Uninzi lweengcali zithi, ewe, zifuna inkqubo yokuxilongwa ngokufanelekileyo
Ukuba ufuna i- diagnostic standard yegolide yesifo esiqhekezayo , ke ewe, ezininzi iingcali ziyavuma ukuba kuya kufuneka ukuba ube ne-endoscopy kunye ne-biopsy, nokuba ngaba uvavanyo lwegazi lwama-celiac lukhuthaze kakhulu. Kodwa kukho into ephikisanayo malunga neli ngcebiso, kwaye oogqirha abambalwa bathi ngoku kunokwenzeka ukuxilonga isifo se-celiac ngaphandle kwenkqubo.
Inkqubo yokuxilonga isifo se-celiac ngokuqhelekileyo iqala ngeemvavanyo zegazi ezikhusela isifo se-celiac. Ezi mvavanyo zikhangele i-antibodies i-gluten ejikelezayo kwigazi lakho xa unesimo.
Ukuba ezo zivivinyo zibuya zikhangelekile (okanye kwezinye iimeko, ukuba ngaba zibi kodwa wena kunye nogqirha wakho usakrokreza isifo seliliac), ugqirha wakho uya kuncomela ukuba uqinisekise isifo se-celiac ukuxilongwa nge-biopsy yamathumbu. Ukuze ufeze oko, uya kufuna ukuqokelela iisampuli ezincinci zamathumbu akho amancinci ukuvavanya kwinkqubo ebizwa ngokuthi i- endoscopy .
Ukuba ezo iisampuli zamathumbu, xa zihlolwe phantsi kwe-microscope, zibonisa uhlobo lomonakalo emathunjini olubizwa ngokuba yi -atrophy , kwaye uya kufumanisa ukuba unesifo se-celiac.
Ezinye iingcali zikholelwa ukuba i-Endoscopy ayimfuneko
Enyanisweni: abaphandi abaninzi abaqhambileyo besifo se-celiac bathi awunayo imfuneko ye-biopsy ukufumanisa isifo se-celiac.
Ngokomzekelo, uDkt. Alessio Fasano, umlawuli weZiko loPhando lweCeliac eMassachusetts General Hospital, uxela ukuba ufuna kuphela ezine kwizinto ezinhlanu zokufumanisa isifo se-celiac. Imiba emihlanu uDkt. Fasano uthi:
- izifo zesifo esiqwengileyo
- iziphumo ezintle kwi- TLG-IgA kunye ne- EMA-IgA yegazi
- iziphumo zokuvavanya izakhi zofuzo
- i-endoscopy kunye ne-biopsy ebonisa i-atrophy
- isisombululo seempawu kwi- gluten-free food
Kwimbono kaDkt. Fasano, ukuba unayo yonke into eluhlu ngaphandle kwemiphumo emihle ye-biopsy ukusuka kwi-endoscopy, ngoko ungaziqhawula i-endoscopy.
Ezinye iingcali ziqaphele ukuba iimvavanyo zegazi ezisetyenziswa kwinkqubo yokuxilonga zichanekile kangangokuthi i-biopsy ukuqinisekisa ukuba ukuxilongwa akusisimfuneko xa iziphumo zokuhlolwa kwegazi zichanekile okanye zichanekile. Ngokomzekelo, abaphandi babika kwiphepha lezokwelapha i- BMC Gastroenterology ukuba bakwazi ukuxilonga okanye ukungabandakanyi isifo se-celiac ngaphandle kwe-intanethi yamathumbu kwi-78% yezigulane.
Ngaba usadinga i-Endoscopy ne-Biopsy?
Kukho ezinye iimeko ezininzi ezinokubangela iimpawu ezifana nezo zifumaneka kwisifo se-celiac, kwaye i-endoscopy ene-biopsy inokukunceda ugqirha wakho ukuba acinge ukuba yeyiphi imeko enayo (nokuba ungenayo). Kwakhona, iimvavanyo zegazi ezisetyenziselwa ukukhenkcelela izifo ze-celiac azikho i-100% ezichanileyo, kwaye ukuchaneka kwazo kuyahlukahluka ngokubhekiselele kwibhaby usetyenziswa ukuqhuba uvavanyo.
Ngako ke, ininzi ye-gastroenterologists ikholelwa ukuba kubalulekile ukuya ngqo kumthombo (oko kukuthi, intlungu yakho encinci) ukubona ngqo ukuba kukho umonakalo onxulumene ne-celiac.
Enyanisweni, i-American College of Gastroenterology iphinda ibuyele kwizikhokelo zayo zeklinikhi zokuxilonga nokulawula isifo se-celiac ukuba i-endoscopy ne-biopsy "iyigxina elibalulekileyo ekuhlolweni kokuxilonga kubantu abane-CD ecatshulwayo [isifo se-celiac] kwaye isinconywa ukuba siqinisekise ukuxilongwa. "U
Nangona kunjalo, kukho iindawo eziphantsi zokufumana i-endoscopy, nayo. Nangona le nkqubo ayikho embi ukuba ihambe (ngokwenene!), Kunokuthatha ixesha elithile ukucwangcisa, kwaye lingaba kubiza (nangona unayo inshuwalense).
Ukongeza, ngelixa ulinde i-endoscopy yakho, kuya kufuneka uqhubeke nokutya i- gluten , ekubeni uvavanyo lukhangele umonakalo owenziwe yi-gluten kumathumbu akho amancinci.
(Funda okunye: Kutheni ndifuna ukutya i-gluten yokuvavanywa kwezifo eziqinileyo ukuba zichaneke? )
ILizwi
Ewe, ngelixa kunezizathu ezivakalayo zokuvuma ukuba inqubo, kunezizathu ezithile zokuziqhayisa, ngokunjalo ukuba iimvavanyo zakho zegazi zibonisa ngokucacileyo ukuba unesi sifo se-celiac.
Kwakhona kunokwenzeka ukuba iingcamango zengcali ziza kutshintsha kwixesha elizayo. Kwiminyaka emashumi anedlulileyo edlulileyo, iingcali zavumelanisiwe ukuba zifuna iiposcopi ezintathu ze-biopsies ukuxilonga isifo se-celiac: esinye sibhale umonakalo wokuqala, esinye sesibini ukulandela ukutya okungekho-gluten ukulungiselela ukuphulukisa, kunye nesithathu ukulungiselela umonakalo omtsha emva komngeni we- gluten .
Ekugqibeleni, ukuba awuqinisekanga ukuba kufuneka ufumane i-endoscopy kunye ne-biopsy ukuqinisekisa ukuba ufumanisa isifo se-celiac, kufuneka uxoxe ngeengxelo kunye neengxaki zakho kunye nodokotela wakho.
Imithombo:
UBürgin-Wolff A. et al. I-biopsy yamathumbu ayisoloko ifunekayo ukuxilonga isifo se-celiac: uhlalutyo oluthile lweemvavanyo zokudibanisa. BMC Gastroenterology. 2013 Jan 23; 13: 19. i-doi: 10.1186 / 1471-230X-13-19.
Rubio-Tapia A. et al. Izikhokelo zeeKliniki ze-ACG: Ukuchonga nokuLawula izifo zeCeliac. I-American Journal yeGastroenterology. 2013 ngoMeyi; 108 (5): 656-76. i-doi: 10.1038 / ajg.2013.79. Epub 2013 Apr 23.
Wakin-Fleming J. et al. Ukuxilongwa kwezifo ze-celiac kubantu abadala ngokusekelwe kwiziphumo zokuhlolwa kwe-serology, ngaphandle kwe-biopsy encinci. I-Clinical Gastroenterology kunye neHepatology. 2013 ngoMeyi; 11 (5): 511-6. i-doi: 10.1016 / j.cgh.2012.12.015. Epub 2013 Jan 7.