Utholakala Lwe-Whipple? Izimpawu, Izimbangela, Nokwelapha

Utholakala lwe-Whipple luyisifo esibangelwa yibhaktheriya elingavamile elihlasela ikakhulukazi amabele amancane futhi lingasakazeka kwamanye amalunga omzimba. Lesi simo senzeka lapho ibhaktheriya ethile ebizwa nge-Tropheryma whipplei ihlasela ukugqoka kwamabele amancane futhi iphazamise ikhono lomzimba lokufunxa izondlo ngendlela efanele.

Nakuba lokhu kungase kubonakale kukhathaza, izindaba ezinhle ukuthi utholakala lwe-Whipple luphethwe kahle ngokwelashwa ngama-antibiotic uma kubanjwa ngokushesha. Ukuqonda izimpawu nokuthola ukunakekelwa okufanele kwezokwelapha kungabangela ukuphulukiswa okugcwele kubantu abaningi.

Ziyini izimpawu zokutholakala kwe-Whipple?

Izimpawu zokutholakala kwe-Whipple zivame ukuvela kancane kancane futhi zingaba zahlukene kakhulu, okwenza ukutholakala kwesifo kube nzima ngezinye izikhathi. Ukuqala umzimba wakho ubonisa izimpawu ezihlobene nokufunxa okungafanele izondlo, kulandele ezinye iziphumo zomzimba njengoba ukutheleleka kusakazeka.

Izimpawu zokuqala ezivamile ongazihlangabezana nazo zihlanganisa:

• Ukuxhinga okungapheli okungase kube namanzi noma okunefutha
• Ukulahlekelwa isisindo esikhulu naphezu kokuba nesifiso sokudla esijwayelekile
• Ubuhlungu besisu nokuqina
• Ubuhlungu bezingqimba nokuvuvukala, ikakhulukazi ezandleni, emadolweni, nasezinqenqemeni
• Ukukhathala nobuthakathaka
• Ukukhukhumeka negesi

Njengoba isimo siqhubeka, ungase uqaphele izimpawu ezengeziwe ezihlasela amanye amasosha omzimba. Lezi zingase zihlanganise ukufiphaza, ama-lymph nodes avuvukile, ukumnyama kwesikhumba, kanye nezimpawu zezinzwa njengokudideka noma izinkinga zokukhumbula ezimweni eziphambili.

Kubalulekile ukuphawula ukuthi ubuhlungu bezingqimba buvame ukuvela eminyakeni eminingi ngaphambi kwezimpawu zokugaya ukudla, okwenza ukuxhumana nokutholakala kwe-Whipple kube lula ekuqaleni. Yingakho abantu abaningi behlangabezana nokulibaziseka ekutholeni ukuxilongwa.

Yini ebangela utholakala lwe-Whipple?

Utholakala lwe-Whipple lubangelwa ukutheleleka ngebhaktheriya ebizwa nge-Tropheryma whipplei. Le bhaktheriya ikhethekile ngoba ikhula kancane kakhulu futhi ingaba nzima ukuyithola ngamaviki okuhlola ajwayelekile.

Ibhaktheriya ihlasela ikakhulukazi ukugqoka kwamabele amancane, lapho iphazamisa khona ukufunxa okujwayelekile kwezondlo. Ngokuhamba kwesikhathi, uma kushiywa lungalashwa, ukutheleleka kungasakazeka ngesistimu yakho ye-lymphatic kwamanye amalunga omzimba, kuhlanganise nenhliziyo, amaphaphu, ubuchopho, nezingqimba.

Okwenza lesi simo sibe ngokukhethekile kuyiqiniso ukuthi ibhaktheriya ibonakala ikhona endaweni, kodwa abantu abaningi abahlangana nayo abathuthuki lesi sifo. Lokhu kusikisela ukuthi abantu abathile bangase babe nokuthambekela kwezakhiwo noma isici sesistimu yabo yokulwa nezifo esibenza babe sengozini yokutheleleka.

Abacwaningi bakholelwa ukuthi abantu abathuthukisa utholakala lwe-Whipple bangase babe nokuntuleka okukhethekile kwesistimu yabo yokulwa nezifo okubavimbela ekuqedeni le bhaktheriya ngokuphumelelayo, yize isistimu yabo yokulwa nezifo isebenza ngokujwayelekile ezinye izifo.

Nini okumele ubone udokotela ngokutholakala kwe-Whipple?

Kufanele ufunuke ukunakekelwa kwezokwelapha uma uhlangabezana nezimpawu zokugaya ukudla ezingapheli ezihlangene nokulahlekelwa isisindo okungachazeki, ikakhulukazi uma lezi zimpawu zihlala amasonto amaningana. Ukuxilongwa okusheshayo nokwelashwa kungavimbela ukutheleleka ukusakazeka kwamanye amalunga.

Xhumana nodokotela wakho ngokushesha uma uqaphela:

• Ukuxhinga okungapheli okuphephe amasonto ambalwa
• Ukulahlekelwa isisindo okungazange kuhlelwe kwamapounds angu-10 noma ngaphezulu
• Ubuhlungu besisu obuqhubekayo ngezinguquko zokugaya ukudla
• Ubuhlungu bezingqimba obungapheli obuphulukisi ngokuphumula noma ngemithi yokwelapha engaphezu kokuthengwa
• Ukukhathala okuqhubekayo okuhlupha imisebenzi yansuku zonke

Funuka ukunakekelwa kwezokwelapha ngokushesha uma uthuthukisa izimpawu zezinzwa njengokudideka, izinkinga zokukhumbula, ubunzima bokuhamba, noma izinguquko embonweni. Lokhu kungase kubonise ukuthi ukutheleleka kusakazeke ohlelweni lwakho lwezinzwa futhi kudinga ukwelashwa okusheshayo.

Khumbula ukuthi utholakala lwe-Whipple luyisifo elingavamile, ngakho izimpawu zakho zivame ukubangelwa ezinye izimo ezivamile. Noma kunjalo, uma ukwelashwa okujwayelekile kwezinkinga zokugaya ukudla kungakusizi, kufanele uxoxe ngokwenzeka kwezizathu ezingavamile nodokotela wakho.

Ziyini izimbangela zengozi zokutholakala kwe-Whipple?

Izici eziningi zingase zikhulise amathuba akho okukhula utholakala lwe-Whipple, yize kubalulekile ukukhumbula ukuthi lesi simo siyisifo esingavamile ngokujwayelekile. Ukuqonda lezi zici zengozi kungakusiza wena nodokotela wakho ukuhlola isimo sakho ngabanye.

Izici zengozi ezibaluleke kakhulu zihlanganisa:

• Ukuba indoda emhlophe eneminyaka ephakathi (lesi simo sihlupha amadoda kaningi ngokuphindwe ka-8 kunabesifazane)
• Ukuba nomlando womndeni wesifo, okubonisa ingxenye yezakhiwo ezingase zibe khona
• Ukuphila noma ukuvakashela izindawo zasemakhaya noma izindawo zokulima njalo
• Ukuba nokukhombisa umsebenzi ekuthungeni, ezilwaneni, noma ematsheni
• Ukuba nezinye izinguquko zezakhiwo ezithinta umsebenzi wesimiso sokulwa nezifo

Ubudala buphinde bube nomthelela, ngezimo eziningi ezenzeka kubantu abaneminyaka engama-40 kuya kwengu-60. Noma kunjalo, lesi sifo ngezinye izikhathi singathinta izingane nabantu abadala.

Kubalulekile ukuqonda ukuthi ukuba nalezi zici zengozi akusho ukuthi uzokhula utholakala lwe-Whipple. Lesi simo sihlala singavamile kakhulu, sihlupha abantu abangaphansi kwesinye kwesigidi ngonyaka. Lezi zici zisiza nje odokotela ukuqonda ukuthi ubani ongabe esengozini kancane.

Ziyini izinkinga ezingase zenzeke ngokutholakala kwe-Whipple?

Uma utholakala lwe-Whipple lungalashwa, ukutheleleka ngebhaktheriya kungasakazeka ngaphandle kwamabele amancane futhi kubangele izinkinga ezinkulu emzimbeni wakho wonke. Izindaba ezinhle ukuthi ukwelashwa okusheshayo ngama-antibiotic kungavimbela izinkinga eziningi ukuba zingakhula.

Izinkinga ezinkulu ongazihlangabezana nazo zihlanganisa:

• Ukondleka okubi kakhulu ngenxa yokufunxa okungafanele izondlo okungapheli
• Izinkinga zenhliziyo, kuhlanganise nokutheleleka kwama-valve enhliziyo (endocarditis)
• Izinkinga zezinzwa njengokulimala kokukhumbula, ukudideka, noma ukuhlwitha
• Izinkinga zombono noma izifo zokunyakaza kwamehlo
• Izinkinga zamaphaphu kuhlanganise ukukhokha okungapheli noma ukuqoqwa kwamanzi
• Ukonakala okubi kwezingqimba ngenxa yokuvuvukala okuqhubekayo

Ezimweni ezingavamile, uma ukutheleleka kufinyelela ebuchopho bakho, kungabangela ukubola kwezinzwa okuqhubekayo okungase kube nzima ukuphulukisa ngokuphelele, ngisho nokwelashwa. Yingakho ukuxilongwa okusheshayo nokwelashwa kubaluleke kakhulu.

Izindaba ezikhuthazayo ukuthi ngokwelashwa okufanele ngama-antibiotic, abantu abaningi baphulile ngokuphelele utholakala lwe-Whipple. Ngisho noma izinkinga sezikhule, eziningi zingaphulukiswa noma zithuthukiswe kakhulu ngokwelashwa okufanele.

Utholakala lwe-Whipple lutholakala kanjani?

Ukutholakala kwe-Whipple kungaba nzima ngoba izimpawu zalo zivame ukulingisa ezinye izifo zokugaya ukudla ezivamile. Udokotela wakho uzovame ukusebenzisa ukuhlolwa okuhlangene ukuqinisekisa ukuxilongwa nokukhipha ezinye izimo.

Inqubo yokuxilongwa ivame ukuqala ngomlando wezokwelapha onemininingwane kanye nokuhlolwa komzimba. Udokotela wakho uzokubuza ngezimpawu zakho, isikhathi sazo, nanoma yikuphi ukukhombisa okungenzeka okungase kukhulise ingozi yakho.

Ukuhlolwa okuqinisekile kakhulu kokutholakala kwe-Whipple yisampula yethishu evela emabeleni amancane, evame ukutholakala ngesikhathi sokugaya ukudla. Ngalesi senzo, udokotela wakho uzothatha isampula encane yethishu evela emabeleni amancane futhi ayihlole ngaphansi komkhulu ukuze abone izimpawu ezibonakalayo zokutheleleka kwe-Tropheryma whipplei.

Ukuhlolwa okuqhubekayo udokotela wakho angase aku-ode kuhlanganisa ukuhlolwa kwegazi ukuze ahlole izimpawu zokondleka okubi noma ukuvuvukala, amasampula e-stool ukuze akhiphe ezinye izimbangela zokuxhinga, kanye nezifundo zokubonisa njenge-CT scans uma kukhona ukukhathazeka ngokutheleleka ukusakazeka kwamanye amalunga.

Ithuluzi lokuxilongwa elisha elibizwa nge-PCR (polymerase chain reaction) testing lingathola izinto ezivela e-genetic zebhaktheriya emasampuleni ethishu, linikeza indlela ezwakalayo neqondile yokuqinisekisa ukuxilongwa.

Yikuphi ukwelashwa kokutholakala kwe-Whipple?

Ukwelashwa kokutholakala kwe-Whipple kuhilela inkambo ehlelwe kahle yama-antibiotic angakwazi ukususa ibhaktheriya ye-Tropheryma whipplei emzimbeni wakho. Ngokwelashwa okufanele, abantu abaningi baphulile ngokuphelele.

Ukwelashwa kwakho kuvame ukulandela indlela enezigaba ezimbili. Isigaba sokuqala sivame ukubandakanya amasonto amabili ama-antibiotic e-intravenous, ngokuvamile i-ceftriaxone noma i-penicillin, okusiza ukunciphisa ngokushesha inani lebhaktheriya ohlelweni lwakho.

Isigaba sesibili siqukethe ama-antibiotic omhlathi esikhathini eside, ngokuvamile i-trimethoprim-sulfamethoxazole, ethathwe unyaka noma emibili. Lokhu kwelashwa okwandisiwe kuyadingeka ngoba ibhaktheriya ingaba nzima ukuyisusa ngokuphelele futhi ingase ifihleke ezindaweni zomzimba wakho lapho ama-antibiotic angangeni kahle khona.

Phakathi kokwelashwa, udokotela wakho uzolandelela intuthuko yakho ngemihlangano yokulandelela njalo futhi angase aphinde athathe amasampula ukuqinisekisa ukuthi ibhaktheriya isuswa. Abantu abaningi baqala ukuzizwa bekhulu ngaphakathi kwamasonto ambalwa ngokuqala ukwelashwa, yize ukuphulukiswa okuphelele kungathatha izinyanga eziningi.

Uma unezinkinga zezinzwa, udokotela wakho angase alungise inkambo yakho yama-antibiotic ukufaka imithi engangena kahle e-blood-brain barrier, njenge-doxycycline noma i-chloramphenicol.

Indlela yokuphatha izimpawu ekhaya ngesikhathi sokwelashwa?

Ngesikhathi ama-antibiotic eyiyona ukwelashwa okuyinhloko kokutholakala kwe-Whipple, kunezindlela eziningi zokusekela ongazithatha ekhaya ukuze usize ukuphatha izimpawu zakho nokusekela ukuphulukiswa kwakho. Lezi zindlela zisebenza kanye nokwelashwa kwakho kwezokwelapha, hhayi njengokushintsha kwakho.

Ukusekelwa kokudla kubaluleke kakhulu ngoba umzimba wakho ungase ube nobunzima ekufunzeni izondlo ngendlela efanele. Cabanga ukusebenza nodokotela obhaliswe ukuze wenze uhlelo lokudla oluqondene nanoma yikuphi ukondleka okubi ongabe ukhule.

Ungase uthole lezi zindlela ziwusizo:

• Dla ukudla okuncane, okuningi esikhundleni sokudla okukhulu okutshwe ukuze kulula ukugaya
• Gxila ekudleni okunezondlo eziningi ukuze ulwe nokondleka okubi
• Thatha izithasiselo zevithamini neziminithi njengoba kunconywe udokotela wakho
• Hlala unamanzi amaningi, ikakhulukazi uma uhlangabezana nokuxhinga
• Thola ukuphumula okwanele ukuze usekele ukuphulukiswa kwesistimu yakho yokulwa nezifo
• Gwema ukudla okubonakala kukhula izimpawu zakho zokugaya ukudla

Ukuphathwa kobuhlungu bezimpawu zezingqimba kungase kuhlanganise ukuqina okuthambile, ukucindezela okufudumele, kanye nezinye izilondolozi zobuhlungu njengoba kuvunyelwe udokotela wakho wezokwelapha. Noma kunjalo, qiniseka ukhulume nodokotela wakho ngaphambi kokuthatha noma iyiphi imithi entsha ngesikhathi uthola ukwelashwa kokutholakala kwe-Whipple.

Gcina idayari yezimpawu ukuze ulandele intuthuko yakho futhi uqaphele noma yiziphi izinguquko noma ukukhathazeka ofuna ukuzixoxa neqembu lakho lokunakekelwa kwezokwelapha ngesikhathi semihlangano yokulandelela.

Kufanele ulungiselele kanjani umhlangano wakho nodokotela?

Ukulungiselela kahle umhlangano wakho nodokotela kungasiza ukuqinisekisa ukuthi uthola ukuxilongwa okuchane kakhulu nokukhathalelwa okufanele. Njengoba utholakala lwe-Whipple luyisifo elingavamile, ukunikeza ulwazi olunemininingwane ngezimpawu zakho nomlando wezokwelapha kubaluleke kakhulu.

Ngaphambi komhlangano wakho, thatha isikhathi sokubhala izimpawu zakho ngokucophelela. Bhala phansi ukuthi yini ngayinye iqalile nini, ibaluleke kangakanani, nokuthi yini eyenza ibe ngcono noma ibe sibi. Lolu lwazi luzosisiza udokotela wakho ukuqonda iphethini nokuqhubeka kwesimo sakho.

Letha ulwazi olulandelayo emhlanganweni wakho:

• Uhlu oluphelele lwezimpawu zakho zonke nokuthi zaqala nini
• Umlando wakho wezokwelapha, kuhlanganise nanoma yiziphi izinkinga zokugaya ukudla ezedlule
• Uhlu lwemithi yonke nezithasiselo ozithathayo
• Ulwazi mayelana nokuhamba kwakamuva noma ukukhombisa okungenzeka kwendawo
• Umlando womndeni wezokwelapha, ikakhulukazi noma yiziphi izimo ezingavamile noma ezingavamile
• Imibuzo ofuna ukuyibuza udokotela wakho

Ungangabazi ukubuza udokotela wakho ukuthi achaze noma yini ongayiqondi. Imibuzo ongaqala ukuyibuza ihlanganisa ukuthi yiziphi izivivinyo ezidingekayo, ukuthi imiphumela isho ukuthini, ukuthi yiziphi izinketho zokwelapha ezitholakalayo, nokuthi yini okulindelekile ngesikhathi sokuphulukiswa.

Uma kungenzeka, letha umngani othembekile noma ilungu lomndeni nawe ukuze usize ukukhumbula ulwazi olukhulu nokusekela ngesikhathi esingase sibe yisikhathi esicindezelayo.

Yini eyinhloko yokutholakala kwe-Whipple?

Into ebaluleke kakhulu okumele uyiqonde ngokutholakala kwe-Whipple ukuthi nakuba kuyisimo esinzima, futhi kuphatheka kakhulu uma kuxilongwa ngokushesha. Ngokwelashwa okufanele ngama-antibiotic, abantu abaningi baphulile ngokuphelele futhi bangabuyela emisebenzini yabo evamile.

Ukuqaphela izimpawu ngokushesha kubalulekile ngoba ukwelashwa okulindile kungabangela izinkinga ezinzima ukuziphulukisa. Uma uhlangabezana nezimpawu zokugaya ukudla ezingapheli ezihlangene nokulahlekelwa isisindo okungachazeki nobuhlungu bezingqimba, ungangabazi ukufuna ukuxilongwa kwezokwelapha.

Khumbula ukuthi utholakala lwe-Whipple luyisifo esingavamile kakhulu, ngakho lezi zimpawu zivame ukubangelwa ezinye izimo ezivamile. Noma kunjalo, uma ukwelashwa okujwayelekile kungakusizi, kufanele uxoxe ngokwenzeka kwezinye izimo nodokotela wakho wezokwelapha.

Isimo sokukhula kokutholakala kwe-Whipple ngokuvamile sihle ngokwelashwa okufanele. Abantu abaningi babona intuthuko enkulu ezimpawu zabo ngaphakathi kwamasonto ambalwa ngokuqala ama-antibiotic, futhi imiphumela yesikhathi eside ihlala ilungile kulabo abaphothula inkambo yabo yokwelashwa.

Imibuzo evame ukubuzwa ngokutholakala kwe-Whipple

Ingabe utholakala lwe-Whipple luyadluliseka?

Cha, utholakala lwe-Whipple aludluliseki futhi alukwazi ukudluliselwa umuntu komunye. Nakuba ibhaktheriya elibangela ingase ikhona endaweni, lesi sifo sibonakala senzeka kuphela kubantu abanokuthambekela okukhethekile kule ntheleleko. Awudingi ukukhathazeka ngokuthi uyibambe komunye umuntu onalesi simo noma uyisakaze kwabanye.

Ingabe utholakala lwe-Whipple lungabuya ngemuva kokwelashwa?

Ukuphulukiswa kungase kwenzeke uma ukwelashwa kuphelelwa noma uma ibhaktheriya ingasuswa ngokuphelele emzimbeni wakho. Yingakho odokotela bancoma izinkambo ezinde zama-antibiotic futhi balandele abantu ngokucophelela ngesikhathi nangemuva kokwelashwa. Ukulandela imiyalo yodokotela wakho ngokunembile nokuphothula inkambo ephelele yama-antibiotic kunciphisa kakhulu ingozi yokubuya kwesifo.

Kuthatha isikhathi esingakanani ukuphulukiswa kokutholakala kwe-Whipple?

Abantu abaningi baqala ukuzizwa bekhulu ngaphakathi kwamasonto angu-2 kuya kwangu-4 ngokuqala ukwelashwa ngama-antibiotic, ngezimpawu zokugaya ukudla ezivame ukuthuthuka kuqala. Noma kunjalo, ukuphulukiswa okuphelele kungathatha izinyanga eziningi, futhi kuzodingeka uqhubeke uthatha ama-antibiotic unyaka noma emibili ukuqinisekisa ukuthi ukutheleleka kususiwe ngokuphelele. Ubuhlungu bezingqimba kanye nezimpawu zezinzwa, uma zikhona, kungathatha isikhathi eside ukuze ziphulukiswe ngokuphelele.

Ingabe izingane zingaba notholakala lwe-Whipple?

Nakuba utholakala lwe-Whipple luyisifo elingavamile kakhulu ezinganeni, ngezinye izikhathi lungase lwenzeke. Uma luthinta izingane, izimpawu zingase zihluke kancane kunalezo ezibonwa kubantu abadala, futhi lesi simo singase sibe nzima kakhulu ukutholakala kwesifo. Uma ingane inezimpawu zokugaya ukudla ezingachazeki ngokulimala kwesisindo, ukuxilongwa kwezokwelapha kubalulekile kungakhathaliseki ukuthi izimbangela ezingase zibe khona zingavamile kangakanani.

Ingabe kunokuphazamiseka kokudla ngesikhathi sokwelashwa kokutholakala kwe-Whipple?

Ayikho imikhawulo ekhethekile yokudla edingekayo yokwelapha utholakala lwe-Whipple ngokwalo, kodwa udokotela wakho angase ancome izindlela ezithile zokudla ukuze usize ukulwa nokondleka okubi nokusekela ukuphulukiswa kwakho. Gxila ekudleni okulinganiselayo, okunezondlo eziningi, futhi ugweme ukudla okubonakala kukhula izimpawu zakho zokugaya ukudla. Udokotela wakho wezokwelapha noma udokotela obhaliswe angakunikeza isiqondiso esiyigugu esisekelwe ezidingweni zakho nezimpangweni zakho.