abantu abatholakala bene-PBC ezigabeni zokuqala. Futhi abanye abantu baba nohlobo olunamandla kakhulu lwalesi sifo. Izimpawu ezifana nokukhathala okukhulu kanye namazinga aphezulu e-bilirubin egazini zingabonisa ukuthi lesi sifo singathuthuka ngokushesha sibe ukwehluleka kwesibindi. Uma ufika kuleso sigaba, uzodinga ukufakelwa isibindi ukuze usinde. Kodwa kulabo abane-PBC abaphumelele ukufakelwa isibindi, isibikezelo sihle kakhulu.

Ungaphila isikhathi esingakanani no (PBC)?

Ngokuvamile kuthatha iminyaka engu-15 kuya kwengu-20 ukuthi lesi sifo sifinyelele esigabeni sokugcina.

Isigaba sokuqala, okusho ukuthi noma ngabe uhlolwe futhi kwatholakala ukuthi une-PBC, ungase ube nokungabi nazimpawu isikhathi eside. Cishe ingxenye yabantu izoqala ukuba nezimpawu eminyakeni emihlanu kuya kweyishumi ezayo.Uma usuvele unezimpawu, isilinganiso sokuphila siyiminyaka engaba yi-10. Abantu abangu-65% abafakelwe isibindi ngempumelelo baphila iminyaka eyi-10.

Ngingazinakekela kanjani uma ngine-(PBC)?

Ukugcina ukudla okunempilo kanye nendlela yokuphila kuzosiza ukugcina isibindi sakho siphilile isikhathi eside ngangokunokwenzeka.

Ngokwesibonelo:

• Yeka ukubhema, ukuphuza utshwala, nokusebenzisa izidakamizwa nemithi ngendlela engafanele noma ngenxa yokuzijabulisa.
• Yidla ukudla okuncane okucutshunguliwe nokupakishwe kahle kodwa udle ukudla okuphelele.
• Nciphisa amafutha agcwele bese udla amafutha angenalutho anempilo.
• Hamba ngezinyawo nsuku zonke. Ukuzivocavoca umzimba okuthwala isisindo kungasiza ekugcineni amathambo ephilile.

Abantu abaningi abane-Primary Biliary Cholangitis bangaphila iminyaka eminingi ngaphandle kwezinkinga ezinkulu. Kodwa-ke, ukuba nesifo esiqhubekayo, ngezinye izikhathi esibulalayo kungakulimaza. Khuluma nodokotela wakho ngezindlela zokunciphisa ukucindezeleka kwakho ngokomzimba, ngokwengqondo nangokomzwelo . Futhi, buza ngamanethiwekhi okusekela asiza abantu abaphila ne-PBC. Khumbula, impilo yakho iyonke inkulu kakhulu kunesifo nje kuphela.

Umlayezo Wokuya Nawe Ekhaya

I-Primary Biliary Cholangitis (PBC) yisifo esingamahlalakhona esithinta imigudu ye-bile yesibindi. Kucatshangwa ukuthi sibangelwa yisimo sokuzivikela komzimba . Nakuba izimpawu zingase zingaveli ekuqaleni, izimpawu ezifana nokukhathala nokulunywa kwesikhumba zingase zivele ngokuhamba kwesikhathi. Njengoba lesi sifo siqhubeka , singaholela ekuqineni kwesibindi kanye nokwehluleka kwesibindi.

Kodwa-ke, ngokutholwa kusenesikhathi kanye nokusetshenziswa kwemithi efana ne-(UDCA), lesi sifo singalawulwa . Abanye abantu bangadinga ngisho nokufakelwa isibindi.

Into ebaluleke kakhulu ukufuna iseluleko sezokwelapha nokulandela indlela yokuphila enempilo uma unalezi zimpawu. Awuwedwa, ungesabi ukukhuluma ngalokhu futhi uthole usizo.

I- Cholangitis Eyinhloko Ye-Biliary, i-PBC, isifo sesibindi, i-bile ducts, i-cirrhosis, i-autoimmune