Ukuthi yini i-Primary Biliary Cholangitis? Izimpawu, Izimbangela, kanye Nokwelashwa

I-Primary biliary cholangitis (PBC) iyisimo esingapheli esithinta isibindi lapho i-immune system yakho ihlasela ngephutha imithambo emincane ye-bile esibindini sakho. Cabanga ngakho njengesistimu yakho yokuzikhusela ephazamisekile futhi ihlasela inyama yempilo yesibindi esikhundleni sokuyivikela.

Le nqubo ye-autoimmune yonakalisa kancane kancane imithambo ye-bile, engumithambo emincane ethwala i-bile evela esibindini sakho ukuze isize ekweluleni amafutha. Ngokuhamba kwesikhathi, lo wonakalo ungabangela ukuba khona kwezindwangu futhi uthinte ukuthi isibindi sakho sisebenza kangcono kangakanani. Izindaba ezinhle ukuthi ngokwelashwa okufanele, abantu abaningi abane-PBC baphila impilo evamile, enempilo.

Zithini izimpawu ze-Primary Biliary Cholangitis?

Abantu abaningi abane-PBC abanawo ama-symptom ezigabeni zokuqala, kungakho ngezinye izikhathi kubizwa ngokuthi “isimo esithule.” Uma izimpawu zivele, zivame ukuvela kancane kancane futhi kube lula ukuziphazamisa ekuqaleni.

Izimpawu zokuqala ezivamile ongaziqaphela zihlanganisa:

• Ukukhathala okuqhubekayo okungaphuli ngokuphumula
• Ukukhahlela okukhulu, ikakhulukazi ezandleni nasezinzwini zakho
• Amehlo omile nomlomo omile
• Ubuhlungu noma ubuhlungu ngakwesokudla phezulu kwesisu sakho

Njengoba isimo siqhubeka, ungaba nezimpawu ezengeziwe. Lezi zingaba ukufiphaza kwesikhumba namehlo (jaundice), ukumnyama kokushisa, kanye nezinsalela ezimhlophe. Abanye abantu nabo baba nokuvuvukala ezinyaweni nasemathunjini.

Izimpawu ezingavamile kodwa ezingenzeka zihlanganisa ubuhlungu lwamathambo, ubuhlungu bamasu, nobunzima bokuqonda. Ungaqaphela futhi ama-deposits amancane, aphuzi phansi kwesikhumba sakho abizwa ngokuthi i-xanthomas, ikakhulukazi eduze kwamehlo akho noma ezingalweni nasemiqondweni yakho.

Yini ebangela i-Primary Biliary Cholangitis?

I-PBC kwenzeka lapho i-immune system yakho ihlasela ngephutha amaseli empilo emithambweni ye-bile njengabaphangi bangaphandle futhi ihlasela. Ososayensi abazi kahle ukuthi kungani le nqubo ye-autoimmune iqala, kodwa ucwaningo luphakamisa ukuthi cishe kuyindlela yokuxuba izinto zofuzo nezemvelo.

I-genes yakho idlala indima ekuqondeni ingozi yakho. Uma unezihlobo ezine-PBC noma ezinye izimo ze-autoimmune, ungase ube nethuba elikhulu lokuthola. Noma kunjalo, ukuba nalezi genes akusho ukuthi uzothola isifo.

Izinto ezibangela i-PBC zingase futhi zifake isandla ekuthuthukiseni i-PBC. Lezi zingaba izifo ezithile, ukukhishwa kumakhemikhali, noma ukubhema. Umbono ukuthi kubantu abanezinto zofuzo, lezi zinto zingase ziqalise impendulo ye-autoimmune.

Kubalulekile ukuqonda ukuthi i-PBC ayithwali futhi awukwazi ukuyithola komunye umuntu. Ayibangelwa yilutho olukwenzile noma awukwenzanga, ngakho-ke asikho isizathu sokuzisola uma utholile.

Nini okumele ubona udokotela nge-Primary Biliary Cholangitis?

Kufanele uxhumane nodokotela wakho uma uhlushwa ukukhathala okuqhubekayo okuthinta imisebenzi yakho yansuku zonke, ikakhulukazi uma kuhlanganiswa nezinye izimpawu. Ukukhahlela okungachazeki okungaphenduli ekwelapheni okuvamile kuyisibonakaliso esibalulekile okufanele ukhulume ngaso nodokotela wakho.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uqaphela ukufiphaza kwesikhumba sakho noma ama-whites amehlo akho, njengoba lokhu kungabonisa ukuthi umsebenzi wesibindi sakho uthinteka. Ukushisa okumnyama noma izinsalela ezimhlophe nazo zingu-changes ezidinga ingxoxo nodokotela wakho.

Uma unemlando womndeni we-PBC noma ezinye izifo zesibindi ze-autoimmune, kubalulekile ukukhuluma lokhu nodokotela wakho ngesikhathi sokuhlolwa okuvamile. Bangase baphakamise ukuhlolwa kwegazi okuqhubekayo ukuqapha umsebenzi wesibindi sakho, ngisho noma ungenawo ama-symptom.

Ungalindi uma uhlushwa ubuhlungu obukhulu besisu, ikakhulukazi ngakwesokudla phezulu, noma uma uthola ukuvuvukala ezinyaweni noma esiswini. Lezi zimpawu zingabonisa ukuthi isimo sakho siqhubeka futhi sidinga ukunakekelwa ngokushesha.

Zithini izinto ezingaba yingozi ze-Primary Biliary Cholangitis?

Ukuqonda izinto ezingaba yingozi kungakusiza wena nodokotela wakho ukuthi niqaphele izimpawu zokuqala ze-PBC. Into ebaluleke kakhulu eyingozi ukuba owesifazane, njengoba cishe u-90% wabantu abane-PBC bangabesifazane, ngokuvamile baqalwa phakathi kweminyaka engu-40 no-60.

Umlando womndeni wakho ubalulekile kakhulu. Uma unezihlobo ezine-PBC noma ezinye izimo ze-autoimmune njenge-rheumatoid arthritis, isifo se-thyroid, noma i-Sjögren's syndrome, ingozi yakho iphakeme kunokulinganiselwe.

Indawo yendawo ibonakala idlala indima futhi. Abantu abahlala ezindaweni zaseNyakatho noma ezinye izindawo njengeNyakatho Yurophu nezingxenye zaseNyakatho Melika banesilinganiso esiphezulu se-PBC. Lokhu kungase kuhlobene nezinto zemvelo noma izindlela zofuzo kulaba bantu.

Ukubhema kubonakala kukhulisa ingozi yakho futhi kungenza isifo siqhubeke ngokushesha uma usithola. Amanye ama-studies aphakamisa futhi ukuthi izifo ezithile, ikakhulukazi izifo zendlela yomchamo, zingase ziqalise i-PBC kubantu abathintekayo.

Ukuba nezinye izimo ze-autoimmune kungandisa amathuba akho okuthola i-PBC. Lokhu kuhlanganisa izimo ezinjenge-Sjögren's syndrome, i-scleroderma, noma isifo se-autoimmune se-thyroid.

Zithini izinhlanganisela ezingenzeka ze-Primary Biliary Cholangitis?

Ngenkathi abantu abaningi abane-PBC baphila impilo evamile ngokwelashwa okufanele, kubalulekile ukuqonda ukuthi yiziphi izinhlanganisela ezingase zithuthuke ukuze ukwazi ukusebenza nodokotela wakho ukuze uzivimbele noma uzilawule ngokuphumelelayo.

Izinhlanganisela ezivamile zihlangene nekhono eliphansi lesibindi sakho lokucubungula izinto ezithile. Ungaba nezinkinga zokufunxa amavithamini ahlanganiswe namafutha (A, D, E, ne-K), okungabangela ubuthakathaka lwamathambo, izinkinga zobuso, noma izinkinga zokopha.

Izinhlanganisela ezingenzeka ezihlobene nesibindi zihlanganisa:

• I-Portal hypertension (ukwanda kokucindezela emithambweni yegazi yesibindi)
• I-spleen enkulu
• Ukuqoqwa kwamanzi esiswini (ascites)
• Imithambo yegazi evuvukile esibindini sakho (varices) engase ikophele
• Ukwehluleka kwesibindi ezimweni eziphambili

Abanye abantu abane-PBC bathuthukisa izinhlanganisela ngaphandle kwesibindi. Lezi zingaba isifo esibuhlungu samathambo (osteoporosis), izinkinga zezinso, noma ingozi enkulu yezinye izifo zomdlavuza, ikakhulukazi umdlavuza wesibindi ezigabeni eziphambili.

Izindaba ezinhle ukuthi ngokuxilongwa kwasekuqaleni nokwelashwa okufanele, izinhlanganisela eziningi zingavikelwa noma ukuqhubeka kwazo kunciphisa kakhulu. Ukuqapha okuqhubekayo kusiza iqembu lakho lokunakekelwa kwezempilo ukuthi liqaphe futhi liqaphe izinkinga ngaphambi kokuba zibe nzima.

I-Primary Biliary Cholangitis ingavikeleka kanjani?

Ngeshwa, asikho isindlela esiqinisekisiwe sokuvimbela i-PBC njengoba kuyisimo se-autoimmune esinezinto zofuzo. Noma kunjalo, ungathatha izinyathelo zokunciphisa ingozi yakho yokuthuthukisa izinhlanganisela noma ucindezele ukuqhubeka kwesifo uma usuqalisiwe.

Ukugcina impilo enempilo kusekela impilo yakho yonke yesibindi. Lokhu kusho ukudla ukudla okulinganiselayo okunothile izithelo, imifino, nama-grains aphelele ngenkathi ugcina ukudla okuqediwe nokusetshenziswa okukhulu kokutshwala.

Uma ubhema, ukuyeka kuyinto ebaluleke kakhulu ongayenza. Ukubhema akukhulisi nje ingozi yakho yokuthola i-PBC kodwa kungenza futhi iqhubeke ngokushesha futhi kunciphisa ukusebenza kahle kokwelashwa.

Ukugcina unolwazi ngokugoma, ikakhulukazi nge-hepatitis A ne-B, kusiza ukuvikela isibindi sakho ekunakekelweni okwengeziwe. Udokotela wakho angase futhi aphakamise ukugwema imithi ethile engase icindezele isibindi sakho.

Uma unemlando womndeni we-PBC noma ezinye izimo ze-autoimmune, ukuhlolwa okuvamile ngokuhlonzwa kwegazi kungasiza ekutholeni isimo kwasekuqaleni lapho ukwelashwa kusebenza kakhulu.

I-Primary Biliary Cholangitis ixilongwa kanjani?

Ukuxilonga i-PBC ngokuvamile kuhlanganisa ukuhlolwa okuningi okusiza udokotela wakho ukuthi aqinisekise isimo futhi akhiphe ezinye izifo zesibindi. Inqubo ngokuvamile iqala ngokuhlonzwa kwegazi okuhlola umsebenzi wesibindi sakho futhi kubuke izimpawu ezithile.

Udokotela wakho uzo-oda ukuhlolwa ukuze alinganise ama-enzymes esibindi, ikakhulukazi i-alkaline phosphatase, evame ukuphakama e-PBC. Bazohlola futhi ama-antimitochondrial antibodies (AMA), akhona cishe ku-95% yabantu abane-PBC.

Ukuhlolwa kwegazi okwengeziwe kungase kuhlanganise ukuhlola amanye ama-autoantibodies nokulinganisa amazinga akho e-bilirubin. Lezi zisiza ukudweba isithombe esiphelele sokuthi isibindi sakho sisebenza kanjani nokuthi iphethini yonakalo ihambisana ne-PBC.

Izifundo zokubuka izithombe ezinjenge-ultrasound, i-CT scans, noma i-MRI zingase zisetshenziswe ukubuka usakhiwo lwesibindi sakho futhi ukhiphe ezinye izimo. Kwezinye izimo, udokotela wakho angase aphakamise i-liver biopsy ukuhlola inyama yesibindi ngaphansi komkhiqizo futhi aqinisekise ukuxilongwa.

Inqubo yokuxilonga ingase ithathe isikhathi esithile, njengoba udokotela wakho efuna ukuba ophelele futhi acubungule zonke izinketho. Le ndlela eqaphelayo iqinisekisa ukuthi uthola ukuxilongwa okuchane kakhulu kanye nenqubo yokwelapha efanele.

Kuyini ukwelashwa kwe-Primary Biliary Cholangitis?

Ukwelashwa kwe-PBC kugxile ekuthuthukiseni ukuqhubeka kwesifo, ukuphatha izimpawu, nokuvimbela izinhlanganisela. Imithi eyinhloko yi-ursodeoxycholic acid (UDCA), esiza ekuthuthukiseni ukugeleza kwe-bile futhi ingase icindezele ukonakala kwesibindi.

I-UDCA ngokuvamile iyilona ukwelashwa lokuqala udokotela wakho azolikhuthaza. Ngokuvamile kuyatholakala futhi kungase kunciphisa kakhulu ukuqhubeka kwe-PBC kubantu abaningi. Cishe uzodinga ukuthatha le mithi isikhathi eside, futhi udokotela wakho uzoqapha impendulo yakho ngokuhlonzwa kwegazi okuqhubekayo.

Uma i-UDCA yodwa inganele, udokotela wakho angase enze i-obeticholic acid, enye imithi engasiza ekuthuthukiseni umsebenzi wesibindi. Abanye abantu nabo bayazuza emithini efana ne-fibrates, engasiza amazinga e-cholesterol nokutheleleka kwesibindi.

Ukuphatha izimpawu kubalulekile ngokulinganayo. Ngokukhahlela, udokotela wakho angase anikeze i-cholestyramine noma ezinye izidakamizwa. Ukukhathala kungase kube nzima ukuwelapha, kodwa ukuguqulwa kwesitayela sokuphila kanye nezinye izidakamizwa kungasiza ekuthuthukiseni amazinga wakho kwamandla.

Ezimeni eziphambili lapho isibindi sonakele kakhulu, ukutshalwa kwesibindi kungase kudingeke. Izindaba ezinhle ukuthi imiphumela yokutshalwa kwesibindi ye-PBC ngokuvamile iyahle, ngemiphumela ephumelelayo kakhulu nokuphila okude okuhle.

Ungayilawula kanjani i-Primary Biliary Cholangitis ekhaya?

Ukukhathalela wena ekhaya kudlala indima ebalulekile ekulawuleni i-PBC nokugcina ikhwalithi yakho yokuphila. Gxila ekudleni ukudla okulinganiselayo okusekela impilo yesibindi ngenkathi uqaphela noma yimaphi ama-deficiencies okudla angase avele.

Udokotela wakho angase aphakamise izithasiselo zamavithamini ahlanganiswe namafutha (A, D, E, ne-K) njengoba i-PBC ingathinta ukuthi umzimba wakho ufuna kahle lezi zondlo. I-calcium ne-vitamin D kubalulekile ikakhulukazi empilweni yamathambo, njengoba i-PBC ingakhuphula ingozi yakho ye-osteoporosis.

Ukuphatha ukukhathala ngokuvamile kudinga ukufumana ibhalansi efanele phakathi kwemisebenzi nokuphumula. Ukuzivocavoca okuvamile, okulula njengokuhamba noma ukubhukuda empeleni kungasiza ekuthuthukiseni amazinga akho kwamandla ngokuhamba kwesikhathi. Lalela umzimba wakho futhi ungazicindezeli kakhulu ezinsukwini ezinzima.

Ngokukhahlela okukhulu, zama ukugcoba amanzi afudumele nge-oatmeal noma i-baking soda, sebenzisa ama-moisturizers angenayo i-fragrance, futhi ugcine ikhaya lakho lipholile futhi libe nomswakama. Gwema amasoseji amakhulu futhi khetha ama-cleansers alula, afunxa umswakama esikhundleni salokho.

Ukuphatha ukucindezeleka kubalulekile njengoba ukucindezeleka okuqhubekayo kungenza izimpawu zibe zimbi. Cabanga ngezindlela ezinjengokucamngca, ukuzivocavoca kokuphefumula okujulile, noma i-yoga elula. Abantu abaningi bathola ukuthi ukujoyina amaqembu wokusekela, ngokomuntu noma ku-inthanethi, kubasiza ukuba bahlanganyele nezici zomzwelo zokuphila nesimo esingapheli.

Kufanele ulungiselele kanjani i-appointment yakho yodokotela?

Ukulungiselela i-appointment yakho kusiza ukuqinisekisa ukuthi uthola okuningi ngesikhathi sakho nodokotela wakho. Qala ngokubhala zonke izimpawu zakho, kuhlanganise nokuthi zaqala nini nokuthi zithinta kanjani impilo yakho yansuku zonke.

Letha uhlu oluphelele lwazo zonke izidakamizwa ozithathayo, kuhlanganise nemithi yokwelapha, imithi yokuthengwa ngaphandle kwesikripthi, kanye nezithasiselo. Buye uqoqe noma yimaphi imiphumela yokuhlolwa yangaphambili noma amarekhodi ezempilo ahlobene nempilo yesibindi sakho.

Lungisa uhlu lwemibuzo ofuna ukuyibuza. Lezi zingase zihlanganise imibuzo mayelana nezinketho zakho zokwelapha, ukuguqulwa kwesitayela sokuphila okufanele ukwenze, izimpawu okufanele uzibheke, noma ukuthi uzodinga kaningi kangakanani i-appointments zokulandelela.

Cabanga ngokuletha ilungu lomndeni noma umngani e-appointment yakho. Bangakusiza ukuba ukhumbule ulwazi olubalulekile futhi banikeze ukwesekwa komzwelo, ikakhulukazi uma uthola izindaba ezinzima noma imiyalo yokwelapha eyingozi.

Bhala umlando wezokwelapha womndeni wakho, ikakhulukazi noma yimaphi amahlobo ane-liver disease, izimo ze-autoimmune, noma i-PBC. Lolu lwazi lungaba lubalulekile ekulinganisweni nodokotela wakho kanye nohlelo lokwelapha.

Yini eyinhloko mayelana ne-Primary Biliary Cholangitis?

Into ebaluleke kakhulu okumele uyiqonde mayelana ne-PBC ukuthi ngenkathi kuyisimo esinzima, ilawuleka kakhulu ngokwelashwa nokukhathalela okufanele. Abantu abaningi abane-PBC baphila impilo evamile, ehlangabezana lapho basebenza eduze neqembu labo lokunakekelwa kwezempilo.

Ukuxilongwa kwasekuqaleni nokwelashwa kwenza umehluko omkhulu kwimiphumela. Uma uhlushwa izimpawu noma unezinto ezingaba yingozi ze-PBC, ungangabazi ukukhuluma nazo nodokotela wakho. Lapho ukwelashwa kuqala, i-outlook yakho yesikhathi eside ilungile.

Khumbula ukuthi i-PBC ithinta wonke umuntu ngokuhlukile. Isipiliyoni sakho singase sihluke kakhulu kunesomunye umuntu, futhi lokho kuyinto evamile. Gxila ekusebenzeni neqembu lakho lokunakekelwa kwezempilo ukuthuthukisa uhlelo lokwelapha olusebenza ngokukhethekile kuwe.

Hlala unolwazi mayelana nesimo sakho, kodwa ungavumeli sikucacise. Ngokwelashwa lanamuhla nocwaningo oluqhubekayo, i-outlook yabantu abane-PBC iyaqhubeka ithuthuka. Thatha izinto usuku ngosuku futhi gubha izinqoba ezincane endleleni.

Imibuzo evamile ebuzwa mayelana ne-Primary Biliary Cholangitis

Ingabe i-Primary Biliary Cholangitis ifana ne-Primary Sclerosing Cholangitis?

Cha, lezi yizimo ezimbili ezihlukile, nakuba zombili zithinta imithambo ye-bile. I-Primary Biliary Cholangitis (PBC) ikakhulukazi ithinta imithambo emincane ye-bile ngaphakathi kwesibindi futhi ivame kakhulu kwabesifazane. I-Primary Sclerosing Cholangitis (PSC) ithinta imithambo emikhulu ye-bile futhi ivame kakhulu kumadoda. Zinimbangela ezihlukile, izimpawu, nokwelashwa, ngakho-ke kubalulekile ukuthola ukuxilongwa okulungile.

Ngingasaba nezingane uma ngine-PBC?

Abesifazane abaningi abane-PBC bangaba nokukhulelwa okunempilo, kodwa kudinga ukuhlela okucophelelayo nokuqapha. Kuzodingeka usebenze eduze nodokotela wakho wesibindi nodokotela wakho wokubeletha ukuze ulawule imithi yakho futhi uqaphe umsebenzi wesibindi sakho phakathi kokukhulelwa. Eminye imithi ye-PBC ingase idingeke ukulungiswa noma iyeke okwesikhashana ngesikhathi sokukhulelwa, ngakho-ke xoxa ngezinhloso zakho zokuhlela umndeni nodokotela wakho kwasekuqaleni.

Ingabe ngizodinga ukutshalwa kwesibindi?

Abantu abaningi abane-PBC abadingi ukutshalwa kwesibindi, ikakhulukazi lapho isimo sixilongwe kwasekuqaleni futhi siphathwe ngokufanele. Ngokwelashwa lamanje njenge-UDCASTLE imithi yanamuhla, abantu abaningi bagcina umsebenzi omuhle wesibindi iminyaka noma ngisho nemashumi eminyaka. Ukutshalwa ngokuvamile kucabangelwa kuphela ezimweni eziphambili lapho isibindi sonakele kakhulu futhi ezinye izindlela zokwelapha azisebenzi kahle.

Ingabe ukuguqulwa kokudla kungasiza ekulawuleni i-PBC?

Ngenkathi kungekho “ukudla kwe-PBC” okuqondile, ukudla kahle kungasekele impilo yakho yonke yesibindi futhi kusize ekulawuleni izimpawu. Gxila ekudleni okulinganiselayo okunothile izithelo, imifino, ama-grains aphelele, namaprotheni alula. Ungase udinge ukulinganisela usawoti uma une-fluid retention, futhi udokotela wakho angase aphakamise izithasiselo zamavithamini. Ukugwema utshwala ngokuvamile kunconywa ukuvimbela ukucindezeleka okwengeziwe kwesibindi.

Ngingadinga kaningi kangakanani ukuhlolwa kwezokwelapha?

Ukuvamile kwe-appointments zakho kuncike esigabeni sesifo sakho nokuthi uphendula kanjani ekwelapheni. Ekuqaleni, ungase ubona udokotela wakho njalo ngenyanga ezintathu kuya kweziyisithupha ukuze uhlolwe igazi nokubuka izimpawu. Uma isimo sakho siqinisile, i-visits ingase ibe yincane, mhlawumbe njalo ngenyanga eziyisithupha kuya kweziyishumi nambili. Udokotela wakho uzoqapha futhi izinhlanganisela futhi angase aphakamise ukuhlolwa okwengeziwe njenge-bone density scans noma izifundo zokubuka izithombe njalo.