Kuthetha ukuthini ukuxolelwa kwisifo sikaCrohn okanye i-ulcerative colitis? Kuba ezininzi izigulane ezinezifo zesibindi (IBD) , kunye noogqirha babo, ukufikelela ekuxoxweni yinjongo ephambili yonyango. Ukuxolelwa kungavela emva kokunyanga ngamayeza okanye emva kokuhlinzwa. Kwezinye iimeko, kunokuthi kwenzeke ngokukhawuleza, kodwa kwabanye, kungathatha ixesha elide kwaye uzame unyango ngeyodwa okanye ngaphezulu kweziyobisi kunye / okanye utyando.
Ngokutsho kweCrohn's and Colitis Foundation yaseMelika, ngexesha lonyaka, abantu abangama-50% abanesifo sikaCrohn baya kuxolelwa okanye babe nezifo ezintle kunye nama-48% abantu abane-ulcerative colitis baya kuxolelwa.
Ukuqonda ukuxolelwa
Ixesha lokuxolelwa lithetha izinto ezahlukeneyo kubantu abahlukeneyo, kuquka izigulane kunye noogqirha. Oku kungabonisa ingxaki encinane xa uthetha ngeendlela zokuxolelwa kunye nendlela enokufezekiswa ngayo. Kwiminyaka emininzi, izigulane zacatshangelwa ukuba zixolelwe ukuba zikhona iimpawu ezimbalwa okanye ezingekho ziphumo ze-IBD . Ngokuqhelekileyo oko kwakuthetha ukuba iimpawu ezinjengeentlungu zesisu , isifo sohudo, okanye izitulo zamanzi zichithwe kakhulu okanye zihambe ngokupheleleyo.
Njengoko kufundwa ngaphezulu malunga ne-IBD, kunjalo ke kuyaqonda ukuba ukuxolelwa kuyinkcazelo ebanzi kunokunciphisa iimpawu. Kwiigulane, ukulawula iimpawu kuya kuba yinto ebalulekileyo ekuphuculeni umgangatho wobomi kwixesha elifutshane.
Nangona kunjalo, kunokukho nezinye iinkqubo eziqhubekayo kunye ne-IBD nangona ezinye iimpawu, okanye zonke iimpawu, ziphelile. Ezinye izigulane zisenokuba nokutshabalala kwe-IBD nangona ziziva zingcono. Ukuvuvukala kukuphawu lwe-IBD enokukwazi ukukhokelela kwiingxaki ezinzulu.
Iintlobo ezahlukeneyo zokuxolelwa
Izigulana zinokufunda okungakumbi malunga ne-IBD ngokufumana ingxoxo malunga nokuxolelwa kunye ne- gastroenterologist . Akukho mvumelwano malunga nencazelo ecacileyo yokuxolelwa kwi-IBD. Kukho, nangona kunjalo, izixhobo ezininzi zokubeka amanqaku ukuba oogqirha bangasebenzisa ukujonga ukuba isiguli siphumelele ukuxolelwa. AmaGastroenterologists ahlukeneyo kunye namaziko e-IBD aya kusebenzisa i-criteria ayifumene iyona ifanelekileyo, oko kuthetha ukuba kunzima ukuthelekisa.
Ezinye zeentlobo ezahlukeneyo zokuxolelwa ziquka:
- Ukuxolelwa kwezinto eziphilayo: Iimvavanyo zeLebhanki ezenziwe kwigazi okanye kwi-stool azibonakali naziphi na iimpawu eziphawulekayo ze-IBD.
- Ukuxolelwa kwezonyango: Xa iimpawu ze-IBD ziye zancipha ukuya kwinqanaba lokuba zingekho okanye zingekho.
- Ukuxoshwa kwe-Endoscopic : Akukho ukuvuvukala kubonwa ngexesha lokuvavanywa apho ugqirha ekwazi ukubona umbane wendlela yokugaya, njenge- colonoscopy okanye sigmoidoscopy .
- Ukuxolelwa kwe-Histologic: Olu hlobo lokuxoxwa luquka ukuphela kokuphela kwexesha kunye neklinikhi yokuxolelwa. Xa ama-biopsies athatyathwa kwaye ahlolwe, umzekelo ngexesha le-colonoscopy, akukho ukuvuvukala kubonakala.
- Ukuxolelwa okuphenywayo: Ukuphanda kungathatha ixesha lokuxolelwa kwabanye abantu abane-IBD, xa kubangela ubuncinci okanye akukho ukuvutha okanye iimpawu.
Kutheni ukuKhutshwa kweeKlinikhi kungeke kwenzeke
Ukuxolelwa kliniki kubaluleke kakhulu kwizigulane kuba kuthetha ukuziva ngcono. Iimpawu ze-IBD ezinokubangela iingxaki kwaye zikhokelela kwizigulana ezingakwazi ukuhlalisana okanye ukuya emsebenzini okanye esikolweni zikho okanye zingekho ngokupheleleyo. Kwabaphi na oogqirha abathile, oku kungaba yipopotho yonyango, kodwa ngokuya kuqondakala ukuba ukuxolelwa kufanele kufake ngaphezu kweempawu zokulawula. Ukufikelela kwizinto ezibizwa ngokuba "ukujula" ukuxolelwa ngoku iinjongo.
Isizathu salokhu kukuba nangona xa kusesikweni sekliniki nokuhamba ubomi njengesiqhelo, i-IBD isenokubangela ukuvuvukala kwindlela yokugaya.
Ucwaningo luye lwabonisa ukuba naphakathi kwe-30% kunye ne-45% yezigulane ezinezilonda zesilonda esiswini ekukhunjweni kwekliniki kunokutshabalalisa okunokufumaneka ngexesha lokuphela kwe-endoscopy. Ingxaki ngolu hlobo kukuba ukuvuvukala kukubeka isigulane sengozini eyongezelelweyo kwiziphumo ezahlukeneyo ezibi. Oku kuvutha komzimba kuhambelana nokuphindaphinda kwe-ulcerative colitis, umngcipheko ophezulu wokuba utyando, kunye neengxaki ezingaphezulu kwexesha elide ezifana nomngcipheko okhulayo womhlaza wekoloni .
Kuthiwani Ukuba Kukhona Ukuvutha?
Ukuba neempawu ezimbalwa okanye akukho mpawu ezigulane kwizigulane, kodwa ukuxolelwa ngokujulileyo okubandakanya ukulawula ukuvuvukala kubalulekile kwimpilo yexesha elide. Xa kusekhona ukuvuvukala okukhoyo kwinkqubo yokugaya, kukho uhlobo oluthile lonyango olufunekayo. Ukusebenza ne-gastroenterologist ukufumanisa ukuba yintoni unyango olufunekayo ngokubhekiselele ekungagcineni kuphela ukuxolelwa kweklinikhi kodwa kwakhona ukuzisa ukuxolelwa kwe-endoscopic kubalulekile. Ezinye izigulana zivakalelwa kukuba zanele ukuba zingenayo impawu ze-IBD, kodwa injongo yonyango kufuneka kwakhona ukuba ukuvuvukala kuphelile. Kukho ngaphezulu kwithuba lesiphumo esihle sexesha elide ukususela kwi-IBD xa i- endoscopy kunye ne- biopsy ibonisa ukuba akukho ukutshabalala okuseleyo kwinkqubo yokutya .
ILizwi
Njengoko oogqirha kunye nososayensi baqaphele malunga nento eyenzekayo kwinkqubo yokugaya abantu abane-IBD, iinguqu zamagama atshintsha. Ukuxolelwa ngenye yekota, kuba isetyenziswe ukuthetha ukungabikho kwezibonakaliso, kodwa ngoku kuthetha okungakumbi. Enyanisweni, ukuxolelwa ngoku kwahlula kwiinqununu ezininzi. Nangona iingcali ze-IBD azivumelani ukuba zonke zivumelane ngenye inkcazo yento exoxwa ngayo, kuyavuma ukuba ukuxolelwa kwekliniki akukwaneli kwizigulane. Abantu abane-IBD abafunanga kuphela iimpawu zabo ezilawulwayo, kodwa kunye nokuvuvukala okubangelwa yi-IBD, ukwenzela ukunciphisa umngcipheko weengxaki ezahlukeneyo. Izigulane zihlakaniphile nge-IBD kwaye ziyakwazi ukuqonda imiba yeentlobo ezahlukeneyo zokuxolelwa kunye nendlela yokufezekisa ukuxolelwa kwe-endoscopic okuya kubakho kwiziphumo ezingcono.
> Imithombo:
> Crohn's and Colitis Foundation of America. "Inyaniso malunga nezifo ezikhuselayo." CCFA.org. 1 Meyi 2011.
> IMoss AC. "Ukuvutha komzimba kunye noClitis Ulcerative in Remission." I-Gastroenterol Hepatol (NY) . 2014 Mar; 10: 181-183.
> Pineton de Chambrun G, Blanc P, uPeyrin-Biroulet L. "Ubungqina obukhoyo obuxhasa ukuphulukiswa kwe-mucosal kunye nokuxolelwa okujulileyo njengenjongo ebalulekileyo yokongela izifo zesifo." Iingcali zoLwazi uGastroenterol Hepatol . 2016 Aug; 10: 915-927.
> Reinink AR, Lee TC, Higgins PD. "Ukuphulukiswa kwe-Endoscopic Mucosal Kucacisa iziPhumo eziKhuselekileyo eziKhuselekileyo kwizifo zesifo se-Bowel: I-Meta-analysis." I-Inflamm Bowel Dis . 2016 Aug; 22: 1859-1869.
> UZallot C, uPeyrin-Biroulet L. "Ukuxoxwa okujulile kwisifo sokuxhamla kwesibindi: ukujonga ngaphaya kwempawu." I-Curr Gastroenterol Rep . 2013 Mar; 15: 315.