Ingabe ikholoni yakho ivuvukele kanje? Ake sifunde nge-Pseudomembranous Colitis!

Ingabe unezinhlungu zesisu ezinzima kanye nesifo sohudo izikhathi eziningana ngosuku? Mhlawumbe uzizwa unesicanucanu kanye nomkhuhlane? Ikakhulukazi, ingabe lezi zimpawu zavela ngemuva kokuthatha ama-antibiotics muva nje ngenxa yesifo esithile? Uma kunjalo, lokhu kuyinto engaba yinto ebalulekile kuwe. Namuhla sizokhuluma ngesimo esibizwa ngokuthi 'i-Pseudomembranous Colitis'. Ungakhathazeki, uma unolwazi olufanele ngalokhu, ungathola ukwelashwa futhi ululame ngokushesha.

Kuyini i-Pseudomembranous Colitis?

Kalula nje, i-'Pseudomembranous Colitis' yisimo sokuvuvukala esibi esenzeka emathunjini ethu amakhulu, noma emathunjini amakhulu. Kulokhu, ngesizathu esithile (kungaba amagciwane, ubuthi, noma esinye isifo), udonga lwangaphakathi lwamathumbu akho amakhulu, noma ulwelwesi lwamafinyila ('mucosa'), luyalimala. Lo monakalo ubangela ukwakheka kwama-plaque aphuzi-amhlophe, ajiyile, anoqweqwe ezindaweni ezonakele. Odokotela babiza lawa ngokuthi 'ama-pseudomembrane'.

Ayini ama-'pseudomembrane'?

Ama-pseudomembrane yilawo akhiwa lapho amaseli asolwelwesini lwamathumbu amakhulu, njengolwelwesi lwamathumbu amakhulu, efa. Cabanga ngale ndlela: uma kukhona ukulimala, amasosha ethu omzimba athumela amaseli amhlophe egazi endaweni. Ngokufanayo, nalapha futhi, izingcezu zamaseli afile zihlangana namaseli amhlophe egazi (ikakhulukazi ama-neutrophils) ukuze zakhe ama-pseudomembrane. Lawa angamasentimitha amabili ububanzi, aphuzi-mhlophe, futhi anezendlalelo eziphakanyisiwe kancane ebusweni.

Ziyini izimpawu zalesi simo?

Umuntu one-pseudomembranous colitis angase abe nezimpawu ezifana nalezi:

• Ubuhlungu obukhulu besisu.
• Uhudo. Lokhu kungenzeka izikhathi eziningana ngosuku, ngezinye izikhathi njengoketshezi.
• Imfiva.
• Isicanucanu.
• Ngezinye izikhathi, ungase ubone igazi noma ubomvu buphuma esitulweni sakho, kodwa lokhu akwenzeki kuwo wonke umuntu.

Yini ebangela i-Pseudomembranous Colitis?

Imbangela eyinhloko nevame kakhulu yalokhu ukutheleleka ngebhaktheriya i-'C. diff' (Clostridioides difficile). Ubuthi obukhiqizwa yileli bhaktheriya bulimaza ulwelwesi lwamathumbu amakhulu. Cishe u-10% wezifo ze-'C. diff' zingaqhubekela esimweni esibi kakhulu esibizwa ngokuthi i-'pseudomembranous colitis.' Eqinisweni, u-90% walezi zimo ubangelwa yibhaktheriya i-'C. diff'. Kodwa-ke, ezinye izimo zamathumbu ezivuvukalayo nazo zingabangela lolu hlobo lomonakalo.

Ibhaktheriya i-C. difficile ikuthinta kanjani lokhu?

Ibhaktheriya i-C. difficile ikhiqiza ubuthi obubhubhisa amangqamuzana angaphakathi kwamathumbu ethu amakhulu. Lokhu kutheleleka kungasakazeka ngokushesha nangokubi kakhulu kunalokho ongakucabanga.

Esikhathini esiningi, uthola ukutheleleka kwe-C. diff ngoba unesinye isifo.Ngemva kokusebenzisa ama-antibiotic. Cabanga ngakho, uma uthatha ama-antibiotic, amanye ama-bacteria "amahle" asemathunjini ethu asiza ukuba sife. Kodwa-ke, ama-antibiotic amaningi awakwazi ukubulala la ma-bacteria 'e-C. diff'. Ngakho-ke, lapho lawo ma-bacteria amahle engasekho, ama-bacteria 'e-C. diff' anethuba lokukhula nokusabalala ngaphandle kokuvinjelwa, okubangela lezi zinkinga ngaphandle kokuncintisana.

Yimaphi ama-antibiotic asebenza kahle kakhulu kulesi simo?

Eqinisweni, noma yiliphi i-antibiotic elibulala amabhaktheriya amahle emathunjini ethu futhi lingathinti amabhaktheriya e-C. diff lingabangela ukutheleleka kwe-C. diff kanye ne-pseudomembranous colitis ephumela lapho. Kodwa-ke, amanye ama-antibiotic kucatshangwa ukuthi ayingozi enkulu. Amanye awo yilawa:

• I-Clindamycin
• Iqembu lezidakamizwa ze-cephalosporin
• Iqembu lezidakamizwa ze-penicillin
• Ama-Fluoroquinolone
• I-Aztreonam
• Ama-Carbapenems

Okubalulekile: Lokhu akusho ukuthi lawa ma-antibiotic amabi. Uma udokotela ewanikeza imithi, kufanele asetshenziswe njengoba kudingeka. Kodwa-ke, ukusebenzisa ama-antibiotic ngokungadingekile kungaholela ezingozini ezinjengalezi.

Ingabe zikhona ezinye izizathu?

I-Pseudomembranous colitis ingenzeka futhi uma ukuvuvukala kwekholoni kubangelwa ezinye izimbangela, ngaphandle kwe-C. diff. Nazi izibonelo ezimbalwa:

• Ukutheleleka kwe-Staphylococcus aureus
• Ukutheleleka kwe-E. coli `(Ukutheleleka kwe-E. coli)`
• Ukutheleleka kwe-Cytomegalovirus
• I-Microscopic colitis
• Isifo sikaBehçet
• I-Ischemic colitis (ukuvuvukala okubangelwa ukuncipha kokunikezwa kwegazi emathunjini)
• Imithi yokulwa nomdlavuza `(Imithi yokwelapha ngamakhemikhali)`
• Ukusetshenziswa kwe-cocaine
• I-Vasculitis (ukuvuvukala kwemithambo yegazi)
• Ubuthi bensimbi enamandla

Ezimweni ezinjalo, lesi sifo sinzima kakhulu noma siyinkimbinkimbi kune-colitis evamile. Ngezinye izikhathi, ukugeleza kwegazi odongeni lwangaphakathi lwe-colon kuyancipha (ischemia), ukufa kwezicubu (necrosis) kwenzeka, futhi kuvela ama-pseudomembranes. Futhi, izifo ezikhona kakade njenge-Inflammatory Bowel Disease (IBD) nazo zingenza i-colon ibe sengozini enkulu yalesi simo.

Ubani osengozini enkulu yokuthola lesi simo?

Kungenzeka kakhulu ukuthi ube nesifo sofuba esingamahlalakhona uma:

• Uma ulaliswe esibhedlela.
• Uma usanda kusebenzisa ama-antibiotic.
• Uma usanda kuhlinzwa.
• Uma umuntu ehlala ekhaya lasebekhulile.
• Uma uneminyaka engaphezu kwengu-65 ubudala.
• Uma unesifo sokuzivikela komzimba.
• Uma amasosha akho omzimba ebuthakathaka.
• Uma usuvele unesifo se-C. diff.

Yiziphi izinkinga ezingaba khona ze-Pseudomembranous Colitis?

Uma lesi simo siba sibi kakhulu futhi kunzima ukusilawula, kungase kube nezinkinga eziyingozi. Ngakho-ke kubalulekile ukuqaphela nalokhu.

• Ukuphelelwa amanzi emzimbeni kanye nokulahlekelwa yi-electrolyte: Ku-pseudomembrane colitis enzima, isifo sohudo singaba khona izikhathi ezifika kwezingu-10-15 ngosuku. Lokhu kungaholela ekuphelelweni amanzi emzimbeni kanye nokulahlekelwa yi-electrolyte. Lokhu kungaholela ezimweni eziyingozi njengomthamo wegazi ophansi, umfutho wegazi ophansi, kanye nokwehluleka kwezinso.
• Ukuvuza koketshezi: Uketshezi lungavuza lusuka odongeni olulimele lwamathumbu amakhulu luye emgodini wesisu, okubangela ukuthi isisu sivuvuke. Lokhu kubizwa ngokuthi ama-ascites. Amaprotheni afana ne-albumin nawo angalahleka emathunjini amakhulu. Uma i-albumin iphansi, uketshezi luyavuza luphuma emithanjeni yegazi, okubangela ukuvuvukala ezithweni (i-edema).
• I-megacolon enobuthi: Ukuvuvukala okukhulu, okungalawulwa kwekholoni okungabangela ukuthi ikholoni ivuvuke kakhulu futhi iyeke ukusebenza. Ekuqaleni, imisipha ekholoni iyayeka ukufinyela, ivimbele ukudlula kwendle. Njengoba ikholoni iqhubeka nokuvuvukala, izindonga zayo zingaqhekeka, okuvumela okuqukethwe ukuthi kuvuzele emgodini wesisu. Lokhu kubizwa ngokuthi i-peritonitis. Lokhu kungaba yingozi empilweni.
• Ukubhoboza kwamathumbu: Imbobo odongeni lwamathumbu amakhulu ingenzeka ngaphandle kwe-megacolon enobuthi. Lokhu kungenzeka uma izilonda zikhula emathunjini amakhulu futhi zidlula odongeni, noma uma kukhona ukufa okukhulu kwezicubu (i-necrosis) odongeni lwamathumbu amakhulu. Lapho amabhaktheriya asemathunjini amakhulu evuza angene emgodini wesisu (i-peritonitis), angasakazeka egazini (i-septicemia).
• I-Sepsis: I-Sepsis yisimo esibangelwa ukuqongelela kwamagciwane egazini (i-septicemia). I-Sepsis iyisifo esiyingozi nesiyingozi esisakazeka emzimbeni wonke. Lokhu kungaholela ekushaqekeni kwe-septic, ukwehluleka kwezitho eziningi, ngisho nokufa.

Lezi zinkinga zingase zesabe ukuzwa ngazo. Kodwa khumbula, azenzeki kuwo wonke umuntu. Ukuxilongwa kusenesikhathi kanye nokwelashwa okufanele kungavimbela lezi zimo ezibucayi.

Ungasithola kanjani lesi sifo?

Udokotela uzoqala ngokukubuza ngezimpawu zakho kanye nomlando wakho wezempilo. Ngemuva kwalokho, bangase bacele ukuhlolwa okuhlukahlukene ukuthola imbangela yezimpawu zakho. Isibonelo, bangase bacele ukuhlolwa kwegazi, ukuhlolwa kwezithombe njengokuskena, kanye nokuhlolwa kwendle. Lokhu kuhlolwa kubheka ukutheleleka, ukuvuvukala, nezinye izinto eziyingozi.

Ukuhlolwa kwendle yakho kuzohlola ngqo ukutheleleka kwe-C. diff. Uma kutholakala, ukwelashwa kuzoqala ngokushesha. Uma ungenazo izinkinga futhi usabela kahle ekwelashweni, kungase kungabi nasizathu esiqondile sokubheka ama-pseudomembranes emathunjini akho amakhulu.

Ngezinye izikhathi, ukuhlolwa kwezithombe (njenge-CT scan) kungabonisa izimpawu ze-pseudomembranous colitis. Uma udonga lwamathumbu amakhulu lujiyile (okufana "nophawu lwesithupha" noma "uphawu lwe-accordion"), udokotela angase anqume ukwenza ezinye izivivinyo.

Okulandelayo, ukuze ubheke ngokujulile, udinga ukwenza isivivinyo esibheka ngaphakathi kwamathumbu amakhulu. Sibizwa ngokuthi i-colonoscopy. Kulokhu, kusetshenziswa ithubhu enekhamera ukubheka ngaphakathi kwamathumbu amakhulu. Uma ubona okuthiwa 'i-pseudomembrane', kuthathwa ingcezu encane yezicubu (i-biopsy) kuyo bese ithunyelwa elabhorethri ukuqinisekisa isifo.

Yiziphi izindlela zokwelapha?

Ukwelashwa kuncike embangela yalesi sifo.

• Uma kuyigciwane elibangelwa amagciwane njenge-C. diff, kuzodingeka unikeze ama-antibiotic athile asebenzayo.
• Uma lesi simo sibangelwa noma siba sibi kakhulu ngenxa yomunye umuthi owusebenzisayo, lowo muthi kungadingeka uyekwe noma ushintshwe.
• Kwezinye izimo, imithi ingase inikezwe ukunciphisa ukuvuvukala emathunjini amakhulu.

Abanye abantu badinga ukunakekelwa okusekelwayo kuphela. Isibonelo, uketshezi olufakwa emthanjeni (uketshezi lwe-IV) ukusiza ngokugcinwa koketshezi, noma ukudla okunomsoco we-IV ukusiza i-colon ukuphumula. Abanye kungadingeka baphathwe ngezinkinga, mhlawumbe egunjini lokunakekelwa okujulile. Abanye abantu abane-colitis noma izinkinga ezinkulu kakhulu kungadingeka bahlinzwe nge-colectomy (ukuhlinzwa ukuze kususwe ingxenye eyonakele ye-colon).

Yimiphi imithi eyinhloko enikezwayo uma ibangelwa yi-`C. diff`?

Uma imbangela ye-pseudomembranous colitis iwukutheleleka kwe-C. diff, kunemithi eminingana etholakalayo yokuyelapha. Udokotela wakho uzokhetha okulungele wena. Imithi enikezwayo yokutheleleka kwe-C. diff yile:

• I-Metronidazole
• I-Vancomycin
• I-Fidaxomicin

Ingabe i-Pseudomembranous Colitis ingavinjelwa?

Indlela ebaluleke kakhulu yokuvimbela lesi sifo ukulawula ukusabalala kwamagciwane e-C. diff emiphakathini esengozini enkulu (ikakhulukazi izibhedlela kanye nezindawo zokuhlala asebekhulile). Abantu abakulezi zindawo banamathuba amaningi okutheleleka futhi babe nezimpawu ezimbi njenge-pseudomembranous colitis.

Ngakho-ke, abasebenzi bezempilo kulezi zinhlobo zezikhungo bathatha izinyathelo ezikhethekile zokulawula ukutheleleka kwe-C. diff:

• Ukuhlukaniswa: Abantu abangenwe yi-C. diff bafakwa ekamelweni elihlukile, noma ekamelweni elisetshenziswa kuphela nabanye abantu abangenwe yileli gciwane. Amagilavu ​​alahlwayo asetshenziswa uma kungena ekamelweni.
• Ukugeza izandla: Ukugeza izandla zakho njalo ngensipho namanzi afudumele kuyindlela engcono kakhulu yokuzivikela ku-C. diff. Leli gciwane limelana nezihlanzi-zandla. Kubaluleke kakhulu ukugeza izandla zakho ngaphambi kokuphatha ukudla.
• Ukubulala amagciwane: Ama-disinfectants avamile awakwazi ukubulala i-C. diff. Kodwa-ke, imikhiqizo esekelwe ku-chlorine ingakwenza lokho. Kubalulekile ukubulala amagciwane ngokuphelele kuzo zonke izindawo umuntu onegciwane ahlangane nazo.

Ingabe lesi sifo singalapheka ngokuphelele? Lingakanani izinga lokufa?

Yebo, i-pseudomembranous colitis ingelapheka ngokuphelele ngokwelashwa. Ezimweni eziningi, izimpawu zizophela ngokushesha. Kodwa-ke, abanye abantu bangadinga ukwelashwa okwengeziwe kanye nesikhathi eside kunabanye. Uma unesifo esiqhubekayo, esinzima ukulawula i-C. diff, kungadingeka ukuthi uhlinzwe kancane ukuze usilaphe. Kwezinye izimo, kungadingeka ukuhlinzwa.

Ngokuphathelene nokufa, yi-2% kuphela yeziguli ezine-pseudomembranous colitis ezifayo. Kodwa-ke, kubantu abanakekelwa isikhathi eside kanye namasosha omzimba abuthaka, leli zinga lingafinyelela ku-15%. Uma kwenzeka inkinga eshiwo ngaphambilini ebizwa ngokuthi i-megacolon enobuthi, izinga lokufa lingakhuphuka lifike ku-35%. Yingakho ukwelashwa okusheshayo kubalulekile.

Kufanele ubonane nini nodokotela?

Uma unezinye zalezi zimpawu, funa iseluleko sezokwelapha ngokushesha:

• Ubuhlungu obukhulu besisu noma ukuqunjelwa.
• Uma unesifo sohudo izikhathi ezingaphezu kwezihlanu ngosuku.
• Uma kukhona igazi esitulweni.
• Uma ungazange uphume isisu izinsuku ezintathu.
• Uma ungakachami usuku lonke, noma uma umchamo wakho umnyama ngombala.
• Uma unomkhuhlane ongaphezu kwama-degree Celsius angu-39 (102 degrees Fahrenheit) izinsuku ezintathu.

Okokugcina, izinto okufanele uzikhumbule

Ukutheleleka ngamagciwane okubangela i-colitis kuvamile, futhi isikhathi esiningi akukubi kangako. Akuwona wonke umuntu othola i-C. diff ozothola i-pseudomembranous colitis. Kodwa-ke, uma wenza kanjalo, kungaba yinto eyesabekayo kancane. Ukwazi ukuthi ikholoni yakho yonakele ngaphakathi kungaba yinto eyesabekayo, enezimpawu ezifana nobuhlungu nokopha.

Uma uba nezimpawu ezinjengalezi, ungadinga ukunakekelwa okukhethekile kwezokwelapha. Kodwa khumbula, ngokwelashwa okufanele, ikholoni yakho ingaphola.Ulwelwesi lwamafinyila, njengolwelwesi lwekholoni yethu, luyaphola kahle uma lungalimalanga. Uma uzizwa sengathi izimpawu zakho ze-colitis azibi ngcono, khuluma nodokotela. Angakusiza ukuthola imbangela yesimo sakho, enze okudingekayo ukuze asimise, futhi anikeze ikholoni yakho konke okudingayo. Into ebaluleke kakhulu ukungesabi futhi ufune iseluleko sezokwelapha ngokushesha.

I- Pseudomembranous Colitis, i-C. diff, isifo sohudo, ubuhlungu besisu, i-colitis, ama-antibiotic