I-Diverticulitis

I-Diverticulitis yenzeka lapho izikhwama ezincane (i-diverticula) emgudwini wakho wokugaya zivutha noma zitheleleke. Cishe uzozwa ubuhlungu obukhulu besisu, imfiva, isicanucanu, futhi izinguquko endleleni amathumbu akho asebenza ngayo. Nakuba i-diverticulosis (ukuba nezikhwama ngaphandle kokuvuvukala) ibonakala kubantu abaningi, ezinye zalezi zimo kuphela eziphenduka i-diverticulitis.

Amadoda angaphansi kweminyaka engama-50 nabesifazane abaphakathi kweminyaka engama-50-70 ubudala bavame ukuthola i-diverticulitis kaningi. I-diverticulitis engalashwa ingangena ezinkingeni ezinkulu njenge amathumba, ukuvaleka kwamathumbu, nezimbobo odongeni lwamathumbu. Ukufunda ngezimbangela zako, izimpawu, kanye nokwelashwa kubaluleka uma ubhekene nezinkinga zokugaya ukudla noma ubhekene nezingozi eziphakeme ezivela eminyakeni yobudala noma izici zokuphila.

Iyini i-Diverticulitis?

Amasaka amancane aphusha ezindaweni ezibuthakathaka kukholoni yakho futhi avuvuke noma atheleleke - lesi simo sibizwa ngokuthi i-diverticulitis. Lokhu kuhlukile ku-diverticulosis, okusho nje ukuba nezikhwama ngaphandle kokuvuvukala. Lezi zikhwama ngokuvamile zakheka kukholoni engezansi, ikakhulukazi kukholoni ye-sigmoid. Abanye abantu abane-diverticulosis babhekana nokuvuvukala ngesikhathi sokuphila kwabo.

Izinhlobo ze-Diverticulitis

Odokotela bahlukanisa i-diverticulitis ngezinhlobo eziningana:

• I-acute diverticulitis: Ivela ngokuzumayo kodwa ixazulula ngokushesha ngokwelashwa
• I-Diverticulitis engapheli: Imiphumela kuziqephu eziningi noma ukuvuvukala okuqhubekayo
• I-diverticulitis engayinkimbinkimbi: Ifomu elivame kakhulu eliphendula kahle ekwelashweni
• I-diverticulitis eyinkimbinkimbi: Ukuvuvukala okunamandla okubangela izinkinga ezinkulu njengokuqhuma

Izimpawu ze-Diverticulitis 

Ubuhlungu besisu esingezansi kwesokunxele bubonakala njengophawu oluyinhloko. Ezinye izimpawu zihlanganisa:

• Umkhuhlane namakhaza
• Ukudabuka noma ukuhlanza
• ukuqunjelwa or isifo sohudo
• Ukuvimbela
• Ukopha kwe-rectal kwezinye izimo

Izinkinga ze-Diverticulitis 

Ososayensi abakazicacisi izimbangela eziqondile, kodwa i-diverticulitis cishe iqala lapho amagciwane noma indle ibambeka ku-diverticula. Izikhwama zangempela zingase zakheke ngenxa yokucindezela okukhulu okuvela ekuqunjelweni. I-diverticulum edabukile ingaholela ekuthelelekeni nasekuvuvukeni.

Ingozi ye-diverticulitis

Amathuba akho okuba nalesi simo akhula ngokuthi:

• Uneminyaka engaphezu kwengu-50
• Ukukhuluphala
• Ukuntuleka kokuzivocavoca umzimba
• Ukubhema
• Imithi ethile efana nama-NSAID nama-steroid
• Ukudla okune-fibre ephansi kanye nenyama ebomvu ephezulu
• Umlando womndeni

Izinkinga ze-Diverticulitis

I-diverticulitis engalashwa ingaholela ezinkingeni ezinkulu:

• Ithumba: Ukutheleleka kudala amaphakethe obomvu
• Ukopha: Kancane kancane
• Ukuvinjwa kwamathumbu: Ithumbu livaleka kancane noma livaleke ngokuphelele
• UFistula: Ukuxhumana okungavamile phakathi kwekholoni nezinye izitho zomzimba 
• Ukubhobozwa: I-Colon ikhiqiza izimbobo ezingabangela izifo ezinzima
• I-Peritonitis: Ukutheleleka okusongela ukuphila kolwelwesi lwe-abdominal cavity

Ukuxilongwa kwe-Diverticulitis

Ukuhlonza ngokushesha kanye nokwelashwa kwe-diverticulitis kungavimbela izinkinga ezinkulu.

Odokotela baqinisekisa i-diverticulitis ngokusebenzisa izindlela eziningana. Baqala ngokubuyekeza umlando wakho wezokwelapha futhi bahlole umzimba. Ukuhlolwa kuhlanganisa ukuhlola ukuthamba kwesisu sakho, ikakhulukazi uma uzwa ubuhlungu ngezansi kwesokunxele. Udokotela wakho angase futhi acele:

• Ukuhlolwa kwegazi okuhlola ukutheleleka nokuvuvukala
• Ukuhlolwa kwendle okukhipha ezinye izimo
• I-CT scan, enikeza ukuxilongwa okunembile kakhulu
• I-Colonoscopy (ngemva kokuba ukuvuvukala kwehle)

Ama-CT scan enza izithombe ezinemininingwane ebonisa odokotela izikhwama kanye nezinkinga ezingaba khona njengamathumba noma ama-fistula.

Ukwelashwa kwe-Diverticulitis 

Izinhlelo zokwelashwa ziyashintsha ngokuya ngokuthi isimo sakho sibucayi kangakanani:

• Ezimweni ezithambile:
  • Phumula futhi unamathele ekuhlanzeni uketshezi izinsuku ezimbalwa
  • Buyela kancane kancane ekudleni okune-fibre ephansi, bese ubuyela ekudleni okuvamile
  • Thatha paracetamol ukunciphisa ubuhlungu (ukugwema ama-NSAID)
  • Nemithi Elwa Namagciwane (akudingeki njalo ezimweni ezithambile)
• Ezimweni ezinzima:
  • Ukulala esibhedlela kuba kudingekile
  • Uzodinga ama-antibiotics emithanjeni kanye noketshezi
  • Kungase kudingeke ukuhlinzwa uma kuvela izinkinga

Ungase udinge ukuhlinzwa ngemva kweziqephu ezinzima eziningi, ukopha, ubuhlungu obukhulu, noma izinkinga ezifana nokubhobozwa noma ithumba. Izinketho zokuhlinzwa zihlanganisa ukukhipha ingxenye yekholoni ethintekile, futhi ngezinye izikhathi kudinga i-colostomy yesikhashana.

Uzoyibona Nini Udokotela

Udokotela wakho udinga ukwazi ngokushesha uma une:

• Ubuhlungu obukhulu besisu obuhlala noma obuba bubi kakhulu
• Umkhuhlane ongaphezu kuka-38°C ongeke uphele
• Igazi livela esitulweni sakho
• Awukwazi ukuyeka oluhlanzayo noma ugcine uketshezi luphansi
• Izimpawu zakho azibi ngcono ngemva kokuzama ukwelashwa ekhaya

Prevention

Lezi zinguquko zendlela yokuphila zisiza ukuvimbela ukuqubuka kwe-diverticulitis:

• Khetha ukudla okunefiber ephezulu njengezithelo, imifino kanye nezinhlamvu
• Hlala usebenza ngokuzivocavoca njalo ukuze wehlise ubungozi bakho
• Zigcine unamanzi amaningi
• Qaphela isisindo sakho
• Yehlisa inyama ebomvu nokudla okugayiwe
• Yeka ukubhema uphuze utshwala obuncane

Imibuzo Evame Ukubuzwa

1. Ingabe i-diverticulitis ingelapheka?

I-acute diverticulitis ngokuvamile iba ngcono ngokwelashwa okufanele, kodwa isimo sokuqala (i-diverticulosis) sihlala. Odokotela bangase batuse ukuhlinzwa ezimweni eziphindelelayo noma ezinzima. 

2. Iyini imbangela eyinhloko ye-diverticulitis?

Odokotela abakayitholi imbangela yangempela okwamanje. I-Diverticulitis cishe iqala lapho amagciwane noma isitulo sivaleleke ezikhwameni ze-diverticula. Kunezici ezimbalwa ezidlala indima:

• Izakhi zofuzo zakho
• Ukudla okune-fibre ephansi kanye nenyama ebomvu ephezulu
• Ingcindezi eyengeziwe kukholoni ngesikhathi sokuqunjelwa
• Ukudabuka okungenzeka odongeni lwe-diverticulum

3. Isiphi isigaba sokuqala se-diverticulitis?

Isigaba sokuqala sibonisa ukuvuvukala ku-diverticula eyodwa noma ngaphezulu. Iziguli ngokuvamile zizwa ubuhlungu obungalindelekile, obunzima (imvamisa ngaphansi kwesisu esingakwesokunxele), imfiva, futhi ziqaphele izinguquko ezindleleni zamathumbu. Lesi sigaba sokuqala ngokuvamile sihlala singelula, okusho ukuthi ukuvuvukala kuhlala kungaphakathi kwezikhwama ngaphandle kokwenza amathumba.

4. Ingabe i-diverticulosis iyingozi?

I-diverticulosis yabantu abaningi ayibangeli izimpawu noma izinkinga. Ezinye iziguli kuphela ezihlakulela i-diverticulitis. Lesi simo sivame kakhulu njengoba sikhula, sithinta iningi labantu abaneminyaka engu-80. Ukudla okune-fiber ephezulu kanye nokuhlolwa okuvamile kusiza ukuvimbela izinkinga.

5. Yikuphi ukudla okubangela i-diverticulitis?

Ucwaningo aluzange luxhumanise ukudla okuthile ngqo ne-diverticulitis. Ukudla okune-fibre ephansi kanye nenyama ebomvu eningi nokudla okugayiwe kungase kwenyuse ingozi. Ngesikhathi sokuqubuka, kufanele ugweme isikhashana ukudla okune-fibre ukuze unciphise ubunzima emathunjini akho.

6. I-diverticulitis ihlala isikhathi esingakanani?

Iningi labantu liyalulama ku-diverticulitis engaxakile ezinsukwini eziyi-12-14. Amacala amancane akhombisa ukuthuthuka phakathi kwezinsuku ezingama-2-3 zokwelashwa. Ama-antibiotic omlomo ngokuvamile ahlala izinsuku ezingu-7-10. Ezinye iziguli zidinga ama-antibiotics emithanjeni izinsuku ezingu-3-5, kulandelwa izinsuku ezingu-10-14 zomuthi womlomo. Iziguli eziningi ziqala ukuzizwa zingcono ezinsukwini ezingu-3-4 ngemva kokuqala kokwelashwa.

UDkt. Karthikeya Raman Reddy

I-MBBS, MD (Imithi Ejwayelekile)
CARE Hospitals, HITEC City, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529