Abubuwan da aka fi sani da IBD sune:
• Ulcerative colitis (YAK) - rinjayar babban hanji, yawanci yana farawa daga dubun;
• Ciwon Crohn - zai iya shafar kowane ɓangare na fili na gastrointestinal: daga kogin da ke cikin murya zuwa ga anus. A cikin tsarin mai kumburi, yawancin nauyin katako na intestinal yana cikin lokaci.
Sanadin cutar da ciwo
Duk da yawancin binciken kimiyya, dalilai na ci gaban VZK ba a bayyana su sosai ba. Bisa ga ka'idar daya, magunguna na IBD sune ƙwayoyin ƙwayoyin cuta ko kwayoyin da suka shiga cikin hanji daga yanayin da kuma haifar da mummunan dauki daga microflora na intestinal al'ada. An yi rajista a asibiti na asali a dukan ƙasashe na duniya, yawancin da ake ciki shine lamarin 50-80 da yawan mutane dubu 100. Kwayar cutar tana rinjayar mutane na kowane zamani, amma yawan shekarun shekaru 15 zuwa 40 sun fi dacewa da shi. Matsayin da ke faruwa a tsakanin maza da mata yana da kusan ɗaya. A cikin kimanin kashi 15 cikin dari na marasa lafiya, dangin zumunta (iyaye, ɗan'uwa ko 'yar'uwa) sun sha wahala daga wannan cuta. Bisa ga binciken, kashi biyu cikin uku na marasa lafiya da cutar Crohn. Shan taba shine kawai abin da aka tabbatar da shi na yanayin waje wanda ke shafar abubuwan da ke ciki na IBD. A cikin kasashe masu ci gaba, cutar Crohn ta kamu da kashi 30-4-0 cikin 100,000 na yawan jama'a. Kwayar Crohn da cututtuka na ulla da ciwon ciki suna nuna halin da ake ciki (jigilar cututtuka da cutar ta biyo baya). Dama da kuma ciwon cututtukan hoto sune magungunan sake dawowa.
Hankula bayyanar cututtuka na ulcerative colitis ne:
• Magancewa da sauri don cin zarafi tare da babban adadi;
• mai yalwa da jini ko ƙuƙwalwa a cikin feces;
• ciwo mai zafi mai tsanani, ragewa bayan cin zarafi;
• malaise da gajiya da yawa;
• zazzabi da asarar ci.
Kwayoyin cututtukan kwayar cutar Crohn suna da bambanci. Wannan shi ne wani ɓangare saboda gaskiyar cewa wani ɓangare na fili na gastrointestinal zai iya shawo kan wannan cuta. A lokacin da cutar Crohn za a iya kiyayewa:
• wani abun da ke ciki tare da jinin jini;
• jin zafi cikin ciki;
• asarar nauyi;
• Tsarin hanzari na hanji, wani lokacin kuma yana haifar da haɗari na intestinal;
• kafawar fistulas (mahaukaci masu haɗari tsakanin gabobin da abin da ke ciki na ciki ya shigar da cavities kusa, misali, a cikin mafitsara ko farji).
Bugu da ƙari, cutar Crohn zai iya rinjayar murfin mucous na bakin, gidajen abinci, ƙananan ƙaran. Wasu marasa lafiya sunyi yaduwar cutar tare da amfani da wasu abinci, amma babu wani abincin da aka ba da shawarar ga marasa lafiya tare da IBD. Sanarwar asali na kowace cuta na kungiyar IBD yawanci ya danganta ne akan bayanan dakin gwaje-gwaje da kuma nazarin mai haƙuri. Bayan da aka tattara magungunan motar da kuma gwadawa ta jiki, ciki har da jarrabawar jarrabawa, to amma ana ba da izinin nazarin cikin ciki da kuma kashin babban hanji. A cikin wannan gwajin, an saka kayan aiki na musamman (sigmoidoscope) ta hanyar anus, ba ka damar nazarin mucosa na intestinal kuma dauki samfurin samfurori don nazarin microscopic.
Shirin binciken
Ko da kuwa sakamakon sakamakon sigmoidoscopy, ana gudanar da karatun da ake biyo baya:
• gwaje-gwaje na jini (ciki har da alamun alamar alamar ƙwayar cuta);
• Radiography na hanji ta amfani da barium enema. A tsakar rana an zubar da hanji tare da laxative. A ranar binciken, an gabatar da maganin barium ta hanyar ɗita, wanda shine nau'i-nau'i na X-ray, wanda ya ba da damar gano wuraren ƙumburi ko ƙuntatawa da hanji. Lokacin da ake zargi da cututtukan Crohn, ana nazarin asibiti na tsakiya. A wannan yanayin, mai haƙuri yana ɗauke da dakatar da barium cikin ciki, wanda zai sa ya yiwu a hango ƙananan hanji;
• Colonoscopy. A cikin wannan binciken, an samar da kayan aiki mai tsabta mai tsauri tare da tushen haske ta hanyar anus kuma yana bada damar duba ƙwayar mucosa na babban hanji da kuma ɗayan. Tare da taimakonsa, ba zamu iya nazarin yankunan da hankalin da ke da wuya ba tare da sigmoidoscopy, amma kuma idan ya cancanta, kuyi aikin biopsy nama. Idan ka yi tunanin shan kashi a cikin hanji na sama, wani nau'i na jarrabawar endoscopic an umarce shi: gastroduodenoscopy. A yayin da ake aiwatar da wannan tsari, an sanya wani katako na musamman, wanda ake kira gastroscopy, ta hanyar cikin esophagus cikin ciki da duodenum. Gastroscope shi ne m fiber optic tube wanda ya baka damar duba duk sassan ciki. An canja hotunan zuwa allon allo. An yi amfani da wannan hanyar don ganewar asali na IBD da kuma hanyoyin ƙwarewa marasa rinjaye. Hanyoyin magani na IBD sun bambanta daga yin amfani da maganin steroid don magance matsalolin ƙwayar cuta, wanda aka yi amfani da su a lokuta masu tsanani. Duk da rashin yiwuwar maganin lafiya, mafi yawan marasa lafiya suna iya jagorancin rayuwa. Bayan ganewar asali na IBD, ana lura da masu haƙuri tare da wani gastroenterologist, yawanci a wurin zama.
Jiyya tare da steroids
Don cire kumburi tare da tabbatarwa na IBD sun tsara kwayoyi masu satar kwayoyi ta hanyar allunan, enemas ko zato. Marasa lafiya sukan ji tsoron ƙaddamar da steroids, suna gaskantawa cewa waɗannan sunadaran da zasu iya haifar da cututtuka maras so, musamman tare da shigarwa mai tsawo. Sakamakon maganin wadannan kwayoyi sun hada da samuwar fuska kamar wata, riba mai yawa, rauni na tsokoki na ƙwanƙwara da ƙarar jini. Sakamakon sakamako na sabon ƙaruwar magungunan sittin na iya zama maras faɗi, duk da haka, a kowane hali, ba'a so a dakatar da karɓar su, kamar yadda jiki yana ɗaukar lokaci don mayar da kansa na samar da hormones steroid.
Cire kumburi
Bayan kawar da farkon cututtuka na cutar, cututtuka 5-aminosalicylic acid (irin su monotherapy ko a hade tare da steroids) sun zama tushen maganin IBD. Sun hada da sulfasalazine, mesalazine da olsalazine. Gwamnatin su ta hana sake dawowa da cutar, ta haka ne ta samar da gafara. Wadannan kwayoyi za a iya amfani da su ta hanyar allunan, enemas ko kyandir kuma ba su da irin wannan mummunar aiki a matsayin steroids. Sakamakon abubuwan da ke faruwa na wannan rukunin sun hada da tashin zuciya, rash, ciwon kai da anemia. Don gano rashin amincewa da mutum, mai haƙuri yana yin nazari da jini a kai a kai. Wani miyagun ƙwayoyi tare da sakamako mai karfi mai kisa yana azadioprine. An yi amfani dashi don rashin daidaituwa ga rage yawan cututtukan steroid, da ma marasa lafiya da IBD mai wahala. Lokacin shan wannan magani, kina buƙatar saka idanu na jini akai-akai. Ƙananan marasa lafiya tare da IBD na buƙatar magani. Idan har yanzu ba'a kula da tsarin aikin farfadowa ba, yiwuwar buƙatar ƙwayar miki ya ƙaru.
Nau'ikan nau'i
Tare da cututtukan da ba a yalwatawa ba, alamun nuna magani a cikin kimanin kashi 30% na marasa lafiya. Mahimmin magani yana da mahimmanci idan ba zai yiwu a shawo kan ƙwaƙwalwa mai tsanani ba tare da taimakon magungunan magungunan maganin magunguna, da mahimmancin karuwar yawan rayuwar mai haƙuri. Bugu da ƙari, ana buƙatar aikin idan ana gano alamun farko na tsari mai kyau a cikin hanji.
Irin ayyukan
A cikin cututtukan Crohn, magungunan maganin yafi dacewa wajen kawar da matsalolin ta hanyar cire wuraren da aka shafa da hanji. Ga mafi yawan marasa lafiya da cututtukan daji, aiki na zabi shine abin da ake kira reconstructive proctocollectomy, wanda ya kunshi cire wani ɓangare na babban hanji sannan sannan ya fara "aljihu" daga gutturo na intestinal da aka haɗa da anastomosis zuwa anus. An yi aiki a matakai biyu, wanda ya bambanta da ƙuƙwalwa, wanda aka cire babban hanji da kumfa guda guda, kuma ana tafiyar da ɓoye na tayin ta hanyar ciwon ciki a cikin jaka na musamman. Tsarin da ya dace yana iya yiwuwa a samu nasarar sarrafa tsarin IBD a mafi yawan marasa lafiya, amma waɗannan cututtuka ba su da tabbas. A cikin irin wannan marasa lafiya, a wasu yanayi, haɗarin tarin ciwon ƙwayar cuta na hanji yana ƙaruwa.
Rashin ci gaba da ciwon ciwon daji na ciwon kofin yana ƙaruwa tare da aiwatar da dukkan hanji (ko ɓangaren ɓangaren) a cikin ƙwayar ƙwayar cuta, kazalika tare da karuwa cikin tsawon lokacin cutar. Ana iya rage hadarin mummunan tsari ta hanyar wucewa ta hanyar wucewa, wanda ya ba da damar gano canje-canjen da suka dace a farkon matakan. Yana da muhimmanci a lura cewa a marasa lafiya tare da IBD mai sauki, yana da muhimmanci ƙwarai. Abu mai wuya, m canje-canje faruwa a kan tushen cutar Crohn, wanda ya fita ba tare da shan kashi na babban hanji.
Hasashen
IBDs suna da halin da ke ci gaba da rayuwa, kuma bayyanuwar su a cikin kowane mai haƙuri shi ne mutum. A lokacin aiki, cutar zai iya haifar da rashin jin daɗi, amma tare da zaɓi na dacewa na maganin miyagun ƙwayoyi, la'akari da ka'idojin cutar, mafi yawan marasa lafiya suna da damar yin aiki sosai, duk da rashin yiwuwar maganin lafiya. A lokacin lokacin gyare-gyaren, mai haƙuri tare da IBD zai iya haifar da rayuwa ta al'ada. Daga cikin marasa lafiya akwai ra'ayi cewa irin abubuwan da suka faru na IBD sun nuna "a kan jijiyoyi", wanda ba daidai ba ne. A gaskiya, sake dawowa da cutar zai iya haifar da mummunan tashin hankali da kuma rashin tausayi, musamman idan an tilasta mai haƙuri ya ziyarci bayan gida. Saboda haka, a lokacin da yake nuna damuwa, jin tausayi da fahimtar bangarori biyu na masu haƙuri da abokan aiki suna da matukar muhimmanci. Ga wata mace da ke shirin daukar ciki, damar da za ta kasance ciki yana da girma a lokacin gyarawa. Yayin da ake ciki, akwai cutar mai tsanani, amma yawanci suna faruwa ne a wani nau'i mai mahimmanci kuma ya amsa da kyau ga maganin miyagun ƙwayoyi. Ra'ayin amfani da hadarin daukar nauyin steroid a lokacin daukar ciki an kiyasta matsayin mai kyau, tun da yiwuwa yiwuwar tasowa a cikin wannan lokacin bai isa ba.