Ukutholakala Kwe-Cholestasis NgokuKhulelwa? Izimpawu, Izimbangela, Nokwelashwa

I-Cholestasis yokuKhulelwa yisimo se-liver esithinta abesifazane abathile phakathi kwesigaba sesibili noma sesithathu sokuKhulelwa. Kwenzeka lapho ama-bile acids eqoqa egazini lakho esikhundleni sokugeleza ngokujwayelekile e-liver yakho ukuze akusize ukwephula ukudla.

Lesi simo sibangela ukukhahlela okukhulu, ikakhulukazi ezandleni nasezinzwini zakho, futhi singathinta impilo yengane yakho. Nakuba kuzwakala kukhulunywa ngokwethusa, ukuqonda ukuthi kwenzekani emzimbeni wakho kungakusiza ukusebenzisana neqembu lakho lokunakekelwa kwezempilo ukuze lilawule ngokuphepha.

Iyini i-cholestasis yokuKhulelwa?

I-Cholestasis yokuKhulelwa yenzeka lapho i-liver yakho ingakwazi ukucubungula ama-bile acids ngokufanele ngesikhathi sokuKhulelwa. I-liver yakho yenza i-bile ukuze isize ekwephuleni amafutha, kodwa ama-hormone okuKhulelwa anganciphisa le nqubo.

Lapho ama-bile acids engaqoki e-liver yakho ngokujwayelekile, aqala ukuqoqana egazini lakho. Lokhu kubangela isiphawu esiyinhloko sokukhahlela okukhulu futhi kungathinta impilo yengane yakho uma kushiywa kungelashwa.

Lesi simo sivame ukuvela ezinyathelweni zokugcina zokuKhulelwa, ngokuvamile ngemuva kwamasonto angu-28. Sithinta cishe omunye kwabaKhulelwayo abayinkulungwane, yize amanani angaba phezulu ezinhlwini ezithile zobuzwe.

Ziyini izimpawu ze-cholestasis yokuKhulelwa?

Isiphawu esibonakalayo kakhulu yikukhahlela okukhulu okuzwakala kuhlukile kunokuguquka kwesikhumba okujwayelekile ngesikhathi sokuKhulelwa. Lokhu kukhahlela kuvame ukuqala ezandleni nasezinzwini zezinyawo zakho, bese kungaqhubeka nakwezinye izingxenye zomzimba wakho.

Nazi izimpawu eziyinhloko ongazihlangabezana nazo:

• Ukuhaha okukhulu, ikakhulukazi ezandleni nasezinzwini zezinyawo, okubi kakhulu ebusuku
• Ukuhaha okusakazekela ezandleni, ezinyaweni, nasesifubeni
• Umbhilo omnyama
• Izinsalela eziluhlaza okwesibhakabhaka noma ezimhlophe
• Ukukhanya kwesikhumba noma amehlo (jaundice), yize lokhu kungavamile
• Ukukhathala okwedlula ukukhathala okujwayelekile ngesikhathi sokuKhulelwa
• Ukwehluleka kokudla
• Ukuphefumula, ikakhulukazi uma kubuyela emuva kokuthuthuka ekuqaleni kokukhulelwa

Ukuhaha okuvela ku-cholestasis kuzwakala kuhlukile kunokukhahlela okujwayelekile ngesikhathi sokuKhulelwa. Ngokuvamile kuchazwa njengokuzwa sengathi kuvela ngaphansi kwesikhumba sakho, futhi ukukhahlela akukuvimbeli.

Yini ebangela i-cholestasis yokuKhulelwa?

Ama-hormone okuKhulelwa, ikakhulukazi i-estrogen ne-progesterone, yizona eziyinhloko eziyimbangela ye-cholestasis yokuKhulelwa. La ma-hormone anganciphisa ukugeleza kwe-bile e-liver yakho.

I-liver yakho isebenza kanzima ngesikhathi sokuKhulelwa ukuze ikusize wena nengane yakho. Lapho amazinga e-hormone efika ezingeni eliphezulu esigabeni sesithathu sokuKhulelwa, ama-liver wabesifazane abathile alwa nokuqhubeka nokuqapha ama-bile acids ngokuphumelelayo.

Izici eziningi zingandisa amathuba akho okukhula lesi simo:

• Umlando womndeni we-cholestasis yokuKhulelwa
• Umlando wakho siqu wesimo ezikhulelweni zangaphambili
• Ukuphepha izingane eziningi
• Ubuhlungu be-liver noma izinkinga ze-gallbladder ngaphambili
• UkuKhulelwa kwe-in vitro fertilization (IVF)
• Izizwe ezithile, ikakhulukazi iScandinavian, iChilean, noma iBolivian

Ezimweni ezingavamile, ukuguquguquka kwe-genetic kungenza abesifazane abathile babe nomuzwa kakhulu ngemiphumela yama-hormone okuKhulelwa ekugelezeni kwe-bile. Lokhu kuchaza ukuthi kungani lesi simo ngezinye izikhathi siqhubeka emindenini.

Nini kufanele ubona udokotela nge-cholestasis yokuKhulelwa?

Kufanele uxhumane nodokotela wakho ngokushesha uma uhlangabezana nokukhahlela okukhulu, ikakhulukazi ezandleni nasezinzwini zezinyawo. Ungalindi kuze kube yisikhathi sakho esilandelayo sokuvakashela udokotela, njengoba ukuxilongwa kwasekuqaleni nokulandelela kubalulekile.

Shaya udokotela wakho ngokushesha uma uqaphela umthondo omnyama, izinsalela eziluhlaza okwesibhakabhaka, noma ukukhanya kwesikhumba noma amehlo. Lezi zibonakaliso zibonisa ukuthi i-liver yakho idinga ukunakekelwa ngokushesha.

Ngisho noma ukukhahlela kwakho kuzwakala kumncane ekuqaleni, kufanele ukukhulumisise neqembu lakho lokunakekelwa kwezempilo. Bangenza izivivinyo zegazi olula ukuze bahlole amazinga e-bile acid yakho nomsebenzi we-liver.

Ziyini izici ezingozi ze-cholestasis yokuKhulelwa?

Ukuqonda izici zakho ezingozi kungakusiza wena nodokotela wakho ukuthi niqaphele izimpawu zokuqala. Abesifazane abathile banethuba elikhulu lokukhula lesi simo ngokususelwa emlandweni wabo siqu nomlando womndeni.

Izici eziyinhloko ezingozi zihlanganisa:

• I-cholestasis yokuKhulelwa yangaphambili (unethuba elingu-60-70% lokuphinda ibuyele)
• Umlando womndeni, ikakhulukazi umama wakho noma odadewenu babe nale simo
• UkuKhulelwa okuningi (i-twins, i-triplets, noma ngaphezulu)
• Ubudala obukhulu bomama (ngaphezulu kweminyaka engu-35)
• Umlando wobulwelwe be-liver noma ama-gallstones
• UkuKhulelwa kwe-IVF
• Ukuguquguquka kwe-genetic okuthinta ukuthuthukiswa kwe-bile acid

Ezinye izizwe zinezinga eliphezulu le-cholestasis yokuKhulelwa. Abesifazane baseScandinavian, i-Araucanian Indian, noma ezinye izizwe zaseNingizimu Melika babhekene nengozi eyenyuke kakhulu.

Ukuba nezici ezingozi akusho ukuthi uzokhula ngokuqinisekile lesi simo. Abesifazane abaningi abanezici eziningi ezingozi banezikhulelwa ezijwayelekile, kanti abanye abangenazo izici ezingabonakali bangathinteka.

Ziyini izinhlanganisela ezingaba khona ze-cholestasis yokuKhulelwa?

Nakuba i-cholestasis yokuKhulelwa ingaphathwa kahle, inezinye izingozi eziqapha iqembu lakho lokunakekelwa kwezempilo ngokucophelela. Ukuqonda lezi zinhlanganisela ezingaba khona kusiza ekuchazeni ukuthi kungani ukwelashwa okusheshayo kubaluleke kangaka.

Ngenxa yengane yakho, ukukhathazeka okuyinhloko kuhlanganisa:

• Ukuzalwa kwangaphambi kwesikhathi (ukuzalwa ngaphambi kwamasonto angu-37)
• Izinkinga zokuphefumula ngenxa yokuzalwa kwangaphambi kwesikhathi
• Ukugqoka kwe-meconium (ingane idlula isisu ngaphambi kokuzalwa)
• Ukufa kwengane esiswini, yize lokhu kungavamile ngokulandelela okuhle
• Ukudinga ukunakekelwa okukhulu ngemuva kokuzalwa

Kuwe njengumama, izinhlanganisela ngokuvamile azibi kakhulu kodwa zingafaka:

• Ukuhaha okukhulu okuvimba ubuthongo nemisebenzi yansuku zonke
• Ukuphuza igazi okukhulu ngesikhathi sokubeletha ngenxa yokushoda kwe-vitamin K
• Amathuba aphezulu okudinga ukubeletha kwangaphambi kwesikhathi
• Ukuphuza igazi ngemuva kokubeletha ezimweni ezingavamile

Izindaba ezinhle ukuthi ngokulandelela okuhle nokuphathwa, izingane nabamama abaningi baphila kahle. Iqembu lakho lokunakekelwa kwezempilo lizokulandela eduze futhi lingase likucele ukuthi ubelethe ngokushesha ukuvimbela izinhlanganisela.

I-cholestasis yokuKhulelwa ixilongwa kanjani?

Udokotela wakho uzoqala ngokulalela izimpawu zakho nokwenza ukuhlolwa komzimba. Ukuhlanganiswa kokukhahlela okukhulu nokuKhulelwa ngokuvamile kuphakamisa ukungabaza ngalesi simo.

Izivivinyo zegazi yiyona ebalulekile ekuqinisekiseni ukuxilongwa. Udokotela wakho uzoqapha amazinga e-bile acid yakho, aphezulu ku-cholestasis yokuKhulelwa. Bazohlola futhi umsebenzi we-liver yakho ukuze babone ukuthi i-liver yakho isebenza kangcono kangakanani.

Izivivinyo eziyinhloko zihlanganisa:

1. Isivivinyo se-bile acid ye-serum (isivivinyo esibaluleke kakhulu)
2. Izivivinyo zomsebenzi we-liver (amazinga e-ALT ne-AST)
3. Amazinga e-bilirubin
4. Ukubalwa kwegazi okuphelele
5. Izivivinyo zokulawula ezinye izimo ze-liver

Ngezinye izikhathi udokotela wakho angase ayalele izivivinyo ezengeziwe ukuze alawule ezinye izimo zesikhumba noma izinkinga ze-liver. Lokhu kungafaka izivivinyo ze-hepatitis noma ama-autoimmune markers uma izimpawu zakho zingacaci.

Imiphumela ngokuvamile ibuya ngosuku noma amabili. Udokotela wakho uzoqonda ukuthi izinombolo zisho ukuthini futhi axoxe ngezinyathelo ezilandelayo ngokususelwa ekujuleni kwama-bile acids akho.

Iyini ukwelashwa kwe-cholestasis yokuKhulelwa?

Ukwelashwa kugxile ekuthuthukiseni amazinga e-bile acid yakho, ukunciphisa ukukhahlela, nokukhuthaza impilo yengane yakho. Imithi eyinhloko esetshenziswayo yi-ursodeoxycholic acid (UDCA), esiza i-liver yakho ukuba isebenze ama-bile acids ngokuphumelelayo.

I-UDCA icatshangelwa ukuba iphephile ngesikhathi sokuKhulelwa futhi ingathuthukisa kakhulu izimpawu zakho ngenkathi inciphisa izingozi engane yakho. Ngokuvamile uzothatha le mithi kuze kube yisikhathi sokubeletha.

Uhlelo lwakho lokwelashwa lungafaka:

• Amaphilisi e-ursodeoxycholic acid (UDCA), ngokuvamile athathwa kabili ngosuku
• I-vitamin K supplements ukuvimbela izinkinga zokopha igazi
• Ukulandelela njalo amazinga e-bile acid
• Ukulandelela okwandisiwe kwengane, kuhlanganise nezivivinyo ezijwayelekile ezingaphuzi
• Ukuhlela ukubeletha kwangaphambi kwesikhathi, ngokuvamile phakathi kwamasonto angu-36-38

Abanye odokotela bangase banikeze ama-antihistamines noma ukwelashwa okusetshenziswayo esikhumbeni ukuze basize ngokukhahlela, yize lokhu kungaxazululi inkinga ekuqaleni. Ukugqoka izingubo ezimfushane nezilula kungakusiza.

Ezimweni ezinzima noma lapho i-UDCA ingasebenzi ngokwanele, udokotela wakho angase acabangele imithi eyengeziwe. Noma kunjalo, i-UDCA ihlala iyilona lokugcina ukwelashwa oluphephile kakhulu.

Indlela yokulawula izimpawu ekhaya ngesikhathi se-cholestasis yokuKhulelwa?

Nakuba ukwelashwa kwezokwelapha kubalulekile, kunezinto eziningi ongenza zona ekhaya ukuze usize ukuphatha izimpawu zakho nokusekela impilo yakho yonke. Lezi zindlela zisebenza kangcono kakhulu kanye nemithi yakho eyalwe yi-doctor.

Ukuze unciphise ukukhahlela, zama lezi zindlela ezimnene:

• Thatha izimbobo ezishisayo (ezingezona ezipholile) noma ama-showers
• Sebenzisa izimonyo ezingenayo i-fragrance, ezimnene ngesikhathi isikhumba sakho sisaluhlaza
• Gqoka izingubo ezilula, eziphefumula ezikhiqizwe ngekotoni
• Gcina igumbi lakho lokulala lipholile ebusuku
• Sebenzisa i-humidifier ukuvimbela umoya owomile
• Zama ukusebenzisa ama-compresses apholile ezindaweni ezikhahlelayo

Gxila ekusekeleni impilo yakho ye-liver ngokukhetha indlela yokuphila enhle. Dlala ukudla okuncane, okuvamile okulula ukuwephula. Faka izithelo nemifino eminingi, futhi uhlale uthola amanzi amaningi.

Ukuphumula ngokwanele kubalulekile, yize ukukhahlela kungenza ubuthongo bube nzima. Zama amasu okuphumula njengoba i-yoga yokuKhulelwa noma ukuzindla ukuze usize ukuphatha ukucindezeleka nokukhuthaza ubuthongo obuhle.

I-cholestasis yokuKhulelwa ingavikeleka kanjani?

Ngeshwa, ayikho indlela eqinisekisiwe yokuvimbela i-cholestasis yokuKhulelwa njengoba ibingelwa ikakhulukazi impendulo yomzimba wakho kuma-hormone okuKhulelwa. Noma kunjalo, ukugcina impilo enhle yonke ingasekele umsebenzi we-liver yakho.

Uma uke waba ne-cholestasis ekukhulelweni kwangaphambili, xoxa ngalokhu nodokotela wakho ekuqaleni kokukhulelwa kwakho okulandelayo. Bangase bafune ukukulandela eduze futhi baqale ukuhlola ngokushesha.

Eminye imikhuba evamile yokusekela i-liver ihlanganisa:

• Ukugcina isisindo esinempilo ngaphambi kokukhulelwa
• Ukudla ukudla okulinganiselayo okugcwele izithelo nemifino
• Ukuhlala uthola amanzi amaningi
• Ukuqeda utshwala ngokuphelele ngesikhathi sokuKhulelwa
• Ukuthatha ama-vitamin okuKhulelwa njengoba kunconywe
• Ukulawula ezinye izimo zezempilo njenge-diabetes

Nakuba lezi zinyathelo zingakwazi ukuqinisekisa ukuvimbela, zisekela impilo yakho yonke futhi zingasiza umsebenzi we-liver yakho kahle ngangokunokwenzeka ngesikhathi sokuKhulelwa.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukuba ulungile ngesikhathi se-appointment yakho kusiza ukuqinisekisa ukuthi uthola ukuxilongwa okuchane kakhulu nokukhathalelwa okuhle kakhulu okungenzeka. Udokotela wakho uzodinga ulwazi oluthile mayelana nezimpawu zakho nomlando wakho wezokwelapha.

Ngaphambi kwe-appointment yakho, bhala phansi ukuthi ukukhahlela kwakho kuqalile nini nokuthi kuguquke kanjani ngokuhamba kwesikhathi. Qaphela ukuthi yiziphi izingxenye zomzimba wakho ezithinteka kakhulu nokuthi yini eyenza ukukhahlela kube ngcono noma kube sibi.

Letha lolu lwazi nawe:

• Uchazo oluqondile lwemizamo yakho yokukhahlela
• Uhlu lwemithi yonke ne-supplements ozithathayo
• Umlando womndeni wezinkinga ze-liver noma i-cholestasis yokuKhulelwa
• Izinkinga zokuKhulelwa ngaphambili noma izinkinga ze-liver
• Imibuzo mayelana nezinketho zokwelashwa nokugadwa
• Izintandokazi zakho zohlelo lokubeletha nokukhathazeka

Ungangabazi ukubuza ukuthi yini okulindelekile ngokulandelela nokuhlela ukubeletha. Ukuqonda isikhathi nezinyathelo ezilandelayo kungasiza ekuthuthukiseni ukukhathazeka ngesimo.

Yini eyinhloko ebalulekile mayelana ne-cholestasis yokuKhulelwa?

I-Cholestasis yokuKhulelwa yisimo esilawuleka uma sixilongwa futhi siphathwa ngokushesha. Nakuba ukukhahlela okukhulu kungabi mnandi futhi izinhlanganisela ezingaba khona zikhathaza, abesifazane abaningi nabantwana baphila kahle ngokunakekelwa kwezokwelapha okuhle.

Into ebaluleke kakhulu ukungawunaki ukukhahlela okukhulu, ikakhulukazi ezandleni nasezinzwini zezinyawo. Ukuxilongwa kwasekuqaleni kuvumela iqembu lakho lokukhathalela impilo ukuthi liqale ukwelashwa nokugadwa ngokushesha.

Khumbula ukuthi lesi simo ngokuvamile siyaphela ngokuphelele ngemuva kokuzalwa. Umsebenzi we-liver yakho ubuyela ejwayelekile, futhi ukukhahlela kuyahamba phakathi kwezinsuku kuya emaviki ngemuva kokuzalwa. Ngokunakekelwa okuhle, ungaba nengane enempilo naphezu kwalesi simo esinzima.

Imibuzo evame ukubuzwa mayelana ne-cholestasis yokuKhulelwa

Ingabe i-cholestasis yokuKhulelwa izophinde ienzeke ezikhulelweni zesikhathi esizayo?

Uma uke waba ne-cholestasis yokuKhulelwa kanye, kunethuba elingu-60-70% lokuthi ibuye ezikhulelweni zesikhathi esizayo. Noma kunjalo, lokhu akusho ukuthi awukwazi ukuba nezingane eziningi ngokuphepha. Iqembu lakho lokukhathalela impilo lizokulandela eduze kusukela ekuqaleni kokukhulelwa futhi lingaqala ukwelashwa ngokushesha uma izimpawu zikhula. Abesifazane abaningi baphila kahle ngokukhulelwa okuningi naphezu kokubuya kwe-cholestasis.

Ngingancisha yini uma ngibe ne-cholestasis yokuKhulelwa?

Yebo, ungancisha ngokuqinisekile ngemuva kokuba ne-cholestasis yokuKhulelwa. Isimo siyaphela ngemuva kokuzalwa, futhi akukuthinti ikhono lakho lokukhiqiza ubisi noma ukuphepha kokuncisha. Uma uthathe i-UDCA ngesikhathi sokuKhulelwa, udokotela wakho uzokuncoma ukuthi uqhubeke yini nayo ngesikhathi sokuncisha, yize ngokuvamile icatshangelwa ukuba iphephile.

Ingane yami izodinga ukulethwa nini?

Odokotela abaningi bancoma ukubeletha phakathi kwamasonto angu-36-38 kwabesifazane abane-cholestasis yokuKhulelwa, kuye ngokukhulu kwesimo sakho namazinga e-bile acid. Iqembu lakho lokukhathalela impilo lizoqondanisa izingozi zokubeletha kwangaphambi kwesikhathi nezingozi zokuqhubeka nokuKhulelwa. Bazokulandela wena nengane yakho eduze ukuze baqonde isikhathi esifanele sokubeletha.

Ingabe ukukhahlela kubi kangako, noma ngiyaphika?

Ukuhaha okuvela ku-cholestasis yokuKhulelwa kububi ngempela futhi kuhlukile kunokukhahlela okujwayelekile ngesikhathi sokuKhulelwa. Ngokuvamile kuchazwa njengokuzwa sengathi kuvela ngaphansi kwesikhumba, futhi abesifazane abaningi bathi yikukhahlela okubi kakhulu abake bakubona. Awuphuki - lesi simpawu sithinta kakhulu ikhwalithi yempilo nobuthongo. Ungangabazi ukufuna usizo nokukhuthaza ukwelashwa okuhle.

Kwenzekani e-liver yami ngemuva kokuzalwa?

Umsebenzi we-liver yakho ngokuvamile ubuyela ejwayelekile phakathi kwezinsuku kuya emaviki ngemuva kokuzalwa. Amazinga e-bile acid awele ngokushesha uma ama-hormone okuKhulelwa encipha, futhi ukukhahlela ngokuvamile kuyahamba phakathi nesonto lokuqala ngemuva kokuzalwa. Udokotela wakho angase ahlole umsebenzi we-liver yakho emavikini ambalwa ngemuva kokuzalwa ukuze aqinisekise ukuthi konke sekubuyele ejwayelekile. Izinkinga ze-liver zesikhathi eside ezivela ku-cholestasis yokuKhulelwa zingaqondakali.