Ingabe ingane yakho ine-Short Bowel Syndrome (SBS)? Ake sixoxe ngayo kalula.

Ingabe ingane yakho encane iyaqhubeka nokugula? Ingabe iyancipha isisindo ngaphandle kokuqaphela, ngisho nangemva kokuphuza ubisi noma ukudla? Ingabe ayikhuli nhlobo? Njengomzali, kuyinto evamile ukuzizwa wesaba kakhulu futhi ukhathazekile uma ubona izinto ezinjengalezi. Ngezinye izikhathi, kungase kube nesimo sezokwelapha ngemuva kwalezi zimpawu esingakakuzwa okuningi ngazo. Namuhla sizokhuluma ngesinye salezi zimo, "i-Short Bowel Syndrome".

Iyini i-Short Bowel Syndrome (SBS)?

Kalula nje, i-Short Bowel Syndrome (SBS) yisimo lapho umzimba wengane yakho ungakwazi ukumunca izakhamzimba noketshezi olwanele. Lokhu kungenxa yokuthi ingxenye yamathumbu amancane engane ayikho noma ayisebenzi kahle. Ngokuqondile, amathumbu awade ngokwanele. Lesi simo singaba khona lapho kuzalwa, noma singase senzeke nangemva kokuba ingxenye enkulu yamathumbu amancane isusiwe ngokuhlinzwa ngenxa yesinye isimo sezokwelapha.

Ukuze siqonde lokhu, ake siqale sibheke okwenzekayo emathunjini ethu amancane.

Indima yamathumbu ethu amancane

Cabanga ngomathumbu amancane njengomugqa omude, 'wokucubungula' efektri. Ukudla esikudlayo kugaywa kancane esiswini bese kungena emathunjini amancane. Bese, njengoba kuhamba ngaleli thumbu elide, konke okubalulekile emzimbeni kulokho kudla - okungukuthi, amaprotheni, ama-carbohydrate (isitashi noshukela), amafutha, amavithamini, amaminerali anjengensimbi, i-calcium - kuyamuncwa emzimbeni. Imfucuza esele ikhishwa ngomathumbu amakhulu njengendle.

Kunezingxenye ezintathu eziyinhloko zamathumbu ethu amancane:

• I-Duodenum: Ingxenye emfushane kakhulu ngemva kwesisu.
• IJejunum: Ingxenye ephakathi.
• Ileum: Ingxenye ende kunazo zonke yamathumbu amakhulu.

Endabeni ye-SBS, lo 'mugqa wokucubungula' awude ngokwanele. Cabanga nje, bekuzokwenzekani uma umgwaqo omude ngekhilomitha ubungasetshenziswa ukumunca izakhamzimba, bese lowo mgwaqo ufinyezwa ngokuzumayo? Imoto ebizwa ngokuthi ukudla ibizogijima kulowo mgwaqo omfushane futhi ingabi nesikhathi sokukhulula yonke imithwalo (izakhamzimba) equkethe. Kwenzeka into efanayo ku-SBS. Ngenxa yokuthi amathumbu mafushane, ukudla kuyaphuma emzimbeni ngaphambi kokuba kugaywe kahle futhi izakhamzimba zimuncwa ngumzimba. Lesi yisimo esibi esingathinta ngisho nokuphila kwengane uma ingelashwa.

Wazi kanjani ukuthi ingane ine-SBS? Ziyini izimpawu?

Ingane ene-SBS ingase ibhekane nesinye noma ngaphezulu salezi zimpawu. Uphawu oluvame kakhulu, ikakhulukazi ezinsaneni nasezinganeni ezincane, uhudo olunamanzi.

Kungani ingane iba ne-Short Bowel Syndrome?

Kunezinhlobo ezimbili eziyinhloko zezizathu zalokhu.

1. Izimbangela zokuzalwa: Abanye abantwana bangazalwa benomathumbu amancane amafushane. Noma bangase bangabi nengxenye yamathumbu, noma amathumbu angase angakhuli ngokugcwele ngesikhathi ekhula esibelethweni sikamama. Lesi simo sibizwa ngokuthi `(Intestinal Atresia)`.

2. Njengomphumela ongemuhle wokuhlinzwa: Ezinye izingane zidinga ukuhlinzwa zisuswe ingxenye yamathumbu azo amancane ngenxa yezinye izimo zezokwelapha. Ezinye zezizathu ezivame kakhulu zalolu hlobo lokuhlinzwa yilezi:

• I-necrotizing enterocolitis: Ukutheleleka okukhulu, ikakhulukazi ezinganeni ezizalwa ngaphambi kwesikhathi, lapho izingxenye zamathumbu zifa khona ngenxa yokuncipha kokugeleza kwegazi.
• I-Gastroschisis: Isimo lapho amathumbu ephuma khona ngaphandle komzimba ngenkathi umntwana ekhula esibelethweni.
• I-Volvulus: Isimo lapho amathumbu esonteka khona futhi alahlekelwe ukugeleza kwegazi.
• Isifo sikaCrohn:Isimo sokuvuvukala kwesistimu yokugaya ukudla isikhathi eside.
• Intususception: Isimo lapho ingxenye yamathumbu ibanjwa khona kwenye ingxenye.

Yiziphi izinkinga ezingaba khona ze-SBS?

I-SBS ayiyona into elula. Uma ingaphathwa kahle, ingane ingaba nezinkinga ezahlukahlukene.

• Ukuphelelwa amanzi emzimbeni: Umzimba ungase uhlale ugcina amanzi ngoba awukwazi ukumunca inani elidingekayo loketshezi.
• Ukungondleki kahle: Ukwehla kwesisindo kanye nokukhula okubambezelekile ngenxa yokuntuleka kokudla okunomsoco okudingekayo.
• Ukuntuleka kwamavithamini namaminerali: Ukuntuleka kwamavithamini abalulekile (A, D, E, K, B12) kanye namaminerali (calcium, magnesium, zinc) emzimbeni.
• Ukuqubuka okukhulu kwe-diaper: Indle evame ukuba ne-asidi ingabangela isikhumba endaweni ye-diaper ukuba sibe bomvu kakhulu futhi sibe buhlungu.
• Isifo sesibindi: Isibindi singathinteka, ikakhulukazi uma uthola ukudla okunomsoco okuphathelene nokuzala (i-TPN) isikhathi eside.
• Amatshe ezinso: Ngenxa yokungalingani ekumuncweni kwezinto ezifana ne-calcium.
• Ukukhula ngokweqile kwamagciwane emathunjini amancane: Ukusebenza kahle kwamathumbu kungaholela ekukhuleni ngokweqile kwamagciwane ayingozi.

Ngakho-ke, uma ingane yakho inezimpawu ze-SBS, ikakhulukazi ngemva kokuhlinzwa kwamathumbu, kubaluleke kakhulu ukubona udokotela wakho ngokushesha .

Yiziphi izindlela zokwelapha i-SBS?

Ukwelapha ingane ene-SBS kuwumzamo weqembu. Abantu abaningi, okuhlanganisa odokotela bezingane, odokotela abahlinzayo, kanye nochwepheshe bezokudla, basebenzisana ukuthuthukisa uhlelo lokwelapha olungcono kakhulu lwengane yakho. Umgomo oyinhloko wokwelashwa ukulawula izimpawu ngenkathi unikeza ingane ukudla okunomsoco okudingekayo.

1. Izinguquko Zokudla Okunempilo

Lena yingxenye ebaluleke kakhulu yokwelashwa.

• Ukudla Okuphelele Kwabazali (TPN): Ngemva kokuhlinzwa kwamathumbu noma lapho amathumbu engakwazi nhlobo ukumunca izakhamzimba, zonke izakhamzimba ingane ezidingayo (amaprotheni, amafutha, ama-carbohydrate, amavithamini, namaminerali) zinikezwa ingane ngoketshezi olukhethekile, njengosawoti, ngomthambo. Lokhu kudlula ngokuphelele uhlelo lokugaya ukudla futhi kwenezela ukudla okunempilo ngqo egazini. Lokhu kuyindlela yokwelapha esindisa impilo yengane.
• Ukudla Okunomsoco Kwangaphakathi / Ukudla Ngepayipi:Uma amathumbu engane esebenza kahle, ukudla okukhethekile okuwuketshezi kunikezwa ngepayipi elifakwa ngekhala liye esiswini noma ngepayipi elixhunywe ngqo esiswini ngokuhlinzwa. Lokhu kunganikeza ingane ukudla okwengeziwe ngaphezu kokudla ekudla ngomlomo.
• Izinguquko ekudleni: Njengoba ingane iqala kancane kancane ukudla ngomlomo, udokotela kanye nochwepheshe wezokudla bazonikeza uhlelo lokudla olukhethekile. Kuyo,
• Kancane kancane, bazokucela ukuthi ubaphe ukudla izikhathi eziningana ngosuku.
• Ithi nciphisa ukudla okunamafutha amaningi, ushukela kanye ne-fiber.
• Ithi ukunikeza ukudla okucebile ngamaprotheni nama-carbohydrate.
• Kunconywa ukunikeza amavithamini namaminerali adingekayo njengezithasiselo.

2. Imithi

Kusetshenziswa imithi ehlukahlukene ukulawula izimpawu nokuthuthukisa ukumuncwa kokudla.

• Imithi enciphisa i-asidi yesisu (`i-Proton pump inhibitors`).
• Ama-antibiotic alawula ukukhula kwamagciwane emathunjini.
• Imithi enciphisa uhudo futhi yehlise ijubane lokungena kokudla emathunjini.
• Izinhlobo zama-hormone athuthukisa ukumuncwa kwezakhamzimba.

3. Ukuhlinzwa

Kwezinye izimo ezinzima kakhulu, kungase kudingeke ukuhlinzwa okwengeziwe ukuze kuthuthukiswe ukusebenza kwamathumbu engane. Isibonelo, kunezinqubo zokwandisa amathumbu. Ezimweni ezinzima kakhulu, lapho kungekho okunye ukwelashwa okusebenzayo, kungadingeka ukufakelwa amathumbu.

Ithemba elihle lokuzivumelanisa namathumbu

Leli yithemba elikhulu kakhulu kubantwana nakubazali abane-SBS. Imizimba yethu iyamangalisa. Ngemva kokususwa kwengxenye yamathumbu, ingxenye esele yamathumbu iqala ukushintsha ngokuhamba kwesikhathi. Lokhu kubizwa ngokuthi 'i-Intestinal Adaptation'.

Yilokhu okwenzekayo:

• Indawo engaphezulu yodonga lwangaphakathi lwamathumbu asele iyanda.
• Izingxenye ezincane ezifana neminwe (i-villi) ezimunca izakhamzimba ziyanwebeka futhi zijiye.
• Ububanzi bamathumbu buyanda.
• Isivinini sokudla siyancipha, okunikeza isikhathi esengeziwe sokuba izakhamzimba zimuncwe.

Ngenxa yale nqubo yokuzivumelanisa nezimo, izingane eziningi ziyakwazi ukushintsha kancane kancane kusukela ekudleni okunempilo (TPN) ziye ekudleni ngomlomo. Imithi emisha, njenge-teduglutide, isiyatholakala manje engasheshisa lokhu kuzivumelanisa nezimo.

I-SBS iwuhambo oluyinselele. Kodwa ngokwelashwa okufanele, ukuphathwa kahle kokudla okunempilo, kanye nothando nokuzinikela kwabazali, laba bantwana bangaphila impilo enhle nejabulisayo. Kubaluleke kakhulu ukuhlala uxhumana nodokotela wakho kanye nethimba lezokwelapha futhi ulandele iseluleko sabo.