Isifo sikaCrohn sisifo esingapheliyo, esingenakuphulukana, nesifo esiphathelene nomzimba esingaxhatshazwayo esingenza ukuvuvukala naphi na kwindlela yokugaya emlonyeni ukuya kwi- anus . Kanye kunye nesifo sesilonda, isifo sikaCrohn sinye yezona ndlela eziphambili zesifo sokukhubaza (IBD) . Isifo sikaCrohn siquka ngokubanzi zonke iintambo zesalonda samathumbu emathumbu, kubangela izilonda ezinzulu.
Abantu abanesifo sikaCrohn bahlala benakekelwa yi- gastroenterologist (ingcali kwisifo sokugaya) kwaye ngamanye amaxesha ugqirha ogqithisileyo (ugqirha ogxininisa kwiphepha lokutya).
Nangona ukuxilongwa kwesifo sikaCrohn kuguquka ubomi kwaye isifo sifanele silawulwe, ikusasa labantu abane-IBD liqaqambile. Kukho ukhetho oluninzi lwezokwelapha kunanini ngaphambili, kwaye uphando olutsha luqhutyelwa ukuze luziswe kwizigulane. Isizathu esona kunye nokunyanga sisasacingwa, kwaye kukho uphando olungaphezulu ngoku lwenziwe kwi-IBD kunanini ngaphambili.
Izinto Ezibaluleke Kakhulu Ukukwazi Ngezifo Ze-Crohn
- Isifo sikaCrohn ngenye indlela ye-IBD kwaye inokuchaphazela nayiphi na inxalenye yendlela yokugaya emlonyeni ukuya kwi-anus.
- Akukho nto eyaziwayo okanye unyango lwesifo sikaCrohn.
- Ukubhema i-cigarettes kunokudlula isifo sikaCrohn.
- Zininzi iintlobo ezahlukeneyo zonyango ezisetyenziselwa ukuphatha isifo sikaCrohn, kuquka i-antibiotics, i-immunomodulators, i-steroids kunye ne-biologics.
- Uphando luye lusetyenziswe ukuphatha isifo sikaCrohn, kunye nokuhlinzwa ngokuphandle ngokuqhelekileyo.
- Abantu abanesifo sikaCrohn banokuhlangabezana noxinzelelo ngaphakathi nangaphandle kwendlela yokugaya ukutya (iingxaki zesisu zomzimba).
- Abafazi abanesifo sikaCrohn bangaba nokukhulelwa okunempilo kunye neentsana .
Iifom zezifo zeCrohn
Imigaqo eyahlukeneyo isetyenziselwa ukuchaza isifo sikaCrohn, kuxhomekeka kwinqanaba le-digestive tract.
Akunjalo zonke izifo zesifo sikaCrohn ziya kuhlaselwa ngokufanelekileyo kwisigaba, kodwa ezi zifom eziqhelekileyo zichazwe kwaye zingasetyenziswa ngabagqirha:
- Ileocolitis. Ifomu eqhelekileyo yesifo sikaCrohn esithinta i- ileum (isiphelo esingaphantsi kwesisu esincinci) kunye nekholoni ( intloko enkulu).
- Ileitis. Eyaziwa nangokuthi i-fistulizing okanye isisifo sesifo sikaCrohn, olu hlobo luchaphazela kuphela i-ileum.
- Isifo seCastroduodenal Crohn. Eli fom lichaphazela isisu ne duodenum (inxalenye yokuqala yesisu esincinci).
- Jejunoileitis. Isifo sikaCrohn esibonakaliswe kwiindawo eziphakathi kwe- jejunum (isigaba esiphakathi samathumbu amancinci).
- Crohn's colitis. Ngamanye amaxesha kuthiwa yi- granulomatous colitis , eli fomu lichaphazela kuphela ikholoni, kwaye akufanele lidideke ne-ulcerative colitis, yindlela ehlukile ye-IBD. I-Crohn's colitis yindlela yesifo sikaCrohn, kwaye akuthethi ukuba umntu unesifo sikaCrohn kunye nesifo sesilonda.
Izibonakaliso zezifo zeCrohn
Isifo sikaCrohn sibangela iimpawu kunye neempawu ezahlukeneyo, ezinye zazo kwindlela yokugaya kunye nezinye zazo ngaphandle kwenkqubo yokutya. Iimpawu zesifo sikaCrohn zingabandakanya:
- ubuhlungu besisu kunye neenkampu
- kwisigxina segazi
- isifo sohudo
- umkhuhlane
- ukulahleka kwesidlo kunye nokulahleka kwesisindo
- i-mucus kwi-stool
- isilonda sephepha lokutya
Izizathu ezinokwenzeka zezifo zeCrohn
Kukho iingcamango malunga nesizathu sesifo sikaCrohn kunye ne-IBD ngokubanzi , kodwa i-IBD okwangoku ibalwa njengesifo se- idiopathic (isifo esingaziwayo). Isifo sikaCrohn sithatha ukugijima kwiintsapho, nangona abaninzi abantu abane-IBD bengenayo imbali yentsapho yesi sifo.
Enye imbono malunga nesizathu se-IBD kukuba ingaba isisombululo okanye isisombululo sokuzivikela ngomzimba, ngokusekelwe ngokukodwa kwi-IBD isifo esisigxina . Iimeko zokusingqongileyo nazo ziye zabandakanywa, kodwa akukho mvumelwano kuluntu lwezonyango ngokubhekiselele kwizinto ezichaphazela ukuqala kwe-IBD.
Esinye isizathu esibangelwayo singabandakanya ii-microorganisms (ibhaktheriya) ehlala kwindlela yokugaya, ebizwa ngokuba ngumzimba okanye isisu se-intestinal microbiome . Akwaqondwa nokokuba utshintsho kwi-microbiome luchaphazela njani ukuphuhliswa kwesifo sikaCrohn, kodwa kuyaziwa ukuba abantu abanesifo sikaCrohn bavame ukuba neentlobo ezincinci zeebhaktheriya kwindlela yabo yokugaya kunabantu abangenayo isifo sokugaya. Isizathu esiyinyani se-IBD sinokuthi sinakho nayiphi na inhlanganisela yale nto okanye into engekafumanwanga.
Izifo Ze-Crohn Ziyabonwa Njani
Ugqirha unokuqala ukukrokra isifo sika-Crohn esisekelwe kwimbali yeempawu ezinjengeentlungu, isifo sohudo, ukulahlekelwa kwesisindo esingafunekiyo, kunye negazi kwisitulo. Iimvavanyo ezimbini ezisetyenziselwa ukuxilongwa kwesifo sikaCrohn zi:
- IColonoscopy . Olu vavanyo lusetyenziswa ukujonga ngaphakathi kwikholoni ukubona ukuba ukuvuvukala kukhoyo.
- Sigmoidoscopy . Ukubukeka ngaphakathi kwikholoni, kufana ne-colonoscopy, kodwa oko kuphela kuya kwinqanaba lokugqibela lomathumbu omkhulu
Ezinye iimvavanyo ezingasetyenziswanga ekuxilongweni, kodwa kunokwenziwa ukujonga umsebenzi wesifo sikaCrohn okanye iingxaki zibandakanya:
- Barium enema . Olu vavanyo luhlobo lwe-x-ray olusebenzisa umzekelo ukuze kulunge ngakumbi ukubona izakhiwo kwindlela ephantsi yokugaya.
- Ukuhlolwa kwegazi. Iimvavanyo zegazi nazo zenziwa rhoqo ukubonelela ngolwazi oluncedo malunga nesimo se-IBD, ngokukodwa iseli elibomvu legazi kunye nokubala kwe- cell cell white . Olunye uvavanyo lwegazi lunokulinganisa amanqanaba e-electrolyte, njenge-sodium kunye ne-potassium, ukuchonga ukuba ziphelile kwi-diarrhea eqhubekayo.
- I-CT (i-computed tomography) iskena . Uhlobo lwe-x-ray olunika umfanekiso wesigcawu somzimba. Kwakhona kuthiwa yi-computed tomography (CT).
- Endoscopy ephezulu . Xa kunokwenzeka izifo kwisigxina esingaphezulu sokutya (njenge-esophagus, umqala, okanye intlungu encinci), lo vavanyo lunokuba luncedo.
- Uchungechunge oluphezulu lwesisu . Enye ifomu ye-x-ray esebenzisa ukungafani kwaye isetyenziselwa umgangatho wokugaya.
- X-ray . Uvavanyo olunokukhawuleza nolulula olungazinikanga ulwazi oluninzi kodwa kusetyenziswa ngamanye amaxesha.
Izifo Ze-Crohn Ziyakwenziwa njani
Bobabini imishanguzo kunye nokuhlinzwa kusetyenziswa ukuphatha isifo sikaCrohn. Ngeentlobo ezahlukeneyo zonyango olukhoyo, kubalulekile ukusebenzisana ngokusondelene ne-gastroenterologist ukufumanisa indlela efanelekileyo yokusebenza.
Amachiza . Iindidi ezahlukeneyo zonyango zingasetyenziselwa ukuphatha isifo sikaCrohn. Amachiza ngokuqhelekileyo awela kwiindidi ezimbini: Izidakamizwa zokulondolozwa, ezithatyathwa ngokuqhubekayo ukukhusela i- flare-ups , kunye nokusetyenziswa kweziyobisi ezisebenza ngokukhawuleza, ezithatyathwa ukuyeka ukuphazamiseka.
Amayeza asetyenziswa ukuphatha isifo sikaCrohn zibandakanya: i- Azulfidine (i-sulfasalazine) ; I-Asacol kunye nePentasa (i-mesalamine); Imuran (azathioprine) ; IPinetinethol (6-MP, mercaptopurine) ; cyclosporine ; I-Rheumatrex (methotrexate) ; Remicade (infliximab) ; Humira (adalimumab) ; Entyvio (Vedolizumab) ; Cimzia (certolizumab pegol) ; kunye ne-corticosteroids, njenge- prednisone kunye ne- Entocort EC (budesonide).
Ukuhlinzwa . Ugqirha usetyenziswa njengonyango kwisifo sikaCrohn. Phantse iipesenti ezingama-70 zabantu abanesifo sikaCrohn baza kutyunjwa kwiminyaka eyi-10 yokuqala emva kokuxilongwa. Kulabo, isiqingatha siya kuba notyando oluninzi kwiminyaka emithathu ukuya emine ezayo. Ukuqhawulwa , apho iqela eligulayo lomathumbu lisuswe, luhlobo oluqhelekileyo lotyando. Ugqirha awuyiphilisi yesifo sikaCrohn.
Umngcipheko weCancer Cancer
Kubantu abanesifo sikaCrohn, kukho izinto ezininzi ezibonakala zichaphazela umngcipheko wokuba nomhlaza we-colorectal . Ezi ngozi ziquka:
- ubudala xa bexilongwa
- Iminyaka eyi-8 ukuya kwe-10 yesifo esisebenzayo ngokuvuvukala
- ukuba neentambo (ukunciphisa intlungu)
- imbali yesifo sesibindi, i- sclerosing cholangitis ephambili
Oogqirha banokuthi bancome i-colonoscopy yokuphonononga nganye kwiminyaka emibili ukuya kwimithathu emva kweminyaka yesibhozo ukuya kwe-10 yesifo sika-Crohn, kwaye ngamnye ukuya kwiminyaka emibini emva kweminyaka engama-20 yesifo sikaCrohn. Abanye abantu abanesifo sikaCrohn banokufuna i-colonoscopy ngezikhathi eziqhelekileyo ukubeka esweni isifo sabo, kwaye ukuhlolwa komhlaza kungenziwa ngexesha elifanayo.
Iimeko ezihambelanayo
Amathumbu athile . Kukho iingxaki ezinxulumene nesifo sikaCrohn, kwaye ezo zenzeke ngaphandle kwekholoni zibizwa ngokuba yingxaki yamathumbu. Iingxaki ezingaphezulu kwamathambo ziquka i- arthritis , ukukhula okulibazisekile kubantwana , izifo zamehlo, ama- gallstones , izimo zesikhumba, izilonda zomlomo kunye nokugqithisa kweempawu ngexesha lokuya esikhathini . Uninzi lwezi nkxalabo luya kulandela inkqubo yesifo sikaCrohn, kwaye iyakwazi ukuhamba phambili ngaphambili nangethuba lokutshatyalaliswa nokuphucula xa isifo sikaCrohn siphelelwe.
Amathumbu . Ezinye zeengxaki zengingqi (intestinal) zengxaki zesifo sikaCrohn zibandakanya i- abscesses , isithintelo sesilonda , isilonda , isifo somhlaza , i- fissures , i- fistula kunye ne- megacolon enetyhefu .
Ukubhema kunye neSifo seCrohn
Abantu abavutha ugwayi , okanye abaye baphefumla kwixesha elidlulileyo, banomngcipheko ophezulu wokuhlaselwa kwesifo sikaCrohn. Ukubuyiselwa kwakhona (ukuhlaselwa), ukuphinda ukuhlinzwa, kunye nokuphathwa kakubi kwamanyango okuqhelekileyo kuqhelekileyo kwizigulane ezineesifo sikaCrohn esitshisa. Abantu abanesifo sikaCrohn bakhuthazwa ngamandla ukuba bayeke ukutshaya.
Ukukhulelwa
Ukukhulelwa okusemgangathweni kunye nosana bobabini abakwaziyo abanesifo sikaCrohn. Indlela isifo sikaCrohn esiya kuphendula ngayo ngexesha lokukhulelwa lihlulwe ngokwahlulo-sithathu: abanye abafazi benza ngcono, ezinye zihlala zifana, kwaye ezinye ziba nzima. Into ebaluleke kakhulu kukufumana ukuxolelwa ngaphambi kokukhulelwa, okanye ukufika apho ngexesha lokukhulelwa, ukuqinisekisa ukuba umama nosana bayaqhubeka benza kakuhle. Ngelishwa, xa isifo sikaCrohn sifuma ngexesha lokukhulelwa komntwana okanye ngexesha lokukhulelwa, umngcipheko wokukhulelwa kwesisu kunye nokuzalwa kwangaphambi kokubeleka kuphezulu.
Prognosis
Ngokunyamekela unyango olufanelekileyo, ukuxela abantu abaninzi abane-Crohn isifo esihle. Uninzi lwabantu abanesifo sikaCrohn banakho ukukholisa ubomi obude, obuvelisayo. Amachiza amatsha kunye nophando kwizizathu ze-IBD ziyaqhubeka nokwandisa umgangatho wobomi kubantu abane-IBD.
ILizwi
Ukuxilongwa kwesifo sikaCrohn siza kunye nomgca wokufunda. I-gastroenterologist kunye nabasebenzi bayo baya kubabaluleka ekuqinisekiseni ukuba umgangatho omhle wobomi ugcinwa. Uninzi lwezigulane ze-IBD zinobudlelwane obusondeleyo kunye ne-gastroenterologists zabo. Kwakhona kubalulekile ukuba abantu abane-IBD bahlakulele inethiwekhi yenkxaso phakathi kwentsapho yabo kunye nabahlobo abanokuba ngabaxhasi. Ukuphila kakuhle nesifo sikaCrohn akusoloko kufinyeleleka ngokugcina utyunjwa ogqirha, ngokulandela isicwangciso sonyango, nokufunda ngokubanzi malunga nesifo.
> Imithombo:
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> Crohn's and Colitis Foundation of America. Izifo zonyango lweCrohn's Medicine Options. CCFA.org 2016.
> Crohn's and Colitis Foundation of America. Izinketho zeCrohn's Treatment. CCFA.org 2016.
> Nørgård B, Hundborg HH, Jacobsen BA, Nielsen GL, Fonager K. Izifo Umsebenzi kwiAbhinqa abakhulelweyo abanezifo zika Crohn kunye neziphumo zokuzalwa: Isifundo seDanish Cohort Study. Am J Gastroenterol . 2007 Sept; 102: 1947-1954.
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