La isifo Crohn is a izifo ezingapheli zokuvuvukala yohlelo lokugaya ukudla (amathumbu amakhulu), aguquguquka ngokuvuleka kanye nezigaba zokuxolelwa. Ibonakala ikakhulukazi ngezinkinga ze ubuhlungu besisu futhi isifo sohudo, okungahlala amasonto ambalwa noma izinyanga ezimbalwa. Ukukhathala, ukuncipha kwesisindo ngisho nokungondleki kahle kungenzeka uma kungekho ukwelashwa okwenziwayo. Kwezinye izimo, izimpawu ezingezona zokugaya ukudla, okuthinta isikhumba, amalunga noma amehlo kungase kuhlotshaniswe nesifo. 

Uzibona kanjani izimpawu zesifo sikaCrohn? 

Uma une isifo Crohn, ukuvuvukala kungathinta noma iyiphi ingxenye yomgudu wokugaya ukudla, kusukela emlonyeni kuya ku-anus. Kodwa ngokuvamile ihlala endaweni ehlanganayoamathumbu amancane futhi ikholoni (amathumbu amakhulu).

Umdwebo wesifo sikaCrohn

Yiziphi izimbangela ze-Crohn's disease?

La isifo Crohn kungenxa yokuvuvukala okuqhubekayo kwezindonga nezingqimba ezijulile ze- umgudu wokugaya ukudla. Lokhu kuvuvukala kungaholela ekuqineni kwezindonga kwezinye izindawo, imifantu nezilonda kwezinye. Izimbangela zokuvuvukala azaziwa futhi kungenzeka ziningi, kufaka phakathi izici zofuzo, ezizimele nezemvelo.

Izici zofuzo

Nakuba isifo sikaCrohn singesona isifo sofuzo ngokuphelele, izakhi zofuzo ezithile zingandisa amathuba okusithola. Eminyakeni yamuva nje, abacwaningi bathole izakhi zofuzo ezimbalwa ezitholakala kalula, kuhlanganise ne-NOD2 / CARD15 gene, okwandisa ingozi yokuthola lesi sifo izikhathi ezine kuya kweziyisihlanu.⁶. Lesi sakhi sofuzo sibamba iqhaza ohlelweni lokuzivikela lomzimba. Nokho, ezinye izici ziyadingeka ukuze lesi sifo senzeke. Njengakwezinye izifo eziningi, kubonakala sengathi ukuthambekela kofuzo kuhlangene nezici zemvelo noma indlela yokuphila kubangela lesi sifo.

Izici ze-autoimmune

Njenge-ulcerative colitis, isifo sikaCrohn sinezici zesifo esizimele (= isifo lapho amasosha omzimba elwa namaseli awo). Abacwaningi bakholelwa ukuthi ukuvuvukala komgudu wokugaya ukudla kuhlobene nokusabela ngokweqile komzimba kwamasosha omzimba ngokumelene namagciwane noma amagciwane asemathunjini.

yizici zemvelo

Kuyaziwa ukuthi izehlakalo zesifo sikaCrohn ziphakeme amazwe athuthukile futhi ivame ukwanda kusukela ngo-1950. Lokhu kusikisela ukuthi izici zemvelo, cishe ezihlotshaniswa nendlela yokuphila yaseNtshonalanga, zingaba nethonya eliphawulekayo ekuqaleni kwalesi sifo. Kodwa-ke, asikho isici esithile esikhonjisiwe. Kunezindlela eziningana ezifundwayo. Ukuchayeka kuma-antibiotic athile, ikakhulukazi avela kusigaba se-tetracycline, kungaba yingozi engaba khona³¹. Ababhemayo basengozini enkulu yokuthola lesi sifo. Abantu abahlezi kakhulu bathinteka kakhulu kunabantu abakhuthele kakhulu³².

Kungenzeka, kepha abukho ubufakazi obuphelele, bokuthi ukudla okunothe kakhulu ngamafutha amabi, inyama noshukela kwandisa ubungozi.³³. 

Abaphenyi ikakhulukazi babheka iqhaza elingaba khona lokutheleleka nge igciwane noma ibhaktheriya (salmonella, campylobacter) ekuqaliseni lesi sifo. Ngaphezu kokutheleleka nge-microbe "yangaphandle", a ukungalingani kwamathumbu emathunjini (okusho ukuthi amabhaktheriya akhona ngokwemvelo endaweni yokugaya ukudla) nawo angabandakanyeka¹⁸.

Ngaphezu kwalokho, izinto ezithile zibonakala zinamandla okuvikela. Lokhu kufaka phakathi ukudla okunothe nge-fiber nezithelo, ukuxhumana ngaphambi konyaka owodwa namakati noma izilwane zasemapulazini, i-appendectomy, kanye nokuba ne-gastroenteritis noma izifo. ukuphefumula³⁴. Akukho nokuhlangana phakathi komuthi wokugoma iMMR (isimungumungwane-rubella-mumps) nesifo sikaCrohn.³⁵.

Izici zengqondo

Sekuyisikhathi eside kucatshangwa ukuthi ukucindezeleka kungabangela ukuquleka. Kodwa-ke, ucwaningo olwenziwe kuze kube manje lubonakala luyiphikisa le hypothesis.

Abantu abasengozini

• Abantu abane umlando womndeni isifo sokuvuvukala (isifo sikaCrohn noma i-ulcerative colitis). Lokhu kuzoba njalo ku-10% kuya ku-25% walabo abathintekayo.
• Imiphakathi ethile zisengozini kakhulu kunezinye, ngenxa yokwakheka kofuzo. Umphakathi wamaJuda (wemvelaphi ye-Ashkenazi), ngokwesibonelo, uzoba izikhathi eziphindwe kayi-4 kuya kwezi-5 ezithinteke kakhulu ngesifo sikaCrohn^3,4.

Isifo sikaCrohn siqhubeka kanjani?

Kuyisifo esingamahlalakhona esikhona kukho konke ukuphila. Ngokuvamile i- isifo Crohn iguqukela ekuqubukeni okuhlanganiswe nezikhathi zokuxolela ezingahlala izinyanga ezimbalwa. Cishe u-10% kuya ku-20% wabantu abanokukhululeka okuhlala njalo ngemva kokugqashuka kokuqala kwalesi sifo. I ukuphindeka (noma izingqinamba) zilandelana ngendlela engalindelekile futhi ziyahlukahluka ngamandla. Ngezinye izikhathi izimpawu ziba namandla kakhulu (ukungakwazi ukudla, ukopha, isifo sohudo, njll.) kangangokuthi ukulaliswa esibhedlela kuba kudingekile.

Izinkinga ezingaba khona nemiphumela

La isifo Crohn kungaholela ezinkingeni ezihlukahlukene zempilo. Kodwa-ke, ukuqina kwezimpawu nezinkinga kuyahluka kakhulu kuye ngomuntu nomuntu.

Izinkinga ezingenzeka

• A ukuvinjelwa komgudu wokugaya ukudla. Ukuvuvukala okungamahlalakhona kungabangela ulwelwesi lomgudu wokugaya ukudla lube lukhuni, okungaholela ekuvalelekeni okuyingxenye noma okuphelele komgudu wokugaya ukudla. Lokhu kungaholela ekuqunjelweni, ukuqunjelwa, noma ekuhlanzweni kwendle. Ukulaliswa esibhedlela okuphuthumayo kungadingeka ukuvimbela ukubola kwamathumbu.
• Izilonda olwelweni lomgudu wokugaya ukudla.
• Izilonda ezizungeze ididi (fistula, imifantu ejulile noma amathumba angapheli).
• Ukopha emgudwini wokugaya ukudla, akuvamile kodwa kwesinye isikhathi kubi.
• Abantu abanesifo sika-Crohn sekholoni banengozi encane eyengeziwe yokuba nomdlavuza wekoloni, ikakhulukazi ngemva kweminyaka eminingana yesifo, ngisho noma belashwa. Ngakho-ke kuyalulekwa ukuthi uhlolwe umdlavuza wamakholomu kusenesikhathi futhi njalo.

Imiphumela engaba khona

• A ukungondleki, ngoba ngesikhathi sezinkinga, iziguli zivame ukudla kancane ngenxa yobuhlungu. Ngaphezu kwalokho ikhono lokumunca ukudla ngodonga lwamathumbu liyaphazamiseka, ngolimi lwezokwelapha sikhuluma nge-malabsorption.
• Un ukukhubazeka kokukhula nokuthomba ezinganeni nasebusheni.
• Ukushoda kwe-iron anemia, ngenxa yokopha emgudwini wokugaya ukudla, okungenzeka ngomsindo ophansi futhi kungabonakali ngeso lenyama.
• Ezinye izinkinga zempilo, njenge-arthritis, izimo zesikhumba, ukuvuvukala kwamehlo, izilonda zomlomo, amatshe ezinso noma ama-gallstones.
• Isifo sikaCrohn, lapho sisesigabeni “esisebenzayo”, sandisa ingozi yokugulaukukhipha isisu ngokuzenzakalelayo kwabesifazane abakhulelwe abanaso. Kungenza kube nzima ukuthi umbungu ukhule. Ngakho-ke kubalulekile ukuthi abesifazane abafisa ukukhulelwa basilawule kahle isifo sabo ngosizo lwemithi futhi baxoxe ngaso nodokotela wabo.

Bangaki abantu abaphethwe isifo sikaCrohn?

Ngokwesizindalwazi se-Afa, kuseNyakatho-ntshonalanga yeYurophu nase-United States lapho sithola khona abantu abaningi abahlaselwe yisifo sikaCrohn. EFrance, cishe abantu abayi-120.000 kuthiwa bayathinteka. Kulezi zifunda, i-Afa ibala amacala ama-4 kuye kwayi-5 kubahlali be-100.000 unyaka ngamunye. 

 ECanada, i- isifo Crohn kuthinta abantu ababalelwa kuma-50 kubantu abayi-100 emazweni athuthukile, kepha kunokuhluka okukhulu ngesifunda sendawo. Indawo emhlabeni enezigameko ezibikwa kakhulu iseNova Scotia, isifundazwe saseCanada, lapho isilinganiso sikhuphukela kuma-000 kubantu abayi-319. EJapan, eRomania naseNingizimu Korea, isilinganiso singaphansi kuka-100,000 kwabangu-25²⁹.

Lesi sifo singenzeka kunoma yisiphi isikhathi, kubandakanya nengane. Ngokuvamile kutholakala kubantu abaneminyaka eyi-10 kuya kwengama-30 ubudala³⁰.

Umbono kadokotela wethu ngalesi sifo

Njengengxenye yendlela yekhwalithi yayo, iPasseportsanté.net ikumema ukuthi uthole umbono wochwepheshe bezempilo. UDkt Dominic Larose, udokotela wezimo eziphuthumayo ukunika umbono wakhe mayelana isifo Crohn :