I-Ulcerative Colitis

-Delile

• Buyekeza kwe-

Yini

I-ulcerative colitis yisifo samathumbu esivuthayo (IBD), igama elijwayelekile lezifo ezibangela ukuvuvukala emathunjini amancane nasekholoni. Kungaba nzima ukuxilonga ngoba izimpawu zayo zifana nezinye izifo zamathumbu kanye nolunye uhlobo lwe-IBD olubizwa ngokuthi i-Crohn's disease. Isifo sikaCrohn siyahluka ngoba sibangela ukuvuvukala kujule odongeni lwamathumbu futhi kungenzeka kwezinye izingxenye zesistimu yokugaya ukudla okuhlanganisa amathumbu amancane, umlomo, umminzo, nesisu.

I-ulcerative colitis ingenzeka kubantu banoma yibuphi ubudala, kepha imvamisa iqala phakathi kweminyaka eyi-15 nengama-30, futhi ingaphansi kaningi phakathi kweminyaka engama-50 nengama-70 ubudala. Ithinta abesilisa nabesifazane ngokulinganayo futhi ibonakala isebenza emindenini, ngemibiko efinyelela kuma-20% wabantu abane-ulcerative colitis enelungu lomndeni noma isihlobo esine-ulcerative colitis noma isifo sikaCrohn. Isigameko esiphakeme se-ulcerative colitis sibonakala kwabaMhlophe nakubantu bohlanga lwamaJuda.

Izimpawu

Izimpawu ezivame kakhulu ze-ulcerative colitis ubuhlungu besisu kanye nesifo sohudo esinegazi. Iziguli nazo zingathola

• I-anemia
• Ukukhathala
• Ukuncipha kwesisindo
• Ukuphelelwa isifiso sokudla
• Ukopha okweqile
• Ukulahlekelwa uketshezi lomzimba kanye nezakhamzimba
• Izilonda zesikhumba
• Ubuhlungu obuhlangene
• Ukwehluleka ukukhula (ikakhulukazi ezinganeni)

Cishe ingxenye yabantu okutholwe ukuthi bane-ulcerative colitis banezimpawu ezithambile. Abanye baba nemfiva kaningi, uhudo olunegazi, isicanucanu, kanye namajaqamba abuhlungu esiswini. I-ulcerative colitis ingase futhi ibangele izinkinga ezifana nesifo samathambo, ukuvuvukala kwamehlo, isifo sesibindi nesifo samathambo. Akwaziwa ukuthi kungani lezi zinkinga zenzeka ngaphandle kwekholoni. Ososayensi bacabanga ukuthi lezi zinkinga zingase zibe umphumela wokuvuvukala okubangelwa amasosha omzimba. Ezinye zalezi zinkinga ziyaphela lapho i-colitis yelashwa.

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Izimbangela

Imibono eminingi ikhona mayelana nokuthi yini ebanga i-ulcerative colitis. Abantu abane-ulcerative colitis banokuphazamiseka kwamasosha omzimba, kodwa odokotela abazi noma lokhu kuphazamiseka kuyimbangela noma kuwumphumela walesi sifo. Amasosha omzimba kukholakala ukuthi asabela ngendlela engavamile kumagciwane asemgudwini wokugaya ukudla.

I-ulcerative colitis ayibangelwa ukucindezeleka ngokomzwelo noma ukuzwela kokudla okuthile noma imikhiqizo yokudla, kepha lezi zinto zingadala izimpawu kwabanye abantu. Ukucindezelwa kokuphila nesilonda esilimaza ulcerative nakho kungaba nomthelela ekwandeni kwezimpawu.

Ukuxilongwa

Ukuhlolwa okuningi kusetshenziselwa ukuxilonga i-ulcerative colitis. Ukuhlolwa komzimba nomlando wezokwelapha ngokuvamile kuyisinyathelo sokuqala.

Ukuhlolwa kwegazi kungenziwa ukuze kuhlolwe i-anemia, okungakhombisa ukopha kukholoni noma i-rectum, noma kungahle kutholakale isibalo samaseli amhlophe aphakeme, okuwuphawu lokuvuvukala kwenye indawo emzimbeni.

Isampula yendle ingabuye iveze amaseli amhlophe egazi, okukhona kwawo okukhombisa ukulimala kolwelwesi noma isifo sokuvuvukala. Ngaphezu kwalokho, isampula yendle ivumela udokotela ukuthi abone ukopha noma ukutheleleka kukholoni noma i-rectum okubangelwa amagciwane, igciwane, noma izimuncagazi.

I-colonoscopy noma i-sigmoidoscopy yizindlela ezinembe kunazo zonke zokwenza ukuxilongwa kwe-ulcerative colitis nokulawula ezinye izimo ezingenzeka, njengesifo sikaCrohn, isifo se-diverticular, noma umdlavuza. Kuzo zombili izivivinyo, udokotela ufaka i-endoscope-ishubhu elide, eliguquguqukayo, elikhanyayo elixhunywe kukhompuyutha kanye ne-TV monitor-ethangeni ukuze abone ingaphakathi lekholoni kanye ne-rectum. Udokotela uzokwazi ukubona noma yikuphi ukuvuvukala, ukopha, noma izilonda odongeni lwekholoni. Ngesikhathi sokuhlolwa, udokotela angase enze i-biopsy, ehilela ukuthatha isampula yethishu olwelweni lwekholoni ukuze ayibuke ngesibonakhulu.

Kwesinye isikhathi ama-x-ray afana ne-barium enema noma ama-CT scan nawo asetshenziselwa ukuxilonga i-ulcerative colitis noma izinkinga zayo.

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Ukwelashwa

Ukwelashwa kwe-ulcerative colitis kuncike ebucayi besifo. Umuntu ngamunye ubhekana ne-ulcerative colitis ngendlela ehlukile, ngakho ukwelashwa kulungiswa umuntu ngamunye.

Ukwelashwa kwezidakamizwa

Umgomo wokwelapha ngezidakamizwa uwukunxenxa nokugcina ukuxola, kanye nokwenza ngcono izinga lempilo yabantu abanesifo sokuqaqamba kwamathumbu. Izinhlobo eziningana zemithi ziyatholakala.

• Aminosalicylates, izidakamizwa eziqukethe i-5-aminosalicyclic acid (5-ASA), zisiza ukulawula ukuvuvukala. I-Sulfasalazine iyinhlanganisela ye-sulfapyridine ne-5-ASA. Ingxenye ye-sulfapyridine ithwala i-anti-inflammatory 5-ASA iye emathunjini. Kodwa-ke, i-sulfapyridine ingase iholele emiphumeleni engathandeki efana nesicanucanu, ukuhlanza, isilungulela, isifo sohudo, kanye nekhanda elibuhlungu. Amanye ama-ejenti ama-5-ASA, afana ne-olsalazine, mesalamine, ne-balsalazide, anokuthwala okuhlukile, imiphumela emibi embalwa, futhi angasetshenziswa ngabantu abangakwazi ukuthatha i-sulfasalazine. Ama-5-ASA anikezwa ngomlomo, nge-enema, noma endaweni yokugcina izinto, kuya ngendawo yokuvuvukala kukholoni. Iningi labantu abane-ulcerative colitis emnene noma elinganiselayo baphathwa ngaleli qembu lezidakamizwa kuqala. Lesi sigaba semithi sisetshenziswa ezimweni zokubuyela emuva.

• Ama-Corticosteroids njenge-prednisone, i-methylprednisone, ne-hydrocortisone nayo inciphisa ukuvuvukala. Angase asetshenziswe abantu abane-ulcerative colitis emaphakathi kuya kokubi kakhulu noma abangaphenduli emithini engu-5-ASA. ICorticosteroids, eyaziwa nangokuthi i-steroids, inganikezwa ngomlomo, ngemithambo yegazi, ngokusebenzisa i-enema, noma nge-suppository, kuya ngendawo yokuvuvukala. Le mithi ingadala imiphumela emibi njengokuzuza kwesisindo, induna, izinwele ebusweni, umfutho wegazi ophakeme, isifo sikashukela, ukushintsha kwemizwelo, ukulahleka kwamathambo, kanye nengozi eyengeziwe yokutheleleka. Ngenxa yalesi sizathu, azinconywa ukuthi zisetshenziswe isikhathi eside, nakuba zibhekwa ziphumelela kakhulu uma zimiselwe ukusetshenziswa kwesikhashana.

• Ama-immunomodulators njenge-azathioprine ne-6-mercapto-purine (6-MP) inciphisa ukuvuvukala ngokuthinta amasosha omzimba. Le mithi isetshenziselwa iziguli ezingaphendulanga kuma-5-ASAs noma ama-corticosteroids noma ancike kuma-corticosteroids. Ama-immunomodulators anikezwa ngomlomo, kodwa-ke, asebenza kancane futhi kungathatha izinyanga eziyisi-6 ngaphambi kokuthi kuzwakale inzuzo ephelele. Iziguli ezithatha le mithi zibhekelwa izinkinga ezibandakanya i-pancreatitis, i-hepatitis, ukwehla kwesibalo segazi elimhlophe, kanye nengozi eyengeziwe yokutheleleka. I-Cyclosporine A ingasetshenziswa ne-6-MP noma i-azathioprine ukwelapha i-ulcerative colitis esebenzayo, enamandla kubantu abangaphenduli kuma-corticosteroids afakwa emithanjeni.

Eminye imishanguzo inganikezwa ukuphumuza isiguli noma ukuqeda izinhlungu, isifo sohudo noma ukutheleleka.

Ngesinye isikhathi, izimpawu ziba nzima ngokwanele ukuthi umuntu kufanele alaliswe esibhedlela. Ngokwesibonelo, umuntu angase ophe kakhulu noma akhishwe isisu esibi esibangela ukuphelelwa amanzi emzimbeni. Ezimweni ezinjalo udokotela uzozama ukunqanda uhudo nokulahleka kwegazi, uketshezi, nosawoti wamaminerali. Isiguli singadinga ukudla okukhethekile, ukondla ngomthambo, imithi, noma kwesinye isikhathi ukuhlinzwa.

Ukuhlinzwa

Cishe amaphesenti angu-25 kuya kwangu-40 eziguli ezinesifo sokuqaqamba kwamathumbu kufanele ekugcineni akhishwe amakholoni ngenxa yokopha okukhulu, ukugula okunzima, ukugqabuka kwekholoni, noma ingozi yomdlavuza. Kwesinye isikhathi udokotela uzoncoma ukuthi kususwe ikholoni uma ukwelashwa kwehluleka noma uma imiphumela emibi ye-corticosteroids noma ezinye izidakamizwa zisongela impilo yesiguli.

Ukuhlinzwa ukususa ikholoni kanye ne-rectum, okwaziwa nge-proctocolectomy, kulandelwa okukodwa kwalokhu okulandelayo:

• I-ileostomy, lapho udokotela ohlinzayo enza khona imbobo encane esiswini, ebizwa ngokuthi i-stoma, bese enamathisela ekugcineni kwethumbu elincane, elibizwa ngokuthi ileum, kuyo. Udoti uzohamba emathunjini amancane futhi uphume emzimbeni nge-stoma. I-stoma icishe ilingane nekota futhi imvamisa itholakala engxenyeni engezansi yesisu esiswini eduze kwebhande lomugqa. Isikhwama sigqokwa ngaphezu komnyango wokuqoqa imfucuza, futhi isiguli sithulula isikhwama lapho kudingeka.

• I-anastomosis ye-ileoanal, noma ukusebenza kokudonsa, okuvumela isiguli ukuba sibe nokunyakaza okuvamile kwamathumbu ngoba kugcina ingxenye yendunu. Kulokhu kuhlinza, udokotela ohlinzayo ususa ikoloni nengaphakathi le-rectum, ashiye imisipha yangaphandle ye-rectum. Udokotela ohlinzayo ube esenamathisela i-ileum ngaphakathi kwe-rectum ne-anus, kwakheke isikhwama. Ukusingathwa kugcinwa esikhwameni bese kudlula endunu ngendlela ejwayelekile. Ukukhipha amathumbu kungase kuvame futhi kube namanzi kunangaphambi kwenqubo. Ukuvuvukala kwesikhwama (pouchitis) kuyinkinga engaba khona.

Izinkinga ze-ulcerative colitis

Cishe amaphesenti ama-5 abantu abane-ulcerative colitis baba nomdlavuza wekoloni. Ingozi yomdlavuza iyanda ngesikhathi sokugula nokuthi ingakanani ikholoni elimele. Isibonelo, uma kuhileleke kuphela ikholoni elingaphansi kanye nengxwaba, ingozi yomdlavuza ayiphakeme kunejwayelekile. Kodwa-ke, uma kuhlanganiswa lonke ikholoni, ingozi yomdlavuza ingaba izikhathi eziphindwe ngama-32 kunesilinganiso esijwayelekile.

Ngezinye izikhathi izinguquko eziyingozi zenzeka kumaseli ahlanganisa ikholoni. Lezi zinguquko zibizwa nge- "dysplasia." Abantu abane-dysplasia banamathuba amaningi okuba nomdlavuza kunalabo abangenawo. Odokotela babheka izimpawu ze-dysplasia lapho benza i-colonoscopy noma i-sigmoidoscopy nalapho behlola izicubu ezisuswe phakathi nalokhu kuhlolwa.

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