Iyini i-Anal Fistula? Izimpawu, Izimbangela, & Ukwelashwa

I-anal fistula iyitunneli elincane elenziwa phakathi kwengaphakathi yomthambo wakho we-anal kanye nokhumba oluzungezile i-anus yakho. Cabanga ngayo njengoxhumano olungalungile olungafanele ukuba khona, okwenza indlela lapho kungekho lutho olukhona ngaphambili.

Le simo sivame ukuvela ngemuva kokuba i-anal abscess (ukuqongelelana okuhlungu kwe-pus) iye yachitha noma yaphathwa. Nakuba kungase kubonakale kukhathaza, i-anal fistulas empeleni ivame kakhulu futhi iyakwazi ukwelashwa ngokunakekelwa okufanele kwezokwelapha.

Ziyini izimpawu ze-anal fistula?

Isilwane esibonakalayo kakhulu ngokuvamile ukukhishwa okuvela ekuvuleni okuncane eduze ne-anus yakho. Lokhu kukhishwa kungaba yi-pus, igazi, noma ukuxuba kokubili, futhi kungaba nokunuka okungalungile.

Ungase uhlangabezane nezimpawu eziningi ezingakhululekile ezingathinta impilo yakho yansuku zonke:

• Ukuqina kokukhishwa okuvela ekuvuleni eduze ne-anus
• Ubuhlungu noma ukungakhululeki, ikakhulukazi uma uhlezi noma ngesikhathi sokuhamba kwesisu
• Ukukhula nokuqhuma oluzungezile indawo ye-anal
• Ukuvuvukala kokhumba oluzungezile i-anus ngenxa yobunye obuhlala bukhona
• I-anal abscesses ephindaphindayo endaweni efanayo
• Ukuqhuma uma i-fistula igula
• Ubunzima bokulawula ukuhamba kwesisu kwezinye izimo

Lezi zimpawu zivame ukuza nokuhamba, okungenza isimo sibe nzima ukubhekana naso. Abanye abantu baphawula ukuthi izimpawu zabo ziyanda ngezikhathi zokucindezeleka noma ukugula lapho i-immune system yabo icindezelekile.

Ziyini izinhlobo ze-anal fistula?

Odokotela bahlukanisa i-anal fistulas ngokusekelwe lapho zenza khona nokuthi zihamba kanjani ngemisipha oluzungezile i-anus yakho. Ukuqonda uhlobo kusiza ekutholeni indlela engcono kakhulu yokwelapha.

Izinhlobo eziyinhloko zihlanganisa:

• I-fistulas elula: Lezi yizona ezivamile futhi kulula ukuziphatha, zihamba ngqo kusuka ngaphakathi kuya ngaphandle
• I-fistulas eyingozi: Lezi zithatha indlela eyinkimbinkimbi kakhulu, ngezinye izikhathi zihlukaniswe noma zihilela imisipha eminingi
• I-Intersphincteric fistulas: Lezi zihlala zisezingxenyeni zamasipha yangaphakathi
• I-Transsphincteric fistulas: Lezi ziwela kuwo womabili ama-rings emisipha yangaphakathi nangaphandle
• I-Suprasphincteric fistulas: Lezi ziqonde phezulu futhi ngaphezu kwemisipha yangaphandle (ayivamile)
• I-Extrasphincteric fistulas: Lezi zidlula ngaphandle kwesistimu yemisipha (ayivamile)

Udokotela wakho uzobona ukuthi yiluphi uhlobo olukhona ngokuhlola nokwenza izivivinyo ze-imaging. Lokhu kuhlukaniswa kubasiza ukuhlela ukwelashwa okuphephile nokusebenza kakhulu esimweni sakho esithile.

Iyini imbangela ye-anal fistula?

I-anal fistulas eningi ivelela ngenxa ye-anal abscess ephukile yodwa noma ephucwe udokotela. Uma i-abscess iphulukile, ngezinye izikhathi ishiya uxhumano olufana nethonneli.

Izici eziningi zingadala ukwakheka kwe-fistula:

• I-anal abscesses yangaphambili (imbangela evamile kakhulu)
• I-Crohn's disease noma ezinye izimo zokuvuvukala kwamathumbu
• Izinkinga ezivela ekuhlinzweni kwe-anal
• I-Tuberculosis ethinta indawo ye-anal (ayivamile)
• Ukutheleleka okuthathwa ngocansi kwezinye izimo
• Ukuphathwa komdlavuza okuthinta indawo yephelivhiki
• I-Diverticulitis ethinta i-rectum
• Ukulimala endaweni ye-anal

Kwezinye izimo ezingavamile, abanye abantu bazalwa be-anal fistulas, nakuba lokhu kungavamile kakhulu kunalabo abavelela kamuva ekuphileni. Ukuqonda imbangela eyingqayizivele kusiza udokotela wakho ukukhetha ukwelashwa okufanele futhi uvikele izinkinga zesikhathi esizayo.

Nini kufanele ubona udokotela nge-anal fistula?

Kufanele ubona umhlinzeki wezempilo uma uqaphela ukuqina kokukhishwa oluvela eduze ne-anus yakho, ikakhulukazi uma kuqhubeke izinsuku ezimbalwa. Ukwelashwa okusheshayo kungavimbela izinkinga futhi kunciphisa ukungakhululeki.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nalokhu:

• Ukuqina noma ukuphindaphinda kokukhishwa eduze ne-anus
• Ubuhlungu obukhulu noma ukukhula endaweni ye-anal
• Ukuqhuma kanye nezimpawu ze-anal
• Izimpawu zokutheleleka njengokukhula okukhulu kobuso noma ubushushu
• Ubunzima bokulawula ukuhamba kwesisu
• Ubuhlungu obukhulu obuphazamisa imisebenzi yansuku zonke

Ungalindi uma unomlando we-Crohn's disease noma ezinye izimo zokuvuvukala, njengoba lezi zingenza i-fistulas ibe nzima ukwelapha. Ukuthola ukunakekelwa kochwepheshe ngokushesha kuvame ukubangela ukwelashwa okulula kakhulu nemiphumela emihle.

Ziyini izici ezingozi ze-anal fistula?

Izimo ezithile nezici zingandisa amathuba akho okukhula kwe-anal fistula. Ukuqonda lokhu kungakusiza wena nodokotela wakho ukuba niqaphele izimpawu zokuqala.

Izici eziyinhloko ezingozi zihlanganisa:

• I-anal abscesses noma ukutheleleka kwangaphambili
• I-Crohn's disease noma i-ulcerative colitis
• I-diarrhea ehlala njalo ecasula indawo ye-anal
• I-immune system ebuthakathaka ngenxa yokugula noma imithi
• Ukuhlinzwa kwe-anal noma i-rectal kwangaphambili
• Ukuphathwa kweradieysheni endaweni yephelivhiki
• Ukutheleleka okuthile okuthathwa ngocansi
• I-Tuberculosis (ezindaweni lapho ivamile khona)

Ukuba noyedwa noma ngaphezulu kwezici ezingozi akusho ukuthi uzokhula ngokuqinisekile i-fistula, kodwa kufanele ukuxoxe nodokotela wakho uma ukhathazekile. Bangakusiza ukuqonda ingozi yakho siqu nokuthi yini okufanele uyilinde.

Ziyini izinkinga ezingase zenzeke nge-anal fistula?

Nakuba i-anal fistulas ngokuvamile ayisiyingozi ekuphileni, ukuzishiya zingaphathwa kungadala izinkinga eziningi ezingakhululekile futhi ezingase zibe nzima. Ukuqonda lezi zinkinga kusiza ekuchazeni ukuthi kungani ukwelashwa kubalulekile.

Izinkinga ezivamile zihlanganisa:

• I-abscesses ephindaphindayo endaweni efanayo
• Ubuhlungu obuhlala njalo nokungakhululeki
• Ukuvuvukala kokhumba nokuwohloka ngenxa yokuqina kokukhishwa
• Ubunzima bokuhlala uhlanzekile kahle
• Ukucindezeleka komphakathi ngenxa yekunuka noma ukuvuza
• Ukuphazamiseka kokulala ngenxa yobuhlungu noma ukungakhululeki

Izinkinga ezinzima kakhulu kodwa ezingavamile zingase zenzeke:

• Ukusabalala kokutheleleka kuma-tissues ajulile
• Ukwakheka kwe-fistulas eminingi exhunyiwe
• Ukungenakulawula ukukhishwa kwesisu uma imisipha ye-sphincter ilimele
• Ngokungavamile, ukuguqulwa okubi ezimweni ezihlala isikhathi eside

Izindaba ezinhle ukuthi ukwelashwa okufanele kungavimbela izinkinga eziningi. Ukungenelela okusheshayo ngokuvamile kuholela emiphumeleni emihle futhi kulondoloza umsebenzi ojwayelekile wesisu.

I-anal fistula ingavikeleka kanjani?

Nakuba ungakwazi ukuvimbela zonke i-anal fistulas, ikakhulukazi lezo ezihlobene nezimo zezokwelapha ezingaphansi, kunezinyathelo ongazithatha ukuze unciphise ingozi yakho. Ukuvimbela kugxile ikakhulu ekuqedeni i-anal abscesses, ezingimbangela eyiyinhloko.

Nazi ezinye izindlela eziwusizo zokuvimbela:

• Sebenzisa ukuhlanzeka okuhle kwe-anal ngaphandle kokugeza ngokweqile
• Gwema ukuhlala isikhathi eside ezindaweni ezinzima
• Phatha i-constipation ngokushesha ukuze ugweme ukucindezela
• Phatha izimo ezingaphansi njenge-Crohn's disease ngokuphumelelayo
• Funani ukwelashwa okusheshayo ngenxa yobuhlungu noma ukukhula kwe-anal
• Gwema imisebenzi engase ilimale indawo ye-anal
• Gcina i-immune system enempilo ngokudla okuhle nokuphumula

Uma uke waba ne-anal abscess ngaphambili, ukulandela imiyalo yokunakekelwa kamuva yodokotela wakho ngokucophelela kungasiza ekuvimbeleni ukwakheka kwe-fistula. Ukuvakasha okuqhubekayo kokulandelela kuvumela umhlinzeki wakho wezempilo ukubamba noma yiziphi izinkinga ngokushesha.

I-anal fistula ihlonishwa kanjani?

Ukuhlonishwa kwe-anal fistula ngokuvamile kuqala ngodokotela wakho ehlola indawo oluzungezile i-anus yakho futhi ebuza ngezimpawu zakho. Bazobheka ukuvula kwangaphandle futhi bangase bahlole kancane ukuqonda indlela ye-fistula.

Udokotela wakho angase asebenzise izindlela eziningana zokuhlola:

• Ukuhlola ngokomzimba kwendawo ye-anal
• Ukuhlola kwe-digital rectal ukuzwa ukungavamile kwangaphakathi
• I-Anoscopy (ukusebenzisa isikhombisi esincane ukubuka ngaphakathi komthambo we-anal)
• I-Fistulography (ukuqhafaza i-contrast dye ukubona indlela ye-fistula ku-X-ray)
• I-MRI scans ye-fistulas eyingozi
• I-Ultrasound kwezinye izimo
• I-CT scans uma kukhona izinkinga ezithathwe

Kwezinye izimo ezingozi, udokotela wakho angase acele ukuhlolwa phansi kokulala. Lokhu kubavumela ukuthi bahlole ngokuphelele i-fistula ngaphandle kokukubangela ukungakhululeki futhi kubasize ukuhlela indlela engcono kakhulu yokwelapha.

Ukuphathwa kwe-anal fistula kuyini?

Ukuphathwa kwe-anal fistulas cishe kuhlale kudinga ukuhlinzwa, njengoba lezi zithunneli zingaphuli ngokwazo. Izindaba ezinhle ukuthi ukwelashwa okuhlinzayo ngokuvamile kuphumelela kakhulu uma kwenziwa nguchwepheshe wezokwelapha.

Izinketho eziyinhloko zokwelashwa zihlanganisa:

• I-Fistulotomy: Ukuvula i-fistula kuyo yonke ubude bayo ukuze kuvumele ukwelashwa kusuka ngaphakathi kuya ngaphandle
• Ukubekwa kwe-Seton: Ukusebenzisa ucingo oluhlukile ukuze kancane kancane usike noma ukhishwe i-fistula
• Izindlela zokuthuthukisa i-flap: Ukusebenzisa i-tissue enempilo ukuvala ukuvula kwangaphakathi
• I-LIFT procedure: Ukubopha i-fistula tract endaweni ye-intershpincteric
• Ukuqhafaza kwe-Fibrin glue: Ukubopha i-fistula nge-adhesive yezokwelapha
• Ukuqhafaza kwe-Fistula plug: Ukubopha ithonneli nge-plug ekhethekile ye-biological

Uchwepheshe wakho wezokwelapha uzokhetha indlela engcono kakhulu ngokusekelwe ohlotsheni lwe-fistula yakho, indawo, nobunzima. I-fistulas elula ngokuvamile idinga inqubo eyodwa kuphela, kuyilapho ezingozi zingase zidinga izigaba eziningi ukuqinisekisa kokubili ukwelashwa nokugcinwa kokulawula kwesisu.

Indlela yokuphatha izimpawu ekhaya ngesikhathi se-anal fistula?

Ngesikhathi ulinde ukwelashwa noma ngesikhathi sokuphulukisa, kunezinto eziningi ongazenza ekhaya ukuze ulawule ukungakhululeki futhi ugcine ukuhlanzeka. Lezi zinyathelo ngeke zikwelaphe i-fistula kodwa zingakwenza ukhululeke kakhulu.

Izindlela zokunakekelwa ekhaya eziwusizo zihlanganisa:

• Thatha izimbobo ezishisayo ze-sitz izikhathi eziningi ngosuku ukuze uthambise indawo
• Gcina indawo ihlanzekile futhi yomile, ushintsha ama-pads njalo
• Sebenzisa imikhiqizo yokuhlanza engakhululekile, engakhululekile
• Faka ama-creams e-barrier ukuvikela ikhumba elizungezile
• Gqoka izingubo eziphumulekile, eziphefumula
• Thatha imithi yokunciphisa ubuhlungu ngaphandle kokubonisana njengoba kuqondiswe
• Dla ukudla okunokhulu lwe-fiber ukuze uvikele i-constipation
• Hlala unomzimba ogcwele amanzi

Gwema ukusebenzisa amasoseji ahlasimulisayo, imikhiqizo enukayo, noma iphepha lesikhungo elihlasimulisayo elingase licasule indawo. Uma uqaphela ubuhlungu obukhulu, ukuqhuma, noma ukuqina kokukhishwa, xhumana nomhlinzeki wakho wezempilo ngokushesha.

Kufanele ulungiselele kanjani i-appointment yakho yodokotela?

Ukulungiselela i-appointment yakho kungasiza ekuqinisekiseni ukuthi uthola okuningi kakhulu ekuhambeni kwakho futhi unike udokotela wakho ulwazi abaludingayo. Ukuzilungiselela kancane kuhamba ibanga elide ekutholeni ukunakekelwa okufanele.

Ngaphambi kwe-appointment yakho:

• Bhala zonke izimpawu zakho nokuthi zaqala nini
• Bala noma yiziphi izinkinga noma ukuhlinzwa kwe-anal kwangaphambili
• Letha uhlu oluphelele lwemithi kanye nezinsiza
• Qaphela noma yimuphi umlando womndeni we-inflammatory bowel disease
• Lungiselela imibuzo mayelana nezinketho zokwelapha nokuphulukisa
• Cabanga ukuletha umngani othembekile noma ilungu lomndeni ngenxa yokusekela

Ungazizwa uhlanya ngokuxoxa ngalezi zimpawu nomhlinzeki wakho wezempilo. Baye babona lezi zimo izikhathi eziningi ngaphambili futhi bakhona ukuze bakusize uzizwe kangcono. Ukuba ovulekile noqotho ngezimpawu zakho kubasiza ukunikeza ukunakekelwa okuhle kakhulu.

Yini okufanele uyikhumbule mayelana ne-anal fistula?

I-anal fistulas yizimo ezivamile, ezilapheka ezivelela lapho ithonneli lenziwa phakathi komthambo wakho we-anal nokhumba oluzungezile i-anus yakho. Nakuba zingase zingakhululeki futhi zikhathaze, azinamaphutha uma ziphathwa kahle.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi lezi zimo azipheli ngaphandle kokwelashwa okuhlinzayo. Noma kunjalo, ngokunakekelwa okufanele kwezokwelapha odokotela abanolwazi, izinga lokuphelela lokwelashwa liphezulu kakhulu, futhi abantu abaningi babuyela emisebenzini evamile ngaphandle kwezinkinga zesikhathi eside.

Ungavumeli ukuhlanya kukuvimbele ekuthola usizo. Abahlinzeki bezempilo baziqhele izimo futhi bangakunikeza izinketho zokwelapha ezisebenza kahle ezizokuthuthukisela ikhwalithi yempilo yakho kakhulu.

Imibuzo evamile ebuzwa mayelana ne-anal fistula

Q1: Ingabe i-anal fistula izophila yodwa ngaphandle kokuhlinzwa?

Ngeshwa, i-anal fistulas ayiphili ngokuphelele ngaphandle kokungenelela okuhlinzayo. Nakuba izimpawu zingase ziye nokuhamba, uxhumano olufana nethonneli ngokuvamile luhlala futhi ngokuvamile ludinga ukuvalwa okuhlinzayo. Ezinye i-fistulas ezilula kakhulu, ezingaphezulu zingase ziphulukise ngokwelashwa okuqondayo, kodwa lokhu akuvamile. Kungcono ukuxoxa ngezinketho zokwelapha nomhlinzeki wezempilo kunokulindela ukuphulukisa okuzenzakalelayo.

Q2: Isikhathi sokuphulukisa singakanani ngemuva kokuhlinzwa kwe-anal fistula?

Isikhathi sokuphulukisa sihluka kuye ngohlobo lokuhlinzwa nobunzima be-fistula yakho. Izinqubo ezilula zingase zidinga amasonto ama-2-4 ukuze kuqale ukwelashwa, kuyilapho ukuhlinzwa okuyingozi kungathatha amasonto ama-6-8 noma ngaphezulu. Abantu abaningi bangabuyela emsebenzini wedeski phakathi kwezinsuku ezimbalwa kuya kwesonto, kodwa ukuphakamisa okunzima nemisebenzi enzima ngokuvamile kuvinjelwe amasonto amaningana. Uchwepheshe wakho wezokwelapha uzonikeza isikhathi esithile esisekelwe enkambweni yakho.

Q3: Ingabe i-anal fistulas ingabuya ngemuva kokuhlinzwa?

Nakuba ukuhlinzwa kwe-anal fistula ngokuvamile kuphumelela kakhulu, kunesihloko esincane sokubuyela, ikakhulukazi nge-fistulas eyingozi. Izinga lokubuyela ngokuvamile liphansi (cishe ama-5-10%) uma ukuhlinzwa kwenziwa nguchwepheshe wezokwelapha. Ukulandela imiyalo yokunakekelwa kamuva ngokucophelela nokubhekana nanoma yiziphi izimo ezingaphansi njenge-Crohn's disease kungasiza ekuqedeni ingozi yokubuyela.

Q4: Ingabe ukuhlinzwa kwe-anal fistula kuhlungu?

Uzokwamukela i-anesthesia ngesikhathi senqubo, ngakho ngeke uzizwe ubuhlungu ngesikhathi sokuhlinzwa. Ukungakhululeki kamuva kuvame futhi kungase kube ukusuka kokulinganisela kuya kokulinganisela, kuye ngobuningi bokuhlinzwa. Abantu abaningi baphatha ubuhlungu kahle ngemithi ebhaliwe, izimbobo ze-sitz, nokunakekelwa okuhle kwesilonda. Ukungakhululeki ngokuvamile kuthuthuka kakhulu ngaphakathi nesonto lokuqala.

Q5: Ngikwazi yini ukuzivocavoca noma ngisebenze ngokujwayelekile nge-anal fistula ngaphambi kokuhlinzwa?

Abantu abaningi abane-anal fistulas bangqhubeka nemisebenzi yabo evamile, nakuba ungase udinga ukuguqula ezinye izindlela ngokusekelwe ezingeni lakho lokuphumula. Ukuzivocavoca okuthambile ngokuvamile kulungile, kodwa imisebenzi ebeka uxinzelelo endaweni ye-anal noma ebangela ukukhuluphala okukhulu kungase kwenze izimpawu zibe zimbi. Kubalulekile ukuhlala uhlanzekile kahle futhi ushintshe ama-pads okuvikela njalo uma uhlangabezana nokukhishwa.