Ngeenjongo zamaphepha amaninzi okuphanda, ukungabi nantoni kuchazwa njengokuba akakwazi ukukhulelwa umntwana unyaka (iinyanga ezili-12) ngelixa ephethe isondo esingaqhelwanga rhoqo. Kuyabasetyhini oku kuthetha ukuba ukukhulelwa akukwenzeka kwaye kumadoda ukuba iqabane lawo lingenzi ukukhulelwa ngelixa lizama unyaka.
IBD kunye nokuNciphisa kweZityalo
Ngokuqhelekileyo, isiphumo sesifo sesibindi (IBD) sokukhulelwa singacacanga.
Ezinye izifundo zibonise ukuba amadoda nabasetyhini abane-IBD abanalo ixabiso lokuzala elihluke kakhulu kubantu abangenayo IBD. Olunye uphando lubonise ukuba amadoda anesifo se-IBD anokunciphisa ubuncwane, kwaye oku kunokwenzeka ukuba kunjalo nakwabesilisa abanesifo sikaCrohn.
Enye inkalo ye-IBD ecingelwa ukuba yindawo yokunciphisa inzala ayikho ingxaki yomzimba kodwa kunokuba isuke kwisigqibo sokuzithandela sokungabantwana. Abantu abane-IBD bahlala bexhalabele ukuba isifo singadluliselwa kubantwana, oko kunokubangela ukuba bakhethe ukuba bangaba nabantwana.
Nangona kunjalo, kukho imiba emininzi ye-IBD enokuchaphazela ukuzala, okubandakanya amanye amayeza, ukuhlinzwa, ukungondleki kakuhle, imiba yengqondo, kunye nempilo jikelele jikelele. Eli nqaku liza kujonga ukuba ezo zinto zingathintela njani ukuzala kumadoda. Amadoda (kunye nabasetyhini) abane-IBD abanenkxalabo malunga nokuzala kwabo kwangoku okanye ngokuzayo kufuneka bacele i-gastroenterologist yabo ukuba ithunyelwe kwi-specialist yezityalo xa kufuneka.
I-IBD ichaphazela njani ukukhulelwa komntu
Uphando malunga nendlela i-IBD echaphazela ngayo ukuzala komntu kunqongophala kunye nobubanzi; akukho phando olunzulu lokubamba ngalo, okwenza kube nzima ukwazi kakuhle kangakanani ukuzala okuchaphazelekayo kumadoda ane-IBD. Noko ke, kukho iimeko ezimbalwa apho kwaziwa ukuba ukuzala kubantu abane-IBD kunokuchaphazeleka.
Isifo sobuso. Njengoko kulindeleke, umsebenzi wesifo unempembelelo kumntu okwazi ukuzala umntwana. Amadoda anesisombululo kwi- IBD-flare-up anamazinga aphezulu e- erectile dysfunction , kwaye ke ukufumana ulawulo oluphantsi kolawulo luya kubaluleka ngaphambi kokuqalisa intsapho.
Mayeza. Uninzi lwamachiza asetyenziswa ukuphathwa kwe-IBD alubonakalwanga luchaphazele ukwanda kwenzalo kubantu, ngaphandle kokunye. I-Azulfidine (i-sulfasalazine) , esetyenziselwa ukunyanga i-ulcerative colitis, inokuchaphazela ukuzala komntu. Ifom yexeshana yokungafumaneki kubangelwa yicandelo le-sulfa yale nkunkuma ukuya kuma-60 ekhulwini ngamadoda athabatha. Phantse iinyanga ezimbini emva kokumisa i-Azulfidine, ukuzala kuya kubuya kwinto ebeyiyo ngaphambi kokuba isiqalo senziwe.
Ukuhlinzwa. Inkqubo yokuphanda eyenziwa ukunyanga i-IBD inokuchaphazela ukuzala komntu, nangona utyando alubandakanyi amalungu omzimba wesini. Uhlobo lotyando olubonakala lubona lunako lokubangela iingxaki ngokuvelisa yizo ezibandakanya iziganeko ezikufutshane nekota. Oku kubandakanya i- proctocolectomy kunye ne- analomosis ye-leal-anal anastomosis (IPAA) , ebizwa ngokuba yi-j-pouch ukuhlinzwa kunye ne-colostomy ukuhlinzwa kunye ne-elaostomy.
Olunye uphando oluncinane lubonise ukuba izigulane ezi-18 eziphuma kwi-18 zinengxaki yokunyuka emva kokuhlinzwa kwe-IPAA. Ukuba utyando olwenziwe kwiziko elizodwa ngabagqirha kunye nabanye oogqirha bezempilo abasebenza ngokugqithiseleyo kwi-IBD kwaye banokugqiba uphando oluninzi lwale hlobo lungabangela ingozi nangaphantsi.
Kuyinto engaqhelekanga, kodwa ukungabi nantoni kunokwenzeka emva kwezi ntlobo ze-IBD. Into ebalulekileyo ukuba uyikhumbule ngolu hlobo kukuba kukho iindlela zonyango ezifumanekayo kubantu abafumana ukunciphisa ukuzala. Elinye unyango lweziyobisi, ngokukodwa, luye lwaboniswa ukuba luncede kumaqela angama-79 ekhulwini.
Ngenxa yoko, nangona kunjalo, ubume bebhanki kufanelekile ukuba sicinge ngamadoda afuna ukufumana intsapho kwaye baya kuhlinzwa ngenxa ye-IBD enokuchaphazela ukuzala kwabo.
Imiba ye-IBD kunye neempembelelo zazo
Amachiza okwelapha i-IBD anokuba nempembelelo ekunakekeleni umntwana kumntwana. Kwezinye iimeko, kungcono ukuba utshintshe amayeza okanye ukuyeka unyango ngaphambi kokuqalisa intsapho. Oku kuya kubahlukileyo kuzo zonke izigulane kunye neentsapho zabo, ngoko kubalulekile ukuxubusha imishanguzo ye-IBD kunye ne-gastroenterologist ngaphambi kokuba unqume ukuba unomntwana.
6-MP. Izifundo ezimbalwa kwi- 6-mercaptopurine (6-MP) kumadoda abelethe abantwana babonisa ukuba kukho ingozi eyongezelelweyo yokukhulelwa okanye ukungaqhelekanga. Ezinye izifundo zazingabikho mngcipheko weengxaki ngokukhulelwa apho ooyise bathatha i-MP-6. Ngenxa yoko, kunconywa ukuba ababoneleli benonophelo lwezempilo bathethe inxaxheba kunye namadoda athatha ama-6-MP afuna ukuba nguyise kunye nokuxoxa ngeengxaki xa ebeletha umntwana.
Azulfidine. Kuye ubuncinane ubuncinci olunye obubonise ukuba kukho umngcipheko omncinci wokukhubazeka kwabantwana abazalwa xa uyise ewathatha i-Azulfidine. Ngako oko, kunokucetyiswa ukuba amadoda aphethe i-IBD afuna ukuzala umntwana ekutshintsheni kwenye iyeza.
Methotrexate. Kuyabasetyhini abafuna ukukhulelwa, i- methotrexate kufuneka imiswe (yi-Category Pregnancy X). Kubantu, kuyacetyiswa ukuba i-methotrexate imiswe malunga neenyanga ezi-3 okanye ezine ngaphambi kokuba uqalise intsapho, njengoko isicatshulwa sinokuhlala emzimbeni iinyanga ezimbalwa.
Ezinye iinkalo ze-IBD Worthinging
Akunjalo nje ngamachiza anokuba nefuthe ekukhuliseni nasekukhulelweni, ukuphazamiseka, ukungabikho kokutya okunomsoco, kunye nosuku lokuphila kunye nesifo esingapheliyo.
Ukuphila nokugula okungapheliyo. Isifo esingapheliyo kunzima ukujamelana nayo, kwaye i-IBD yinto echaphazela iinkalo ezininzi zobomi babantu. Ukuba nomfanekiso womzimba onempilo kunokuba ngumzabalazo kwabanye abantu abane-IBD. I-IBD inokushiya umntu evakalelwa ngathi ayithandeki okanye angathandeki kumlingane. Oku kunokuba nefuthe lokunciphisa isondo lesini, oko kukunciphisa amathuba okukhulelwa.
IBD kunye nokudandatheka. Enye into ekufuneka uyiqwalasele ukuxhamla phakathi kwe-IBD kunye nokudakumba , okuchaphazela nomnqweno womntu wokulala ngesondo. Ukuba nolwalamano olufanelekileyo lwezesondo kunye nokuba nabantwana kunzima xa behlangabezana neengxaki ze-IBD kunye ne-IBD. Ukuthetha ne-gastroenterologist malunga nale miba kunokunceda, kuba bangakwazi ukuxhamla kwi-IBD. Kwamanye amaxesha, ukufumana izikhokelo kumsebenzi wengcali yengqondo yengqondo kunokucetyiswa. Kukho unyango olunokukunceda kakhulu ekufundeni ukuhlala nesifo esingapheliyo, kwaye nokuba nokuba nomntu onokuthetha naye malunga nalo kunganceda.
I-Flare-ups. Ukuvuvukala okusebenzayo, oko kwenzekayo kwinkqubo yokugaya ukutya ngexesha lokuhlaselwa kwe-IBD, kunokuchaphazela ezinye iinkqubo zomzimba. Ukuvuvukala kunemiphumo emibi ekuzaleni, ngokukodwa xa ukuvuvukala kuthathwa njengobunzima. Ucwaningo luye lwabonisa ukuba amadoda ane-IBD kunye nokuvuvukala okukhulu kunamazinga aphezulu e-erectile dysfunction.
Ukutya. Akukho ninzi yophando malunga nokuba isimo sesondlo sinokuchaphazela njani abantu abane-IBD abafuna ukuzala abantwana. Kukho ubungqina bokuba ukusilela kwe-zinc kunokunciphisa ukuzala, kwaye izigulane ezininzi ezinezifo zikaCrohn ziye zaboniswa ukuba zinamazinga aphantsi e-zinc. Isondlo kubalulekile kunoma yimuphi na oza kuba nguyise kwaye ingabaluleke ngakumbi kubayeni abanesifo sikaCrohn abavuthayo emathunjini amancinci avimbela ukuxutywa kakuhle kwamavithamini.
Ukuhlala engenabantwana. Abantu abane-IBD maxa wambi banquma ukungabi nabantwana ngenxa yokukhathazeka ukuba i-IBD ingadlulelwa. I-IBD inayo inxalenye yezofuzo, kodwa ayikho into yokuba umzali one-IBD uza kuba nomntwana okhulisa i-IBD. Umngcipheko wokudlulela i-IBD kumntwana uhluka ngoxhomekeke kwisifundo, kodwa kucatshangelwa ukuba phakathi kweepesenti ezili-10 kunye ne-20 ekhulwini. Kunconywa ukuba abantu abane-IBD bathethe noogqirha babo malunga nale nkxalabo kuba kuya kuqinisekiswa ukuqonda ukuba iimeko eziphantsi zingozi.
Inqaku esuka
Kwiimeko ezininzi, ukuxilongwa kwe-IBD akuyi kukhokelela kwesinye ukuxilongwa kokungabikho kwengqondo. Kodwa kukho iindawo ezithile zokukhathazeka ngamadoda ane-IBD, ingakumbi kulabo baneentlobo ezithile zokuhlinzwa okanye abasesifo.
Njengemibandela eninzi ye-IBD, ukufumana ukuvuvukala phantsi kolawulo kuya kuba yinto ebalulekileyo ekunikezeni ithuba elihle lokuba nguyise. Ukuthetha ngokuba nguyise onomdla we-gastroenterologist kungekudala kunokuba uncede. Ukuba kuyimfuneko, i-gastroenterologist ingenza ukuthunyelwa kwengcali yenzalo eqeqeshiwe ekuncedeni ukuxilonga nokuphatha iingxaki ngokuzala.
> Imithombo:
> UBertstsson I, Oresland T, Hultén L. "Ukuziphatha ngokwesini kwizigulane ezinezilonda zesilonda ngaphambi nangemva kokubuyisela i-proctocolectomy: i- future study." I- Scand J Gastroenterol . 2004; 39: 374-379.
> El-Tawil AM. "Ukukhubazeka kwe-Zinc kumadoda aneesifo sikaCrohn kunokubangela ukuba umsebenzi wesidoda awuthathaka kunye nokungabikho kwamadoda." Andrologia . 2003 Dec; 35: 337-341.
> Tavernier N, Fumery M, Peyrin-Biroulet L, Colombel JF, Gower-Rousseau C. "Ukuhlaziywa kwesistim: ukuvelisa kwisifo esingenasifo sokugonywa." I-Pharmacy Ther. 2013: 38: 847-853.
> I-Timmer A, i-Bauer A, iDignass A, uRogler G. "Umsebenzi wesondo kubantu abanezifo zesibindi sokuvuvukala: uphando olwenziwa ngokulandelana." KwiKlinikhi yaseGastroenterol Hepatol . 2007 Jan; 5: 87-94.