Mitundu iwiri yoyamba ya matenda opatsirana (IBD) - Matenda a Crohn ndi ulcerative colitis-nthawi zambiri zimagwirana pamodzi. Koma, zina mwa makhalidwe awo ndi zosiyana kwambiri.
Mwachidule
Matendawa amakhala ndi zizindikiro zambiri, koma mankhwala awo, onse azachipatala ndi opaleshoni, sali chimodzimodzi. Nthawi zambiri, gastroenterologist ophunzitsidwa (pogwiritsa ntchito zotsatira zosiyanasiyana za mayeso) amatha kudziwa ngati vuto la IBD ndi Crohn's disease kapena ulcerative colitis.
Komabe, pali zizindikiro zomwe zimakhala zovuta kuti munthu adziwe kuti ali ndi mtundu umodzi wa IBD. Nthawi zina, matenda opatsirana amatha kokha pokhapokha panthawi yomwe matendawa akuchitika kapena mankhwalawo amachititsa kuti maonekedwe a IBD awoneke mosavuta.
Odwala ndi IBD akhoza kusokonezeka kwambiri chifukwa cha kusiyana kwa matendawa. Monga momwe zilili ndi vuto linalake, maphunziro ndi chida chofunika kwambiri chokhala nawo mbali pulogalamu yachithandizo cha mankhwala.
Ngati matenda anu sali olimba, musawope. Kwa anthu ena zingatenge nthawi kudziwa ngati IBD ili ngati matenda a Crohn kapena ngati zilonda za zilonda zam'mimba. Pafupifupi 15 peresenti ya milandu, anthu amapezeka kuti ali ndi matenda a indeterminate (IC).
IBD ikuchiritsidwa kwambiri ndipo palinso mankhwala ambiri mu zida zomwe zikuthandiza anthu okhala ndi mitundu yonse kukhala ndi mphamvu yowononga matenda awo. Kusiyanitsa kwakukulu pakati pa zilonda zam'mimba ndi matenda a Crohn ndizofotokozedwa pansipa.
Zizindikiro
Zizindikiro zambiri za ulcerative colitis ndi matenda a Crohn ndi ofanana, koma pali kusiyana kosaonekera.
- Odwala matenda opatsirana m'mimba amatha kupweteka m'munsi kumanzere kwa mimba, pamene odwala a Crohn akudwala (koma osati nthawi zonse) amamva kupweteka pamimba pamimba.
- Ndi matenda a zilonda zam'mimba, kutuluka m'magazi kumatenda nthawi zambiri pamene kutuluka kwa magazi kumakhala kochepa kwambiri kwa odwala omwe ali ndi matenda a Crohn.
Malo Otupa
- Mu matenda a Crohn, malo otupa amatha kupezeka paliponse pambali pakamwa mpaka pakamwa.
- Mu ulcerative colitis, matumbo akuluakulu (colon) ndiwo malo okha omwe amakhudzidwa. Komabe, mwa anthu ena omwe ali ndi zilonda zam'mimba zomwe zimatuluka m'mimba mwachinyamatayo, ileumu , ikhozanso kusonyeza kutupa.
Chitsanzo cha Kutupa
Chitsanzo chimene mtundu uliwonse wa IBD umatenga m'magawo amagazi ndi osiyana kwambiri.
- Ulcerative colitis imakhala ikupitirirabe m'madera otentha. Nthaŵi zambiri, matenda a zilonda zam'mimba amayamba m'tchire kapena chifuwa chachikulu ndipo amafalikira kudzera m'tchire pamene matenda akukulirakulira.
- Mu matenda a Crohn, kutukuka kumachitika pamatchetechete mu ziwalo 1 kapena zina m'matumbo . Mwachitsanzo, gawo la matenda la coloni likhoza kuoneka pakati pa magawo awiri abwino.
Maonekedwe
Pa colonoscopy kapena sigmoidoscopy, dokotala akhoza kuyang'ana mkati mkati mwa colon.
- Mu colon yomwe imakhala ndi ntchito ya Crohn's, khoma la colon likhoza kukulitsidwa ndipo, chifukwa cha kachitidwe kakang'ono ka matenda ndi matupi abwino, akhoza kukhala ndi mawonekedwe a "chiboliboli" .
- Mu ulcerative colitis, khoma la koloni ndi lochepa kwambiri ndipo limasonyeza kutupa mosalekeza popanda ziphuphu zamatenda wathanzi mu gawo la matenda.
Granulomas
Granulomas ndi maselo otentha omwe amagwidwa pamodzi kuti apange zilonda. Granulomas ali mu Crohn's disease, koma osati mu ulcerative colitis. Choncho, akapezeka m'zigawo zamtundu zomwe zimatengedwa kuchokera ku gawo lotentha la kapangidwe ka zakudya, ndiye chizindikiro chosonyeza kuti matenda a Crohn ndi oyenerera.
Zilonda
- Mu ulcerative kolitisitis, kupaka ntchentche mumatumbo akulu ndi ulcerated. Zilondazi sizingapitirire kupyola mkati mwake.
- Mu matenda a Crohn, zilonda zamkati zimakhala zozama kwambiri ndipo zimatha kufalikira m'mbali zonse zamkati.
Mavuto
Mu matenda a Crohn, ziboliboli , fissures , ndi fistula sizovuta kumvetsa. Izi zimapezeka nthawi zambiri m'matenda a ulcerative colitis.
Kusuta
Chimodzi mwa zinthu zochititsa chidwi kwambiri za IBD ndicho kugwirizana ndi kusuta fodya kapena fodya .
- Kusuta kumagwiridwa ndi matenda oopsa kwambiri odwala a Crohn's disease ndipo angawonjezere pangozi yobwereranso ndi opaleshoni.
- Kwa anthu ena omwe ali ndi zilonda zam'mimba, kusuta kuli ndi chitetezo, ngakhale kusuta sikulimbikitsidwa chifukwa cha zoopsa zaumoyo. Ulcerative colitis nthawi zambiri imatchedwa "matenda osuta fodya."
Kuchiza
Mankhwala
Kawirikawiri, mankhwala omwe amagwiritsidwa ntchito pochiza matenda a Crohn ndi matenda a zilonda zam'mimba ndi ofanana. Komabe, pali mankhwala omwe ali othandiza kwa mtundu umodzi wa IBD pambali pa mzake.
Njira zazikulu zothandizira matenda a zilonda zam'mimba zimaphatikizapo mankhwala 5-ASA ndi corticosteroids . Mankhwala 5-ASA samagwiritsidwa ntchito pochiza matenda a Crohn, ngakhale kuti corticosteroids ali.
Mankhwala ena amavomerezedwa kuti agwire mtundu umodzi wa IBD kapena winayo. Mwachitsanzo, Cimzia (certolizumab pegol) amavomerezedwa kuti adye matenda a Crohn ndi Colazal (balsalazide disodium) amavomerezedwa kuti adwale matenda a ulcerative.
Mankhwala atsopano, kuphatikizapo Huma (adalimumab) ndi Entyvio (vedolizumab) , amavomereza matenda onse a Crohn ndi ulcerative colitis.
Opaleshoni
Kwa odwala omwe ali ndi matenda a Crohn, opaleshoni kuchotsa ziwalo za matumbo angapereke mpumulo ku zizindikiro, koma matendawa amayamba kubwerera. Chifukwa kutupa kumapezeka mumatumbo akuluakulu mu ulcerative colitis, kuchotsa chiwalo chimenecho (chotchedwa colectomy) chimatengedwa ngati " mankhwala ."
Kuchotsa mbali yokha ya coloni sikuchitika kawirikawiri ndi odwala zilonda zam'mimba, monga matendawa adzabwererenso mu gawo la colon yomwe yatsala.
Pambuyo pa colectomy, wodwala wodwala zilonda zam'mimba akhoza kukhala ndi leostomy kapena imodzi mwa mitundu yambiri yamkati yomwe imapangidwa kuchokera m'mimba mwachindunji. Amapupa amkati sangakhale ochiritsidwa ku odwala a Crohn's amene ayenera kukhala ndi colectomy, chifukwa matenda a Crohn angapezeke m'thumba . Ngati thumba lidawotchedwa, liyenera kuchotsedwa mu opaleshoni ina.