Mchitidwe uwu wa IBD si Crohn's disease kapena ulcerative colitis
Ponena za matenda opatsirana a m'magazi (IBD) , mitundu iŵiri yomwe nthawi zambiri imayankhulidwa ndi ulcerative colitis ndi matenda a Crohn, koma pali kachilombo kachitatu kamene kamatchedwa indeterminate colitis. Kutsekemera kwapadera kumagwiritsidwa ntchito ngati kuganiza kuti mtundu wina wa IBD ulipo, koma sudziwa kuti ndi mtundu wanji wa matendawa.
Izi ndizosokoneza komanso zotsutsana pa IBD, zomwe zimakhudza kwambiri odwala komanso madokotala. Zikuyesa kuti kulikonse pakati pa 10 peresenti ndi 15 peresenti ya anthu omwe ali ndi IBD akuganiziridwa kuti ali ndi matenda opatsirana. Nthaŵi zina, matenda a mtundu wina wa IBD angapangidwe pambuyo pake, pamene pali umboni wochuluka kapena matendawa amasintha.
Kodi Ndikutani Kwambiri Kwambiri?
IBD nthawi zambiri imakhala ngati ambulera, yomwe Crohn's disease ndi ulcerative colitis imagwa. Komabe, pali zochitika zina zomwe munthu ali ndi mtundu wa IBD umene sungathe kusonkhanitsidwa kukhala imodzi mwa zidebe. Izi sizikutanthauza kuti matenda a Crohn kapena matenda a zilonda zam'mimba sizingapangidwe mtsogolomu, koma zomwe zikutanthauza kuti pakalipano, sakudziwa bwinobwino mtundu wa matendawa.
Matenda omwe apita patsogolo kuposa magawo ake oyambirira ndikupita patsogolo, makamaka, zingakhale zovuta kuzigawa chifukwa cha kutentha ndi momwe zingakhalire mu colon .
Komano, pamene matenda ali ochepa kapena okhululukidwa , ndipo pali njira yochepa ya kutupa, zingakhalenso zovuta kupanga chidziwitso cholimba. Matenda oyambirira nthawi zina amakhalanso ovuta kuti azindikire chifukwa kusintha komwe IBD imayambitsa mu maselo ndi omwe angawoneke mu chiwerengero cha microscope mwina sikupezeka.
Kugonana koopsa kumapitirirabe kukhala nkhani yotsutsana m'magulu ena ndipo kungathenso kukhala wovomerezeka. Ochita kafukufuku ena apanga chithandizo cha matenda opatsirana omwe amatha kuonedwa kuti ndi njira yachitatu ya IBD, pamene ena amakhulupirira kuti ndi malo ogwiritsira ntchito mpaka pamene wina angapangidwe. Dokotala kapena wodwala matenda osadziŵa zambiri omwe ali ndi matenda a IBD akhoza kugawana zomwe akuwona kuti wodwala azikhala ndi matenda enaake, komabe katswiri wodziŵa zambiri amatha kuzindikira kuti mwina ndi Crohn's disease kapena ulcerative colitis.
Zizindikiro ndi Zizindikiro Za Kutupa Kwambiri
M'malo mophatikizidwa ndi zizindikiro zosiyanasiyana za matenda a zilonda zam'mimba ndi matenda a Crohn, matendawa amatha kukhala ndi zizindikiro zomwe poyamba zinalongosola mu 1978, ngakhale kuti si malamulo ovuta komanso ofulumira. Kutsekemera kwa m'mimba kungakhale ndi zonse kapena zifukwa zina pansipa:
- Mtundu wa zilonda: Kutsekemera kwa m'mimba kumatha kugwiritsidwa ntchito pamene pali kutupa kokha m'matumbo akulu, koma zilonda siziwoneka ngati zomwe zimachitidwa ndi ulcerative colitis. Mu ulcerative kolitis, zilonda zamkati zomwe zimapezeka m'matumbo akulu zimangophatikizapo mkati mwa mucosa, womwe umakhala ndi khoma la m'mimba. Ngati zilondazo zili zakuya kuposa zomwe zimayembekezeredwa ndi ulcerative colitis, ndipo palibe chitsimikizo chakuti matendawa ndi Crohn's, angayambitse dokotala panjira yopanga chidziwitso choyamba cha matenda opatsirana. Zilonda zamtunduwu nthawi zina zimatchedwa zilonda zamthambo (kutanthauza kuti zimapita mozama kudzera m'matumbo) kapena zimakhala ngati ziphuphu. Nthawi zina zilonda zam'mimba zimakhala zochepa (pafupifupi 13 peresenti), ndipo nthawi zina zimakhala ngati "V" (pafupifupi 60 peresenti ya milandu).
- Kuchita mwachidwi: Chizindikiro china cha kupatsirana kwa chifuwa chachikulu ndi chakuti kachilombo kawirikawiri sikumakhudzidwa, kapena ayi. Mu ulcerative kolitisitis, rectum imayamba kutenthedwa, ndipo chifukwa chake, ngati si choncho, sizowoneka ngati chizindikiro chomwe chingagwiritsidwe ntchito kuti chidziwike. Mu matenda a Crohn, kachilomboka kamatha kapena sichisonyeza kutupa.
- Dulani zilonda: Mu matenda a Crohn, kutupa kumatha kudumpha m'mimba mwa matumbo, kumasiya malo otukuka ndi minofu yambiri. Mu ulcerative kolitis, kutupa kumayamba mu rectum ndipo kumapitirira kupyolera mu colon mu njira yokondweretsa. Ndi matenda otsekula m'mimba, pakhoza kukhala madera akudumpha, kapena osachepera, zikuwoneka ngati pali madera akudutsa pakati pa zigawo zotentha. Pakhoza kukhala zifukwa zingapo zomwe ulcerative colitis imawoneka kuti yadumpha zilonda, chifukwa chake izi zikhoza kukhala chinthu china chomwe sichithandiza kuti mupeze matenda olimbitsa thupi.
Kuchiza kwa Indeterminate Colitis
Mwamwayi, mayesero azachipatala kwa anthu omwe ali ndi matenda oterewa amatha, ndipo zimakhala zophweka kuti apange chithandizo. Nthaŵi zambiri, kuperewera kwa matenda osapatsirana kumatetezedwa ndi mankhwala omwewo ndi opaleshoni monga ulcerative colitis. Kusiyanitsa kudzakhala ngati kuli kutupa m'mimba yaing'ono (monga gawo loyamba, lomwe ndi leamu), ndipo panthawiyi dongosolo la mankhwala likhoza kukhala losiyana ndi lofanana ndi la Crohn's disease.
Ndondomeko ya chithandizo cha matenda opatsirana omwe angakhalepo amatha kuphatikizapo mankhwala awa:
- Asacol (mesalamine)
- Azulfadine (sulfasalazine)
- Immunosuppressants ( Imuran , 6 MP , cyclosporine )
- Matendawa (methotrexate)
- Mankhwala a sayansi: Remicade (infliximab) ; Huma (adalimumab) ; Entyvio (Vedolizumab) ; ndi Golimumab (Simponi)
- Corticosteroids ( EC entocort (budesonide) ndi prednisone )
Njira zothandizira opaleshoni yowonjezereka zimakhalanso zofanana ndi za ulcerative colitis, zomwe zimaphatikizapo leal pouch anal anastomosis kapena IPAA (yomwe imatchedwa j-pouch) ndi ileostomy. Mu ileostomy, chidebecho chimachotsedwa ndipo mapeto a matumbo aang'ono amabweretsa kupyolera mu chifuwa (chomwe chimatchedwa stoma ). Munthu yemwe ali ndi leostomy amanyamula chovala pamimba kuti agwire chotsitsa, chomwe tsopano chimachoka mthupi kupyola gawo la matumbo omwe ali kunja kwa thupi. Sungulo imasonkhanitsa mu chipangizocho ndipo imachotsedwa mu chimbuzi ngati pakufunika.
Kuperewera kwa Colitis ndi J-Pouches
Nthawi zina, kupwetekedwa kwapachilendo kumatengedwa ngati kuti kumakhala ngati ulcerative colitis. Chifukwa cha izo, anthu ena omwe ali ndi matenda opatsirana amatha kukhala opaleshoni ya j-poch, yomwe nthawi zambiri imakhala yogwiritsidwa ntchito kwa anthu omwe ali ndi matenda oopsa a ulcerative. Mu opaleshoni ya j-pouch, matumbo akuluakulu amachotsedwa opaleshoni ndipo gawo lomalizira la matumbo aang'ono amapangidwira mthumba mawonekedwe a "J" ndipo amapezeka ku anus (kapena rectum, ngati wina atasiya dokotala) . J-poch imatenga gawo la rectum, ndipo imagwira chophimba. Kuchita opaleshoni sikuchitika makamaka ku Crohn's disease chifukwa pali chiopsezo chochepa kuti chikwama chikhoza kukhudzidwa ndi Crohn's ndipo chiyenera kuchotsedwa.
Komabe, kafukufuku wasonyeza kuti anthu omwe ali ndi matenda oterewa amatha kuchita bwino kwambiri ndi j-pochi monga anthu omwe ali ndi zilonda zam'mimba. Komabe, ofufuza ena adanena kuti kulephera kwa j-poch kwa odwala omwe ali ndi matenda a indeterminate kumakhala kovuta chifukwa zizindikiro za matenda sizunifolomu: pali kusiyana kwakukulu kowerengera gululi la odwala lonse.
Milandu Yonse ya Kugonjetsa Kwambiri Kwambiri Sizifanana
Chinthu chinanso chochititsa mantha cha kupwetekedwa kwapadera ndi chakuti makhalidwe akhoza kukhala osiyana pakati pa odwala. Ichi ndi vuto ndi IBD ambiri: Ndi matenda ovuta omwe ndi ovuta kuwagawa. Tsatanetsatane wa kuperewera kwa chifuwa chosakwanira pakalipano sichikukhazikitsidwa, ngakhale pali ziganizo zambiri.
Pali zochitika zina za matenda opatsirana omwe amayamba kuganiza kuti ndi "matenda a Crohn" pamene ena amakhala "odwala ulcerative colitis," omwe amatanthauza kuti pali odwala omwe ali ndi chiwerengero chokhazikika pakati pa matenda awiriwa. Izi zimapangitsa kuphunzira, ndikumvetsetsa, kupweteka kwa chifuwa chachikulu kumakhala kovuta.
Kuzindikira kwa Kugonjetsa Kwambiri Kumatha Kusintha
Nthaŵi zambiri, matenda a Crohn's or ulcerative colitis amapezeka. Nthawi ndi chifukwa chake izi zikuchitika zidzakhala zosiyana kwambiri. Nthaŵi zina, ngati kutupa kwatsopano kumakula m'matumbo aang'ono pamene poyamba kunali kutupa m'koloni, mwina ndiye kuti matenda a Crohn apezeka tsopano. Muzochitika zina, vutoli lingathe kuchitika madokotala kuti apeze njira imodzi ya IBD kupitirira. Zovuta zina, kaya m'mimba kapena m'mimba , zimakhala zosiyana ndi mtundu umodzi wa IBD, ndipo kupezeka kwawo kungathandize kuthandizira.
Chifukwa chimodzi chomwe chili kofunika kuti matendawa akhale chimodzi mwa mitunduyi ndi kupanga pulani yothandizira. Mankhwala omwe amavomerezedwa ndi Food and Drug Administration ndi ofunika, ndipo mwa njira iyi, matenda a Crohn ndi ulcerative colitis amachiritsidwa mosiyana. Kudziwa kuti chimodzi mwa mitundu ikuluikulu ya IBD ndikutenga chithandizo chomwe chavomerezedwa ku matendawa. Mankhwala ambiri amavomerezedwa ku mitundu yonse ya IBD, koma pali ena omwe amavomereza kuti Crohn's disease kapena ulcerative colitis. Kuonjezera apo, mankhwala ena angakhale othandiza kwambiri ku matendawa kusiyana ndi ena. Choncho, ndi zopindulitsa kupeza chitsimikizo chotsimikiziridwa chomwe chinaperekedwa pansi.
Mawu Ochokera
Kupeza matenda a chifuwa chachikulu kumakhala ndi kusakayika kwakukulu ndipo kungakhale kokhumudwitsa pamene mukuganizira za kuyang'anira matenda ndi chithandizo. Ndikofunika kuti aliyense amene ali ndi IBD akhale wolimbikira yekha, koma ndizofunikira kwa anthu omwe ali ndi matenda a chiwindi. Kupeza gulu lachipatala lothandizira komanso kuthandizana ndi abale ndi abwenzi omwe angapereke thandizo ndi kumvetsa kudzakuthandizira kulimbana ndi matendawa. Anthu ena amatha kukhala ndi matenda a chifuwa chachikulu kwa kanthawi, asanasinthe chilichonse, choncho kuphunzira zambiri momwe zingathere pa IBD ndikugwirizanitsa chithandizo choyenera chikhale cholinga chachikulu.
> Zotsatira:
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