Cholangitis Yasebili Ephambili

Izitho ze-bile zithwala i-bile evela e-liver yakho ziye esibindini sakho esincane. Uma izitho ze-bile zilimele, i-bile ingabuyela e-liver, ibangele ukulimala kwamangqamuzana e-liver. Lolu limale lungabangela ukwehluleka kwe-liver.

I-primary biliary cholangitis yisifo sokuzikhukhumeza komzimba lapho izitho ze-bile zivuvukala futhi zibhujiswe kancane kancane. Ngaphambili kwakubizwa ngokuthi i-primary biliary cirrhosis.

I-bile yisigaxa esenziwa e-liver. Sisiza ekudayiseni nasekuthatheni amavithamini athile. Siphinde sisize umzimba uthathe amafutha futhi ususe i-cholesterol, izinto eziyingozi namangqamuzana egazi abomvu asebenze kakhulu. Ukuvuvukala okuqhubekayo e-liver kungabangela ukuvuvukala nokulimala kwezitho ze-bile okwaziwa ngokuthi i-cholangitis. Ngezinye izikhathi, lokhu kungabangela ukwenziwa kwamabala okungapheli kwelisu, okuthiwa yi-cirrhosis. Kungabangela nokuhluleka kwe-liver ekugcineni.

Nakuba lithinta bobabili abesilisa nabesifazane, i-primary biliary cholangitis ithinta kakhulu abesifazane. Kubhekwa njengesifo sokuzikhukhumeza komzimba, okusho ukuthi uhlelo lokuphepha lomzimba wakho luhlasela ngephutha amangqamuzana nezicubu eziphilile. Abacwaningi bacabanga ukuthi ukuxubana kwezinto ezivela ezifundweni nasezindaweni ezizungezile kuqalisa lesi sifo. Ngokuvamile sithuthuka kancane kancane. Kulesi sikhathi, asikho isilondolozi se-primary biliary cholangitis, kodwa imithi inganciphisa ukulimala kwe-liver, ikakhulu uma ukwelashwa kuqala ngokushesha.

Ngaphezu kwengxenye yabantu abane-primary biliary cholangitis abanawo noma yimaphi imimonyo ebonakalayo uma behlonishwa. Isikweletu singahlolwa uma kuenziwa ukuhlolwa kwegazi ngezizathu ezingezona, njengokuvivinya okuvamile. Iimpawu zivele zikhule eminyakeni emi-5 kuya kwengu-20 elandelayo. Labo abanemimonyo uma behlonishwa ngokuvamile baba nemiphumela emibi.

Izimpawu zokuqala ezivamile zihlanganisa:

• Ukukhathala.
• Ukukhahlela kwesikhumba.

Futhi izimpawu nezimpawu kamuva zingafaka:

• Ukufiphaza kwesikhumba namehlo, okuthiwa yi-jaundice.
• Amehlo nomlomo owomile.
• Ubuhlungu ngakwesokudla phezulu esiswini.
• Ukukhula kwespleen, okuthiwa yi-splenomegaly.
• Ubuhlungu lwamathambo, imisipha noma amajoyinti.
• Izinyawo nezinyawo eziqengqelekayo.
• Ukubunjwa kwamanzi esiswini ngenxa yokwehluleka kwesibindi, okuthiwa yi-ascites.
• Ukufakwa kwamafutha, okuthiwa yi-xanthomas, esikhumbeni sokuzungezile amehlo, ama-eyelids noma ezikhefini zezandla, izinyawo, ama-elbows noma amadolo.
• Ukufiphaza kwesikhumba okungaxhunyanisiwe nokukhanya kwelanga, okuthiwa yi-hyperpigmentation.
• Amathambo abuthakathaka futhi abuthakathaka, okuthiwa yi-osteoporosis, okuholela ekuqhekekeni kwawo.
• I-cholesterol ephezulu.
• Ukululama okungase kuhlanganise izisu ezinobukhulu, okuthiwa yi-steatorrhea.
• I-thyroid engasebenzi kahle, okuthiwa yi-hypothyroidism.
• Ukulahlekelwa isisindo.

Akuqondakali ukuthi yini ebangela i-primary biliary cholangitis. Ochwepheshe abaningi bayibheka njengesiifo sokuzikhukhumeza komzimba lapho umzimba uziqhuma khona. Abacwaningi bakholelwa ukuthi le mpendulo yokuzikhukhumeza ingase iqalwe izinto ezingqongile nezinto ezivela ezifundweni. Ukuvuvukala kwesibindi okubonwa ku-primary biliary cholangitis kuqala lapho izinhlobo ezithile zamaseli amhlophe egazi okuthiwa yi-T cells, aziwa nangokuthi yi-T lymphocytes, ziqala ukuqoqana esibindini. Ngokuvamile, la maseli okuvikela umzimba athola futhi asize ekuvikeleni emagciwini, njengebhaktheriya nezinambuzane. Kodwa ku-primary biliary cholangitis, abhubhisa ngephutha amaseli aphilile ahlanganisa imithambo emincane ye-bile esibindini. Ukuvuvukala emithambeni emincane kunyakaza futhi ekugcineni konakalisa amanye amaseli esibindini. Njengoba amaseli efa, athathelwa indawo yi-scar tissue, eyaziwa nangokuthi yi-fibrosis, engaletha i-cirrhosis. I-Cirrhosis ukwenziwa kwe-scar tissue esibindini okwenza kube nzima esibindini sakho ukusebenza kahle.

Izici ezilandelayo zingase zikhulise ingozi yakho ye-cholangitis ekuqaleni:

• Ubulili. Abantu abaningi abane-cholangitis ekuqaleni bangabesifazane.
• Ubudala. Kuvame kakhulu ukwenzeka kubantu abaneminyaka engama-30 ukuya kwengu-60.
• I-Genetics. Kunokwenzeka ukuthi uthole le simo uma unelungu lomndeni elinalo noma ebelilinayo.
• I-Geography. Kuvame kakhulu kubantu abavela enyakatho yeYurophu, kodwa i-cholangitis ekuqaleni ingathinta zonke izizwe nezinhlobo.

Abacwaningi bacabanga ukuthi izici ze-genetic ezihlangene nezici ezithile zezindawo eziphilayo zibangela i-cholangitis ekuqaleni. Lezi zici zezindawo eziphilayo zingafaka:

• Ukutheleleka, njengokutheleleka kwezindlela zokukhishwa kwemizimba.
• Ukubhema iziqhumane, ikakhulukazi isikhathi eside.
• Ukuvezwa ekemikhini enobuthi, njengasezindaweni ezithile zomsebenzi.

Njengoba ukulimala kwesibindi kuya kubi, i-primary biliary cholangitis ingabangela izinkinga zezempilo ezinzima, okuhlanganisa:

• Ukushwabana kwesibindi, okuthiwa yi-cirrhosis. I-Cirrhosis yenza kube nzima ukuthi isibindi sakho sisebenze futhi kungase kube yimbangela yokwehluleka kwesibindi. Kusho isigaba esiphezulu se-primary biliary cholangitis. Abantu abane-primary biliary cholangitis ne-cirrhosis banesimo sezempilo esibi. Banesikhathi esiningi sokuthola ezinye izinkinga.
• Ukuqina kwespleen, okuthiwa yi-splenomegaly. I-spleen yakho ingaqina ngamaseli egazi amhlophe nama-platelets. Lokhu kungenxa yokuthi umzimba wakho awusayihlanza ubuthi egazini njengoba kufanele.
• Amatshe e-gallbladder namatshe e-bile duct. Uma i-bile ingakwazi ukugeleza nge-bile ducts, ingaqina ibe yamathe e-ducts. La matshe angabangela ubuhlungu nokutheleleka.
• Ukuqina kwesibindi. Ukushwabana kwesibindi kukwandisa amathuba okuqina kwesibindi. Uma unesibindi esishwabene, uzodinga ukuhlolwa njalo komdlavuza.
• Amathambo abuthakathaka, okuthiwa yi-osteoporosis. Abantu abane-primary biliary cholangitis banesikhathi esiningi sokuthola amathambo abuthakathaka, abuthakathaka angaphula kalula.
• Ukwehluleka kwe-vitamin. Ukungabi nama-bile anele kuchaphazela ikhono lomzimba wakho lokudla amafutha nama-vitamin ahlaliswa amafutha, i-A, i-D, i-E ne-K. Ngenxa yalokhu, abanye abantu abane-primary biliary cholangitis ephambili bangaba namanani aphansi ala ma-vitamin. Amanani aphansi angabangela izinkinga zezempilo ezihlukahlukene, okuhlanganisa ukubona ebusuku nokuphuza igazi.
• Ukuphakama kwe-cholesterol. Abantu abafika ku-80% abane-primary biliary cholangitis banesilinganiso esiphezulu se-cholesterol.
• Ukunciphisa umsebenzi wengqondo, okuthiwa yi-hepatic encephalopathy. Abanye abantu abane-primary biliary cholangitis ephambili ne-cirrhosis banokushintsha kwesimo sengqondo. Bangaba nezinkinga zokukhumbula nokugxila.
• Ukuthola izifo ezinye. I-primary biliary cholangitis ihlotshaniswa nezinye izifo, okuhlanganisa neziqeda i-thyroid, isikhumba namalunga. Ingase ihlangane nemihlobiso yamehlo nomlomo, isifo esithi yi-Sjogren's syndrome.

Uchwepheshe wakho wezempilo uzokubuza ngomlando wakho wezempilo kanye nomlando wezempilo yomndeni wakho, futhi enze ukuhlolwa komzimba. Izivivinyo nezinqubo ezilandelayo zingasetshenziswa ukuthola i-cholangitis yokuqala ye-biliary. Izivivinyo zegazi: Izivivinyo zesibindi. Lezi zihloli zegazi ziqapha amazinga ezinye izinto ezihlanganisiwe ezingase zibonise isifo sesibindi nokulimala komthambo we-bile. Izivivinyo ze-antibody zezimpawu zesifo sokuzimela komzimba. Izivivinyo zegazi zingase zenziwe ukuhlola ama-anti-mitochondrial antibodies, aziwa nangokuthi yi-AMAs. Lezi zinto aziveli lutho kubantu abangenayo leyo gciwane, ngisho noma benesinye isifo sesibindi. Ngakho-ke, ukuhlolwa okuhle kwe-AMA kubhekwa njengophawu olukhulu lalesi sifo. Noma kunjalo, inani elincane labantu abane-cirrhosis yokuqala ye-biliary abanayo i-AMAs. Ukuhlolwa kwe-cholesterol. Ngaphezu kwengxenye yabantu abane-cholangitis yokuqala ye-biliary banokwanda okukhulu kwamafutha egazi, kufaka phakathi amazinga e-cholesterol ephelele. Izivivinyo ze-imaging zingasiza iqembu lakho lezokunakekelwa kwezempilo ukuqinisekisa ukuxilongwa noma ukukhipha ezinye izimo ezinezimpawu ezifanayo. Izivivinyo ze-imaging ezibheka isibindi nemisila ye-bile zingafaka: I-ultrasound. I-ultrasound isebenzisa amaza omsindo aphezulu ukuvelisa izithombe zezakhiwo ezikulo mzimba wakho. I-FibroScan. Usebenzisa i-probe efana ne-ultrasound, le nqubo ingathola ukwenziwa kwe-scarring yesibindi. I-Magnetic resonance cholangiopancreatography, eyaziwa nangokuthi yi-MRCP. Le MRI ekhethekile yenza izithombe eziningi zezitho zakho nemisila ye-bile. I-Magnetic resonance elastography, eyaziwa nangokuthi yi-MRE. I-MRI ihlanganiswe namaza omsindo ukuveza imephu yombono yezitho zangaphakathi, ebizwa ngokuthi yi-elastogram. Ukuhlolwa kusetshenziswa ukuthola ukukhuluphala kwesibindi okungase kube uphawu lwe-cirrhosis. Uma ukuxilongwa kusekusabambezeleka, uchwepheshe wakho wezempilo angase enze i-biopsy yesibindi. Isibonelo esincane se-tissue yesibindi sisuswa ngokusika usebenzisa i-needle encane. Sibe selivivinywa elabhorethri, ukuqinisekisa ukuxilongwa noma ukuthola ubukhulu besifo. Ukunakekelwa eMayo Clinic Iqembu lethu lokunakekela labaqeqeshwe beMayo Clinic lingakusiza ngezinkinga zakho zezempilo ezihlobene ne-cholangitis yokuqala ye-biliary Qala Lapha Ulwazi Olwengeziwe Ukunakekelwa kwe-cholangitis yokuqala ye-biliary eMayo Clinic I-CT scan I-biopsy yesibindi I-MRI Bonisa olunye ulwazi oluhlobene

Ukwelapha isifo Akukho ukwelapha i-cholangitis yasekuqaleni ye-biliary, kepha kukhona imithi ekhona ekusiza ekuthambiseni ukuqhubeka kwesifo nokuvimbela izinkinga. Izindlela zihlanganisa: I-Ursodeoxycholic acid. Lolu lwemi, olukwaziwa nangokuthi yi-UDCA noma i-ursodiol (i-Actigall, i-Urso), luvamise ukusetshenziswa kuqala. Lusiza ekuhambiseni i-bile ngaphesheya kwesibindi sakho. I-UDCA ayilulaphi i-cholangitis yasekuqaleni ye-biliary, kepha kubonakala sengathi ilungisa umsebenzi wesibindi futhi inquma ukwenziwa kwesibindi. Kuncane amathuba okuthi kusize ngokukhahlela nokuqeda amandla. Imiphumela emibi ingaba ukwanda kobunzima, ukulahleka kweenwele nokukhahlela. I-Obeticholic acid (i-Ocaliva). Izifundo zibonisa ukuthi uma i-obeticholic acid inikezwa yodwa noma ihlanganiswe ne-ursodiol izinyanga eziyi-12, ingasiza ekuthuthukiseni umsebenzi wesibindi nokuthambisa i-liver fibrosis. Noma kunjalo, ukusetshenziswa kwayo kuvame ukulinganiselwa ngoba kungabangela ukwanda kokukhahlela. Ama-fibrates (i-Tricor). Abacwaningi abaqiniseki ngokuphelele ukuthi lolu lwemi lusebenza kanjani ekusizeni ukunciphisa izimpawu ze-cholangitis yasekuqaleni ye-biliary. Kepha, uma kuthathwa ne-UDCA, kunciphise ukuvuvukala kwesibindi nokukhahlela kwabanye abantu. Kuyadingeka izifundo eziningi ukuze kuqondwe izinzuzo zesikhathi eside. I-Budesonide. Uma ihlanganiswe ne-UDCA, i-corticosteroid budesonide ingaba yinzuzo enhle ye-cholangitis yasekuqaleni ye-biliary. Noma kunjalo, lolu lwemi luhambisana nemiphumela emibi ehlobene ne-steroid kubantu abanesifo esithuthukile. Kuyadingeka ukuhlolwa okuningi kwesikhathi eside ngaphambi kokuba i-budesonide ibe yisikhuthazo sokwelapha lesi simo. Ukuhlinzwa kwesibindi. Uma imithi ingasayilawuli i-cholangitis yasekuqaleni ye-biliary futhi isibindi siqala ukwehluleka, ukuhlinzwa kwesibindi kungasiza ekudedeleni impilo. Ukuhlinzwa kwesibindi kuqeda isibindi sakho esigula ngesibindi esinempilo esivela kumnikelo. Ukuhlinzwa kwesibindi kuhambisana nemiphumela emihle yesikhathi eside kubantu abane-cholangitis yasekuqaleni ye-biliary. Noma kunjalo, ngezinye izikhathi isifo sibuyela eminyakeni embalwa kamuva esibindini esitholiwe. Ukwelapha izimpawu Iqembu lakho lokunakekelwa kwezempilo lingakuncoma ukwelashwa ukuze kulawule izimpawu nezibonakaliso ze-cholangitis yasekuqaleni ye-biliary futhi kukwenze ukhululeke. Ukwelapha ukukhathala I-cholangitis yasekuqaleni ye-biliary ibangela ukukhathala. Kepha imikhuba yakho yansuku zonke, ukudla okuhle nokuzivocavoca, nezinye izimo zezempilo zingathinta indlela ozizwa uqede amandla ngayo. Kubalulekile futhi ukuhlolwa ukuze kuvinjelwe isifo se-thyroid njengoba sivame kakhulu kubantu abane-cholangitis yasekuqaleni ye-biliary. Ukwelapha ukukhahlela Ama-antihistamines avame ukusetshenziswa ekuthambiseni ukukhahlela. Angasiza ngokulala uma ukukhahlela kukugcina uvukile. Ama-antihistamines angaba yi-diphenhydramine, i-hydroxyzine hydrochloride ne-loratadine. I-Cholestyramine yiphawuda elingase liyeke ukukhahlela. Kufanele ihlanganiswe nokudla noma izinto eziphuzwayo. I-Rifampin iyilutho lokulwa nezifo ezingase liyeke ukukhahlela. Indlela elikwenza ngayo lokhu ayaziwa. Abacwaningi bacabanga ukuthi kungase kuvimbele impendulo yengqondo ezinto ezikhuthaza ukukhahlela egazini. Abaphikisi be-opioid njengalabo abane-naloxone ne-naltrexone bangasiza ukukhahlela okuhlobene nesifo sesibindi. Njenge-rifampin, le miyeke kubonakala sengathi inquma umuzwa wokukhahlela ngokusebenza ebuchosheni bakho. I-Sertraline iyilutho lokwelapha olukhulisa i-serotonin ebuchosheni, elibizwa ngokuthi yi-selective serotonin reuptake inhibitor, noma i-SSRI. Ingasiza ekuthambiseni ukukhahlela. Ukwelapha amehlo omile nomlomo Ama-tears angenhla nezinye izinto ezithatha indawo yesaliva zingasiza ekuthambiseni amehlo omile nomlomo. Zingatholakala ngaphandle noma ngaphandle kwesikripthi. Ukukoma i-gum noma ukuncela ushukela oluqinile kungakusiza futhi ukwenze usaliva eminingi futhi kuphakamise umlomo owomile. Ukwelapha izinkinga Ezinye izinkinga zivame ukuhlobene ne-cholangitis yasekuqaleni ye-biliary. Iqembu lakho lokunakekelwa kwezempilo lingakuncoma: Izithasiselo zevithamini neziminithi. Uma umzimba wakho ungawagcini amavithamini noma ezinye izondlo, kungadingeka uthathe amavithamini A, D, E ne-K. Ungase futhi udinga izithasiselo zekhalsiyam, i-folic acid noma insimbi. Ukwelapha ukunciphisa i-cholesterol. Uma unezinga eliphezulu le-cholesterol egazini lakho, iqembu lakho lokunakekelwa kwezempilo lingakuncoma ukusebenzisa imithi ebizwa ngokuthi yi-statin ukuze ikusize ekuthambiseni amazinga akho. Imithi yokwelapha ukulahleka kwamathambo. Uma unemathambo abuthakathaka noma abuncane, okuthiwa yi-osteoporosis, ungase unikezwe imithi noma izithasiselo, njengekhalsiyam ne-vitamin D, ukuze unciphise ukulahleka kwamathambo futhi uthuthukise ubukhulu bamathambo. Ukuzivocavoca njengokuhamba nokusebenzisa izinto ezilula izinsuku eziningi ngesonto kungasiza ekuthuthukiseni ubukhulu bamathambo akho. Ukwelapha ukwanda kokucindezela e-portal vein, okuthiwa yi-portal hypertension. Iqembu lakho lokunakekelwa kwezempilo cishe lizokuhlola futhi likuqaphele i-portal hypertension nezinsimbi ezinkulu uma une-scarring ethuthukile yesifo sesibindi. Ukuba namanzi esibindini kuyisici esivamile se-portal hypertension. Ngamanzi ambalwa esibindini, iqembu lakho lokunakekelwa kwezempilo lingakuncoma kuphela ukulinganisela usawoti ekudleni kwakho. Izimo ezinzima kakhulu zingadinga imithi ebizwa ngokuthi yi-diuretics noma inqubo yokususa amanzi okuthiwa yi-paracentesis. Ulwazi Olwengeziwe ukunakekelwa kwe-cholangitis yasekuqaleni ye-biliary eMayo Clinic Ukuhlinzwa kwesibindi Cela i-aphoyintimenti

Ukuphila nesifo sesibindi esingapheli esingenayo imithi kungadumaza. Ukukhathala nje kuphela kungathinta kakhulu ikhwalithi yokuphila kwakho. Umuntu ngamunye uthola izindlela zokubhekana nokucindezeleka kwesifo esingapheli. Ngokuhamba kwesikhathi, uzothola okusebenza kuwe. Nazi ezinye izindlela zokuqala: Funda ngesimo sakho. Okwengeziwe oqonda nge-primary biliary cholangitis, kakhulu ongahlanganyela ekunakekelweni kwakho. Ngaphezu kokukhuluma neqembu lakho lokunakekelwa kwezempilo, funa ulwazi ebhukwini lakho lomphakathi nakwiwebhusayithi ezihambisana nezinhlangano ezidumile njenge-American Liver Foundation. Zinike isikhathi. Ukudla kahle, ukuzivocavoca nokupumula ngokwanele kungakusiza uzizwe kangcono. Zama ukuhlela kusengaphambili izikhathi lapho ungadinga khona ukuphumula okwengeziwe. Thola usizo. Uma abangane noma umndeni befuna ukusiza, bavumele. I-primary biliary cholangitis ingakhathalisa, ngakho-ke yamukela usizo uma othile efuna ukuthenga impahla yakho, ukugeza izingubo noma ukupheka ukudla kwakho. Tshela labo abanikezayo usizo ukuthi yini oyidingayo. Funani ukwesekwa. Ubuhlobo obuqinile bungakusiza ugcine isimo sengqondo esihle. Uma abangane noma umndeni benenkinga yokuqonda ukugula kwakho, ungathola ukuthi iqembu lokusekela lingasiza.