Izifo eziningi zegciwane lesisu zisabela kahle ekwelapheni futhi azibangeli izinkinga eziyingozi. Isongo esiyinhloko ukuvuvukala okungapheli, iqembu elibandakanya i-leite yokugcina noma yokuguqula (i-granulomatous, i-enteritis yesifunda).
Isifo sikaCrohn - izimbangela
Odokotela abakaze baqonde ukuthi kungani lokhu kuhlasela kuphakama, kunemibono embalwa nje yemvelaphi yayo. Izimbangela eziphakanyisiwe ze-leitis esibulalayo:
- ukushintshashintsha kwezakhi zofuzo;
- ukuphazamiseka kwe-autoimmune;
- ukutheleleka kwamagciwane noma amabhaktheriya.
Isifo sika-Crohn's-classification
Kunezinhlobo eziningi zezifo ezichazwe, ezihlukaniswe ngamaqembu amaningana kuye ngokuthi indawo yendawo yokuvuvukala iyini, ubunzima bayo, imvelo nezinye izici. Ngokwezilinganiso zanamuhla zamazwe omhlaba, i-terminal leitis (i-Crohn's disease) ihlukaniswa ngokwezinqubo ezine:
- iminyaka yesiguli;
- i-phenotype yesifo;
- indawo yangaphakathi yokuvuvukala;
- ukuqina kwesifo.
Amaqembu ngobudala:
- kuze kube yiminyaka engu-16 (A1);
- kusukela eminyakeni engu-17 kuya kwengu-40 ubudala (A2);
- ngemuva kweminyaka engama-41 (A3).
Isifo sikaCrohn sincike ku-phenotype:
- ukuvuvukala (B1) - i-pathology ayinzima, ngezinye izikhathi i-perianal lesion ijoyina;
- Ukuvimbela noma ukugcoba (B2) - izindonga zamathumbu ziyancipha, kukhona ukukhuliswa kwangaphambili noma isithiyo;
- Ukungena ngaphakathi (B3) - kunezifestula, izixuku zokuvuvukala nama-abscesses.
Izinhlobo ze-pathology ngokwenziwa kwendawo:
- ileitis (L1) - ileum;
- i-colitis (L2) - intumbu enkulu phakathi kwezimpumputhe futhi iqondile;
- ileocolitis (L3) - noma yikuphi indawo ephakathi kwe-rectum kanye nengxenye ekhuphuka emathunjini amakhulu;
- izitho zesigcawu esingenhla sesisu (L4).
Amafomu wesifo ngesibindi:
- ukukhanya;
- ukulinganisela;
- phezulu;
- ukukhululwa;
- ukwandisa;
- okuphindaphindiwe emva kwesikhathi.
Isifo sika-Crohn - izimpawu
Ukubonakaliswa kwemitholampilo ye-pathology ezethuliwe kufana nezinga layo, indawo yangakini kanye nenqubo yokuvuvukala, imvamisa yokuphindaphindiwe nezinye izici. Kunezibonakaliso ezithile ezingekho emthethweni ezihambisana nesifo esibulalayo - izimpawu zesimo esijwayelekile:
- imfiva noma ukuchithwa;
- ubuthakathaka;
- ukukhathala okuqhubekayo;
- isisindo somzimba esinciphile;
- ubuhlungu besisu;
- ukungabi nesifiso sokudla;
- I-diarrhea ihlala isikhathi esingaphezu kwamaviki ayisithupha.
I-terminal catarrhal ileitis
Lolu hlobo lwesifo lubonakala ngokuvuvukala kuphela kwezingqimba zamangqamuzana ezitho zomuthi wamathumbu. Isifo sikaCrohn sefomu le-catarrhal lingase lihambisane nezimpawu zamathumbu namathumbu. Iqembu lokuqala lemibonakaliso yemitholampilo ihlanganisa:
- ubuhlungu, ukulingisa i- appendicitis enzima;
- isicasuli;
- i-anorexia;
- ukuhlanza;
- ukuvula;
- isifo sohudo.
Izibonakaliso zangasese zesifo sikaCrohn:
- conjunctivitis, uveitis noma keratitis;
- i-aphthous stomatitis;
- i-cholangitis ye-sclerosing ;
- i-cirrhosis;
- i-pyelonephritis;
- ukubola kwesibindi kwesibindi;
- i-cholelithiasis;
- i-cystitis;
- i-hydronephrosis;
- i-cholangiocarcinoma;
- i-amyloidosis yezinso;
- nephrolithiasis.
I-Terminal follicular ileitis
Ku-submucosa ye-thin and ileum, inani elikhulu lama-Peyer's plaques atholakala. Lezi ziyi-follicle ezikhethekile ze-lymphoid, ezenzelwe ukukhiqizwa kwama-immunoglobulin. I-terminal ye-terminal isithinta kakhulu izakhiwo ezinjalo, okuholela ekuboniseni izimpawu ezivele zikhona kanye nokubonakaliswa kwemitholampilo eyengeziwe:
- ukutholakala kwezifo eziningi, ikakhulukazi izifo ezithathelwanayo;
- i-spondylitis e-ankylosing;
- i-nodal erythema;
- i-pyrenerma ehlukumezayo;
- i-angiitis;
- izinqubo zokunamathisela;
- i-monoarthritis;
- i-peritonitis;
- izifundo ze-fistulous;
- amakhanda angaphakathi;
- Ukunciphisa ukukhanya kwe-lumen nokuvimbela emathunjini;
- ukwanda okuqhubekayo ekushiseni komzimba.
I-eliitis terminal esibulalayo
Lesi sifo sikaCrohn sibonakala ekwakheni izilonda ezijulile ezingxenyeni zamangqamuzana ezingxenyeni zomuthi wamathumbu. Ukuvuvukala okuhlanganiswa nezinqubo ezithintekayo kubhekwa njengenye yezinhlobo eziyingozi kakhulu ze-leitis esibulalayo, okuholela emiphumeleni eyingozi neyingozi yokuphila. Isifo se-Ulcerous Crohn - ukubonakaliswa:
- ukuguqulwa kwezindonga zamathumbu;
- ukuphuma kwangaphakathi;
- megacolon enobuthi;
- ama-abscesses ngenxa yokutheleleka kwesibili.
Isifo sikaCrohn - ukuxilongwa
Isithombe se-clinical of leitis esibulalayo akuyona into ecacile, ngakho-ke okokuqala igastroenterologist kufanele ikhumbule ezinye izifo eziningi ezinezibonakaliso ezifanayo. Kubalulekile ukuhlukanisa i-digestive pathologies, ephelezelwa yisifo sohudo, kanye nokuxilongwa kwezifo zikaCrohn - ukuhlukana ngokuhlukile uma kwenziwa ngezifo ezinjalo:
- i-mesenteritis;
- i-appendicitis;
- i-salmonellosis;
- ukungena;
- shigellosis;
- i-colitis;
- isifo sofuba esiswini;
- i-angiitis;
- i-gonorrheal noma i-chlamydial proctitis;
- amebiasis;
- i-lymphoma yamathumbu.
Izindlela ze-Instrumental nezama-hardware zisetshenziselwa ukuqinisekisa ukuthi yikuphi ukugcina:
- ikholonoscopy;
- i-endoscopy ne-biopsy;
- i-radiograph yesikhumba sesisu;
- i-resonance magnetic noma i-tomography ehlanganisiwe yamathumbu ngokuphambene.
Ukuhlolwa kwesifo sikaCrohn
Ukucwaninga kwelabhulali kuyasiza ekusekeni ukuxilongwa okufanele. Indlela eyinhloko yokuthola isifo sikaCrohn ukuhlolwa kwegazi:
- for antibodies kuya Saccharomyces cerevisae (okubizwa ngokuthi ASCA);
- okuvamile;
- i-biochemical;
- immunological.
Ukwengeza, ukuhlaziywa kwesibalo kwenziwa:
- i-bacteriological;
- kuya ezingeni le-calprotectin;
- i-parasitic.
Ukwelashwa kwesifo sikaCrohn
Ngenxa yokungabi khona kwezimbangela ezidumile ze-pathology ejwayelekile, ukwelashwa okukhethekile kokuqedwa kwayo akukakhiwa. Zonke izinketho, indlela yokwelapha isifo sikaCrohn, ubilise phansi ukuyeka inqubo yokuvuvukala, ukuvimbela izinkinga nokubuyela emuva. Izindlela eziyinhloko zokwelashwa yimithi nokudla. Lapho kukhona imiphumela ebuhlungu ye-leitis yokuphela, ukungenelela kokuhlinzwa kwenziwa.
Isifo sikaCrohn: ukwelashwa - izidakamizwa
Isiqondiso esiyinhloko ekwelapheni lesi sifo ukususwa kokuvuvukala nokubuyiselwa kwenqubo evamile yokugaya ukudla. I-Terminal Ileitis - ukwelashwa kuhilela ama-pharmacy elandelayo:
- i-glucocorticoids - i-Prednisolone, i-Methylprednisolone;
- salicylates - Mesazalin, Sulfasazalin;
- immunosuppressants - Methotrexate, i-Azathioprine;
- amahomoni angama-hormone - uBudesonide, i-Beklazone;
- ama-antibiotics - i-Rifaximin, i- Ciprofloxacin ;
- amalungiselelo ephilayo wezobuchwepheshe bezakhi zofuzo - i-Etanercept, i-Infliximab nabanye.
Isifo sikaCrohn siyaqhubeka siphenywa, ngakho ososayensi bahlale befuna izindlela ezintsha zokubhekana nesifo esibulalayo. Izinketho ezingase zifinyelelwe yizo:
- abavimba be-integrin receptors - i-Vedolizumab;
- phila abaxhasi noma ama-bacterium ashintshwe ngokofuzo;
- ama-sorbents;
- i-conjugated acid linoleic;
- Ukulandelana kwe-DNA;
- amalungiselelo e-nanotechnology;
- ama-enzyme;
- i-plasmapheresis;
- ama-stem cells - polychrome;
- ukubeka ekamelweni lokuxuba;
- kusho inambuzane - i-Naltrexone;
- i-plasmabsorption;
- imishanguzo ephikisana nesifo sofuba samathumbu;
- Amalungiselelo asekelwe amaqanda ama-porcine izimpethu (TSO) nabanye.
Ngezifo zikaCrohn
Zonke iziguli ezine-gastroenterologist ne-diagnostic ebonisiwe kufanele zinikezwe ukudla okukhethekile. Ukudla kwe-leitis esibulalayo kukhethwa ngokucabangela uhlobo lwesigaba sesifo kanye nokuba khona kwezinkinga. I-degree elula ye-pathology, ukudla okuningi kuvunyelwe ukuba kudliwe. Ukudla kwesifo sikaCrohn kuhilela okuhlukile:
- ufulawa omusha nemikhiqizo yokubhaka;
- ukudla okulula;
- izimpande ezicebile;
- izitshalo zemifino nezitshalo;
- imikhiqizo yokubhema;
- ubisi nemikhiqizo yobisi;
- inyama enamafutha, inhlanzi;
- ukudla okusemathinini;
- ibhali, i-millet, ibhali lensiza;
- ubhontshisi;
- noma yimaphi amaswidi;
- imifino;
- iziphuzo ezibandayo nezibandayo;
- i-cocoa noma ikhofi ngobisi.
Ukuphakanyiswa okuphakanyisiwe:
- izitsha ezivela ezinhlanzini ezinamafutha aphansi noma inyama enobuthi, ezitshisiwe noma eziphekiwe (soufflé, cutlets kanye nabanye);
- rusks kusuka ofulawa ophezulu kakhulu;
- i-calcined noma igcwele cottage ushizi omusha;
- amahlumela angenamandla noma angenamafutha anezela amaqanda ama-egg, ama-meatball, ama-creamal broths (ama-mango, ilayisi);
- amaqanda (abilisiwe abilisiwe omelet);
- ibhotela, njengokugcwalisa izitsha;
- ama-apula aluhlaza;
- i-oatmeal, irayisi, i-semolina iphariji emanzini afomeni;
- itiye elihlaza;
- ikhofi noma i-cocoa emanzini;
- berry iziphuzo izithelo;
- amajusi wezithelo ezihlanjululwe;
- i-kissel;
- umhluzi we-dogrose.
Kubalulekile ukuba udle kaningi nangezingxenye ezincane, ngaphezu kwalokho uthathe amaminerali namavithamini, ikakhulukazi amaqembu B, A, D, E no K. Uma kunesidingo, udokotela angalungisa ukuhluka okunikeziwe kokudla (ithebula 4 ngokusho kwePevzner) ngokwemigomo elandelayo:
- izici ze-pathology;
- ukuqina kwemibonakaliso yemitholampilo;
- ubukhulu bezimpawu;
- ukutholakala kwezifo ezihambisanayo nezinkinga;
- inhlalakahle yomuntu;
- imiphumela emibi yokwelashwa kwezidakamizwa.
Isifo sika-Crohn - ukwelashwa ngamakhambi abantu
Eziningi zokupheka ezinye zisiza ukuyeka ngokushesha inqubo yokuvuvukala nokubuyisela ukugaya okufanele. Iseluleko somphakathi indlela yokwelapha i-leitis esibulalayo kufanele ihlanganiswe nemithi yokwelashwa. Ngokwehlukana, izindlela zokwelapha zemvelo zinomthelela omncane kakhulu, ngakho zisetshenziselwa izinyathelo zezempilo ezengeziwe.
Itiye elwa nokuvuvukala
Izithako:
- izimbali ze-chamomile ekhemisi - 30-35 g;
- amanzi abilayo - 200-210 ml.
Ukulungiselela, sebenzisa:
- Thela izinto zokusetshenziswa zemifino ngamanzi ashisayo.
- Ngamahora angu-1-3.
- Phuza yonke imithi yokwelapha ngaphambi kokudla.
- Phinda izikhathi ezingu-5-6 ngosuku.
Decoction against isifo sohudo
Izithako:
- Izithelo zikaBilberry - 100-140 g;
- amanzi - ilitha eli-1.
Ukulungiselela, sebenzisa:
- Bilisa amajikijolo ngamanzi abilayo imizuzu engu-10.
- Hlunga i-compote ephumela.
- Phuza ikhambi phakathi nosuku.
Ukwehliswa kwe-Spasmolytic
Izithako:
- izimpande ze-marshmallow zingama-100-150 g;
- amanzi - 50-80 ml.
Ukulungiselela, sebenzisa:
- Hlanganisa futhi uthathe izingcezu ezincane zezinto zokusetshenziswa.
- Thele ngamanzi abandayo endaweni ejulile, ukuze uketshezi luhlanganise kuphela izimpande.
- Bambelela amahora angu-6-10.
- Gcoba umcucu ophumela emgodini ohlukile.
- Phuza 2 tsp 2-4 izikhathi ngosuku, ungeze imithi eklasini yamanzi.
I-decoction ye-Antiulcer
Izithako:
- Izimpande zelayisorice ezihlanzekile - 2-3 g;
- amanzi - 150-200 ml.
Ukulungiselela, sebenzisa:
- Bilisa izinto zokusetshenziswa zemifino ngamanzi abilayo (imizuzu engu-10-15).
- Bambelela isigamu sehora.
- Hlunga isixazululo.
- Phuza ikhambi phakathi kokudla kathathu ngosuku.
- Phulukisa isikhathi esingaphezu kwenyanga, bese uthatha ikhefu bese uqhubeka.
Imiphumela yesifo sikaCrohn
Ukugula okuhloliwe kunenkambo engapheli, ngakho-ke iqhubeka njalo futhi iholela ezimweni eziyingozi. Izifo ze-Crohn - izinkinga:
- ukuphuma kwesikhumba emkhathini wesisu;
- ama-fissures adala ;
- ukuqotshwa kwezilonda zamangqamuzana;
- i-dysbiosis;
- umdlavuza wekolon;
- ama-abscesses;
- i-fistula .
Ngenxa yokuphulwa kokumunca kwezakhi, isifo sikaBarill sihambisana nalokhu:
- ukukhathala ngokulahlekelwa kwesisindo esinamandla;
- hypovitaminosis;
- i-dysbacteriosis.
Isifo sikaCrohn - ukubikezela
Ukuphelisa ngokuphelele ukuphela kwesifo lesi sizathu, umuntu kuzodingeka ukunamathela ekudleni ngaso sonke isikhathi, bahlanganyele ukwelapha futhi kuvimbele pathology. Ngenkathi umuntu engakwazi ukulawula kuphela isifo sikaCrohn - ukubikezelwa kokuphila kulungile, kunikezwe:
- ukuhambisana nezincomo zokusungulwa kokudla;
- ukulahlwa kwezidakamizwa;
- ukuvakashelwa njalo ku-gastroenterologist;
- ukwelashwa okwesikhashana nokuvimbela izinkinga.