Kwa cholinga cha mapepala ambiri ofufuzira, kusabereka kumatanthawuza kuti sangathe kutenga pakati kwa mwana kwa chaka chimodzi (miyezi 12) pomwe amakhala ndi chiwerewere chosadziletsa. Kwa amayi omwe amatanthauza kuti kutenga mimba sikuchitika komanso kwa amuna omwe mnzawo sangakwanitse kutenga mimba poyesa chaka.
IBD ndi kuchepetsa ubereki
Kawirikawiri, zotsatira za matenda opweteka m'magazi (IBD) pa kubereka sizidziwika.
Kafukufuku wina wasonyeza kuti abambo ndi amai omwe ali ndi IBD alibe malire omwe amasiyana kwambiri ndi anthu omwe alibe IBD. Kafukufuku wina wasonyeza kuti amuna omwe ali ndi IBD akhoza kuchepetsa chiberekero, ndipo izi zimakhala makamaka kwa amuna omwe ali ndi matenda a Crohn.
Mbali imodzi ya IBD yomwe imalingalira kuti ndi yomwe imapangitsa kuchepetsa kubereka sikuli vuto lenileni koma m'malo mwa chisankho chopanda kukhala ndi ana. Anthu omwe ali ndi IBD nthawi zambiri amadera nkhaŵa kuti matendawa akhoza kuperekedwa kwa ana, zomwe zingawachititse kusankha kusakhala ndi ana.
Komabe, pali zinthu zambiri za IBD zimene zingakhudze chonde, kuphatikizapo mankhwala ena, opaleshoni, zakudya zopanda thanzi, nkhani zamaganizo, komanso thanzi labwino. Nkhaniyi idzafotokoza momwe zifukwazi zingakhudzire chonde kwa amuna. Amuna (ndi akazi) omwe ali ndi IBD omwe ali ndi nkhaŵa zokhuza kubereka kwawo pakalipano kapena zam'tsogolo ayenera kufunsa azimayi awo kuti adziwitse kwa katswiri wa chonde ngati akufunikira.
Mmene Zimakhudzira Kubereka kwa Amuna
Kafukufuku wokhudzana ndi momwe IBD imakhudzira kubereka kwaumunthu kumasowa ndi kuya kwake; palibe zofukufuku zambiri zomwe zingapangitse, zomwe zimapangitsa kuti zikhale zovuta kudziwa momwe abambo omwe ali ndi IBD amakhudzidwa kwambiri. Komabe pali zifukwa zingapo zomwe zimadziwika kuti kubereka kwa amuna omwe ali ndi IBD kungakhudzidwe.
Chikhalidwe cha matenda. Monga momwe tingayembekezere, zochitika za matenda zimakhudza mphamvu ya munthu kubereka mwana. Amuna amene ali ovuta kwambiri ku IBD amavutika kwambiri ndi erectile malingaliro , kotero kuti kuyendetsa bwino kumakhala kofunikira musanayambe banja.
Mankhwala. Mankhwala ambiri omwe amachitira matenda a IBD sanawonetsedwe kuti amachititsa kuti abambo azikhala ochuluka kwambiri, ndi zosiyana. Azulfidine (sulfasalazine) , yomwe imagwiritsidwa ntchito pochizira matenda a zilonda zam'mimba, ingakhudze ubereki wamwamuna. Mtundu wosaperewera kwa kanthaŵi kochepa umayambitsa sulfa chigawo cha mankhwalawa mpaka pafupifupi 60 peresenti ya amuna amene amatenga. Pafupi miyezi iwiri mutasiya Azulfidine, kubereka kumabwereranso ku zomwe zinalipo mankhwala asanayambe.
Opaleshoni. Njira zopangira opaleshoni zomwe zimachitika pofuna kuchiza IBD zingakhudze ubereki wamwamuna, ngakhale kuti opaleshoniyo siimaphatikizapo ziwalo zoberekera amuna. Mtundu wa opaleshoni umene umawoneka kuti uli ndi mphamvu zowonjezera kubereka ndizo zomwe zikuphatikizira pafupi ndi kachilomboka. Izi zimaphatikizapo proctocolectomy ndi chikho-anal anastomosis (IPAA) , yomwe imatchedwa opaleshoni ya j-pouch ndi opaleshoni ya colostomy ndi opaleshoni ya ileostomy.
Phunziro limodzi laling'ono linasonyeza kuti odwala awiri pa 18 ali ndi vuto ndi kutaya magazi pambuyo pa opaleshoni ya IPAA. Kuchita opaleshoni yomwe imachitika pazipatala zapadera ndi madokotala ochita opaleshoni ndi ena othandizira zachipatala omwe amadziwika kwambiri mu IBD ndipo atha kuchita opaleshoni zambiri za mtundu umenewu akhoza kubweretsa mavuto.
Ndizochitika kawirikawiri, koma kusabereka kungachitike pambuyo pa ma opaleshoni a IBD. Chofunika kwambiri kukumbukira ichi ndi chakuti pali mankhwala omwe amapezeka kwa amuna omwe amachepetsa kubereka. Chithandizo chimodzi cha mankhwala, makamaka, chasonyezedwa kuti chithandizire pa 79 peresenti ya milandu.
Pachifukwa ichi, ubongo wamabambo ndi wofunika kuwerengera amuna omwe akufuna kukhala ndi banja ndipo adzachitidwa opaleshoni kwa IBD yomwe ingakhudze kubereka kwawo.
Mankhwala a IBD ndi Zotsatira Zake
Mankhwala ochizira IBD akhoza kukhala ndi mphamvu yakubala mwana. Nthawi zina, zingakhale bwino kusintha mankhwala kapena kusiya mankhwala musanayambe banja. Izi zidzakhala zosiyana kwa wodwala aliyense ndi banja lake, choncho ndikofunika kukambirana za IBD ndi gastroenterologist musanasankhe kukhala ndi mwana.
6-MP. Kafukufuku wochepa pa 6-mercaptopurine (6-MP) mwa amuna omwe anabala ana anasonyeza kuti pangakhale chiopsezo chowonjezeka chokhala ndi mimba kapena zosafunikira. Kafukufuku wina sanawonetseke kuti ali ndi mimba yomwe abambo anali kutenga 6 MP. Chifukwa cha ichi, akulimbikitsidwa kuti opereka chithandizo cha zaumoyo ayambe kukambirana ndi amuna omwe amatenga 6-MP amene akufuna kukhala tate ndikukambirana zomwe zingatheke pamene abereka mwana.
Azulfidine. Pakhala pali phunziro limodzi lomwe linasonyeza kuti pangakhale chiopsezo chochepa cha kubala kwa ana omwe anabadwa pamene abambo anali kutenga Azulfidine. Choncho, tingalimbikitsidwe kuti amuna omwe ali ndi IBD amene akufuna kubereka mwana amasinthira ku mankhwala ena.
Methotrexate. Kwa amayi omwe akufuna kutenga mimba, methotrexate iyenera kuyimitsidwa (ndi Mimba ya Mimba X mankhwala). Kwa amuna, zimalimbikitsanso kuti metrotrexate imaleke pafupi ndi miyezi itatu kapena inayi musanayambe banja, monga mankhwala akhoza kukhala m'thupi kwa miyezi ingapo.
Mbali zina za IBD Worth Worthing
Si mankhwala okha omwe angakhudze chonde komanso kutenga mimba, kusala kudya, kusowa zakudya zamagulu, komanso tsiku ndi tsiku lamoyo wodwala matenda aakulu kumabweretsa mavuto.
Kukhala ndi matenda osatha. Matenda aakulu ndi ovuta kupirira, ndipo IBD ndi imodzi yomwe imakhudza mbali zambiri za moyo wa anthu. Kukhala ndi chithunzi cha thupi kungakhale kulimbana kwa anthu ena omwe ali ndi IBD. IBD ikhoza kumusiya munthu kuti asamveke ngati wosakondweretsa kapena wosayenera kwa mnzanuyo. Izi zingakhale ndi zotsatira zochepetsa kugonana, zomwe zimachepetsa mwayi wokhala ndi pakati.
IBD ndi kuvutika maganizo. Chinthu china choyenera kuganizira ndi kugwirizana pakati pa IBD ndi kuvutika maganizo , komwe kumakhudza chikhumbo cha munthu kuti agone naye. Kukhala ndi chiyanjano chabwino chogonana komanso kukhala ndi ana n'kovuta polimbana ndi mavuto a IBD ndi IBD. Kuyankhula ndi gastroenterologist pa nkhanizi kungathandize, chifukwa akhoza kugwirizana ndi IBD. Nthaŵi zina, kupeza chitsogozo kuchokera kwa katswiri wa zaumoyo kungathandize. Pali mankhwala omwe angathandize kwambiri pakuphunzira kukhala ndi matenda osatha, ndipo ngakhale kukhala ndi munthu woti uyankhule nawo kungathandize.
Kukwera. Kutupa kwamtundu, zomwe ndi zomwe zimachitika m'dongosolo lakumagazi pa nthawi ya IBD, zimakhudza machitidwe ena ambiri a thupi. Kutupa kumakhalanso ndi zotsatira zoyipa pa chonde, makamaka pamene kutupa kumaonedwa kuti ndi koopsa. Zofukufuku zawonetsanso kuti amuna omwe ali ndi IBD ndi kutupa kwakukulu ali ndi miyeso yapamwamba ya kuwonongeka kwa erectile.
Zakudya zabwino. Palibe kafukufuku wambiri momwe momwe umoyo umakhudzira amuna omwe ali ndi IBD omwe akufuna kubereka ana. Pali umboni wina wakuti kusowa kwa zinki kungachepetse chonde, ndipo odwala ambiri omwe ali ndi matenda a Crohn awonetsedwa kuti ali otsika kwambiri. Chakudya chofunikira ndi chofunikira kwa bambo aliyense amene angakhale bambo ndipo zingakhale zofunikira kwambiri kwa amuna omwe ali ndi matenda a Crohn omwe ali ndi kutupa m'mimba yomwe imateteza mavitamini abwino.
Kukhalabe wopanda mwana. Anthu omwe ali ndi IBD nthawi zina amasankha kuti asakhale ndi ana chifukwa cha nkhawa kuti IBD ikhoza kuperekedwa. IBD ili ndi gawo la chibadwa, koma sizinaperekedwe kuti kholo lomwe liri ndi IBD lidzakhala ndi mwana yemwe amapanga IBD. Vuto lopatsira mwanayo IBD kwa mwana limasiyana malinga ndi kuphunzira, koma akuganiza kuti ali pakati pa 10 peresenti ndi 20 peresenti. Ndikoyenera kuti anthu omwe ali ndi IBD akambirane ndi madokotala awo za zodetsa nkhawazi chifukwa zingakhale zotsimikizika kuti mumvetsetse kuti zoopsazo ndi zotsika bwanji.
Chidziwitso Chochokera
Kawirikawiri, kupezetsa matenda a IBD sikudzawatsogolera ku matenda ena opatsirana. Koma palinso madera ena okhudzidwa ndi amuna omwe ali ndi IBD, makamaka kwa omwe ali ndi opaleshoni yambiri kapena omwe ali ndi matenda.
Monga ndi mbali zambiri za IBD, kupeza kutupa pansi kudzakhala chinthu chofunikira kwambiri popereka mwayi wabwino wokhala bambo. Kulankhula za kukhala bambo ndi gastroenterologist posakhalitsa kungathandize. Ngati kuli kotheka, gastroenterologist ikhoza kutumiza katswiri wa chonde yemwe amaphunzitsidwa kuthandizira kupeza ndi kuthetsa mavuto ndi kubereka.
> Zotsatira:
> Berndtsson I, Oresland T, Hultén L. "Kugonana kwa odwala omwe ali ndi zilonda zam'mimba zisanayambe ndi pambuyo pobwezeretsa proctocolectomy: phunziro loyembekezera ." Scand J Gastroenterol . 2004; 39: 374-379.
> El-Tawil AM. "Kulephera kwa zinki kwa amuna omwe ali ndi matenda a Crohn kungapangitse kuti umuna ukhale wosauka komanso kusabereka kwa mwamuna." Andrologia . 2003 Dec; 35: 337-341.
> Tavernier N, Fumery M, Peyrin-Biroulet L, Colombel JF, Gower-Rousseau C. "Ndondomeko yowonongeka: kubereka mu matenda osapsa opaleshoni opatsirana." Kudyetsa Pharmacol Ther. 2013; 38: 847-853.
> Timmer A, Bauer A, Dignass A, Rogler G. "Kugonana kwa anthu omwe ali ndi matenda opweteka kwambiri: kafukufuku omwe amawatsogolera." Clin Gastroenterol Hepatol . 2007 Jan; 5: 87-94.