Isifo sikaCrohn yisifo esingelapheki, esingelapheki, esivivinya umzimba esingasibangela ukuvuvukala noma kuphi lapho kuhamba khona umgudu wokugaya kusukela emlonyeni kuya ku- anus . Kanye nesifo sofuba esiswini, isifo sikaCrohn singenye yezinhlobo ezinkulu zezifo zesifo sofuba (IBD) . Isifo sikaCrohn ngokuvamile sihilela zonke izigcawu zodonga lwamathumbu, okwenza izilonda ezijulile.
Abantu abanesifo sikaCrohn ngokuvamile banakekelwa yi- gastroenterologist (isazi esifo sokugaya ukudla) futhi ngezinye izikhathi udokotela ohlinzayo ohlinzayo (udokotela ohlinzayo ogxile emgqeni wokugaya).
Nakuba ukuxilongwa kwesifo sikaCrohn kuyinto yokushintsha impilo futhi isifo sidinga ukuphathwa, ikusasa labantu abane-IBD likhanya. Kukhona ukhetho oluningi lwezokwelapha kunanini ngaphambili, futhi izindlela zokwelapha ezintsha zifundiswa ukuze zilethwe ezigulini. Isizathu esiqondile kanye nokwelashwa kusacwaningwa, futhi kukhona ucwaningo olwengeziwe olwenziwa manje kwi-IBD kunanini ngaphambili.
Izinto Ezibaluleke Kakhulu Ukukwazi Ngezifo Ze-Crohn
- Isifo sikaCrohn sinhlobo olulodwa lwe-IBD futhi singathinta noma iyiphi ingxenye yegciwane lokugaya kusukela emlonyeni kuya ku-anus.
- Ayikho imbangela noma imithi eyaziwayo yesifo sikaCrohn.
- Ukubhema ugwayi kungalimaza isifo sikaCrohn.
- Izinhlobo eziningi zemithi zisetshenziswa ukuphatha isifo sikaCrohn, kuhlanganise nama-antibiotics, ama-immunomodulators, i-steroids, ne-biologics.
- Ukwelashwa kusetshenziselwa ukwelapha isifo sikaCrohn, kanti ukuhlinzekwa komthengisi kuyinto evamile kakhulu.
- Abantu abanesifo sikaCrohn bangase babe nezinkinga ngaphakathi nangaphandle kwendlela yokugaya (izinkinga ezingaphezu kwamathumbu).
- Abesifazane abanesifo sikaCrohn bangaba nokukhulelwa okunempilo kanye nezingane .
Amafomu wezifo zikaCrohn
Kusetshenziselwa amagama ahlukene ukuchaza isifo sikaCrohn, kuye ngokuthi iyiphi ingxenye yegciwane lokugaya isithintekile.
Akuzona zonke izifo zesifo sikaCrohn eziyokwehla kahle kwisigaba, kepha lezi yizifomu ezivame ukuchazwa futhi zingasetshenziswa odokotela:
- Ileocolitis. Ifomu ejwayelekile kunazo zonke zesifo sikaCrohn esithinta i- ileum (ukuphela okuphansi komathumbu omncane) kanye nekoloni (amathumbu amakhulu).
- Ileitis. Eyaziwa nangokuthi i-fistulizing noma iphazamise isifo sikaCrohn, lolu hlobo luthinta kuphela i-ileum.
- Isifo se-Gastroduodenal Crohn. Leli fomu lithinta isisu ne duodenum (ingxenye yokuqala yomathumbu amancane).
- Jejunoileitis. Isifo sikaCrohn esibonakala ezindaweni ezivame ukuvuvukala kwi- jejunum (isigaba esiphakathi samathumbu amancane).
- I-Crohn's colitis. Ngezinye izikhathi kuthiwa yi- granulomatous colitis , leli fomu lithinta kuphela ikoloni, futhi akufanele lidideke ne-ulcerative colitis, okuyindlela ehlukile ye-IBD. I-Crohn's colitis iyindlela ye-Crohn's disease, futhi akusho ukuthi umuntu unesifo sikaCrohn nesifo sochungechunge.
Izimpawu zezifo zika Crohn
Isifo sikaCrohn senza izibonakaliso nezimpawu ezihlukahlukene, ezinye zazo emgqatsheni wokugaya futhi ezinye zazo ngaphandle kwesistimu yokugaya. Izimpawu zesifo sikaCrohn zingabandakanya:
- ubuhlungu besisu kanye nama-cramps
- isitokisi segazi
- isifo sohudo
- umkhuhlane
- ukulahlekelwa kwesidlo nokulahlekelwa kwesisindo
- i-mucus esitokisini
- isilonda somuthi wokugaya
Izizathu Ezenzekayo Zezifo Ze-Crohn
Kukhona imibono mayelana nombangela we-Crohn's disease kanye ne-IBD ngokujwayelekile , kodwa i-IBD okwamanje ihlukaniswa njengesifo se- idiopathic (isifo esingaziwa). Isifo sikaCrohn sivame ukugijima emindenini, nakuba abantu abaningi abane-IBD bengenalo umlando womndeni wesifo.
Enye imbono mayelana nesizathu se-IBD yukuthi ingaba yisifo sengqondo sokuzivikela noma sokuzivikela ngomzimba, ngokuyinhloko esekelwe ekubeni i-IBD yisifo esiphathelene nomzimba . Izinto eziphathelene nomvelo nazo zifakiwe, kepha akukho ukuvumelana emphakathini wezokwelapha mayelana nokuthi yiziphi izinto ezingase zithonye ukuqala kwe-IBD.
Esinye isizathu esingaba khona singabandakanya ama-microorganisms (amabhaktheriya) ahlala emgqeni wokugaya, okuthiwa igulane noma i- microbiome yamathumbu. Akuqondakali okwamanje ukuthi ukuguquka kwe-microbiome kungathinta kanjani ukuthuthukiswa kwesifo sikaCrohn, kodwa kuyaziwa ukuthi abantu abanesifo sikaCrohn bavame ukuba nezinhlobo ezimbalwa zebhaktheriya endleleni yabo yokugaya kunezidakamizwa ezingenayo isifo sokugaya. Isizathu sangempela se-IBD sisengaba nanoma iyiphi inhlanganisela yalezi noma ngisho nento engakaze itholakale.
Indlela Ukugula Kuka-Crohn Kuyatholakala Ngayo
Udokotela angase akhohlwe kuqala isifo sikaCrohn esekelwe emlandweni wezimpawu ezifana nobuhlungu, isifo sohudo, ukulahlekelwa isisindo esingalindelekile, negazi esitokisini. Lezi zivivinyo ezimbili ezazisetshenziselwa ukuxilongwa ngesifo sikaCrohn yizi:
- I-Colonoscopy . Lokhu kuhlolwa kusetshenziselwa ukubheka ngaphakathi kolononi ukubona ukuthi ukuvuvukala kukhona.
- I-Sigmoidoscopy . Ukubukeka ngaphakathi kolononi, kufana ne-colonoscopy, kodwa lokho kuya kuphela esigabeni sokugcina samathumbu amakhulu
Okunye ukuhlolwa okungase kungasetshenziswanga ekuxilongweni, kepha kungenziwa ukuqapha umsebenzi we-Crohn's disease noma izinkinga kubandakanya:
- Barium enema . Lolu luhlolo luhlobo lwe-x ray olusebenzisa umehluko ukuze ubone kangcono izakhiwo ezingxenyeni eziphansi zokugaya.
- Ukuhlolwa kwegazi. Ukuhlolwa kwegazi kubuye kwenziwe njalo ukunikeza ulwazi oluwusizo mayelana nesimo se-IBD, ikakhulukazi iseli elibomvu legazi kanye nokubala kwegazi elimhlophe . Ezinye izivivinyo zegazi zingalinganisa amazinga e-electrolyte, njenge-sodium ne-potassium, ukucacisa ukuthi aphelile yini kuhudo oluqhubekayo.
- I-CT (i-computed tomography) yokuskena . Uhlobo lwe-x-ray olunikeza isithombe esiphambene nesitho somzimba. Futhi ibizwa nge-computed tomography (CT).
- Endoscopy ephezulu . Uma kunesifo esingaba nesifo esiphambanweni sokugaya (okufana nesisu, umphimbo, noma intombazane encane), lokhu kuhlolwa kungasiza.
- Uchungechunge oluphezulu lwamathunjini . Olunye uhlobo lwe-x-ray olusebenzisa ukuphambene futhi lisetshenziselwa umgogodla wokugaya phezulu.
- X-ray . Isivivinyo esisheshayo nesilula esinganikeza ulwazi oluthe xaxa kepha sisasebenza ngezinye izikhathi.
Ukuthi Izifo ZaseCrohn Zithathwa kanjani
Kokubili imithi nokuhlinzwa kusetshenziselwa ukwelapha isifo sikaCrohn. Njengoba kunezinhlobonhlobo zokwelapha ezitholakalayo, kubalulekile ukusebenza eduze ne-gastroenterologist ukuthola inqubo engcono kakhulu yezenzo.
Imithi . Imithi ehlukahlukene ingasetshenziswa ukuphatha isifo sikaCrohn. Imithi ngokuvamile iwela emikhakheni emibili: Izidakamizwa zokulondolozwa, ezithathwa ngokuqhubekayo ukuvimbela ama- flare-ups , nezidakamizwa ezisebenza ngokushesha, ezithathwa ukuze zimise ukuphazamiseka.
Imithi esetshenziselwa ukwelapha isifo sikaCrohn ihlanganisa: i- Azulfidine (sulfasalazine) ; I-Asacol nePentasa (mesalamine); Imuran (azathioprin) ; I-Purinethol (i-6-MP, i-mercaptopurine) ; i-cyclosporine ; I-rheumatrex (methotrexate) ; I-Remicade (i-infliximab) ; Huma (adalimumab) ; I-Entyvio (i-Vedolizumab) ; I-Cimzia (i-certolizumab pegol) ; kanye ne-corticosteroids, njenge- prednisone ne- Entocort EC (i-budesonide).
Ukuhlinzwa . Ukuhlinzwa kusetshenziselwa ukwelashwa kwesifo sikaCrohn. Cishe amaphesenti angu-70 abantu abanesifo sikaCrohn bazohlinzwa eminyakeni eyishumi yokuqala ngemva kokuxilongwa. Kulabo, isigamu sizohlinzwa ngaphezulu eminyakeni emithathu kuya kweyine ezayo. Ukususwa , lapho isifo esithathekile samathumbu sisusiwe, uhlobo oluvame kakhulu lokuhlinzwa. Ukwelashwa akuwona ukwelashwa kwesifo sikaCrohn.
Ingozi Yamanqamu Emathunjini
Kubantu abanesifo sikaCrohn, kunezici eziningana ezibonakala zithinta ingozi yokuthuthukisa umdlavuza we-colorectal . Lezi zingozi zihlanganisa:
- esencane lapho ehlushwa
- Iminyaka engu-8 kuya kwengu-10 yesifo esisebenzayo ngokuvuvukala
- ukuba nezinkinga (ukunciphisa amathumbu)
- umlando wesifo sesibindi, isisekelo se-sclerosing cholangitis
Odokotela bangase batuse ikolonoscopy yokuhlola yonke iminyaka emibili kuya kwemibili emva kweminyaka eyisishiyagalolunye kuya kweyishumi ye-Crohn's disease, futhi njalo eminyakeni emibili emva kweminyaka engu-20 yesifo sikaCrohn. Abanye abantu abanesifo sikaCrohn bangadinga i-colonoscopy ngezikhathi ezithile ukuqapha isifo sabo, futhi ukuhlolwa komdlavuza kungenziwa ngesikhathi esifanayo.
Izimo ezihlobene
Okungeziwe emathunjini . Kungaba nezinkinga ezihlobene nesifo sikaCrohn, futhi lokho okwenzeka ngaphandle kwekoloni kubizwa ngokuthi izinkinga ezingaphezu kwamathumbu. Izinkinga ezingaphezulu kwamathumbu zihlanganisa i- arthritis , ukukhula okubambezelekile ezinganeni , izifo zamehlo, izigulane , izimo zesikhumba, izilonda zomlomo , nokuya kwezimpawu ezinzima ngesikhathi sokuya esikhathini . Eziningi zalezi zinkinga zizolandela inkinga yesifo sikaCrohn, futhi zingase zibe zimbi nakakhulu ngaphambi nangesikhathi sokuqhafaza futhi zithuthukise lapho isifo sikaCrohn siphelelwe yisikhathi.
Amathumbu . Ezinye zezinkinga zangasese zendawo (emathunjini) zesikhumba sikaCrohn zibandakanya ama-abscesses , ukuvinjelwa kwesisu , isifo somzimba , isifo somdlavuza , ama- fissures , i- fistula , ne- megacolon enobuthi .
Ukubhema nezifo zikaCrohn
Abantu ababhema ugwayi , noma ababhemayo esikhathini esidlule, banengozi enkulu yokuthuthukisa isifo sikaCrohn. Ukubuyela emuva (ukuhlaselwa), ukuhlinzwa okuphindaphindiwe, kanye nokwelashwa okunamandla okugulisa umzimba kujwayelekile kulabaguli abanesifo sikaCrohn ababhemayo. Abantu abanesifo sikaCrohn bakhuthazwa kakhulu ukuba bayeke ukubhema.
Ukukhulelwa
Ukukhulelwa okunempilo kanye nomntwana kokubili kungenzeka kwabesifazane abanesifo sikaCrohn. Indlela isifo sikaCrohn esiphendule ngayo ngesikhathi sokukhulelwa sehlukaniswe ngokuyisithathu: abanye besifazane benza ngcono, abanye bahlala okufanayo, futhi abanye bebuhlungu kakhulu. Into ebaluleke kakhulu ukungena ekuxoxweni ngaphambi kokukhulelwa, noma ukufika lapho ngesikhathi sokukhulelwa, ukuqinisekisa ukuthi umama nosana bayaqhubeka benza kahle. Ngeshwa, uma isifo sikaCrohn sishaya ngesikhathi ingane ikhulelwa noma ngesikhathi sokukhulelwa, ingozi yokukhulelwa kwesisu nokubeletha ngaphambi kwesikhathi iphakeme.
Isibikezelo
Ngokunakekelwa kahle kwezempilo, ukuchazwa kwabantu abaningi abane-Crohn's disease kuhle. Abantu abaningi abane-Crohn's disease bayakwazi ukuhola ukuphila okude, okukhiqizayo. Imithi emisha kanye nokucwaninga ngezimbangela ze-IBD ziyaqhubeka nokwandisa ikhwalithi yokuphila kubantu abane-IBD.
Izwi elivela
Ukuxilongwa kwesifo sikaCrohn kuhambisana nekhasi lokufunda eliphakeme. I-gastroenterologist kanye nabasebenzi bazoba ababucayi ekuqinisekiseni ukuthi izinga elihle lokuphila lilondolozwe. Iningi labaguli be-IBD babe nobuhlobo obuseduze nama-gastroenterologists abo. Kubalulekile futhi ukuthi abantu abane-IBD bahlakulele inethiwekhi yokusekela phakathi komndeni wabo nabangane abangaba ngabagqugquzeli. Ukuphila kahle nesifo sikaCrohn akusifinyeleleki ngokugcina ukuqokwa kwabadokotela njalo, kulandela uhlelo lwezokwelapha, nokufunda ngangokunokwenzeka ngesifo.
> Imithombo:
> Ban L, Tata LJ, Fiaschi L, Ikhadi T. Izingozi ezincane zezinkinga ezinkulu zokuzalwa ezinganeni ezingamama nge-IBD nemiphumela yemithi. I-Gastroenterology . 2014 Jan; 146: 76-84.
> Crohn's and Colitis Foundation of America. Izinkinga zokwelashwa kwezifo zika Crohn's. CCFA.org 2016.
> Crohn's and Colitis Foundation of America. Izinketho ze-Crohn's Treatment. CCFA.org 2016.
> Nørgård B, Hundborg HH, Jacobsen BA, Nielsen GL, Fonager K. Izifo Umsebenzi kwabesifazane abakhulelwe abanezifo zika Crohn kanye nemiphumela yokuzalwa: Isifundo seDanish Cohort Study. Am J Gastroenterol . 2007 Sept; 102: 1947-1954.
> Veloso FT. Izibikezelo zemithi yokwelashwa kweCrohn's disease. I-Eur J Gastroenterol Hepatol . 2016 Jul 7. [Epub ngaphambi kokuphrinta]