Ukukhulelwa Nethonya Imishanguzo ye-IBD isenesikhathi sokukhulelwa nomntwana
Ingabe Abesifazane Abano-IBD Baba Nezingane?
Yebo, abesifazane abanezifo zesifo sofuba (IBD) bangaba nabantwana. Esikhathini esidlule, abesifazane abane-IBD bacekwa ngokukhulelwa. Kodwa manje amasu okuphatha i-IBD enza ukuba umntwana abe nokuphephile kokubili umama nengane. Ukuba nesifo esingapheli ngesikhathi ukhulelwe kudinga ukunakekelwa ngokucophelela odokotela abaqeqeshiwe, kodwa ukukhulelwa okusempilo nomntwana kokubili kungenzeka.
Ingabe Amadoda Nabafazi Abano-IBD Benze Ukunciphisa Izindleko Zokuzala?
Izinga lokubeletha kwabesifazane abane-IBD zifana nabesifazane abanempilo enhle. Abesifazane abane-Crohn's disease esebenzayo bangase banciphise ukuzala. Ukuhlela umndeni kuyisihloko esibalulekile kunoma yimuphi owesifazane, kodwa ikakhulu kulabo abane-IBD. Kunezimo lapho ukukhulelwa kungase kungabeliswa khona, njengokungathi ngesikhathi sokushayisana noma ngenkathi kuthatha imithi ethile.
Kuye kwaziwa iminyaka eminingi ukuthi i-sulfasalazine (i-Azulfadine), isidakamizwa esetshenziselwa ukuphatha lezi zimo, singabangela ukungabi namuntu okwesikhashana ngamadoda angama-60%. Ingxenye ye-sulfa yesidakamizwa ingashintsha isidoda, kodwa lokhu kuguqulwa ezinyangeni ezimbili zokuvimba ukusetshenziswa kwayo. Ukuhlinzwa kwe-Proctocolectomy kumadoda kungabangela ukungabi namandla, nakuba lokhu kungavamile.
Ngokusho kokubuyekezwa okunye kwezincwadi, ukungabi nabantwana kubonakala kuma-48% wabesifazane abahlinzwa ukuze baphathe isifo sofuba esiswini. Lokhu kungenzeka ngenxa yokulahla emathangeni amathanga angase ayenze ngemuva kokuhlinzwa okunjalo okukhulu.
Ingozi yokungabi nalutho ngemuva kokukhipha i-colectomy sekuyiminyaka eminingana ngoba imibuzo eminingi yabonisa izinga eliphezulu lokungabi nalutho. Kukhona imibiko efanayo yokungabikho kweziguli ezigulini zikaCrohn.
Iyiphi Impumelelo Imithi Eyenayo Ekukhulelweni?
Abesifazane abaningi bakholelwa ukuthi kufanele bayeke imithi ngesikhathi sokukhulelwa, noma kunjalo, ukuqhubeka nokuthatha imithi ye-IBD inikeza ithuba elihle lokugwema ukuphazamiseka.
Imithi eminingi ye-IBD iye yaboniswa ukuthi iphephile ukuqhubeka ngesikhathi sokukhulelwa, futhi abaningi banomlando omude wokusetshenziswa okuphephile iziguli. Ukuphathwa Kwezokudla Nezidakamizwa (FDA) kuye kwadala uhlelo lokuhlukanisa ukusetshenziswa kwemithi ngesikhathi sokukhulelwa (bheka ithebula 1 ngezansi).
Ucwaningo luye lwabonisa ukuthi izidakamizwa eziningi ezivame ukusetshenziselwa ukwelashwa kwesondlo kanye nokuhlaselwa okunamandla kwe-IBD kuphephile kwabesifazane abakhulelwe ukuba basebenzise. Lezi izi:
- I-Sulfasalazine (i-Azulfidine [Isigaba sokukhulelwa B]
- Izinhlobo zama mesalamine (Asacol, Pentasa, Rowasa [Isigaba sokukhulelwa B]
- I-Corticosteroids (i-prednisone [Ukukhulelwa kwesigaba B]
- Biologics ( Remicade , Humira , Vedolizumab , Stelara , Cimzia )
Lapho Izidingo Zezokwelapha Zingaba Ngomuntu Ngamunye
Imithi eminingi ye-IBD izobe iphephile ukuqhubeka ngesikhathi sokukhulelwa futhi akufanele ikhishwe ngaphandle kwezincomo eziqondile yi-gastroenterologist kanye ne-OB / GYN ejwayele inkinga ethilekazi ye-IBD. Nokho, kunezinye izidakamizwa ezingase zidingeke zilungiswe ngesikhathi sokukhulelwa.
Immunosuppressants. Imithi ye-immunosuppressive azathioprine (Imuran [Isigaba sokukhulelwa D] kanye no-6-mercaptopurine (Purinethol noma i-6-MP [Ukukhulelwa kwesigaba D]) bawela i-placenta futhi bangatholakala egazini legazi.
Noma kunjalo, bangase batuswa ngokucophelela ngenkathi bekhulelwe odokotela abathile ukuze balwe nokushayeka okukhulu. Lezi zidakamizwa azange zandise ubungozi bokukhubazeka kokuzalwa.
I-Methotrexate ne-thalidomide. I-Methotrexate (Isigaba sokukhulelwa X) kanye ne- thalidomide (Isigaba sokukhulelwa X) kukhona izidakamizwa ezimbili zokuzivikela ezingasetshenziswanga ngesikhathi sokukhulelwa njengoba zinomthelela kumntwana ongakazalwa. I-Methotrexate ingabangela ukukhipha isisu kanye nokungajwayelekile kwamathambo, futhi kufanele inqatshwe izinyanga ezintathu ngaphambi kokukhulelwe, uma kungenzeka. I-Thalidomide iyaziwa ngokubangela ukukhubazeka kwezitho kanye nezinye izinkinga ezinkulu zomzimba ebusweni.
Ukusetshenziswa kuvunyelwe kuphela ngokulawulwa kokubeletha okunzima nokuhlolwa kokukhulelwa njalo.
I-Metronidazole. I-Metronidazole (i- Flagyl [Isigaba sokukhulelwa B], i-antibiotic ejwayele ukusetshenziselwa ukuphatha izinkinga ezihlobene ne-IBD, kungenzeka ukuthi ingaphephile ku-fetus ngemuva kwe-trimester yokuqala. Ucwaningo olulodwa lubonise ukuthi i-metronidazole ayizange ibangele ukukhubazeka kokuzala esikhathini sokuqala, kepha akukho izifundo zesikhathi eside ezenziwe. Izifundo ezimfushane zalesi sidakamizwa zivame ukusetshenziswa ngesikhathi sokukhulelwa, nakuba izifundo ezinde zilokhu ziphikisana.
Ukukhulelwa Kuthinta Kanjani Inqubo Ye-IBD?
Isifundo se-IBD kulo lonke isikhathi sokukhulelwa sivame ukuhlala sifana nesimo somuntu ngesikhathi sokukhulelwa. Ngenxa yalesi sizathu, kubalulekile kwabesifazane abacabangela ukukhulelwa ukugcina imithi yabo yokwelapha futhi basebenze ukuletha, noma ukugcina, isifo sabo ekuxoxweni.
Phakathi kwabesifazane abakhulelwe kuyilapho i-IBD yabo ingasebenzi, ingxenye yesithathu ithuthukisa, ingxenye yesithathu ibe yimbi, kanti nesithathu kwesipiliyoni akukho shintsho kwisifo sabo. Phakathi kwabesifazane abakhulelwe ngenkathi i-ulcerative colitis ishaywa, izingxenye ezimbili kwezintathu zizoqhubeka zithola izifo ezisebenzayo.
Odokotela bangase baphathe ukuqhuma okukhulu kwe-IBD okwenzeka ngesikhathi sokukhulelwa okungakahlelwe kakhulu. Ukuthola ukukhululwa kubalulekile ukusiza ukuqinisekisa ukuthi ukukhulelwa kunempilo ngangokunokwenzeka.
Ithebula 1 - Izigaba Zezidakamizwa ze-FDA
| Isigaba | Incazelo |
| A | Ucwaningo olwanele, olulawulwa kahle kwabesifazane abakhulelwe alubonisi ubungozi bokungalingani kokubeletha. |
| B | Izifundo zezilwane azivezi ubufakazi bokulimaza komntwana, kodwa azikho izifundo ezanele ezilawulwa kahle kwabesifazane abakhulelwe. Noma izifundo zezilwane zibonisa umphumela omubi, kodwa izifundo ezanele ezilawulwa kahle kwabesifazane abakhulelwe ziye zahluleka ukubonisa ingozi kumntwana. |
| C | Izifundo zezilwane ziye zabonisa umphumela omubi futhi azikho izifundo ezanele ezilawulwa kahle kwabesifazane abakhulelwe. KANYE ayikho isifundo sezilwane esenziwe, ayikho izifundo ezanele ezilawulwa kahle kwabesifazane abakhulelwe. |
| D | Ukufunda, okwanele, okulawulwa kahle noma okuqaphele, kwabesifazane abakhulelwe baye babonisa ingozi kumntwana. Kodwa-ke, izinzuzo zokwelapha zingaphezu kwezingozi ezingenzeka. |
| X | Izifundo, ezaneleyo ezilawulwa kahle noma ezithokozisayo, ezilwaneni noma abesifazane abakhulelwe ziye zabonisa ubufakazi obuhle bokungafani kokubeletha. Umkhiqizo uyaphikisana nabesifazane abakhona noma abangakhulelwa. |
Zikhona yini Izinkinga Ngokukhulelwa Futhi IBD?
Kulabo besifazane abane-ulcerative colitis nesifo sikaCrohn ekuxoxweni, izingozi zokukhulelwa kwesisu, ukubeletha nokuzalwa okungavamile kufana nalabo besifazane abanempilo. Ukwelashwa kwesifo sikaCrohn ngesikhathi sokukhulelwa noma ngesikhathi sokukhulelwa kuhlotshaniswa nengozi ephezulu yokukhulelwa kwesisu nokubeletha ngaphambi kwesikhathi.
Ama-hemorrhoids yinkinga evamile kwabesifazane abakhulelwe, ngamaphesenti angaba ngu-50 abesifazane ababhekene nabo. Izimpawu ze-IBD, ezifana nesifo sohudo noma ukuqothulwa, ingakwandisa ingozi yezimpawu zokugcoba. Kunezinhlobo eziningana zokwelashwa ezizokwehlisa izidakamizwa ezifana ne-Kegel umzimba, ukugcina indawo ehlanzekile ihlanzekile, ukugwema ukuhlala nokuma isikhathi eside futhi ukuphakamisa okunzima noma okulinganiselayo, usebenzisa i-petroleum jelly ukupholisa uhlangothi nokunciphisa ukunyakaza kwamathumbu, ukuhlala ice pack for relief from burning, ehlezi ngamanzi afudumele afanele ukumboza ama-hemorrhoids, besebenzisa ama-suppository noma ama-creams.
Ingabe i-IBD Ithola Ukudluliselwa Kuyabantwana?
Abanye abantu abane-IBD bangase bangabi nabantwana ngenxa yokukhathazeka ukuthi izingane zingathola ifa labo. Eminyakeni yamuva, kuye kwagxila embonweni wokuthi i-IBD igijima emindenini futhi ingahle ixhunywe nezakhi zofuzo ezithile. Abacwaningi abanakho izimpendulo ezicacile mayelana nokuthi i-IBD idluliselwa kanjani phakathi kwezizukulwane, kodwa kukhona ucwaningo ngamathuba okuba izingane zizuze isifo somzali wazo.
Kubonakala sengathi kunengozi enkulu yokuthola isifo se-Crohn kune-ulcerative colitis, ikakhulukazi emindenini yamaJuda. Kodwa-ke, izingane ezinomzali oyedwa abane-Crohn's disease zineengozi yokuphila engapheli 7 kuya kwezingu-9 kuphela zokuthuthukisa isimo, futhi ingozi engama-10 kuphela yokuthuthukisa uhlobo oluthile lwe-IBD. Uma bobabili abazali bane-IBD, lokhu kubungozi kwanda cishe ku-35%.
Yini Eyokusiza Ngaphambi Kokukhulelwa Noma Ngesikhathi Yokukhulelwa?
Abesifazane manje bakhuthazwa ukuba imizimba yabo ilungiselele ukukhulelwa ngokunyusa ukudla kwe-folic acid, ukuyeka ukubhema, ukuthola umzimba wokuzivocavoca nokudla okunempilo. Kwabesifazane abane-IBD, into ebaluleke kunazo zonke ezithonya inkambo yokukhulelwa kanye nempilo yengane yisimo somsebenzi wesifo. Ukuyeka noma yimiphi imithi engase ibe yingozi kumntwana okhulayo nayo ibalulekile. Ukukhulelwa okuhleliwe ngesikhathi i-IBD isesekhokhweni inethuba elikhulu lomphumela omuhle.
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