Isigaba se-IBD asiyisifo sikaCrohn okanye isifo sezilonda zesilonda
Xa kuxubusha izifo zesibindi sokuvuvukala (IBD) , iifom ezimbini ezidla ukuthetha malunga ne-ulcerative colitis nesifo sikaCrohn, kodwa kukho ukuxilongwa kwesithathu okubizwa ngokuba yi-indeterminate colitis. Ukugqithwa kwe-colitis kusetyenziswa xa kucingwa ukuba uhlobo lwe-IBD lukhona, kodwa alukaqondi ukuba luphi uhlobo lwesifo.
Esi sihloko esididekayo nesinokuphikisana kwi-IBD, ngefuthe elibanzi kwizigulane kunye noogqirha. Kuqikelelwa ukuba naphi phakathi kweepesenti ezili-10 kunye neepesenti ezili-15 zabantu abane-IBD bacinga ukuba bane-colitis engapheliyo. Kwezinye iimeko, ukuxilongwa kolunye uhlobo lwe-IBD lungenziwa kamva, xa kukho ubungqina obuninzi okanye isifo sitshintsha.
Yiyiphi i-Colitis e-Indeterminate
I-IBD ihlala iphakanyisiwe njengexesha le-ambulla, phantsi kwesifo sikaCrohn kunye nesifo se-ulcerative colitis. Nangona kunjalo, kukho iimeko apho umntu unomhlobo we-IBD ongenakukwazi ukuhlulwa njengamnye wale mabhakethi. Oku akuthethi ukuba ukuxilongwa kwesifo sikaCrohn okanye isifo se-ulcerative colitis ngeke senziwe kwixesha elizayo, kodwa oko kuthetha ukuthini ukuba okwangokunje, akucaci ukuba yeyiphi ifom yesifo esikhoyo.
Izifo eziye zaqhubeka ngaphaya kwamanqanaba okuqala kwaye zithuthuka, ingakumbi kunzima ukuba zihlukanise ngenxa yobume bokuvuvukala kunye nokuba luninzi kangakanani kwi- colon .
Ngakolunye uhlangothi, xa izifo zihamba okanye zilahlwa , kwaye kuncinci endleleni yokuvuvukala, kunokuba kunzima ukwenza isifo sokuxilongwa. Izifo zakuqala zambi kunzima ukuxilonga ngenxa yokuba utshintsho olubangelwa yi-IBD kwiiseli kwaye lunokubonakala kwi- biopsy ngaphantsi kwe-microscope kungenzeka ukuba lukho.
I-coletary inteterminate iyaqhubeka ibe yinto ephikisanayo kwezinye iindidi kwaye inokuthi ithathelwe ingqalelo. Abanye abaphandi baye benza ityala le-colerm indeterminate ukuba baqwalaselwe njengendlela yesithathu ye-IBD, ngelixa abanye begcina ukuba yindawo yokubamba kwaze kwagqitywa esinye isifo. Ugqirha okanye ugqirha wezilwanyana ongenakukwazi ukufumanisa i-IBD unokukhetha ukuba babona ntoni kwisigulane ukuba abe ngumlwelwe ongapheliyo, kodwa unogqirha onokuzibonela ngakumbi unokwazi ukucacisa ukuba sisifo sesifo sikaCrohn okanye isifo se-ulcerative colitis.
Iimpawu kunye neMpawu zoLungelelwano lwe-Colitis
Esikhundleni sokuba ngumatshini weziganeko ezahlukeneyo zesibini kunye nesifo sikaCrohn, i-colitis engapheliyo idibene neempawu eziye zachazwa ngowe-1978, nangona zingekho imithetho eqinile kwaye ikhawulezileyo. I-colitis e-Indeterminate ingaba nayo yonke into okanye ezinye zeempawu ezilapha:
- Uhlobo lwezilonda: I- colet e-inteterminate ingasetyenziselwa kwiimeko apho kukho ukuvutha kuphela emathunjini amakhulu, kodwa izilonda azibukeli ngathi zibangelwa yi-ulcerative colitis. Kwi-ulcerative colitis, izilonda ezitholakalayo emathunjini amakhulu ziza kubandakanya kuphela umgca ongaphakathi ngaphakathi kwe-mucosa, elineendonga zamathumbu emathumbu. Ukuba ezo zilonda zizinzulu kunokuba zilindeleke ukuba zinezilonda zesilonda, kwaye akukho nanye into ebonisa ukuba isifo sisifo sesifo sika-Crohn, singakhokelela ugqirha phantsi kwendlela yokwenza i-diagnostic yokuqala ye-colitis. Olu hlobo lwezilonda ngamanye amaxesha luchazwa njengezilonda zesisu (okuthetha ukuba zihamba ngokujonge ngodonga lwamathumbu) okanye zifana nezikhuni. Kwezinye iimeko izilonda ezinjenge-fissure ezincinci (malunga neepesenti ezingama-13 zamatyala), kwaye ngamanye amaxesha zenziwe njenge "V" (malunga nama-60 ekhulwini amatyala).
- Ukubandakanyeka ngokuthe ngqo: Olunye udidi lwe-colitis olungapheliyo kukuba i-rectum ayinakubandakanyeka, okanye ingabandakanyeka ngokupheleleyo. Kwi-ulcerative colitis, i-rectum iyancipha kwakhona, kungenxa yoko, xa kungenjalo, akuncinci nje njengesibonakaliso esingasetyenziselwa ukuxilongwa. Kwi-Crohn's disease, i-rectum inakho okanye ingabonakali ukuvuvukala.
- Gweba izilonda: Kwi-Crohn's disease, ukuvuvukala kunokudumbula indawo yamathumbu, ukushiya i-patchwork yeendawo ezivuthayo kunye nezinye izicubu ezinempilo. Kwi-ulcerative colitis, ukuvuvukala kuqala kwi-rectum kwaye iqhubela phambili kwi-colon kwipatheni ephathekayo. Nge-colitis engapheliyo, kunokubakho indawo yeqaqa, okanye ubuncinci, kubonakala sengathi kuneendawo ezidlulayo phakathi kwamacandelo atshabalalayo. Kukho izizathu ezininzi zokubangela ukuba i-ulcerative colitis ibonakale isuka kwizilonda, yintoni le nto inokuba yinto enye engasinceda ngaso sonke isikhathi ukwenza isifo sokuxilongwa.
Unyango lwe-colitis e-Indeterminate
Ngelishwa, izilingo zeklinikhi kubantu abane-colitis ezingenanto ziyabikho, zenza kube nzima ukuphucula unyango. Kwiimeko ezininzi, i-colitis engagqithwanga iyaphathwa ngamachiza afanayo kunye nokuhlinzwa njengokuba i-ulcerative colitis. Umahluko uya kuba ngaba kukho ukuvuvukala emathunjini amancinci (njengenxalenye yokuqala, leyo ye-ileum), kwaye kwimeko apho isicwangciso sonyango sinokungafani kwaye sifane nesifo sesifo sikaCrohn.
Isicwangciso sonyango se-indeterminate colitis singabandakanya la mayeza:
- Asacol (mesalamine)
- Azulfadine (sulfasalazine)
- I-Immunosuppressants ( Imuran , 6-MP , i- cyclosporine )
- Rheumatrex (methotrexate)
- Imithi ye-biologic: Remicade (infliximab) ; Humira (adalimumab) ; Entyvio (Vedolizumab) ; kunye neGolimumab (Simponi)
- I-Corticosteroids (i- Entocort EC (i-budesonide) kunye ne- prednisone )
Inkqubo yokuphanda i-colitis engapheliyo iyafana neyo-ulcerative colitis, equka isikhwama se-aleal anastomosis okanye i-IPAA (ebizwa ngokuba yi-j-poch) kunye ne-eyostomy. Kwi-ileostomy, ikoloni isuswe kwaye isiphelo samathumbu amancinci siziswa ngokufakwe kwisisu (esibizwa ngokuba yi- stoma ). Umntu ophethe i-ileostomy unxiba isisombululo kwisisu ukuze abambe isitulo, ngoku eshiya umzimba ngecandelo lomathumbu omncinci ongaphandle komzimba. I-Stool iqokelela kwisixhobo kwaye ikhutshwe endlwini yangasese njengoko kuyimfuneko.
I-Indeterminate Colitis kunye ne-J-Pouches
Kwezinye iimeko, i-colitis e-indeterminate iphathwa njengeyona nto ifana ne-ulcerative colitis. Ngenxa yoko, abanye abantu abane-colitis e-indeterminate baye bafumana utyando lwe-j-pouch, olugcinwa ukusetyenziswa kuphela kubantu abane-diagnosis ye-ulcerative colitis. Ngophenyo lwe-j-pouch, intlaba enkulu isuswa kwaye isahlulo sokugqibela samathumbu amancinci senziwa yesikhombisi isimo se "J" kwaye siqhotyoshelwe kwi-anus (okanye i-rectum, ukuba nayiphi na ishiyweji) . I-j-pouch ithatha indima yecala, kwaye igcina isitulo. Olu hlobo lugqirha aluqhelekanga kwisifo sikaCrohn kuba kukho umngcipheko omncinci ukuba isikhokhethi sinokuchaphazeleka yiCrohn kwaye kufuneka sisuswe.
Nangona kunjalo, uphando luye lwabonisa ukuba abantu abane-colitis e-indeterminate bavame ukwenza okuncinci kakuhle nge-j-poches ezifana nabantu abane-ulcerative colitis. Nangona kunjalo, abanye abaphandi baye bachaza ukuba izinga lokungaphumeleli kwe-j-pouch kwizigulane ezine-colitis ezingapheliyo zinokuphakama kuba iimpawu zesifo azifani: kukho ukuhluka okungafaniyo ukufundisisa eli qela lezigulane ngokupheleleyo.
Zonke iimeko ze-Colitis e-Indeterminate Not Similar
Enye into edibanisayo ye-colitis engapheliyo kukuba iziganeko zinokuhluka phakathi kwezigulane. Le ngxaki nge-IBD ngokubanzi: Isifo esiyinkimbinkimbi esinzima ukuyibeka. Inkcazo ye-colitis engapheliyo ayinayo i-standard standard, nangona kukho izikhokelo ezibanzi.
Kukho ezinye iziganeko ze-colitis ezingapheliyo ezicatshulwa ngokuthi "isifo seCrohn" xa ezinye "zinokwenzeka ukuba i-ulcerative colitis," oku kuthetha ukuba kukho izigulane kwisigaba esingenakunqwenelekayo esingaba khona naphakathi kwimiba ephakathi kwezi zifo zimbini. Oku kwenza ukuba kufundwa, ngoko ke ukuqonda, i-colitis engapheliyo yinto enzima.
Ukuxilongwa kwe-Colitis Engagqityiweyo Ingavumelekile
Kwiimeko ezininzi, ukuxilongwa kwesifo sikaCrohn okanye isifo se-ulcerative colitis ekugqibeleni sifinyelelwe. Ngexesha kwaye kwaye kutheni le nto eyenzekayo iya kuba yinto eguquguqukayo. Kwezinye iimeko, ukuba ukutshaya kwintsholongwane kwintliziyo encinci xa kwakukho kuphela ukuvuvukala kwikholoni, kusenokwenzeka ukuba ukuxilongwa kwesifo sikaCrohn kungenziwa ngoku. Kwezinye iimeko, iimeko ezinokuthi zenzeke zize zenzeke iingongoma zogqirha kwizikhokelo zokufumanisa uhlobo olulodwa lwe-IBD ngaphezu kwexesha. Ezinye iingxaki, nokuba ngamathumbu emathunjini okanye emathunjini amade , zixhaphake kakhulu ngefomu enye ye-IBD ngenye, kwaye ubukho babo buyakunceda ekwenzeni ukuxilongwa.
Esinye isizathu sokuba kubalulekile ukufumana ukuxilongwa kwesinye sezi fom kudala isicwangciso sonyango esisebenzayo. Amachiza avunywe yi-Food and Drug Administration yimeko ethile, kwaye ngale ndlela, isifo sikaCrohn kunye nesifo sezilonda zesilonda siphathwa ngokuhlukileyo. Ukufumanisa ukuba kukho enye yeendlela ezimbini ezibalulekileyo ze-IBD kuthetha ukufumana unyango olwamkelweyo eso sifo. Uninzi lwezokwelapha luvunyiwe kwiintlobo zombini ze-IBD, kodwa kusekho ezinye ezivunyelwe ukuba zifakwe kwisifo sikaCrohn okanye isifo se-ulcerative colitis. Okona, ezinye iinkatho zonyango zingase ziphumelele nakwezinye zezi zifo kunezinye. Ngako oko, kunenzuzo ukufumana ukuxilongwa okucacileyo.
ILizwi
Ukufumana ukuxilongwa kwe-colitis engapheliyo kuza nexabiso elingafanelekiyo kwaye kunokukhathazeka xa ucinga ukuphathwa kwesifo kunye nonyango. Kubalulekile ukuba nabani na onayo i-IBD ibe ngummeli okhuselekileyo, kodwa kubalulekile kubantu abane-colitis engapheliyo. Ukufumana iqela lokunakekelwa kwezempilo elixhasayo ngokupheleleyo kunye neenethiwekhi zentsapho kunye nabahlobo abanokukunceda kunye nokuqonda kuya kunceda ekujonganeni nesifo. Abanye abantu bahlala nokuxilongwa kwe-colitis engapheliyo, ngaphambi kokuba nantoni na iguqulwe, kwaye ngoko ke ukufunda okuninzi kangangoko malunga ne-IBD kunye nokuhlanganisa intsebenziswano yenethiwekhi kufuneka kube yintloko.
> Imithombo:
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> Pezim ME, Pemberton JH, Beart RW Jr, et al. "Umphumo we" indeterminant "kolitis emva kwesikhwama se-leal-anal anastomosis." I-Dis Colon Rectum . 1989 Aug; 32: 653-658.
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