Isifo sokuqina kwesibindi esiyinhloko

Amapayipi e-bile amashubhu ahambisa i-bile kusuka esibindini iye emathunjini amancane. Inyoni yinto esiza ngokugaya. Yonke imibhobho yenyongo ndawonye ibizwa ngokuthi yi-biliary tract.

Lapho ama-bile ducts evuvukala noma evuvukala, lokhu kuvimba ukugeleza kwenyongo. Lezi zinguquko zingaholela ekulimaleni kwesibindi okuthiwa i-cirrhosis. Lokhu kubizwa ngokuthi yi-biliary cirrhosis. I-cirrhosis esezingeni eliphakeme ingaholela ekuhlulekeni kwesibindi.

Imbangela yamapayipi e-bile avuthayo esibindi ayaziwa. Kodwa-ke, i-cirrhosis eyinhloko ye-biliary iyisifo esizimele. Lokho kusho ukuthi amasosha omzimba wakho ahlasela ngephutha izicubu ezinempilo. Lesi sifo singaxhunyaniswa nokuphazamiseka okuzenzakalelayo njenge:

• Isifo seCeliac
• Umkhuba kaRaynaud
• I-Sicca syndrome (amehlo owomile noma umlomo)
• Isifo sendlala yegilo

Lesi sifo sivame ukuthinta abesifazane abaneminyaka ephakathi nendawo.

Abantu abangaphezu kwesigamu abanazo izimpawu ngesikhathi sokuxilongwa. Izimpawu zivame ukuqala kancane. Izimpawu zokuqala zingafaka:

• Isicanucanu nobuhlungu besisu
• Ukukhathala nokuphelelwa amandla
• Amafutha afakwa ngaphansi kwesikhumba
• Indle enamafutha
• Ukulunywa
• Ukudla okungekuhle nokulahlekelwa isisindo

Njengoba ukusebenza kwesibindi kubi, izimpawu zingafaka:

• Ukwakhela oketshezi emilenzeni (edema) nasesiswini (ascites)
• Umbala ophuzi esikhunjeni, ulwelwesi lwamafinyila, noma amehlo (i-jaundice)
• Ububomvu ezintendeni zezandla
• Emadodeni, ukungabi namandla, ukuncipha kwamasende, nokuvuvukala kwamabele
• Ukulimala okulula nokopha okungavamile, imvamisa kusuka emithanjeni evuvukile emgudwini wokugaya ukudla
• Ukudideka noma izinkinga zokucabanga
• Izitulo ezinombala ophuzi noma ezinobumba

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba.

Ukuhlolwa okulandelayo kungabheka ukubona ukuthi isibindi sakho sisebenza kahle yini:

• Ukuhlolwa kwegazi le-albhamu
• Ukuhlolwa kokusebenza kwesibindi (i-serum alkaline phosphatase ibaluleke kakhulu)
• Isikhathi se-Prothrombin (PT)
• Ukuhlolwa kwegazi le-cholesterol ne-lipoprotein

Olunye uvivinyo olungasiza ukukala ukuthi izifo zesibindi ezinzima zingaba kanjani:

• Izinga eliphakeme le-immunoglobulin M egazini
• I-biopsy yesibindi
• Ama-anti-mitochondrial antibodies (imiphumela inhle ngamacala angama-95%)
• Izinhlobo ezikhethekile ze-ultrasound noma i-MRI elinganisa inani lezicubu ezibomvu (kungabizwa nge-elastography)
• Imagnetic resonance cholangiopancreatography (MRCP)

Inhloso yokwelashwa ukunciphisa izimpawu nokuvimbela izinkinga.

I-Cholestyramine (noma i-colestipol) inganciphisa ukulunywa. I-Ursodeoxycholic acid ingathuthukisa ukususwa kwenyongo egazini. Lokhu kungathuthukisa ukusinda kwabanye abantu. Umuthi omusha obizwa nge-obeticholic acid (Ocaliva) nawo uyatholakala.

Ukwelashwa kokufakwa esikhundleni kukavithamini kubuyisa amavithamini A, K, E no-D, alahleka ezitulweni ezinamafutha. Isengezo se-calcium noma eminye imithi yamathambo ingangezwa ukuvimbela noma ukwelapha amathambo abuthakathaka noma athambile.

Ukuqapha isikhathi eside nokwelashwa kokuhluleka kwesibindi kuyadingeka.

Ukufakelwa kwesibindi kungaphumelela uma kwenziwa ngaphambi kokuhluleka kwesibindi.

Umphumela ungahluka. Uma lesi sifo singelashwa, abantu abaningi bazofa ngaphandle kokufakelwa kwesibindi. Cishe ikota eyodwa yabantu abanesifo iminyaka eyishumi bazoba nokuhluleka kwesibindi. Odokotela manje sebengasebenzisa imodeli yezibalo ukubikezela isikhathi esihle sokwenza ukufakelwa. Ezinye izifo, njenge-hypothyroidism ne-anemia, nazo zingakhula.

Ukuqina kwesibindi kungaholela ekuhlulekeni kwesibindi. Izinkinga zingafaka:

• Ukopha
• Ukulimala ebuchosheni (encephalopathy)
• Ukungalingani kwe-Fluid ne-electrolyte
• Ukuhluleka kwezinso
• I-Malabsorption
• Ukungondleki
• Amathambo athambile noma abuthakathaka (i-osteomalacia noma i-osteoporosis)
• Ama-Ascites (i-fluid buildup esiswini sesisu)
• Ingozi eyengeziwe yomdlavuza wesibindi

Shayela umhlinzeki wakho uma une:

• Ukuvuvukala kwesisu
• Igazi ezitulweni
• Ukudideka
• I-jaundice
• Ukulunywa kwesikhumba okungapheli futhi akuhlobene nezinye izimbangela
• Kuhlanza igazi

I-cholangitis eyinhloko ye-biliary; I-PBC

• I-cirrhosis - ukukhipha

• Uhlelo lokugaya ukudla
• Indlela yeBile

I-Eaton JE, uLindor KD. I-primary biliary cholangitis. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 91.

UFogel EL, uSherman S. Izifo ze-gallbladder ne-bile ducts. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 146.

Izibani LW. Isibindi: izifo ezingenayo i-neoplastic. Ku: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. URosai no-Ackerman's Pathology Yokuhlinzwa. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2018: isahluko 19.

USmith A, Baumgartner K, Bositis C. Cirrhosis: ukuxilongwa nokuphathwa. Ngingudokotela Womndeni. 2019; 100 (12): 759-770. I-PMID: 31845776 pubmed.ncbi.nlm.nih.gov/31845776/.