Amathumbu akuzona kuphela izitho ezithintekayo
Isifo sikaCrohn yisifo sesifo sofuba esingapheli esingathinta noma yikuphi ingxenye yamathambo emathunjini kusukela emlonyeni kuya ku-anus. Nakuba kuvame ukubangela izimpawu zamathumbu ezifana nokuqhaqhaza, ukuphuza, ukuphazamisa isifo sohudo, isicanucanu, ukuhlanza kanye negazi ezitheni. Izinkinga zihlanganisa ukuvinjelwa kwesibindi kanye nokubhuka emathunjini.Kungase kube yingozi enkulu yomdlavuza wesisu.
Isifo sikaCrohn singathinta nezinye izinhlelo zomzimba futhi kuholele ezinkingeni ezinzima ezifana nokukhubazeka kombono, isifo se-arthritis, izilonda zesikhumba, i-osteoporosis, i-gallstones, i-thrombosis ejulile ye-vein, ukuhluleka kwesibindi, nezinkinga ezihlukahlukene ze-neurological okusukela ekubhekaneni nesifo sohlangothi.
Izimpawu zesisu
Ipheshana lamathumbu (GI) yilona uhlelo lomzimba oluthinteka kakhulu isifo sikaCrohn. Amaphesenti angama-30 amacala ahlanganisa intombazane encane, ikakhulukazi i-leum esibulalayo (ukuhlanganiswa kokudla okuncane okususelwe emathunjini amancane kuya emathunjini amakhulu). Eminye amaphesenti angu-20 ahlanganisa kuphela ikoloni, kuyilapho amaphesenti angu-45 abandakanya kokubili amathumbu amancane nekoloni.
Phakathi kwezibonakaliso zesimo sezifo zika Crohn:
- Ubuhlungu besisu buyisibonakaliso sokuqala futhi kuvame ukugxila engxenyeni engezansi kwesisu lapho i-leum esiphezulu ikhona khona. Ubuhlungu bungase buhambisane nokuchotshozwa, ukuqhaqhabalaza, ukuguqulwa, nokuhlukunyezwa.
- Uhudo lubuye luvame futhi luyahlukahluka ngokuya endaweni yokuvuvukala. Ukuvuvukala kwe-ileum (ileitis) kuvame ukuphumela emanzini amanzi. Ukuvuvukala kwe-colon (i-colitis), ngokuphambene, kuvame ukuholela ekuqhubeni okuvamile okuhlukahluka.
- Ngenkathi igazi elisezinhlakeni lingavamile kakhulu nesifo sikaCrohn kunesifo se-ulcerative colitis (i-disorder ehlobene nayo ebizwa ngokuthi isifo sofuba sesibindi ), ngezinye izikhathi singase siphumelele uma ukuvuvukala emathunjini kunzima.
- Ukukhathazeka kwesisu nokuhlunguphazwa kwesisu kuzoholela ekudleni okungenalutho nokulahlekelwa kwesisindo. Ukunciphisa ukudla nokudla okunomsoco kungase kuphuthumise ukulahlekelwa kwesisindo.
Ukuvuvukala kwipheshana le-GI akukhawulelwe emathunjini kuphela. Izilonda zomlomo ezivamile (i- aphthous ulcers ) zivame kubantu abanesifo sikaCrohn, kuyilapho ubuhlungu obunzima, i-fistula, i-fissures, noma i-abscesses kungaholela ekungcoleni okukhulu nangokweqile. Isisu nesisu asivamile ukuthinteka kakhulu.
Izinkinga zomzimba
Ngaphansi komthwalo oqhubekayo wokuvuvukala, izindonga zamathumbu ziyoba nokuqina okungaguquguquki, jikelele njengoba izingxenye zezicubu ezibomvu ziqala ukwakha. Lokhu akukona nje ukumbalwa kwesigungu samathumbu emathunjini, kukhulisa ukuvuvukala okuphelele kanye nengozi yezinkinga ezincane kanye nesikhathi eside.
Phakathi kwazo:
- Ukuvinjelwa kwesisu kuyisifo esivame kakhulu kunazo zonke zesifo sikaCrohn futhi kungenzeka sibe mnene noma sikhulu, kuye ngokuthi izinga lokuvimbela. Izimpawu zihlanganisa ukuchoboza, ukubhuqa, nokuhlanza.
- Amaphambosi emathunjini omzimba (izikhumba ezitholakala emaphaketheni ezibangelwa yi-bacteria) imbangela ingabangela ubuhlungu besisu, isisa, nomkhuhlane.
- I-fistula emathunjini emathunjini ayi-openness engavamile lapho amanzi okugcoba angakwazi ukuvuza futhi abangele ukutheleleka njengoba evuza isikhumba nezinye izitho.
- I-perforation ye-bowel (ukuphuka) ingase ibangelwe ngenxa ye-abscess noma i-fistula, evumela ukuthi okuqukethwe kwamathumbu kuqhume emgodini bese kudala isifo esibi (peritonitis).
- I-megacolon eyingozi iyinkimbinkimbi engavamile kodwa eyinkimbinkimbi yesifo sikaCrohn lapho i-colon ikhuphuka ngokuzumayo futhi ilahlekelwa ikhono layo lokuthola inkontileka. Izimpawu zihlanganisa ukuvinjelwa okukhulu, ubuhlungu, umkhuhlane, izinga lokushaya kwenhliziyo ngokushesha, nokuqeda kwamathumbu emathumbu. Uma kushiywe kungalashwa i-buildup yegesi ingaholela ekuqhekekeni, ukushaqeka kwamanzi nokufa.
Ingozi yomdlavuza wokulala ingase ibe nokwanda kwabantu besifo seCrohn, nakuba ubufakazi bukhona manje.
Umdlavuza we-Colorectal uvame ukuhlotshaniswa ne-ulcerative colitis lapho ingozi iphelelwe phakathi kwamaphesenti amahlanu namaphesenti ayisishiyagalombili ngaphezu kweminyaka engu-20. Ingozi kubantu abane-Crohn's disease, ngokuphambene nalokho, kubhekwa njengesizotha kodwa okwanele ukuvumela ukuhlola njalo.
Izimpawu ezingavamile
Lezo zimpawu ezingenakuqhathaniswa nezifo zesifo sikaCrohn (lezo ezivela ngaphandle kwepheshana le-GI) zide kakhulu futhi zithinta njengalezo ezithinta amathumbu. Babangelwa ukuvuvukala okuqhubekayo okugxile kumapheshana we-GI kodwa kuthinta umzimba isikhathi esithile.
Izimpawu ezivame kakhulu zokugcoba zihlanganisa amehlo, amalunga, isikhumba, i-gallbladder, isimiso sezinzwa, negazi noma imithwalo yegazi.
Amehlo
Ukuvuvukala kwesendlalelo esiphakathi kweso (uveitis) kungabangela umbono obonakalayo, ukuzwela ukukhanya, nokuzwa kweso. Uma kuthinta umhlophe weso (sclera), kungaholela episcleritis. Zombili lezi zivame ukuthi izimo ezibucayi ezizixazulula zodwa kodwa, ngaphansi komthwalo wokuvuvukala okungapheli, zingaholela ekulimaleni okungapheli nokulahlekelwa kombono.
Amalungu kanye nezicubu ezixhunyiwe
Isifo sikaCrohn sihlotshaniswa neqembu lezifo ezibizwa ngokuthi i-sponeythroloththropathy ye-seronegative lapho isifo esisodwa noma ngaphezulu sithinteka yi-arthritis noma okunamathiselwe kwesinye noma ngaphezulu kwesisindo kuthinteka yi-enthesitis. Kubantu abanesifo sikaCrohn, kunezindawo ezintathu ezihlukunyezwa yi-arthritis:
- Amalunga amakhulu amakhulu amadolo, izintambo, amahlombe, i-elbow, nesandla
- Amalunga amancane amahlanu noma ngaphezulu ezandleni noma ezinyaweni, ezenzeka symmetrically (okusho noma kokubili izandla noma zombili izinyawo)
- Umgogodla, oholele ku-spondylitis e-ankylosing
Izimpawu ze-arthritis zihlanganisa amajoyina abuhlungu, afudumele, avuvukile, futhi aqinile ahambisana nokulahlekelwa kokuhamba ngokuhlanganyela.
Isikhumba
Isimo sesikhumba esivame kakhulu esihambisana nesifo sikaCrohn yi-erythema nodosum ebonakala iphakanyisiwe, ithenda, ama-nodules obomvu, ikakhulukazi nxazonke. Ama-nodules abangelwa ukuvuvukala kwama-adipose (amafutha) amangqamuzana angaphansi kwesikhumba esingaphansi kwesikhumba.
Enye, isimo sesikhumba esibi kakhulu sibizwa nge-pyoderma gangrenosum. Lesi simo esibuhlungu sibonakala ngesifo sokulonda esiswini esivame ukuqala emlenzeni njengento encane kodwa kungakhula usayizi kubangele ukufa kwezicubu ezibalulekile (necrosis).
Amathoni
I-osteoporosis, isimo esibonakala ngokulahlekelwa kwethambo, kuvamile kubantu abadala abane-Crohn's disease yesikhathi eside. Ngeke nje kubangele ubuhlungu obuphansi emuva, kungandisa kakhulu ingozi yokuphuka. I-Clubbing yeminwe ibuye ibonwe ngezikhathi ezithile.
Izingane ezinesifo sikaCrohn nazo zijwayele ukuphuthuma ukuthuthukiswa, ngokuvamile zihlobene nokuphuza ukuthuthukiswa kwamathambo. Amaphesenti angaba ngu-50 alawa bantwana azoba nokuphakama okungavamile, kanti cishe amaphesenti angama-25 azoba nesigamu esifushane (kuchazwa ngokuthi ukwehluka okubili ngezansi ukuphakama okushiwo iminyaka yobudala nobulili). Ukukhulelwa kubuye kubambezeleka njalo.
I-Gallbladder
Isifo sika-Crohn sinciphisa amandla amathumbu okubuyisela ubhiya obunwe yi-gallbladder nesibindi ngokugaya. Ukungalingani ekusithekeni nasekubuyiseleni kabusha kungaholela ekuqoqweni kwe-bile salts ku-gallbladder, okubangelwa ingozi eyandayo ye-gallstones.
Ama-gallstones angabangela ubuhlungu obukhulu kakhulu futhi abangela ukuchoboza, ukuhlushwa, ukuhlanza, ukuhlanza nokuhlunguphaza ngemuva noma kwesisu kwesokudla.
Isistimu Yezinzwa Eziphakathi
Kulinganiselwa ukuthi omunye wabantu abayisikhombisa abanezifo ze-Crohn's symptoms eziyimpilo. Kungenzeka kube mnene ukulinganisela futhi kufaka phakathi ikhanda, ukucindezeleka, noma ukuzwakala kwezandla nezinyawo (izinzwa ze-neuropathy). Ezinye zingase zibi kakhulu futhi zibandakanye:
- I-Anterior ischemic optic neuropathy, ukulahlekelwa okungazelelwe kwombono ophakathi ngenxa yokunciphisa ukugeleza kwegazi kuya emantongeni optic
- I-post-reversible encephalopathy syndrome (PRES), i-disorder disorder ekhonjiswe ukukhanda ikhanda, ukudideka, ukuhlukunyezwa nokulahlekelwa okubukwayo.
- I-axonal polyneuropathy engapheli, engabonakalisa ngokulahlekelwa ukulawulwa kwemoto nokuzwa
Izimpawu ze-neurological ze-Crohn's disease aziqondi kahle. Izinkinga ezinzima zikholelwa ukuthi zihlobene nezifo ezinzima ezingaphenduliwe isikhathi eside.
Igazi neSystem Circulatory
Abantu abanesifo sikaCrohn bavame ukuba nesifo segazi ngenxa yokungabi nabampofu abampofu emathunjini. Kodwa, kukhona futhi olunye uhlobo olubizwa ngokuthi i-autoimmune hemolytic anemia lapho isimiso somzimba sokuzivikela sibhekela futhi sibhubhisa amangqamuzana egazi abomvu. Izimpawu zingase zihlanganise ukukhathala, isikhumba esilahlekile, ukuphefumula, ukukhanya okuncane, isizungu, nokushaya kwenhliziyo okusheshayo.
Isifo sikaCrohn siholela ekuhlanganiseni okungavamile kwamaplatelets kanye nokwakhiwa kwezindwangu zegazi. Lokhu kungaholela ekucindezeleni okujulile kwe-vein (DVT), ukuvimbela ukugeleza kwegazi kuya emlenzeni ongabangela izimpawu zobuhlungu, ukuvuvukala, ukufudumala nokugubha.
Uma kungaphathwa ngendlela efanele, i-clot yegazi ingakwazi ukukhipha futhi ishukumise umlenze ebuchosheni, enhliziyweni nasemaphaphini, lapho kungabangela ukushaya, ukuhlasela kwenhliziyo, noma ukuvuthwa kwe-pulmonary.
Nini Ukubona Udokotela
Izimpawu zesifo sikaCrohn zingaba zihlukahlukene futhi ziguquke kangangokuthi kungase kube nzima ukwazi isikhathi sokubona udokotela. Ekugcineni, isici esisodwa esihlukanisa isifo sikaCrohn kusuka enkingeni yakho yokugaya isisu-ukuphikelela kwezimpawu.
Kubalulekile ukuthi ubone udokotela uma uhlangabezana nalokhu okulandelayo:
- Izikhukhula eziqhubekayo zokuhuda ezingaphenduli kumakhemikhali angaphezu kwe-counter-the-counter (OTC)
- Ubuhlungu besisu okuqhubekayo noma okuphindaphindiwe
- Igazi kulesi sikhundla
- Ukulahlekelwa kwesisindo esingachaziwe
- Umkhuhlane ongachaziwe uhlala isikhathi esingaphezu kwezinsuku ezimbalwa
> Imithombo:
> Baumgart, isifo sikaDonhn. I-Lancet. 2012; 380 (9853): 1590-1605 I-DOI: 10.1016 / S0140-6736 (12) 60026-9.
> Ha, F. no Khalil, isifo sikaH. Crohn: ukuvuselelwa kwemitholampilo. I-Therap Adv Gastroenterol. 2015; 8 (6): 352-359. I-DOI: 10.1177 / 1756283X15592585.
> Nemati, R .; Mehdizadeh, S .; Salimipour, H. et al. Ukubonakaliswa kwemvelo okuhlobene nesifo sikaCrohn: isenzo sabasebenzi. Umlayezo wesifo sangasese 2017; gox034. I-DOI: 10.1093 / i-gastro / gox034.