Ochwepheshe abaningi bathi yebo, udinga inqubo yokwelashwa okufanele
Uma ufuna isifo se-celiac ejwayelekile ngegolide, u-yebo, ochwepheshe abaningi bayavuma ukuthi uzodinga ukuthi ube ne-endoscopy ne-biopsy, noma ngabe ukuhlolwa kwegazi le-celiac kuqinisile . Kodwa kukhona okusobala ukuthi kukhona ukuphikisana okuzungezile le ncomo, kanti odokotela abambalwa manje bathi kungenzeka ukuxilonga isifo se-celiac ngaphandle kwenqubo.
Inqubo yokuhlola isifo se-celiac ngokuvamile iqala ngokuhlolwa kwegazi ukuthi isikrini sesifo se-celiac. Lezi zivivinyo zifuna ama-antibodies ukuba abe ne-gluten ejikeleza kakhulu egazini lakho uma unesimo.
Uma lezo zivivinyo zibuya zihle (noma kwezinye izimo, uma zingenakulungiswa kodwa wena nodokotela wakho usalokhathaza isifo se-celiac), udokotela wakho uzokutusa ukuthi uqinisekise isifo se-celiac ukuxilongwa nge-biopsy yamathumbu. Ukufeza lokho, uzodinga ukuqoqa amasampula amancane emathumbu amancane ukuze ahlolwe ngenqubo ebizwa ngokuthi i- endoscopy .
Uma lezo zampula zamathumbu, ezihlolwe ngaphansi kwe-microscope, zibonisa ukulimala kwamathumbu emathunjini okuthiwa yi- atrophy ene-villous , khona-ke uzobe uthola ukuthi unesifo se-celiac.
Ezinye izazi zikholelwa ukuthi i-Endoscopy ayidingekile
Yiqiniso: abacwaningi abaningi be-celiac sifo bathi awudingi ngempela i-biopsy yokuthola isifo se-celiac.
Isibonelo, uDkt. Alessio Fasano, umqondisi weCent for Celiac Research eMassachusetts General Hospital, uthi udinge kuphela izici ezine eziyisihlanu zokuthola isifo se-celiac. Izici ezinhlanu uDkt. Fasano uthi:
- izimpawu zesifo se-celiac
- imiphumela emihle kakhulu kwi- tTG-IgA ekhethekile ye-celiac kanye nokuhlolwa kwegazi kwe- EMA-IgA
- imiphumela emihle yokuhlola izakhi zofuzo
- i-endoscopy ne-biopsy ebonisa i-atrophy enonya
- ukuxazulula izimpawu ekudleni okungenalo i-gluten
Ngombono kaDkt. Fasano, uma unayo yonke into ohlwini ngaphandle kwemiphumela emihle ye-biopsy kusukela endoscopy, khona-ke ungakwazi ukweqa i-endoscopy.
Ezinye izazi zithi ukuhlolwa kwegazi okusetshenziselwa inqubo yokuxilonga kunembile kangangokuthi i-biopsy ukuqinisekisa ukuxilongwa akusekho isidingo lapho imiphumela yokuhlolwa kwegazi inembile noma inamandla kakhulu. Ngokwesibonelo, abacwaningi babika encwadini yezokwelapha i- BMC Gastroenterology ukuthi bakwazi ukuxilonga noma ukukhipha isifo se-celiac ngaphandle kwegazi lomzimba emathunjini angu-78%.
Ingabe usadinga i-Endoscopy ne-Biopsy?
Kunezinye izimo eziningi ezingabangela izimpawu ezifana nezitholakala kwisifo se-celiac, futhi i-endoscopy ene-biopsy ingasiza udokotela wakho ukuthi anqume ukuthi yini onayo (nokuthi awunayo). Futhi, ukuhlolwa kwegazi okusetshenziselwa ukukrini kwesifo se-celiac akuwona onembile eyi-100%, futhi ukunemba kwabo kungahlukahluka kuye ngokuthi ibha elisetshenziselwa ukucubungula ukuhlolwa.
Ngakho-ke, ama-gastroenterologists amaningi akholelwa ukuthi kubalulekile ukuya ngqo emthonjeni (okungukuthi, intombazane yakho encane) ukubona ngqo ukuthi ngabe kukhona umonakalo ohlobene no-celiac.
Eqinisweni, i-American College of Gastroenterology iphinda ibuyele emibhalweni yayo yokwelapha ukuhlolisisa nokuphatha isifo se-celiac ukuthi i-endoscopy ne-biopsy "iyisici esibucayi ekuhloleni ukuhlonza abantu abane-CD [isifo se-celiac] futhi kunconywa ukuqinisekisa ukuxilongwa. "
Kodwa-ke, kunezinto ezingezansi zokuthola i-endoscopy, futhi. Yize le nqubo imbi ngempela ukungena (ngempela!), Kungathatha isikhathi ukuhlela, futhi kungabiza (ngisho noma unomshuwalense).
Ngaphezu kwalokho, ngenkathi ulinde i-endoscopy yakho, kuzodingeka uqhubeke nokudla i- gluten , ngoba ukuhlolwa kubheka umonakalo owenziwe nge-gluten emathunjini akho amancane.
(Funda kabanzi: Kungani kudingeka ngidle i-gluten yokuhlolwa kwesifo se-celiac ukuze inembile? )
Izwi kusuka
Ngakho-ke, nakuba kunezizathu ezinhle kakhulu zokuvumelana nenqubo, kunezizathu ezithile zokuyidlula, futhi ikakhulukazi uma ukuhlolwa kwegazi kwakho kubonisa ukuthi unesifo se-celiac.
Kungenzeka futhi ukuthi imibono yobuchwepheshe kulokhu izoshintsha esikhathini esizayo. Emashumini ayisithupha edlule, ochwepheshe bavuma ukuthi udinga ama- endoscopies amathathu nge-biopsies ukuxilonga isifo se-celiac: eyodwa ukuloba umonakalo wokuqala, okwesibili ukuqala kokudla okungenalutho kwe-gluten kuya ekuphulukisweni kwedokhumenti, futhi okwesithathu ukuloba umonakalo omusha ngemuva kwenselelo ye-gluten .
Ekugcineni, uma ungaqiniseki ukuthi kufanele ube ne-endoscopy ne-biopsy ukuqinisekisa ukuthi uhlolwe yini ngesifo se-celiac, kufanele uxoxisane ngempilo yakho kanye nenkinga yakho.
Imithombo:
UBürgin-Wolff A. et al. I-biopsy yezinambuzane ayidingi njalo ekuhloleni isifo se-celiac: ukuhlaziywa okubukeziwe kokuhlolwa kwe-antibody okuhlangene. BMC Gastroenterology. 2013 Jan 23; 13: 19. i-doi: 10.1186 / 1471-230X-13-19.
Rubio-Tapia A. et al. Imikhombandlela yemitholampilo ye-ACG: Ukuxilongwa nokuphathwa kwezifo zeCeliac. I-American Journal ye-Gastroenterology. 2013 Meyi; 108 (5): 656-76. doi: 10.1038 / ajg.2013.79. I-Epub 2013 Apr 23.
Wakin-Fleming J. et al. Ukuxilongwa kwesifo se-celiac kubantu abadala ngokusekelwe emiphumeleni yokuhlolwa kwe-serology, ngaphandle kwe-small-bowel biopsy. I-Gastroenterology Clinic ne-Hepatology. 2013 Meyi; 11 (5): 511-6. i-doi: 10.1016 / j.cgh.2012.12.015. Epub 2013 Jan 7.