Ingabe uvame ukudinga ukuya endlini yokugezela? Ingabe isisu sakho sibuhlungu njengommese? Wake waphawula igazi elincane esitulweni sakho? Ungazinaki lezi zinto njengezivamile. Ngoba zingaba izimpawu zesimo esibizwa ngokuthi i-Ulcerative Colitis (UC), esidinga ukunakwa okuthile. Ungesabi, akuyingozi njengoba ucabanga. Ake sixoxe ngalokhu ngendlela elula nenobungane futhi senze konke kucace.
Kalula nje, kuyini i-Ulcerative Colitis (UC)?
I-Ulcerative Colitis (UC) yisimo esihlala isikhathi eside esingelapheki kodwa esingaphathwa kahle. Sibangela ukuvuvukala kanye nezilonda ezincane (izilonda) olwelwesini lwamathumbu ethu amakhulu (ikholoni) kanye ne-rectum. Kalula nje, ingaphakathi lamathumbu liyavuvukala futhi libuhlungu.
I-UC ingenye yezifo ezimbili ezinkulu eqenjini lezifo ezibizwa ngokuthi i-Inflammatory Bowel Disease (IBD) . Esinye isifo sikaCrohn. Umuntu one-UC angase abe nezimpawu ezifana nohudo oluvamile, ubuhlungu besisu, kanye negazi esitulweni.
Uhlobo lwalesi sifo ukuthi asihlali sinezimpawu ezifanayo.
- Ukuqhuma: Phakathi nalesi sikhathi, izimpawu ziba zimbi kakhulu.
- Ukuxolelwa (isikhathi sokuxolelwa): Phakathi nalesi sikhathi, ungaphila ngokujwayelekile ngaphandle kwezimpawu.
Umgomo oyinhloko wokwelashwa ukunciphisa ukuqubuka kwesikhumba nokwandisa ukudamba ngangokunokwenzeka.
Yiziphi izinhlobo eziyinhloko ze-UC?
Odokotela bahlukanisa i-UC ngokusekelwe ekutheni ukuvuvukala kwenzeka kuphi emathunjini akho amakhulu. Ngokuvamile kuqala eduze kwendunu, noma i-rectum. Kungasakazeka kuwo wonke amathumbu amakhulu. Ake sibheke leli shadi ukuze sikusize ukuqonde lokhu kangcono.
| Uhlobo lwe-UC | Indawo ethintekile |
|---|---|
| I-proctitis yezilonda | Ukuvuvukala kukhawulelwe e-rectum. |
| I-Proctosigmoiditis | Kuthinta ingxenye yokugcina yendunu (i-rectum) kanye nengxenye engezansi enobunjwa buka-S yamathumbu amakhulu (i-sigmoid colon). |
| I-colitis yesobunxele | Ukuvuvukala kusakazeke ohlangothini lwesobunxele lwamathumbu amakhulu. |
| I-Pancolitis | Kulokhu, ukuvuvukala kuthinta ikholoni yonke. |
Ngaphezu kwalezi zinhlobo, i-UC ihlukaniswa njengethambile , ephakathi nendawo, noma enzima kuye ngokuthi izimpawu zinzima kangakanani. Uhlobo olubi kakhulu, olungavamile kakhulu futhi olungasongela ukuphila, lubizwa ngokuthi i-fulminant ulcerative colitis . Ezimweni ezinjalo, kudingeka usizo lwezokwelapha ngokushesha.
Ziyini izimpawu zalesi sifo?
Izimpawu ze-UC zinganda kancane kancane ngokuhamba kwesikhathi. Ezigabeni zokuqala, ungase ube nezimpawu ezincane. Kamuva, njengoba isifo siqhubeka, kungase kuvele izimpawu ezengeziwe. Ake sibheke lezi ngokwehlukana.
| Isibonakaliso | Incazelo |
|---|---|
| Izici ezithambile ezingabonakala kuqala | |
| Uhudo | Indle ekhululekile. Kungase kube negazi noma kungabi yigazi. Kungase kwenzeke kane ngosuku noma ngaphansi. |
| Isidingo sokuzikhulula ngokuzumayo | Ngizizwa ngidinga ukuya endlini yangasese. Kunzima ukuyilawula. |
| I-Tenesmus | Ukuzizwa sengathi udinga ukuya endlini yangasese, kodwa awukwazi ukuphuma endlini yangasese. |
| Ubuhlungu besisu/ukukhwehlela | Ukuzwa ukuqaqamba okuncane noma ukuqaqamba esiswini esingezansi. |
| Izimpawu ezimaphakathi nezinzima ezingase zivele kamuva | |
| Uhudo oluvamile | Uhudo ngaphezu kwezikhathi ezine ngosuku. |
| Igazi, uketshezi, noma ubomvu kanye nendle | Kukhona igazi elibonakalayo, uketshezi olufana ne-mucus, noma ubomvu esitulweni. |
| Ubuhlungu obukhulu besisu | Ubuhlungu obukhulu besisu obungabekezeleleki. |
| Ukukhathala | Ukuzizwa ukhathele kakhulu futhi ukhathele ngaphandle kwesizathu. |
| Ukwehlisa isisindo | Ukwehla kwesisindo okungazelelwe okungalindelekile. |
| Ukuhlanza kanye nesicanucanu | Ukulahlekelwa yisifiso sokudla kanye nesicanucanu. |
| Imfiva | Ukuzizwa ushisa. |
Ingabe ikhona eminye imiphumela ngaphandle kwamathumbu?
Yebo. Cishe kuma-25% eziguli ezine-UC, lokhu kuvuvukala kungathinta ezinye izingxenye zomzimba ngaphezu kwamathumbu. Ngemuva kwalokho, kungase kuvele nezimpawu ezihlobene.
- Ubuhlungu nokuvuvukala kwamalunga: Amalunga anjengamadolo nezindololwane angaba buhlungu futhi avuvuke.
- Izinkinga zamehlo: Kungase kube nokubomvu, ukuvuvukala, kanye nokulunywa kwamehlo.
- Izinkinga zesikhumba: Kungase kuvele amaqhubu abuhlungu, amabala, noma izilonda esikhumbeni.
Kungani lesi sifo senzeka? Yiziphi izinto ezibangela ingozi?
Eqinisweni, imbangela eqondile ye-UC ayikakatholakali. Kodwa-ke, abacwaningi bakholelwa ukuthi ibangelwa yinhlanganisela yezici eziningana.
Umqondo oyinhloko ukuthi lokhu kubangelwa uhlelo lokuzivikela olusebenza ngokweqile . Cabanga ngakho njengebutho lethu lesizwe. Umsebenzi walo ukuvikela umzimba kubahlaseli bakwamanye amazwe njengamagciwane namagciwane. Kodwa ngezinye izikhathi lolu hlelo luyaphambuka bese luqala ukuhlasela amangqamuzana ethu aphilile. Ku-UC, uhlelo lokuzivikela luhlasela amangqamuzana asemathunjini. Yilokho okubangela lokhu kuvuvukala kanye nezibazi.
Kunezici eziningana ezingabangela lesi simo:
- Ubudala: Lesi sifo sivame ukutholakala kubantu abasha abaneminyaka ephakathi kuka-15 no-30, noma kubantu asebekhulile ngemva kweminyaka engu-60.
- Izakhi zofuzo: Uma othile emndenini wakho, njengomama wakho, ubaba, noma umfowenu, enesifo i-UC noma i-Crohn's, nawe usengozini enkulu yokuba naso.
- I-microbiome yamathumbu: Amathumbu ethu ayikhaya lezigidi zamabhaktheriya awusizo, kanye namabhaktheriya ayingozi, amagciwane, kanye nesikhunta. Kutholakale ukuthi izinguquko ekulinganisweni kwale ndawo ezungezile zingase zibe nomthelela ku-UC.
Into ebalulekile ukuthi ukucindezeleka nokudla okudlayo akubanga imbangela yokukhula kwe-UC. Kodwa-ke, uma usuvele une-UC, lezi zinto zingenza izimpawu zakho zibe zimbi kakhulu, noma zibangele ukuqubuka. Ngakho-ke uma usutholakele ukuthi unalesi simo, kubalulekile ukuthola ukuthi yini ngempela ekubangelayo bese uzigwema.
Yiziphi ezinye izinkinga ezingaba khona ngenxa ye-UC?
Ukuba ne-ulcerative colitis kwandisa kancane ingozi yokuthola ezinye izinkinga zempilo, ngakho-ke kubalulekile ukuhlala ngaphansi kokuqashwa ngudokotela.
- I-anemia: Ukopha okuqhubekayo okuvela emathunjini kungabangela ukwehla kwenani lamaseli abomvu egazi emzimbeni, okuholela ekulahlekelweni kwegazi.
- Umdlavuza wamathumbu amakhulu: Abantu abane-UC basengozini enkulu yokuthola umdlavuza wamathumbu amakhulu kunabantu abaningi. Le ngozi incike ekutheni usunesikhathi esingakanani une-UC nokuthi iyiphi ingxenye yamathumbu amakhulu ethintekile. Kubalulekile ukukhuluma nodokotela wakho ngalokhu futhi uthole ukuhlolwa njalo kwe-colonoscopy .
- I-Osteoporosis: Ukuvuvukala isikhathi eside emzimbeni kanye nokwelashwa okuthile kungabangela ukuba amathambo abe buthakathaka futhi aphuke kalula.
- Izinkinga zesibindi: Akuvamile ukuthi lokhu kuvuvukala kungathinta nesibindi, okubangela isimo esibizwa ngokuthi i-primary sclerosing cholangitis .
- Imiphumela ekukhuleni kwezingane: Uma ingane iba ne-UC, ukukhula kwayo kungase kuphazamiseke ngoba ayikwazi ukumunca kahle izakhamzimba emathunjini.
Izimo eziphuthumayo ezidinga ukunakekelwa kwezokwelapha okusheshayo
Uma lezi zimpawu zivela, kuba yisimo esiphuthumayo. Yiya eMnyangweni Wezimo Eziphuthumayo wesibhedlela esiseduze (i-ETU) ngokushesha.
- Ukuphelelwa amanzi emzimbeni: Uhudo oluningi lungabangela ukuphelelwa amanzi emzimbeni, okungaholela ekuphelelweni amanzi emzimbeni. Ezimweni ezimbi kakhulu , uketshezi lwe-IV (usawoti) lunganikezwa esibhedlela.
- Ukubhoboka kwamathumbu amakhulu: Uma ukuvuvukala kuba kubi kakhulu, udonga lwamathumbu amakhulu lungabhoboka. Lesi yisimo esiyingozi kakhulu.
- Ukopha ngokweqile: Uma ukopha kakhulu kakhulu ukuthi awukwazi ukukulawula, kungadingeka ukuthi umpontshelwe igazi.
- I-megacolon enobuthi: Lena inkinga enkulu kakhulu, engavamile. Kulesi simo, amathumbu amakhulu ayavuvukala, ayeki ukusebenza, bese eqala ukumunca ubuthi obuvela ngaphakathi emzimbeni.
- Amahlule egazi: I-UC yandisa ingozi yokwakheka kwamahlule egazi emithanjeni yegazi yomzimba.
Uthola kanjani lesi sifo?
Ngemva kokulalela izimpawu zakho, udokotela uzoyala ukuhlolwa okuningana ukuqinisekisa lesi sifo.
- Ukuhlolwa kwegazi: Hlola i-anemia (inani eliphansi legazi) noma izimpawu zokuvuvukala.
- Ukuhlolwa kwendle: Hlola igazi, amagciwane, noma izimuncagazi esitulweni.
- Ukuhlolwa kwezithombe: Ukuhlolwa okufana ne-X-ray, i-CT scan, noma i-MRI kunganikeza umbono ngesimo samathumbu.
- Ukuhlolwa kwe-Endoscopic: Lena yindlela enembile kakhulu yokuxilonga i-UC. Kufakwa ipayipi elincane neliguquguqukayo elinekhamera (i-endoscope) nge-anus bese kuthi ingaphakathi lamathumbu amakhulu libukwe esikrinini. Lokhu kuhlolwa kubizwa ngokuthi i-colonoscopy noma i-sigmoidoscopy . Ngalesi sikhathi, kususwa ingcezu encane yezicubu ku-colon ukuze ihlolwe. Lokhu kubizwa ngokuthi i -biopsy .
Iphathwa kanjani?
Kunemigomo emibili eyinhloko yokwelapha. Eyokuqala ukulawula izimpawu ngesikhathi sokuqubuka kwesifo nokuletha ukuphulukiswa kwaso. Eyesibili ukugcina ukuphulukiswa kwaso isikhathi eside ngangokunokwenzeka. Lokhu kwenziwa kakhulu kusetshenziswa imithi nokuhlinzwa.
Imithi
Kunezinhlobo eziningana zemithi enganciphisa ukuvuvukala emathunjini.
- Ama-Aminosalicylates: Uhlobo lomuthi oluvame ukusetshenziswa kwi-UC emnene kuya kwephakathi. Izibonelo: i-sulfasalazine, i-mesalamine .
- Ama-Corticosteroids:Lezi yimithi enamandla yokulwa nokuvuvukala. Zinikezwa isikhathi esifushane kuphela ngesikhathi sokuqhuma okukhulu. Ngoba ukusetshenziswa isikhathi eside kunemiphumela emibi eminingi. Izibonelo: i-prednisone, i-budesonide .
- Ama-immunosuppressants: Izidakamizwa ezilawula ukusebenza ngokweqile kwesimiso somzimba sokuzivikela. Izibonelo: i-azathioprine, i-methotrexate .
- I-Biologics: Lezi izindlela zokwelapha ezintsha, eziqondiwe eziqondiswe ezingxenyeni ezithile zesimiso somzimba sokuzivikela ezibangela ukuvuvukala. Izibonelo: i-infliximab (Remicade®), i-adalimumab (Humira®) .
- Izithibi ze-JAK: Lezi futhi ziyiklasi elisha lemithi evimba inqubo ebangela ukuvuvukala. Izibonelo: i-tofacitinib (Xeljanz®) .
Ukuhlinzwa
Uma lesi sifo singenakulawuleka ngemithi, noma uma kuvela izinkinga ezinkulu, kungase kudingeke ukuhlinzwa. Cishe abantu abangu-30% abane-UC bazodinga ukuhlinzwa phakathi nesikhathi sokuphila kwabo.
Kunezinhlobo ezimbili eziyinhloko zokuhlinzwa. Zombili zihilela inqubo ebizwa ngokuthi i-proctocolectomy , ehilela ukususa amathumbu amakhulu kanye nengxenye yokugcina ye-rectum.
1. I-Proctocolectomy kanye nesikhwama se-ileal: Lolu ukuhlinzwa okuvamile. Kule nqubo, amathumbu amakhulu ayasuswa, isikhwama senziwe ngengxenye yamathumbu amancane, bese sixhunywa endunu. Ngemva kokwelashwa, uzokwazi ukuhamba kahle kwamathumbu.
2. I-Proctocolectomy kanye ne-ileostomy: Lokhu kwenziwa uma ukuhlinzwa okungenhla kungenzeki. Kule nqubo, wonke amathumbu amakhulu ayasuswa, kudalwe imbobo (stoma) esiswini, bese kufakwa isikhwama ukuze kuqoqwe indle ngaphandle.
Yini engenziwa ukuvimbela lesi sifo ukuthi singabi sibi kakhulu?
Ukuthola izimbangela zakho nokuzigwema kunganciphisa kakhulu ingozi yokuqhuma kwesifo.
- Lawula ukucindezeleka: Lala ngokwanele, uvivinye umzimba, futhi wenze okuthile okuzolisayo njengokuzindla.
- Gwema imithi ethile yokudambisa izinhlungu: Ama-NSAID (isib. i-ibuprofen, i-diclofenac) angenza izimpawu ze-UC zibe zimbi kakhulu. Kungcono ukuthatha umuthi ofana ne -paracetamol womkhuhlane noma ubuhlungu. Njalo xhumana nodokotela wakho ngaphambi kokuthatha noma yimuphi umuthi.
- Gwema ukudla okubangela i-UC: Akuwona wonke umuntu onezimbangela ezifanayo. Abanye abantu banomuzwa wokuzwela ubisi, kanti abanye bangase babe nomuzwa wokuzwela ukudla okune-fiber ephezulu. Indlela engcono kakhulu yokuthola ukuthi yini ekubangelayo ukugcina idayari yokudla bese ubhala phansi ukudla okudlayo kanye nezimpawu ozizwayo. Bese, khuluma nodokotela wakho bese uhlela uhlelo lokudla olukusebenzelayo.
Kubaluleke kakhulu ukuhlala uxhumana nodokotela wakho njalo. Thatha imithi oyinikezwe udokotela wakho njengoba nje uyalelwe, noma ngabe awunazo izimpawu. Ukuyeka imithi kungabangela ukuthi lesi sifo siphinde sivuke.
Umlayezo Wokuya Nawe Ekhaya
- I-Ulcerative Colitis (UC) iyisimo esihlala isikhathi eside kodwa esingalawuleki, ngakho-ke ungasesabi ngokungadingekile.
- Ngisho noma uphilile futhi ungenazo izimpawu, thatha imithi njengoba nje udokotela wakho ekuyalele.
- Thola ukuthi yikuphi ukudla, iziphuzo, kanye nezinto ezibangela ukucindezeleka ezikugulisayo, bese uzama ukuzigwema.
- Uma uhlangabezana nezimpawu ezifana nohudo oluvame ukwenzeka, ukopha ngokweqile ngendle yakho, ubuhlungu obukhulu besisu, kanye nomkhuhlane, ungakushayi indiva bese ubona udokotela ngokushesha.
- Njengoba une-UC, ingozi yakho yokuba nomdlavuza wamathumbu amakhulu iphakeme kancane, ngakho qiniseka ukuthi wenza i-colonoscopy ngesikhathi udokotela wakho esincomayo.
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