Amathumbu awayena kuphela amalungu achaphazelekayo
Isifo sikaCrohn sisifo esingapheliyo sesibindi esisifo esingasichaphazela nayiphi na inxalenye yesisu esiswini emlonyeni ukuya kwi-anus. Nangona kudla ukuba kubangele iimpawu zesisu ezinjengokuqhaqhabalaza, ukunyanzelisa, ukuchithwa kwesifo sohudo, isisongela, ukuhlanza kunye negazi kwizihlalo. Iingxaki zibandakanya isithintelo sesibilini kunye nokukhulelwa kwamathumbu.
Isifo sikaCrohn sinokuchaphazela ezinye iinkqubo zesebe kwaye zikhokelela kwiinkathazo ezinzulu ezifana nokukhubazeka kombono, i-arthritis, izilonda zesikhumba, i-osteoporosis, i-gallstones, i-thrombosis ye-vein deep, ukuhluleka kwesibindi, kunye neengxaki ezahlukeneyo ze-neurological ranging from seizures to stroke.
Iimpawu zesisu
Inxalenye yesisu (GI) yinkqubo yumbutho echaphazelekayo ngokusisifo esiphathelene nesifo sikaCrohn. Phantse iipesenti ezingama-30 zamatyala zibandakanya intlungu encinci, ngokukodwa i-ileum yesiganeko (idibaniselwano apho ukutya okufuthiwe ngokukodwa kuhamba ukusuka emathunjini amancinci kuya emathunjini amakhulu). Ezinye iipesenti ezingama-20 zibandakanya kuphela ikholoni, ngelixa iipesenti ezingama-45 zibandakanya intliziyo encinci kunye nekholoni.
Phakathi kweempawu zesifo seCrohn:
- Iintlungu zesisu zisoloko zibonakaliso lokuqala kwaye zihlala zijoliswe kwicala elingezantsi lasebundini apho i-leum yokuphela ikhona. Intlungu inokuhamba kunye nokuqhaqhaqhaqhaqha, ukuqhaqhaqhaqha, ukunyanzela, kunye neentlanzi.
- I-diarrhea iqhelekile kwaye ingahluka ngokusekelwe kwindawo yokuvuvukala. Ukuvuvukala kwe-ileum (ileitis) ngokuqhelekileyo kubangela izibhedlele zamanzi. Ukuvuvukala kwe-colon (i-colitis), ngokuchaseneyo, ngokuqhelekileyo kubangela ukuba kubekho ukuhamba okungaqhelekanga okungafaniyo.
- Nangona igazi kwiisithambiso esingaqhelekanga kwisifo sikaCrohn kunokuba sisifo sezilonda zesilonda (isifo esichaphazelekayo sichazwe njengesifo sesibilini ), ngamanye amaxesha kungabonakala ukuba ukuvuvukala emathunjini kunzima.
- Ukukhathazeka kwesisu kunye nesisu esiswini kuya kubakhokelela ekudleni kwesondlo kunye nokulahlekelwa kwindleko. Amahlwempu okufumana ukutya kunye nezondlo zingaphaya ngokukhawuleza ukulahleka kwesisindo.
Ukuvuvukala kwiphecana le-GI akukhawulelwanga kumathumbu kuphela. Izilonda zomlomo eziphindaphindiweyo (i- aphthous ulcers ) ziqhelekileyo kubantu abane-Crohn's disease, ngelixa utywala obunzima, i-fistula, i-fissures, okanye i-abscesses kunokukhokelela ekudakaleni okukhulu kunye nokungahambisani nomzimba. Isisu kunye nesisu asixhaphaki kakhulu.
Iingxaki zesisu
Ngaphantsi komthwalo oqhubekayo wokuvuvukala, iindonga zamathumbu ziya kufana nokuqina, ngokubanzi njengamaqhekeza enqabileyo eqalayo ukwakha. Oku akubangeli nje ukunciphisa isithintelo samathumbu emathunjini, kunyuse ukuvutha kwamanzi kunye nomngcipheko weengxaki ezifutshane kunye nexesha elide.
Phakathi kwabo:
- Isithintelo se-Bowel yinkxalabo eqhelekileyo yesifo sikaCrohn kwaye ingaba nomnene okanye inzima, kuxhomekeke kwinqanaba lomqobo. Iimpawu ziquka ukuxubha, ukubhubhisa kunye nokuhlanza.
- Amathumba emathumbu omzimba (ama-pocket of pus abangelwa yi-bhakteria) kubangelwa ubuhlungu besisu, isisa kunye nomkhuhlane.
- I-festula yamathumbu ayimifuziselo engavamile apho i-gastric fluid ingadala kwaye ibangele ukusuleleka xa ivuza ekhumbeni nakwamanye amalungu.
- Ukugqithwa kwebilini (ukuphuka) kungenzeka ngenxa yentswelo okanye i-fistula, okuvumela ukuba okuqukethwe kwamathumbu kuqhube kwisisu esiswini kwaye kubangele isifo esiyingozi (peritonitis).
- I-megacolon inetyhefu yinto engabonakaliyo kodwa engathandabuzekiyo yesifo sikaCrohn apho i-colon ihlutha ngokukhawuleza kwaye ilahlekelwe yiyo ikhontrakthi. Iimpawu ziquka ukubetha okukhulu, intlungu, umkhuhlane, isantya senhliziyo esheshayo, kunye nesisu somzimba. Ukuba ukushiywa kungakhange kulandelwe i-buildup yegesi ingakhokelela ekugqibeleni, ukutshatyalaliswa kwezinto kunye nokufa.
Umngcipheko wesifo somhlaza unokwanda kancinci isifo se-Crohn, nangona ubungqina ngoku buxutywe.
Umdlavuza ogqithisileyo udla ngokuqhelekileyo kunye ne-ulcerative colitis apho ingozi i-pegged phakathi kweesentimitha ezintlanu kunye neesibhozo ezisibhozo ngaphezulu kweminyaka engama-20. Umngcipheko kubantu abanesifo sikaCrohn, ngokuchaseneyo, kuthathwa njengento ethobekileyo kodwa eyaneleyo yokuvumela ukuhlolwa kwesoloko.
Izibonakaliso ezingaphezulu
Lezo zibonakaliso ezingapheliyo zesifo sikaCrohn (ezo zivela ngaphandle kwephepha le-GI) zide kakhulu kwaye zinempembelelo njengoko zichaphazela amathumbu. Bange kubangelwa ukuvuvukala okuqhubekayo okujoliswe kwiphecana le-GI kodwa kuthintela umzimba njengethuba.
Izimpawu eziqhelekileyo eziqhelekileyo zibandakanya amehlo, amalunga, isikhumba, i-gallbladder, isimiso senzwa, kunye negazi okanye imithwalo yegazi.
Amehlo
Ukuvutha komgca ophakathi kwiso (uveitis) kunokubangela umbono obonakalayo, uvelwano olukhanyayo kunye nentlungu yeso. Xa ichaphazela umhlophe welihlo (i-sclera), kunokukhokelela kwi-episcleritis. Zomibini zihlala ziimeko ezinobungozi ezizenzekelayo, kodwa, phantsi komthwalo wesifo esingapheliyo, kunokukhokelela kumonakalo ongapheliyo kunye nokulahleka kombono.
Amalungu kunye neziTishu ezixhumeneyo
Isifo sikaCrohn sidibene neqela lezifo ezibizwa ngokuba yi-seronegative spondyloarthropathy apho omnye okanye amaninzi amaninzi achaphazeleka yi-arthritis okanye omnye okanye amaninzi afakelwe ukuxhamla imisipha achaphazeleka yi-enthesitis. Kubantu abanesifo sikaCrohn, kukho iindawo ezintathu ezichaphazelekayo yi-arthritis:
- Amalungu amaninzi amakhulu anamaxolo, amaqatha, amahlombe, i-elbow, kunye nesandla
- Izihlanganisi ezinhlanu okanye ngaphezulu ezincinci ezandleni okanye ezinyaweni, ezenzeka ngokulinganayo (okubhekisela kwisandla okanye zombini iinyawo)
- Umqolo, okhokelela kwisipulylitis esicacisayo
Iimpawu ze-arthritis zibandakanya izilwanyana ezibuhlungu, ezifudumalayo, ezikhukhumeleyo, kunye neziqili ezihamba kunye nokulahleka kokuhamba ngokubambisana.
Isikhumba
Isifo esilona siqhelekileyo sikhumba esihambisana nesifo sikaCrohn yi-erythema nodosum ebonakala iphakanyisiwe, ithenda, iifomvu ezibomvu, ikakhulukazi ezijikelezayo. Iigulane zibangelwa ukuvuvukala kwe-adipose (inqatha) iiseli kwi-layer deeper layer of skin.
Enye, imeko yesikhumba esibi kakhulu ibizwa ngokuba yi-pyoderma gangrenosum. Isi simo esibuhlungu sibonakala sisifo sesilonda esivame ukuqala emlenzeni njengento encinci kodwa inokwandisa ubungakanani obangela ukufa kwe-tissu enkulu (necrosis).
Amathambo
I-osteoporosis, imeko ebonakaliswe kukulahlekelwa kwethambo, iqhelekile kubantu abadala abanexesha elide le-Crohn's disease. Akunakwenzeka nje ukuba kubangele intlungu engaphantsi, inokunyusa kakhulu umngcipheko wokuphuka. I-Clubbing yeminwe iphinda ibonwe ngezihlandlo.
Abantwana abanesifo sikaCrohn nabo banamathuba okuphuhlisa ukuphuhliswa, ngokubanzi kuxhamene nokulibaziseka ukuphuhliswa kwamathambo. Amaphesenti angaphezu kwama-50 ala bantwana aya kuba nobude obungaphantsi, ngelixa iipesenti ezingama-25 ziza kuba neqondo elifutshane (kuchazwe njengento emibini engaphantsi kwe-height height for the child's age and gender). Ukuphinda kutshabalala kudla ngokukhawuleza.
Gallbladder
Isifo sikaCrohn sinciphisa amandla amathumbu omzimba wokubuyisela ibheyile efihliwe yi-gallbladder kunye nesibindi sokutya. Ukungalingani ekusithekeni nasekubuyiseleni kwakhona kunokukhokelela ekubutheni i-bile salts kwi-gallbladder, okubangele ingozi eyongeziweyo ye-gallstones.
I-Gallstones inokuba yinto ebuhlungu kakhulu kwaye ibangela ukunyanzelisa, ukunyanzelisa, isicathulo, ukuhlanza kunye nentlungu kuyo okanye ngasemva kwesisu.
System Central Nervous System
Kuqikelelwa ukuba omnye wabantu abasixhenxe abanobuhlungu besifo sikaCrohn. Bokuba nobumnene ukuya kumodareyitha kunye nokuquka intloko, ukuxinezeleka, okanye ukutshitshisa okanye ukuphazamiseka kwezandla kunye neenyawo. Abanye banokuba banzulu kwaye ba ndakanya:
- Interior ischemic optic neuropathy, ukulahleka ngokukhawuleza kombono ongundoqo ngenxa yokunciphisa ukuhamba kwegazi kwi-nertic optic
- Isifo se-encephalopathy syndrome (Postes), isifo sengqondo esichazwe yintloko, ukudideka, ukuxhatshazwa kunye nokulahleka okubonakalayo.
- I-axonal polyneuropathy, engabonakaliswa ngokulahlekelwa kwemoto kunye nokuvakalelwa
Iimpawu zeengqondo ze-Crohn's disease aziqondi kakuhle. Iingxaki ezinzima zikholelwa ukuba zidibene nesifo esibi, esingasigxina.
Igazi neNkqubo yeCyculatory
Abantu abanesifo sikaCrohn bahlala benesifo semfuyo ngenxa yokungabi nantoni kwezondlo ezithintekayo emathunjini. Kodwa, kukho enye uhlobo ebizwa ngokuba yi-autoimmune i-hemolytic anemia apho i-immune system ihlasela kwaye ichithe iiseli zayo ezibomvu zegazi. Iimpawu zingabandakanywa ukukhathala, isikhumba esiluhlaza, ukuphefumula okufutshane, ukukhanya okukhawulezileyo, ukuxakeka, kunye nentliziyo esheshayo.
Isifo sikaCrohn sikhokelela ekugqibeleni ngokungaqhelekanga kweeplatelet kunye nokubunjwa kwegazi. Oku kunokukhokelela kwingcungcuthe ye-thrombosis (DVT) enzulu, ukuphazamiseka kwegazi ukuya emlenzeni onokubangela iimpawu zentlungu, ukuvuvukala, ukufudumala kunye nokunyanyisa.
Ukuba kungaphathwa kakubi, i-clot yegazi ingakwazi ukudibanisa nokuhambisa umlenze kwi-brain, intliziyo kunye nemiphunga, apho kunokubangela ukubetha, ukuhlasela kwintliziyo, okanye ukuvutha kwamapulmoni.
Nini ukubona iDokotela
Izibonakaliso zesifo sikaCrohn sinokuba zihlukeneyo kwaye ziguquke kangangokuthi kunokuba kunzima ukwazi ixesha lokubona ugqirha. Ekugqibeleni, enye into eyenza isahlulo sesifo sikaCrohn esivela kwisifo sakho se-mill is a persistence of symptoms.
Kubalulekile ke ngoko ukubona ugqirha ukuba ufumana oku kulandelayo:
- Izibilini eziqhubekayo zesirhudo ezingaphenduliyo kwiinkqubo ezingaphezulu kwe-counter-counter (i-OTC)
- Iintlungu zesisu eziqhubekayo okanye eziphindaphindiweyo
- Igazi kwi-stool
- Ukulahleka kwesisindo esingachazwanga
- Umkhuhlane ongacacanga uhlala ngaphezu kweentsuku ezimbalwa
> Imithombo:
> Baumgart, isifo sikaDonhn. Lancet. 2012; 380 (9853): 1590-1605 INGXELO: 10.1016 / S0140-6736 (12) 60026-9.
> Ha, F. no Khalil, isifo sikaH. Crohn: ukuhlaziywa kweklinikhi. Adv Gastroenterol. 2015; 8 (6): 352-359. INGXELO: 10.1177 / 1756283X15592585.
> Nemati, R .; Mehdizadeh, S .; Salimipour, H. et al. Ukubonakaliswa kweeuroloki ezinxulumene nesifo sikaCrohn: isenzo sabasebenzi. Ingxelo yokuHlaba i-Gastroenter 2017; gox034. INGXELO: 10.1093 / gastro / gox034.