Ukwelashwa Okusha Nemithi Ye-Ulcerative Colitis

-Delile

• Ukwelashwa kwamanje
• Ama-Aminosalicylates
• Ama-Corticosteroids
• Ama-immunomodulators
• Abavimbeli be-TNF
• Ukuhlinzwa
• Izidakamizwa ezintsha
• I-Tofacitinib (Xeljanz)
• Ama-biosimilars
• Ukwelashwa okuphenywayo
• Ukufakelwa kabusha kwe-Fecal
• Ukwelashwa kwe-stem cell
• Ukuhlolwa kwemitholampilo
• Ukudla okudlela endlini

Ukubuka konke

Uma une-ulcerative colitis (UC), inhloso yokwelashwa ukumisa amasosha omzimba wakho ekuhlaseleni ulwelwesi lwamathumbu akho. Lokhu kuzokwehlisa ukuvuvukala okubangela izimpawu zakho, futhi kukufake ekuxolelweni. Udokotela wakho angakhetha ezinhlotsheni ezahlukahlukene zemithi ukukusiza ukufeza lezi zinhloso.

Eminyakeni embalwa edlule, isibalo semithi esetshenziselwa ukwelapha i-UC sikhuphukile. Abaphenyi bafunda ezinye izindlela zokwelashwa ezintsha futhi ezingathuthukiswa ekuhlolweni kwemitholampilo.

Ukwelashwa kwamanje

Izinhlobo ezimbalwa zemithi ziyatholakala ukwelapha i-UC. Udokotela wakho uzokusiza ukhethe eyodwa yalezi zindlela zokwelapha ngokususelwa ku:

• ubunzima besifo sakho (obumnene, obulinganiselayo, noma obukhulu)
• imiphi imishanguzo osuyithathile
• uphendule kahle kanjani kuleyo mithi
• impilo yakho yonke

Ama-Aminosalicylates

Leli qembu lezidakamizwa liqukethe isithako se-5-aminosalicylic acid (5-ASA). Kubandakanya:

• i-sulfasalazine (i-Azulfidine)
• i-mesalamine (Canasa)
• i-olsalazine (Dipentum)
• i-balsalazide (Colazal, Giazo)

Uma uthatha le mithi ngomlomo noma njenge-enema, iyasiza ukwehlisa ukuvuvukala emathunjini akho. Ama-aminosalicylates asebenza kangcono ku-UC omnene ukuya kokulingene, futhi angasiza ekuvikeleni ukuqhuma.

Ama-Corticosteroids

ICorticosteroids (izidakamizwa ze-steroid) icindezela amasosha omzimba ukwehlisa ukuvuvukala. Izibonelo zifaka:

• umabhebhana
• webhilo
• imethylprednisolone
• ebudeside

Udokotela wakho angahle anikeze enye yalezi zidakamizwa isikhathi esifushane ukwehlisa isibonakaliso sophawu. Akuwona umqondo omuhle ukuhlala kuma-steroids isikhathi eside, ngoba angadala izinkinga ezinjengoshukela wegazi ophakeme, ukuzuza kwesisindo, ukutheleleka, nokulahleka kwamathambo.

Ama-immunomodulators

Le mithi icindezela amasosha akho omzimba ukuwavimbela ukuthi abangele ukuvuvukala. Ungaqala ukuthatha omunye wale mithi uma ama-aminosalicylates engakusizanga izimpawu zakho. Izibonelo zama-immunomodulators zifaka:

• i-azathioprine (Azasan)
• I-6-mercaptopurine (6MP) (iPurinethol)
• i-cyclosporine (iSandimmune, iNeoral, abanye)

Abavimbeli be-TNF

Ama-block blockers we-TNF awuhlobo lomuthi we-biologic. I-biologics yenziwa ngamaprotheni afakwe izakhi zofuzo noma ezinye izinto zemvelo. Zisebenza ezingxenyeni ezithile zesistimu yakho yokuzivikela ezifela ukuvuvukala.

Izidakamizwa ezilwa ne-TNF zivimba amaprotheni omzimba omzimba abizwa nge-tumor necrosis factor (TNF) adala ukuvuvukala. Bangasiza abantu abane-UC elingene ngokulingene abanezimpawu ezingakathuthuki ngenkathi bekwezinye izidakamizwa.

Ama-block blockers we-TNF afaka:

• i-adalimumab (Humira)
• golimumab (Simponi)
• infliximab (i-Remicade)
• i-vedolizumab (Entyvio)

Ukuhlinzwa

Uma ukwelashwa okuzamile kungazange kulawule izimpawu zakho noma kuyeke ukusebenza, ungadinga ukuhlinzwa. Inqubo ebizwa nge-proctocolectomy isusa lonke ikholoni ne-rectum ukuvimbela ukuvuvukala okuqhubekayo.

Ngemuva kokuhlinzwa, ngeke ube nekholoni yokugcina imfucuza. Udokotela wakho ohlinzayo uzokwakha isikhwama ngaphandle komzimba wakho esibizwa nge-ileostomy, noma ngaphakathi komzimba wakho kusuka engxenyeni yamathumbu akho amancane (ileum).

Ukuhlinzwa kuyisinyathelo esikhulu, kepha kuzokhulula izimpawu ze-UC.

Izidakamizwa ezintsha

Eminyakeni embalwa edlule, kuye kwavela izindlela ezimbalwa zokwelashwa kwe-UC.

I-Tofacitinib (Xeljanz)

IXeljanz ingeyesigaba semithi esaziwa ngokuthi yiJanus kinase (JAK) inhibitors. Le mithi ivimba i-enzyme i-JAK, eyenza amaseli amasosha omzimba ukuthi akhiqize ukuvuvukala.

UXeljanz uvunyelwe kusukela ngo-2012 ukwelapha i-rheumatoid arthritis (RA), futhi kusukela ngo-2017 ukwelapha i-psoriatic arthritis (PsA). Ku-2018, i-FDA iphinde yavuma ukuthi yelaphe abantu abane-UC abanesilinganiso esiphansi abangaphendulanga kuma-block blockers we-TNF.

Lesi sidakamizwa yindlela yokuqala yokwelashwa ngomlomo yesikhathi eside ye-UC ephakathi. Ezinye izidakamizwa zidinga ukumnika noma ukujova. Imiphumela emibi evela ku-Xeljanz ifaka phakathi i-cholesterol ephezulu, ikhanda elibuhlungu, isifo sohudo, imikhuhlane, ukuqubuka kanye nama-shingles.

Ama-biosimilars

Ama-biosimilars ayisigaba esisha semithi esenzelwe ukulingisa imiphumela ye-biologics. Njenge-biologics, le mithi ihlose amaprotheni omzimba omzimba afaka isandla ekuvukeleni.

Ama-biosimilars asebenza ngendlela efanayo ne-biologics, kepha angabiza kakhulu. Kufakwa izinhlamvu ezine ekugcineni kwegama ukusiza ukuhlukanisa umuthi we-biosimilar kusuka ku-biologic yasekuqaleni.

I-FDA ivume ama-biosimilars amaningana we-UC eminyakeni embalwa edlule, kufaka phakathi:

• infliximab-abda (i-Renflexis)
• i-infliximab-dyyb (i-Inflectra)
• i-infliximab-qbtx (Ixifi)
• i-adalimumab-adbm (Cyltezo)
• adalimumab-atto (Amjevita)

Ukwelashwa okuphenywayo

Abaphenyi bahlala befuna izindlela ezingcono zokulawula i-UC. Nazi izindlela zokwelashwa ezimbalwa ezingaphansi kophenyo.

Ukufakelwa kabusha kwe-Fecal

Ukufakelwa kwe-fecal, noma ukufakelwa kwendle, kuyindlela yokuhlola ebeka amabhaktheriya anempilo kusuka esitokisini somnikeli kukholoni yomuntu one-UC. Umqondo ungazwakala ungathandeki, kepha amabhaktheriya amahle asiza ukwelapha umonakalo ovela ku-UC futhi abuyisele ibhalansi enempilo yamagciwane esiswini.

Ukwelashwa kwe-stem cell

Ama-stem cell amangqamuzana amancane akhula abe wonke amaseli nezicubu ezahlukahlukene emizimbeni yethu. Banamandla okuphulukisa zonke izinhlobo zomonakalo uma sibopha futhi sizisebenzisa kahle. Ku-UC, ama-stem cells angashintsha amasosha omzimba ngendlela esiza ukwehlisa ukuvuvukala nokuphulukisa ukulimala.

Ukuhlolwa kwemitholampilo

Odokotela banezindlela ezahlukahlukene zokwelashwa ze-UC kunanini ngaphambili. Noma kunezidakamizwa eziningi kangaka, abanye abantu banenkinga yokuthola eyodwa ebasebenzelayo.

Abaphenyi bahlala befunda izindlela ezintsha zokwelashwa ezivivinyweni zokwelashwa. Ukujoyina esinye salezi zifundo kungakunika ukufinyelela kumuthi ngaphambi kokuba utholakale emphakathini. Buza udokotela ophatha i-UC yakho uma isivivinyo somtholampilo endaweni yangakini singakulungela.

Ukudla okudlela endlini

Umbono wabantu abane-UC ungcono kakhulu namuhla, ngenxa yemithi emisha engathulisa ukuvuvukala kwamathumbu. Uma uzame isidakamizwa futhi akusizanga, yazi ukuthi ezinye izinketho zingathuthukisa izimpawu zakho. Phikelela, futhi usebenze eduze nodokotela wakho ukuthola ukwelashwa okuzokusebenzela ekugcineni.