Xoxani Ngokungenzeka NgeThimba Lakho Lezempilo
Abantu abanesifo sofuba (IBD) abavame ukuhlinzwa njengokwelashwa kwesifo sabo. Izinhlobo ezimbili ezibalulekile ze-IBD, i-ulcerative colitis nesifo sikaCrohn, ziphathwa ngezinhlobo ezahlukene zokuhlinzwa. Njengoba isifo sikaCrohn, esingathinta kokubili intombazane enkulu kanye encane , ukuvuselela ukukhipha isifo esibambile samathumbu kungukuhlinzwa okuvame ukwenziwa njalo.
Kwezinye izimo zesifo sikaCrohn, ukuhlinzeka nge-ostomy-kungaba okwesikhashana noma okuphakade-kungenziwa futhi. Ukuhlinzwa kwe- ulcerative, okuyinto echaphazela kuphela amathumbu amakhulu, ukuhlinzwa okukhethwa kakhulu yi- pocket-anal anal anastomosis (IPAA), eyaziwa ngokuthi i-j-poch . Kulinganiselwa ukuthi iziguli ezingu-30% ezine-ulcerative colitis zidinga ukuhlinzwa ukuze zilaphe isifo.
Kuyini Ukuhlinzwa Kwe-J-Pouch?
Ekuhlinzekeni kwe-j-pouch, intumbu enkulu isusiwe futhi ingxenye yokugcina yamathumbu amancane aphinde asebenze ukuze akhe isikhwama (ngokuvamile esesimo se "J," nakuba ezinye izimo nazo ngezinye izikhathi zenziwa). I-j-poch ixhunywe ku-anus, okusho ukuthi isiguli singasusa okuningi "ngokujwayelekile." Umathumbu omkhulu usukile, kodwa asikho isidingo sokwakhiwa kwesisu nokugqoka uhlelo lokusebenza lwangaphandle ukuqoqa isitoloni.
I-j-isikhwama se-j-isikhwama ngokuvamile asikwenziwanga ngesifo sikaCrohn. Isizathu esiyinhloko salokhu kungenxa yokuthi isifo sikaCrohn singathinta isikhwama (esenziwe nge-ileum) ngemuva kokudalwa kwayo.
Uma i-j-isikhwama sehliswa, ingase iholele ezinkingeni kanye nokuhluleka kokugcina kwesikhwama. I-j-poch ehlulekile ingasho ukuhlinzekwa okwengeziwe ukususa nokudala ileostomy. Ukuhlinzwa okunye, okwamanje, ngeke kusize ukuthuthukisa ikhwalithi yokuphila yesiguli.
Lapho kutholakala i-Crohn ngemuva kokuhlinzwa kwe-J-Pouch
Kwezinye izimo, abantu abaye bathola ukuthi bane-ulcerative colitis kamuva batholakala ukuthi banesifo sikaCrohn.
Lokhu ngezinye izikhathi kwenzeka ngemuva kokuba isiguli sitholwe ukuhlinzwa kwe-j-poch, nakuba kungavamile. Lezi ziguli kungenzeka ukuthi zinezifo zikaCrohn kusukela ekuqaleni, nakuba lokho kwakungesiyo i-diagnosis yokuqala. Ingxenye yesizathu salokhu ukuthi isifo sikaCrohn ngezinye izikhathi sithinta nje amathumbu amakhulu ( okuthiwa i-Crohn's colitis ), okwenza kube sengathi sengathi i-ulcerative colitis iyisifo sokuxilongwa kwangempela. Njengoba isikhathi siqhubeka, futhi ezinye zezibonakaliso noma izimpawu zesifo sikaCrohn ziyabonakala , ukuxilongwa kungashintshwa.
Ngokwemvelo, abanye abantu abane-IBD abacubungula ukuhlinzwa oku-1, 2, noma okuyi-3 ukudala i-j-poch bangase babe nokukhathazeka okujulile mayelana nokuthi kungenzeka ukuthi ushintsho luyaxilongwa kusuka ku-ulcerative colitis kuya kwisifo sikaCrohn.
Ukushintsha Ukuxilonga Kuvamile Kanjani?
Ucwaningo oluthile lubuke inani leziguli ezitholwe ukuthi zinesifo sikaCrohn ngemuva kokuhlinzwa kwe-j-pouch. Amaphesenti alawo mabanga aphinde ahloliswe avela ngaphansi kwe-1% kuya phezulu kwe-13% ocwaningweni owodwa. Abalobi besifundo ababika amaphesenti aphezulu bakhomba ukuthi imiphumela yabo ibonakala iphakeme ngisho kubo. Bayaqhubeka bethi baqaphela ukuthi akulandeli kahle nezinye izifundo eziningi, ezisezingeni elingaphansi kwe-10%.
Ucwaningo oluningi oluvela eminyakeni embalwa edlule lubeka iphesenti elinganiselwa ku-5% ngoba ikhono labahlengikazi lokuthola uhlobo olufanele lwe-IBD luyathuthuka. Amaphesenti ahlukile phakathi kwezikhungo ezahlukene zokuhlinzeka ezenza ukuhlinzwa kwe-IPAA. Kwesinye isifundo esenzelwe izingane ezine-ulcerative colitis noma i-indeterminate colitis, ukuxilongwa kwesifo sikaCrohn ngemuva kokuhlinzwa kwaba ngu-13%.
Odokotela abahlinzayo eCleveland Clinic (isikhungo esiyinhloko sobuhle kakhulu se-IBD kanye nokuhlinza nge-j-pouch) babika inani labo leziguli ezixilongwa ukuthi bane-Crohn's disease emva kokuhlinzwa kwe-IPAA kwehla ngokuhamba kwesikhathi.
Njengoba inqubo yokwelashwa okunembile ithuthuka, kanjalo nenani leziguli ezinezifo ezixilongwayo liyancipha.
Singakwazi Yini Ukubikezela Ubani Ongaba Nezifo Ze-Crohn?
Akukho ukuvumelanisa ngokucacile indlela yokuhlonza iziguli ezitholakale ezine-ulcerative colitis ezingase zitholwe kamuva ukuthi zibe nesifo sikaCrohn. Kodwa okungenani kukhona isifundo esisodwa, ukuthi iziguli ezazitholakale zine-ulcerative colitis zisencane futhi zinezinkinga ezingaphezu kwamandla omzimba zingase zithole ukuguqulwa kwesifo se-Crohn ngemva kokuhlinzwa kwe-j-poch. Ukuchiza "ukungaphumeleli" futhi ekugcineni ukuba ne-j-isikhwama esusiwe kujwayelekile kakhulu ezigulini okutholakala ukuthi unesifo sikaCrohn. Kodwa-ke, kulabo abakwazi ukugcina isikhwama sabo futhi bathole ukuthi kubasebenza kahle kubo, kubonakala sengathi akukho umehluko emkhakheni wabo wokuphila kanye nekhwalithi yokuphila kulabo ababenokuhlinzwa kwe-IPAA futhi baqinisekisile ukubola kwe-ulcerative .
Okubalulekile
Kutholakala ukuthi unesifo sikaCrohn ngemuva kokuxilongwa kwe-ulcerative colitis kanye nokuhlinzwa kwe-j-poch kuyinto yokukhathazeka okusemthethweni. Kungenzeka ukuthi kudingeke kukhulunywe ngaso isikhathi eside ne- gastroenterologist kanye nodokotela ohlinzayo ngaphambi kokuhlinzwa, ikakhulukazi kubantu abaye bathola ukuthi bancane noma abanenkinga yokugcoba. Iziguli kufanele zicele odokotela abahlinzayo ngesibalo seziguli eziye zahlolwa kabusha ngemuva kokuhlinzwa. Kodwa-ke, kubalulekile ukuqaphela ukuthi lokhu akuyona into ejwayelekile -ukuguquka kokuguqulwa kwesifo kuyancipha ngokuhamba kwesikhathi njengoba amasu okuxilonga we-IBD athuthukisiwe.
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