Lefu la Crohn

Lefu la Crohn ke lefu moo likarolo tsa tšilo ea lijo li ruruhang.

• Hangata ho kenyelletsa pheletso e tlase ea mala a manyane le qalo ea mala a maholo.
• E kanna ea hlaha karolong efe kapa efe ea ts'ebetso ea tšilo ea lijo ho tloha molomong ho isa qetellong ea rectum (anus).

Lefu la Crohn ke mofuta oa mafu a ho ruruha a mala (IBD).

Ulcerative colitis ke boemo bo amanang.

Lebaka le tobileng la lefu la Crohn ha le tsejoe. E etsahala ha sesole sa 'mele sa hau se hlasela ka phoso le ho senya lisele tsa' mele tse phetseng hantle (autoimmune disorder).

Ha likarolo tsa tšilo ea lijo li lula li ruruhile kapa li ruruhile, marako a mala a ba matenya.

Lintho tse ka bang le karolo ho lefu la Crohn li kenyelletsa:

• Liphatsa tsa lefutso tsa hau le nalane ea lelapa. (Batho ba basoeu kapa ba leloko la Bajuda ba Europe Bochabela ba kotsing e kholo.)
• Lintho tsa tikoloho.
• Tloaelo ea 'mele oa hau ea ho itšoara hofeta ho libaktheria tse tloaelehileng ka maleng.
• Ho tsuba.

Lefu la Crohn le ka hlaha ka nako efe kapa efe. E hlaha haholo bathong ba pakeng tsa lilemo tse 15 le 35.

Matšoao a ipapisitse le karolo ea tšilo ea lijo e amehang. Matšoao a qala ho tloha bobeng ho ea bohlokong, 'me a ka hlaha a ba a feta, ka linako tsa ho phatloha.

Matšoao a mantlha a lefu la Crohn ke:

• Mahlaba a bohloko ka mpeng (ka mpeng).
• Feberu.
• Mokhathala.
• Ho felloa ke takatso ea lijo le ho theola boima ba 'mele.
• U ikutloa eka u hloka ho feta litulo, leha mpa ea hao e se e se na letho. E ka kenyelletsa ho ts'oenyeha, bohloko le ho pepeta.
• Letšollo le metsi, le ka bang le mali.

Matšoao a mang a kenyeletsa:

• Ho sokela
• Liso kapa ho ruruha mahlong
• Ho ntša boladu, mameno, kapa litulo ho tsoa ka hare ho pherekano kapa nko (e bakoang ke ntho e bitsoang fistula)
• Bohloko bo kopaneng le ho ruruha
• Liso tsa molomo
• Ho tsoa mali le likoti tse nang le mali
• Marinini a ruruhileng
• Bonolo, maqhubu a khubelu (maqhutsu) tlasa letlalo, a ka fetohang liso tsa letlalo

Tlhahlobo ea 'mele e ka bonts'a boima kapa bonolo ka mpeng, lekhopho la letlalo, manonyeletso a ruruhileng kapa liso tsa molomo.

Liteko tsa ho fumana lefu la Crohn li kenyelletsa:

• Barium enema kapa li-GI tse kaholimo (masapo)
• Colonoscopy kapa sigmoidoscopy
• CT scan ea mpa
• Capsule endoscopy
• MRI ea mpa
• Enteroscopy
• Monghali enterography

Tloaelo ea setuloana e ka etsoa ho hlakola lisosa tse ling tse ka bang teng tsa matšoao.

Lefu lena le ka fetola sephetho sa liteko tse latelang:

• Boemo ba albin bo tlase
• Sekhahla se phahameng sa sed
• CRP e phahameng
  
• Mafura a mantle
• Palo e tlase ea mali (hemoglobin le hematocrit)
• Liteko tse sa tloaelehang tsa mali a sebete
• Palo e phahameng ea lisele tse tšoeu tsa mali
• Boemo bo phahameng ba fecal calprotectin setulong

Malebela a ho laola lefu la Crohn hae:

LIJO LE Phepo e nepahetseng

U lokela ho ja phepo e nepahetseng, e nepahetseng. Kenyelletsa likhalori tse lekaneng, liprotheine le limatlafatsi tse tsoang lihlopheng tse fapaneng tsa lijo.

Ha ho lijo tse khethehileng tse bontšitsoeng ho etsa hore matšoao a Crohn a be betere kapa a mpefale. Mefuta ea mathata a lijo e ka fapana ho ea ka batho.

Lijo tse ling li ka mpefatsa letšollo le khase. Ho thusa ho kokobetsa matšoao, leka:

• Ho ja lijo tse nyane letsatsi lohle.
• Ho noa metsi a mangata (noa hanyane khafetsa ho pholletsa le letsatsi).
• Ho qoba lijo tse nang le fiber e ngata (matlapi a korong, linaoa, linate, lipeo le popcorn).
• Ho qoba lijo tse mafura, tse mafura kapa tse halikiloeng le lisoso (botoro, majarine le tranelate e boima).
• Ho fokotsa lihlahisoa tsa lebese haeba o na le mathata a ho cheka mafura a lebese. Leka li-cheeses tse nang le lactose e tlaase, tse kang Switzerland le cheddar, le sehlahisoa sa enzyme, se kang Lactaid, ho thusa ho senya lactose.
• Ho qoba lijo tseo u tsebang ho baka khase, joalo ka linaoa le meroho lelapeng la moroho, joalo ka broccoli.
• Ho qoba lijo tse nokiloeng ka linoko tse ngata.

Botsa mofani oa tlhokomelo ea bophelo mabapi le livithamini le liminerale tse ling tseo u ka li hlokang, joalo ka:

• Lisebelisoa tsa tšepe (haeba u haelloa ke mali).
• Calcium le vithamine D li tlatsetsa ho thusa ho boloka masapo a hao a le matla.
• Vithamine B12 ho thibela phokolo ea mali, haholo haeba o tlositsoe (ileum) e nyane.

Haeba u na le ileostomy, u tla hloka ho ithuta:

• Liphetoho tsa lijo
• U ka fetola mokotla oa hau joang
• U ka hlokomela stoma ea hau joang

KHOTHATSO

U kanna oa ikutloa u tšoenyehile, u soabile, kapa u hlomohile u bile u sithabetse maikutlo ka ho ba le lefu la mala. Liketsahalo tse ling tse sithabetsang bophelong ba hau, joalo ka ho falla, ho felloa ke mosebetsi, kapa ho lahleheloa ke motho eo u mo ratang ho ka mpefatsa mathata a tšilo ea lijo.

Botsa mofani oa hau malebela a hore na u ka sebetsana le khatello ea maikutlo joang.

MERIANA

U ka noa moriana ho phekola lets'ollo le leng bohloko haholo. Loperamide (Imodium) e ka rekoa ntle le lengolo la ngaka. Kamehla bua le mofani oa hau pele u sebelisa lithethefatsi tsena.

Meriana e meng e thusang ka matšoao a kenyelletsa:

• Lisebelisoa tsa fiber, tse kang psyllium powder (Metamucil) kapa methylcellulose (Citrucel). Botsa mofani oa hau pele u nka lihlahisoa tsena kapa laxatives.
• Acetaminophen (Tylenol) bakeng sa bohloko bo bobebe. Qoba lithethefatsi tse kang aspirin, ibuprofen (Advil, Motrin), kapa naproxen (Aleve, Naprosyn) e ka mpefatsang matšoao a hau.

Mofani oa hau a ka fana ka meriana ho thusa ho laola lefu la Crohn:

• Aminosalicylates (5-ASAs), meriana e thusang ho laola matšoao a bonolo ho isa ho a itekanetseng. Mefuta e meng ea lithethefatsi e nooa ka molomo, 'me e meng e lokela ho fuoa ka nepo.
• Corticosteroids, e kang prednisone, e phekola lefu le tebileng la Crohn. Li kanna tsa nkuoa ka molomo kapa tsa kenngoa kahare ho rectum.
• Meriana e khutsisang karabelo ea sesole sa 'mele.
• Lithibela-mafu ho phekola li-abscesses kapa fistula.
• Lithethefatsi tse itšireletsang mafung joalo ka Imuran, 6-MP, le tse ling ho qoba ts'ebeliso ea nako e telele ea li-corticosteroids.
• Phekolo ea biologic e ka sebelisoa bakeng sa lefu le matla la Crohn le sa arabeleng ho mefuta efe kapa efe ea meriana.

HO SEBETSA

Batho ba bang ba nang le lefu la Crohn ba ka hloka ho buuoa ho tlosa karolo e senyehileng kapa e kulang ea mala. Maemong a mang, mala a maholo kaofela a tlosoa, kahare kapa ntle le 'mala.

Batho ba nang le lefu la Crohn le sa arabeleng meriana ba ka hloka ho buuoa ho sebetsana le mathata a joalo ka:

• Ho tsoa mali
• Ho hloleha ho hola (baneng)
• Fistula (likhokahano tse sa tloaelehang lipakeng tsa mala le sebaka se seng sa 'mele)
• Tšoaetso
• Ho khutsisa mala

Ho buuoa ho ka etsoang ho kenyelletsa:

• Ileostomy
• Ho tlosa karolo ya mala a maholo kapa mantle a manyane
• Ho tlosoa mala a maholo ho ea ho rectum
• Ho tlosoa mala a maholo le boholo ba rectum

Crohn's and Colitis Foundation of America e fana ka lihlopha tsa ts'ehetso hohle United States - www.crohnscolitisfoundation.org

Ha ho na pheko bakeng sa lefu la Crohn. Boemo bona bo tšoauoa ka linako tsa ntlafatso tse lateloang ke ho phatloha ha matšoao. Lefu la Crohn le ke ke la phekoleha, le ha motho a etsoa opereishene. Empa kalafo ea ho buoa e ka fana ka thuso e kholo.

U na le kotsi e kholo ea mofetše oa mala le mala haeba u na le lefu la Crohn. Mofani oa hau a ka fana ka maikutlo a liteko tsa ho hlahloba mofetše oa mala. Hangata colonoscopy e khothaletsoa haeba o kile oa ba le lefu la Crohn le amanang le colon lilemo tse 8 kapa ho feta.

Ba nang le lefu le matla la Crohn ba ka ba le mathata ana:

• Abscess kapa tšoaetso mala
• Phokolo ea mali, khaello ea lisele tse khubelu tsa mali
• Thibelo ea mala
• Fistula ka senya, letlalo kapa botšehali
• Khōlo e liehang le kholo ea thobalano ho bana
• Ho ruruha hoa manonyello
• Ho hloka limatlafatsi tsa bohlokoa, joalo ka vithamine B12 le tšepe
• Mathata ka ho boloka boima ba 'mele bo phetseng hantle
• Ho ruruha ha methapo ea bile (primary sclerosing cholangitis)
• Matlalo a letlalo, joalo ka pyoderma gangrenosum

Bitsa mofani oa hau haeba u:

• Ho ba le bohloko bo bohloko mpeng
• Ha o khone ho laola letšollo ka liphetoho tsa lijo le lithethefatsi
• Fokotse boima ba 'mele, kapa ngoana ha a be boima
• E-ba le mali a tsoang ka lehlakoreng le leng, drainage kapa liso
• Ho ba le feberu e tšoarellang matsatsi a fetang a mabeli kapa a mararo, kapa feberu e phahameng ho feta 100.4 ° F (38 ° C) ntle le bokuli
• E-ba le ho nyekeloa le ho hlatsa ho tšoarellang nako e fetang letsatsi
• Eba le diso tsa letlalo tse sa foleng
• E-ba le mahlaba a kopaneng a u thibelang ho etsa mesebetsi ea hau ea letsatsi le letsatsi
• E-ba le litla-morao tsa meriana eo u e sebelisang bakeng sa boemo ba hau

Lefu la Crohn; Lefu la ho ruruha ha mala - lefu la Crohn; Enteritis ea tikoloho; Ileitis; Ileocolitis e nang le granulomatous; Lefu la IBD - Crohn

• Lijo tsa Bland
• Ho patoa - seo u lokelang ho se botsa ngaka ea hau
• Lefu la Crohn - ho tsoa
• Letšollo - seo u lokelang ho se botsa mofani oa tlhokomelo ea bophelo ba hau - motho e moholo
• Ileostomy le ngoana oa hau
• Ileostomy le lijo tsa hau
• Ileostomy - ho hlokomela stoma ea hau
• Ileostomy - ho fetola mokotla oa hau
• Ileostomy - ho tsoa
• Ileostomy - seo u lokelang ho se botsa ngaka ea hau
• Phallo e kholo ea mala - ho tsoa
• Ho phela le ileostomy ea hau
• Lijo tse nang le fiber e fokolang
• Ts'ebetso e nyane ea mala - ho tsoa
• Mefuta ea ileostomy

• Tsamaiso ea ho sila lijo
• Lefu la Crohn - X-ray
• Maloetse a ho ruruha
• Li-fistula tse sa tloaelehang
• Libaka tse amehileng ke lefu la Crohn
• Ho ruruha ha lefu la ulcerative
• Maloetse a ho ruruha - letoto la lihlooho tse

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Lichtenstein GR. Maloetse a ho ruruha. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 132.

Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE. Tataiso ea Kliniki ea ACG: Tsamaiso ea lefu la Crohn ho batho ba baholo. Ke J Gastroenterol. 2018; 113 (4): 481-517. PMID: 29610508 www.ncbi.nlm.nih.gov/pubmed/29610508.

Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Colon le rectum. Ka: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Buka ea Sabiston ea Ngaka ea ho Buoa. 20th, ed. Philadelphia, PA: Elsevier; 2017: khaolo ea 51.

Sandborn WJ. Tlhahlobo le kalafo ea lefu la Crohn: sesebelisoa sa qeto ea bongaka. Gastroenterology. 2014; 147 (3): 702-705. PMID: 25046160 www.ncbi.nlm.nih.gov/pubmed/25046160.

Lehlabathe BE, Siegel CA. Lefu la Crohn. Ka: Feldman M, Friedman LS, Brandt LJ, bahlophisi. Sleisenger le Fordtran's Mpeng le Mafu a Sebete. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 115.