Lesi sigaba se-IBD akuyona isifo sikaCrohn noma isifo sofuba esiswini
Lapho ekhuluma ngesifo sofuba esiswini (IBD) , izinhlobo ezimbili ezivame ukukhulunywa ngazo ziyi-ulcerative colitis nesifo sikaCrohn, kodwa kukhona ukuxilongwa kwesithathu okuthiwa i-colitis engapheli. Ukwehla kwesifo socansi kuyasetshenziswa uma kucatshangwa ukuthi uhlobo oluthile lwe-IBD lukhona, kodwa alukaqondwa ukuthi yiluphi uhlobo lwesifo.
Lesi yisihloko esididekayo nesinengxabano ku-IBD, okubaluleke kakhulu kweziguli kanye nodokotela. Kulinganiselwa ukuthi noma kuphi phakathi kwamaphesenti angu-10 namaphesenti angu-15 abantu abane-IBD bacatshangwa ukuthi bane-colitis engapheli. Kwezinye izimo, ukuxilongwa kwesinye isimo se-IBD kungenziwa kamuva, uma ubufakazi obengeziwe bukhona noma isifo sishintsha.
Iyiphi i-Colitis Engagqamile
I-IBD ivame ukubeka isikhathi njengesivulela, lapho isifo sikaCrohn nesifo sokulonda kwezilonda kuwela khona. Kodwa-ke, kunezimo ezithile lapho umuntu enolwazi lwe-IBD olungenakuhlukaniswa khona ngalunye kulawo mabhakede. Lokhu akusho ukuthi ukuxilongwa kwesifo sikaCrohn noma i-ulcerative colitis ngeke kwenzeke esikhathini esizayo, kodwa ukuthi kusho ukuthini ukuthi okwamanje, akucaci ukuthi yiluphi uhlobo lwesifo olukhona.
Izifo eziye zaqhubeka ngaphezu kwezinyathelo zayo zokuqala futhi zithuthuka, ikakhulukazi, zingase zibe nzima ukuhlukanisa ngenxa yobungako bokuvuvukala nokuthi zingakanani phakathi kwikholoni .
Ngakolunye uhlangothi, lapho izifo ziqubuzana noma zilahlwa , futhi zikhona kancane endleleni yokuvuvukala, kungase kube nzima ukwenza ukuxilongwa okuqinile. Izifo zakuqala futhi kunzima ngezinye izikhathi ukuxilonga ngoba izinguquko ezenziwa yi-IBD kumaseli futhi ezingabonakala ku- biopsy ngaphansi kwe-microscope kungenzeka zingabi khona okwamanje.
Ukwehla kwesifo sofuba kuyaqhubeka kuba yingxabano eminye imibuthano futhi kungase kubhekwe njengokuziphendulela. Abanye abacwaningi baye benza icala lokuqothula isigciwane socansi ukuze kubhekwe njengendlela yesithathu ye-IBD, kuyilapho abanye begcina ukuthi indawo yokuhlala kuze kube yilapho esinye isifo singasetshenziswa. Udokotela noma udokotela ongatholakali kahle nge-IBD angase ahlukanise lokho abakubonayo esigulini ukuba abe nesifo sochungechunge esingapheli, kepha isifo sokuhlonza isifo esithile esinokuhlangenwe nakho singakwazi ukunquma ukuthi kungakhathaliseki ukuthi yisifo sikaCrohn noma isifo sochungechunge.
Izimpawu Nezibonakaliso Zokuqeda I-Colitis
Esikhundleni sokuba yinkimbinkimbi yezici ezihlukahlukene zombili izilonda ze-ulcerative kanye nesifo sikaCrohn, ukubola kwesibindi kuhlotshaniswa neqoqo lezibonakaliso ezachazwe ekuqaleni ngo-1978, nakuba zingekho imithetho eqinile futhi esheshayo. Ukwehla komgogodla kungaba nakho konke noma ezinye zezici ngezansi:
- Uhlobo lwezilonda: Ukunqunywa kwe-colitis kungase kusetshenziswe ezimweni lapho kukhona ukuvuvukala kuphela emathunjini amakhulu, kepha izilonda azibuki njengalezo ezibangelwa ukubola kwesilonda. Nge-ulcerative colitis, izilonda ezitholakala emathunjini amakhulu ziyobandakanya kuphela ngaphakathi kwe-mucosa, ebeka udonga lwamathumbu emathunjini. Uma lezo zilonda zijulile kunalokho okuvame ukulindelwa nge-ulcerative colitis, futhi akekho enye inkomba yokuthi lesi sifo empeleni isifo sikaCrohn, kungase kuholele udokotela phansi endleleni yokwenza ukuxilongwa kokuqala kokugulana okungapheli. Lezi zilonda ngezinye izikhathi zichazwe ngokuthi izilonda zomshuwalense (okusho ukuthi zijule ngaphakathi kodonga lwamathumbu) noma zifana nezinkukhu. Kwezinye izimo izilonda ezinjenge-fissure zincane (cishe ngamaphesenti angu-13 wamacala), futhi ngezinye izikhathi zibunjwa njenge-"V" (cishe ngamaphesenti angaba ngu-60).
- Ukubandakanyeka okunomthelela: Okunye ukuhlukaniswa kwe-colitis engapheli ukuthi i-rectum ngokuvamile ayihilelekile, noma ingabandakanyeka ngokugcwele. E-ulcerative colitis, i-rectum ivame ukuvutha futhi, yingakho, lapho kungenjalo, akuyona into ecacile njengesibonakaliso esingasetshenziselwa ukuxilongwa. Esighedlela sikaCrohn, i-rectum ingase ibonise noma ingabonisi ukuvuvukala.
- Gwema izilonda: Esigabeni sikaCrohn, ukuvuvukala kungase kweqe izindawo zamathumbu, kushiye indawo egcwele izikhumba nezinye izicubu ezinempilo. E-ulcerative colitis, ukuvuvukala kuqala e-rectum futhi kuqhubekela phambili ngekoloni ngendlela ephathekayo. Nge-colitis engapheli, kungase kube ukweqa izindawo, noma okungenani, kubonakala sengathi kukhona ukweqa izindawo phakathi kwezigaba ezivuthayo. Kukhona izizathu eziningana zokuthi kungani i-ulcerative colitis ingase ibonakale isuka izilonda, yingakho lesi sici singaba esinye isici esingasisiza ngaso sonke isikhathi ekwenzeni ukuxilongwa okuqinile.
Ukwelashwa kwe-Indeterminate Colitis
Ngeshwa, ukuvivinywa kokwelashwa kubantu abane-colitis engapheli kuyaswela, okwenze kube inselele ukuthuthukisa ukwelashwa. Ezimweni eziningi, ukwelashwa okungapheli kuyaphathwa ngemithi efanayo kanye nokuhlinza njengoba kusetshenziswa ulcerative colitis. Umehluko uzoba uma kukhona ukuvuvukala emathunjini amancane (njengengxenye yokuqala, okuyinto i-ileum), futhi uma kunjalo uhlelo lwezokwelapha lungase luhluke kakhulu futhi lufane nesifo sikaCrohn.
Uhlelo lwezokwelapha lwe-indeterminate colitis lungase lufake le mithi:
- I-Asacol (mesalamine)
- I-Azulfadine (i-sulfasalazine)
- Ama- Immunosuppressants ( Imuran , 6-MP , i- cyclosporine )
- I-rheumatrex (methotrexate)
- Imithi ye-biologic: Remicade (infliximab) ; Huma (adalimumab) ; I-Entyvio (i-Vedolizumab) ; ne- Golimumab (Simponi)
- I-Corticosteroids (i- Entocort EC (i-budesonide) ne- prednisone )
Izinqubo zokuhlinzwa ze-colitis ezingapheli nazo zifana ne-ulcerative colitis, ezifaka isikhwama se-leal anal anastomosis noma i-IPAA (okuvame ukubizwa ngokuthi i-j-poch) ne-ileostomy. E-ileostomy, ikoloni isuswe futhi ukuphela kwamathumbu amancane kulethwa ngokufakwe esiswini (okuthiwa i- stoma ). Umuntu onesi-uleostomy ubopha isisetshenziswa esiswini ukuze athathe isikhumba, esivela emzimbeni ngesigaba samathumbu amancane angaphandle komzimba. Isitoreji siqoqa kulolu hlelo futhi sihanjiswa endlini yangasese uma kudingeka.
I-Indeterminate Colitis ne-J-Pouches
Kwezinye izimo, ukwelashwa okungapheli kuyaphathwa njengokungathi kunjenge-ulcerative colitis. Ngenxa yalokho, abanye abantu abane-colitis engaphelele baye bathola ukuhlinzwa kwe-j-poch, okuvame ukugcinwa ukusetshenziswa kuphela kubantu abane-diagnosis ye-ulcerative colitis. Ekuhlinzekeni kwe-j-pouch, intombazane enkulu isuswe ngokuhlinzwa futhi ingxenye yokugcina yamathumbu amancane yenziwa isikhwama sokuma "J" futhi ifakwe kwi-anus (noma i-rectum, uma kukhona okushiywe udokotela ohlinzayo) . I-j-poch ithatha indima ye-rectum, futhi igcina isitoreji. Lokhu kuvulwa akuvamile ukwenza isifo seCrohn ngoba kunengozi encane yokuthi isikhwama singathinteka yi-Crohn's futhi sidinga ukususwa.
Kodwa-ke, ucwaningo luye lwabonisa ukuthi abantu abane-colitis e-indeterminate bavame ukwenza kahle kakhulu ngama-j-poche njengoba abantu abanesifo sokulonda kwesilonda. Kodwa-ke, abanye abacwaningi baye babonisa ukuthi izinga lokuhluleka kwe-j-poch in iziguli ezine-colitis engapheli kungaba phezulu ngenxa yokuthi izici zesifo azifani: kunokuhluka kakhulu ukutadisha leli qembu leziguli lonke.
Zonke izimo ze-colitis ezingenayo azifani
Esinye isici esiyinkimbinkimbi se-colitis engapheli ukuthi izici zingahlukahluka phakathi kweziguli. Lena inkinga nge-IBD ngokujwayelekile: Isifo esiyinkimbinkimbi esinzima ukuyihlukanisa. Incazelo ye-colitis engapheli okwamanje ayikho isimiso, nakuba kuneminye imihlahlandlela ebanzi.
Kukhona ezinye izimo ze-colitis engapheli okucatshangwa ngokuthi "isifo sikaCrohn esingaba khona" kuyilapho abanye "kungenzeka ukuthi i-ulcerative colitis", okusho ukuthi kuneziguli ezisezingeni eliphelele elingase libe yikuphi kulo lonke uhlangothi phakathi kwezi zifo ezimbili. Lokhu kwenza ukutadisha, ngakho-ke ukuqonda, i-colitis engapheli kuyinto enzima.
Ukuxilongwa Kwe-Colitis Engenayo Kungase Kuguquke
Ezimweni eziningi, ukutholakala kwesifo sikaCrohn noma isifo sokulonda kwesilonda kufike ekugcineni. Isikhathi futhi kungani lokhu kwenzeka kuyoba okuguquguqukayo kakhulu. Kwezinye izimo, uma ukuvuvukala okusha kukhula emathunjini amancane lapho ngaphambilini bekukhona ukuvuvukala kuphela ekoloni, kungenzeka ukuthi ukuxilongwa kwesifo sikaCrohn manje kungenziwa. Kwezinye izimo, kungase kwenzeke ukuthi kunenkinga yokuthi odokotela baqondise ukuhlolisisa uhlobo olulodwa lwe-IBD ngaphezulu. Izinkinga ezithile, emathunjini noma emathunjini engeziwe , zivame kakhulu ngefomu elilodwa le-IBD ngaphezu komunye, futhi ukutholakala kwabo kungasiza ekwenzeni ukuxilongwa.
Esinye isizathu sokubaluleka kokuthola ukuxilongwa kwesinye salezi zindlela ukudala uhlelo olusebenzayo lwezokwelapha. Imithi evunywe yi-Food and Drug Administration iqondene nesimo esithile, futhi ngale ndlela, isifo sikaCrohn kanye nesifo sokulonda kwesilonda siphathwa ngendlela ehlukile. Ukuxilongwa kweyodwa yezinhlobo ezimbili eziyinhloko ze-IBD kusho ukwamukela ukwelashwa okuvunyelwe leso sifo. Izindlela eziningi zokwelapha zamukeleke kuzo zombili izinhlobo ze-IBD, kodwa kusekhona ezinye ezivunyelwe noma isifo sikaCrohn noma isifo sofuba esiswini. Ngaphezu kwalokho, ezinye izindlela zokwelapha zingase ziphumelele nakakhulu kwezinye zezifo kunezinye. Ngakho-ke, kunenzuzo ukuthola ukuxilongwa okucacile okuphethwe phansi.
Izwi elivela
Ukuthola ukuxilongwa kwe-colitis engapheli kuhambisana nenani elilinganayo lokungaqiniseki futhi kungakhungathekisa uma ucabangela ukuphathwa kwesifo nokuphathwa. Kubalulekile kunoma ubani onayo i-IBD ukuba abe ngummeli onobugovu, kodwa kubalulekile kubantu abane-colitis engapheli. Ukuthola ithimba lokunakekelwa kwezempilo elisisekela ngokugcwele kanye nenethiwekhi yomndeni nabangane abanganikeza usizo nokuqonda kuzosiza ekubhekaneni nesifo. Abanye abantu bangase baphile ngokuxilongwa kwe-colitis engapheli isikhathi esithile, ngaphambi kokuba noma yini iguquke, ngakho-ke ukufunda okuningi ngangokunokwenzeka mayelana ne-IBD nokuhlanganisa inethiwekhi yokusekela kufanele kube ukugxila okukhulu.
> Imithombo:
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> Intengo AB. "Ukuxubana emzimbeni wesifo sofuba esingavumelani nesibindi - 'i-colitis indeterminate'." J Clin Pathol . 1978 Jun; 31: 567-577.