Chii chinonzi Pseudomembranous Colitis? Zviratidzo, Zvinokonzera, & Kurapa

Pseudomembranous colitis chirwere chinoratidzwa nekuzvimba kwakanyanya kwematumbu makuru (colon) kunoita kuti pave nemapazi akakora, ane ruvara rweyero anonzi pseudomembranes pamusoro pemukati memukati. Izvi zvinoitika kana mabhakitiriya anokuvadza akawanda mumatumbu ako mushure mekunge mabhakitiriya akanaka aurayiwa, kazhinji nekushandisa mishonga inorwisa mabhakitiriya.

Fungidzira colon yako seyakavharwa nemabhakitiriya akanaka anodzivirira zvinhu zvese kuti zvive zvakanaka. Kana mishonga inorwisa mabhakitiriya ikauraya aya mabhakitiriya akanaka, mabhakitiriya anokuvadza senge Clostridioides difficile (C. diff) anogona kuwanda nekukurumidza uye kuburitsa chepfu inokuvadza mukati memukati memukati.

Zviratidzo zve pseudomembranous colitis ndeapi?

Chiratidzo chekutanga chinowanzoitika ndicho manyoka emvura anouya panguva kana mushure mekutora mishonga inorwisa mabhakitiriya. Ungacherechedza kuti manyoka aya ane kunhuhwirira kwakashata uye anoitika kakawanda pazuva.

Heano zviratidzo zvaunofanira kutarisa, kutanga nezvinowanzoitika:

• Manyoka emvura kakawanda (katatu kana kupfuura pazuva)
• Kurwadziwa kwemudumbu
• Kupisa uye kunotonhora
• Kusvotwa uye kushaya chido chekudya
• Ropa kana mvura mumanyoka
• Zviratidzo zvekushaya mvura mumuviri senge kuzvidza musoro kana muromo wakaoma

Mukuwedzera, ungave nekumhanya kwemoyo, kuzvimba kwakanyanya kwemudumbu, kana zviratidzo zvekushaya mvura mumuviri zvakanyanya. Aya maratidzo anowanzoonekwa mukati memazuva mashoma kusvika kumavhiki mashoma mushure mekutanga kutora mishonga inorwisa mabhakitiriya, kunyangwe dzimwe nguva zvingatora mwedzi.

Chii chinokonzera pseudomembranous colitis?

Chinokonzera chikuru ndicho kuwanda kwakanyanya kwe Clostridioides difficile mabhakitiriya mumatumbu ako mushure mekunge mabhakitiriya ako emukati atadza kushanda zvakanaka. Izvi zvinowanzoitika kana ukatora mishonga inorwisa mabhakitiriya inouraya mabhakitiriya akanaka neakaipa.

Ngatitarisei zvinhu zvinokonzera chirwere ichi:

• Kushandisa mishonga inorwisa mabhakitiriya (kunyanya clindamycin, fluoroquinolones, cephalosporins, uye penicillins)
• Mishonga yekurapa kenza
• Proton pump inhibitors yekurapa acid reflux
• Kuenda kuchipatara kana kugara kwenguva refu muma institution ekutarisirwa kwevanhu vakwegura
• Kuve wakamborwara neC. diff kare

Mumamiriro ezvinhu asingawanzoitika, pseudomembranous colitis inogona kuitika pasina kushandisa mishonga inorwisa mabhakitiriya. Izvi zvinogona kuitika nekuda kwechirwere chakakomba, inflammatory bowel disease, kana mishonga inodzora sisitimu yako yekudzivirira muviri. Chinhu chikuru ndechekuti pane dambudziko pakukwana kwematumbu ako.

Rini unofanira kuona chiremba nekuda kwe pseudomembranous colitis?

Unofanira kubata nachiremba wako nekukurumidza kana ukawana manyoka asingaperi panguva yekutora mishonga inorwisa mabhakitiriya kana mukati memwedzi miviri mushure mekumira kutora mishonga. Usamirire kuona kana zviratidzo zvichapora zvega.

Tsvaga rubatsiro rwekukurumidza kana uine kurwadziwa kwakanyanya kwemudumbu, kupisa kwakanyanya kupfuura 101.3°F (38.5°C), zviratidzo zvekushaya mvura mumuviri, kana ropa mumanyoka ako. Aya maratidzo anogona kuratidza matambudziko akakomba anoda kurapwa nekukurumidza.

Kunyangwe zviratidzo zvishoma zvinoda kutarisirwa nachiremba nekuti pseudomembranous colitis inogona kuipa nekukurumidza. Kuongororwa nekukurumidza uye kurapwa kunovandudza zvikuru mugumisiro wako uye kudzivirira matambudziko anokuvadza.

Zvinhu zvinowedzera njodzi yekuwana pseudomembranous colitis ndeapi?

Njodzi yako inowedzera zvakanyanya kana uchangotombo tora mishonga inorwisa mabhakitiriya, kunyanya iyo inouraya marudzi mazhinji emabhakitiriya. Zera rinotambawo basa, vanhu vane makore anopfuura 65 vane njodzi yakakura nekuda kwekuchinja kwekuita kwesisitimu yekudzivirira muviri nema bacteria emukati.

Zvinhu zvakati wandei zvinogona kukugadzira kuti uve nenjodzi yakakura yekuwana chirwere ichi:

• Kurapwa nemishonga inorwisa mabhakitiriya (mukati memwedzi miviri kusvika mitatu)
• Zera rinopfuura makore 65
• Kuenda kuchipatara kana kugara mu institution ekutarisirwa kwevanhu vakwegura
• Sisitimu yekudzivirira muviri yakasimba
• Kuve wakamborwara neC. diff kare
• Inflammatory bowel disease
• Chirwere cheitsvo chisingaperi
• Kushandisa proton pump inhibitors

Vashandi vezveutano nevanhu vanoshanyira zvipatara kazhinji vane njodzi yakakura yekubata chirwere ichi. Kuve nezvinhu zvakawanda zvinowedzera njodzi hazvirevi kuti uchawana chirwere ichi, asi zvinoreva kuti unofanira kuziva zviratidzo kana uri kutora mishonga inorwisa mabhakitiriya.

Matambudziko anogona kuitika nekuda kwe pseudomembranous colitis ndeapi?

Kunyangwe vanhu vazhinji vanopora zvakakwana nekurapwa kwakakodzera, pseudomembranous colitis inogona kukonzera matambudziko akakomba kana isina kurapwa. Dambudziko rakakomba ndiro kushaya mvura mumuviri nekuda kwemanyoka asingaperi.

Heano matambudziko anogona kuitika, kubva kuawanzoitika kusvika kune asingawanzoitika asi akakomba:

• Kushaya mvura mumuviri kwakanyanya uye kusakwana kwema electrolytes
• Matambudziko etsvo nekuda kwekushaya mvura mumuviri
• Toxic megacolon (kuzvimba kwakanyanya kwecolon)
• Colon perforation (gomba pamukati memukati)
• Sepsis (chirwere chinouraya chinopararira mumuviri)
• Rufu muzviitiko zvakakomba, zvisina kurapwa

Zvirwere zvinodzokorora zvinotambudza vanhu vanosvika 20-25%, zvinoreva kuti chirwere ichi chinogona kudzoka kunyangwe mushure mekurapwa kwakabudirira. Izvi zvinoitika nekuti spores kubva kumabhakitiriya eC. diff anogona kurarama mumatumbu ako uye kudzoka gare gare. Zvizhinji zvezvirwere zvinodzokorora zvinopindura zvakanaka pakurapwa, kunyangwe vamwe vanhu vangada kurapwa kwakasarudzika.

Pseudomembranous colitis inoongororwa sei?

Chiremba wako anotanga nekubvunza nezvekushandisa kwako mishonga inorwisa mabhakitiriya uye zviratidzo zvako, ipapo anorayira bvunzo dzemanyoka kuti aone mabhakitiriya eC. diff nechepfu yavo. Aya ma bvunzo anowanzova danho rekutanga uye rakakosha mukuongorora.

Maitiro ekuongorora anowanzo sanganisira nzira dzakawanda dzekusimbisa chirwere uye kuona kukomba kwaro. Mupi wako wehutano anogona kutora sampuli dzakawanda dzemanyoka nekuti mabhakitiriya eC. diff nechepfu haasi nguva dzose aripo mune imwe neimwe sampuli.

Bvunzo dzimwe dzinosanganisira bvunzo yeropa kuti uone zviratidzo zvechirwere uye kushaya mvura mumuviri. Muzviitiko zvakakomba, chiremba wako anogona kukurudzira CT scan yemudumbu rako kuti aone matambudziko senge kuzvimba kwecolon kana perforation.

Dzimwe nguva colonoscopy inodiwa kuti uone zvakananga mapazi yero (pseudomembranes) pamusoro pecolon yako. Izvi zvinobatsira kusimbisa kuongororwa kana bvunzo dzemanyoka dzisingaoneki kana paine matambudziko anokonzera.

Kurapa kwe pseudomembranous colitis chii?

Kurapa kunotarisa pakumisa mishonga inorwisa mabhakitiriya iri kushandiswa (kana uchiri kuitora) uye kutanga mishonga yakatarwa inorwisa mabhakitiriya eC. diff. Kurapa kunowanzotaurwa ndiko vancomycin kana fidaxomicin.

Chiremba wako acharayira mushonga wakakodzera zvichienderana nekukomba kwechirwere chako uye nhoroondo yako yezvehutano. Vancomycin inowanzova sarudzo yekutanga yezviitiko zvakanyanya, nepo fidaxomicin ingasarudzwa kana wakamborwara kare.

Muzviitiko zvishoma, vamwe vanachiremba vanogona kuraira metronidazole, kunyangwe izvi zvisingawanzoitiki ikozvino. Kurapa kunowanzoita mazuva gumi kusvika gumi nemana, uye unofanira kutanga kunzwa zvakanaka mukati memazuva mashoma ekutanga kutora mushonga.

Muzviitiko zvakakomba zvine matambudziko, ungada kuenda kuchipatara kuti upe mvura mumuviri, kutarisirwa kwakanyanya, uye dzimwe nguva kuvhiyiwa. Fecal microbiota transplantation (FMT) ndiyo nzira itsva yekurapa vanhu vane zvirwere zvinodzokorora zvisingapindure kumishonga inorwisa mabhakitiriya yakajairwa.

Ungazvichengetedza sei panguva yekurapa kwe pseudomembranous colitis?

Kuchengetedza mvura mumuviri ndicho chinhu chakakosha nekuti manyoka anogona kukonzera kushaya mvura mumuviri nekukurumidza. Inwa mvura yakawanda, muto, kana zvinwiwa zvine electrolytes zuva rese.

Kuzorora kunokosha pakupora kwako, saka usazvidzvinyirire kuti uite mabasa ako ese panguva yauri kupora. Muviri wako unoda simba kuti urwise chirwere uye kugadzirisa mukati memukati memukati.

Dya zvokudya zviri nyore kudya kana uchida kudya. BRAT diet (bananas, rice, applesauce, toast) inogona kuva nyore pamudumbu rako, asi usazvidzivirira kudya izvi chete kana uchikwanisa kudya zvimwe zvakasiyana.

Dzivisa zvigadzirwa zvemukaka, zvokudya zvine mafuta, nezvokudya zvine fiber yakawanda kusvika zviratidzo zvako zvapera, sezvo izvi zvingawedzera manyoka. Probiotics hazvikukurudzirwe panguva yekurapa nekuti zvinogona kukanganisa mishonga yako yakarayirwa.

Pseudomembranous colitis inogona kudzivirirwa sei?

Nzira yakanakisa yekudzivirira ndeyekushandisa mishonga inorwisa mabhakitiriya chete kana zvichidiwa uye sezvakarayirwa nachiremba wako. Usachengetere mishonga inorwisa mabhakitiriya yakasara kana kugovera nevamwe.

Kuchenesa maoko zvakanaka kunokosha, kunyanya muzvipatara apo spores dzeC. diff dzinogona kurarama pamusoro kwemazuva mazhinji. Geza maoko ako zvakanaka neshampo nemvura panzvimbo pekushandisa chete ma sanitizer ane doro, izvo zvisingaurayi spores dzeC. diff.

Kana uri muchipatara kana institution ekutarisirwa kwevanhu vakwegura, ita shuwa kuti vashandi vezveutano vanogeza maoko avo usati watarisirwa uye mushure mekutarisirwa. Usatya kukurudzira kana ukaona kuti vakakanganwa.

Chengetera mararamiro akazara nechikafu chakanaka uye kurovedza muviri nguva dzose kuti ubatsire sisitimu yako yekudzivirira muviri nehutano hwematumbu ako. Kunyangwe usingakwanisi kudzivirira zvachose kubata neC. diff, sisitimu yekudzivirira muviri yakasimba inobatsira muviri wako kurwisa chirwere.

Ungagadzirira sei kuona chiremba wako?

Nyora zviratidzo zvako zvese, kusanganisira nguva zvakatanga uye kakawanda kwazvinoitika. Taura zvakajeka nezvekuwanda uye chitarisiko chemanyoka ako, sezvo ruzivo urwu ruchibatsira chiremba wako kuona kukomba kwaro.

Uya nerondedzero yakazara yemishonga yese yawakatora mumazuva matatu apfuura, kusanganisira mishonga inorwisa mabhakitiriya, mishonga yekutengesa, uye zvinowedzerwa. Nyora mazita, zviyero, uye mazuva awakatora.

Gadzira mibvunzo nezve nzira dzako dzekurapa, nguva yekupora inotarisirwa, uye nguva yaungatevera. Bvunza nezvezviratidzo zvingada kutarisirwa nekukurumidza.

Funga kuuya nemhuri kana shamwari inogona kukubatsira kuyeuka ruzivo rwakakosha, kunyanya kana uchinge usina kunzwa zvakanaka. Vanogonawo kupa rutsigiro uye kubatsira kudzivirira kutarisirwa kwako kana zvichidiwa.

Chii chinonyanya kukosha nezve pseudomembranous colitis?

Pseudomembranous colitis chirwere chakakomba asi chinorapika chinowanzoitika mushure mekushandisa mishonga inorwisa mabhakitiriya. Kuziva nekukurumidza uye kurapwa kunounza migumisiro yakanaka kune vanhu vazhinji.

Chinhu chakakosha kukurangarira ndechekuti manyoka asingaperi panguva kana mushure mekushandisa mishonga inorwisa mabhakitiriya haasi chinhu chakajairika uye anoda kuongororwa nachiremba. Usazviedza kuzvibata kana kufunga kuti zvichapora zvega.

Nekurapwa kwakakodzera, vanhu vazhinji vanopora zvakakwana mukati mevhiki imwe kusvika mbiri. Kutevera mirairo yechiremba wako zvizere uye kuzvichengeta panguva yekupora kuchakupa mukana wakanaka wekupora zvakakwana, pasina matambudziko.

Mibvunzo inowanzo bvunzwa nezve pseudomembranous colitis

Q1. Ndingawana pseudomembranous colitis here pasina kutora mishonga inorwisa mabhakitiriya?

Hungu, kunyangwe zvisingawanzoitika. Unogona kuwana chirwere ichi kubva kumishonga yekurapa kenza, mishonga yekurapa acid reflux, kana chirwere chakakomba chinokanganisa mabhakitiriya emukati. Zvisinei, anenge 90% yezviitiko zvinosanganisirwa nekushandisa mishonga inorwisa mabhakitiriya.

Q2. Zvinotora nguva yakareba sei kupora kubva ku pseudomembranous colitis?

Vanhu vazhinji vanotanga kunzwa zvakanaka mukati memazuva 2-3 ekutanga kurapwa, nekupora zvakakwana kunowanzoita mavhiki 1-2. Zvisinei, mukati memukati memukati ungada mavhiki mashoma kuti apone zvizere, saka kunzwa kusagadzikana kwematumbu kungaramba kuripo kunyangwe zviratidzo zvimwe zvapera.

Q3. Pseudomembranous colitis inotapuriranwa here?

Mabhakitiriya eC. diff anokonzera chirwere ichi anogona kutapuriranwa kubva kune munhu kuenda kune mumwe munhu kuburikidza nezvinhu zvakasvibiswa uye kusachenesa maoko zvakanaka. Zvisinei, unonyanya kuwana zviratidzo kana mabhakitiriya emukati ako akatotadza kushanda zvakanaka nekuda kwemishonga inorwisa mabhakitiriya kana zvimwe zvinhu.

Q4. Pseudomembranous colitis inogona kudzoka here mushure mekurapwa?

Zvinosuruvarisa, hungu. Anenge 20-25% yevanhu vanowana chirwere ichi zvakare, kazhinji mukati memavhiki 2-8 mushure mekupedza kurapwa. Izvi zvinoitika nekuti spores dzeC. diff dzinogona kurarama mumatumbu ako uye kudzoka zvakare. Zvirwere zvinodzokorora kazhinji zvinopindura zvakanaka kumishonga imwechete kana yakasiyana.

Q5. Kune mimwe migumisiro ye pseudomembranous colitis here?

Vanhu vazhinji vanopora zvakakwana pasina migumisiro yakareba. Zvisinei, vamwe vanogona kuwana kuchinja kwenguva pfupi mumaitiro ematumbu kana kunzwa kusagadzikana nezvimwe zvokudya kwemazuva mashoma. Zvisingawanzoitika, zviitiko zvakakomba zvinogona kukonzera matambudziko ematumbu akareba, asi izvi hazviwanzoitika nekurapwa kwakakodzera.