Uke waba nobuhlungu besisu ngemva kokuthatha ama-antibiotic? Ake sifunde nge-Pseudomembranous Colitis!

Wake waba nobuhlungu besisu noma igciwane lesisu ngemva kokuthatha inkambo yama-antibiotic? Ngokuvamile kuyaphela ngemva kosuku noma ezimbili. Kodwa-ke, ngezinye izikhathi lesi simo singaba sibi kakhulu. Namuhla sizokhuluma ngesimo esisodwa esibi kangaka esingahlotshaniswa nokusetshenziswa kwama-antibiotic. Lokhu sikubiza ngokuthi i-Pseudomembranous Colitis. Nakuba igama lingase lizwakale lingavamile, kubaluleke kakhulu ukwazi ngakho.

Kalula nje, iyini i-Pseudomembranous Colitis?

Lokhu ukuvuvukala okukhulu (i-colitis enzima) okwenzeka emathunjini ethu amakhulu (ikholoni), okusho ukuvuvukala nokulimala. Cabanga ukuthi kukhona okulimaza ulwelwesi oluthambile (i-mucosa) ngaphakathi emathunjini ethu amakhulu. Lo monakalo ungabangelwa yibhaktheriya, ubuthi obukhiqizwa yilelo bhaktheriya, noma esinye isifo.

Uma kwenzeka lo monakalo, kwakheka ama-plaque aqinile, aqinile phezu kwezindawo ezilimele. Njengoba nje uqweqwe lwakheka esikhumbeni sethu lapho sinenxeba. Kodwa lawa akuzona uqweqwe lwangempela. Akhiwe ngamaseli afile namaseli amhlophe egazi. Lawa ma-membrane aphuzi-amhlophe yilokho odokotela abakubiza ngokuthi "ama-pseudomembrane." Igama elithi "pseudo" lisho "amanga." Lokho kusho ukuthi angama-membrane angamanga. Lesi simo yilokho esikubiza ngokuthi i-pseudomembranous colitis.

Ziyini izimpawu zalesi simo?

Umuntu onalesi simo angase abe nezimpawu ezahlukahlukene, kodwa kunezinto ezimbalwa eziyinhloko ezingabonakala.

Kungani lolu hlobo lwesifo luvela? Iyini imbangela eyinhloko?

Imbangela eyinhloko nevame kakhulu yalokhu ukutheleleka ngebhaktheriya i-Clostridium difficile , esiyibiza ngokuthi i-C. diff ngamafuphi. Lena yimbangela yamacala angaphezu kuka-90%.

Manje ungase uzibuze ukuthi leli gciwane le-C. diff lingasibangela kanjani lesi sifo. Indaba iqhubeka kanje:

Izigidi zamabhaktheriya, amahle namabi, zihlala emathunjini ethu. Lawa mabhaktheriya amahle enza lukhulu emizimbeni yethu. Manje ake ucabange ukuthi udokotela ukukunikeza ama-antibiotics kwesinye isifo (isibonelo, ukutheleleka komphimbo). Lawa ma-antibiotics abulala amagciwane emizimbeni yethu. Kodwa uma enza lokho, awabulali nje kuphela amagciwane amabi abangele ukugula, kodwa futhi nenani elikhulu lamabhaktheriya amahle emathunjini ethu.

Lokhu kukhula ngokweqile kwamagciwane e-C. diff kuqala ukukhiqiza ubuthi obonakalisa ulwelwesi lwamathumbu ethu amakhulu. Lawa buthi abangela ukuba amangqamuzana amathumbu afe futhi alimale, okwakha ama-pseudomembrane esikhulume ngawo ngaphambili.

Ama-antibiotic avame ukubangela ukutheleleka kwe-C. diff

Nakuba noma yimaphi ama-antibiotic angabangela le ngozi, ezinye izinhlobo zinamathuba amaningi okubangela le ngozi. Ezinye zalezi zifo zifaka:

• I-Clindamycin
• Izinhlobo zeCephalosporin
• Izinhlobo ze-Penicillin
• Izinhlobo ze-Fluoroquinolones

Ingabe zikhona ezinye izimbangela ngaphandle kwe-C. diff?

Yebo. Nakuba ukutheleleka kwe-C. diff kuyimbangela eyinhloko, lesi simo singabangelwa nezinye izimbangela, okungajwayelekile kakhulu.

• Ezinye izifo ezibangelwa amagciwane (isib. *Staphylococcus aureus*, *E. coli*)
• Ukutheleleka kwe-Cytomegalovirus
• Ukwehla kokugeleza kwegazi kuya emathunjini amakhulu (i-Ischemic colitis)
• Eminye imithi ye-chemotherapy yomdlavuza
• Ezinye izifo ezizimele

Ubani osengozini enkulu yokuthola lesi sifo?

Nakuba noma ubani engaba nalesi simo, abanye abantu basengozini enkulu.

• Abantu abathola ukwelashwa ezibhedlela: Izibhedlela ziyizindawo lapho amagciwane afana ne-C. diff angasakazeka khona kalula.
• Abantu abasanda kuthatha ama-antibiotic: Njengoba sikhulume ngakho ngaphambili, lokhu kuyisici esiyinhloko esiyingozi.
• Abantu abangaphezu kweminyaka engama-65 ubudala: Ngoba amasosha omzimba ayancipha njengoba ekhula.
• Abantu abasemakhaya asebekhulile:
• Abantu abanezivikeli mzimba ezibuthakathaka: (isib. abantu abanegciwane lesandulela ngculazi, iziguli ezinomdlavuza)
• Abantu abanezifo zokuzivikela komzimba: (isib. Isifo Sokuvuvukala Kwamathumbu - IBD)
• Abantu abake baba nokutheleleka kwe-C. diff ngaphambilini:

Yiziphi izinkinga ezingase ziphakame uma lokhu kuba kubi kakhulu?

Lokhu kungase kuzwakale kusabisa kancane kuwe. Kodwa khumbula, lezi zinkinga zivame ukwenzeka kuphela uma isifo siba sibi kakhulu futhi ukwelashwa okufanele kunganikezwa. Yingakho sincoma ukubona udokotela kusenesikhathi.

• Ukuphelelwa amanzi emzimbeni kanye nokungalingani kwama-electrolyte: Uma uhambisa amathumbu izikhathi eziyi-10-15 ngosuku, ulahlekelwa amanzi amaningi kanye nama-electrolyte. Uma lokhu kuba kubi kakhulu, kungaholela ezimweni eziyingozi njengomfutho wegazi ophansi kanye nokwehluleka kwezinso.
• I-Megacolon Enobuthi: Lesi yisimo esiyingozi kakhulu. Okwenzekayo ukuthi ukuvuvukala kwekholoni kuba kubi kakhulu kangangokuthi ikholoni iba yinkinga, igesi kanye nendle kubambeke, futhi ikholoni iba nkulu kangangokuthi ingaqhuma.
• Ukubhoboza kwamathumbu: Ukulimala okukhulu kungabangela imbobo odongeni lwamathumbu. Uma lokhu kwenzeka, amagciwane avela emathunjini angangena emgodini wesisu futhi abangele izifo ezisongela ukuphila (i-peritonitis, i-sepsis).
• I-Sepsis: Isimo esisongela ukuphila lapho ukutheleleka kusakazeka khona emzimbeni wonke futhi izitho zomzimba ziqala ukwehluleka.

Udokotela usithola kanjani lesi sifo ngokunembile?

Uma uya kudokotela, uzokubuza ngezimpawu zakho, noma yimiphi imithi osanda kuyithatha (ikakhulukazi ama-antibiotic), bese ekwenza izivivinyo ezithile ukuqinisekisa ukuthi unesifo.

1. Ukuhlolwa kwendle: Lolu ukuhlolwa okubaluleke kakhulu. Kuthathwa isampula yendle yakho bese kuhlolwa ukuthi ikhona yini i-C. diff bacteria noma ubuthi obukhiqizwa yi-bacteria.

2.Ukuhlolwa kwegazi: Lokhu kusiza ukuhlola ukutheleleka kanye nenani eliphezulu lamaseli amhlophe egazi.

3. I-Colonoscopy: Lokhu kuhilela ukufaka ithubhu elincane elinekhamera nge-anus ukuze kuhlolwe ingaphakathi lamathumbu amakhulu. Lokhu kusenza sibone ngamehlo womabili ukuthi ngabe kukhona yini ama-pseudomembrane esikhulume ngawo. Uma kudingeka, kungathathwa ingcezu encane yezicubu (i-biopsy) ukuze ihlolwe.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kuncike embangela kanye nobunzima besifo.

• Ukwelapha imbangela: Uma ukutheleleka kwe-C. diff kuyimbangela, udokotela wakho uzokunikeza umuthi othize we-antibiotic ongabulala amagciwane. I-Metronidazole, i-Vancomycin, ne-Fidaxomicin eminye yale mithi.
• Ukunakekelwa Okusekelayo: Lokhu kungafaka phakathi ukunikeza uketshezi lwe-IV ukuvimbela ukuphelelwa amanzi emzimbeni kanye nokunikeza ukudla okunomsoco ngemithambo ukuze kuphumule amathumbu.
• Ukuhlinzwa: Ezimweni ezinzima kakhulu, njengezinkinga ezifana ne-megacolon enobuthi, ukususwa kwengxenye eyonakele yekholoni (i-colectomy) kungadingeka. Kodwa-ke, lokhu akuvamile kakhulu.

Yini okufanele siyenze ukuze sisinde kulesi simo?

Ukuvimbela lokhu kubaluleke kakhulu, ikakhulukazi ezindaweni ezifana nezibhedlela kanye nezindawo zokuhlala asebekhulile.

• Geza izandla zakho njalo: I-C. diff imelana nezihlanzi-zandla ezisebenzisa utshwala, ngakho-ke ukugeza izandla zakho kahle ngensipho namanzi kuyisivikelo esingcono kakhulu.
• Ukuhlukaniswa: Ezibhedlela, iziguli ezine-C. diff infection zelashwa ekamelweni elihlukile.
• Ukuhlanza izindawo: I-C. diff ingaphila ezindaweni isikhathi eside. Kubalulekile ukuhlanza izindawo njalo ngesibulali-magciwane esisekelwe ku-chlorine.

Kufanele simbone nini udokotela ngokushesha okukhulu?

Uma unezinye zezimpawu ezilandelayo, bona udokotela ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela.

Nakuba kuvamile ukuzwa ubuhlungu besisu ngemva kokuthatha ama-antibiotic, akulula ngaso sonke isikhathi. Ngezinye izikhathi kungaba ukuqala kwesimo esibi njenge-Pseudomembranous Colitis. Yingakho kubaluleke kakhulu ukulalela umzimba wakho. Uma unokungabaza ngezimpawu zakho, ungangabazi ukukhuluma nodokotela wakho. Ngokwelashwa okufanele, ungalulama ngokuphelele kulesi simo.