Diverticulitis ndi matenda opatsirana omwe amapezeka m'magulu ang'onoang'ono omwe amapezeka m'mimba amatha kutentha kapena kudwala. Ngakhale asayansi amakhulupirira kuti zakudya zochepa kwambiri zimayambitsa matendawa, sadziŵa kwenikweni kuti njira ziti zimayambitsa mapangidwe (otchedwa diverticula) ndi chifukwa chake zizindikiro zimakula mwa anthu ena osati mwa ena.
Zina mwazikuluzikuluzikuluzikuluzikulu, zaka, kunenepa kwambiri, ndi kusuta zimadziwika kuti zimayambitsa / kapena kuuma kwa diverticulitis zizindikiro.
Zomwe Zimayambitsa
Diverticulosis -pomwe kupanikizika kosalekeza pa colon kumayambitsa minofu yake, kuchititsa malo ofooka kuti aziwombera ndi kupanga zikwama zotchedwa diverticula-ndizolowera kwa diverticulitis. Izi kawirikawiri sizikhala zizindikiro ndipo sizovuta. Diverticulitis imakhalapo pamene zikwamazo zimatha kutuluka kapena kudwala, zomwe zimabweretsa ululu.
Matumbo a m'mimba amatha kupereka mabakiteriya malo oposa. Izi zikachitika, kutupa kwa msinkhu kumalo kumathandiza kuti tizilombo toyambitsa matenda tilowe m'kati mwake. Izi zikhoza kuyambitsa kutupa kwa mitsempha ya mesenteric (yomwe imagwirizanitsa m'matumbo ndi khoma la m'mimba), zomwe zingayambitse chitukuko cha feteleza kapena m'mimba.
Malinga ndi kafukufuku wofalitsidwa m'nyuzipepala yotchedwa Therapeutic Advances in Gastroenterology , pakati pa 10 peresenti ndi 25 peresenti ya diverticulitis flares angakhale chifukwa cha matenda a bakiteriya.
Nthawi zambiri kusagwirizana kwa mabakiteriya kumatanthauza chifukwa cha diverticulitis, makamaka msinkhu wa Escherichia ndi Clostridium coccoides mabakiteriya. Kafukufuku wochuluka mpaka lero, sanatsatire mfundoyi.
Ngakhale kuti chakudya chochepa kwambiri chakhala chikuwoneka ngati chochititsa chachikulu cha diverticulitis, umboni wochirikiza chiphunzitso ichi umatsutsana kwambiri ndi wosagwirizana.
Komabe, sizodabwitsa kuti chakudya chimathandiza kwambiri pa chiopsezo chake cha diverticulosis ndi diverticulitis (zambiri pamunsimu).
Genetics
Mankhwala amtunduwu amawonekeranso kuti amathandiza kwambiri pa matenda osiyanasiyana. Izi zikuthandizidwa mwa mbali ndi kafukufuku wopangidwa ku Sweden, zomwe zasonyeza kuti chiopsezo cha diverticulitis ndi choposa katatu ngati muli ndi mapasa apamtima ndi diverticulitis. Ngati mapasa anu ali ofanana, mutha kuwonjezeka kasanu ndi kawiri poyerekeza ndi anthu ambiri, malinga ndi ofufuza.
Zonse zanenedwa, pafupifupi 40 peresenti ya mitundu yonse ya diverticulitis milandu imakhulupirira kuti imakhudzidwa ndi chibadwidwe (ngakhale kuti zenizeni zenizeni za kusintha kwa izi sizikudziwika).
Zakudya
Lingaliro loti zakudya zochepa zochepa zimakhala zofunikira pa chitukuko cha matenda osiyanasiyana.
Asayansi ambiri amavomereza kuti mapangidwe a zikwama zimakhudzidwa kwambiri ndi kukakamizidwa kosalekeza mkati mwa colon, ndipo chofunikira kwa icho ndi kudzimbidwa -chikhalidwe chomwe chimagwirizana ndi kusowa kwa zakudya zakudya. Ngati izi zimachitika, zidole zimakhala zovuta kudutsa ndikupanga kusokonezeka kwabwino kwa matumbo m'mimba, makamaka mu sigmoid colon (gawo pafupi ndi rectum kumene ambiri amayamba).
Chiyambi
Kuchokera ku zochitika zakale, matenda a diverticular adapezeka koyamba ku United States kumayambiriro kwa zaka za m'ma 1900. Izi zili pafupi nthawi yomwe chakudya chotsatiridwa chinali choyamba kudya zakudya za ku America, kusinthasintha chakudya chathu kuchokera ku mitsempha yofiira, yomwe imakhala ndi mitsempha yambiri, yopaka ufa, womwe uli ndi fiber.
Masiku ano, kudya kwa nyama yofiira, mafuta a hydrogenated, ndi zakudya zowonongeka zakhala ndi mliri weniweni wa matenda osiyanasiyana m'mayiko otukuka monga United States, England, ndi Australia, komwe mlingo wa diverticulosis umayenda pafupifupi 50 peresenti.
Mosiyana ndi zimenezi, matenda osiyanasiyana amapezeka ku Asia ndi Africa, kumene anthu amakonda kudya nyama zofiira zochepa komanso ndiwo zamasamba, zipatso, ndi mbewu zonse. Zotsatira zake, mlingo wa diverticulosis m'madera amenewa ndi ochepera 0,5 peresenti.
Mu 1971, madokotala ochita opaleshoni Denis Burkitt ndi Neil Painter analimbikitsa chiphunzitso chakuti "zakudya zochepetsetsa" zomwe zili mu shuga ndi otsika kwambiri zimayambitsa kukwera kwa diverticulitis ku Western hemisphere countries. Ichi chinali chiphunzitso chomwe chidzatha kutsogolera njira ya chithandizo kwa zaka 40 zotsatira, ndi madokotala nthawi zonse kuti adziwe zakudya zamtundu wapamwamba monga chithandizo choyamba ndi chithandizo.
Komabe, lero, pali kukayikira kwakukulu ndi chisokonezo pofotokoza momwe zakudya zodyera zimayendera mu diverticulitis.
Umboni Wolimbana
Mu 2012, ofufuza a University of North Carolina School of Medicine adanena kuti, pakati pa odwala 2,104 omwe anayesedwa ndi colonoscopy , kudya zakudya zam'mimba komanso maulendo omwe amapezeka kawirikawiri, zinawonjezera chiopsezo cha diverticulosis. chifukwa cha chitukuko cha matenda.
Kumbali ina, maumboni ambiri amasonyeza kuti chakudya chokwanira kwambiri chingathe kuchepetsa mavuto ena akuluakulu a diverticulitis. Phunziro la 2012 kuchokera ku yunivesite ya Oxford, yomwe idabwereza kafukufuku kafukufuku wokhudza zaumoyo wa anthu oposa 15,000, inanena kuti kudya kwapamwamba kwakukulu kunagwiritsidwa ntchito ndi kuchepa kwa 41 peresenti ya chiwerengero cha anthu odwala ndi matenda ku matenda osiyanasiyana.
Ngakhale kufufuza kosatsutsana sikungapangitse kuti phindu la zakudya zogwiritsira ntchito kwambiri, liwonetsetse kuti zakudya sizothandiza kwambiri popewera kuyamba kwa matenda osiyanasiyana komanso kupeŵa mavuto a nthawi yaitali.
Zoopsa Zina
Ukalamba umasewera mbali yaikulu pakupanga machulukidwe, kuphatikizapo theka la milandu yomwe imapezeka pakati pa anthu oposa 60. Ngakhale kuti diverticulosis ndi yachilendo kwa anthu oposa 40, chiopsezo chimakula mosavuta. Pofika zaka 80, pakati pa 50 peresenti ndi 60 peresenti ya akuluakulu adzalimbikitsa diverticulosis. Mwa awa, ambiri mwa mmodzi mwa anayi adzakhala ndi diverticulitis.
Kunenepa kwambiri ndilo vuto lalikulu. Kafukufuku wa 2009 kuchokera ku University of Washington School of Medicine, yomwe inatsatira mbiri ya ukhondo ya amuna opitirira 47,000 pazaka 18, inatsimikizira kuti kunenepa-kutanthauza kuti thupi laumphawi (BMI) laposa 30-laposa kawiri ya diverticulitis ndi katatu chiopsezo cha magazi osiyana siyana poyerekeza ndi amuna omwe ali ndi BMI pansi pa 21.
Sm oking ndi, mwina n'zosadabwitsa, nkhawa, nayenso. Chizoloŵezichi chimadziwika kuti chimapangitsa kutupa komwe kungawonjezere chiopsezo cha matenda osiyanasiyana, ndipo chikhoza kuchititsa kuti mitundu iwonongeke mwakulimbikitsa kutupa komwe kumachepetsa minofu yomwe yayamba kale kuwonongeka, kuonjezera chiwopsezo cha kupuma, fistula, ndi m'mimba. Malinga ndi kafukufuku wochokera ku Imperial College London, chiwopsezochi chikuwonekera kukhala chachikulu mwa anthu omwe amasuta fodya kuposa tsiku lililonse.
Mankhwala otsutsana ndi kutupa (osaperoidal anti-inflammatory drugs (NSAIDs) imayanjananso kwambiri ndi diverticulitis ndi diverticular magazi. Ngakhale kuti aspirin yakhala ikudziwika kuti ndiyiyi yaikulu, zakhala zatsimikiziridwa kuti NSAID zonse zili ndi mphamvu zofanana. Amaphatikizapo makina otchuka, oposa-a-counter-aleve (naproxen) ndi Advil (ibuprofen).
Mosiyana ndi, oral oral corticosteroids ndi opiate analgesics ndizochititsa kuti perforated diverticulitis, kuphatikiza ndi katatu pangoziyike. Vuto likuwoneka kuti likuwonjezeka ndi ntchito yayitali.
> Zotsatira:
> Aune, D .; Sen, S .; Leitzmann, M. et al. "Kusuta fodya komanso chiopsezo cha matenda a diverticular - ndondomeko yowonongeka komanso kufotokoza kafukufuku wophunzira." Colorectal Dis . 2017; 19 (7): 621-33. DOI: 10.1111 / codi.13748.
> Crowe, F .; Appleby, P .; Allen, N. et al. "Zakudya ndi chiopsezo cha matenda a diverticular ku Oxford gulu la European Prospective Investigation ku Cancer and Nutrition (EPIC): kuyesera kuphunzira za anthu a ku Britain ndi osadya zomera." BMJ. 2011; 343: d4131. DOI: 10.1136 / bmj.d4131.
> Granlund, J .; Svensson, T .; Olen, O. et al. "Zotsatira za chibadwa pa matenda osiyana-maphunzilo a mapasa." Aliment Pharmacol Ther . 2012; 35: 1103-7. DOI: 10.1111 / j.1365-2036.2012.05069.x.
> Njira, L .; Liu, Y .; Aldoori, H. et al "Kulemera kwambiri kumawonjezera ngozi za diverticulitis ndi magazi ochuluka." Gastroenterology. 2009; 136 (1): 115-22.e1. DOI: 10.1053 / j.gastro.2008.09.025.
> Tursi, A. "Diverticulosis lero: yosagwiritsidwa ntchito komanso yosakafufuzidwa." Ther Advances Gastroenterol. 2015; 9 (2): 213-28. DOI: 10/1177 / 1756283x1562128.