Amatumbo siwo okhawo omwe akukhudzidwa
Matenda a Crohn ndi matenda opatsirana a m'mimba omwe amatha kukhudza mbali iliyonse ya m'mimba pakamwa mpaka ku anus. Ngakhale kuti zimayambitsa zizindikiro za m'mimba monga kuphulika, kukhumudwitsa, kutsekula m'mimba, kunyoza, kusanza, ndi magazi m'mabedi. Zowononga zimaphatikizapo kutchinga kwa m'mimba komanso kupweteka kwa m'mimba. Pakhoza kukhala chiopsezo chowonjezeka cha khansa ya m'mimba.
Matenda a Crohn angasokonezenso machitidwe ena am'thupi ndipo amachititsa mavuto aakulu monga masomphenya, matenda a nyamakazi, zilonda za khungu, matenda otupa mafupa, zilonda zam'mimba, matenda a chiwindi, matenda a chiwindi, ndi matenda osiyanasiyana a mitsempha kuyambira kuvulala mpaka kupweteka.
Zizindikiro za m'mimba
Matenda a m'mimba (GI) ndi njira yogwirira ntchito makamaka yomwe imakhudzidwa ndi matenda a Crohn. Pafupifupi 30 peresenti ya milandu imakhala ndi matumbo aang'ono, makamaka a terminal (leamu) omwe amagwiritsidwa ntchito kuchokera m'mimba mwachinyama kupita kumatumbo akuluakulu. Mbali 20 peresenti imaphatikizapo coloni yekha, pamene 45 peresenti imaphatikizapo matumbo aang'ono ndi colon.
Zina mwa zizindikiro za matenda a Crohn:
- Kupweteka kwa m'mimba nthawi zambiri kumakhala chizindikiro choyamba ndipo nthawi zambiri kumakhala kumbali ya kumanja kwa mimba kumene malo otchedwa leamu amapezeka. Kupweteka kungakhale kuphatikizana ndi kupunduka, kuphulika, kukhumudwa, ndi kunyoza.
- Kutsekula m'mimba kumakhalanso kofala ndipo kumasiyana malinga ndi malo omwe kutupa. Kutupa kwa leamu (ileite) kaŵirikaŵiri kumadzetsa madzi. Kutupa kwa koloni (colitis), mosiyana, kawirikawiri kumabweretsa nthawi zambiri zomwe zimakhala zosiyana.
- Ngakhale kuti magazi ali m'malo osasinthasintha ndi Crohn's disease kuposa ulcerative colitis (matenda ena omwe amachitiranso kuti ndi otupa ), nthawi zina zimakhala zovuta ngati matumbo akumwa kwambiri.
- Kupweteka kwa mimba ndi kupweteka m'mimba nthawi zambiri kumabweretsa chilakolako chosauka komanso kuwonongeka kwa thupi. Osauka chakudya ndi zakudya zimapititsa patsogolo kulemera kwake.
Kutupa mu thirakiti la GI silimangokhala m'mimba yekha. Zilonda zam'kamwa zomwe zimapezeka nthawi zambiri zimapezeka mwa anthu omwe ali ndi matenda a Crohn, pamene kunyala, fistula, fissures, kapena abscesses zimakhala zovuta kwambiri komanso kusadziletsa. Mimba ndi mimba sizimakhudzidwa kwambiri.
Zovuta za m'mimba
Pansi pa mtolo wambiri wa kutupa, makoma a matumbowo amakhala osasunthika, omwe amawoneka ngati makulidwe a zilonda zofiira amayamba kumanga. Izi sizimangowonjezera kutsekula kwa m'mimba, zimapangitsa kuti kutupa kwathunthu komanso ngozi zazing'ono komanso zazing'ono zikhale zovuta.
Mwa iwo:
- Kutsekeka kwa thupi ndilo vuto lofala kwambiri la matenda a Crohn ndipo akhoza kukhala ofatsa kapena ovuta, malingana ndi kukula kwa chitetezo. Zizindikiro zimaphatikizapo kupunduka, kuphulika, ndi kusanza.
- Ziphuphu za m'mimba (zipolopolo zapasitiki zomwe zimayambitsa mabakiteriya) zimayambitsa kupweteka m'mimba, chifundo, ndi malungo.
- Matenda a m'mimba amatha kutsegula m'mimba mwakachetechete omwe amatha kutuluka m'mimba ndi ziwalo zina.
- Mphuno imatha chifukwa cha abscess kapena fistula, zomwe zimatuluka m'mimba zimatuluka m'mimba ndipo zimayambitsa matenda aakulu (peritonitis).
- Megacolon ya poizoni ndizovuta koma zovuta kwambiri za matenda a Crohn omwe umatuluka mwadzidzidzi ndipo imataya kuthekera kwake. Zizindikiro zimaphatikizapo kupweteka kwambiri, kupweteka, kutentha thupi, kuthamanga kwa mtima, komanso kutaya kwa m'mimba. Ngati simunasankhidwe, mpweyawu ukhoza kuwonongeka, kusokonezeka, ndi imfa.
Kuopsa kwa khansara yowopsya kungapangitse anthu kuwonjezeka kwa matenda a Crohn, ngakhale kuti umboniwo ukutsutsana.
Khansara yapamwamba imakhala yogwirizanitsa ndi ulcerative colitis yomwe imakhala yoopsa pakati pa zisanu ndi zisanu ndi zisanu ndi zitatu peresenti pazaka 20. Kuopsa kwa anthu omwe ali ndi matenda a Crohn, mosiyana, amaonedwa kuti ndi odzichepetsa koma okwanira kuti awonetsere nthawi zonse.
Zizindikiro zosadziwika
Zizindikiro zosakanizidwa za matenda a Crohn (omwe amapezeka kunja kwa kapepala ka GI) ali kutali kwambiri komanso amakhudza kwambiri monga omwe amachititsa matumbo. Iwo amachititsa kutupa kosalekeza komwe kumayambira pa kapepala ka GI koma kumakhudza thupi nthawi.
Zizindikiro zowonjezereka kwambiri zimaphatikizapo maso, ziwalo, khungu, ndulu, dongosolo lamanjenje, ndi mitsempha ya magazi.
Maso
Kutupa kwa pakati pa diso (uveitis) kungayambitse masomphenya, kuwonetsa kuwala, ndi ululu wa maso. Pamene zimakhudza zoyera za diso (sclera), zimatha ku episcleritis. Zonsezi zimakhala zosautsa zomwe zimadzisintha okha, koma, polemedwa ndi kutupa kosatha, zingapangitse kuwonongeka kwamuyaya ndi kutayika kwa masomphenya.
Zogwirizana ndi Zosakaniza Zogwirizana
Matenda a Crohn akugwirizanitsidwa ndi matenda omwe amatchedwa seronegative spondyloarthropathy omwe amodzi kapena angapo amakhudzidwa ndi nyamakazi kapena chimodzi kapena zambiri zowonjezera minofu zimakhudzidwa ndi matendawa. Kwa anthu omwe ali ndi matenda a Crohn's, pali malo atatu omwe amadwala nyamakazi:
- Zingwe zazikulu zokhudzana ndi mawondo, ziuno, mapewa, chigoba, ndi dzanja
- Zigulu zisanu kapena zingapo zing'onozing'ono pamanja kapena m'mapazi, zimachitika mwachimake (kutanthawuza mwina m'manja onse kapena m'mapazi onse)
- Msana, womwe umatsogolera ku ankylosing spondylitis
Zizindikiro za nyamakazi zimakhala zopweteka, zotentha, zotupa, ndi ziwalo zolimba zomwe zimaphatikizapo kutayika kwa mgwirizano.
Khungu
Matenda ambiri omwe amapezeka ndi khungu la Crohn ndi aerythema nodosum omwe amawoneka ngati otukuka, ofewa, ofiira, omwe amawonekera kwambiri. Zimakhuthala zimayambitsidwa ndi kutupa kwa maselo a mafuta (adipose) m'madzi ozama kwambiri.
Chimodzi, chikopa chachikulu cha khungu chimatchedwa pyoderma gangrenosum. Chikhalidwe chowawa chimenechi chimakhala ndi zilonda za zilonda zam'mimba zomwe zimayambira pamlendo ngati kamphongo kakang'ono koma zimatha kuwonjezera kukula kwake kumayambitsa imfa (necrosis).
Miyala
Matenda a osteoporosis, omwe amadziwika ndi imfa ya mafupa, amapezeka kwa anthu akuluakulu omwe ali ndi matenda a Crohn's. Sizingangowonjezera kupweteka kwa m'mbuyo, kungachititse kuti pakhale ngozi. Kugwiritsanso zala kumayanjananso nthawi zina.
Ana omwe ali ndi matenda a Crohn amachitanso kuchepetsa kukula, zomwe zimagwirizana ndi kuchepetsa kukula kwa mafupa. Pafupifupi 50 peresenti ya ana awa adzakhala ochepa kwambiri, pamene pafupifupi 25 peresenti adzakhala ndi nthawi yochepa (kutanthauzidwa ngati zolakwika ziwiri pansipa kutanthauza kutalika kwa msinkhu wa mwana ndi mwamuna). Utha msinkhu umakhalanso kuchedwa.
Gallbladder
Matenda a Crohn amachepetsa matumbo a m'matumbo a kubwezeretsa bile omwe amavutitsidwa ndi ndulu ndi chiwindi chifukwa cha chimbudzi. Kusayenerera kwachinsinsi ndi reabsorption kungachititse kuti kusungunuka kwa salt salt mu gallbladder, kumabweretsa chiopsezo chowonjezeka cha gallstones.
Miyala imakhala yopweteka kwambiri ndipo imayambitsa kupweteka, kunyoza, kunyoza, kusanza, ndi kupweteka kumbuyo kapena kumtunda kwa kumimba.
Ndondomeko Yam'madzi Yamkati
Akuti munthu mmodzi mwa anthu asanu ndi awiri alionse ali ndi zizindikiro za matenda a Crohn's disease. Zingakhale zofatsa mpaka zochepa komanso zimakhala ndi kupweteka mutu, kuvutika maganizo, kapena kupweteka kwa manja ndi mapazi (nthenda ya ubongo). Zina zingakhale zovuta kwambiri ndipo zikuphatikizapo:
- Anterior ischemic optic neuropathy, kutaya mwadzidzidzi kwa masomphenya apakati chifukwa cha kuchepa kwa magazi kupita ku mitsempha ya optic
- Matenda osokoneza ubongo (PRES), matenda a mitsempha omwe amadziwika ndi kupweteka mutu, chisokonezo, kugwidwa ndi kutayika.
- Matenda osakanikirana omwe amatha kuwonetsetsa, omwe amatha kuwonetsa ndi kutayika kwa magalimoto ndi mphamvu
Zizindikiro za matenda a Crohn's disease sizimveka bwino. Mavuto akuluakulu amakhulupirira kuti akugwirizanitsidwa ndi matenda akuluakulu osatetezedwa nthawi yaitali.
Magazi ndi dongosolo la Circulatory
Anthu omwe ali ndi matenda a Crohn nthawi zambiri amakhala ndi magazi m'thupi chifukwa chosowa zakudya zamatumbo m'matumbo. Koma, palinso mtundu wina wotchedwa autoimmune hemolytic anemia momwe ma chitetezo cha mthupi amaukira ndi kuwononga maselo ake ofiira. Zizindikiro zingakhale monga kutopa, khungu loyera, kupuma kwafupipafupi, kumutu, chizungulire, ndi kugunda kwa mtima.
Matenda a Crohn amachititsanso kuti mapulaneti apangidwe bwino komanso kupanga magazi. Izi zingachititse kuti mitsempha yambiri ikhale yopweteka kwambiri (DVT), kuyimitsidwa kwa magazi kupita ku mwendo umene ungayambitse zizindikiro za ululu, kutupa, kutentha, ndi kupweteka.
Ngati simukuchiritsidwa moyenera, magazi amatha kutaya ndi kuyendetsa mwendo ku ubongo, mtima, ndi mapapo, kumene angayambitse kupwetekedwa mtima, kupweteka kwa mtima, kapena kupuma kwapopysi.
Nthawi Yomwe Muwone Dokotala
Zizindikiro za matenda a Crohn zikhoza kukhala zosiyana komanso zosiyana kwambiri zomwe zingakhale zovuta kudziwa nthawi yoti muwone dokotala. Chomaliza, chomwe chimasiyanitsa matenda a Crohn ku vuto lanu la mimba ndi kupitiriza kwa zizindikiro.
Ndikofunika kwambiri kuti muwone dokotala ngati muli ndi zotsatirazi:
- Zomwe zimayambitsa matenda otsegula m'mimba zomwe sizikugwirizana ndi mankhwala oposa a (OTC)
- Mimba ya m'mimba yomwe imapitirira kapena imabwereza
- Magazi mu mpando
- Kutaya kosawerengeka kosadziwika
- Matenda osadziwika amakhalapo kwa masiku angapo
> Zotsatira:
> Baumgart, matenda a D. Crohn. Lancet. 2012; 380 (9853): 1590-1605 DOI: 10.1016 / S0140-6736 (12) 60026-9.
> Ha, F. ndi Khalil, matenda a H. Crohn: chithandizo chamagetsi. Malangizo Op Gastroenterol. 2015; 8 (6): 352-359. DOI: 10.1177 / 1756283X15592585.
> Nemati, R .; Mehdizadeh, S .; Salimipour, H. et al. Mawonetseredwe a ubongo okhudzana ndi matenda a Crohn: chithandizo cha ogwira ntchito. Wokondweretsa Rep. 2017; gox034. DOI: 10.1093 / gastro / gox034.