I-Ulcerative Colitis

I-Ulcerative colitis yisimo sezokwelapha esingalapheki esinomthelela ezimpilweni zezigidi emhlabeni wonke. Lesi sifo samathumbu esivuvukalayo sibangela ukuvuvukala nezilonda olwelweni lwamathumbu amakhulu kanye ne-rectum, okuholela ezinhlobonhlobo zezimpawu ezingakhululekile. Ukuqonda i-ulcerative colitis kubalulekile ekulawuleni imiphumela yaso kanye nokwenza ngcono izinga lempilo yalabo abathintekile.

Ake sihlole ukuthi iyini i-ulcerative colitis, izinhlobo zayo ezihlukahlukene, kanye nezimpawu ezivamile okufanele uziqaphele. Sizophinde sihlole izimbangela nezici zobungozi, izinkinga ezingaba khona, kanye nezindlela zokuxilonga i-ulcerative colitis. 

Iyini I-Ulcerative Colitis?

I-Ulcerative colitis (UC) yisifo sesisu esivuvukalayo sesikhathi eside (IBD) esithinta amathumbu amakhulu, ikakhulukazi ikholoni kanye ne-rectum. Lesi simo sesikhathi eside sidala ukuthi amasosha omzimba ahlasele ulwelwesi lwamathumbu, okuholela ekuvuvukeni kanye izilonda endaweni engaphakathi yekholoni.

Lesi simo sibonakala ngezikhathi zezimpawu ezisebenzayo, ezaziwa ngokuthi ama-flare-ups noma ukubuyela emuva, okulandelwa yizikhathi zokuphumula lapho izimpawu ziphela. I-ulcerative colitis ingakhula kunoma iyiphi iminyaka, kodwa ivame ukutholakala kubantu abaphakathi kweminyaka engu-15 no-30 ubudala. 

Izinhlobo ze-Ulcerative Colitis

I-Ulcerative colitis (UC) ingathinta noma yiziphi izingxenye zekholoni kanye ne-rectum, okuholela ezinhlotsheni ezahlukene zesimo. Izinhlobo ezintathu eziyinhloko ze-UC yilezi: 

• I-Ulcerative Proctitis: Njengoba iyifomu elithambile, i-ulcerative proctitis ithinta cishe ingxenye eyodwa kwezintathu yabantu abane-UC. Kulolu hlobo, ukuvuvukala kukhawulelwe ku-rectum, ngokuvamile okubandakanya ngaphansi kwama-intshi angu-6 wendawo. 
• I-Colitis yohlangothi lwesobunxele: Lolu hlobo lwe-UC lubangela ukuvuvukala kusuka ku-rectum kuze kufike ku-splenic flexure, ukugoba eduze kwe-spleen. Lolu hlobo luhlanganisa i-proctosigmoiditis, lapho ukuvuvukala kuthinta ikholoni ye-rectum kanye ne-sigmoid (ingxenye engezansi, emise okwe-S yekholoni). 
• I-colitis engapheli: Eyaziwa nangokuthi i-pancolitis, i-extensive colitis iyindlela enzima kakhulu. Kuthinta ikholoni lonke, ukuvuvukala kuqale ku-rectum futhi kudlulele ngale kwe-splenic flexure. 

Ubunzima be-UC bungahluka ukusuka kokumaphakathi kuye komaphakathi noma kuqine, kuye ngezimpawu kanye nezinga lokuvuvukala. Ezimweni ezingavamile, ifomu elisongela ukuphila elibizwa ngokuthi i-fulminant ulcerative colitis lingase libe khona, elidinga ukunakekelwa okuphuthumayo kwezokwelapha.

Izimpawu ze-Ulcerative Colitis

Izimpawu ze-Ulcerative colitis zingahluka ngobukhulu futhi ngokuvamile ziba zimbi ngokuhamba kwesikhathi. Lokhu kubandakanya: 

• Uhudo oluphindayo olungaqukatha amafinyila, igazi, noma ubomvu
• Ubuhlungu besisu 
• Ukukhathala okukhulu
• Ukulahlekelwa kwesifiso
• Ukwehla kwesisindo
• Ukwehla kwesisu
• I-nausea
• Fever

Ngaphezu kwezimpawu zamathumbu, cishe amaphesenti angu-25 abantu abane-ulcerative colitis baba nezimpawu zangaphandle kwamathumbu. Lokhu kungafaka: 

• Amalunga abuhlungu futhi avuvukele (arthritis)
• Izilonda zomlomo
• Ukucasuka, amehlo abomvu
• Izinkinga ezihlobene nesikhumba njengamaqhubu abuhlungu, ukuqubuka, noma izilonda

Umthelela we-ulcerative colitis empilweni yansuku zonke ungaba obalulekile kwabanye abantu. Izimpawu ezifana nokuphuma kwamathumbu ngokushesha kanye ne-tenesmus (ukuzwa isidingo sokusebenzisa indlu yangasese kodwa ungakwazi) kungaphazamisa kakhulu. 

Izimbangela Nezingozi Zezinto Eziyingozi Ye-Ulcerative Colitis

Nakuba izimbangela eziqondile zokuqubuka komlilo ngokuvamile zingaziwa, abacwaningi bakholelwa ukuthi kuwukuhlangana okuyinkimbinkimbi kwezinto ezihlukahlukene. Ithiyori eyamukelwa kabanzi iphakamisa ukuthi i-ulcerative colitis (UC) yisimo sokuzivikela komzimba lapho amasosha omzimba ehlasela ngephutha izicubu zekholoni enempilo, okubangela ukuvuvukala nokulimala.

Ziningana izici eziyingozi ezihlonziwe ezingase zandise amathuba okuba ne-ulcerative colitis. Lokhu kubandakanya:

• Iminyaka yobudala idlala indima, kanti ukuxilonga okuningi kwenzeka phakathi kweminyaka eyi-15 nengama-30 noma ngemuva kweminyaka engama-60. 
• Ubuhlanga nobuzwe nakho kunomthelela engcupheni, lapho abantu abamhlophe, ikakhulukazi labo bozalo lwamaJuda ase-Ashkenazi, besengozini kakhulu.
• I-Genetics inomthelela omkhulu engozini ye-ulcerative colitis. Ukuba nesihlobo se-first degree (umama noma ubaba) esinalesi simo kwandisa amathuba okuba sithuthuke. 
• Izici zemvelo nazo zinomthelela ekuthuthukisweni kwe-ulcerative colitis. Ukudla okunamafutha amaningi, ukucindezeleka, nokubhema kungase kwenze izimpawu zakho zibe zimbi nakakhulu.
• Ezinye izici, njengokuhlala emadolobheni, imithi ethile, nomlando we-gastroenteritis, kuye kwaxhunyaniswa nengozi eyengeziwe ye-ulcerative colitis.

Izinkinga

I-ulcerative colitis ingaholela ezinkingeni eziningana ezinzima ezinomthelela empilweni yomuntu jikelele kanye nekhwalithi yokuphila. Lokhu kungase kuhlanganise:

• Ayanda amathuba okuba nomdlavuza wamathumbu, ikakhulukazi kulabo abanesifo sokuqaqamba kwamathumbu esinzima noma esikhulu. 
• Ukukhula nokungathuthuki kahle kwezingane kanye nentsha 
• I-primary sclerosing cholangitis
• I-megacolon enobuthi 
• Ukusetshenziswa kwemithi ye-steroid ukwelapha i-ulcerative colitis kungabangela kwamathambo njengomphumela ohlangothini.

Sifo

Ukuxilonga i-ulcerative colitis, odokotela basebenzisa inhlanganisela yezindlela, njenge: 

• Umlando Wezokwelapha: Odokotela babuza ngezimpawu zakho, izici ezibangela ukuqubuka kwe-UC, kanye nanoma yiziphi izimpawu ezengeziwe.
• Ukuhlola Umzimba: Phakathi nalokhu kuhlolwa, udokotela angase ahlole izimpawu ezibalulekile, alalele imisindo yesisu, futhi enze ukuhlolwa kwe-digital rectal ukuze ahlole igazi esitokisini.
• Ukuhlolwa kwegazi: Basiza ekuboneni izimpawu ze-ulcerative colitis kanye nezinkinga ezingaba khona njenge-anemia. Lokhu kuhlola kungase futhi kuveze izimpawu zokutheleleka noma ezinye izifo zokugaya ezingase zibangele izimpawu ezifanayo.
• Ukuhlolwa kwendle: Indle yesiguli ihlaziywa ngezibonakaliso zokuvuvukala emathunjini. 
• I-Endoscopy: Lokhu kuhlolwa kokuxilonga kuvumela odokotela ukuthi babheke ulwelwesi lwamathumbu amakhulu futhi bathathe amasampula ezicubu (ama-biopsies) ukuze bahlaziye kabanzi. 

Ukwelashwa Kwe-Ulcerative Colitis

Ukwelashwa kwe-ulcerative colitis kuhloswe ukunciphisa izimpawu nokugcina ukuthethelelwa. 

• Imithi:
  • Imithi elwa nokuvuvukala, njengama-aminosalicylates (5-ASAs), imvamisa iwumugqa wokuqala wokwelashwa kwe-ulcerative colitis emaphakathi kuya komaphakathi. Le mithi isiza ukunciphisa ukuvuvukala futhi ingasetshenziswa ngomlomo, njengama-suppositories, noma nge-enemas.
  • I-Corticosteroids iyasebenza ekwehliseni ukuvuvukala, kodwa ayifanele ukusetshenziswa isikhathi eside ngenxa yemiphumela engemihle engaba khona.
  • Ama-Immunosuppressants asiza ekwelapheni ama-flare-ups futhi agcine ukuxolelwa ngokunciphisa umsebenzi wamasosha omzimba. 
  • Imithi ye-biologic iqondise amaprotheni athile ohlelweni lokuzivikela komzimba ukunciphisa ukuvuvukala. 
• Ukuhlinzwa: Ezimweni lapho imithi ingasebenzi noma kuvela izinkinga, odokotela bangase basikisele ukuhlinzwa. Lokhu kuhilela ukukhipha ikholoni kanye ne-rectum (proctocolectomy) nokudala i-ileostomy noma isikhwama sangaphakathi (isikhwama se-ileoanal) sokususa udoti.

Uzoyibona Nini Udokotela

• Uma unezimpawu ze-ulcerative colitis futhi ungakatholakali, kubalulekile ukubonana nodokotela ngokushesha ngangokunokwenzeka. 
• Kulabo asebetholakele bene-ulcerative colitis, thintana nodokotela wakho ngokushesha uma ucabanga ukuthi unokuqubuka okukhulu. 
• Funa usizo lwezokwelapha ngokushesha uma uba nohudo olunzima, olubeleselayo, ukuvuza kwegazi endunu yakho namahlule esitulweni sakho, ubuhlungu obungapheli, noma umkhuhlane ophezulu. 
• Kubalulekile futhi ukuthintana nodokotela wakho uma kukhona okubonayo izimpawu zokutheleleka, njengokukhwehlela, imfiva, noma umphimbo obuhlungu. 

Prevention

Nakuba kungenakwenzeka ukuvimbela i-ulcerative colitis ngokuphelele, kunezinyathelo ongazithatha ukuze unciphise amathuba okuqubuka futhi ulawule isimo ngempumelelo. Lokhu kubandakanya:

• Ukuthatha imithi yakho njengoba uyalelwe kubalulekile. Lena enye yezindlela ezingcono kakhulu zokugcina i-ulcerative colitis ilawulwa futhi uvimbele ukuvutha. 
• Imithi ethile ingenza izimpawu ze-ulcerative colitis zibe zimbi nakakhulu. Lokhu kuhlanganisa ama-antibiotic athile kanye nama-NSAID, angabangela ukuvuvukala emathunjini. 
• Ukuhlolwa njalo nodokotela wakho kubalulekile, ngokuvamile njalo ngemva kwezinyanga eziyisithupha ngenkathi uxolelwe. Uma une-flare-up, thintana nodokotela wakho ngokushesha. Kungase kudingeke ukuthi benze izivivinyo ukuze bakhiphe ezinye izimbangela zezimpawu zokugaya ukudla, njengezifo.
• Ukulawula ingcindezi kungenye ingxenye ebalulekile yokuvimbela ukuqubuka. Nakuba ukucindezeleka kungase kungabangeli ukuqubuka ngokuqondile, kungenza izimpawu zokugaya zibe zimbi nakakhulu. 
• Zama ukuthola okungenani amahora ayisikhombisa okulala ngobusuku, uvivinye umzimba njalo, futhi uthole izindlela ezinempilo zokukhulula ukucindezeleka, njengokuzindla.

Isiphetho

I-Ulcerative colitis yisimo esiyinselele esinomthelela omkhulu ezimpilweni zalabo abathintekile. Khumbula, nakuba lingekho ikhambi, izindlela zokwelapha i-ulcerative colitis ezihlukahlukene ezisebenzayo zingasiza ukulawula izimpawu, ukunciphisa imvamisa yokuqubuka, futhi kuthuthukise izinga lempilo. Ukuphila ne-ulcerative colitis kudinga ukunakekelwa nokunakwa okuqhubekayo. Ukuhlolwa njalo, ukuphathwa kwemithi ngendlela efanele, nokulungiswa kwendlela yokuphila kuyisihluthulelo sokugcina ukuxola nokuvimbela izinkinga. Ungangabazi ukuxhumana nodokotela wakho uma uhlangabezana nezimpawu noma unokukhathazeka. Ngokuphathwa okufanele nokusekelwa, abantu abaningi abane-ulcerative colitis bangaphila ukuphila okwanelisayo futhi babhekane ngokuphumelelayo nezinselele zalesi simo.

Imibuzo Evame Ukubuzwa

1. Sibi kangakanani i-ulcerative colitis?

I-Ulcerative colitis (UC) yisimo esingelapheki samathumbu esingathinta kakhulu izinga lempilo yomuntu. Nakuba ubunzima bayo buhluka, kungaholela ezinkingeni ezinkulu njengokwanda kwengozi yomdlavuza wamathumbu kanye nokungakhuli kahle kwezingane. Ezimweni ezingavamile, ifomu elinzima elibizwa ngokuthi i-fulminant ulcerative colitis ingaba yingozi empilweni, idinga ukunakekelwa okuphuthumayo kwezokwelapha.

2. Ingabe i-ulcerative colitis ingaphela?

I-Ulcerative colitis yisimo sesikhathi eside esingavamile ukuzihambela sodwa. Kodwa-ke, ngokwelashwa okufanele, abantu abaningi baba nezikhathi zokukhululeka lapho izimpawu zehla. Cishe u-70% weziguli usabela kahle emithini futhi bathole ukuthethelelwa. Kulabo abangaphenduli emithini, ukuhlinzwa ukuze kukhishwe ikholoni kungelapheka ngokuphumelelayo i-ulcerative colitis.

3. Iyini imbangela ehamba phambili ye-ulcerative colitis?

Imbangela yangempela ye-UC ayikaziwa. Kodwa-ke, kuthathwa njengesimo se-autoimmune lapho amasosha omzimba ehlasela ngephutha izicubu ze-colon enempilo. Abacwaningi bakholelwa ukuthi inhlanganisela yezinto zofuzo nezemvelo kungenzeka ibangele lokhu kusabela okungavamile kwamasosha omzimba.

5. Kungani i-colitis iqala?

Nakuba imbangela eqondile ye-ulcerative colitis ingacacile, izici eziningana zingase zibe nomthelela ekuqalekeni kwayo. Lokhu kuhlanganisa ukuthambekela kofuzo, iminyaka (izifo eziningi zenzeka phakathi kweminyaka eyi-15-30), kanye nobuhlanga (kuvame kakhulu kubantu abamhlophe bozalo lwaseYurophu). Izici zemvelo kanye nezinguquko ku-gut microbiome nazo zingadlala indima ekuthuthukisweni kwalesi simo.

6. I-colitis ihlala isikhathi esingakanani?

I-Ulcerative colitis ngokuvamile ihlanganisa izikhathi zokuqubuka okulandelwa ukukhululeka. Ubude balezi zikhathi bungahluka kakhulu kumuntu nomuntu. Ngokwelashwa okufanele, abantu abaningi bangakwazi ukuthola isikhathi eside sokuxolelwa. Kodwa-ke, kwabanye, izimpawu zingase zibe zimbi ngokuhamba kwesikhathi, okungase kuholele esidingweni sokuhlinzwa kuma-30% wamacala.

 UDkt. Jagadeeswar S

CARE Medical Team

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