I-ulcerative colitis

I-ulcerative colitis yisimo lapho ulwelwesi lwamathumbu amakhulu (i-colon) ne-rectum luvutha khona. Kuyindlela yesifo samathumbu esivuthayo (IBD). Isifo seCrohn yisimo esihlobene.

Isizathu se-ulcerative colitis asikaziwa. Abantu abanalesi simo banezinkinga kumasosha omzimba. Kodwa-ke, akucaci ukuthi izinkinga zokuzivikela ezifweni zibanga lokhu kugula. Ingcindezi kanye nokudla okuthile kungadala izimpawu, kepha akubangeli i-ulcerative colitis.

I-ulcerative colitis ingathinta noma yiliphi iqembu leminyaka yobudala. Kukhona iziqongo ezineminyaka yobudala eyi-15 kuye kwengama-30 bese ziphinde zibe neminyaka engama-50 kuye kwengu-70.

Lesi sifo siqala endaweni engunxande. Ingahlala ku-rectum noma isabalale ezindaweni eziphakemeyo zamathumbu amakhulu. Kodwa-ke, lesi sifo asidluli ezindaweni. Kungabandakanya wonke amathumbu amakhulu ngokuhamba kwesikhathi.

Izici zobungozi zifaka umlando womndeni we-ulcerative colitis noma ezinye izifo ezizimele, noma uzalo lwamaJuda.

Izimpawu zingaba nzima kakhulu. Zingaqala kancane noma ngokuzumayo. Ingxenye yabantu inezimpawu ezimnene kuphela. Abanye banokuhlaselwa okunzima kakhulu okwenzeka kaningi. Izici eziningi zingaholela ekuhlaselweni.

Izimpawu zingafaka:

• Ubuhlungu esiswini (esiswini) nokucinana.
• Umsindo wokuxokozela noma wokufafaza wezwa phezu kwamathumbu.
• Igazi futhi mhlawumbe ubomvu esitokisini.
• Uhudo, kusuka eziwombeni ezimbalwa kuya kaningi kakhulu.
• Imfiva.
• Uzwa ukuthi udinga ukuphasa indle, yize amathumbu akho engenalutho. Kungabandakanya ukuhlunga, ubuhlungu, nokucinana (tenesmus).
• Ukwehla kwesisindo.

Ukukhula kwezingane kungancipha.

Ezinye izimpawu ezingase zivele nge-ulcerative colitis zifaka okulandelayo:

• Ubuhlungu obuhlangene nokuvuvukala
• Izilonda zomlomo (izilonda)
• Isicanucanu nokuhlanza
• Izigaxa zesikhumba noma izilonda

I-Colonoscopy ene-biopsy ivame ukusetshenziselwa ukuxilonga i-ulcerative colitis. I-Colonoscopy isetshenziselwa ukuhlola abantu abane-ulcerative colitis yomdlavuza wekoloni.

Olunye uvivinyo olungenziwa ukusiza ukuxilonga lesi simo lubandakanya:

• I-Barium enema
• Qedela ukubalwa kwegazi (CBC)
• Amaprotheni asebenza ngoku-C (CRP)
• Izinga le-sedimentation ye-Erythrocyte (ESR)
• I-stool calprotectin noma i-lactoferrin
• Ukuhlolwa kwama-antibody ngegazi

Kwesinye isikhathi, ukuhlolwa kwamathumbu amancane kuyadingeka ukuhlukanisa phakathi kwesifo sezilonda esibuhlungu kanye nesifo seCrohn, kufaka phakathi:

• Iskena se-CT
• I-MRI
• Ucwaningo oluphezulu lwe-endoscopy noma lwe-capsule
• UMnu enterography

Izinhloso zokwelashwa uku:

• Lawula ukuhlaselwa okunamandla
• Vimbela ukuhlaselwa okuphindaphindiwe
• Siza ikholoni liphole

Ngesikhathi sesiqephu esibi, ungadinga ukwelashwa esibhedlela ngokuhlaselwa okunzima. Udokotela wakho angakunikeza ama-corticosteroids. Unganikezwa izakhamzimba ngomthambo (IV line).

UKUDLA NOKUDLA OKONDLEKILEYO

Izinhlobo ezithile zokudla zingase zibe sibi kakhulu isifo sohudo nezimpawu zegesi. Le nkinga ingaba nzima kakhulu ngezikhathi zesifo esisebenzayo. Iziphakamiso zokudla zifaka:

• Yidla ukudla okuncane usuku lonke.
• Phuza amanzi amaningi (phuza amanani amancane usuku lonke).
• Gwema ukudla okunefayibha ephezulu (i-bran, ubhontshisi, amantongomane, imbewu kanye ne-popcorn).
• Gwema ukudla okunamafutha, okunamafutha noma okuthosiwe nososo (ibhotela, imajarini nokhilimu osindayo).
• Nciphisa imikhiqizo yobisi uma ungabekezelelani ne-lactose. Imikhiqizo yobisi ingumthombo omuhle wamaprotheni ne-calcium.

UKUCINDEZELEKA

Ungazizwa ukhathazekile, unamahloni, noma udabukile noma ucindezelekile ngokuba nengozi yamathumbu. Ezinye izehlakalo ezicindezelayo empilweni yakho, njengokuhamba, noma ukulahlekelwa ngumsebenzi noma othandekayo kungadala ukwanda kwezinkinga zokugaya ukudla.

Buza umhlinzeki wakho wokunakekelwa kwezempilo ngamathiphu wokuthi ungakulawula kanjani ukucindezeleka kwakho.

IMITHI

Imithi engasetshenziselwa ukunciphisa inani lokuhlaselwa ifaka phakathi:

• Ama-5-aminosalicylates afana ne-mesalamine noma i-sulfasalazine, engasiza ukulawula izimpawu ezilinganiselayo. Ezinye izinhlobo zomuthi zithathwa ngomlomo. Abanye kumele bafakwe ku-rectum.
• Imithi yokuthulisa amasosha omzimba.
• Ama-Corticosteroids afana ne-prednisone. Zingathathwa ngomlomo ngesikhathi se-flare-up noma zifakwe ku-rectum.
• Ama-immunomodulators, imithi ethathwe ngomlomo ethinta amasosha omzimba, njenge-azathioprine ne-6-MP.
• Ukwelashwa nge-Biologic, uma ungaphenduli kwezinye izidakamizwa.
• I-Acetaminophen (iTylenol) ingasiza ekunciphiseni ubuhlungu obumnene. Gwema izidakamizwa ezifana ne-aspirin, ibuprofen (Advil, Motrin), noma naproxen (Aleve, Naprosyn). Lokhu kungenza izimpawu zakho zibe zimbi kakhulu.

UKUHLINZA

Ukuhlinzwa ukususa ikholoni kuzokwelapha i-ulcerative colitis futhi kususe usongo lomdlavuza wekoloni. Ungadinga ukuhlinzwa uma une:

• Colitis engaphenduli ekwelashweni okuphelele kwezokwelapha
• Izinguquko kulwelwesi lwekholoni eziphakamisa ingozi yokwanda komdlavuza
• Izinkinga ezinzima, njengokuqhekeka koloni, ukopha kakhulu, noma i-megacolon enobuthi

Isikhathi esiningi, kukhishwa lonke ikholoni, kufaka phakathi i-rectum. Ngemuva kokuhlinzwa, ungahle ube:

• Ukuvuleka esiswini sakho okubizwa nge-stoma (ileostomy). Indle izokhipha ngalesi sikhala.
• Inqubo exhuma amathumbu amancane endunu ukuthola ukusebenza kwamathumbu okujwayelekile.

Ukwesekwa kwezenhlalo kungasiza ekucindezelekeni kokubhekana nokugula, futhi amalungu eqembu lokusekelwa nawo angaba nezeluleko eziwusizo zokuthola ukwelashwa okungcono kakhulu nokubhekana nalesi simo.

ICrohn's and Colitis Foundation of America (CCFA) inemininingwane nezixhumanisi zokuxhasa amaqembu.

Izimpawu zimnene cishe engxenyeni eyodwa yabantu abane-ulcerative colitis. Izimpawu ezinzima kakhulu mancane amathuba okuthi ziphendule kahle emithini.

Ukwelashwa kungenzeka kuphela ngokususwa okuphelele kwethumbu elikhulu.

Ingozi yomdlavuza wekoloni iyanda eminyakeni eyishumi ngayinye ngemuva kokutholakala kwesilonda sokulimala kwezilonda.

Unengozi enkulu yomdlavuza omncane wamathumbu namakholoni uma une-ulcerative colitis. Ngesinye isikhathi, umhlinzeki wakho uzoncoma ukuhlolwa ukuze kuhlolwe umdlavuza wekoloni.

Iziqephu ezinzima kakhulu eziphindaphindayo zingadala ukuthi izindonga zamathumbu ziqine, okuholele ku:

• Ukunciphisa noma ukuvimbela ikholoni (okuvame kakhulu kwisifo seCrohn)
• Iziqephu zokopha kakhulu
• Izifo ezinzima
• Ukukhuliswa okungazelelwe (ukujula) kwamathumbu amakhulu kungakapheli usuku kuya ezinsukwini ezimbalwa (megacolon enobuthi)
• Izinyembezi noma izimbobo (ukugcotshwa) kukholoni
• Ukushoda kwegazi, ukubalwa kwegazi okuphansi

Izinkinga zokumunca izakhi zomzimba zingaholela ku:

• Ukuncipha kwamathambo (i-osteoporosis)
• Izinkinga zokugcina isisindo esinempilo
• Ukukhula kancane nokukhula ezinganeni
• Ukushoda kwegazi noma ukubalwa kwegazi okuphansi

Izinkinga ezivamile ezingaba khona zingabandakanya:

• Uhlobo lwe-arthritis oluthinta amathambo namalunga ezansi komgogodla, lapho luxhuma khona ne-pelvis (ankylosing spondylitis)
• Isifo sesibindi
• Ithenda, izigaxa ezibomvu (amaqhuqhuva) ngaphansi kwesikhumba, okungaphenduka izilonda zesikhumba
• Izilonda noma ukuvuvukala esweni

Shayela umhlinzeki wakho uma:

• Uba nobuhlungu besisu obuqhubekayo, ukopha okusha noma okwandayo, umkhuhlane ongapheli, noma ezinye izimpawu zesifo sokulunywa yizilonda emathunjini
• Une-ulcerative colitis futhi izimpawu zakho ziba zimbi noma azithuthuki ngokwelashwa
• Uba nezimpawu ezintsha

Akukho ukuvimbela okwaziwayo kwalesi simo.

Izifo ezivuthayo zamathumbu - i-ulcerative colitis; I-IBD - i-ulcerative colitis; I-colitis; I-Proctitis; I-proctitis enezilonda

• Ukudla kweBland
• Ukushintsha isikhwama sakho se-ostomy
• Uhudo - yini ongayibuza umhlinzeki wakho wezokunakekelwa kwempilo - umuntu omdala
• Ileostomy nengane yakho
• Ileostomy nokudla kwakho
• Ileostomy - ukunakekela i-stoma yakho
• Ileostomy - ukushintsha isikhwama sakho
• Ileostomy - ukukhishwa
• Ileostomy - yini ongayibuza udokotela wakho
• Ukukhishwa kwamathumbu amakhulu - ukukhishwa
• Ukuphila ne-ileostomy yakho
• Ukudla okuphansi kwe-fiber
• Ukukhishwa okuphelele kwe-colectomy noma i-proctocolectomy
• Izinhlobo ze-ileostomy
• I-ulcerative colitis - ukuphuma

• Colonoscopy
• Uhlelo lokugaya ukudla
• I-ulcerative colitis

IGoldblum JR, amathumbu amakhulu. Ku: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. URosai no-Ackerman's Pathology Yokuhlinzwa. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2018: isahluko 17.

UMowat C, uCole A, uWindsor A, et al. Imihlahlandlela yokuphathwa kwezifo ezivuthayo zamathumbu kubantu abadala. Isibindi. 2011; 60 (5): 571-607. I-PMID: 21464096 pubmed.ncbi.nlm.nih.gov/21464096/.

URubin DT, u-Ananthakrishnan AN, uSiegel CA, uSauer BG, uMD omude. Imihlahlandlela yemitholampilo ye-ACG: i-ulcerative colitis kubantu abadala. NginguJ Gastroenterol. 2019: 114 (3): 384-413. I-PMID: 30840605 kushicilelwe.ncbi.nlm.nih.gov/30840605/.

Ungaro R, Mehandru S, Allen PB, Peyrin-Biroulet L, Colombel JF. I-ulcerative colitis. I-Lancet. 2017; 389 (10080): 1756-1770. I-PMID: 27914657 pubmed.ncbi.nlm.nih.gov/27914657/.