Zilonda zam'mimba

Zamkati

• Onaninso za

Ndi chiyani

Ulcerative colitis ndi matenda otupa am'mimba (IBD), dzina lenileni la matenda omwe amayambitsa kutupa m'matumbo ang'ono ndi m'matumbo. Zingakhale zovuta kuzindikira chifukwa zizindikiro zake ndizofanana ndi matenda ena am'mimba komanso mtundu wina wa IBD wotchedwa Crohn's disease. Matenda a Crohn amasiyana chifukwa amayambitsa kutupa mkati mwa khoma lamatumbo ndipo amatha kupezeka m'malo ena am'mimba kuphatikiza m'matumbo, pakamwa, pamimba, ndi m'mimba.

Ulcerative colitis imatha kupezeka mwa anthu amisinkhu iliyonse, koma imayamba kuyambira azaka zapakati pa 15 ndi 30, komanso pafupipafupi pakati pa 50 ndi 70 wazaka. Zimakhudza amuna ndi akazi mofanana ndipo zimawoneka ngati zikuyenda m'mabanja, ndi malipoti a 20 peresenti ya anthu omwe ali ndi ulcerative colitis omwe ali ndi achibale awo kapena achibale omwe ali ndi ulcerative colitis kapena Crohn's disease. Kuchuluka kwa ulcerative colitis kumawonedwa mwa Azungu ndi anthu amtundu wachiyuda.

Zizindikiro

Zizindikiro zofala kwambiri za ulcerative colitis ndizopweteka m'mimba ndi kutsegula m'mimba kwamagazi. Odwala amathanso kumva

• Kuchepa kwa magazi m'thupi
• Kutopa
• Kuchepetsa thupi
• Kutaya njala
• Kutuluka magazi m'matumbo
• Kutaya madzi amthupi ndi michere
• Zotupa pakhungu
• Ululu m'magulu
• Kulephera kukula (makamaka mwa ana)

Pafupifupi theka la anthu omwe amapezeka ndi ulcerative colitis ali ndi zizindikilo zochepa. Ena amadwala malungo kaŵirikaŵiri, kutsegula m’mimba, nseru, ndi kupweteka kwambiri m’mimba. Ulcerative colitis ingayambitsenso mavuto monga nyamakazi, kutupa kwa diso, matenda a chiwindi, ndi osteoporosis. Sizidziwika chifukwa chake mavutowa amachitikira kunja kwa m'matumbo. Asayansi akuganiza kuti zovuta izi zitha kukhala chifukwa cha kutupa komwe kumayambitsidwa ndi chitetezo chamthupi. Ena mwa mavutowa amatha akalandira chithandizo.

[tsamba]

Zoyambitsa

Pali malingaliro ambiri okhudza zomwe zimayambitsa matenda am'mimba. Anthu omwe ali ndi ulcerative colitis ali ndi zovuta zina m'thupi, koma madotolo sakudziwa ngati izi ndizoyambitsa kapena zotsatira za matendawa. Chitetezo cha mthupi chimakhulupirira kuti chimagwira modabwitsa mabakiteriya am'mimba.

Ulcerative colitis sikuti imayamba chifukwa cha kupsinjika maganizo kapena kukhudzidwa ndi zakudya zina kapena zakudya zina, koma izi zimatha kuyambitsa zizindikiro mwa anthu ena. Kupsinjika kwa kukhala ndi ulcerative colitis kumathandizanso kukulitsa zizindikilo.

Matendawa

Mayesero ambiri amagwiritsidwa ntchito pozindikira ulcerative colitis. Kuyezetsa thupi komanso mbiri yazachipatala nthawi zambiri amakhala gawo loyamba.

Mayeso amwazi angapangidwe kuti muwone kuchepa kwa magazi m'thupi, komwe kumatha kuwonetsa kutuluka kwa magazi m'matumbo kapena m'matumbo, kapena atha kupeza kuchuluka kwa maselo oyera a magazi, chomwe ndi chizindikiro cha kutupa kwinakwake mthupi.

Chitsanzo cha chopondapo chikhoza kuwululanso maselo oyera a magazi, omwe kupezeka kwawo kumasonyeza zilonda zam'mimba kapena matenda otupa. Kuphatikiza apo, chopondapo chimamulola dokotala kuti azindikire kutuluka kwa magazi kapena matenda m'matumbo kapena m'matumbo omwe amayambitsidwa ndi mabakiteriya, kachilombo, kapena majeremusi.

Colonoscopy kapena sigmoidoscopy ndi njira zolondola kwambiri zodziwira ulcerative colitis ndikuwongolera zina zomwe zingachitike, monga matenda a Crohn, matenda a diverticular, kapena khansa. Pazoyesa zonse ziwiri, adokotala amaika endoscope-chubu lalitali, chosasunthika, chowala cholumikizidwa ndi makina owonera makompyuta ndi TV-mu anus kuti muwone mkatikati mwa coloni ndi rectum. Dokotala athe kuwona kutupa, kutuluka magazi, kapena zilonda zilizonse pakhoma lamatumbo. Pakuyesa, adotolo amatha kupanga biopsy, yomwe imakhudza kutenga pang'ono minofu kuchokera pakatikati mwa colon kuti muwone ndi microscope.

Nthawi zina ma x-ray monga barium enema kapena CT scans amagwiritsidwanso ntchito pofufuza ulcerative colitis kapena zovuta zake.

[tsamba]

Chithandizo

Chithandizo cha zilonda zam'mimba zimatengera kuopsa kwa matendawa. Munthu aliyense amakumana ndi zilonda zam'mimba mosiyana, choncho chithandizo chimasinthidwa kwa munthu aliyense.

Chithandizo chamankhwala

Cholinga cha mankhwalawa ndikulimbikitsa ndikukhalabe ndi chikhululukiro, ndikuwongolera moyo wa anthu omwe ali ndi zilonda zam'mimba. Mitundu ingapo ya mankhwala ilipo.

• Aminosalicylates, mankhwala omwe ali ndi 5-aminosalicyclic acid (5-ASA), amathandiza kuthetsa kutupa. Sulfasalazine ndi kuphatikiza sulfapyridine ndi 5-ASA. Chigawo cha sulfapyridine chimanyamula anti-inflammatory 5-ASA kupita kumatumbo. Komabe, sulfapyridine imatha kubweretsa zovuta zina monga mseru, kusanza, kutentha pa chifuwa, kutsegula m'mimba, ndi mutu. Othandizira ena a 5-ASA, monga olsalazine, mesalamine, ndi balsalazide, ali ndi chonyamulira china, zotsatira zoyipa zochepa, ndipo atha kugwiritsidwa ntchito ndi anthu omwe sangatenge sulfasalazine. 5-ASAs amaperekedwa pakamwa, kudzera mu enema, kapena m'malo operekera, kutengera komwe kutupa kumayambira. Anthu ambiri omwe ali ndi zilonda zam'mimba zochepa kapena zochepa amathandizidwa ndi gulu ili la mankhwala. Gulu la mankhwalawa limagwiritsidwanso ntchito mukamayambiranso.

• Mankhwala a Corticosteroids monga prednisone, methylprednisone, ndi hydrocortisone amachepetsanso kutupa. Atha kugwiritsidwa ntchito ndi anthu omwe ali ndi ulcerative colitis wocheperako kapena osayankha mankhwala a 5-ASA. Corticosteroids, yomwe imadziwikanso kuti steroids, ikhoza kuperekedwa pakamwa, kudzera m'mitsempha, kudzera mu enema, kapena mu suppository, malingana ndi malo otupawo. Mankhwalawa amatha kuyambitsa zovuta zina monga kunenepa, ziphuphu, tsitsi kumaso, matenda oopsa, matenda ashuga, kusinthasintha kwamaganizidwe, kutayika kwa mafupa, komanso chiopsezo chowonjezeka cha matenda. Pachifukwa ichi, sakuvomerezedwa kuti agwiritsidwe ntchito kwa nthawi yayitali, ngakhale kuti amaonedwa kuti ndi othandiza kwambiri akapatsidwa ntchito yochepa.

• Ma immunomodulators monga azathioprine ndi 6-mercapto-purine (6-MP) amachepetsa kutupa pokhudza chitetezo cha mthupi. Mankhwalawa amagwiritsidwa ntchito kwa odwala omwe sanayankhe ku 5-ASAs kapena corticosteroids kapena omwe amadalira corticosteroids. Ma immunomodulators amaperekedwa pakamwa, komabe, amachita pang'onopang'ono ndipo zimatha kutenga miyezi isanu ndi umodzi phindu lonse lisanamveke. Odwala omwe amamwa mankhwalawa amayang'aniridwa ngati pali zovuta zina monga kapamba, matenda a chiwindi, kuchepa kwa maselo oyera a magazi, komanso chiopsezo chotenga matenda. Cyclosporine A itha kugwiritsidwa ntchito ndi 6-MP kapena azathioprine kuchiza ulcerative colitis yolimba mwa anthu omwe samayankha mtsempha wa corticosteroids.

Mankhwala ena angaperekedwe kuti akhazikike mtima pansi wodwalayo kapena kuchepetsa ululu, kutsegula m’mimba, kapena matenda.

Nthawi zina, zizindikilo zimakhala zovuta kwambiri kotero kuti munthu ayenera kuchipatala. Mwachitsanzo, munthu akhoza kutaya magazi kwambiri kapena kutsekula m’mimba kwambiri komwe kumayambitsa kutaya madzi m’thupi. Zikatero, dokotala amayesa kuletsa kutsekula m'mimba ndi kutaya magazi, madzi, ndi mchere wamchere. Wodwala angafunike chakudya chapadera, kudyetsa kudzera m'mitsempha, mankhwala, kapena nthawi zina opaleshoni.

Opaleshoni

Pafupifupi 25 mpaka 40 peresenti ya odwala zilonda zam'mimba ayenera kuchotsedwa m'matumbo chifukwa cha magazi ambiri, matenda oopsa, kuphulika kwa matumbo, kapena chiopsezo cha khansa. Nthawi zina adotolo amalimbikitsa kuti achotse m'matumbo ngati mankhwala atalephera kapena ngati zoyipa za corticosteroids kapena mankhwala ena akuwopseza wodwalayo.

Opaleshoni yochotsa colon ndi rectum, yotchedwa proctocolectomy, imatsatiridwa ndi imodzi mwa izi:

• Ileostomy, m’mene dokotala wa opaleshoni amapangira kabowo kakang’ono m’mimba, kotchedwa stoma, ndi kumangirira kumapeto kwa matumbo aang’ono, otchedwa ileum, kwa iyo. Zinyalala zimadutsa m'matumbo ang'onoang'ono ndikutuluka mthupi kupyola mu stoma. Stoma ili pafupi kukula kotala ndipo nthawi zambiri imakhala kumunsi chakumanja kwa mimba pafupi ndi lamba. Chikwama chimavalidwa pakhomo lakutola zinyalala, ndipo wodwalayo amathira pansi thumba ngati pakufunika.

• Ileoanal anastomosis, kapena ntchito yokoka, yomwe imalola wodwalayo kukhala ndi matumbo abwinobwino chifukwa amateteza gawo lina la anus. Pa opaleshoniyi, dokotalayo amachotsa matumbo ndi mkati mwa rectum, ndikusiya minofu yakunja ya rectum. Dokotalayo amamangirira leamu mkati mwa rectum ndi anus, ndikupanga thumba. Zinyalala zimasungidwa m'thumba ndikudutsa anus mwachizolowezi. Kusuntha kwa matumbo kumatha kumachitika pafupipafupi komanso kumakhala madzi kuposa kale. Kutupa kwa thumba (pouchitis) ndizovuta zina.

Zovuta za ulcerative colitis

Pafupifupi 5 peresenti ya anthu omwe ali ndi ulcerative colitis amakhala ndi khansa ya m'matumbo. Chiwopsezo cha khansa chikuwonjezeka ndikutalika kwa matendawa komanso kuchuluka kwa m'matumbo. Mwachitsanzo, ngati kungotsala m'matumbo ndi m'matumbo, chiopsezo cha khansa sichoposa chachilendo. Komabe, ngati colon yonse ikukhudzidwa, chiopsezo cha khansa chimatha kuwirikiza kawiri 32 kuposa momwe zimakhalira.

Nthawi zina kusintha kosasinthika kumachitika m'maselo omwe ali m'matumbo. Zosinthazi zimatchedwa "dysplasia." Anthu omwe ali ndi dysplasia amatha kukhala ndi khansa kuposa omwe alibe. Madokotala amayang'ana zizindikiro za dysplasia pochita colonoscopy kapena sigmoidoscopy komanso poyang'ana minofu yomwe imachotsedwa panthawi ya mayeserowa.

Onaninso za