Unyango lweZifo eziBulisayo

Ukunyanga kwezifo ze-Bowel Disease (IBD)

Izifo ezithintekayo zezifo (IBD) , ezibandakanya isifo sikaCrohn, i-ulcerative colitis, kunye ne-colitis engapheliyo, izifo ezingapheliyo kwenkqubo yokutya. Kukho akukho nonyango nawuphi na uhlobo lwe-IBD, kodwa kukho iindlela zokwenza unyango olufanelekileyo. Apha sixubusha unyango olwamkelekileyo kwiindlela ezimbini eziphambili ze-IBD: isifo sikaCrohn kunye nesifo se-ulcerative colitis. Izigulane ezine-colitis ezingapheliyo (okuqikelelwa ukuba zibandakanya malunga neepesenti ezili-10 zezigulane ezine-IBD) zinikezelwa unyango oluvunyiweyo lwe-ulcerative colitis.

> Khangela indlela i-ulcerative colitis echaphazela ngayo ikoloni.

Kukho amayeza amaninzi avunyelwe ukusetyenziswa kubantu abane-Crohn's disease kunye ne-ulcerative colitis. Ezinye, ke, zivunyelwe enye okanye enye. Izidakamizwa zineendlela ezahlukeneyo zokwenza kwaye zinikezelwe, ngoko ke izigulane kunye ne- gastroenterologists zisebenza kunye ukuze zithole ukhetho olungagqibekanga kuphela iimpawu zabo, kodwa luya kufana nesimo sengqondo somntu.

• Ukuba ngumhla wokuhlaselwa kwi-Vaccinations Kubalulekile kubantu abane-IBD

• Ziziphi iindawo ezahlukileyo phakathi kwezi 6 ze-Biologics ze-IBD?

Iindaba ezilungileyo kukuba ukuba elinye unyango okanye uhlobo olulodwa lonyango alusebenzi, kukho ezinye iziyobisi kwiklasi efanayo, okanye kwelinye iklasi, onokuzama ukulandela. Ngona iindaba ezilungileyo kukuba amanye amayeza adalwa ukunyanga i-IBD, kwaye kukho ithemba elingakumbi kunanini ngaphambili ukufumana unyango olusebenza kakuhle ukulawula iimpawu ze-IBD kunye nokuvutha kwe-IBD.

Uphando luyeyona ndlela yokuphatha i-IBD, kunye nesifo sesibini sikaCrohn kunye nesifo sobomi, izifo ezahlukeneyo zonyango zisetyenziselwa unyango. Nangona kunjalo, uhlobo lotyando olusetyenzisiweyo luyahlukahluka ngokusekelwe ekubeni luyenziwe ukuphatha isifo sika-Crohn okanye isifo sezilonda zesilonda.

Oku ngenxa yezi ndlela ezahlukeneyo ezi zifo zichaphazela inkqubo yokutya kunye nendlela ukuhlinzwa kuphucula iimpawu kunye nomgangatho wobomi kwizigulane. Nangona ucinga lotyando luyingozi, lusetyenziswa kuphela emva kokuba ezinye zonyango zizame kwaye azisebenzi.

Iinjongo ze-IBD Treatment

Kukho amayeza amaninzi ahlukeneyo asetyenziswa ukuphatha i-IBD. Ezi zonyango zikhulunywe ngokukodwa ngamacandelo, kwaye zibandakanya ama-antibiotics, i-biologics, i-corticosteroids, kunye ne-immunomodulators. Unyango olunamachiza unomgomo wokuloba ezimbini: ukufumana ukuphazamiseka phantsi kokulawulwa kunye nokuxolelwa, kwaye ugcine ukuxolelwa uye ukukhusela ukukhupha okunye. Ezinye iziyobisi zisetyenziselwa enye yezo njongo okanye enye, kwaye ezinye zisetyenziselwa zombini.

Akukho mgangatho omnye wonyango osetyenziswa kuwo wonke umntu onomsebenzi we-IBD. Kukho izikhokelo ezinikezelwa ngamacandelo ezonyango, kodwa unyango alukho ubungakanani obufanayo-zonke iziphakamiso. Unyango lwonyango luya kufuneka lube nolungelelwaniso ukuze luhambelane neemfuno zesigulane ngasinye.

Oko kuthethwa, nangona kunjalo, izigqibo malunga nokukhetha unyango zi sekelwe ubungqina obuvela kuphando.

Izonyango zeCrohn's Disease

Amachiza kwiiCrohn's

Amachiza asetyenziswa ukuphatha isifo sikaCrohn aquka:

Antibiotics

• Cipro (ciprofloxacin)
• Flagyl (metronidazole)

Immunomodulators

• 6-mercaptopurine (iPinetinethol, 6-MP)
• Azathioprin (Imuran neAzasan)
• Folex, iRheumatrex (methotrexate)
• Prograf (Tacrolimus)
• I-Sandimmune, i-Neoral (i-cyclosporine A)

Corticosteroids

• ICortenema (i-hydrocortisone)
• Deltasone ( prednisone )
• Entocort (budesonide)
• Medrol (methylprednisolone)
• Iproctofoam-HC (i-hydrocortisone acetate, i-foam rectal)

Iingcali zonyango

• Cimzia (certolizumab pegol)
• Entyvio (vedolizumab)
• Humira (adalimumab)
• I-Inflectra (infliximab-dyyb)
• Remicade (infliximab)
• Stelara (ustekinumab)
• Tysabri (natalizumab)

Ugqirha lwezifo zeCrohn

Ukuhlinzwa ngokuqhelekileyo kwenziwa emva kokuba imishanguzo ayinakunceda ekuvukeleni okanye kukho iingxaki. Uhlobo lotyando olwenziwayo luya kusekelwe kwindawo yokuvuvukala kwesifo sikaCrohn esibangela nokuba sele sisasazeka kangakanani.

Ugqirha awuyi kuba yonyango kwisifo sikaCrohn kwaye, kwabanye abantu, isifo soCrohn sifikelwa ukubuyela kwenye indawo.

Utyando lwesifo sikaCrohn luhlala luphucula, kwaye kwezinye iimeko kunokuthi kwenziwe ngeendlela ezincinci zokungahambi (ezifana nokuhlinzwa okwenziwe nge-laparoscopic ) ezithintekayo ngexesha lokubhedlele kunye nokuphucula. Nazi ezinye zeendlela eziqhelekileyo zokuhlinzwa okwenziwe ukuphatha isifo sika-Crohn:

• Ukumelana : Uhlobo oluqhelekileyo lotyando olwenziwe ukuphatha isifo sikaCrohn kukuthengiswa. I-resection yiyiphi inxalenye yesisu esiswini okanye isifo esususwayo, kwaye iziphelo zombini zeethambo eziphilileyo ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde zibuye ziphinde ziphinde ziphinde ziphinde ziphinde zibuye ziphinde ziphinde zibuye ziphinde zibuye ziphinde ziphinde zibuye ziphinde ziphinde ziphinde zibuye ziphinde ziphinde zibuye ziphinde ziphinde zibuye ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde zibuye ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde zibuye ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde ziphinde zi Oku kunokwenziwa emathunjini amancinane okanye emathunjini amakhulu .
• I-strictureplasty : Isifo sikaCrohn sinokubangela izicubu ezinqabileyo ezakhayo kwaye zingabangela ukunciphisa emathumbu. Xa isahlulo somathumbu sincinci kakhulu, sinokuvulwa kwakhona ngexesha lotyando lwe-strictureplasty.
• I-Proctocolectomy : Kwezinye abantu abanezifo zikaCrohn apho kungekho sifo kwi-rectum, i-proctocolectomy yokubuyisela ingenziwa. Umathumbu omkhulu ususwe kwaye isiphelo samathumbu amancinci axhunyiwe ngqo kwi-anus. Oku kuthetha ukuba i- stoma ayifuni kwaye i- stool ingadluliselwa phantsi. Olu hlobo lotyando luhlala lwenziwa kuphela kwiqela elithile lezigulane. Olu hlobo lonyango lubizwa ngokuba yi-ileoanal anastomosis.

• Isikhokelo Sakho Ukufumana I-Course Of Prednisone

• Oko abantu abane-IBD bafanele bazi ngo-Cipro

• Utyando lwe-Ostomy : Abanye abantu abanesifo sikaCrohn esithinta i-colon baya kutyunjwa ukuze benze i-ileostomy. Yilapho i-colon isuswe kwaye i-stoma idalwe kwisisu. I-Stool idlula emzimbeni nge stoma esikhundleni sezantsi, kwaye i-ostomy isebenzi igugile kwisisu ukuze ibambe. Uninzi lwabantu abanesifo sikaCrohn abayi kulufuna ukuhlinzwa ostomy.

Unyango lwe-Ulcerative Colitis

Amachiza okuLilcerative Colitis

Amachiza asetyenziswa ukunyanga i-ulcerative colitis iquka:

Aminosalicylates (5-ASA)

• Azulfidine (sulfasalazine)
• Asacol , Pentasa, Lialda, Apriso , Delzicol (i-mesalamine)
• Canasa (i-mesamineine suppositories)
• Colazal (balsalazide)
• IDipentum (olsazine)
• I-Rowasa (i-mesalamine enemas)

Immunomodulators

• 6-mercaptopurine (iPinetinethol, 6-MP)
• Azathioprin (Imuran neAzasan)
• I-Sandimmune, i-Neoral (i-cyclosporine A)
• Tacrolimus (Prograf)

Corticosteroids

• ICortenema (i-hydrocortisone enema)
• Deltasone ( prednisone )
• Entocort (budesonide)
• Medrol (methylprednisolone)
• Iproctofoam-HC (i-hydrocortisone acetate, i-foam rectal)
• Uceris (budesonide)

Iingcali zonyango

• Entyvio (vedolizumab)
• Humira (adalimumab)
• I-Inflectra (infliximab-dyyb)
• Remicade (infliximab)
• Simponi (golimumab)

Uphando lwe-Ulcerative Colitis

I- Crohn's neColitis Foundation of America iqikelela ukuba naphakathi kwama-23 eepesenti kunye neepesenti ezingama-45 zesilonda esiswini se-ulcerative. Ukukhethwa kwindlela yokugonywa kwezilonda zesilonda rhoqo kubandakanya ukususwa kwe-intestine enkulu (colectomy), ngokudalwa kwe-stoma okanye isikhwama sangaphakathi sokuqokelela isitulo. Okukhethwa kwindlela yokugonywa kwesilonda esiswini kubandakanya:

• Iprotocolectomy ngokudalwa kwesikhwama se-pelvic : Emva kokuba ikholoni isuswe ukunyanga i-ulcerative colitis, isikhwama sangaphakathi senziwa kwinqanaba lokugqibela lentlungu encinci (i-ileum). Ngesi sikhwama, akukho sikhwama se-ostomy yangaphandle okanye i-stoma ngenxa yokuba isikhwama senza njenge-rectum. Iifolothi zepelvic zingenziwa ngezimbalwa ezimbalwa ezahlukeneyo, kodwa enye esetyenziswa rhoqo yi-j-pouch. Olu hlobo lonyango lubizwa ngokuba yi-leal pouch-anal anastomosis, okanye i-IPAA.
• Iprotocolectomy ngokudala i-ileostomy : Emva kokuba i-colectomy, ezinye izigulane ezine-ulcerative colitis zine-eliostomy ekupheleni. I-stoma idalwe kwisisu kwisigxina se-stool kunye ne-ostomy isebenzi igqitywe kwi-stoma. Iingcamango zokuba nesifo se-stoma ziyabonakala, kodwa ezininzi izigulane ezinezilonda zesilonda zinezilwanyana ezinomgangatho ophezulu emva kokuba nokuhlinzwa kwe-eliostomy kwaye zihamba kakuhle nge-stoma yazo.

ILizwi

Kukho ukhetho oluninzi lwezokwelapha kunye nophenyo olukhoyo namhlanje ukuphatha isifo sikaCrohn kunye nesifo sezilonda zesilonda kunokuba ngaphambili. Uphulo oluye lwafumaneka kwiminyaka yamuva lusebenza ngokugqithiseleyo, kwaye kukho ukufundiswa okungakumbi.

Inxalenye ebaluleke kakhulu yokwelapha i-IBD ngempumelelo kwaye ukufumana ukuxolelwa kukubona i-gastroenterologist rhoqo kwaye ithabatha amayeza ngexesha. Ngeentlobo ezahlukeneyo zonyango ezikhoyo, izigulane ezininzi ziyakunciphisa ukuvuvukala, ukukhusela iingxaki, nokuphucula umgangatho wobomi babo.

> Imithombo:

> Bhandari BM, Kroser JA. "Izifo ezithintekayo zezifo." Ikholeji yaseMerika yaseGastroenterology. Matshi 2010, Matshi 2011. I-Cleveland Clinic Foundation. 26 Septemba 2013.

> Braegger CP, Nicholls S, Murch SH, Stephens S, MacDonald TT. "I-tumor necrosis yinto ye-alpha kwisitulo njengommakishi we-infestation." Lancet. 1992; 339: 89.

> Crohns & Colitis Foundation of America. "Ugqirha lwe-Crohn's Disease & Ulcerative Colitis." CCFA.org. 31 Agasti 2010.

> Terdiman JP, Gruss CB, Heidelbaugh JJ, Sultan S, Falck-Ytter YT, i-AGA Institute Clinical Practice and Quality Management Committee. "I-American Gastroenterological Association Institute Guideline kwi-Use of Thiopurines, i-Methotrexate, kunye ne-Anti-TNF-i-Biologic Drugs ye-Induction kunye nokulondolozwa kweMpilo yokuKholelwa kwiZifo zeCrohn." Gastro. 2013; 145: 1459-1463.