Isifo Sokuvuvukala Kwamathumbu (Ibd)

Isifo sikaCrohn nesifo se-ulcerative colitis zombili yizinhlobo ze-inflammatory bowel disease. Isifo sikaCrohn sivame ukubathinta abantu engxenyeni yokugcina yesisu esincane, okuthiwa yi-ileum, nezingxenye zekoloni. I-ulcerative colitis ithinta ikholoni kuphela.

I-Inflammatory bowel disease, ebizwa nangokuthi yi-IBD, iyigama elikhulu leqembu lemikhakha ebangela ukukhuluphala nokutheleleka kwezicubu endleleni yokugaya ukudla.

Izinhlobo ezivame kakhulu ze-IBD zihlanganisa:

• I-ulcerative colitis. Lokhu kuhlanganisa ukuvuvukala nezihlamba, ezibizwa ngokuthi ama-ulcer, endaweni yomugqa wekoloni ne-rectum.
• Isifo sikaCrohn. Kulolu hlobo lwe-IBD, umugqa wendlela yokugaya ukudla uthintwe. Leli simo sivame ukubandakanya izigaba ezijulile zendlela yokugaya ukudla. Isifo sikaCrohn sivame ukubathinta abantu esiswini esincane. Kodwa-ke, singathinta nesisu esikhulu, futhi, ngokungavamile, ingxenye engaphezulu yendlela yokugaya ukudla.

Izimpawu zombili i-ulcerative colitis nesi-fo sikaCrohn ngokuvamile zihlanganisa ubuhlungu besisu, ukululama, ukuphuma igazi emgodini, ukukhathala okukhulu nokulahlekelwa isisindo.

Kwabanye abantu, i-IBD iyisifo esilula. Kodwa kwabanye, kuyisimo esibangela ukukhubazeka futhi singabangela izinkinga eziyingozi impilo.

Amapapasi esifo sokuvuvukala kwamathumbu ahlukahlukana kuye ngokuthi ukuvuvukala kubi kangakanani nokuthi kwenzeka kuphi. Amapapasi angaba ukusuka kokulula kuya kokukhulu. Umuntu onalesifo sokuvuvukala kwamathumbu cishe uzobe nezikhathi zesifo esikhulu esilandela izikhathi zokuthi isifo siyeke.

Amapapasi avamile kokubili ku-Crohn's disease nase-ulcerative colitis afaka phakathi:

• Ukululama kwesisu.
• Ubuhlungu besisu nokuqina kwesisu.
• Igazi emathunjini.
• Ukwehluleka kokudla.
• Ukunciphisa isisindo ngaphandle kokuzikhandla.
• Ukuzizwa ukhathele kakhulu.

Bona udokotela noma omunye ochwepheshe wezempilo uma uhlangabezana noshintsho oluhlala lukade emikhweni yakho yokuzila, noma uma unezinye zezimpawu zesifo sokuvuvukala kwamathumbu. Nakuba isifo sokuvuvukala kwamathumbu ngokuvamile asibi, yisifo esinzima esingaholela ezinkingeni ezingaholela ekufeni kwabanye abantu.

Imbangela eqondile yesifo sokuvuvukala kwamathumbu ayaziwa. Ngaphambili, ukudla nokucindezeleka kwakucatshangelwa, kodwa manje, ochwepheshe bezempilo bayazi ukuthi lezi zinto zingenza isifo sokuvuvukala kwamathumbu sibe sibi, kodwa azisona imbangela yaso. Izinto eziningi cishe zidlalela indima ekukhuleni kwalo.

• Isimumo sokuvikela umzimba. Esinye isizathu esingaba khona ukuguquka emsebenzini wesimumo sokuvikela umzimba. Uma isimo sokuvikela umzimba sizama ukulwa nevairas noma ibhaktheriya ehlangene, impendulo yokuvikela umzimba engavamile yenza isimo sokuvikela umzimba sihlasele amaseli atholakala emgqeni wokugaya ukudla futhi.
• I-jini. Izimpawu eziningi ze-jini ziye zahlanganiswa ne-IBD. Izimfanelo ezidluliselwa emindenini zibonakala zidlalela indima ekutheni i-IBD ivame kakhulu kubantu abanawo amalungu omndeni anayo leyo nto. Noma kunjalo, abantu abaningi abane-IBD abanawo lo mlando womndeni.
• Izici ezikhuthazayo zezimo ezingqongile. Abacwaningi bakholelwa ukuthi izici zezimo ezingqongile zingadlalela indima ekubeni ne-IBD, ikakhulu izici eziqeda i-microbiome yomthambo. Lokhu kungafaka phakathi:
  • Ukukhuliswa endaweni ehlanzekile njengengane, ngokubekwa okulinganiselwe emagciwaneni.
  • Ukuba nokutheleleka kwamathumbu ekuqaleni kokuphila.
  • Ukusebenzisa ama-antibayothi ngonyaka wokuqala wokuphila.
  • Ukukhuliswa ngokunikezwa ibhodlela kakhulu.
• Ukukhuliswa endaweni ehlanzekile njengengane, ngokubekwa okulinganiselwe emagciwaneni.
• Ukuba nokutheleleka kwamathumbu ekuqaleni kokuphila.
• Ukusebenzisa ama-antibayothi ngonyaka wokuqala wokuphila.
• Ukukhuliswa ngokunikezwa ibhodlela kakhulu.
• Ukukhuliswa endaweni ehlanzekile njengengane, ngokubekwa okulinganiselwe emagciwaneni.
• Ukuba nokutheleleka kwamathumbu ekuqaleni kokuphila.
• Ukusebenzisa ama-antibayothi ngonyaka wokuqala wokuphila.
• Ukukhuliswa ngokunikezwa ibhodlela kakhulu.

Izimbangela ezingozi zesifo sokuvuvukala kwamathumbu zihlanganisa:

• Ubudala. Abantu abaningi ababa ne-IBD baqaphela ngaphambi kokuba babe neminyaka engu-30. Kodwa abanye abantu abawutholi lo luphuphuma kuze kube yilapho sebeminyaka engu-50 noma engu-60.
• Uhlanga noma ubuzwe. I-IBD ivame kakhulu kubantu abamhlope, kodwa ingaba khona kunoma ubani. Inani labantu abane-IBD liyakhula nakwezinye izizwe nezizwe.
• Umlando womndeni. Usesengozini enkulu uma unezihlobo zegazi — njengomzali, umfowethu noma ingane — enalesifo.
• Ukubhema isigarethi. Ukubhema isigarethi yiyona imbangela ebaluleke kunazo zonke engalawuleki yokuthola i-Crohn's disease.

Ukubhema kungasiza ekunciphiseni i-ulcerative colitis. Noma kunjalo, ukonakala kwayo empilweni yonke kuphazamisa noma iyiphi inzuzo, futhi ukuyeka ukubhema kungathuthukisa impilo jikelele yesisu lakho kanye nokunikeza ezinye izinzuzo eziningi zempilo.

• Imithi yokulwa nokuvuvukala engayona i-steroid. Lokhu kuhlanganisa i-ibuprofen (Advil, Motrin IB, nabanye), i-naproxen sodium (Aleve), i-diclofenac sodium nabanye. Le miithi ingandisa ingozi yokuthola i-IBD noma yonakalise lesi sifo kubantu abane-IBD.

Ukubhema isigarethi. Ukubhema isigarethi yiyona imbangela ebaluleke kunazo zonke engalawuleki yokuthola i-Crohn's disease.

Ukubhema kungasiza ekunciphiseni i-ulcerative colitis. Noma kunjalo, ukonakala kwayo empilweni yonke kuphazamisa noma iyiphi inzuzo, futhi ukuyeka ukubhema kungathuthukisa impilo jikelele yesisu lakho kanye nokunikeza ezinye izinzuzo eziningi zempilo.

I-Ulcerative colitis ne-Crohn's disease zinazinye izinkinga ezifanayo nezinye ezikhethekile kuyo yonke imibandela. Izinkinga ezitholakala kuzo zombili izimo zingafaka:

• Ukuqina komlomo. Ukuba ne-ulcerative colitis noma i-Crohn's disease eithinta iningi lomlomo wakho kungandisa ingozi yakho yomdlavuza womlomo. Ukuhlola umdlavuza nge-colonoscopy ngezikhathi ezithile kuqala ngokuvamile eminyakeni engu-8 kuya kwe-10 ngemuva kokwenziwa ukuxilongwa. Buza ochwepheshe bezempilo ukuthi nini nokuthi kangakanani kufanele wenze lo viwo.
• Ukutheleleka kwesikhumba, amehlo namalunga. Izimo ezithile, kufaka phakathi i-arthritis, izilonda zesikhumba nokutheleleka kwamehlo, okuthiwa yi-uveitis, kungenzeka ngesikhathi se-IBD flare-ups.
• I-primary sclerosing cholangitis. Kulolu simo olungavamile olutholakala kubantu abane-IBD, ukutheleleka kubangela ukwenziwa ama-scar ngaphakathi kwe-bile ducts. Le miqala ekugcineni iyancipha imiqala, ivinela ukugeleza kwe-bile. Lokhu kungagcina kubangela ukonakala kwesibindi.
• Izingqimba zegazi. I-IBD iyandisa ingozi yezingqimba zegazi ezinhlangothini nasemithanjeni.
• Ukuphelelwa amanzi okukhulu. Ukukhuluphala kakhulu kungabangela ukuphelelwa amanzi.

Izinkinga ze-Crohn's disease zingafaka:

• Ukuvimbela kwamathumbu. I-Crohn's disease ithonya ubukhulu bomthunzi wamadwala. Ngokuhamba kwesikhathi, izingxenye zamathumbu zingakhula futhi zinciphe, okungavimba ukugeleza kokudla. Ukuhlinzwa kungadingeka ukususa ingxenye yomlomo olugulayo. Ngokungavamile, ukuvimbela kwamathumbu noma umlomo kungabonakala ku-ulcerative colitis futhi kungaba uphawu lomdlavuza womlomo.
• Ukondleka okungalungile. Ukukhuluphala, ubuhlungu besisu nokuqina kungenza kube nzima kuwe ukudla noma ukuthi amathumbu akho athole izondlo ezanele ukukugcina unomsoco. Kuhle futhi ukuthuthukisa i-anemia ngenxa yesisindo esincane sesinyithi noma i-vitamin B-12 ebangelwa yisifo.
• I-Fistulas. Ngezinye izikhathi ukutheleleka kungasabalala ngokuphelele ngokusebenzisa udonga lwamathumbu futhi kudale i-fistula - ukuxhumana phakathi kwezingxenye ezahlukene zomzimba okungeyona into evamile. I-Fistulas eduze noma ngaphandle kwendawo yomlomo yiyona evamile. Kodwa-ke i-fistulas ingase ibe khona ngaphakathi noma ngase udongeni lwesifunda sesisu. Ezimweni ezithile, i-fistula ingatheleleka futhi yakhe iphokothi le-pus elaziwa ngokuthi yi-abscess.
• I-Anal fissure. Lokhu kuyikhala elincane elingaphakathi kwesikhumba esigubungela umlomo noma esikhuneni esizungezile umlomo lapho ukutheleleka kungenzeka khona. Ngokuvamile kuhlotshaniswa nokuphuma kwesitulo okuhlungu futhi kungabangela i-fistula eduze komlomo.

Izinkinga ze-ulcerative colitis zingafaka:

• I-Toxic megacolon. I-Ulcerative colitis ingabangela ukuba umlomo ubanzi ngokushesha futhi uqine, isimo esinzima esaziwa ngokuthi yi-toxic megacolon.
• I-hole emgomweni, ebizwa ngokuthi yi-perforated colon. I-Perforated colon ngokuvamile ibangelwa yi-toxic megacolon, kodwa ingase ibe khona yodwa.

UGastroenterologist uWilliam Faubion, M.D., uyaphendula imibuzo evame ukubuzwa mayelana nesifo se-inflammatory bowel disease.

[Umculo udlala]

Lesi sifo se-IBD singithinta kangakanani?

Kungani abantu beba ne-IBD?

Iningi lethu elibandakanyeka ocwaningweni lalesi simo lingaphakamisa ukuthi kunezizathu ezintathu ezinkulu esizihlola ngalesi simo. Eyesihlanu iyindawo yokuhlala. Iningi lethu likholelwa ukuthi kukhona ukuhlukumezeka kwendawo okuholela ekubeni khona kokuvuvukala okuqhubekayo esibindini. Lokho kuhlukumezeka kwendawo yokuhlala kungaba ukudla. Kungaba i-bug ethile ehlala esibindini, noma kungaba umsebenzi wale bug, okuyinto futhi umsebenzi wokudla. Okwesibili okubaluleke kakhulu ukuba nama-jini afanele. I-genetics yesifo se-inflammatory bowel disease iyinkimbinkimbi futhi empeleni iyasabalala. Ngakho-ke abantu abaningi banesimo se-genetic esifanele salesi sifo kodwa abasitholi lesi sifo. Khona-ke izingxenye yesithathu yilezi zinto ezimbili zithinta uhlelo lokukhulula. Futhi uhlelo lokukhulula yilokho empeleni okubangela ukubola okuqhubekayo okukhona esibindini esibhalela imithi yokwelapha.

Ingabe i-IBD ingathinta isikhathi sami sokuphila?

Impendulo emfushane yi-cha, ngeke. Kunezinhlobo eziningi zocwaningo lapho iziguli ezine-inflammatory bowel disease zilawulwa ngokumelene neziguli ezineminyaka efanayo, ngezinkinga zempilo ezifanayo, ngaphandle kwesifo se-inflammatory bowel disease, zifinyelela ekuphileni okulinganayo.

Ingabe ukudla kwami ​​kuthinta i-IBD?

Uma umuntu enesibindini esincane esihlobene nesifo se-Crohn, okuthile okuthiwa yi-stricture, ukudla kuba kubalulekile kakhulu ngoba uma iziguli ezithile zidla ukudla okune-roughage noma ukhula kakhulu, khona-ke lezo zinhlobo zokudla zingabangela ukugcwala noma ukuvimba ukuncipha esibindini esincane, okuholela ezimpawu zesimo esithi ukuphazamiseka: Ubuhlungu besisu, ukugabha, umsindo omkhulu esibindini. Enye indlela ukudla kungathinta ngayo isifo uma unekonakala kwesibindini esincane, lokho kungathinta ikhono lakho lokwenza izinhlobo ezithile zemisebenzi esibindini esincane - njengokufunxa imikhiqizo yobisi, isibonelo.

Ingabe kukhona ingozi yomdlavuza ngokuba ne-IBD?

I-risk factor ebaluleke kakhulu yomdlavuza iyoba i-colorectal noma umdlavuza wesibindini esikhulu. Futhi lokho kuza, sikholelwa, ekuvuvukaleni okuqhubekayo kwesibindini. Kungakho kuyinto enhle ukuhlala uxhumana eduze neqembu lakho lokwelashwa. Futhi kungakho sincoma i-colonoscopies ejwayelekile, ukudlulisa isikhombimsebenzisi phezulu esibindini, ukubuka lezo zinguquko zokuqala ezihlobene nomdlavuza.

Iyini ingozi yokudlulisa i-IBD kubantwana bami?

Lona umbuzo ovamile futhi ofanele phakathi kwabazali abafika ukuhlolwa ngesifo sabo se-inflammatory bowel disease. Ngokuvamile ingozi iphakeme kancane ngesifo se-Crohn kunesifo se-ulcerative colitis. Kodwa lokho kusho ukuthi, usenokuba nethuba elingaphezulu lokuba yilungu elilodwa lomndeni wakho onalesi simo, kunokuba nokuthiwa yi-familial penetrance.

Ingabe ukufakelwa kwe-stool kuyiqiniso?

Impendulo emfushane yi-yebo. Lesi sayensi empeleni yakhiqizwa ngokutheleleka kunokuba yisifo se-inflammatory bowel disease. Isayensi yakhiqizwa phakathi nesikhathi esingaba iminyaka engu-15. Futhi empeleni ifike ebudaleni ngokutheleleka okuthiwa yi-clostridium difficile noma i-C. diff. Ukufakelwa kwe-stool manje empeleni kuyithuluzi elivamile lokwelapha ukutheleleka okuphindaphindayo noma okungapheli ngalesi sihlobo se-C. diff. Ngenxa yokujabula emkhakheni wezifo ezithathelwanayo noma emkhakheni we-C. diff, kunamavivinyo amaningi asebenza esifweni se-inflammatory bowel disease.

Ngingaba kanjani umlingani omuhle kakhulu eqenjini lami lezokwelapha?

Ngicabanga ukuthi ukubonakala yilokho kokuqala ongakwenza. Sihlala sikubheka lokhu njengobudlelwane phakathi koguli nomhlinzeki. Kukhona okuningi okufanele sikubheke lapho sikhuluma ngemithi yesifo se-inflammatory bowel disease. Ezinye zalezo zidakamizwa zinezici zengozi. Ngakho-ke lezo zingxoxo ziyabaluleka, zingaba nzima futhi zithathe isikhathi. Ngakho-ke ukubonakala, ukuba khona, ukuhlanganyela kulezo zingxoxo, nokuzifundisa. Kunezithombo eziningi ezikhona zokuhlola ukuthi yiziphi izingozi nezinzuzo zemizamo ehlukene ehlukene. Ukuxhumana kahle neqembu lakho futhi futhi, ukuba khona nje nokuvela.

[Umculo udlala]

Ukuze kuqinisekiswe ukuxilongwa kwe-IBD, ochwepheshe bezempilo ngokuvamile bancoma ukusetshenziswa kwezivivinyo nezinqubo:

• Izifundo ze-Stool. Isibonelo se-stool singasetshenziswa ukuhlola igazi noma izilwanyana, ezifana nebhaktheriya ebangela ukutheleleka noma, ngokungavamile, izinambuzane, esitulini. Lezi zingaba izimbangela zokweluka nokukhuluphala. Ngezinye izikhathi ukubuka amamaki esitulini okuvuvukala, njenge-calprotectin, kungaba usizo.

Izivivinyo zegazi. Izivivinyo zegazi zingahlola izimpawu zokutheleleka noma i-anemia - isimo lapho kungekho amaseli abomvu egazi anele okuthwala i-oksijini ezihlangeni.

Lezi zivivinyo zingasetshenziswa futhi ukuhlola amazinga okuvuvukala, umsebenzi welaphe, noma ukuba khona kokutheleleka okungasebenzi, njengotshwala. Igazi lingase lihlolwe futhi ngokuba khona kokukhulula ekuthelelekeni.

Phakathi ne-colonoscopy, ochwepheshe bezempilo ubeka i-colonoscope esibindini ukuhlola yonke i-colon.

Phakathi kokuhlolwa kwe-flexible sigmoidoscopy, ochwepheshe bezempilo ubeka i-sigmoidoscope esibindini ukuhlola i-colon ephansi.

• Colonoscopy. Lokhu kuhlolwa kuvumela ukubuka yonke i-colon nezingxenye zesibindini esincane ngokusebenzisa i-tube encane, eguquguqukayo, enezibani enenkhamera ekupheleni. Phakathi nenqubo, isibonelo esincane se-tissue okuthiwa yi-biopsy singathathwa ukuze sihlolwe. I-biopsy iyindlela yokwenza ukuxilongwa kwe-IBD kunokuvuvukala kwezinye izinhlobo.
• Flexible sigmoidoscopy. Lokhu kuhlolwa kusebenzisa i-tube encane, eguquguqukayo, enezibani ukuhlola i-rectum ne-sigmoid, ingxenye yokugcina ye-colon. Uma i-colon ivuvukile kakhulu, lokhu kuhlolwa kungase kwenziwe esikhundleni se-colonoscopy ephelele.
• Upper endoscopy. Kule nqubo, i-tube encane, eguquguqukayo, enezibani isetshenziswa ukuhlola i-esophagus, isisu, nengxenye yokuqala yesibindini esincane, okuthiwa yi-duodenum. Nakuba kunqabile ukuthi lezi zindawo zihileleke nesifo se-Crohn, lokhu kuhlolwa kungase kunconywe uma une-nausea nokugabha, ubunzima bokudla, noma ubuhlungu besisu oluphezulu.
• Capsule endoscopy. Lokhu kuhlolwa ngezinye izikhathi kusetshenziswa ukusiza ukuxilongwa kwesifo se-Crohn esibandakanya isisu esincane. Uginya i-capsule enenkhamera kuyo. Izithombe zithunyelwa kurekhoda oyigqoka ebhande lakho, ngemva kwalokho i-capsule iphuma emzimbeni wakho ngaphandle kokubuhlungu esitulini sakho. Ungase usadinga i-endoscopy nge-biopsy ukuze uqinisekise ukuxilongwa kwesifo se-Crohn. I-capsule endoscopy akufanele yenziwe uma kukhona ukuphazamiseka kwesibindini okucatshangelwayo.
• Balloon-assisted enteroscopy. Ngaleli vi, i-scope isetshenziswa ndawonye nedivayisi okuthiwa yi-overtube. Lokhu kuvumela ubuchwepheshe ukubuka kude esibindini esincane lapho ama-endoscopes ajwayelekile angafinyeleli khona. Leli thuba liwusizo lapho imiphumela ye-capsule endoscopy ingalindelekile kodwa ukuxilongwa kusaphikiswana.
• X-ray. Uma unezimpawu ezinkulu, umhlinzeki wakho angase asebenzise i-X-ray ejwayelekile yendawo yesisu lakho ukuze akhiphe izinkinga ezinkulu, njenge-toxic megacolon noma i-colon ephukile.
• Computerized tomography, okuthiwa futhi yi-CT. Ungase ube ne-CT scan - ubuchwepheshe be-X-ray obukhulu obunikeza imininingwane engaphezulu kunokwenza i-X-ray ejwayelekile. Lokhu kuhlolwa kubuka yonke i-bowel kanye nezihlangeni ngaphandle kwe-bowel. I-CT enterography yi-CT scan ekhethekile enikeza izithombe ezingcono zesibindini esincane. Lokhu kuhlolwa kuye kwasetshenziswa i-barium X-rays ezindaweni eziningi zezokwelapha.
• Magnetic resonance imaging, okuthiwa futhi yi-MRI. I-MRI scanner isebenzisa i-magnetic field namaza erediyo ukudala izithombe eziningiliziwe zezihlangeni nezihlangeni. I-MRI iwusizo ngokukhethekile ekuhloleni i-fistula eduze kwendawo yanal noma isisu esincane, ukuhlolwa okuthiwa yi-MR enterography. Ngokungafani ne-CT, awekho ukuvezwa kweradietion nge-MRI.

Umgomo wokwelapha isifo sokuvuvukala kwamathumbu ukuthambisa ukuvuvukala okubangela izimpawu. Emacaleni amahle kakhulu, lokhu kungase kubangele ukukhululeka kwezimpawu kuphela kodwa futhi nokuphulukiswa isikhathi eside nokunciphisa ingozi yezinhlungu. Ukwelapha i-IBD kuvame ukubandakanya imithi noma ukuhlinzwa. Imithi yokulwa nokuvuvukala ngokuvamile iyisinyathelo sokuqala ekwelapheni isifo sokuvuvukala kwamathumbu, ngokuvamile ngezifo ezinzima kuya ezinkulu. Imithi yokulwa nokuvuvukala ihlanganisa ama-aminosalicylates, njenge-mesalamine (Delzicol, Rowasa, nabanye), i-balsalazide (Colazal) ne-olsalazine (Dipentum). Muva nje, imithi enikezwa ngomlomo eyaziwa ngokuthi yizinhlayiya ezincane iye yaba khona ekwelapheni i-IBD. Abaphikisi be-Janus kinase, ababizwa nangokuthi yi-JAK inhibitors, uhlobo lwemithi yemolekyuli encane esiza ekuthambiseni ukuvuvukala ngokuqondisa izingxenye zesimiso somzimba esibangela ukuvuvukala emathunjini. Abanye abaphikisi be-JAK be-IBD bahlanganisa i-tofacitinib (Xeljanz) ne-upadacitinib (Rinvoq). I-Ozanimod (Zeposia) enye uhlobo lwemithi yemolekyuli encane etholakala ye-IBD. I-Ozanimod iyimithi eyaziwa ngokuthi yi-sphingosine-1-phosphate receptor modulator, ebizwa nangokuthi yi-S1P receptor modulator. I-US Food and Drug Administration, ebizwa nangokuthi yi-FDA, iye yakhipha isixwayiso mayelana ne-tofacitinib, isho ukuthi izifundo zoqobo zibonisa ingozi enkulu yezimo ezihlobene nenhliziyo kanye nomdlavuza ngokuthatha le mithi. Uma uthatha i-tofacitinib ye-ulcerative colitis, ungayeki ukuthatha imithi ngaphandle kokukhuluma nomsizi wezempilo kuqala. I-Biologics iyigama eliqala lezokwelapha lapho ukwelapha kuqondiswe ekwenzeni izinto eziyingozi emzimbeni ezibangela ukuvuvukala. Ezinye zalezi zidakamizwa zinikwa nge-intravenous, ebizwa nangokuthi yi-IV, infusions kanye nezinye ziyizibopho ozinikeza wena. Izibonelo zihlanganisa i-infliximab (Remicade), i-adalimumab (Humira), i-golimumab (Simponi), i-certolizumab (Cimzia), i-vedolizumab (Entyvio), i-ustekinumab (Stelara) ne-risankizumab (Skyrizi). Ama-antibiotics angase asebenziswe nezinye izidakamizwa noma lapho ukutheleleka kuyinkinga- uma kukhona isifo se-Crohn's perianal, isibonelo. Ama-antibiotics avame ukubhalwa yi-ciprofloxacin (Cipro) ne-metronidazole (Flagyl). Ngaphezu kokuphatha ukuvuvukala, ezinye izidakamizwa zingasiza ekuthambiseni izimpawu. Kodwa qiniseka ukukhuluma nochwepheshe wezempilo ngaphambi kokuthatha noma iyiphi imithi engekho ngaphansi kwelayisensi. Kuye ngokuthi i-IBD yakho imbi kangakanani, okunye noma ngaphezulu kwalokhu kungase kunconywe:

• Ama-Antidiarrheals. Isikhunta sefayibha-njenge-psyllium (Metamucil) noma i-methylcellulose (Citrucel)-singasiza ekuthambiseni isifo sokuhlanza esibuthakathaka kuya esiphakathi ngokwengeza ubuningi emathunjini. Ngokuhlanza okukhulu, i-loperamide (Imodium A-D) ingase isebenze. Lezi zidakamizwa kanye nezithasiselo zingaba yingozi noma zingasebenzi kubantu abane-strictures noma ukutheleleka okuthile. Xhumana neqembu lakho lokunakekelwa kwezempilo ngaphambi kokuqala lezi zindlela zokwelapha.
• Imithi yokunciphisa ubuhlungu. Ngobuhlungu obuthambile, i-acetaminophen (Tylenol, nabanye) ingase inconywe. Noma kunjalo, imithi ebizwa ngokuthi yi-nonsteroidal anti-inflammatory drugs, ehlanganisa i-ibuprofen (Advil, Motrin IB, nabanye), i-naproxen sodium (Aleve) ne-diclofenac sodium, cishe izokwenza izimpawu zibe zimbi futhi ingenza isifo sibe sibi kakhulu.
• Amavithamini nezithasiselo. Uma ungathathi izondlo ezanele, amavithamini nezithasiselo zezondlo zingase zinconywe. Ama-Antidiarrheals. Isikhunta sefayibha-njenge-psyllium (Metamucil) noma i-methylcellulose (Citrucel)-singasiza ekuthambiseni isifo sokuhlanza esibuthakathaka kuya esiphakathi ngokwengeza ubuningi emathunjini. Ngokuhlanza okukhulu, i-loperamide (Imodium A-D) ingase isebenze. Lezi zidakamizwa kanye nezithasiselo zingaba yingozi noma zingasebenzi kubantu abane-strictures noma ukutheleleka okuthile. Xhumana neqembu lakho lokunakekelwa kwezempilo ngaphambi kokuqala lezi zindlela zokwelapha. Uma ukulahlekelwa isisindo kukhulu, ochwepheshe wezempilo angase ancome ukudla okukhethekile okunikezwa ngompompi wokudla, okuthiwa yi-enteral nutrition, noma izondlo ezifakwe emithanjeni, okuthiwa yi-parenteral nutrition. Ukusekelwa kwezondlo kungathuthukisa ukudla kwakho okuphelele futhi kuvumele amathumbu aphumule. Ukupumula kwamathumbu kunganciphisa ukuvuvukala esikhathini esifushane. Uma une-stenosis noma i-stricture emathunjini, iqembu lakho lokunakekelwa lingase lincome ukudla okune-residue ephansi. Lokhu kudla kungasiza ekuthambiseni amathuba okudla okungagayiwe okuzovalelwa engxenyeni ecindezelekile yomthambo futhi kubangele ukuvimba. Uma ukushintsha ukudla nendlela yokuphila, ukwelashwa ngemithi, noma ezinye izindlela zokwelapha zingakuthambisi izimpawu zakho ze-IBD, ukuhlinzwa kungase kunconywe.
• Ukuhlinzwa kwe-ulcerative colitis. Ukuhlinzwa kubandakanya ukususwa kwesigxobo sonke nesigxobo. I-pouch yangaphakathi bese yenziwa futhi inamathele esigxotsheni. Lokhu kuvumela ukudlula kwamathumbu ngaphandle kokuba nesikhwama samathumbu ngaphandle komzimba. Kubantu abathile, ukwenza i-pouch yangaphakathi akunakwenzeka. Esikhundleni salokho, ochwepheshe bokuhlinzwa benza ukuvulwa okuhlala njalo esiswini, okuthiwa yi-ileal stoma, lapho amathumbu edlula khona ukuze aqoqwe esikhundleni esinamathiselwe.
• Ukuhlinzwa kwe-Crohn's disease. Abantu abafika kwabathathu kwabahlanu abane-Crohn's disease badinga okungenani ukuhlinzwa okukodwa ekuphileni kwabo. Noma kunjalo, ukuhlinzwa akululaphi isifo se-Crohn's. Phakathi nokuhlinzwa, udokotela ohlinzayo ususa ingxenye eyonakele yomthambo wesisu bese uqondanisa izingxenye ezempilo. Ukuhlinzwa kungase futhi kusetshenziswe ukuvala ama-fistulas nokukhipha ama-abscesses. Izinzuzo zokuhlinzwa kwe-Crohn's disease ngokuvamile ziyisikhashana. Lesi sifo siphinde sibuye kubantu abaningi, ngokuvamile eduze kwesicubu esihlanganisiwe. Indlela engcono kakhulu ukulandela ukuhlinzwa ngemithi ukuze kunciphise ingozi yokubuyela kwesifo.

Ngezinye izikhathi ungase uzizwe ungenamandla uma ubhekene nesifo sokuvuvukala kwamathumbu. Kodwa-ke ukushintsha ekudleni nasempilweni yakho kungasiza ekulawuleni izimpawu zakho nokwenza isikhathi phakathi kokubhebhetheka kube side.Akulabufakazi obuqinile bokuthi lokho okudlayo kubangela isifo sokuvuvukala kwamathumbu. Kodwa-ke ezinye izibiliboco neziphuzo zingenza izimpawu zibe zimbi kakhulu, ikakhulukazi ngesikhathi sokubhebhetheka.Ungase uthole ukuthi kuwusizo ukugcina idayari yokudla ukuze uqaphele ukuthi udlulani, kanye nendlela ozizwa ngayo. Uma uthola ukuthi ezinye izibiliboco zibangela izimpawu zakho ukuba zibe zimbi, ungazama ukuqeda lezo zibiliboco.Nawa amanye amacebo okuqondisa ukudla angakusiza ekulawuleni isimo sakho:

• Khawufinyeze imikhiqizo yobisi. Abantu abaningi abanesifo sokuvuvukala kwamathumbu bathola ukuthi izinkinga ezinjengesihlalo esikhulu, ubuhlungu besisu kanye negesi ziyathuthuka ngokuqeda noma ukungasebenzisi imikhiqizo yobisi. Ungase ube nesifo sokungatholi lactose - okungukuthi, umzimba wakho awukwazi ukugaya ushukela wobisi, oluthiwa yi-lactose, ekudleni kobisi. Ukusebenzisa umkhiqizo we-enzyme njengeLactaid kungasiza futhi.
• Dla ukudla okuncane. Ungase uthole ukuthi uzizwa kangcono ukudla ukudla okuncane okuyisihlanu noma isithupha ngosuku kunokudla okukhulu okuyibili noma okuyintathu.
• Phuza amanzi amaningi. Zama ukuphuza amanzi amaningi nsuku zonke. Amanzi angcono kakhulu. U-Alkohols neziphuzo eziqukethe i-caffeine zivusa ama-intestines akho futhi zingenza isihlalo esikhulu sibe sibi kakhulu, kuyilapho iziphuzo ezi-carbonated zivame ukukhiqiza igesi.
• Cabanga ngamavithamini amaningi. Ngoba i-Crohn's disease ingaphazamisa ikhono lakho lokufunxa izondlo futhi ngoba ukudla kwakho kungase kube kunqanyuliwe, izithasiselo zamavithamini amaningi neziminero zivame ukuba usizo. Xhumana neqembu lakho lokunakekelwa kwezempilo ngaphambi kokuthatha noma yimaphi amavithamini noma izithasiselo.
• Khuluma nodokotela wezondlo. Uma uqala ukulahlekelwa isisindo noma ukudla kwakho sekuye kwaba kunqanyuliwe kakhulu, khuluma nodokotela obhalisiwe wezondlo.

Ukubhema kukhulisa ingozi yokuba ne-Crohn's disease, futhi uma usuvele unayo, ukubhema kungayenza ibe zimbi. Abantu abane-Crohn's disease ababhema banesilinganiso esikhulu sokubuyela emuva futhi badinga imithi nokuhlinzwa okuphindaphindwayo.

Ukubhema kungasiza ekuvimbeni i-ulcerative colitis. Noma kunjalo, ukonakala kwayo empilweni yonke kuphakathi kokusiza, futhi ukuyeka ukubhema kungathuthukisa impilo yonke yomgudu wakho wokugaya ukudla, kanye nokuletha ezinye izinzuzo eziningi zempilo.

Ubuhlobo bokucindezeleka ne-Crohn's disease buphikiswana, kodwa abantu abaningi abane lesi sifo babika ukubhebhetheka kwezimpawu ngezikhathi zokucindezeleka okukhulu. Uma unesikhathi esinzima sokulawula ukucindezeleka, zama enye yalezi zindlela:

• Biofeedback. Leli thuluzi lokuncipha kokucindezeleka lingakufundisa ukunciphisa ukucindezeleka kwemisipha nokunciphisa izinga lenhliziyo yakho ngosizo lomshini wokubuyisela impendulo. Umgomo ukukusiza ukuba ungene esimweni sokuphumula ukuze ukwazi ukubhekana kalula nokucindezeleka.
• Ukuphumula okuvamile nokuzivocavoca kokuphefumula. Indlela eyodwa yokubhekana nokucindezeleka ukupumula njalo nokusebenzisa amasu anjengokuphefumula okujulile, okuhamba kancane ukukusiza uzizwe uthulile.

Abantu abaningi abanezifo zokugaya ukudla basebenzise uhlobo oluthile lwemithi yokugeleza neyehlukile. Noma kunjalo, kunama-study ambalwa ahlelekile kahle wokuphepha nokusebenza kahle kwalezi zindlela zokwelapha.

Abacwaningi bacabanga ukuthi ukwengeza amabhaktheriya amaningi awusizo atholakala ngokuvamile emgudwini wokugaya ukudla kungasiza ekuqedeni i-IBD. La mabhaktheriya abizwa ngokuthi yi-probiotics. Nakuba ucwaningo lunqanyuliwe, kunobunye ubufakazi bokuthi ukwengeza i-probiotics kanye nokuthatha imithi kungasiza.

• Yiba nolwazi. Enye yezindlela ezinhle kakhulu zokuphatha kangcono i-IBD yakho ukwazi konke okungenzeka ngesifo sokuvuvukala kwamathumbu. Funafuna ulwazi oluvela emithonjeni ethembekile enjenge-Crohn's and Colitis Foundation.
• Joyina iqembu lokusekela. Nakuba amaqembu okusekela engawona wonke umuntu, anganikeza ulwazi oluyigugu ngesimo sakho kanye nokusekelwa ngokomzwelo. Amalungu eqembu avame ukwazi ngezindlela zakamuva zokwelapha noma izindlela zokwelapha ezihlanganisiwe. Ungase futhi uthole ukuthi kuyaduduza ukuba phakathi kwabanye abane-IBD.
• Khuluma nodokotela wezempilo yengqondo. Abanye abantu bathola ukuthi kuwusizo ukubonisana nodokotela wezempilo yengqondo oqondileyo ngesifo sokuvuvukala kwamathumbu nenzondo yomzwelo engayibangela.

Nakuba ungase uzizwe udumele ngokuphila ne-IBD, ucwaningo luyaqhubeka, futhi isimo siyalungiswa.