Kurapa Kwezvirwere Zvirwere Zvirwere

Inorwarisa Bowel Disease (IBD) Mishonga

Zvirwere zvinokonzera kupisa (IBD) , izvo zvinosanganisira Crohn's disease, ulcerative colitis, uye indeterminate colitis, zvirwere zvisingaperi zvekudya kwekudya. Ikozvino haisi mushonga wehupi hupi hweBD, asi kune nzira dzakanaka dzokurapa. Pano tinokurukura nezvemishonga inogamuchirwa kune miviri mikuru yeBD: Crohn's disease uye ulcerative colitis. Varwere vane indeterminate colitis (iyo inofungidzirwa kuti inosanganisira anenge 10 muzana yevarwere vane IBD) inowanzopiwa kurapwa kunogamuchirwa kuonda kwehutachiona.

> Cherechedza kuti sei ulcerative chirwere chinokanganisa koro.

Kune mishonga yakawanda inobvumidzwa kushandiswa kune vanhu vane Crohn's disease uye ulcerative colitis. Vamwe, zvakadaro, vanobvumirwa chete kune mumwe kana mumwe. Zvinodhaka zvine maitiro akasiyana-siyana ekushanda uye kupa, saka varwere uye gastroenterologists vanogona kushanda pamwe chete kuti vawane chisarudzo icho chisinganyatsobudiriri zviratidzo zvavo, asi chinopindirana mumararamiro evarwere.

• Kuve-ku-Date pane Vaccinations Kunokosha Kune Vanhu Vane IBD

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Mashoko akanaka ndeokuti kana imwe mishonga kana rudzi rumwe rwemishonga isiri kuita basa, pane zvimwe zvinodhaka mukirasi imwechete, kana mune imwe kirasi, inogona kuedzwa zvakare. Kunyange zviri nani zviri nani ndezvokuti mishonga yakawanda iri kushandiswa mukurapa IBD, uye pane tariro huru kupfuura kare kare kuti uwane mushonga unoshanda zvakanaka kutarisa zviratidzo zveBD uye kuvhiringidza IBD kunokonzera.

Kuvhiya inzirawo yekurapa IBD, uye yeRodhn's disease uye ulcerative colitis, marudzi akasiyana-siyana ekuvhiya anoshandiswa semushonga. Zvisinei, rudzi rwekuvhiya hunoshandiswa richave rwakasiyana zvichienderana nokuti rakaitwa kurapa chirwere cheCrohn kana chironda chekuonda.

Izvi zvinokonzerwa nenzira dzakasiyana-siyana zvirwere izvi zvinokanganisa chirongwa chekudya uye kushanda kunovandudza zviratidzo uye mararamiro ehupenyu kuvarwere. Apo pfungwa yekuvhiya inotyisa, inoshandiswa chete mushure mokunge mamwe mishonga akaedzwa uye haasisiri kushanda.

Zvinangwa zveBD Treatment

Kune mishonga yakasiyana yakasiyana-siyana inoshandiswa kurapa IBD. Iyi mishonga inowanzotaurwa pamusoro pemakirasi, uye inosanganisira maantibiotics, biologics, corticosteroids, uye immunomodulator. Mishonga ine mishonga ine chinangwa chemaviri: kuwana ruzha- pasi pasi pekutonga uye mukuregererwa, uyezve kuchengetedza kukanganwirwa kuenda uye kudzivirira mamwe mahara-ups. Mimwe mishonga inoshandiswa kune imwe yezvinangwa kana imwe, uye imwe inoshandiswa zvose.

Ikoko hakuna mutezo mumwechete werapi inoshandiswa kumunhu wese ane IBD. Ikoko kune mazano anopiwa nevechiremba, asi kurapwa hakusi imwe-yakakosha-inokodzera-zvose zvinokurudzira. Kuchengetwa kwechiremba kuchadikanwa kuenzaniswa kugadzirisa zvinodiwa zvevarwere vese.

Izvozvo zvichiti, zvisinei, zvisarudzo pamusoro pekusarudzwa kwemishonga zvinobva pauchapupu hunobva pakutsvakurudza.

Crohn's Disease Treatments

Mishonga yeCrohn's Disease

Mishonga inoshandiswa kubata chirwere cheCrohn inosanganisira:

Antibiotics

• Cipro (ciprofloxacin)
• Flagyl (metronidazole)

Immunomodulators

• 6-mercaptopurine (Purinethol, 6-MP)
• Azathioprine (Imuran naAzasan)
• Folex, Rheumatrex (methotrexate)
• Prograf (Tacrolimus)
• Sandimmune, Neoral (cyclosporine A)

Corticosteroids

• Cortenema (hydrocortisone)
• Deltasone ( prednisone )
• Entocort (budesonide)
• Medrol (methylprednisolone)
• Proctofoam-HC (hydrocortisone acetate, rectal foam)

Biologic Therapies

• Cimzia (certolizumab pegol)
• Entyvio (vedolizumab)
• Humira (adalimumab)
• Inflectra (infliximab-dyyb)
• Remicade (infliximab)
• Stelara (ustekinumab)
• Tysabri (natalizumab)

Kuvhiya kwaCrohn's Disease

Kazhinji kuvhiyiwa kunoitwa mushure mekunge mishonga isiri kubatsira nekuputika kana kune zvinetso. Chirwere chekuvhiyiwa chakaitwa chichave chakavakirwa pane nzvimbo yekuvhiringidzika kwechirwere cheCrohn chiri kukonzera uye kuti yakareba zvakadini.

Kuvhiya hakuzove kurapa kwechirwere cha Crohn uye, mune vamwe vanhu, chirwere cheCrohn chirwere chinogona kudzokera pane imwe nzvimbo.

Kuvhiya kwechirwere cheCrohn kunogara kuchivandudza, uye pane dzimwe nguva zvinogona kuitika nenzira shomanana dzisingaiti (dzakadai sokuvhiya kweparoscopic ) iyo inopera nenguva panguva yechipatara uye nguva yekudzorera. Heano maitiro mashomanana emhando dzakawanda dzinowanikwa pakuvhiyiwa kunoitwa kurapa chirwere cha Crohn:

• Kuregererwa : Rudzi rwakajairika rwekuvhiya rwakaitwa pakurapa chirwere cheCrohn chirwere. A resection ndeye apo chikamu chemukati chirwere chinopisa kana chirwere chibviswa, uye mapepa maviri ehutano hwakanaka anoderedzwa zvakare pamwe zvakare (anonziwo anastomosis). Izvi zvinogona kuitwa mumukati muduku kana mumukati mukuru .
• Strictureplasty : Chirwere cheCrohn chinogona kukonzera mvere dzemaoko dzinovaka uye dzinogona kukonzera kuderedza mumatumbo. Apo chikamu chemukati chikava chakanyanya kuderera, chinogona kuvhurwa zvakare panguva yekuvhiyiwa kweprictureplasty.
• Proctocolectomy : Mune vamwe vanhu vane Crohn's disease apo pasina chirwere mune rectum, kugadzirisa proctocolectomy kunogona kuitwa. Utumbo hukuru hubviswa uye kuguma kwemukati mudumbu kunosangana zvakananga kune anus. Izvi zvinoreva kuti stoma haifaniri uye chigaro chinogona kupfuudzwa pasi. Izvi zvinowanzovhiyiwa chete mune rimwe boka revarwere. Ukuvhiyiwa kunonziwo yeooanal anastomosis (yakananga-kupfuura-nenzira).

• Mutungamiri Wako Kuwana Nzira yePrednisone

• Zvinonzi Vanhu Vane IBD Vanofanira Kuziva Pamusoro Pechi Cipro

• Kuvhiyiwa kwemhuka : Vamwe vanhu vane chirwere cheCrohn chinokanganisa korocha vachavhiyiwa kuti vaite ileostomy. Iyi ndiyo apo mbiru inobviswa uye stoma inogadzirwa pamimba. Chifukidzo chinobuda kunze kwemuviri kuburikidza ne stoma pane pasi, uye chigadzirwa chewastomy chakapfekedzwa pamuviri kuti chigone. Vanhu vazhinji vane Crohn's disease havazodiwi chirwere chemaostomy.

Zvirwere zveUlcerative Colitis

Mishonga yeUlcerative Colitis

Mishonga inoshandiswa kurapa utachiona hwekurwadza inosanganisira:

Aminosalicylates (5-ASA)

• Azulfidine (sulfasalazine)
• Asacol , Pentasa, Lialda, Apriso , Delzicol (mesalamine)
• Canasa (mesalamine suppositories)
• Colazal (balsalazide)
• Dipentum (olsazine)
• Rowasa (mesalamine enemas)

Immunomodulators

• 6-mercaptopurine (Purinethol, 6-MP)
• Azathioprine (Imuran naAzasan)
• Sandimmune, Neoral (cyclosporine A)
• Tacrolimus (Prograf)

Corticosteroids

• Cortenema (hydrocortisone enema)
• Deltasone ( prednisone )
• Entocort (budesonide)
• Medrol (methylprednisolone)
• Proctofoam-HC (hydrocortisone acetate, rectal foam)
• Uceris (budesonide)

Biologic Therapies

• Entyvio (vedolizumab)
• Humira (adalimumab)
• Inflectra (infliximab-dyyb)
• Remicade (infliximab)
• Simponi (golimumab)

Kuvhiya kweUlcerative Colitis

Crohn's naColitis Foundation yeAmerica inofungidzira kuti pakati pe 23 muzana uye 45 muzana yealcerative colitis varwere vanovhiyiwa. Zvokuvhiya zvealcerative colitis nguva dzose zvinosanganisira kubviswa kwemukati mamukaka (colectomy), nekugadzirwa kwe stoma kana mukati rehomwe kutora chigaro. Zvokuvhiyiwa zvealcerative colitis zvinosanganisira:

• Protocolectomy nekugadzirwa kwechikwata chepilvic : Mushure mokunge chikoni chacho chabviswa kuti chirape ulcerative colitis, chikwama chemukati chinogadzirwa kunze kwechikamu chekupedzisira chemukati mudumbu (the ileum). Nechikwata ichi, hapana chekunze chekudzivirira ostomy kana kuti stoma nokuti chikwama chinoita se rectum. Tsvina yepelvic inogona kuitwa mune zvishoma zvisikwa zvakasiyana, asi iyo inowanzoshandiswa ndiyo j-pouch. Ukuvhiya kunonziwo yeal pouch-anal anastomosis, kana IPAA.
• Protocolectomy nekusikwa kweeostomy : Mushure mekunyanya kukonzera, vamwe varwere vane ulcerative colitis vane yeostomy yekupedzisira yakagadzirwa. A stoma inoumbwa pamubvunzo wekufamba kwechigaro uye chigadzirwa che ostomy chakapfekedzwa pamusoro pe stoma. Pfungwa yekuve ne stoma inotyisa, asi vazhinji varwere vane ulcerative colitis vane unhu hwepamusoro hwehupenyu mushure mekuvhiyiwa neoodomy uye vanoita zvakanaka kwazvo ne stoma yavo.

Shoko Rinobva

Kune dzimwe nzira dzakawanda dzokurapa uye dzokuvhiya dziripo nhasi kuti dzirape Crohn's disease uye ulcerative colitis kupfuura kare. Zvirwere izvo zvakave zviripo mumakore achangobva kupfuura zvinobudirira, uye pane zvakawanda zviri kudzidzwa.

Chikamu chakakosha pakurapa IBD kubudirira uye kuzviwana mukuregererwa ndekuona gastroenterologist nguva dzose uye kutora mishonga panguva. Nezvimwe zvakasiyana-siyana zvemishonga zvinowanikwa, varwere vakawanda vanogona kuburutsa kuvhiringidza, kudzivirira matambudziko, uye kuvandudza hupenyu hwehupenyu hwavo.

> Sources:

> Bhandari BM, Kroser JA. "Chirwere chechirwere chezvirwere." American College of Gastroenterology. March 2010, March 2011. Cleveland Clinic Foundation. 26 Septemba 2013.

> Braegger CP, Nicholls S, Murch SH, Stephens S, MacDonald TT. "Tumor necrosis chinonzi alpha muchitsiko sechiratidzo chemuviri kuputika." Lancet. 1992; 339: 89.

> Crohns & Colitis Foundation of America. "Kuvhiya kwaCrohn's Disease & Ulcerative Colitis." CCFA.org. 31 Aug 2010.

> Terdiman JP, Gruss CB, Heidelbaugh JJ, Sultan S, Falck-Ytter YT, iyo AGA Institute Clinical Practice uye Quality Management Committee. "American Gastroenterological Association Institute Guideline pamusoro peKushandiswa kweTyopurines, Methotrexate, uye Anti-TNF-a Biologic Zvinodhaka zveInduction uye Maintenance yekuregererwa Mukurwara kweCrohn's Disease." Gastro. 2013; 145: 1459-1463.