BV vs Trich: Kungani Lokho Okufanayo Kwezokwelapha Kungasho Ukuthi Igciwane Elifanayo

I-BV ne-trich yehliswa ibe yinto eyodwa eguqula lokho okwenzayo ngokulandelayo: i-trichomoniasis iyisikhunta esidluliselwa ngokocansi, kanti i-bacterial vaginosis ayibhekwa njenge-STI. Zombili zingelashwa nge-metronidazole 500 mg kabili ngosuku izinsuku eziyisikhombisa, kodwa ukwelashwa komlingani nokuhlolwa kokulandela akufani.

ISIFINGQEZI ESISHAZILEYO: Okubaluleke Kakhulu

• Kubantu besifazane, imithi yokuqala yokwelashwa ngomlomo ingafana kwezombili: i-metronidazole 500 mg kabili ngosuku izinsuku eziyisikhombisa.
• I-trich idinga ukwelashwa kwabalingani abakhona ngokocansi. Ukwelashwa komlingani okujwayelekile akukhuthazwa njengamanje kwe-BV.
• Izimpawu zokuphuma zinganciphisa inketho kodwa azikwazi ukuthola igciwane kunoma yikuphi ukugula. Kokubili i-BV ne-trich kungase kube nezimpawu ezimbalwa noma kungekho nhlobo.
• Ukuhlolwa kuyabahlukanisa, futhi ukuhlolwa okuyingcakamvula okungezinhle akukhiphi i-trich.
• Uma izimpawu zibuyela emuva ngemuva kokwelashwa, isinyathelo esilandelayo sincike ekutholeni igciwane, ukugula okubuyayo okungenzeka, nokuthi ngabe ukwelashwa kokuqala kwasebenza yini.

Awazi ukuthi yikuphi ukugula okwelashayo? Imithi efanayo ingasetshenziswa ku-BV naku-trich, kodwa ukuthola ukwelashwa okulungile kubalulekile. Uma ungazibonisi ukuthi yini ebanga izimpawu zakho, zama i-August AI's free symptom checker ukuzihlole zingakapheli imizuzu emi-2, noma ubhuke ukuvakashelwa okungaphuthuimwrite eshibhile ngo-$39 online kuya kudokotela oneziqu zase-US.

BV vs trich: okunye kwalokhu kuphela okungukugula okudluliselwa ngokocansi

I-BV vs trich ukuqhathanisa phakathi kwezinto ezimbili ezihlukene. I-trichomoniasis igciwane nge-parasite i-Trichomonas vaginalis futhi idluliselwa ngokocansi. I-bacterial vaginosis ukungalingani kwamagciwane omchamo, akuyona i-STI. Ngokudida, imithi yokuqala yokwelashwa ngomlomo yomibili yile ndlela efanayo ngomthamo ofanayo: i-metronidazole 500 mg kabili ngosuku izinsuku eziyisikhombisa.

Iziqondiso ze-CDC zika-2021 ze-STI Treatment Guidelines zichaza i-trichomoniasis njenge-STI engewona eyegciwane edume kakhulu emhlabeni jikelele. I-BV ihlukile ngohlobo. Ama-lactobacilli avame ukubusa umchamo ashintshwa yi-Gardnerella, i-Prevotella nezinye izinhlobo zamagciwane ezingekho emoyeni, futhi i-CDC ayibheki i-BV njenge-STI, nakuba ihlotshaniswa ngokusobala nomsebenzi wezocansi.

Ukubakhona kwebhange kukunika ukuthi ubheje kuphi. Ukubuyekezwa okungapheliyo kwedatha eqinisekisiwe yezisiqondiso zika-2021 kwabeka ukubakhona kwe-BV phakathi kwabesifazane abazala abadala ku-23% kuya ku-29% emhlabeni wonke, ngezilinganiso zaseNyakatho Melika ezingama-33.2% kwabesifazane abamnyama, ama-30.7% kwabesifazane baseHispanic, ama-22.7% kwabesifazane abamhlophe kanye nama-11.1% kwabesifazane base-Asia. Imininingwane ye-NHANES kusuka ngo-2013 kuya ku-2014 yabeka i-US trichomoniasis ku-1.8% kwabesifazane no-0.5% kumadoda, yenyuka yaya ku-8.9% kwabesifazane abamnyama kanye no-4.2% kumadoda amnyama. I-BV iphakeme cishe kangokuphindwe kayishumi kuno-trich.

Lokho Okufanayo Kwezokwelapha Kungasho Ukuthi Imithetho Efana Nenomlingani

Umehluko we-trichomoniasis vs BV oguqula lokho okwenzayo ngokulandelayo akuyona iphilisi, kodwa umlingani wakho. I-CDC ithi ukwelashwa okufanayo kwabo bonke abalingani abakhona ngokocansi kubalulekile ku-trichomoniasis, noma ngabe umlingani unazo izimpawu noma cha, futhi ukuthi abantu abathandana nabo kufanele bagweme ukuxebulana kuze kube yilapho bobabili sebeqedile ukwelashwa futhi izimpawu sezidlulile.

Ku-BV, isiqondiso siholela ngakolunye uhlangothi. Ukwelashwa okujwayelekile kwabalingani bokocansi akukhuthazwa, ngoba akuthuthukisi amazinga okuphulukisa noma kunciphise ukuphindeka. Ukwelapha umlingani nge-BV akukhona ukuqapha. Yimane nje ukuboniswa kwama-antibiotic ngaphandle kwenzuzo eyilinganisiwe.

Lokho okungafani kokuziphatha kunomphumela ongokoqobo abantu abaningi abawuthola kanzima. Uma uqeda izinsuku eziyisikhombisa ze-metronidazole nge-trich nomlingani wakho engathathile lutho, igciwane libuyela kuwe. Lokho kufundeka njenge-"antibiotic ayizange isebenze" lapho empeleni kungukubuyiselana okungama-ping-pong. Kunjalo nje ukuthi i-CDC incoma ukuhlola kabusha abesifazane abasebancane nabathandana ngokocansi kwe-trichomoniasis cishe izinyanga ezintathu ngemuva kokwelashwa. Ngakho-ke ngaphambi kokuba unqume ukuthi imithi yakho yehlulekile, buza ukuthi umlingani wakho uthathe ini ngempela.

Ukuphuma Kwensizayo Kuyakunciphisa, Akukwazi Ukunquma Ngakho

Noma ngabe ubheka i-trich noma i-BV discharge, lokho okubonayo kukunika umbono, akuzange kube ukuthola ukugula. Amaphethini akudala ayahlukahluka:

• I-trichomoniasis: ukuphuma kombala ophuzi-luhlaza okomile, ukulunywa nokusha kwe-vulvar, ubuhlungu lapho uchama, futhi ngezinye izikhathi ukopha ngemuva kocansi noma i-"strawberry cervix," ebonakala kumbalwa nje abantu.
• I-bacterial vaginosis: ukuphuma okubunono, okungafani nokuhlakaniphile okumhlophe okungadala iphunga elinjengezinhlanzi eliba namandla ngemuva kocansi, ngokuvamile kuncane ukulunywa nokuvuvukala okubonakalayo.

Nansi into amakhasi amaningi anga kuzwanga: 70% kuye ku-85% abantu abane-trichomoniasis banezimpawu ezimbalwa noma abanawo nhlobo, futhi cishe u-84% abesifazane abane-BV abanamazolwane ngokuya ngezilinganiso ezibhekiswe yi-CDC. Ukungabi khona kwezimpawu akukhiphi noma yikuphi ukugula. I-vaginal pH iphakeme ngaphezu kwe-4.5 kokubili, ngakho ibhodi lokuhlola le-pH lesitolo alikwazi ukubahlukanisa.

Okufanele kwenziwe ngenkathi ulindele ukuhlolwa ukugcina irekhodi. Uhlelo lokusebenza lokuhlala njalo njenge-August AI lungakusiza ukuthi ubhale izinguquko zokuphuma, nini iphunga libi kakhulu, nokuthi ukuqala kwezimpawu kuhambisana kanjani nomlingani omusha, njengokungeziwe kunokuba esikhundleni salokho. Uma isici sakho esiyinhloko siyizilonda noma izinqamu esikhundleni sokuphuma, ubheka enye into ngokuphelele, futhi kuyasiza ukwazi ukuthi i-herpes ibukeka kanjani ezigabeni ezihlukene.

Kuphela Ukuhlolwa Kwelebhu Okungahlukanisa i-BV ne-trich

Ukuhlolwa kwe-BV noma kwe-trich akuyona eyodwa, ngoba lezi zimo ezimbili azitholwa ngendlela efanayo. Ku-trichomoniasis, ukuhlolwa kwama-nucleic acid amplification (NAAT) kunama-95% kuye ku-100% amandla, ngenkathi i-wet-mount microscopy ithola kuphela ama-44% kuye ku-68% amacala. Lokho kuhluka kubalulekile: i-wet mount engalungile ayikhiphi i-trich, futhi uma umtholampilo wakho wabheka isilayidi wakutshela ukuthi kucacile, lokho kungukuhlanganiswa okubuthakathaka.

I-BV itholakala ngokwelashwa ngokuqondile, kusetshenziswa Amsel's criteria (ukuphuma okubunono, i-pH engaphezu kwe-4.5, ukuhlolwa okuhle kwe-whiff, namaseli e-clue ku-microscopy) noma i-Nugent-scored Gram stain. Amaphaneli e-BV asekelwe ku-NAAT ayatholakala, kodwa awawona amazinga ezokwelapha njengoba eyi-NAAT ku-trich.

Umgomo owodwa wesikhathi usindisa ukudideka okuningi. Ungaphinde uhlole i-trich nge-NAAT ngaphambi kwezonto ezintathu ngemuva kokwelashwa, ngoba i-nucleic acid esele kusuka emagciwaneni afile ingakha umphumela wokuhlola ongakabi ngokoqobo. Noma kunjalo, othile kufanele athathe isampuli yomchamo. Uhlu lwezimpawu namabhodi okuhlola i-pH akuyona esikhundleni.

Imithi Efana Nayo, Isikhathi Esihlukile: Indlela I-Metronidazole Eyabela Ngayo Kokubili

I-Metronidazole ye-trichomoniasis ne-metronidazole ye-BV ziyinto efanayo ngamahlelo ahlukene ngempela, futhi isikhathi sincike kokubili egciwaneni kanye nobulili besiguli.

Ushintsho luka-2021 yilokho okufanele kuqondwe kahle. I-CDC yanquma ukuthi abesifazane bangadli umthamo owodwa ka-2 g we-trich ngoba isikhathi sezinsuku eziyisikhombisa sikhombise amazinga okuphulukisa angcono. Amadoda asathola umthamo owodwa, yingakho imithi yomlingani ingabonakala ihlukile kwakho futhi zombili zingaba ezilungile.

I-Flagyl igama lomkhiqizo ongase ulibone ebhodleleni, futhi i-Flagyl ye-BV iyona njengezinsuku eziyisikhombisa. Ngokujwayelekile amazinga okuphulukisa angama-84% kuye ku-98% nge-metronidazole kanye no-92% kuye ku-100% nge-tinidazole, yingakho i-tinidazole iyisinyathelo se-CDC lapho i-trich iqhubeka ngemuva kwe-metronidazole. I-Metronidazole ivame ukuba yimithi ejwayelekile, futhi indlela imithi e-online etholwa ngayo ngalolo suku ihambelana lapha uma usunayo imiphumela yokuhlolwa.

Uma Izimpawu Zibuyela Emva, Cacisa Okunye Okunye Ukugula, Hhayi Ipipi Elihlulekile

Yebo, ungaba ne-BV ne-trichomoniasis ngasikhathi sinye, futhi akuyona into engajwayelekile kakhulu. Ukuba ne-BV kwandisa ingozi yokuthola i-trichomoniasis, kanye ne-chlamydia, i-gonorrhea, i-M. genitalium, i-HPV kanye ne-HSV-2. Lezi zimo ziyasondelana kunokuba zikhalele omunye nomunye, ngakho-ke umphumela omuhle komunye akuyona ubufakazi obelwela omunye.

Lapho izimpawu zibuyela emuva, hlukanisa izinkinga ezimbili ezihlukene kakhulu. Ukuphindeka kwegciwane kusho ukuthi imithi yasebenza futhi umlingani ongaphathwanga ubuyisa igciwane. Ukwehluleka kwangempela kokwelashwa kusho ukuthi imithi ayizange ikuqede igciwane ekuqaleni. Isixazululo sihlukile komunye nomunye, futhi akukho nolulodwa oluxazululwa ngokugcwalisa imithi efanayo.

Uma izimpawu ziqhubeka ngemuva kwesikhathi esigcwalisiwe esiphelele, hlolelwa kabusha esikhundleni sokwelashwa ngokungaboni. I-Tinidazole iyisinyathelo se-CDC sokuphindeka kwe-trich, futhi i-BV ephindayo ingase idinge isikhathi eside noma imithi yokuvimbela eyenziwa udokotela. Uhlelo lokusebenza lokuhlala njalo njenge-August AI lungakusiza ukuthi ubhale ukuthi izimpawu zagcina zichibekile yini ngosuku lokugcina lwesikhathi, ukuze ukuvakashelwa kokulandela kuqale ngesikhathi esikhundleni sokucabanga.

Lapho Izimpawu Zomchamo Zidinga Udokotela, Nokuthi Zifike Ngokushesha Kanjani

Shayela u-911 noma uye egumbini lezimo eziphuthumayo manje uma:

• Unomkhuhlane noma ubanda kanye nobuhlungu esiswini esingezansi, okungase kubonise isifo sokuphazamiseka komgogodla
• Unobuhlungu obukhulu esiswini obunokuhlanza noma ukugabha
• Unokuphuma okubhebhethekile noma okungajwayelekile komchamo
• Ukhulelwe futhi uhlushwa yizidala, ingcindezi yesisu noma ukuphuma kwegazi

Bhuka ukuvakashelwa phakathi neviki elilandelayo uma:

• Ukuphuma okusha noma iphunga kuqale ngemuva komlingani omusha
• Izimpawu ziqhubeka noma ziyanda ngemuva kokuqeda umthamo ogcwele okhishwe udokotela
• Unazo izimpawu ngenkathi ukhulelwe, kucatshangelwa izixhumanisi nokuzalwa ngaphambi kwesikhathi kanye nesisindo esingezansi sokuzalwa
• Umlingani uhlolwe ukuthi une-trich

Khuluma nodokotela ngaphambi kokuba uqale uma:

• Ukhulelwe noma uyamuncisa
• Wake waba nempendulo embi ku-metronidazole noma i-tinidazole ngaphambili
• Uphuza i-warfarin, i-lithium noma i-disulfiram
• Wake waba nezigameko ezintathu noma ngaphezulu ngonyaka

Ngokwengxenye ephakathi, ukuvakashelwa kwe-telehealth kuyisinyathelo sokuqala esifanele. I-$39 online urgent care visit ka-August ikuxhumanisa nodokotela oneziqu zase-US ongahlola izimpawu zakho futhi aphinde anikeze imithi lapho kufanele, futhi udokotela uyazinqumela ukuthi imithi ifanele yini. Zicacisele ngokukhawulelwa: ukuvakashelwa online akukwazi ukuthatha isampuli yomchamo noma ukwenza ukuhlolwa kwesisu, ngakho ukuhlolwa kwelebhu okuhlukanisa lezi zifo ezimbili kusamele kwenzeke endaweni.

Imibuzo Evame Ukubuzwa

Ngabe ngempela kufanele ngigweme utshwala ngenkathi ngithatha i-metronidazole?

Yebo. Isiqondiso esijwayelekile ukugwema utshwala phakathi nokwelashwa kanye namahora angama-24 ngemuva komthamo wakho wokugcina we-metronidazole, noma amahora angama-72 ngemuva komthamo wokugcina we-tinidazole. Ubufakazi obusha bukhombisa ukuthi ingozi yomphumela we-disulfiram-like ingokoqobo kangakanani, ngakho umthetho uqaphele kakhulu kunokuqinisekisiwe. I-Metronidazole ibangela ukugula kanye nokunambitheka kwensimbi yodwa, futhi ukwengeza utshwala ngeke kukwenze kube ngcono lelo sonto.

Amadoda angathola i-bacterial vaginosis?

Cha. I-Bacterial vaginosis ichazwa ngokushintsha kwamagciwane omchamo, ngakho abantu abangenamchamo abakwazi ukuyithola. Abalingani besilisa bangathwala amagciwane ahlobene ne-BV, kodwa i-CDC ayincomi ukubelapha, ngoba ukwenza lokho akuthuthukisi amazinga okuphulukisa noma ukuphindeka. I-trichomoniasis iyisimo esiphambene: amadoda ayayithola, ngokuvamile ngaphandle kwezimpawu, futhi bayayidinga imithi.

Ngabe i-metronidazole iphephile ukuyithatha ngenkathi ukhulelwe noma uyancamisa?

Yebo. I-CDC ibheka i-metronidazole ingeyona ingozi enkulu ekukhulelweni, futhi izifundo eziningana azizange ziyihlobanise nemiphumela ye-teratogenic noma ye-mutagenic. I-Tinidazole kufanele igwenywe ngenkathi ukhulelwe. Uma uyamuncisa, isiqondiso ukubeka ibhakethe lokuncamisa amahora angama-12 kuye kwangama-24 ngemuva komthamo we-metronidazole nama-72 amahora ngemuva kwe-tinidazole. Tshela udokotela okukhiphela imithi ukuthi ukhulelwe noma uyancamisa ngaphambi kokuba ugcwalise noma yini.

Ngabe i-trichomoniasis izodlula yodwa ngaphandle kokwelashwa?

Kuvamile. I-trichomoniasis igciwane nge-parasite ephila, futhi ngokuvamile iyaqhubeka kuze kube yilapho ilashwa. Ngoba abantu abaningi abayithwalayo bazizwa bekhululekile, umphumela ojwayelekile wokulinda yizinyanga zokudlulisa lokho kubalingani kungazelelwe kunokuba kudlule ngokwayo. Ekukhulelweni izintengo ziphakeme, njengoba igciwane elingelashwanga lihlotshaniswa nokuzalwa ngaphambi kwesikhathi kanye nesisindo esingezansi sokuzalwa.

Ingabe izimpawu zami zingaba yisikhunta esivame ukubakhona esikhundleni se-BV noma i-trich?

Ngezinye izikhathi. Isikhunta singukugula kwesithathu abantu abakubeka embuzweni we-BV vs trich, futhi ngokuvamile sibukeka ngendlela ehlukile: ukuphuma okumhlophe okuminyene, ukulunywa okunamandla, ububomvu be-vulvar, ukuphuma okujwayelekile, kanye ne-vaginal pH ehlala evamile esikhundleni sokukhuphukela ngaphezu kwe-4.5. Ukuzelapha nge-antifungal etholakala ezitolo lapho empeleni une-BV noma i-trich kukubiza isonto futhi kubambezele imithi efanele.

Isiphetho Nge-BV vs Trich

Imithi efanayo, imithetho ephambene yabalingani. Zombili izifo ziphathwa ngendlela yokuqala nge-metronidazole 500 mg kabili ngosuku izinsuku eziyisikhombisa, kodwa i-trich idinga ukuthi bonke abalingani abakhona bathole imithi ngokuqala ngenkathi abalingani be-BV bengafanele banikezwe imithi nhlobo. Izimpawu namabhodi okuhlola i-pH akukwazi ukukutshela ukuthi yikuphi onakho, ngakho isinyathelo esilandelayo esisodwa ukuhlolwa okusekelwe kusampuli ngaphambi kwanoma yimiphi imithi. Uma izimpawu zibuyela emuva kamuva, hlolelwa kabusha esikhundleni sokuphinda. Leli khasi libonisa i-CDC 2021 STI Treatment Guidelines.

Isitatimende: Lesi sihloko senzelwe imininingwane kuphela futhi akusona iseluleko sezokwelapha. Njalo thintana nodokotela oqeqeshiwe ukuze uthole izinqumo zokuthola nokwelashwa. Uma uhlangabezana nesimo esiphuthumayo sezokwelapha, shayela u-911 noma uye egumbini lezimo eziphuthumayo eliseduze ngokushesha.