Zviitiko zvemakamuri zvinogona kuitika asi hazvina tariro
Vanhu vane chirwere chinoputika chirwere (IBD) vanogona kuve nenjodzi yekugezera nekuda kwezvikonzero zvakasiyana-siyana. Wana boka revanhu vane IBD pamwe chete uye uchanzwa "anenge asingazviiti" uye "haana kuzviita" uye "nzvimbo dzepamusoro dzandakanyora" nyaya. Kana uri mumoto, zvinoita kuti uwane fecal incontinence (fecal soiling, kana ngozi dzekugezera), asi kazhinji kacho chinetso chechinguvana chinogadzirisa apo kutsamwa-kwakawanikwa kunotungamirirwa.
Vanhu vazhinji vanofunga kuti incontinence idambudziko rinongobatsira vakuru vakwegura. Ichokwadi ndechokuti incontinence inogona kuitika kuna ani zvake, pane imwe nzvimbo yehupenyu. Inofungidzirwa kuti vanhu vanosvika mamiriyoni gumi nematanhatu muUnited States vanoona kutengesa kwepecal. Kunyange vanhu vane hutano vanogona kuve nekusagadzikana kwenguva pfupi kana vane utachiona hwebhakitiriya (zvakadai semhuka isina kubvongodzwa) kana chirwere chepachiviri (dzimwe nguva chinonzi "chirwere chemimba").
Incontinence inyaya yakaoma kutaura pamusoro, uye kunyange yakasimba kubata nayo, asi kunyange zvakadaro, haifaniri kuregererwa. Ichi chinyorwa chichakurukura zvikuru pamusoro pezvikonzero uye mamiriro ezvinhu e-fecal incontinence anowirirana neBD.
Chii Chinonzi Incontinence?
Incontinence apo apo gwasi rinosiya muviri usingabviri. Izvi zvinosanganisira zvinhu zvakasiyana-siyana-chero chinhu chinobva pachidiki chiduku chinokwira ichibva kune anus (zvakadai sekupfuura gasi) kumaradhi asingadziviriki.
Incontinence inogona kunge yakaguma nechinetso nemisungo munharaunda yeanorectal, kana kuti kubva mumigunha yehutano iyo inokanganisa kukwanisa kuziva kana yava nguva yekuendesa matumbo.
Tinodzidza sevana nzira yekugadzirisa dambudziko remuviri wedu uye kugara takachena. Kuzvidzivirira kune chimwe chinhu, vazhinji vedu tinodzidziswa, kuti tiite muchivande mudzimba.
Nokudaro, incontinence ndechimwe chezvinyorwa zvinowanikwa mumutauro wedu, uye vanhu vanobvuma pachena kune iyo vanosekwa. Zvinosuruvarisa, vanhu vakawanda havambofi vakakurukura dambudziko racho nemutengi wehutano.
Ndivanaani Vanowana Kuora?
Incontinence inogona kuitika kuna ani zvake, kunyange zvazvo inowanzoonekwa nevakadzi kupfuura varume. Mimwe yemamiriro ezvinhu anosangana nefecal incontinence anosanganisira chirwere uye chirwere chendaneti. Vanhu vane zvirwere zvakakomba zvisingaperi uye avo vanopfuura makore makumi matanhatu nemashanu vanowanzoitawo kuti vasava nehanya. Vakadzi vanogona kukura nekusava nemhosva nekuda kwekukuvadza pasi pepulvic panguva yekuberekwa .
Zvinokonzera
Diarrhea. Incontinence yakabatana neBD inogona kunge yakakonzerwa nehutano hwekukurumidzira, iyo ndiyo inoda kushandiswa yekushandisa chimbuzi. Vanhu vazhinji vane IBD vanogona kufananidzwa nekudiwa kwekumhanya kune chimbuzi, kunyanya kana paine chirwere uye ichiita chirwere. Iko panguva iyi nguva zviitiko zvekugezera zvinogona, uye zvinoita, zvinoitika. Incontinence kubva kumararamiro inokonzerwa nokuputika mune anus uye rectum iyo inokonzerwa neBD, uyewo kuti mvura yakadzika (chirwere) yakanyanya kuoma kuti anal sphincter igare pane yakasimba.
Iko kukurumidzira kutamisa matumbu kunofanira kuvandudzika apo kupisa-kwarapwa kunoitwa uye chirwere chinotanga kupera.
Kusuruvara. Vanhu vane IBD, kunyanya avo vane Crohn's disease, vari pangozi yevasi . Chivharo chetachiona chinokonzera kuunganidzwa kwepus, iyo inogona kugadzira chivako panzvimbo yehutachiona. Chikamu chiri mu anus kana rectum chinogona kukonzera kusava nehanya, kunyange izvi zvisingawanzoitiki. Mune zvimwe zviitiko, chipfeko chinogona kukonzera fistula . Fistula inogadzirisa iyo inoumba pakati pemiti miviri miviri kana pakati pomuviri mumuviri uye paganda. Kana fistula inoumba pakati peanus kana rectum uye ganda, chigaro chinogona kupera kuburikidza nefistula.
Kupisa. Kuputika mune rectum chimwe chikonzero chinokonzera fecal incontinence. IBD iyo inokonzera kuvhiringidzika mu rectum inogona kutungamirira kukura kwemasumbu munzvimbo iyoyo. Apo rectum inokuvadza nenzira iyi, inogona kuita kuti miviri isanyanya kuderera. Nekurasikirwa kwekusimba, rectum haigoni kubata sechigaro chakawanda, uye izvi zvinogona kukonzera kusadzikama.
Surgery. Kuvhiya munzvimbo inonzi rectal kunogonawo kukuvadza mishonga muinus. Dambudziko rinowanzoonekwa kune vakawanda vakwegura, uye avo vane IBD havasi izvozvi, ndezvemhemorrhoids . Hemorrhoids yakave nemidziyo yakawedzerwa yeropa mune rectum inokwanisa kubuda kana kuita zvimwe zviratidzo. Kunyange zvazvo zvipembenene zvinowanzobatwa nemishonga epamba zvakadai sekudya zvakanyanya fiber, kunwa mvura yakawanda, nekushandisa kupfuura-the-creams creams uye suppositories, chirwere chinoshandiswa kune mamwe maitiro akaoma. Kana mishonga iri mu sphincter ichikuvara panguva yekuvhiyiwa kwehemorrhoid, iyo inogona kutungamirira kusina kuchena.
Kurapa
Kune mishonga yakawanda ye fecal incontinence, iyo inobva kumakamuri epamba-pamba kunoshandiswa pakugadzirwa kwemazamu uye emakumbo. Apo chinokonzeresa chinokonzera kuva chirongwa cheBD, kurapwa kwaizove kuita kuti IBD ishandiswe. Kugadziriswa kwekuputika mune anus uye rectum uye kuderedzwa kwehurwere kunogona kubatsira kumisa kusagadzikana.
Mishonga. Kune vamwe vanhu, mishonga inogona kurairwa kuti iite incontinence. Nokuda kwekurara, an anti-diarrheal agent anogona kushandiswa, kunyange zvazvo mhando idzi dzemishonga hazviwanzoshandiswa kuvanhu vane IBD (kunyanya ulcerative colitis). Mune imwe nyaya iyo fecal incontinence inobatanidza kuvharwa, zvinokonzerwa nemarara zvinogona kunyorwa (zvakare, izvi hazviwanzoitiki kune vanhu vane IBD).
Injectable mishonga. Makore achangopfuura akaona kushandiswa kwejeri re dextranomer nekuda kwekudzivirira iyo inorohwa zvakananga murusvingo rwomumatare. Iyo gel rinowedzera rusvingo rwechirwere chine simba. Kutungamirirwa kwemishonga iyi kunoitwa muhofisi yechiremba mumaminitsi mashomanana, uye kazhinji varwere vanogona kudzoka zvakare mabasa ezvisikwa anenge evhiki mushure mokugamuchira jira.
Biofeedback. Imwe mushonga wevanhu vane hutano husina kunaka ndeye biofeedback. Biofeedback inzira yekudzidzisazve pfungwa uye muviri kuti ushande pamwechete. Yakaratidza kubudirira mune mukurapa zvimwe zvirwere zvemuviri mune vamwe varwere, uye inowanzoshandiswa mushure mimwe mimwe mishonga inoratidza kuti haina kubudirira. Biofeedback chirwere chinopererwa kunze chinowanzoitwa kwemavhiki. Muzvirongwa zvebiofeedback, varwere vanodzidza kupinda mukana nemisungo yepasi yavo pasi uye kuti vave nekutonga kuri nani.
Bowel retraining . Kune vamwe vanhu, zvinogona kubatsira kuisa pfungwa pahutano hwehutano hwakanaka. Muchifuva chekudzidzira, varwere vanoisa pfungwa dzavo pamakumbo avo kwechinguva kwezuva zuva rega rega, kuitira kuti vashandise tsika dzekugara. Izvi zvinowanzowedzerwa nekushandura mune zvekudya, zvakadai sokunwa mvura yakawanda kana kudya zvimwe fiber.
Surgery. Kana dambudziko racho rakatarirwa kuti rive romuviri (zvakadai semisungo uye mishonga inokanganisa nekuvhiringidzika kana kubereka), chirwere chekugadzirisa mishonga chingashandiswa. Mune chirongwa chekuvhiya chinonzi sphincteroplasty, mishonga yakakanganiswa mumatare esphincter inobviswa, uye masara akasara akasimbiswa. Sphincter chirwere chekugadzira chakaitwa nekutora musuru kubva kune rumwe rutivi rwemuviri (zvakadai sehudyu), uye kuishandura kuti ishandise maronda akaora mu sphincter. Mune zvimwe zviitiko, kushandiswa kwe sphincter kunogona kuitwa. Mukuvhiya uku, ine inflatable tube inowanikwa munharaunda yakare. Varwere vanoshandisa pombi kuti vazarurire iyo kupfuudza chigaro, uye vozovhara zvakare mushure mekuzvidzivirira. Kunyanya kushandiswa kwekuvhiya kwakashandiswa pakurapa fecal incontinence ndiyo colostomy , iyo iyo apo ikoni inounzwa kuburikidza nemadziro emimba (kusika stoma ) uye chigaro chinounganidzwa mune chimwe chinhu chinosungirirwa chakapfekedzwa parutivi rwemuviri. A colostomy inowanzoitwa apo mamwe mishonga yose yakakundikana.
Sources:
American Society of Colon & Rectal Surgeons. "Bowel Incontinence." FACRS.org. 2012.
Ansari P. "Absentctal Abscess." The Merck Manual Home Health Handbook. May 2012.
Upenyu Uye IBD. "Kukurumidzira uye Kusagadzikana." European Federation of Crohn's uye Ulcerative Colitis Associations (EFCCA). 2013.
Palsson OS, Heyman S, Whitehead WE. "Kurapa kweByfefeedback kwekushanda kwemashoko anorectal disorders: kubvunzurudza kwakakwana kwehutano." Appl Psychophysiol Biofeedback . 2004 Sep; 29: 153-174.
US. National Institutes of Health. Dhipatimendi reHutano neHuman Services. "Fecal Incontinence." National Digestive Diseases Information Clearinghouse. 20 Apr 2012.