Isixazululo Esivamile Ngo-IBD, I-Arthritis Ithinta Ukulinganiselwa 25% Weziguli
Isifo samathumba esibhubhisayo (IBD) sihlotshaniswa nezinye izimo eziningana, kuhlanganise nesifo senhliziyo esiyinhloko se-sclerosing cholangitis , ama- fissures , i- fistula ne-arthritis. I-arthritis iyinkimbinkimbi evamile kakhulu yokunciphisa umzimba, ephazamisa ukulinganiselwa kwabangu-25% bazo zonke iziguli ze-IBD. Izinhlobo ezimbili ezivame kakhulu ze-arthritis ezitholwa iziguli ze-IBD ziyi-arthritis ye-peripheral kanye ne-axial arthritis.
Ngenxa yokuthi i-arthritis ivame kakhulu, kubalulekile ukuthi abantu abane-IBD banakekele izinhlungu nezinhlungu. Nakuba ubuhlungu obuningi buzobe bujwayelekile, kufanele bukhuliswe ekuqeshweni nodokotela bakho. Ukugcina amalunga ngendlela enempilo ngangokunokwenzeka nokugwema imisebenzi eyenza umonakalo, kanye nokuhlala phezu kwanoma yiziphi izinkinga uma zikhula, kubalulekile. Uma ubuhlungu buba nzima, kufanele kukhulunywe nge-gastroenterologist noma i-rheumatologist ngaphambi kokuqala imithi yokwelashwa, ngoba abantu abane-IBD bangadinga ukugwema izinhlobo ezithile zezidakamizwa (ikakhulukazi ama-NSAID, bheka ingxoxo ngezansi).
I-Peripheral Arthritis
I-arthritis ye-peripheral ivame kakhulu kubantu abane-ulcerative colitis noma isifo se-Crohn se- colon . Ezinhlobonhlobo ze-arthritis ezithinta abantu abane-IBD, kulinganiselwa ukuthi ama-60% kuya ku-70% athathwe yi-arthritis ye-peripheral. Ngokuvamile, inkambo ye-arthritis ilandela lokho ye-IBD, enezingxabano kanye nokuxoxisana ngokuhambisana.
Ayikho ivivinyo elilodwa elingakwazi ukuhlola i-arthritis ye-peripheral. Esikhundleni salokho, ukuhlolwa okuningi, njengokuhlolwa kwegazi, ukuhlaziywa kwamanzi okuhlangene , kanye nama- x-ray , kusetshenziselwa ukukhipha ezinye izimo ezingabangela izimpawu.
Izimpawu ze-arthritis ye-peripheral zifaka:
- Ubuhlungu obuhlangene
- Ukuvuvukala kwamalunga
- Ukugubha kwelinye lamalunga noma ngaphezulu
- Izimpawu ezihamba phakathi kwamalungu
I-arthritis ye-peripheral ivame ukuphazamisa isigqoko, isibindi, amadolo, ne-ankle. Uma ubuhlungu obuvela e-peripheral arthritis bungalashwa, bungadlulela ezinsukwini ezimbalwa ukuya emavikini; Nokho, ukulimala okungapheli kwamalungu akuvamile ukuthola.
Ukwelapha i-arthritis ye-peripheral ngokuvamile kuhilela ukuphumula amajoyini abuhlungu kanye ne-splints kanye nokushisa okumanzi okuvamile. Ukuzivocavoca okunqunywe umuthi wezitho zomzimba kusetshenziselwa ukuthuthukisa ukuhamba kokuhamba. Ngezinye izikhathi izidakamizwa ezingezona ukuvuvukala (ama-NSAID) asetshenziselwa ukunciphisa ubomvu, ukuvuvukala, nobuhlungu bezingxube ezivuthayo - kodwa ama-NSAID angathuthukisa izimpawu ze-IBD .
Enye indlela yokwelapha leli fomu le-arthritis ukulawula ukuvuvukala ekoloni ngenxa ye-IBD. Izimpawu ze-arthritis zivame ukwehlisa lapho i-IBD iqubuzela, futhi izidakamizwa eziningana ezisetshenziselwa ukwelapha i-IBD zingase zibe usizo nasemthonjeni we-arthritis. Iziguli ze-IBD ziphathwa nge- prednisone zivame ukuthola umphumela wokubambisana wezinhlungu ezihlangene. Iziguli ezithola izidakamizwa ze- anti- tumor necrosis factor-alpha (anti-TNF), njenge- Remicade (infliximab) noma i- Humira (adalimumab) , ukuphatha i-IBD yazo ingabuye ikwazi ukuthuthukisa izimpawu ze-arthritis.
I-Azulfidine (i-sulfasalazine) , i-5-Aminosalicylate imithi esekuyisikhathi eside isetshenziselwa ukuphatha i-IBD, ingase ihlinzeke ngokukhululeka kwesibiniso nakuba kungekho ubufakazi obukhulu bokusekela ukusetshenziswa kwayo. Esinye isidakamizwa esinqunyelwe ukuphatha i-IBD, methotrexate , singase sibe yindlela yokwelapha efanelekayo ye-arthritis ye-peripheral.
I-Axial Arthritis (i-Spondyloarthropathy)
Ezimweni ze-axial arthritis, izimpawu zingase zivele izinyanga noma iminyaka ngaphambi kokuqala kwe-IBD. Izimpawu zihlanganisa ubuhlungu nokuqina ezinhlangothini zekholomu yomgogodla eyisekuqaleni kakhulu ekuseni, kodwa izokwenza ngcono ngomsebenzi womzimba. I-axial arthritis esebenzayo isithinta kakhulu abantu abasha futhi ayifuni ukuqhubeka neziguli ezingaphezu kuka-40.
I-axial arthritis ingabangela ukuhlanganiswa kwamathambo ekholomu ye-vertebral. Le nkinga engapheli ingaholela ekunciphiseni ukuhamba okuhamba phambili nasemkhawulweni wokuqhuma umdanso owenza ikhono lokufiphala ngokujulile.
Umgomo wokwelashwa we-axial arthritis ukukhulisa ukuhamba komgogodla. Ukwelashwa ngokwemvelo, ukusebenzisa izivivinyo zangasese kanye nokwelula nokusebenzisa ukushisa okumanzi ngemuva, kukhona izinhlobo ezimbili ezivamile zokwelashwa. Ezinye iziguli zizuza ngokunakekelwa nge-NSAID.
Ukwelapha i-IBD ngokuvamile ayinamthelela kuloluhlobo lwe-arthritis; Kodwa-ke, imishanguzo ye-TNF ne-Azulfidine ingaba nenzuzo ethile ekunciphiseni izimpawu.
I-Ankylosing Spondylitis
I-ankylosing spondylitis (AS) iyindlela yokudla kwamathambo lapho amalunga emgogodleni nasesikhwameni ashaywa. NJENGOBA kubonakala kuthinta labo abanesifo sikaCrohn kaningi kunelabo abane-ulcerative colitis, kanye namadoda kaningi kunabesifazane. I-AS ibhekwa njengingavamile ngoba ithinta kuphela u-1% kuya ku-6% kulabo abane-IBD. Kukhona okungenzeka kube nesakhi sezakhi zofuzo ku-AS, kodwa yini ebangela ukuthi le fomu ye-arthritis ingakaziwa.
Ukuqala kwe-AS kuvame ukuhambisana nokulahlekelwa ukuguquguquka komgogodla ophansi. Ukwelashwa kufaka ukuphathwa kobuhlungu nokuvuselelwa ukuze kugcinwe ukuguquguquka komzimba. I-Remicade ne-Humira bayavunyelwa ukwelashwa kokubili i-IBD ne-AS, futhi ingase iphumelele ekuphatheni izimo zombili ngesikhathi esifanayo. I-Azulfidine ingase ibe usizo ekunciphiseni izimpawu, ikakhulukazi ukuqina kosuku. Ezinye izifundo zibonise i-methotrexate ukuthi iyasiza ku-AS, kanti abanye abakhombisi inzuzo; i-methotrexate ivame ukusetshenziswa ukuphatha i-AS ngokuhlanganiswa nezinye izidakamizwa. Kodwa-ke, ngisho nangokwelashwa, abanye abantu abane-AS basabonakaliswa uphawu, futhi amathambo omgogodla angahlangana ndawonye.
Imithombo:
I-Bourikas LA, i-Papadakis KA. "Ukubonakaliswa Kwama-musculoskeletal of Infmmatory Disease." Ngomhla ka-2009; 1915-1924. 21 Jan 2016.
U-Chen J, u-Liu C. "I-Sulfasalazine ye-spondylitis e-ankylosing." Database Cochrane Yokuhlolwa Okuhlelekile 2005: CD004800. 21 Jan 2016.
Kaufman I, Caspi D, Yeshurun D, Dotan I, Yaron M, Elkayam O. "Umphumela we-infliximab ngokubonakaliswa okungahambisani nokugula kwesifo sikaCrohn." I-Rheumatol Int Aug 2005; 25: 406-10. Epub 2004 Aug 12. 21 Jan 2016.
I-Orchard TR. "Ukuphathwa Kwe-Arthritis Kwabeziguli Eziphethwe Izifo Ezivuthayo." I-Gastroenterol Hepatol (NY) . 2012 Meyi; 8: 327-329. 21 Jan 2016.
UPeluso R, Atteno M, Iervolino S, et al. "I-Methotrexate ekwelapheni i-arthritis ye-peripheral in ulcerative colitis." Rheumatismo 2009 Jan-Mar; 61: 15-20. 21 Jan 2016.
van der Heijde D, Dijkmans B, Geusens P, et al. "Ukusebenza nokuphepha kwe-infliximab ezigulini ezine-spondylitis e-ankylosing: Imiphumela yelingo lokulawulwa kwe-placebo elilawulwa yi-placebo (ASSERT)." I-Arthritis & Rheumatism Feb 2005; 52: 582-591. 21 Jan 2016.
Yüksel I, Ataseven H, Başar O, Köklü S, et al. "I-Arthritis Yokuphazamiseka Ngendlela Yokudambisa Amathumba." Dig Dis Sci 11 Meyi 2010. 21 Jan 2016.