Ingabe ikholoni lakho linobuthi obukhulu? (Ikholoni Enobuthi) Ake sifunde ngakho.

Wake waba nobuhlungu obukhulu besisu, ukuqunjelwa, kanye nomuzwa ongapheli wokungakhululeki emzimbeni wakho? Ngezinye izikhathi lokhu kungaba ukuqala kwenkinga enkulu. Namuhla sizokhuluma ngesimo esibucayi kancane, kodwa esingelapheka uma sibonakala ngokushesha. Lokho kubizwa ngokuthi `(Toxic Megacolon)`. Igama lizwakala liyesabeka kancane, akunjalo? Kodwa ake sikuqonde kalula lokhu.

Kuyini `(I-Megacolon Enobuthi)`? Kalula nje...

Kalula nje, `(I-Toxic Megacolon)` yisimo esibucayi kakhulu, esiphuthumayo esenzeka emathunjini akho amakhulu (okwaziwa nangokuthi `(Ikholoni)`). Sibangelwa ukuvuvukala okukhulu, okungukuthi, ukuvuvukala noma ukulimala (`(I-Colitis)`) kwamathumbu amakhulu.

Cabanga ngale ndlela: amathumbu ethu amakhulu afana nepayipi eliguquguqukayo. Linolwelwesi oluncane ngaphakathi. Ngokuvamile, uma uthola i-colitis, kuthinta lolulwelwesi. Kodwa uma ukuvuvukala kuba kubi kakhulu , kungasakazeka ezingqimbeni ezijulile zamathumbu, okungukuthi, imisipha ezindongeni zamathumbu.

Kwenzekani uma lokhu kwenzeka? Imisipha esezindongeni zamathumbu iyayeka ukusebenza kahle. Le misipha yiyo esunduza ukudla nomoya emathunjini. Uma iyeka ukusebenza, ukudla nomoya kuyabhajwa ngaphakathi kwamathumbu. Bese izindonga zamathumbu ziba buthaka, zinwebeke, futhi zikhule. Ziyakhukhumala njengebhaluni. Into eyingozi kakhulu ukuthi imfucuza eqoqana ngale ndlela yakha ubuthi futhi ivuza ngalezo zindonga ezibuthakathaka iye egazini. Bese umzimba wonke uqala ukuba nobuthi. Lokhu sikubiza ngokuthi i-megacolon enobuthi noma i-"Toxic Megacolon"`.

Uyini umehluko phakathi kwe-`(Toxic Megacolon)` nezinye izinhlobo ze-`(Megacolon)`?

Manje ungase ucabange, "Azikho yini ezinye izifo ezibangela ukuba ikholoni ivuvuke?" Yebo, zikhona. Ngezinye izikhathi ikholoni ingavuvukala ngenxa yokuvinjelwa (`(Izithiyo)`), noma ngezinye izikhathi ngaphandle kokuvinjelwa (`(Izithiyo-mbumbulu)`). Lokhu kubizwa nangokuthi `(Megacolon)`.

Kodwa-ke, ubuchwepheshe be-`(Toxic Megacolon)` ukuthi, njengoba kushiwo ngaphambili, ubuthi busakazeka emzimbeni wonke (`(Systemic Toxicity)`) . Lokhu akwenzeki njalo kwezinye izinhlobo ze-`(Megacolon)`. Ikakhulukazi, lesi simo esinobuthi sivame ukubonakala nge-`(Colitis)` eyenzeka ngokuvuvukala kwamathumbu (`(Colitis)`, okungukuthi, ngenxa yezifo ezahlukahlukene noma izimo ze-`(Inflammatory)`. Yilapho kuvela khona izimpawu ezifana nomfutho wegazi ophansi, ukushaya kwenhliziyo okusheshayo, kanye nokudideka.

Yiziphi izinkinga ezinkulu ezingase zivele ngenxa ye-`(Toxic Megacolon)`?

Lokhu kubhekwa njengesimo esiphuthumayo sezokwelapha , njengoba kungaholela ezinkingeni eziningana ezinkulu ezingaba yingozi empilweni.

• Ukubhoboka/ukuqhekeka kwamathumbu : Engikushoyo ukuthi izindonga zamathumbu ziba buthakathaka futhi zinwebeke. Uma lokho kwenzeka, kungaqhekeka noma kuqhume kalula.
• Ukopha okukhulu kwesisu kanye nokulahlekelwa igazi : Amathumbu angase alimale futhi angase ophe kakhulu.
• Ukutheleleka kwesistimu kanye ne-sepsis: Uma ubuthi obuvela emathunjini bungena egazini, ukutheleleka kungasakazeka emzimbeni wonke, okuholela esimweni esiyingozi esibizwa ngokuthi i-sepsis.
• I-Abdominal compartment syndrome: Ukwanda kwengcindezi ngaphakathi kwesisu kungathinta ezinye izitho zomzimba.

Kubaluleke kakhulu: Uma unezimpawu ezinjengalezi, into engcono kakhulu ongayenza ukufuna iseluleko sezokwelapha ngokushesha.

I-Toxic Megacolon ingabangela kanjani ukufa?

Lokhu kuyindaba engathi sína. Njengoba kushiwo ngaphambili, izindonga zekholoni, ezibuthakathaka futhi ezinwetshiwe, zingadabuka kalula futhi zibhobozeke. Uma kwenzeka ukubhoboza okunjalo, ukuphuma kwegazi okukhulu kungavela ngaphakathi kwesisu, futhi izinto ezifana nendle zingavuza zingene emgodini wesisu, okubangela ukutheleleka ngaphakathi kwesisu (i-peritonitis). Lokhu kutheleleka kungaqongelela ngokushesha egazini futhi kufake ubuthi emzimbeni wonke, okuholela esimweni esibizwa ngokuthi ukushaqeka okunobuthi. Futhi, lapho ingcindezi ngaphakathi kwesisu ikhuphuka kakhulu, ukugeleza kwegazi kwezinye izitho ezibalulekile (njengezinso namaphaphu) kungaphazamiseka, futhi zingase ziswele umoya-mpilo futhi zehluleke. Lesi yisona sizathu esiyinhloko sokufa.

Ziyini izimpawu ze-`(Toxic Megacolon)`?

Kulesi simo, kungase kuvele izimpawu ezahlukahlukene. Ezinye zazo zingase zizwakale njengobuhlungu besisu obujwayelekile. Kodwa uma unezimpawu ezingaphezu kweyodwa, noma uma zinzima kakhulu, kufanele ukhathazeke.

• Uhudo (ngokuvamile olunegazi) : Ukunyakaza kwamathumbu okuqhubekayo, futhi uma kuhambisana negazi, lokho kuyisibonakaliso esiyingozi.
• Ubuhlungu besisu kanye nokuthamba : Ubuhlungu obuzwakala sengathi isisu sakho siyacindezelwa, futhi bubuhlungu ngisho noma usithinta.
• Isisu esivuvukile : Isisu siyakhula, njengokungathi sigcwele umoya.
• Ukuvuvukala kanye nobuhlungu begesi (`(Ubuhlungu begesi kanye negesi)`) : Isisu sigcwele igesi, okubangela ubuhlungu.
• Ukucanuzela nokuhlanza : Ukuzizwa ugula esiswini sakho, uzizwa sengathi uzohlanza.
• Isiyezi (`(Isiyezi)`)
• Ukuphelelwa amanzi emzimbeni : Ukulahlekelwa amanzi emzimbeni. Izimpawu zifaka phakathi umlomo owomile kanye nokuncipha kokuchama.
• Isilinganiso senhliziyo esisheshayo : Ukwanda kwesilinganiso sokushaya kwenhliziyo.
• Umkhuhlane (`(Umkhuhlane)`)
• Umfutho wegazi ophansi (`(Umfutho wegazi ophansi)`) : Ukwehla komfutho wegazi.
• Ukudideka kwengqondo : Ukungakwazi ukuqonda okwenzekayo, ukuzizwa udidekile.
• Ukukhathala/ukungabi namandla : Umuzwa wobuthakathaka.

Iyini imbangela eyinhloko ye-`(Toxic Megacolon)`?

Eqinisweni, noma yiluphi uhlobo lwe-colitis enzima lungabangela i-megacolon enobuthi. Kodwa-ke, ivame ukubangelwa yisimo esibizwa ngokuthi isifo samathumbu esivuvukalayo (IBD).Isifo samathumbu esivuvukalayo (IBD) igama elijwayelekile lezinhlobo eziningana ze-colitis ezingamahlalakhona, okusho ukuthi zihlala isikhathi eside futhi kunzima ukwelapha. Isibonelo, i-Ulcerative Colitis kanye neSifo sikaCrohn ziwela ngaphansi kwalesi sigaba. Uma lezi zimo zingalawulwa kahle ngokudla kanye nemithi, zingagcina zithinte izingqimba ezijulile zekholoni, okuholela ku-Toxic Megacolon.

Yiziphi ezinye izimbangela ze-Toxic Megacolon?

`(I-Toxic Megacolon)` iyinkinga ye-`(Colitis)` enzima. Ngakho-ke kungaba nezimbangela eziningi zalokhu `(Colitis)`. Okusho ukuthi, `(I-Toxic Megacolon)` ingabangelwa izinhlobo ezahlukene zezimo ze-`(Colitis). Ake sibone ukuthi ziyini:

• I-Ulcerative Colitis : Lolu uhlobo oluvame kakhulu lwe-IBD futhi luyimbangela enkulu ye-Toxic Megacolon. I-Toxic Megacolon ivame ukwenzeka eminyakeni embalwa yokuqala ngemva kokuxilongwa.
• Isifo sikaCrohn : Lolu olunye uhlobo lwe-IBD. Luthinta kakhulu amathumbu amancane, kodwa lungathinta namathumbu amakhulu. Abantu abanesifo sikaCrohn nabo basengozini yokuthola i-Toxic Megacolon ekuqaleni kwalesi sifo.
• I-Ischemic Colitis : Uma amathumbu enganikezwa igazi ngendlela efanele (i-Intestinal Ischemic Syndrome), lokhu kungabangela i-Ischemic Colitis. Lokhu kunzima kancane ukukwelapha, futhi kungadlulela ku-Toxic Megacolon.
• I-Radiation Colitis : Ukwelashwa ngemisebe yezifo ezifana nomdlavuza kungabangela i-colitis yesikhashana njengomphumela ongemuhle. Kodwa-ke, kwabanye abantu, ingaqhubeka isikhathi eside futhi ibangele izinkinga.
• I-Infectious Colitis : Ukutheleleka ngamagciwane, amagciwane, noma amagciwane kungabangela i-colitis. Ezinye izinhlobo zokutheleleka cishe zithinta abanye abantu. Ngisho nokudla okulula okunobuthi noma umkhuhlane wesisu kungabangela i-colitis enzima kwabanye abantu. Abantu abanamasosha omzimba abuthakathaka basengozini enkulu yokutheleleka njenge-cytomegalovirus.
• I-Pseudomembranous Colitis : Lolu uhlobo lwe-colitis ethelelanayo ebangelwa yibhaktheriya i-Clostridium difficile (C. diff). Ivame ukubizwa ngokuthi yisici esiyingozi se-megacolon enobuthi. Ivame ukuvela kubantu abathatha ama-antibiotic ukuze bathole olunye ukutheleleka. Lokhu kungenxa yokuthi lapho amabhaktheriya amahle emathunjini ebulawa ama-antibiotic, amabhaktheriya e-C. diff aqala ukukhula ngaphandle kokulawulwa. Lokhu kutheleleka kwe-C. diff kungaba kubi kakhulu ngokushesha okukhulu.

Yiziphi izici eziyingozi zokuthuthukisa `(i-Toxic Megacolon)`?

Abanye abantu banamathuba amaningi okuthola lesi simo. Bangobani?

• Abantu abane-`(Isifo Sokuvuvukala Kwamathumbu (IBD))`.
• Abantu abanezifo zokuzivikela komzimba (okungukuthi izifo lapho amasosha omzimba ehlasela khona amangqamuzana omzimba)
• Abantu abane-`(HIV/AIDS)`.
• Abantu abake bafakelwa izitho zomzimba noma abathatha imithi yokucindezela amasosha omzimba.
• Abantu abanesifo sikashukela.
• Abantu abanesifo sezinso.
• Abantu abanesifo samaphaphu esingamahlalakhona (Isifo Sokuvimbela Amaphaphu Esingamahlalakhona - i-COPD).
• Abantu abanezinkinga zenhliziyo (`(Ukuhluleka Kwenhliziyo Okuhlanganisiwe)`).

Futhi, eminye imithi oyithathayo ingenza lesi simo "se-Toxic Megacolon" sibe sibi kakhulu:

• Izinhlobo zemithi yobuhlungu (`(Ama-opioid)`)
• Imithi engeyona i-steroidal elwa nokuvuvukala (ama-NSAID - isibonelo i-Ibuprofen, i-Diclofenac)
• Eminye imithi yokucindezeleka (`(Ama-antidepressant)`)
• Imithi yokulwa ne-cholinergic
• Imithi yokwelapha isifo sohudo (sebenzisa lokhu ngokucophelela, njengoba kungenza isimo sibe sibi kakhulu ngokuvimbela ukuhamba kwamathumbu)
• Ukulungiswa kwamathumbu (umuthi onikezwa ukuhlanza isisu ngaphambi kokuhlolwa kwekholoni) (Lokhu kungaba yingozi kumuntu osevele ene-colitis)

I-Toxic Megacolon ihlolwa kanjani ?

Udokotela uzokubuza ngezimpawu zakho, noma yiziphi izifo zangaphambilini, kanye nanoma yimiphi imithi oyiphuzayo. Lolu lwazi lubalulekile ngoba ezinye izifo noma imithi ingandisa ingozi yokuthola i-Toxic Megacolon. Eminye imithi, njenge-steroids, ingacindezela nezimpawu ze-Toxic Megacolon. Udokotela uzobe esekwenza ukuhlolwa ngokomzimba.

Ngesikhathi sokuhlolwa ngokomzimba, udokotela wakho uzohlola isisu esivuvukile, ukuthamba, kanye nokungakhululeki. Bangase basebenzise i-stethoscope ukulalela ukunyakaza kwamathumbu okwehlayo. Izimpawu zakho ezibalulekile (ukushaya kwenhliziyo, izinga lokushisa, kanye nomfutho wegazi) zizohlolwa izimpawu zobuthi, njengomkhuhlane, umfutho wegazi ophansi, kanye nokushaya kwenhliziyo okusheshayo.

Ngaphezu kwalokho, kungadingeka ukuhlolwa kwegazi kanye nokuhlolwa kwesithombe sesisu (isib. i-X-ray, i-ultrasound yesisu, noma i-CT scan) ukuqinisekisa ukuxilongwa. Lokhu kuhlolwa kwesithombe kubheka ukuthi ikholoni ivuleke kangakanani nokuthi ngabe kukhona yini ezinye izinkinga. Ukuhlolwa kwegazi kungahlola inani lamaseli amhlophe egazi kanye namaseli abomvu egazi, futhi kunganquma ukuthi kukhona yini ukuvuvukala okukhulu.

Kunezindlela eziningana ezisetshenziswayo ukuxilonga `(i-Toxic Megacolon)`:

• Ubufakazi bokuthi ikholoni ingaphezu kwamasentimitha ayi-6 ububanzi.
• Ukuba nezici okungenani ezintathu kwezilandelayo:
• Umkhuhlane ongaphezu kuka-100.4 Fahrenheit (38 Celsius).
• Isilinganiso senhliziyo esidlula ukushaya okungu-120 ngomzuzu.
• Ukwanda kwenani lamaseli amhlophe egazi.
• I-anemia (ukwehla kwenani lamaseli abomvu egazi).
• Ukuba nesici esisodwa okungenani kulezi ezilandelayo:
• Ukuphelelwa amanzi emzimbeni (`(Ukuphelelwa amanzi emzimbeni)`).
• Ukungalingani kwe-electrolyte/fluid.
• Isimo sengqondo esishintshile.
• Umfutho wegazi ophansi (`(Umfutho wegazi ophansi)`).

Ngaphezu kwalokho, udokotela angase afune ukuhlola amasampula egazi noma endle yakho ukuze abone ukuthi kukhona yini ukutheleleka okuthile.

Yiziphi izindlela zokwelapha `(Toxic Megacolon)`?

Lesi simo sidinga izinsuku ezimbalwa zokwelashwa esibhedlela. Umgomo wokwelashwa kokuqala ukuzinzisa isimo sakho nokunciphisa ubukhali be-colitis. Uma unesifo esifana ne-sepsis, ungadinga ukwelashwa egunjini lokunakekelwa okujulile (ICU). Isibonelo, ukuphefumula ngomshini kwezinkinga zokuphefumula noma i-dialysis yokwehluleka kwezinso.

Ngaphandle kwalokho, lezi izindlela zokwelapha zokuqala ezivamile ze-`(Toxic Megacolon)`:

• Uketshezi lwe-IV : Yelapha ukuphelelwa amanzi emzimbeni futhi ulinganisele ama-electrolyte.
• Ama-antibiotic : Yelapha izifo uma zikhona noma uvimbele ukwenzeka kwezifo.
• `(Ama-Corticosteroids)` : Uhlobo lomuthi olunikezwa ukunciphisa ukuvuvukala (ukuvuvukala).
• Ukuphumula kwamathumbu : Ukudla okunomsoco kwamathumbu / Ukuncelisa ngamapayipi.

Uma ama-corticosteroids engasithuthukisi lesi simo, udokotela angase asebenzise olunye uhlobo lomuthi, njenge-immune modulator. Lokhu kungasiza ekunciphiseni ukusabela ngokweqile kwesimiso sokuzivikela komzimba, okungaholela ekuvuvukeni ngokweqile kanye nokwanda kwamaseli amhlophe egazi ezicutshini.

Ukuhlinzwa

Cishe ama-50% eziguli angelapheka ngemithi. Abanye bangadinga ukuhlinzwa, ikakhulukazi uma kunezinkinga ezisongela ukuphila. Lapho belapha umuntu nge-megacolon enobuthi, odokotela bavame ukubonisana nodokotela abahlinzayo kusenesikhathi ukuze basize ekwenzeni izinqumo. Ngezinye izikhathi, udokotela angase anqume ukuthi kuphephile ukususa ingxenye eyonakele yekholoni (i-colectomy) ukuze kuvinjelwe ezinye izinkinga noma izingozi.

Uma une-colectomy, kuzodingeka futhi ukuthi uhlinzwe i-ostomy. I-ostomy yimbobo eyenziwe esiswini sakho ukuze kudlule indle. Lesi yimbobo lapho indle idlula khona lapho amathumbu akho engasebenzi kahle. Kuye ngohlobo lwe-colectomy onayo, kungadingeka ukuthi uhlinzwe i-ostomy okwesikhashana noma unomphela. Kungakhathaliseki ukuthi yesikhashana noma yesikhathi eside, ukuzivumelanisa ne-ostomy kungaba ushintsho olukhulu futhi kube nzima kancane, ikakhulukazi esimweni esiphuthumayo. Kodwa uzothola ukwesekwa okudingayo ukuze udlule kukho.

Ingabe i-Megacolon enobuthi ingelashwa?

Yebo, uma ufuna ukwelashwa kusenesikhathi, amathuba akho okusinda aphezulu kakhulu. Cishe abantu abangu-93% abelashwa nge-`(Toxic Megacolon)` bayalulama ngokugcwele. Kodwa-ke, uma kuvela izinkinga ezifana nokubhoboka kwamathumbu, izinga lokusinda lingaba ngu-75%. Izinkinga eziningi zenzeka lapho i-`(Toxic Megacolon)` ishiywa ingelashwa isikhathi eside. Ngakho-ke, kubaluleke kakhulu ukuqonda ukungathi sína kwesimo sakho bese uthatha isinyathelo ngokushesha.

I-megacolon enobuthi iyisimo esiphuthumayo sezokwelapha esingavela ngokuzumayo nangokungalindelekile. Usengozini enkulu uma usanda kutholakala unesifo samathumbu esivuvukalayo (i-IBD) esingalawulwa kahle. Kodwa-ke, singase senzeke ngesikhathi sokutheleleka okukhulu noma esinye isifo sofuba esibi. Qaphela noma yiziphi izinguquko noma ukuba kubi kwezimpawu zakho ezivamile.

Uma une-colitis enzima futhi uqala ukuzizwa ungaphilile noma unobuthi, funa iseluleko sezokwelapha ngokushesha. Ukwelashwa kusenesikhathi kuyindlela engcono kakhulu yokuvimbela izinkinga ezisongela ukuphila. Kungakusiza futhi ugweme ukuhlinzwa. Ngisho noma kufanele wenze i-colectomy ephuthumayo kanye ne-ostomy, khumbula ukuthi uzothola lonke usizo oludingayo ukuze uvumelane nezinguquko.

Into ebaluleke kakhulu (Umyalezo Wokuya Ekhaya)

I-Megacolon enobuthi iyisimo esibucayi kakhulu, esiphuthumayo esenzeka emathunjini amakhulu. Sibangelwa yi-colitis enzima (ukuvuvukala/ukulimala kwe-colon). Uma unezimpawu ezifana nokuqunjelwa, ubuhlungu obukhulu besisu, uhudo olunegazi, umkhuhlane, kanye nokushaya kwenhliziyo okusheshayo, ungazinaki. Lesi yisimo esiphuthumayo sezokwelapha. Uma uthola ukwelashwa esibhedlela ngokushesha, ungalulama ngokuphelele. Ngakho-ke, uma unalezi zimpawu, bona udokotela ngokushesha. Uma ulinda isikhathi eside, kulapho uzoba nezinkinga eziningi khona futhi kulapho amathuba okuthi ufe khona. Nakekela impilo yakho.

I- Megacolon enobuthi, i-Colitis, Ukuvuvukala kwekholoni, Ubuhlungu besisu, Uhudo, Ukuhlinzwa, Isimo Esiphuthumayo