Uke wahlinzwa ukuze kususwe inyongo yakho? Ingabe usenobuhlungu obukhulu ngezikhathi ezithile ohlangothini oluphezulu kwesokudla lwesisu sakho? Ingabe bufana nobuhlungu obutholakala ngamatshe enyongo? Abantu abaningi bacabanga ukuthi ngemva kokususwa kwenyongo yabo, ubuhlungu besisu sabo buphela ngokuphelele. Kodwa ngezinye izikhathi imbangela yalobu buhlungu akuyona into esiyicabangayo, kodwa yinto ehlukile. Yilokho esizokhuluma ngakho namuhla.
Kalula nje, iyini iSphincter yase-Oddi?
Ukuze siqonde lokhu, ake siqale sibheke inqubo yokugaya ukudla emzimbeni wethu. Kuyinto eyinkimbinkimbi kakhulu futhi emangalisayo. Izitho eziningi zomzimba, njengesibindi sethu kanye ne-pancreas, zisebenza ndawonye ukuguqula ukudla esikudlayo kube amandla.
- Isibindi: Yilapho kukhiqizwa khona ikhemikhali ebizwa ngokuthi i-bile. Igcinwa okwesikhashana enyongweni.
- I-Pancreas: Le ndlala ikhiqiza ama-enzyme asiza ekugayeni ukudla.
Inyongo evela esibindini kanye nama-enzyme avela ku-pancreas kumele ageleze ndawonye aye emathunjini ethu amancane. Umsipha omncane olawula lolo hambo, osebenza njengesango, ubizwa ngokuthi i-Sphincter of Oddi .
Uma isebenza kahle, lo msipha, obizwa ngokuthi i-Sphincter of Oddi, uvula ngesikhathi esifanele, uvumela i-bile nama-enzyme ukuthi adlulele emathunjini amancane. Bese uvala futhi.
Ngakho-ke iyini i-Sphincter of Oddi Dysfunction (i-SOD)?
Kalula nje, i-Sphincter of Oddi Dysfunction yilapho lelo sango esikhulume ngalo, umsipha obizwa ngokuthi i-Sphincter of Oddi, lingavuli kahle uma kufanele. Kwenzekani-ke? Ukuthi ama-enzyme e-bile kanye ne-pancreatic awakwazi ukungena emathunjini amancane futhi abhajwe kulelo payipi. Uma libhajwe kanje, libangela ubuhlungu obukhulu esiswini, okufana nalokho okwenzekayo uma unamatshe enyongo.
Lesi simo sivame ukubonakala kubantu abasuswe inyongo yabo (i-cholecystectomy). Ngenxa yalesi sizathu, ngezinye izikhathi sibizwa ngokuthi "i-post-cholecystectomy syndrome."
Yiziphi izinhlobo nezigaba eziyinhloko zalesi simo?
Lesi simo singahlukaniswa ngezinhlobo ezimbili eziyinhloko kanye nezigaba ezintathu. Kubalulekile ukwazi lokhu, ngoba ukwelashwa kuncike kulolu hlobo.
| Uhlobo / Isigaba | Kuchazwe kalula |
|---|---|
| Izinhlobo Ezimbili Eziyinhloko | |
| I-Biliary Dyskinesia | Lokhu kwenzeka lapho imisele yenyongo ivaleka, okuvimbela inyongo ukuthi ingene emathunjini amancane. |
| I-Pancreatitis | Kulesi simo, ukuvaleka kwenzeka ku-pancreas, okubangela ukuvuvukala kwe-pancreas. |
| Izigaba Ezintathu Eziyinhloko | |
| Izigaba I kanye ne-II | Kulezi zigaba ezimbili, odokotela bangathola ubufakazi obucacile benkinga ngokuhlolwa. Isibonelo, ukuhlolwa kwegazi okungavamile noma ukuskena kwe-ultrasound okubonisa imisele ye-bile evulekile noma imisele ye-pancreatic. |
| Isigaba III | Lolu uhlobo olunzima kakhulu ukulubona. Ngoba abukho ubufakazi obucacile balokhu emibikweni yegazi, kuma-scan, njll. Ubufakazi obuwukuphela kwalesi sifo ubuhlungu besisu sesiguli. Ngakho-ke, ukwelapha lokhu nakho kuyinkimbinkimbi kancane. |
Ziyini izimpawu zalesi sifo?
Uphawu oluyinhloko noluvame kakhulu lwalesi simo ubuhlungu obukhulu besisu, obufana nobuhlungu obuba khona lapho kwakheka amatshe enyongo.
- Lapho ubuhlungu buvela khona: Ubuhlungu obuvuthayo obuqala ohlangothini oluphezulu kwesokudla lwesisu.
- Ukusabalalisa ubuhlungu: Ngezinye izikhathi lobu buhlungu bungazwakala sengathi buya ehlombe noma emhlane kwesokudla.
- Ubude bobuhlungu: Ubuhlungu buvame ukuphela ngemva kwemizuzu engama-30 kuya ehoreni. Kodwa-ke, bungabuya ngelinye ilanga.
Ngaphezu kwalokhu kubuhlungu okuyinhloko, ezinye izimpawu eziningana zingabonakala:
- Isicanucanu nokuhlanza
- Imfiva
- Ukugodola
- Uhudo
Into ebalulekile ukuthi lezi zimpawu azifani ngaso sonke isikhathi. Ngezinye izinsuku ziyafika zidlule, kanti kwezinye izinsuku zingase zingabekezeleleki.
Kungani lokhu kwenzeka? Yiziphi izinto ezibangela ingozi?
Akukho sizathu esisodwa salokhu. Ngezinye izikhathi izibazi noma ukuvuvukala kwemigudu yenyongo kungavimba ukugeleza kwenyongo. Ngezinye izikhathi, ngaphandle kokuvaleka, kungabangelwa inkinga nge-sphincter yomsipha we-Oddi uqobo.
Kodwa kunezinhlobo eziningana zamaqembu asengozini enkulu yokuba nalesi simo.
- Okuvame kakhulu: Abesifazane abaneminyaka ephakathi kuka-20-50 abake basuswa inyongo ngokuhlinzwa.
- Ezinye izinto eziyingozi:
- Abantu abake bahlinzwa ukwehlisa isisindo (ukuhlinzwa kwe-Gastric bypass).
- Abantu abathola i-pancreatitis ephindaphindayo.
- Abantu ababenamatshe enyongo.
- Abantu abake bafakelwa isibindi.
- Abantu abane-thyroid engasebenzi kahle (i-Hypothyroidism).
- Abantu abane-Irritable Bowel Syndrome (IBS).
- Abantu abaphuza utshwala ngokweqile.
- Abantu abasebenzisa imithi ethile yokudambisa izinhlungu (ikakhulukazi ama-opioid).
Ingabe kungaba yingozi uma kungelashwa?
Lesi akusona isimo esisongela impilo, futhi izinkinga ezinkulu azivamile. Kodwa-ke, ubuhlungu obukhulu obubangelwa yiso bungaba yisithiyo esikhulu ekusebenzeni kwakho ngendlela evamile.
Kodwa uma kuqhubeka ngaphandle kokwelashwa, izimo ezilandelayo zingase zingabi khona njalo:
- I-pancreatitis engapheli: Umonakalo ongapheli we-pancreas obangelwa ukuvuvukala okuqhubekayo.
- I-Jaundice: Ukuphuzi kwesikhumba kanye nokumhlophe kwamehlo okubangelwa ukunqwabelana kwe-bilirubin, ingxenye ye-bile, emzimbeni.
Udokotela usithola kanjani lesi sifo?
Uma unalezi zimpawu, into yokuqala udokotela wakho azokwenza ukuhlola ezinye izimo ezingase zibangele ubuhlungu besisu sakho, ngoba lolu hlobo lobuhlungu lungabangelwa ezinye izimo eziningi.
Isibonelo, udinga ukuqinisekisa ukuthi azikho izimo ezibucayi njengesifo sesilonda se-peptic, i-choledocholithiasis, noma umdlavuza we-pancreatic noma we-bile duct. Okumangazayo ukuthi ubuhlungu bezinye izifo zenhliziyo (njenge-angina) bungazwakala njengobuhlungu besisu.
Ngemva kokukhipha konke lokhu, udokotela wakho angase akucele ukuthi wenze lezi zivivinyo:
- Ukuhlolwa kwegazi: Hlola amazinga aphezulu esibindi kanye nama-enzyme e-pancreatic.
- Ukuhlolwa kwezithombe:Hlola noma yikuphi ukukhubazeka ku-sphincter yemisipha noma imigudu ye-Oddi. Lokhu kungafaka phakathi izivivinyo ezifana ne-Abdominal Ultrasound, i-CT scan, i-Endoscopic Ultrasound (EUS), i-Upper Endoscopy, kanye ne-Magnetic Resonance Cholangiopancreatography (MRCP).
Ukuhlolwa okukhethekile: i-ERCP ene-Manometry
Ngezinye izikhathi, uma zonke lezi zivivinyo zingaphelele, udokotela angase akuthumele esivivinyweni esikhethekile esibizwa ngokuthi i-Endoscopic Retrograde Cholangiopancreatography (ERCP) nge-manometry .
Lokhu kuhilela ukuya ku-Sphincter of Oddi ngosizo lwe-endoscope, ukufaka ipayipi elincane kakhulu lepulasitiki, nokukala ingcindezi ukuze ubone ukuthi leyo misipha ifinyela futhi ikhula kahle kangakanani.
Kodwa lokhu kuhlolwa kwe-ERCP kuza nengozi encane. Abanye abantu, cishe abangu-15 kuya ku-30 kwabayi-100, bangaba ne-pancreatitis ngemuva kwalokhu kuhlolwa. Ngakho-ke, odokotela benza lokhu kuphela ngemva kokucabangisisa kahle futhi kuphela uma kudingeka ngempela.
Yiziphi izindlela zokwelapha lokhu?
Indlela yokwelapha incike ebunzimeni bezimpawu zakho nokuthi ukusiphi isigaba.
1. Uma ubuhlungu bungebukhulu kakhulu (ikakhulukazi esigabeni sesi-3):
Udokotela uzokunikeza imithi yokudambisa izinhlungu (engeyona i-opioid) kanye nemithi yokukhulula imisipha.
2. Uma ubuhlungu bukhulu (ngezigaba I kanye ne-II):
Uma kunzima ukulawula ngemithi, udokotela angakudlulisela ekwelashweni okubizwa ngokuthi i-ERCP nge-sphincterotomy . Lokhu kwenziwa ngaphansi kwe-anesthesia noma ngaphansi kwe-anesthesia. Udokotela ohlinzayo usebenzisa i-endoscope ukuya ku-Sphincter of Oddi, asike inani elincane lomsipha obambekile, bese ewukhulula. Ngesikhathi esifanayo, bahlola amatshe emigudwini ye-bile.
Izingozi zokwelashwa kwe-sphincterotomy
Lokhu kwelashwa kusiza ukunciphisa ubuhlungu ezigulini eziningi ezinezigaba I kanye ne-II. Kodwa-ke, futhi kuyinqubo eyinkimbinkimbi enezingozi ezithile.
- Cishe i-10% - 15% yeziguli zingase zibe nezinkinga ezifana ne-pancreatitis.
- Nakuba lokhu kuvuvukala kuvame ukuba kuncane, ngezinye izikhathi kungaba kubi kakhulu futhi kusongela nokuphila.
- Ezimweni ezinjalo, kungadingeka uhlale esibhedlela isikhathi eside ukuze uthole ukwelashwa.
Ngakho-ke, odokotela basebenzisa lokhu kwelashwa kuphela uma kungenakukwazi ukulawulwa ngezinye izindlela zokwelapha.
Umlayezo Wokuya Nawe Ekhaya
- Uma uqhubeka nokuba nobuhlungu esiswini ngemva kokususwa kwenyongo yakho, ungakushayi indiva. Ngokuqinisekile bonana nodokotela.
- Lobuhlungu bungase bubangelwe yi-Sphincter of Oddi Dysfunction (SOD), isimo esingase senzeke ngisho noma inyongo ingekho.
- Kunezinhlobo eziningana zalesi sifo. Ezinye zitholakala kalula ngokuhlolwa, kodwa ezinye (ikakhulukazi uhlobo lwesithathu) kunzima ukuzibona.
- Kunezindlela zokwelapha ezifana namaphilisi kanye ne-ERCP ene-sphincterotomy, ezenziwa kuphela uma kudingeka. Kodwa-ke, khumbula ukuthi lezi zindlela zinezingozi ezithile.
- Khuluma nodokotela wakho ngezimpawu zakho, ukuthi zivela kanjani, kanye nohlobo lobuhlungu bakho. Lokhu kuzokusiza ukuthi ukhethe ukwelashwa okufanele nokuphephile kakhulu kuwe.
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