A Comple Common Complication Of IBD, Arthritis Inobata Anofungidzirwa 25% Yevarwere
Chirwere chechirwere chinokonzera chirwere (IBD) chinosanganiswa nemamwe mimwe mitemo, kusanganisira chirwere cheropa chinonzi primary sclerosing cholangitis , fissures , fistulas , uye arthritis. Arthritis ndiyo inonyanya kushandiswa pakuwedzera kwepfungwa, iyo inofungidzirwa inofungidzirwa 25% yevashandi veBD. Mhando mbiri dzakawanda dzinowanzosangana neArthritis dzinowanikwa neVIV varwere inoparara arthritis uye axial arthritis.
Nemhaka yokuti arthritis yakakurumbira, zvinokosha kuti vanhu vane IBD vakwanise kutarira aches nemarwadzo. Kunyange zvazvo humwe hurombo huri kuitika, hunofanirwa kuendeswa kumisangano pamwe nevarapi vako. Kuchengeta manhengo sehutano sezvinobvira nekudzivirira zvinhu zvinokuvadza, pamwe nekugara pamusoro pematambudziko chero ipi zvayo kana ikakwira, inokosha. Kana kurwadziwa kunotambudza, kunofanira kutaurwa pamusoro pegastroenterologist kana rheumatologist usati watanga mishonga yemarwadzo, nokuti vanhu vane IBD vangada kudzivisa mamwe marudzi emishonga (kunyanya NSAIDs, ona kukurukurirana pasi).
Peripheral Arthritis
Peripheral arthritis inowanzoonekwa kune vanhu vane chironda chekurwara kana chirwere cheCrohn chekoloni . Kubva pamhando dzakasiyana dzeArthritis inobata vanhu vane IBD, inofungidzirwa kuti 60% kusvika ku70% inoshungurudzwa nehutachiona hweArthritis. Kazhinji, nzira yeArthritis inotevera iyo yeBD, ine mhirizhonga uye kuregererwa kuwirirana.
Ikoko hakuna chiyero chimwe chete chinogona kuongorora hutachiona hwehutachiona. Pane kudaro, kuongororwa kwakawanda, kwakadai sekuongororwa kweropa, kubatana kwechirwere ichi , uye x-ray , zvinoshandiswa kurega mamwe mamiriro ezvinhu angave achikonzera zviratidzo.
Zviratidzo zvepachiviri arthritis zvinosanganisira:
- Joint pain
- Kufuridzira majoints
- Kushushikana mune imwe kana mamwe mapfundo
- Zviratidzo zvinotama pakati pezvisungo
Peripheral arthritis inowanzochinja huta, huno, mabvi, uye maziso. Kana marwadzo kubva kumarapritis arthritis akasiyiwa asingateereri, anogona kugara kubva mumazuva mazhinji kusvika kumavhiki; zvisinei, kukanganisa kusingaperi kwezvibatanidzwa hakuwanzowaniki.
Kurapa piripritis arthritis kunowanzobatanidza kuzorora marwadzo anorwadza pamwe chete nemakumbo uye kupisa kunonyorova. Kudzidzira kunorayirwa nechiremba wepanyama kunoshandiswa kuvandudza hupenyu hwekufamba. Zvisiri-steroidal anti-inflammatory drugs (NSAIDs) dzimwe nguva zvinoshandiswa kuderedza kubwinya, kuzvimba, uye kurwadziwa kwezvikamu zvinopisa - asi NSAID dzinogona kuwedzera zviratidzo zveBD .
Imwe nzira yekurapa iyi maitiro eArthritis ndeyekuwana kutarisa pamusoro pekuputika mumakoloni nekuda kweBDD. Zviratidzo zveArthritis zvinowanzoderera apo IBD inoderera, uye mishonga yakasiyana-siyana inoshandiswa kurapa IBD inogona kubatsirawo pakutsvaga arthritis. VARV vanorapwa ne prednisone vanowanzowana bhonasi yechirwere chekusunungurwa kubva kune marwadzo pamwe chete. Varwere vanogamuchira anti- tumor necrosis factor-alpha (anti-TNF) zvinodhaka, zvakadai seRemicade (infliximab) kana Humira (adalimumab) , kuti vararame IBD yavo inogonawo kugadziridzwa zviratidzo zveArthritis.
Azulfidine (sulfasalazine) , 5-Aminosalicylate zvinodhaka izvo zvakagara zvichishandiswa kurapa IBD, zvinogona kupawo zviratidzo zvekusununguka kunyange pasina humwe uchapupu hunotsigira kushandiswa kwayo. Imwe mishonga inorayirwa kuti iite IBD, methotrexate , inogonawo kuva mushonga unoshanda weperiipheral arthritis.
Axial Arthritis (Spondyloarthropathy)
Muzviitiko zveaxial arthritis, zviratidzo zvinogona kuonekwa mwedzi kana makore kusati kwavapo kweBD. Zviratidzo zvinosanganisira kurwadziwa uye kuoma mukati memajoini emutsara wepasipera ayo ari kunyanya mambakwedza, asi achavandudza nekuita basa. Kushanda axial arthritis kunowanzokonzera vanhu vaduku uye kazhinji hachisi kupfuurira kune varwere vanopfuura makumi mana.
Axial arthritis inogona kutungamirira pakukanganiswa kwemapfupa echinyorwa chetsika. Izvi zvinogara zvichiita zvinogona kutungamirira pakuderera kwemafambiro ekumhanya uye kumashure kwechibvumirano chinokanganisa kukwanisa kutora kufema zvakanyanya.
Chinangwa chekurapa kweaxial arthritis ndechokuwedzera ruzhinji rwekufamba kwemutsara. Kurapa kwepanyama, kushandiswa kwemashure uye kutambisa muviri uye kushandiswa kwemhepo inopisa kumusana, ndiyo miviri miviri yekurapa. Vamwe varwere vanobatsirwa nemishonga neNSAIDs.
Kurapa IBD kazhinji hakugoni kuitika pamhando iyi yeArthritis; zvisinei, mishonga inorwisa-TNF uye Azulfidine inogona kuva yeimwe rubatsiro mukuderedza zviratidzo.
Ankylosing Spondylitis
Ankylosing spondylitis (AS) inorudzi rweArthritis apo majoini ari mumucheto uye mapepa anopera. AS inowanzokonzera avo vane chirwere cheCrohn kakawanda kupfuura avo vane chironda chekuonda, uye varume kakawanda kupfuura vakadzi. AS inonzi ishoma nokuti inongoguma inofungidzirwa 1% kusvika 6% yevaya vane IBD. Ikoko kunogonawo kuve nemuviri weA, asi chii chinoita kuti chimiro che arthritis chisati chizivikanwe.
Kutanga kweA AS kunowanzosangana nekurasikirwa kwekushandura muchepere. Kurapa kunosanganisira kurapa kurwa uye kugadziriswa kuti urambe uchinetseka. Remicade uye Huma vanobvumirwa kuitira kurapwa kweBDD neAIDS, uye inogona kushanda mukurapa zvose zviri zviviri panguva imwe chete. Azulfidine inogona kubatsira mukuderedza zviratidzo, kunyanya kusagadzikana kwemangwanani. Zvimwe zvidzidzo zvakaratidza methotrexate kuti ive yakakosha ye AS, asi vamwe vasingaratidzi rubatsiro; methotrexate inowanzoshandiswa kurapa AS mukubatana nemimwe mishonga. Zvisinei, kunyange nemishonga, vamwe vanhu vane AS vanoramba vachiratidza zviratidzo, uye mapfupa emusana anogona kusangana pamwe chete.
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