Ingxaki eqhelekileyo ye-IBD, iArthritis ichaphazela i-25% yezigulane
Isifo sesibindi sokuvutha (IBD) sinxulumene nezinye iimeko, kubandakanywa nesifo sesibindi sokuqala se-sclerosing cholangitis , i- fissures , i- fistula kunye ne-arthritis. I-arthritis yinkxalabo eqhelekileyo yokudityaniswa komzimba, echaphazela ukuqikelelwa kwe-25% yazo zonke izigulane ze-IBD. Iimbali ezibini eziqhelekileyo ze-arthritis ezifumana izigulane ze-IBD ziyi-arthritis ne-axial arthritis.
Ngenxa yokuba isifo se-arthritis siqhelekile, kubalulekile ukuba abantu abane-IBD baqwalasele i-aches kunye neentlungu. Nangona ixabiso elithile liza kuba liqhelekileyo, kufuneka liveliswe kwiindawo zokuqeshwa kunye noogqirha bakho. Ukugcina amalunga njengempilweni ngokusemandleni kwaye ukuphepha imisebenzi eyenza umonakalo, kunye nokuhlala ngaphezulu kweengxaki xa zihluma, zibalulekile. Ukuba intlungu ibangela ukukhathazeka, kufuneka ixoxwe kunye nesifo se-gastroenterologist okanye i-rheumatologist ngaphambi kokuba uqalise nayiphina imithi yeentlungu, kuba abantu abane-IBD banokufuna ukuphepha ezithile iintlobo zamachiza (ikakhulu i-NSAID, jonga ingxoxo engezantsi).
I-Peripheral Arthritis
I-arthritis ye-Peripher ixhaphakile kubantu abane-ulcerative colitis okanye isifo se-Crohn sekholoni . Kwiintlobo ezahlukeneyo zesifo se-arthritis esichaphazela abantu abane-IBD, kulinganiselwa ukuba ama-60% ukuya kuma-70% athatyathwa yi-arthritis ye-peripheral. Ngokuqhelekileyo, ikhosi yesifo se-arthritis ilandela i-IBD, kunye ne- flare-ups kunye nokuxoxisana.
Akukho vavanyo olulodwa olunokuthi luxilonge i-arthritis ye-peripheral. Endaweni yoko, iimvavanyo eziliqela, ezifana nokuhlolwa kwegazi, ukuhlalutya kwamanzi kunye ne- x-ray , zisetyenziselwa ukukhuphela ezinye iimeko ezingabangela iimpawu.
Iimpawu ze-arthritis zengcingo ziquka:
- Intlungu ehlangeneyo
- Ukuvuvukala kwamalungu
- Ukunyameka kwelinye lamalungu amaninzi
- Iimpawu ezifudukela phakathi kwamalungu
I-arthritis ye-Peripheral iyakuthintela i-elbow, isandla, idolo kunye ne-ankle. Xa ubuhlungu besifo se-arthritis sishiywa singaphenduliwe, singadlulela kwiintsuku eziliqela ukuya kwiiveki; nangona kunjalo, umonakalo ongunaphakade kumalungu awaqhelekanga.
Ukwelapha i-arthritis ye-peripheral ngokuqhelekileyo kubandakanya ukuphumla iingxube ezibuhlungu kunye neengqamlezo kunye nobushushu obushushu obushushu. Ukuzivocavoca okunqunywe ngumphathiswa wenyama kusetshenziselwa ukuphucula uluhlu lwezityalo. Ngamanye amayeza asetyenziswa ukunciphisa ubomvu, ukuvuvukala, kunye nentlungu yeengxube ezivuthayo - kodwa i-NSAID ingathuthukisa iimpawu ze-IBD .
Enye indlela yokwelapha le ndlela ye-arthritis kukufumana ukulawula ukuvuvukala kwi-colon ngenxa ye-IBD. Iimpawu ze-arthritis ziza kuncipha xa i-IBD i-quiescent, kwaye izidakamizwa ezininzi ezisetyenziselwa ukuphatha i-IBD nazo zinokuncedisa i-arthritis ye-peripheral. Izigulane ze-IBD eziphathekayo kunye ne- prednisone zivame ukufumana impembelelo yebhonasi yecala lokukhupha intlungu. Izigulane ezifumana isifo se- anti- tumor necrosis-alpha (anti-TNF), njenge- Remicade (infliximab) okanye i- Humira (adalimumab) , ukunyanga i-IBD nayo inokuphucula impawu ze-arthritis.
I-Azulfidine (i-sulfasalazine) , i-5-Aminosalicylate yeziyobisi eye isetyenziselwa ukuphatha i-IBD, inokunika uncedo lwempawu nangona kungekho ubungqina obuninzi bokuxhasa ukusetyenziswa kwayo. Esinye isicatshulwa esilungiselelwe ukunyanga i-IBD, methotrexate , sinokuba yinkqubo efanelekileyo yonyango ye-arthritis.
I-Axial Arthritis (i-Spondyloarthropathy)
Kwiimeko ze-axial arthritis, iimpawu zingabonakala iinyanga okanye iminyaka ngaphambi kokuqala kwe-IBD. Iimpawu ziquka intlungu kunye nokuqina kumalunga omqolo wesipelini osesona sikhulu kakhulu kusasa, kodwa siya kuphucula ngomsebenzi wokwenyama. I-arthritis esebenzayo echaphazelekayo ichaphazela abantu abancinci kwaye inqabileyo iqhubeka kwizigulane ezingama-40.
I-Axial arthritis ingakhokelela ekuhlanganyeleni kwamathambo ekholenda ye-vertebral. Le nkxalabo enesigxina ingakhokelela ekunciphiseni kwintlobo ye-ntshukumo kwimva kunye nomda wokunyuka kwembambo ophazamisa ukukwazi ukuphefumula.
Injongo yonyango ye-axial arthritis kukukhuphula uluhlu lwesigxina. Ulwaphulo oluthile, ukusebenzisa i-postural and stretching exercises kunye nokusetyenziswa kobushushu obumanzi ngasemva, ezimbini iindlela eziqhelekileyo zonyango. Ezinye izigulane zifumana unyango kwi-NSAID.
Ukunyanga i-IBD ayinasiphumo kulo hlobo lwesifo samathambo; Nangona kunjalo, iyeza-anti-TNF kunye ne-Azulfidine inokuba yinzuzo ethile ekunciphiseni iimpawu.
Ankylosing Spondylitis
I-Ankylosing spondylitis (AS) yindlela ye-arthritis apho amanxeba emgodini kunye ne-pelvis atshabalala. NJENGOBA kunzima ukuchaphazela abo abanesifo sikaCrohn kaninzi kunabantu abanesifo sokulonda i-ulcerative, kunye namadoda amaninzi kunabesifazane. I-AS ithathwa njengeyinqabile kuba ichaphazela kuphela u-1% ukuya ku-6% walabo abane-IBD. Kukho kwakhona inxalenye yezofuzo kwi-AS, kodwa yintoni ebangela ukuba le fom ye-arthritis ingaziwa.
Ukuqala kwe-AS kudla ngokuhambisana nelahleko yokuguquguquka kwintsipho esezantsi. Unyango lubandakanya ukuphathwa kweentlungu kunye nokuvuselelwa ukuze kugcinwe ukuguquguquka komgudu. I-Remicade ne-Humira zivunyiwe ukuba zonyango lwe-IBD kunye ne-AS, kwaye zinokusebenza ngokunyanga kwiimeko zombini ngexesha elinye. I-Azulfidine inokuba luncedo ekunciphiseni iimpawu, ngokukodwa ukunyamezela kwasekuseni. Ezinye izifundo zibonise i-methotrexate ukuba luncedo kwi-AS, ngelixa abanye bengabonakali inzuzo; i-methotrexate isetyenziselwa ukuphathwa njenge-AS ngokudibene nezinye iziyobisi. Nangona kunjalo, nangaphandle kwonyango, abanye abantu abane-AS basabonakalisa impawu, kwaye amathambo omgudu angaphinda ahlangane.
Imithombo:
Bourikas LA, Papadakis KA. "Izibonakaliso zeMisculoskeletal of Infmmatory Dwels Disabilities." Kwi-Bowel Dis 2009; 1915-1924. 21 uJuni 2016.
U-Chen J, uLiu C. "I-Sulfasalazine ye-spondylitis e-ankylosing." I-Cochrane Database yeeNkqubo zoVavanyo 2005: CD004800. 21 uJuni 2016.
UKaufman I, uCaspi D, u-Yeshurun D, uDotan I, Yaron M, uElkayam O. "Impembelelo ye-infliximab ngokubonakaliswa kwezinto eziqhelekileyo zesifo sikaCrohn." Rheumatol Int Aug 2005; 25: 406-10. Epub 2004 Agasti 12. 21 Jan 2016.
Orchard TR. "Ulawulo lweArthritis kwizigulane ezinezifo ezikhubazayo." I-Gastroenterol Hepatol (NY) . 2012 ngoMeyi; 8: 327-329. 21 uJuni 2016.
UPeluso R, Atteno M, Iervolino S, et al. "I-Methotrexate kwonyango ye-arthritis ye-peripheral in colitis." Rheumatismo 2009 Jan-Mar; 61: 15-20. 21 uJuni 2016.
van der Heijde D, Dijkmans B, Geusens P, et al. "Ukusebenza kunye nokukhuselwa kwe-infliximab kwizigulane ezine-spondylitis ezingenayo: Iziphumo zolu vavanyo olulawulwe ngokulandelelanayo, lwe-placebo (ASSERT)." Arthritis & Rheumatism Feb 2005; 52: 582-591. 21 uJuni 2016.
Yüksel I, Ataseven H, Başar O, Köklü S, et al. "I-Arthritis ye-Peripheral in the Coursion of Inflammatory Bowel Diseases." I-Dig Dis Sci 11 Meyi 2010. 21 uJuni 2016.