Ama-syndromes ubuhlungu obukhulu obuhlelwe kabusha
I-proctalgia engapheli yisikhathi esiphelile. Libhekisela esimweni lapho umuntu abhekana khona nobuhlungu obuphindaphindiwe obubuhlungu obuncane bokungenani okungamaminithi angama-20, kungekho simo esithile esikwaziyo sokwakhiwa kwesimo sempilo noma esihlotshaniswayo sokubika ubuhlungu.
Leli gama lalisetshenziswa kuze kube yilapho i-Rome IV Criteria for Colorectal Disorders iqeda ngo-2016.
Kodwa-ke, cishe kungenzeka kubonakale ekuxilongweni nasekuhlukanisweni kuze kube yilapho ochwepheshe bezokwelapha beqala ukusebenzisa indlela entsha. Funda ukuthi kusho ukuthini leli gama nokuthi lishintshiwe kanjani.
Izinguquko ku-Definition of Proctalgia engapheli
Ngaphansi kwesimo seRoma III, i-proctalgia engapheli yahlukaniswa nobude bezinkomba zayo kusukela ku- proctalgia fugax , ekhonjiswe ubuhlungu obubukhali obunzima bokuzibulala obuhlala ngaphansi kwemizuzu engu-20. I-proctalgia engapheli yahlukaniswa ngokwengeziwe ku- levator ani syndrome , ekhonjiswe ukuzwela komzimba we-leverator uma kuthintwa ngesikhathi sokuhlolwa kwe-rectal ngodokotela, kanye nesifo esingenakulinganiswa sobuhlungu be-anorectal uma kungenaso isisa.
Lapho ucwaningo lungatholi amaqoqo ahlukene wezimpawu ze-proctalgia fugax ne-proctalgia engapheli, i-proctalgia yegama elingapheli yaqedwa eRoma IV. Kodwa-ke, izindlela ezisemqoka kanye nokukhetha kokwelashwa kuhluke kulezi zindlela zokuphatha kanye neRoma IV zihlanganisa ama-subtypes angaphansi kwe-proctalgia engapheli njengama-syndromes awo.
- I-Levator ani syndrome : Kulolu hlobo lwe-proctalgia engapheli, abantu babhekana nozwela ku-puborectalis (imisipha ngaphakathi kwekhanda lakho) uma kuthintwa ngesikhathi sokuhlolwa kwe-rectal udokotela.
- Ubuhlungu obungacacisiwe bokusebenza bokuzibulala : Leli fomu le-proctalgia elingapheli liyatholakala uma ungezwa ububele obunjalo ku-puborectalis uma kuthintwa ngesikhathi sokuhlolwa kwe-rectal.
- I-Proctalgia fugax : I-Rome IV ngezigaba zenze izinguquko ekuchazeni leli gama. Manje ubude obukhulu buyimaminithi angu-30 kunemizuzu engama-20 futhi indawo iseceleni kune-rectum noma i-anus.
Izimpawu
Izimpawu zala ma syndromes zivame ukuzwa njengento ephuthumayo yokuphumula noma ukuzwa okunjenge-pressure-rectum-okuvame ukuhlangenwe nakho ngaphezulu ngaphezulu kwe-rectum. Kungase kube nzima uma uhlezi isikhathi eside futhi kungase kube lula uma usukuma noma ulala phansi. Ukukhathazeka kungakhula njengoba usuku lugqoka kepha alufaneki ebusuku. Ubuhlungu bungase buzwe kaningi ngezikhathi ezilandelayo:
- Ukulandela ubulili
- Ukulandela ukunyakaza kwamathumba
- Phakathi nezikhathi zokucindezeleka.
- Ngesikhathi sokuhamba ibanga elide
Ukuxilongwa
Ngama-syndromes ayengama-subtypes we-proctalgia engapheli, ukukhubazeka kwamathambo okusebenza (i-FGD), ukuhlolwa kokuhlola kuyongelwa kuphela ukulawula ezinye izinkinga zempilo. Uma kungenjalo, odokotela bayothola ukuxilongwa ngokusekelwe ezimpawu ngokusho kwe-IV IV ye-FGDs:
- Ubuhlungu obuphuthumayo noma obuphindaphindiwe obubuhlungu noma obuhlungu
- Ukukhathazeka kumele kudlule okungenani imizuzu engu-30
- Ezinye izimbangela zokuhlukunyezwa komzimba (isakhiwo noma isistimu) kumele zikhishwe ngaphandle
- Izimpawu kumele zibe khona okungenani izinyanga ezintathu ngokuqala okungenani izinyanga eziyisithupha ngaphambi.
Ukuze ubone ukuthi kukhona i-levator ani syndrome, udokotela wakho kungenzeka enze uhlolo lwe-rectal ukuze avivinye ububele.
Izimbangela
Isizathu esiqondile salezi zimo okwamanje asiyazi. Esikhathini esidlule, kwakucatshangwa ukuthi lesi simo sasiwumphumela wokungaboni okungapheli noma ukuvuvukala kwemisipha ngaphakathi kwezemvelo , nakuba ukusekelwa kocwaningo lwale mbono kukhawulelwe. Olunye ucwaningo olusanda kuvela lukhomba ukuthi kunokwenzeka ukuthi i- dyssynergic defecation , isimo lapho imisipha yomgogodla ungaqhubeki ngendlela efanele ngayo.
Izinto ezingase zande ingozi yomuntu yokuthuthukisa lezi zindlela ezihlanganisa i-syndromes zifaka:
- Ukuhlinzwa okulinganayo
- Ukubeletha
- Ukuhlinzeka ngama-pelvic
- Ukuhlinza umgogodla
Kukhona futhi ubudlelwano phakathi kwe-proctalgia engapheli kanye namazinga aphezulu okucindezeleka nokukhathazeka kokukhathazeka. Kodwa-ke, akuyazi uma lezi zimpawu zomzwelo zandisa ingozi, noma ingumphumela wokuthola izibonakaliso zobuhlungu obungapheli.
Ukwelapha
I-Biofeedback manje iyindlela yokwelashwa ye-levator ani syndrome ngemuva kokuboniswa ucwaningo ukuze iphumelele kakhulu uma kuqhathaniswa nokugqugquzelwa kagesi komsele wamanzi kanye nokusikhipha imisipha ye-lever. Ukukhuthazwa kagesi kuye kwaboniswa ukuthi kuyasiza futhi kungasetshenziswa uma i-biofeedback ingatholakali. Lezi zindlela zokwelapha zishintsha izendabuko ezisetshenzisiwe, ezibandakanya ukusikhipha kwe-digital ye-leverator muscle, imisipha yokuphumula, kanye nokusetshenziswa kwamanzi okugeza , okwakubonisa ukuphumelela okulinganiselwe. Ukuhlinzwa akubhekwa njengokwelashwa okuphumelelayo kwe-proctalgia engapheli.
Imithombo:
> Chiarioni G, Asteria C, i-Whitehead W. I-proctalgia yansuku zonke kanye nezinkinga ezibuhlungu zemizimba ye-pelvic: Izincazelo ezintsha ze-etiologic kanye nokwelapha "I- World Journal of Gastroenterology 2011 17: 4447-4455.
> Schmulson MJ, uDrossman DA. Yini Entsha eRoma IV? I-Journal ye-Neurogastroenterology ne-Motility . 2017; 23 (2): 151-163. doi: 10.5056 / jnm16214.