Lesi simo sibangelwa ukungabi nokuphuma kwegazi kuya emathunjini amakhulu
I-Ischemic colitis yilapho ukugeleza kwegazi kuya emathunjini amakhulu kuphazanyiswa. Ukuguquka kwegazi okuqhubekayo emathunjini kuyadingeka ukugcina lezo zitho ziphilile, futhi uma ukugula noma ukulimala kubangela ukuthi imithwalo yegazi ivinjelwe noma iminyene, ingabangela ukuchotshozwa kwe-ischemic. I-Ischemic colitis ingenzeka kunoma yikuphi ubudala kodwa ivame kakhulu kubantu abangaphezu kweminyaka engama-60.
I-Ischemic colitis ivame ukuphathwa esibhedlela ngezinyathelo ezisekelayo, kodwa kwezinye izimo kungenzeka ukuthi kudingeke ukuba kuhlinzekwe. Esikhathini esiningi, i-ischemic colitis ihamba kancane ngokuhamba kwesikhathi, kodwa kwezinye izimo ingaqala ngokuzumayo (kube nzima). I-ischemic colitis enhle iyisimo esiphuthumayo sezokwelapha, yingakho kubalulekile ukubona udokotela ngokushesha uma kukhona ubuhlungu obukhulu besisu.
I-Ischemic colitis ayihlobene ne-ulcerative colitis, uhlobo lwesifo sofuba esiswini (IBD) . "I-Colitis" yigama elisho ukuvuvukala ekoloni, engabangelwa izifo nezimo ezihlukahlukene. I-Ischemic colitis, kodwa, ehlotshaniswa nesifo senhliziyo, nokugcina impilo enempilo ngokudla nokuzivocavoca kubalulekile ukunciphisa ingozi. Ezimweni eziningi, ischemic colitis iphathwa ngokuphumelelayo futhi ixazulula ezinsukwini ezimbalwa ngaphandle kwezinkinga. I-Ischemic colitis ngokuvamile ayikho futhi abantu balulame kahle.
Izimbangela ze-Ischemic Colitis
Kunezimbangela ezintathu eziyinhloko eziletha igazi emathunjini, okuthiwa imishanguzo ye-mesenteric. Igazi eline-oksijeni liyadingeka yizo zonke izitho zomzimba ukuze zisebenze kahle, futhi imishanguzo ye-mesenteric iyindlela ehlinzeka ngaleyogazi emathunjini. Uma lezi mithwashwane zivinjelwe noma zivinjelwe ngokuphelele, ukugeleza kwegazi kuncishisiwe (okubizwa ngokuthi i-infarction), futhi ukufa kweseli kungase kwenzeke emathunjini amakhulu (futhi ngezinye izikhathi amancane).
Kunezizathu ezimbalwa ezahlukahlukene zokuthi kungani imishanguzo ye-mesenteric ingavinjelwa:
- I-cholesterol ephakeme : Imishanguzo ye-mesenteric ingavinjelwa uma kunesakhiwo se-plaque ngaphakathi kwabo. I-plaque yenziwe nge-cholesterol, amafutha, imikhiqizo yamasheli eselula, i-calcium ne-fibrin. Uma i-plaque ivimbela imishanguzo kuyisimo esibizwa ngokuthi i-atherosclerosis. Kubantu abanesifo se-coronary or disease of vascular disease, isifo sokuqina kwesifo somzimba singumphumela ovamile we-ischemic colitis.
- I-clot yegazi : Enye imbangela ye-ischemic colitis i-clots yegazi. Lapho amaplatelet namaprotheni e-plasma egazini ehlangene ndawonye, angakha i-clot ekhulu ngokwanele ukuvimbela konke noma ingxenye yomthambo. Ama-blood clots angenzeka ngemuva kokulimala kodwa futhi ayinkimbinkimbi yezinye izifo nezimo eziningana futhi njengesenzakalo esibi semithi ethile.
- Ukuhlinzwa: Ukwelashwa emthini kungabangela izicubu ezinzima ukuba zenze. Kwezinye izimo, izicubu ezibomvu zingenzeka kangangokuba zivimbela ngaphakathi kwegazi.
- Ukusetshenziswa kwezidakamizwa: Kokubili i-cocaine ne-methamphetamine zihlotshaniswa ne-ischemic colitis. Lokhu kungenxa yokuthi lezi zidakamizwa zingabangela imithwalo yegazi ukuthi iminyane.
Izingozi Zezingozi
Ezinye zezinto ezibeka ingozi ngenxa ye-ischemic colitis zihlanganisa:
- Uneminyaka engaphezu kwengu-60
- Ukuhluleka kwenhliziyo ukulahla
- Isifo sikashukela
- Umfutho wegazi ophansi
- Imithi (nakuba ingavamile), kuhlanganise namagciwane, i-chemotherapy, ama-hormone (estrogen), imithi yokuxilonga ehlobene ne-IBS kanye ne-pseudoephedrine
- Ukuhlinzwa kwangaphambili ku-aorta
Izimpawu ze-Ischemic Colitis
Ngokujwayelekile, uphawu abantu abaningi abane-ischemic colitis abanalo ubuhlungu obusheshayo, obufana nesisu esiswini . Lolu buhlungu lungase lubonakale ngemuva kokudla futhi kungase kube nesisa esiswini. Ezimweni eziningi ubuhlungu buyamengcele, kepha uma imishanguzo evinjiwe ingakwesokudla kwesisu, ubuhlungu bungase bunzima. Lezi zimbhoshongo ezisemaceleni zisebenza emathunjini amakhulu kanye emathunjini amancane .
Uma kunomthelela omncane wamathumbu nge-ischemic colitis, isimo singase sibe buhlungu futhi sibe nengozi enkulu yezinkinga ezinkulu.
I-Ischemic colitis nayo ingabangela izitofu ezigazini, negazi libhekene nebala elibomvu elimhlophe. I-nausea, isifo sohudo, ukuhlanza, umkhuhlane, kanye nokuphuthumayo, okudingekayo njalo ukusebenzisa indlu yangasese kuyizinye izimpawu ezingase zibe khona ze-ischemic colitis.
Ukuthola Ischemic Colitis
Udokotela angase abone ukuthi i-ischemic colitis isekelwe ezintweni eziningana, kuhlanganise nomlando womzimba oqaphile kanye nemiphumela yezivivinyo ezithile. Ngoba i-ischemic colitis ivame ukubangela ezinye izimpawu ezifanayo ze-IBD (lezi zifomu ezimbili eziyinhloko njengesifo sikaCrohn kanye nesifo sokulonda kwesilonda), kufanele kunakekelwe ukuhlukanisa phakathi kwalezi zimo. Kwezinye izimo, ukuxilongwa kwe-ischemic colitis kungaba yinkinga ngoba izimpawu ziyafana nezinye izimo.
Ezinye izivivinyo ezingase zisetshenziswe ekwenzeni ukuxilongwa zihlanganisa:
- I-colonoscopy: I-colonoscopy iyimvivinywa lapho i-tube enokukhanya ekugcineni ifakwa ngaphakathi kwe-anus ukubona ngaphakathi emathunjini amakhulu.
- Iskena se-Computed tomography (CT) : I-CT scan iyinhlobo ye-x-ray esetshenziselwa ukubona izicubu nezitho esiswini.
- I-angiogram ye-Mesenteric: Phakathi nalesi sivivinyo, idayisi yokuphambene ijojowe eminye yemithambo ye-mesenteric, nge-groin endaweni. Ama-X-ray athathwa ukuze abone ngaphakathi kwe-artery.
- Isibalo segazi elimhlophe (i-WBC) : Ukubalwa kwamangqamuzana egazi omhlophe okuphakeme kunendlela evamile ukuthi kukhona ukuvuvukala emzimbeni okungase kuhlotshaniswe ne-ischemic colitis.
Ukwelapha i-Ischemic Colitis
Ukwelashwa kwe-ischemic colitis kuzoxhomeka ebukhulu besimo, ngesifo esiyingozi esidinga ukwelashwa okunamandla. Ezimweni lapho kubhekwa khona isimo somoya omnene, ukwelashwa kungase kube nenqubo yama-antibiotic, ukudla okunomsoco, uketshezi olunamandla, nokuphathwa kobuhlungu. Uma i-ischemic colitis itholakala ukuthi ibangelwa kwesinye isimo, leso simo esiyinkimbinkimbi sidinga ukwelashwa. Amakilasi athile emithi asetshenziselwa ukwelapha imithi ye-migraines noma isifo senhliziyo ingase igxile emithanjeni yegazi futhi ingadinga ukuba ishiyiwe isikhathi. Kulezi zimo ezinzima, i-ischemic colitis ingaxazulula ezinsukwini ezimbalwa.
Kwesinye, amacala amakhulu kakhulu, imishanguzo enjengalezo eziphula ama-blood clots (thrombolytics) nokukhulisa imishanguzo (vasodilators) ingasetshenziswa. Uma umcibisholo ungagcini, ukuhlinzekwa ukukhipha ukuvinjelwa kungenye ukwelashwa okungenzeka, kodwa lokhu kuvame ukusebenza kuphela uma ezinye izifo zingasebenzi. Uma kukhona i- perforation (imbobo) ekolonini, noma isigaba esincane (ukulinganisa) , ukuhlinzwa kungadingeka ukuze kulungiswe lezi zinkinga. Uma kukhona izicubu ekoloni efile, ukuhlinzwa kuzokwenziwa ukuze kususwe leso sigaba samathumbu ( ukubuyisana ).
Izwi elivela
I-Ischemic colitis iyayikhathazeka kakhulu kodwa izimo eziningi zixazululwa ezinsukwini ezimbalwa ngaphandle kokuphathwa kabi. Amacala amakhulu angadinga ukuhlinzwa kodwa abantu abaningi balulame kahle ngaphandle kwezinkinga. Noma yisiphi isikhathi kukhona ushintsho emikhondweni yemilenze, njengokungena endlini yokugezela kaningi noma kaningi kangako, kufanele kukhulunywe nodokotela. Igazi kulesi sikhumba noma ubuhlungu besisu, okuyinto indlela i-ischemic colitis eqala ngayo ngokuvamile, kufanele ihlale ihambela udokotela ukuze ithole ukuthi yini ebangela lezi zimpawu.
> Imithombo:
> Beck DE, de Aguilar-Nascimento JE. "Ukuphathwa Okuhlinzekwayo kanye Nomphumela We-Ischemic Colitis Elula." Ochsner J. 2011; 11: 282-285.
> Rania H, Mériam S, Rym E, Hyafa R, Amine A, Najet BH, uLassad G, Mohamed TK. "Ischemic colitis ngamaphuzu amahlanu: i-update 2013." I-Tunis Med 2014; 92: 299-303.