Rectal pain syndromes reclassified
Chronic proctalgia ishoko rakange rarega. Iyo yakataura nezvemamiriro ezvinhu umo munhu anowirwa kurwadziwa kwepachivirikiti kwekanguva kwemaminitsi makumi maviri, asina chimiro chinogoneka kana hutano hunoenderana nehuwandu hwekuzvidavirira kune marwadzo.
Izwi iri raishandiswa kusvikira Roma IV Criteria yeColorectal Disorders yakabvisa muna 2016.
Zvisinei, zvinogona kunge zvichiri kuonekwa mukuongororwa uye kuenzaniswa kusvikira vashandi vezvechiremba vakatanga kushandisa zvitsva. Dzidza zvinorehwa neshoko uye kuti rakatsiviwa sei.
Kuchinja kuDondedzero yeRecentalgia Isingaperi
Pasi pemuRoma III maitiro, chronic proctalgia yakanga yakasiyana nekureba kwenguva yezviratidzo zvayo kubva kuproctalgia fugax , iyo inoratidzirwa nekurwadziwa kwechimbichimbi chinotyisa chinopedza maminitsi makumi maviri. Chronic proctalgia yakaparadzaniswa zvakare mu levator ani syndrome , inoratidzirwa nekunzwisisika kwemuviri wemuvhenekeri iyo inobatwa panguva yekuongorora kwechiremba, uye kusingazivikanwi kushandiswa kwehutano hwehutano kana pasina rudo.
Apo kutsvakurudza kwakasawana zvikamu zvakasiyana zvezviratidzo zveproctalgia fugax uye chronic proctalgia, izwi rechirwere proctalgia rakabviswa muRoma IV. Zvisinei, nzira dzepasi uye kusarudzwa kwehutano zvakasiyana kune idzi syndromes neRoma IV dzinosanganisira maitiro ainge ari pasi pemazuva ano proctalgia sevako syndromes.
- Levator ani syndrome : Mune chimiro chechirwere chinonzi proctalgia, vanhu vanonzwa tsitsi pa puborectalis (musuru mukati memapapiro enyu) apo inobatwa panguva yekuongorora kwechiremba.
- Usingazivikanwi hutano husingaiti maitiro : Ichi chimiro chechironic proctalgia chinoratidzwa kana iwe uchinzwa usiri unyoro hwakadaro pane puborectalis kana huri kuitika panguva yekuongorora kwemashure.
- Proctalgia fugax : IRoma Rome yakagadziridzwa yakaita shanduro yezwi iri. Iye zvino nguva yakareba ndeyemaminitsi makumi matatu pane maminitsi makumi maviri uye nzvimbo yacho iri mumutsara pane pane muzasi rectum kana anus.
Zviratidzo
Zviratidzo zve syndromes idzi zvinowanzoonekwa sechinhu chine nguva refu chine tsvina kana kuti kushungurudzika-kufanana mukati mutsva-kakawanda kunowanikwa kune zvakanyanya pamusoro peiyo rectum. Zvinogona kukuvadza kana iwe ugere kwenguva yakareba uye unogona kusununguka paunomira kana kurara pasi. Kusuruvara kunogona kuwedzerwa sezvinoitwa nezuva asi hazviwanzoitiki usiku. Marwadzo angave akanzwika kakawanda panguva dzinotevera:
- Kuita zvepabonde
- Ichitevera kufamba kwemuviri
- Munguva dzenguva yekudzvinyirira.
- Pakufamba kwenguva refu
Kuziva
Nokuda kwemishonga inonzi syndromes iyo yaiva subtypes yeprotalgia chisingagumi, chirwere chebasa chinoshanda (FGD), zvirwere zvekuongororwa zvinongorongedzerwa kutonga kunze kwemamwe matambudziko ehutano. Kana zvisina kudaro, vanachiremba vachaita kuti vaongororwe zvichienderana nezviratidzo maererano neRome IV mazano eFGDs:
- Kurwara kana kukonzera kurwadziwa kwemawere kana kupera
- Kushungurudzika kunofanira kutora kwemaminitsi makumi matatu
- Zvimwe zvinokonzera kurwadziwa kwemawere (chimiro kana kuti systemic) chinofanira kutarisirwa kunze
- Zviratidzo zvinofanira kunge zviripo kwemwedzi mitatu nekutanga kwemwedzi mitanhatu isati yasvika.
Kuti uone kuvepo kwevashandi ani syndrome, chiremba wako angangodaro achiongorora kuongorora kuti aongorore unyoro.
Zvinokonzera
Chikonzero chaicho chaicho chemamiriro aya hachizivikanwe. Munguva yakapfuura, yaifungidzirwa kuti chiitiko chacho chaive chikonzero chekusingaperi kusagadzikana kana kuputika kwemisungo mukati mevhu repelvic , kunyange zvazvo tsvakurudzo yekutsigira kwechikonzero ichi yave isina kukwana. Zvimwe zvinotsvaga tsvakurudzo zvinoratidza kuti inogona kuita dyssynergic defecation , mamiriro ayo maitiro emusara wepelvic asingashandisi sezvaanofanira.
Zvimwe zvinogona kuwedzera mungozi yemunhu wekuvandudza idzi syndromes dzinosanganisira:
- Anal opera
- Kubereka
- Kuvhiyiwa kwepelvic
- Kuvhiyiwa kwepamuviri
Iko kunewo sangano pakati pemazuva ano proctalgia uye yakakwirira maitiro ekuora mwoyo uye kushungurudzika kwepfungwa. Zvisinei, hazvizivikanwe kana izvi zviratidzo zvepfungwa zvinowedzera dambudziko, kana kuti chikonzero chekuwana, zviratidzo zvisingagumi zvemarwadzo emaronda.
Kurapa
Biofeedback iye zvino inoshandiswa kurapwa kwevashandi ani syndrome mushure mekuratidzwa nekutsvakurudza kuti ive yakanyatsobudirira kana ichienzaniswa neyemagetsi ekusimudzirwa kwechirwere chemafuta uye kuisirwa kwemashure emishu. Kukurudzira magetsi kwakaratidzwa kuti kunobatsira uye kunogona kushandiswa kana biofeedback isiripo. Aya marapirwo anotsiva mararamiro anoshandiswa, ayo akabatanidza kuiswa kwemajitisi ejiti ani musumbu, kusununguka kwemisungo, uye kushandiswa kwetizaziti , izvo zvose zvakaratidza kushanda kwakakwana. Kuvhiya hakufungi kuti inobatsira kurapa kwenguva refu proctalgia.
Sources:
> Chiarioni G, Asteria C, Whitehead W. Chronic proctalgia uye isingaperi maperembudzi ekurwadziwa kwepilvic: Mazano matsva etiologic uye kurapa " World Journal of Gastroenterology 2011 17: 4447-4455.
> Schmulson MJ, Drossman DA. Chii Chitsva muRoma IV? Nhamba yeNeurogastroenterology neMotility . 2017; 23 (2): 151-163. doi: 10.5056 / jnm16214.