Iimpawu ezithile zeZifo ze-Crohn kunye ne-Ulcerative Colitis zingabangela ukukhulelwa
Ubutyebi becinga ngokubanzi, kubafazi, njengokuba banako ukukhulelwa umntwana. Kubafazi abalala rhoqo, bengakhulelwa malunga neenyanga ezili-12 kubonisa ukuba ukuzala kunganciphisa.
Kukho ngaphezulu kwimbali, nangona kunjalo, ngakumbi kubasetyhini abanezifo ezingapheliyo ezifana nesifo sesibindi sokugula (IBD) .
Ukuze ukhulelwe ngaphandle koncediso, umntu kufuneka abe nesondo esenza ukuba umntwana enze. I-IBD ingayiphonsa imithintelo endleleni, kubandakanye kaninzi amaqabane abelana ngesondo kunye nokuba ukukhulelwa kukusekelwe njani ukuba ibhinqa iziva kakuhle, iqhutywe, okanye iqhutywe i-IBD.
Ukuqonda indlela i-IBD echaphazela ngayo ukuvelisa kudla ngokuqinisekisayo kuba ezinye iinkalo ze-IBD eziboniswe ukunciphisa ukuzala zilawulwa. Eli nqaku liza kuxubusha indlela izinto ezinxulumene ne-IBD, kuquka nempilo yengqondo, imichiza kunye nokuhlinzwa, kuthintela inzala kubasetyhini.
I-IBD kunye noButyebi kwabasetyhini
Indlela yokuba nesifo sikaCrohn okanye isifo sezilonda zesilonda sithintela ukuzala ngokubanzi kwabasetyhini akuqondwa ngokupheleleyo. Kubasetyhini abane-Crohn's disease, uphando lubonisa ukuba ukuzala "kuyinto eqhelekileyo okanye kufuphi nesiqhelo," kunye nakwabhinqa abane-ulcerative colitis abangenalo utyando, ukuzala "kuyinto evamile."
Abasetyhini abane-IBD ayinanto yokunciphisa inzala kuwo ebhodini.
Ngamanye amazwi, abafazi abane-IBD bavame ukukhulelwa kaninzi njengabasetyhini abangenawo IBD. Nangona kunjalo, i-IBD ithinta wonke umntu ngokungafaniyo, kwaye kukho ezinye izizathu zokuba i-IBD inokuchaphazela ukuzala. Ngokomzekelo, kulabo abanesifo esibi okanye abo baneentlobo ezithile zokuhlinzwa, ukuzala kunganciphisa.
Abasetyhini abane-IBD abanenkxalabo malunga nokuzala kufuneka baxoxe nabo kunye noogqirha babo. Ukwesaba malunga nokukwazi ukukhulelwa okanye ukukhulelwa okunempilo kunokulawulwa rhoqo. Ukongeza, ukululekwa kwangaphambili kubalulekile kuba ne-IBD kunye nayiphi na ingxaki ephantsi kolawulo iya kunika ithuba elihle lokulondoloza nokuzala.
Iimpawu ezichaphazelekayo ze-IBD ezinokuthi zithinte ukukhula
Nangona i-IBD ngokwayo ingabonakali ibangela ukuncipha kwenzalo kwiimeko ezininzi, kukho izizathu ezithile zokuthi ukuzala kubasetyhini abane-IBD kuncitshiswa. Abasetyhini abaninzi banokucinga ukuba kubalulekile ukuyeka ukuthatha imishanguzo ye-IBD ukuze ukhulelwe kodwa akunjalo ngaso sonke isikhathi, kwaye ngokuyinene ngokuqhelekileyo ukutshintsha. Ukuba nezifo ezisebenzayo ngamanye amaxesha zinganciphisa ukuzala, kodwa kungekho rhoqo. Nangona kunjalo, kubalulekile ukwazi ukuba ukuxolelwa kunika iimeko ezingcono kakhulu zokukhulelwa okunempilo.
Isifo sobuso. Kubafazi abanesifo sikaCrohn, ukuvutha kwe-IBD kunokunciphisa ukuzala, kodwa akukho qi Ukuba ne- IBD ukuphazamiseka kunokunciphisa ukuzala ngenxa yokuba kunokunciphisa ukulala ngesondo kunye nesondo kungenakukhathazeka kwabasetyhini. Kubalulekile ukuba abafazi abane-IBD baceba ukukhulelwa xa isifo singasebenzi.
Mayeza. Kubafazi, amaninzi amayeza asetyenziswa rhoqo ukuphathwa kwe-IBD awazange aboniswe ngenxa yokunciphisa ukuzala. Nangona kunjalo, kuyafaneleka ukuba kuqaphela ukuba abafazi abathatha imettretrexate akufanele bakhulelwe, njengoko le nkunkuma ikwahlukileyo kwiCandelo X yokukhulelwa kwaye iboniswe ukuba ibangelwe ukukhulelwa kubantwana. I-Gastroenterologists inokuphinda ikhuthaze ukuyeka ukusebenzisa i-steroids (njenge- prednisone ) ngaphambi kokukhulelwa, esinye esinye isizathu sokucwangcisa ukukhulelwa nokuxoxa ngokusetyenziswa kwamachiza kunye neqela lezempilo.
Abasetyhini abane-IBD abathatha amanye amayeza baya kufuna ukuxoxa ngefuthe lala mayeza onokuzala kunye nokukhulelwa kunye ne-gastroenterologist kunye nomdlavuza / ugqirha.
Nangona amayeza amaninzi acingwa ukuba akhuselekile ngexesha lokukhulelwa kunye nokukhulelwa, i-IBD nganye ibhinqa iyahlukileyo kwaye kufuneka utshintshe unyango.
Nangona umfazi efumana ukhulelwe ngokungalindelekanga, imishanguzo ye-IBD ayinakuvalwa ngaphandle kokuqala ukuxubusha imeko ne-gastroenterologist. Ukugcina ukuvuvukala kwe-IBD kukubalulekileyo ekukhulelweni okunempilo.
Utyando lwe-J-pouch. Kwabesetyhini abane-ulcerative colitis abanesiqhwenga se-analomosis (IPAA) ye-ileal-anal anal (ebizwa ngokuba yi- j-pouch surgery), ukuzala kunokunciphisa. Abagqirha abakwazi ukuqikelela ukuzaliswa kwexesha elizayo kunoma yimuphi umfazi omnye, kodwa uphando lubonisa ukuba ukunyanzeliswa kokunciphisa kwabasetyhini emva kokutyunjwa kwe-j-pouch kungabikho naphakathi kwama-30 ukuya kuma-50 ekhulwini, ngokucacileyo ngokuphathelele.
Ngokuqhelekileyo kuba izicubu ezinqabileyo zingabinqanda okanye zivimbele ngokupheleleyo okanye zimbini zombini zee-fallopian tubes, ezivimbela iqanda ukuba lihambe ukusuka kwi- ovary ukuya kwisibeletho . Esi siphumo sokuhlinzwa siyaziwa, kwaye abafazi abakwenzayo kule nkqubo bafuna ukulondoloza ukuzala kwabo kufuneka baxoxe ngamathuba okuvelisa ubuncwane kunye ne-gastroenterologist kunye nodokotela ogqirha.
Utyando alubonakali libe nefuthe ekukwazi ukukhulelwa okanye ukufumana umntwana ophilileyo, opheleleyo. Oko kuthetha ukuthini ukuba unyango lwezityalo, ngokuqhelekileyo kwi-vitro fertilization (IVF), lunokunceda ukuba iibhubhu ze-fallopian zivaliwe. Olunye uphando lubonise ukuba i-IVF inezinga elifanayo lokuphumelela kwabasetyhini abane-IBD njengoko kwenzayo kwabasetyhini abangenawo IBD.
Kwezinye iimeko, ababoneleli benonophelo lwempilo banokuthabatha ukuba nabantwana ngaphambi kokuba bazalise utyando lwe-j-pouch, ukuze balondoloze ukuzala. Oku kunokuthetha ukukhulelwa nokukhupha umntwana emva kokuhlinzwa okwenziwe nge-colectomy kwaye ngelixa i-ileostomy isendaweni. Ezi zigqibo zikhethiweyo kwaye ngamnye umfazi uya kufuna ukuthetha ngokungekho nje ngababoneleli bezempilo kodwa kunye namalungu entsapho, ukuze ahlolisise zonke iinketho ezikhoyo kubo ukuqala okanye ukugqiba intsapho yabo.
Olunye uphando lwe-IBD. Kukho uphando oluthile olufumaneka kwindlela ezinye iintlobo ze-IBD zokuhlinzwa zithintela ukuvelisa kwabasetyhini. Olunye uphando lubonisa ukuba kubafazi abanesifo sikaCrohn, utyando lunokuba nempembelelo encinci ekunciphiseni ukuzala. Nangona kunjalo, ezinye iingxelo zibonisa ukuba xa utyando luza kunceda ukugcina i-IBD ekuxoxweni, ukuveliswa kuphuculwe. Njengoko kunye neminye imiba yokuzala kunye ne-IBD, iqinisa into yokuba ukugcina ukuvuvukala kuya kuba yinto ephambili ekuphuculeni amathuba okukhulelwa.
Ezinye iinkalo ze-IBD kunye nendlela ezichaphazela ngayo ukulimala kwabasetyhini
Imiba yomfanekiso. Abanye abafazi abane-IBD bafumana ubunzima ngomfanekiso womzimba. Oku kungabikho ekujonganeni nemimandla eyahlukeneyo ye-IBD (intlungu, isifo sohudo, izibazi ezipakanyayo) okanye nemiphumo emibi evela kumachiza.
Imiba yomfanekiso yombutho ibalulekile ukuxoxa ne-gastroenterologist, kwaye kwezinye iimeko, ukuhanjiswa kwingcali yezempilo yengqondo ingaba yindlela efanelekileyo yokusebenza. Ukujongana nemiba yomzimba kunokuthetha ukuya kwiiseshoni zonyango okanye ukwenza omnye umsebenzi ukulungisa iingcamango ezimbi, kodwa kwiimeko ezininzi, kunokunceda kwaye kukhokelela ekuphuculeni umgangatho wobomi.
Inomdla kwisini. Ucwaningo oluninzi lubonisa ukuba abafazi abane-IBD banokuba nomdla wokuhlaselwa ngesondo , okuya kunciphisa ukuzala kwabo. Izizathu zokungabi noluvo "ngokovakalelo" zibandakanya ukutshatyalaliswa, ukuvakalelwa, okanye ulwabelana ngesondo (ezinjengeenkathazo kwiindawo zengingqi).
Ukusebenza ukujongana nale miba kunokuthatha ixesha kwaye kufuna uncedo kubangaphandle kubaboneleli bezempilo kodwa nakwiqabane eliqondayo. Kwezinye iimeko, i-libido iya kuthatha xa iingxaki zomzimba zilawulwa, kodwa kwabanye, ukuthunyelwa kwiprofethi yengqondo yengqondo kunokuba luncedo ekuxoxiseni ezi ngxaki kunye nokunikela izicwangciso.
Ukuxinezeleka. Uphando olwodwa lwabafazi abali-181 abane-IBD bacebisa ukuba akuyiyo inkxalabo yesifo ngokwayo esiba yingxaki enkulu kwinkqubo yesondo. Kule phando, okwenziwe ngophando olunikezwa ngabantu abangenaye ngaphandle kwe-IBD, abafazi baphendula ukuba ukudakumba kwakuyingxaki ebalulekileyo echaphazela umsebenzi wabo wesini. Olunye uhlolisiso olwalubhengeza abafazi abangama-336 abane-IBD babenemiphumo efanayo, kwaye bafumanisa ukuba isimo sengqondo esicindezelekileyo sinciphise umdla wokwenza isondo.
Ubuhlungu beentlobano zesini. Ixesha lezonyango kwiintlungu ngexesha lesini, i-dyspareunia. Ubuhlungu ngexesha lesondo lunokuthi lwenzeke ngezizathu ezahlukeneyo, kodwa njengoko luhambelana ne-IBD, lube ngumphumo emva kokuhlinzwa okanye ngenxa yeengxaki kwiindawo ezinje (njenge-fistula). Ukuba nentlungu inokunciphisa amandla kunye nomnqweno wokulala ngesondo kwaye ngoko ke, kunokukhokelela ekunciphiseni ukuzala.
Abasetyhini abaneentlungu ngexesha lesini baya kufuna ukuthetha ne-gastroenterologist yabo kunye nomzimba wabo wegazi ukuze bafumane oko kubangela intlungu kunye nendlela yokuphathwa ngayo. Ezinye iingcamango ezinokukunceda zibandakanya ukusebenzisa i-lubrication ukunceda nawuphi na owomileyo okanye usebenzise indawo efanelekileyo ngexesha lesini. Nangona kunjalo, intlungu enzima kwaye iqhubekayo imele ihlolwe ngugqirha, nangona kunokuhlazisa ukuthetha.
Ukungabi namntwana ngokuzithandela. Kukho ukuxhomekeka phakathi kwabantu abane-IBD ukuphepha ukuba nabantwana kuzo zonke iimeko, ngenxa yezixhala ngenxa yokudlulisa eso sifo kumntwana. Kwamanye amaxesha, kunokubakho iingxaki kuba ngenxa yokuba ne-IBD, umfazi akakwazi ukukhulelwa kunye nokukhulelwa okusemgangathweni kunye nosana.
Kuyinyaniso ukuba iminyaka edlulileyo, oogqirha banokucebisa abanye abasetyhini abane-ulcerative colitis okanye isifo sikaCrohn ukuze bagweme ukukhulelwa, kodwa akusoloko kunjalo. Unyango luye lwaphucula kakhulu kwaye kumaxesha amaninzi, amayeza angeke ayimfuneko ukuvalwa ngexesha lokukhulelwa. Ukongezelela, umngcipheko wokudlula i-IBD kumntwana uphantsi. Ngoku siyazi ukuba i-IBD inengxenye yezofuzo, kodwa kucatshangelwa ukuba inokubangela ukusingqongileyo.
Olunye uphando lubonisa ukuba abasetyhini abangazange banikwe imfundo eninzi malunga ne-IBD babengenakukwazi ukuthintela ukuba nabantwana, kaninzi bengenasidingo. Ukuthetha ne-gastroenterologist kunye nabanye ababoneleli ngezempilo malunga nemingcipheko yokukhulelwa, ukuzalwa kunye nokudlula i-IBD kubantwana kubalulekile ekwenzeni izigqibo malunga nokuba nosapho. Kwiimeko ezininzi, ukwesaba malunga nokukhulelwa kunye nomngcipheko we-IBD kuya kuba lula kakhulu.
ILizwi
Kwiimeko ezininzi, ukuzala akunakwenyuka kubafazi abane-IBD. Kukho iimeko ezinokuchaphazela ukukwazi ukukhulelwa, kuquka ukuxinezeleka kunye neentlobo ezithile zokuhlinzwa.
Ngelishwa, kuboniswe ukuba abafazi abane-IBD abanalo ulwazi olufunekayo ukwenza izigqibo malunga nokukhulelwa. Oku kungaba yimpembelelo enkulu kubo kuba nabantwana, kuba inkolelo yokuba ukukhulelwa nokuzalwa kufuneka kugwenywe.
Ukuthetha nomgudu we-gastroenterologist kunye nabanye abaqeqeshi bezempilo malunga nokuzala kungakhokelela kwiziphumo ezingcono kuba amathuba okukhulelwa nokuba nomntwana ophilileyo angcono kunokuba ucinge. Uncedo lwemibandela eninzi eyancipha inzala iyafumaneka-yinto nje yokwazi ngabo kunye nokugqiba oko kukulungele.
> Imithombo:
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> Oza SS, Pabby V, Dodge LE, et al. "Kwi-Vitro Fertilization kwabaseTyhini abanezifo ezithintekayo izifo zesifo sezifo ziphumelele njengabasetyhini ukusuka kwi-General Population Defence." KwiKlinikhi yaseGastroenterol Hepatol . 2015 Sep; 13: 1641-6.e3.
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