I-IBD eqhelekileyo yile:
• I-Ulcerative colitis (YAK) - ithintela intumbu enkulu, ngokuqhelekileyo isuka kwi-rectum;
• Isifo sika-Crohn - sinokuchaphazela nayiphi na inxalenye yesisu esiswini: ukusuka emlonyeni womlomo ukuya kwi-anus. Kwinkqubo yokuvuvukala, ububanzi bodonga lwamathumbu buvame ukubandakanya.
Izizathu kunye nokuxhatshazwa
Nangona inani elikhulu lophando lwezenzululwazi, izizathu zokuphuhliswa kwe-VZK azizange zicaciswe ngokupheleleyo. Ngokweminye imfundiso, izifo-gciwane ze-IBD ziyi-virus okanye ibhaktheriya ezangena emathunjini kwindawo engqongileyo kwaye zikhuphe isifo esiphezulu se-intestinal microflora. I-ulcerative colitis ibhaliswe kuwo onke amazwe ehlabathini, ukuxhaphaka kwayo kukho amacala angama-50-80 ngamawaka angamawaka ayi-100. Esi sifo sichaphazela abantu banoma yiphina ubudala, kodwa iqela elidala leminyaka eli-15 ukuya kwe-40 lihleleleke kuyo. Izinga lomlinganiselo phakathi kwamadoda nabasetyhini lifana ngokufanayo. Kwimizuzu engama-15 yezigulane, izihlobo eziseduze (abazali, umzalwana okanye udade) nazo zihlupheke kwesi sifo. Ngokutsho kophando, zibini kwisithathu sezigulane ezine-Crohn's disease smoke. Ukubhema kukuphela kwento eqinisekisiwe yendalo yangaphandle echaphazela iziganeko ze-IBD. Kwamazwe athuthukileyo, ukusabalalisa kwesifo sikaCrohn kungama-30-4-0 kwiimeko ezingama-100 zabantu. Isifo sikaCrohn kunye nesifo se-ulcerative colitis sibonakala ngekhosi ephindaphindiweyo (iziqendu zesifo esilandelayo zilandelwa zihlandlo zokuhamba kwe-asymptomatic flow). Ukunyamezela kunye neentsholongwane zentsholongwane yizona zihlandlo eziphindaphindiweyo zokuphindaphinda.
Iimpawu eziqhelekileyo zesifo sezilonda zesilonda:
• Ukufisa ukunyanzelisa isisombululo esininzi;
• ukuxutyushwa kwegazi okanye i-mucus emanzini;
• ubuhlungu besisu esiswini, ukunciphisa emva kokuchaswa;
• i-malaise jikelele kunye nokukhathala;
• umkhuhlane kunye nokulahleka kwesidlo.
Izibonakaliso zesifo sikaCrohn zihlukile. Oku kuyingxenye ngenxa yokuba nayiphi na inxalenye yesondlo sesisu kunokuchaphazeleka kwesi sifo. Xa isifo sikaCrohn singabonwa:
• isitifiketi esilahlayo kunye nokudibanisa kwegazi;
• ukutyumza intlungu kwisisu;
• ukulahleka kwesisindo;
• Isifo sesisu, ngamanye amaxesha siholele emathunjini omzimba;
• ukwakheka kwe-fistula (amalunga engavumelekanga phakathi kwamalungu apho izitho zangaphakathi zamathumbu zingena emagqabini athile, umzekelo, kwi-vestile okanye kwisisu).
Ukongezelela, isifo sikaCrohn sinokuchaphazela umlenze womlonyeni womlomo, amajoyina, izitho ezingaphantsi. Ezinye izigulane zidibanisa ukukhushulwa kwesi sifo ngokusetyenziswa kokutya okuthethile, kodwa akukho nto yokutya ekhuthazwa kwizigulane ezine-IBD. Ukuxilongwa kwesiphi na isifo seqela le-IBD ngokuqhelekileyo kusekelwe kwiinkcukacha zebhubhoratri kunye nokuhlolwa kwesigulane. Emva kokuqokelela ngokucophelela uvavanyo lwe-anamnesis kunye nokuhlolwa ngokusemzimbeni jikelele, kubandakanywa novavanyo lomunwe lwe-rectum, i-renumeroscopy ivame ukunikezelwa, evumela ukuhlolisisa umgangatho wangaphakathi we-rectum kunye nengxenyana engezantsi yamathumbu amakhulu. Ekufezeni lo vavanyo, isistim esizodwa (sigmoidoscope) sifakwe kwi-anus, kukuvumela ukuba uhlolisise i-mucosa yamathumbu kwaye uthathe isampuli yamathambo kwiimviwo ezincinci.
Isicwangciso soPhando
Kungakhathaliseki ukuba iziphumo ze-sigmoidoscopy, ezi zifundo zilandelayo ziqhutyelwa:
• iimvavanyo zegazi (kubandakanywa nobukho bamakishi ophulo lwenkqubo);
• Imifanekiso yeengxwaba zamathumbu usebenzisa i-enum ye-barium. Ngomhla ubathumbu luchithwe nge-laxative. Ngomhla wokufundwa, isisombululo se-barium senziwa ngokusebenzisa i-rectum, into ebonakalayo ye-X-ray, evumela ukuba ichonge indawo yokuvuvukala okanye ukunciphisa intumbu. Xa ukhunjulwa ngesifo sikaCrohn, umgudu ophezulu wamathumbu uphinde uhlolwe. Kule meko, isigulane sithatha ukumiswa kwe-barium ngaphakathi, okwenza kube lula ukujonga ngeso silwanyana esiswini;
• I-colonoscopy. Kule sifundo, isisombululo esikhulu se-endoscopic esinomthombo wokukhanya senziwa ngokusebenzisa i-anus kwaye ivumela ukuhlolwa kwe-mucosa yamathumbu amakhulu kunye ne-rectum. Ngoncedo lwawo, awukwazi ukuhlola kuphela indawo zamathumbu ezingenakufikeleleka nge-sigmoidoscopy, kodwa nangona kunyanzelekile, ukuqhuba i-biopsy yamathambo. Ukuba ukrokrela ukutshatyalaliswa emathunjini angaphezulu, olunye uhlobo lweemviwo zokugqibela lubekwe: gastroduodenoscopy. Ekufezeni le nkqubo, i-endoscope ekhethekileyo, ebizwa ngokuba yi-gastroscopy, ifakwe kwi-esophagus ukuya kwisisu kunye ne-duodenum. I-Gastroscope i-flexible fiber optic tube evumela ukuba uhlole zonke izitho zesisu. Umfanekiso udluliselwa kwiseva yesikrini. Le ndlela isetyenziselwa ukuxilongwa kwe-IBD kunye neenkqubo zokucoca ezincinci. Izindlela zokonyango ze-IBD ziyahlukahluka ekuthathweni komlomo kwezilungiso ze-steroid ukungenelela kwongxamnye, okusetyenziswa kwiimeko ezinzima. Nangona kungenakwenzeka ukunyanga okupheleleyo, ezininzi izigulane ziyakwazi ukuqhuba ubomi obusebenzayo. Emva kokuxilongwa kwe-IBD, isigulane siyabonwa kunye ne-gastroenterologist, ngokuqhelekileyo kwindawo yokuhlala.
Unyango nge steroids
Ukususa ukuvuvukala nokuxilisa kwe-IBD kunika izidakamizwa ze-steroid ngendlela yamacwecwe, i-enemas okanye i-suppositories. Izigulane zihlala zinoyika ukutyunjwa kwe-steroids, zikholelwa ukuba ezi zinto zingabangela imiphumo engafunekiyo, ingakumbi ngokufumana ixesha elide. Imiphumo emibi yalezi ziyobisi kubandakanya ukubunjwa kobuso obunjengeenyanga, ukuzuza ubunzima, ubuthathaka bemisipha yomzimba kunye nokunyuswa kwengcinezelo yegazi. Imiphumo emibi yesizukulwana esitsha se-steroids ingenakuchazwa kancinci, nangona kunjalo, akufuneki ukuba uyeke ngokukhawuleza ukuthatha, njengoko umzimba uthatha ixesha lokubuyisela isigqi salo semveliso ye-hormone ye-steroid.
Ukususwa kwesibindi
Emva kokupheliswa kweempawu zokuqala zesifo, ama-5-aminosalicylic acid acreative preparations (ngendlela ye-monotherapy okanye ngokudibanisa ne-steroids) yakha isiseko sonyango lwe-IBD. Ziquka i-sulfasalazine, i-mesalazine ne-olsalazine. Ulawulo lwawo luvimbela ukuphindaphinda kwesi sifo, ngaloo ndlela unikeze ukuxolelwa okuzinzile. Ezi zi yobisi zingasetyenziselwa ngendlela yamacwecwe, i-enemas okanye ikhandlela kwaye ayinayo inyathelo enonya njengeSteroids. Iziphumo eziqhelekileyo zeziphumo zeli qela ziquka ukuncwina, ukugqithisa, intloko kunye nokuphelelwa kwegazi. Ukufumanisa ukunyamezela kwabo, isiguli sihlolisiswa rhoqo ngegazi. Esinye isilwanyana esinomtsalane onamandla wokuqhaqhayisa i-azathioprine. Isetyenziselwa ukunyamezela ukunyamezeleka kokunciphisa umthamo we-steroids, kunye nezigulane ezine-IBD ezilawulwa nzima. Xa uthatha le chiza, kufuneka ubeke iliso rhoqo kwiibalo zegazi. Ipesenti encinci yezigulane ezine-IBD zifuna unyango. Ukuba isicwangciso sokwelapha esaneleyo asihambelwanga, ukungenakwenzeka kwongenelelo lokungenelela kunyuka.
Iifom ezinzima
Ngaphandle kwe-ulcerative colitis, izibonakaliso zonyango lotyando lwenzeka kwi-30% yezigulane. Unyango oluphandwayo luyimfuneko xa kungenakwenzeka ukucima ukwanda okukhulu nangokunceda amayeza aphezulu, kunye nokunciphisa okukhulu kumgangatho wobomi wobomi. Ukongezelela, usebenzayo kufuneka ukuba iimpawu zangaphambili zenkqubo enobungozi emathunjini zifunyenwe.
Iintlobo zemisebenzi
Kwi-Crohn's disease, unyango oluphambili lujoliswe ekupheliseni iingxaki ngokususa iindawo ezichaphazelekayo zamathumbu. Ngezona zigulane ezine-ulcerative colitis, ukukhetha okukhethiweyo yinto ebizwa ngokuba yi-protocollectomyomy, ehlanganisa ukukhupha ingxenye yamathumbu amakhulu kwaye yenze "ipokhethi" ukusuka kumathumbu emathunjini axhunyiwe yi-anastomosis kwi-anus. Umsebenzi uqhutyelwa ngamanyathelo amabini, ngokungafani ne-colectomy, apho intumbu enkulu kunye nesigxina sisuswa ngokukodwa, kwaye ukugqithiswa kwe-stool kwenziwa nge-ileostoma kwisigxobo esikhethekileyo. Ukunyanga okwaneleyo kwenza ukuba kukwazi ukulawula ngempumelelo ikhosi ye-IBD kwizigulane ezininzi, kodwa ezi zifo aziphilwanga. Kwizigulane ezinjalo, phantsi kweemeko ezithile, umngcipheko wokuvelisa izicubu ezinzima zamathumbu zanda.
Umngcipheko wokuba nomhlaza wecolon okanye i-rectum iyanda ngokubandakanyeka kwamathumbu onke (okanye inxalenye enkulu) kwinkqubo yokuvuvukala, kunye nokwanda kweso sifo. Umngcipheko wenkqubo enobungozi inokuncitshiswa ngokudlula i-colonoscopy, evumela ukufumana utshintsho olusesikweni kwangoko. Kubalulekile ukuba uqaphele ukuba kwizigulane ezine-IBD ezintle, ziphantsi kakhulu. Kunqabile kakhulu, utshintsho olubi luvela kwimvelaphi yesifo sikaCrohn, esenza ngaphandle kokutshatyalaliswa kwamathumbu amakhulu.
Forecast
Ii-IBD zibonakaliswa yinkqubo engapheliyo, kwaye ukubonakaliswa kwazo kwisigulane ngasinye. Kwisigaba esisebenzayo, eso sifo singabangela ukungathandeki okukhulu, kodwa ngokukhetha okufanelekileyo kwonyango lweziyobisi, ngokuqwalasela iziganeko zesigaba sesi sifo, ezininzi izigulane zigcina amandla okusebenza ngokupheleleyo, nangona kungenakwenzeka kokunyanga okupheleleyo. Ngethuba lexesha lokuxolelwa, isigulane esinesi-IBD singakhokelela ubomi obuqhelekileyo. Phakathi kwezigulane kukho uluvo lokuba ukugqithisa kwe-IBD kubonakala "kumathambo", okungahambi kakuhle. Enyanisweni, ukuphindaphinda kwesi sifo kunokukhokelela ekuphazamiseni okukhulu kunye nokudandatheka, ngakumbi xa isigulane sinyanzeliswa ukuba sivame ukutyelela indlu yangasese. Ngako oko, ngexesha lokuxhatshazwa, uvelwano kunye nokuqonda kwinqanaba lamalungu entsapho kunye nabalingane kubaluleke kakhulu. Kuba ibhinqa liceba ukukhulelwa, ithuba lokukhulelwa liphezulu ngelixa ukuxolelwa. Ngexesha lokukhulelwa, kunokubakho ukugqithisa kwesi sifo, kodwa ngokuqhelekileyo kuvela kwifomu engekho nzima kwaye uphendule kakuhle kunyango lweziyobisi. Umlinganiselo wenzuzo kunye nomngcipheko wokuthatha i-steroids ngexesha lokukhulelwa kuqikelelwa njengento efanelekileyo, ekubeni amathuba okuphuhlisa iziphumo ezichaphazelekayo ngeli xesha liphantsi ngokwaneleyo.