Imiba emininzi inokufaka isandla ekutshintsheni ekukhuleni kwabantwana abane-IBD
Iziganeko zonyango ezinzulu zidla ukuba ziyiingxaki zabantu abadala, kodwa abantwana banokuphuhlisa izifo zokugaya, kwaye ngokwenene, malunga nekota yesigulana sazo zonke izigulane ezinezifo zesibindi (IBD) ziyafunyanwa njengabantwana. Abantwana abane-IBD bajongene nobunzima bokukhula kunye nabantwana abathile, ukuphuculwa kwindlela yokukhula yabo kunokuba ngumqondiso wokuqala wokuba bane-IBD.
Ukukhula okuqhelekileyo kubantwana abane-IBD kunokuchaphazeleka kakubi ngezinto ezinjengokuvutha kwamathumbu emathunjini, ukungondleki, ukunciphisa ikhalori, kunye nemiphumo emibi yeyeza .
Enye inkxalabo enkulu kukuba ukukhula kwamathambo kwizingane kunye ne-IBD kunokugqitha emva koonyana abaneminyaka efanayo abanalo i-IBD. Ukuze ufunde okungakumbi malunga nendlela ukuphakama komntu omdala onokuchaphazeleka ngayo yi-IBD ebuntwaneni, ndaphendukela kwi- UpToDate -i-reference ekhompyutheni ethembekileyo eyenziwa ngamagqirha amaninzi kunye nezigulana zifuna ulwazi olunzulu lwezonyango.
"Ngenxa yokuba abantwana abanokulibaziseka ngokugqithiseleyo bebade belibazisekile kwixesha lesithambo, ukukhula okubambelelekayo kunokwenzeka emva kokuqala kobuntwaba." Noko ke, ukukhula ngexesha lokutshatyalaliswa kwexesha kunokusenokunganyaniseki kwabo banexesha elide lokuvuvukala, ukungondleki, okanye ukunyanga kwama-corticosteroid. inokuchaphazeleka. "
Imiba emininzi ingathintela kakubi ukuphakama komntu omdala ophethe i-IBD, kuquka nexesha elide, elikhutheleyo; ukutya okunesondlo; kwaye uthathe izidakamizwa ze-steroid ezifana ne- prednisone ukunciphisa ukuvuvukala.
Isifo sikaCrohn, ngokukodwa, sidibene neengxaki zokukhula ezingakumbi kubantwana kunokuba isifo se-ulcerative colitis, kodwa zonke iindidi ze-IBD zingaba nemiphumo emibi ekukhuleni.
Isondlo esifanelekileyo kunye nokukhutshwa
Ukuze kulungiswe le miba, kufuneka kuthathelwe ingqalelo ekuqinisekiseni ukuba abantwana abane-IBD bafumana ukutya okunempilo kwaye bafumana isifo sabo phantsi kolawulo ngokukhawuleza.
Ukufumana ukuxolelwa ngethuba lokutshatyalaliswa kwinyanga yokubaluleka kuyinxalenye ebalulekileyo yokuncedisa ukuba ukukhula kwamathambo kunye nokukhula kwethambo kwenzeka kwizinga eliqhelekileyo.
Olunye unyango olungasetyenziselwa abantu abadala kodwa lisetyenziswe kubantwana kukutya okunomsoco wokutya (EEN). Kwi-EEN, ininzi izondlo (ukuya kwi-90% yeekhalori eziyimfuneko) zithathwa ngeziphuzo ezizodwa zokutya kunye / okanye ityhulo yokutya xa kuyimfuneko. Le ndlela yonyango ifumaneke ukuba iphumelele njenge-steroids ekunciphiseni ukuxolelwa kwaye iye yaboniswa ukukhuthaza ukuphulukiswa kwe-mucosal kwezinye izigulane.
IziCwangciso zokuTyhila
Ukusebenzisa amayeza ngaphandle kwe-steroids nanini na kunokwenzeka esinye isicwangciso esinokukunceda ukugcina ukukhula kwamathambo kubantwana abane-IBD. Xa i-steroids iyadingeka, uyithatha yonke imihla (esikhundleni sosuku ngalunye) kunye nokunciphisa i-dosage ngokukhawuleza ngokukhuselekileyo kunokusetyenziswa ekuncedeni ukugcina impilo yezonyama kubantwana. (Ukuba umntwana wakho okwangoku usebenzisa i-steroids, ungatshintshi umthamo wakhe ngaphandle kokuthetha nodokotela wabo.) Kuyaziwa ukuba i-steroids iyichaphazela amathambo, kwaye iyakwazi ukukhokelela kwi- osteoporosis .
Ukunciphisa imiphumo ye-IBD ekukhuleni komntwana inokuqinisekisa ukuba abantwana abane-IBD banethuba elihle lokufikelela kwinqanaba lokukhula eliqhelekileyo kunye nokuphakama kwabantu abadala.
Kukho umgangatho wokuphatha i-IBD kwabantwana ngokugqithiseleyo kunabanye abadala ukuze kufikelelwe ukukhutshwa ngokukhawuleza nokugcina ukukhula kwethambo oluqhelekileyo. Iingcali zingancoma ukuphatha i-IBD nge "phezulu-down" indlela endaweni ye "step-up". Oko kuthetha ukuthini ukuba isifo se-gastroenterologist sinokuncoma i-biologic (leyo inokunikezwa ngokunyakanyiswa okanye ukujova okanye ukuhlanganiswa kokubini) njengonyango lokuqala, kunokuba uzame umlomo omdala okanye unyango lwamayeza kunye nokulinda ukubona oko kwenzekayo. Kuloo bantwana bafunyanwe ngaphambi kokuba baphumelele, le ndlela inganceda ukufezekisa umzekelo wokukhula oqhelekileyo ngaphambi kokukhula.
ILizwi
Kwezinye iimeko, ukukhula okubi kunokuba ngumqondiso wokuqala wokuba i-IBD ingxaki kumntwana. Kubantwana abane-IBD, ukukhula kungenakuqhubeka kunye noko kuthethwa khona, kunye neepesenti zokukhula zingancipha. Kwimeko enjalo, amanyathelo kufuneka athathwe ukuze athole i-IBD phantsi kolawulo kwaye avelise ukukhula kwakhona apho kufanele ukuba khona.
> Umthombo:
> Usuku lwe-AS, i-Lopez RN. "Isondlo esisodwa sokungeniswa kwabantwana abanesifo sikaCrohn." Ihlabathi J Gastroenterol. 2015; 21: 6809-6816. > iphoni>: 10.3748 / wjg.v21.i22.6809
> Gasparetto M, Guariso G. "Isifo sikaCrohn kunye nokusilela kokukhula kwabantwana nakwishumi elivisayo." Ihlabathi J Gastroenterol . 2014; 20: 13219-13233. > i-doi >: 10.3748 / wjg.v20.i37.13219
> Lev-Tzion R, Turner D. "Ingaba unyango lwe-IBD unyango oluhlukile kunabantu abadala?" I- Minerva Gastroenterol Dietol . 2012 Juni; 58: 137-150.
> Sanderson IR. "Ingxaki zokukhula kubantwana abane-IBD." Nat Rev Gastroenterol Hepatol . 2014; 11: 601-610. > iphoni >: 10.1038 / nrgastro.2014.102
> Teitelbaum JE. Ukungaphumeleli kokukhula kunye nobutyebi obuncitshiswayo kubantwana abanezifo zesibindi. " UpToDate . 6 Okthoba 2015.