Ingabe ingane yakho ine-Short Bowel Syndrome (SBS)? Ake sixoxe ngalokhu kalula!

Ingabe ingane yakho ivame ukuba nezinkinga zesisu ezifana nohudo? Kungakhathaliseki ukuthi uyinika ukudla okungakanani, kubonakala sengathi ayidli ngokwanele, futhi ayikhuluphali? Noma ingabe lezi zimpawu zivele ngemva kokuhlinzwa kwamathumbu? Njengomama noma ubaba, kuvamile ukuthi uzizwe wesaba kakhulu futhi ukhathazekile uma ubona izinto ezinjengalezi. Namuhla sizokhuluma nge-Short Bowel Syndrome (SBS), isimo esingabangela lezi zimpawu, kodwa akukhulunywa kakhulu ngaso.

Kalula nje, iyini i-Short Bowel Syndrome (SBS)?

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.

Lesi simo singaba khona kusukela ekuzalweni. Futhi, ngezinye izikhathi i-SBS ingenzeka ngemva kokuba ingxenye enkulu yamathumbu amancane isusiwe ngokuhlinzwa ngenxa yesinye isimo sezokwelapha. Lokhu kubizwa nangokuthi "i-Short gut syndrome".

Ngakho-ke, iyini indima yaleli thumba elincane?

Ukuze sikuqonde kangcono lokhu, ake siqale sifunde kancane ngomathumbu amancane, iqhawe lohlelo lwethu lokugaya ukudla. Cabanga ngomathumbu amancane njengebhande elide lokuhambisa elisefektri. Ukudla esikudlayo kuphenduka uketshezi esiswini bese kuhamba ngaleli bhande. Endleleni, izindonga zamathumbu, ezisebenza njengezisebenzi zasefektri, zihlukanisa zonke izinto ezinhle kulokho kudla - okungukuthi, izakhamzimba ezibalulekile ezifana namaprotheni, ama-carbohydrate, amafutha, amavithamini, insimbi, i-calcium, kanye noketshezi - bese zikufaka egazini. Okunye, okungasizi emzimbeni, kuya emathunjini amakhulu futhi kukhishwe njengendle.

Amathumbu amancane anezingxenye ezintathu eziyinhloko:

• I-Duodenum: Lena yingxenye emfushane kakhulu ngemva kwesisu.
• I-Jejunum: Lena yingxenye ephakathi.
• Ileum: Lena yingxenye ende kunazo zonke. Iphelela emathunjini amakhulu.

I-SBS ithinta kanjani amathumbu amancane?

Manje cabanga, bekuzokwenzekani uma singasusa ingxenye enkulu ebhandeni lokuhambisa impahla kuleyo fektri esikhulume ngayo? Izimpahla (okungukuthi ukudla) bezizophela ngokushesha kakhulu ebhandeni lokuhambisa impahla. Izisebenzi (izindonga zamathumbu) bezingeke zibe nesikhathi esanele sokuhlukanisa izinto ezinhle (ukudla okunempilo) nezimpahla. Kwenzeka into efanayo ku-SBS.

Ngokuvamile, umntwana uzalwa enesisu eside kancane kunesivamile. Kufana nengxenye eyengeziwe. Ngisho noma ingxenye encane ye-duodenum ne-jejunum isuswa ngesikhathi sokuhlinzwa, i-ileum ingathatha umsebenzi wezingxenye zombili futhi ilinganisele ukumuncwa kwezakhamzimba.

Uma lesi simo singelashwa, ingane ingaba nezimo ezingathi sína njengokungondleki kahle futhi ibe yingozi empilweni.

Wazi kanjani ukuthi ingane ine-SBS? Ziyini izimpawu?

Uma usola ukuthi ingane yakho inalesi simo, qaphela lezi zimpawu. Uma unesinye noma ngaphezulu kwalezi zimpawu zilandelana, bona udokotela ngokushesha.

Kungani izingane zinalesi simo?

Njengoba igama lisho, imbangela eyinhloko yalokhu ukuvaleka kwamathumbu. Kunezinhlobo ezimbili eziyinhloko zezimbangela ezibangela lokhu:

1. Izinkinga zokuzalwa: Abanye abantwana bazalwa benokukhubazeka okuthile kwamathumbu.

• Ukuncipha kobude bamathumbu azalwa nawo.
• Ukuzalwa ungenaso ingxenye yamathumbu.
• I-atresia yamathumbu yigama lezokwelapha elisho ukwehluleka kwamathumbu ukukhula ngokuphelele esibelethweni.

2. Njengomphumela ongemuhle wokuhlinzwa: Ezinye izimo zezokwelapha ezinzima zidinga ukususwa kwengxenye yamathumbu amancane engane ngokuhlinzwa. I-SBS nayo ingenzeka.

Yiziphi izimo ezidinga ukususwa kwengxenye yamathumbu ngokuhlinzwa?

• I-necrotizing enterocolitis: Lokhu kwenzeka lapho ukugeleza kwegazi ezindongeni zamathumbu kuncipha, okubangela ukuba izingxenye zamathumbu zife. Lesi simo sivame kakhulu ezinganeni ezizalwa ngaphambi kwesikhathi.
• I-Gastroschisis: Lokhu kwenzeka lapho amathumbu ephuma ngaphandle komzimba ngenkathi umntwana esakhula esibelethweni.
• I-Volvulus: Ukujikijelana kwamathumbu. Lokhu kunganqamula ukugeleza kwegazi futhi kulimaze leyo ndawo.
• Isifo sikaCrohn: Isimo sokuvuvukala okungapheli kwesistimu yokugaya ukudla.
• Ukungena ngaphakathi: Ingxenye eyodwa yamathumbu ibanjwa ngaphakathi kwenye ingxenye.

Yiziphi izinkinga ezingaba khona ze-SBS?

Uma i-SBS ingelashwa kahle, ingane ingaba nezinkinga ezahlukahlukene, ezinye zazo ezingaba zimbi kakhulu.

• Ukuphelelwa amanzi emzimbeni: Ukugcina amanzi njalo emzimbeni ngoba umzimba awukwazi ukumunca inani elidingekayo loketshezi.
• Ukungondleki kahle: Ukwehla kwesisindo kanye nokungakwazi ukukhuluphala ngenxa yokumuncwa kabi kwezakhamzimba.
• Ukuntuleka kwamavithamini namaminerali: Ukuntuleka kwamavithamini abalulekile (A, D, E, K, B12) kanye namaminerali (calcium, magnesium, zinc) emzimbeni.
• Ukuqubuka okukhulu kwe-diaper: Ukucasuka okukhulu kwesikhumba okubangelwa ukuhamba kwamathumbu njalo kanye nendle ene-asidi ephezulu.
• Isifo sesibindi: Ukulimala kwesibindi okubangelwa ukudla okunomsoco isikhathi eside kanye nezinye izimbangela.
• Amatshe ezinso: Ngenxa yokungalingani ekumuncweni kwe-calcium ne-oxalate.
• Ukukhula ngokweqile kwamagciwane: Ukukhula ngokweqile kwamagciwane ayingozi emathunjini amancane.
• Ukungabekezelelani kokudla: Isibonelo, ukungakwazi ukugaya imikhiqizo yobisi equkethe i-lactose.

Odokotela basithola kanjani lesi sifo?

Uma uyisa ingane yakho kudokotela, izoqala ngokubuza ngezimpawu zengane kanye nomlando wezokwelapha womndeni. Ngemuva kwalokho, ingane izohlolwa. Kungenziwa izivivinyo eziningana ukuqinisekisa ukuxilongwa nokuthola imbangela eqondile:

• Ukuhlolwa kwegazi: Hlola igazi lengane ukuze uthole izinto ezifana namazinga amavithamini namaminerali, kanye ne-anemia.
• Ukuhlolwa kwamafutha endle: Kuhlola ukuthi kunamafutha angagayiwe angakanani esitulweni.
• Ama-X-ray: Ukubheka isimo samathumbu. Unganikwa uketshezi olukhethekile, njenge-barium, bese uthathwa i-X-ray.
• I-CT scan: Thola isithombe esicacile samathumbu nezinye izitho zesisu.

Yiziphi izindlela zokwelapha i-SBS?

Kunemigomo emibili eyinhloko yokwelapha ingane ene-SBS. Eyokuqala ukunikeza ingane ukudla okunomsoco ekudingayo ukuze ikhule. Enye ukulawula izimpawu ezifana nesifo sohudo. Izindlela eziningana zokwelapha zisetshenziswa ndawonye ukuze kufezwe lokhu.

1. Izinguquko zokudla okunempilo

Lena yingxenye ebaluleke kakhulu. Kuye ngesimo sengane, odokotela kanye nochwepheshe bezokudla basebenzisana ukudala uhlelo lokudla olufanele kakhulu ingane.

• Izinguquko ekudleni: Uma ingane yakho ikwazi ukudla ngomlomo, udokotela wakho angase atuse ukuthi iyinike ukudla okuncane izikhathi eziningana ngosuku . Bangase batuse ukuthi inciphise ukudla okunamafutha amaningi, ushukela olula, kanye ne-fiber bese inika ukudla okunama-calorie amaningi okucebile ngama-carbohydrate namaprotheni.
• Ukudla Okuphelele Kwabazali (TPN): Lokhu kuhilela ukunikeza zonke izakhamzimba (uketshezi, ushukela, amaprotheni, amafutha, amavithamini) ngqo emthanjeni njengoketshezi, okudlula ngokuphelele uhlelo lokugaya ukudla lwengane. Le ndlela ivame ukusetshenziswa ngemva kokuhlinzwa kwamathumbu noma lapho ingane ingakwazi ukudla ngomlomo.
• Ukudla Okunomsoco Kwangaphakathi: Kulokhu, kufakwa ipayipi eliguquguqukayo ngekhala noma ngqo esiswini noma emathunjini amancane, bese kunikezwa ukudla okumanzi ngalo. Le ndlela isiza ekuhlinzekeni ukudla okunomsoco okwengeziwe ngaphezu kwenani lokudla okudliwa ngomlomo.

2. Imithi

Kusetshenziswa imithi ehlukahlukene ukulawula izimpawu nokuthuthukisa ukumuncwa kokudla.

• Ama-antibiotic: Lawula ukukhula ngokweqile kwamagciwane emathunjini.
• Imithi yokwehlisa i-asidi yesisu (i-proton pump inhibitors, ama-H2 blockers): Yehlisa izinkinga ezibangelwa yi-asidi yesisu.
• Imithi yokulwa nohudo: Yehlisa ijubane lokungena kokudla emathunjini, okuvumela isikhathi esengeziwe sokuba izakhamzimba zimuncwe.
• Ama-hormone okukhula: Athuthukisa ukumuncwa kwezakhamzimba ngamathumbu.

3. Ukuhlinzwa

Ezinye izingane zingadinga ukuhlinzwa okwengeziwe ukuze kuthuthukiswe ukusebenza kwamathumbu. Lokhu kufaka phakathi:

• Ukwandisa ubude bamathumbu (ngokusebenzisa izindlela ezikhethekile zokuhlinzwa).
• Ukunciphisa ijubane lokunyakaza kokudla.
• Ukususa izithiyo zamathumbu.

Ezimweni ezimbi kakhulu, ingane ingadinga ukufakelwa amathumbu/isibindi.

Ithemba elihle lokuzivumelanisa namathumbu

Leli yithemba elikhulu kubazali bezingane ezine-SBS. Ukuzivumelanisa namathumbu inqubo lapho ingxenye esele yamathumbu ithuthukisa khona ukusebenza kwayo ngokuhamba kwesikhathi ngemva kokususwa kwengxenye yamathumbu.

Kulokhu, udonga lwangaphakathi lwamathumbu asele luyaqina, futhi izakhiwo ezifana neminwe ezibizwa ngokuthi i-villi ezimunca izakhamzimba ziba zinde futhi ziqine. Lokhu kuvumela amathumbu amancane asele ukuthi amunce izakhamzimba ngendlela ephumelela kakhulu kunangaphambili. Le nqubo yokuzivumelanisa nezimo ingaphumelela kakhulu, njengoba amathumbu ezingane ezincane eqhubeka nokukhula ngokwemvelo aze afike ebudaleni obuncane.

Imijovo yokugoma esanda kwethulwa njenge-teduglutide iyasheshisa le nqubo yokuzivumelanisa nezimo futhi isiza ekukhipheni izingane ekudleni okunomsoco okufana ne-TPN.

Yini ongayenza njengomzali?

Nakuba lolu hambo luyinselele, awuwedwa. Kukhona ithimba elihle kakhulu elizokusiza ukuphatha isimo sempilo yengane yakho.

• Udokotela wezingane
• Udokotela wezifo zesisu wezingane
• Uchwepheshe wezokudla wezingane
• Udokotela ohlinzayo wezingane

Umsebenzi wakho oyinhloko ukulandela imiyalelo enikezwe yileli thimba lezokwelapha ngqo. Kubalulekile ukuqikelela kakhulu ekondleni ingane, ukunikeza imithi ngesikhathi, futhi uma usebenzisa ukwelashwa okufana ne-TPN, kubalulekile ukuqikelela kakhulu ekuyigcineni ihlanzekile.

I-SBS ingaba yisimo sokuphila konke kwabanye abantwana. Kodwa-ke, kwabanye abantwana, lesi simo sithuthuka kakhulu ngokuhamba kwesikhathi. Ngokwelashwa okufanele kwezokwelapha, ukudla okunempilo, kanye nokunakekelwa ngothando, abaningi balaba bantwana bangaphila impilo evamile nejabulisayo.