Ukukhulelwa kunye nemiphumo ye-IBD Medication Have On Pregnancy And Baby
Ngaba Abasetyhini abane-IBD banabantwana?
Ewe, abasetyhini abanezifo zesibindi (IBD) banokuba nabantwana. Kwixesha elidlulileyo, abafazi abane-IBD bacebiswe ngokukhulelwa. Kodwa izicwangciso zolawulo lwe-IBD zangoku zenze ukuba ukhusele umntwana usana nomntwana. Ukuba nesifo esingapheliyo xa ukhulelwe kudinga ukunyamekela ngokugqithisileyo ngamagqirha aqeqeshiwe, kodwa ukukhulelwa okusemgangathweni kunye nosana kubonakala kunokwenzeka.
Ngaba Amadoda Nabasetyhini abane-IBD baye bahlawula izinga lokutya?
Izinga lokukhula kwenzalo yabasetyhini abane-IBD zifana nabasetyhini abanempilo entle. Abasetyhini abanezifo ezikhutheleyo ze-Crohn bangaba nokunciphisa ukuzala. Ucwangciso losapho luyintloko ebalulekileyo kuyo nayiphi na ibhinqa, kodwa ngokukodwa kulabo abane-IBD. Kukho iimeko apho ukukhulelwa kungenakucetyiswa, njengokuba ngexesha lokutshatyalaliswa okanye xa uthabatha amachiza athile.
Kuye kwaziwa iminyaka emininzi i-sulfasalazine (i-Azulfadine), isilwanyana esisetyenziselwa ukunyanga le miqathango, sinokubangela ukungapheli kwesikhashana kwi-60% yamadoda. Icandelo le-sulfa yesilwanyana linokutshintsha i-sperm, kodwa le mpembelelo iguqulwa ngaphakathi kweenyanga ezimbini zokuyeka ukusetyenziswa kwayo. Ukuhlinzwa okwenziwa ngabantu ku-Proctocolectomy kungabangela ubuthathaka, nangona oku kunqabile.
Ngokomnye uphononongo lweencwadi, ukungabikho kwengqondo kubakho kuma-48% wabasetyhini abaye baphelelwa ukuba baphathe i-ulcerative colitis. Oku mhlawumbi ngenxa yobuncwane kwiibhulo zokulala ezingenzeka emva kokuhlinzwa okunzulu.
Umngcipheko wokungabikho kwengqondo emva kokuba u-colectomy sele uphelelwe umbuzo iminyaka emininzi kuba uphando oluninzi lubonise amanqanaba ahlukeneyo okungafumaneki. Kukho iingxelo ezifanayo zokungabikho kwintsholongwane kwizigulane zikaCrohn.
Yimpembelelo Yini Imithi Eya Kukhulelwa?
Abasetyhini abaninzi bakholelwa ukuba kufuneka bayeke ukufumana imithi ngexesha lokukhulelwa, nangona kunjalo, ukuqhubeka nokuthatha imishanguzo ye-IBD kunika ithuba elihle lokuphepha.
Uninzi lwamachiza kwi-IBD luye lwaboniswa ukuba lukhuselekile ukuqhubeka ngexesha lokukhulelwa, kwaye abaninzi banomlando omude wokusetyenziswa ngokukhuselekileyo zizigulane. Ulawulo lwezoKutya kunye neDrug (iDAA) luye lwadala inkqubo yokuhlengahlengisa ukusetyenziswa kwamachiza ngexesha lokukhulelwa (jonga iThebhile 1 ngezantsi).
Ucwaningo luye lwabonisa ukuba ezininzi iziyobisi eziqhelekileyo zisetyenziselwa ukongamela unyango kunye ne-flavour-ups ye-IBD ikhuselekile kubafazi abakhulelweyo basebenzise. Zezi:
- I-Sulfasalazine (i-Azulfidine [Udidi lokukhulelwa B]
- Iifomu ze- mesalamine (i-Asacol, i-Pentasa, i-Rowasa [Udidi lokukhulelwa B]
- I-Corticosteroids (prednisone [Ubunzima beBakala B]
- Biologics ( Remicade , Humira , Vedolizumab , Stelara , Cimzia )
Xa kufuneka unyango lwezonyango lube ngumntu ngamnye
Uninzi lwamachiza e-IBD luya kukhuseleka ukuqhubeka ngexesha lokukhulelwa kwaye akufanele liphelelwe ngaphandle kweengcebiso ezicacileyo ngu-gastroenterologist kunye ne-OB / GYN eyaziwayo kwimeko ethile yebhinqa ye-IBD. Kukho amayeza, nangona kunjalo, enokudinga ukulungiswa ngexesha lokukhulelwa.
Immunosuppressants. Izidakamizwa ze-immunosuppressive azathioprin (Imuran [Isigaba sokukhulelwa D]) kunye ne-6-mercaptopurine (iPinetinet okanye 6-MP [Ubunzima beNqanaba lokuBumba] Dlulisa i-placenta kwaye inokufumaneka kwi-intambo yegazi.
Nangona kunjalo, banokucetyiswa ngokulumka ngexesha lokukhulelwa ngamagqirha athile ukuze alwe nokulwa. Ezi ziyobisi azikwandisi umngcipheko weziphene zokuzalwa.
Methotrexate kunye ne-thalidomide. I-Methotrexate ( Ubunzima beCandelo X) kunye ne- thalidomide (Ubunzima beCandelo X) zezidakamizwa ezimbini ezingasetyenziswanga ngexesha lokukhulelwa njengoko zinefuthe kumntwana ongakazalwa. I-Methotrexate ingabangela ukukhipha isisu kunye nokungaqhelekanga kwezifo, kwaye kufuneka kupheliswe inyanga ezintathu ngaphambi kokukhulelwa, ukuba kunokwenzeka. I-Thalidomide iyaziwa ngokubangela ukukhubazeka kwezitho kunye nezinye iimeko ezinzima zomzimba kwi-fetus.
Ukusetyenziswa kuvunyelwe kuphela ngokulawulwa ngokukhawuleza kokuzalwa kunye nokuvavanya ukukhulelwa rhoqo.
Metronidazole. I-Metronidazole (i- Flagyl [ Ubunqunu Bgaba B]), i-antibiotic edlalwa ngamanye amaxesha ukuphatha iingxaki ezinxulumene ne-IBD, inokuthi ikhuselekile kumntwana emva kokuqala kwe-trimester. Olunye uphando lubonisa ukuba i-metronidazole ayizange ibangelwe iziphene zokuzalwa kwi-trimester yokuqala, kodwa akukho zifundo zangexesha elide zenziwe. Izifundo ezimfutshane zesi sirhoxiso zisetyenziselwa ukukhulelwa, nangona iikhosi ezide zihlala ziphikisana.
Ukukhulelwa Kuyakuthinta Njani I-IBD?
Ikhosi ye-IBD lonke ixesha lokukhulelwa lihlala lifana nelo xesha ngexesha lokukhulelwa. Ngenxa yoko, kubalulekile kubafazi abacinga ukukhulelwa ukuze bagcine i-regimen yonyango kwaye basebenze ukuzisa, okanye ukugcina, isifo sabo ngokuxoxwa.
Phakathi kwabasetyhini abakhulelweyo xa i-IBD yabo ingasebenzi, esinye sesithathu siphucula, esinye sesithathu sibi kakhulu, kwaye esinye sesithathu asizange sitshintshe kwisifo sabo. Phakathi kwabasetyhini abakhulelwe xa i-ulcerative colitis iqhuma, i-sibini yesithathu iza kuqhubeka nokufumana izifo ezikhutheleyo.
Oogqirha banokuphatha unyango ophezulu lwe-IBD owenzeka ngexesha lokukhulelwa okungalindelekanga kakhulu. Ukufumana ukuxolelwa kubalulekile ukukunceda ukuqinisekisa ukuba ukukhulelwa kunempilo kunokwenzeka.
Itheyibhile 1 - I-FDA IziDakamizwa zeDrug
| Udidi | Inkcazo |
| A | Ucwaningo olwaneleyo, olulawulwa kakuhle kwabasetyhini abakhulelweyo alubonisanga mngcipheko wokungabikho komntwana obuthathaka. |
| B | Izifundo zezilwanyana azibonakalisi ubungqina bengozi kumntwana, nangona kungekho zaneleyo, izifundo ezilawulwa kakuhle kwabasetyhini abakhulelweyo. OKANYE izifundo zezilwanyana zibonisa impembelelo embi, kodwa izifundo ezifanelekileyo, ezilawulwa kakuhle kwabasetyhini abakhulelweyo baye bahluleka ukubonisa umngcipheko kumntwana. |
| C | Izifundo zezilwanyana ziye zabonisa impembelelo embi kwaye akukho zifundo ezifanelekileyo, ezilawulwa kakuhle kwabasetyhini abakhulelweyo. OKANYE akukho zifundo zezilwanyana ezenziweyo, akukho zifundo ezifanelekileyo, ezilawulwa kakuhle kwabasetyhini abakhulelweyo. |
| D | Ucwaningo, olwaneleyo, olulawulwa kakuhle okanye oluqwalaselayo, kwabasetyhini abakhulelweyo baye babonisa umngcipheko kumntwana. Nangona kunjalo, iinzuzo zonyango zingadlulisa umngcipheko omkhulu. |
| X | Izifundo, ezaneleyo ezilawulwe kakuhle okanye ezithengileyo, kwizilwanyana okanye kwabasetyhini abakhulelweyo baye babonisa ubungqina obuhle bokungabikho komntwana. UMveliso uphikisana nabasetyhini abakhulelweyo okanye abakhulelweyo. |
Ngaba kukho naziphi iingxaki ngokukhulelwa kunye ne-IBD?
Kwabesetyhini abane-ulcerative colitis kunye nesifo sikaCrohn ekuxoxweni, ingozi yokukhulelwa kwesisu, ukuzalwa komntwana kunye nokungaqhelekanga komzimba kufana nalabo bafazi abasempilweni. Isifo sesifo sikaCrohn ngexesha lokukhulelwa okanye ngexesha lokukhulelwa lidibene nomngcipheko ophezulu wokukhulelwa kwesisu nokuzalwa kwangaphambi kokuzalwa.
Ama-hemorrhoids yinkathazo eqhelekileyo kubasetyhini abakhulelweyo, kunye nama-50 ekhulwini kwabasetyhini ababhekene nabo. Iimpawu ze-IBD, ezinjenge-diarrhea okanye ukuziqhayisa, okunokwenyusa umngcipheko weemfumba. Kukho unyango oluthile oluya kunciphisa i-hemorrhoids njenge-Kegel yokuzilolonga, ukugcina indawo engafanelekanga, ukuphepha ukuhlala kunye nokuma ixesha elide kunye nokuphakamisa okunzima okanye okulinganiselayo, usebenzisa i-petroleum jelly ukupholisa i-rectum nokunciphisa ukuhamba, ukuhlala ipakethe ye-ice for relief from burning, ehleli ngamanzi afudumele afanelekileyo ukugubungela ama-hemorrhoid, kunye nokusebenzisa i-suppositories okanye i-creams.
Ngaba i-IBD ifikeleleka kubantwana?
Abanye abantu abane-IBD banokuhlala bengenamntwana ngenxa yokukhathazeka ukuba abantwana bangazuza ilifa labo. Kwiminyaka yakutshanje, bekuye kugxininiswa kwingcamango yokuba i-IBD isebenza kwiintsapho kwaye inokudibaniswa kunye namajethi athile. Abaphandi abanakho iimpendulo ezicacileyo malunga nendlela i-IBD idluliselwa ngayo phakathi kwezizukulwana, kodwa kukho uphando olunokwenzeka lokuba abantwana bazuze isifo sabo somzali.
Kubonakala kubonakala kunomngcipheko oqaqambileyo wokufumana isifo seCrohn kune-ulcerative colitis, ngakumbi kwiintsapho zamaYuda. Nangona kunjalo, abantwana abanomzali omnye abaneesifo sikaCrohn banomngcipheko we-7 ukuya ku-9% wokuphila kwimeko, kwaye ingozi ye-10% yokuphuhlisa uhlobo oluthile lwe-IBD. Ukuba ngaba bobabini abazali bane-IBD, lo mngcipheko ukhuphuke ube malunga nama-35%.
Yintoni Eyokunceda Ngaphambi Kokudibana okanye Ngexesha Lokukhulelwa?
Abasetyhini banokukhuthazwa ukuba bafumane imizimba yabo ilungiselele ukukhulelwa ngokunyusa i-folic acid, ukuyeka ukutshaya, ukufumana umthambo wokuzivocavoca, nokutya okunempilo. Kuyabasetyhini abane-IBD, into ebalulekileyo echaphazela inkambo yokukhulelwa kunye nempilo yengane yimeko yesifo. Ukuyeka nayiphi na imishanguzo enokuba yingozi kumntwana okhulayo kubalulekile. Ukukhulelwa okucwangcisiweyo xa i-IBD ikhutshwe inethuba elihle kakhulu kwisiphumo esihle.
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