Yini Ukhansela Lwekoloni (Lwamathumbu)? Yiziphi Izimpawu Zalo? Kubangelwa Yini?

I-Colon (Amathumbu) Umdlavuza: Izimpawu, Izimbangela, Ukuhlolwa Nezindlela Zokwelapha

Umdlavuza we-colon, owenzeka esithombeni esikhulu samathumbu amakhulu kanye nerectum, uyisifo esibucayi esithinta indawo ebalulekile ohlelweni lokugaya ukudla. Imvamisa uqala ngokwakheka kwamapholiphu ebusweni bamathumbu, lawo aphenduka umdlavuza ngokuhamba kwesikhathi. Izimpawu zesifo, izimbangela kanye nokwelashwa kuncike esigabeni somdlavuza kanye nesimo jikelele sempilo yomuntu. Ukuhlolwa kusenesikhathi, njengazo zonke izinhlobo zomdlavuza, kunikeza inzuzo enkulu ekulweni nomdlavuza we-colon.

Yini Umdlavuza We-Colon (Amathumbu)?

Umdlavuza we-colon uqala emathunjini amakhulu futhi ungomunye wemidlavuza evame kakhulu emhlabeni jikelele. Lesi sifo sivame kakhulu kubantu abaneminyaka engaphezu kwengu-50, kodwa singavela kunoma iyiphi iminyaka. Uma sikhuluma ngesakhiwo samathumbu amakhulu, cishe side ngo-1,5–2 amamitha, sihlukaniswe izigaba ezimbili eziyinhloko: i-colon kanye ne-rectum. I-rectum iyingxenye yokugcina eseduze kakhulu ne-anus futhi iyindawo lapho indle igcinwa khona ngaphambi kokuphuma emzimbeni. I-colon ibhekisela engxenyeni enkulu yamathumbu ngaphambi kwe-rectum. Ngemva kokuthi ukudla kudlule emathunjini amancane kuye e-colon, lapha amanzi namaminerali ayamuncwa bese imfucuza igcinwa e-rectum.

Umdlavuza we-colon uqala kumaseli atholakala esigabeni semucosa esimboza ingaphakathi lamathumbu amakhulu.

I-Anatomy ye-Colon

Umdlavuza uvame ukutholakala kulezi zindawo;

I-Sigmoid colon (ingxenye yokugcina emise okwe-S) : Ingxenye ye-colon exhuma ne-rectum. Kuyindawo evame kakhulu ukutholakala umdlavuza. Lapha indle iba yome kakhulu, okwenza amaseli achayeke isikhathi eside emfucuzweni, okwandisa ubungozi bomdlavuza.

I-Rectum : Ingxenye ye-colon eseduze kakhulu ne-anus. Umdlavuza otholakala lapha ubizwa ngomdlavuza we-rectum, kodwa imvamisa kubizwa ndawonye njenge “colorectal cancer”.

I-Colon ephumayo (kwesokudla): Kuyindawo yokuqala lapho imfucuza eselulwelo evela emathunjini amancane ifika khona. Imvamisa imidlavuza kule ngxenye ibonakala izimpawu sekwephuzile, ngoba indle iseyilwelo. Yingakho imidlavuza ye-colon yesokudla ivame ukubonakala esigabeni esithuthukile.

I-Colon evundlile (transverse) : Ingxenye eqondile exhumanisa i-colon yesokudla neyesobunxele. Umdlavuza ungavela lapha, kodwa akuvamile njengakwezinye izingxenye.

I-Colon eyehlayo (kwesobunxele): Ingxenye lapho imfucuza ihamba iye e-anus. Imidlavuza lapha ivame ukubonakala izimpawu zokuqala ezifana nokubambezeleka kwendle, ukuncipha kobubanzi bendle, noma ukopha.

Cishe u-40–50% wezimo utholakala ku-sigmoid colon kanye ne-rectum, cishe u-20% ku-colon ephumayo (kwesokudla), kanti okusele kutholakala ku-colon evundlile (transverse) kanye ne-colon eyehlayo (kwesobunxele).

Yini Umdlavuza We-Colorectal?

Umdlavuza we-colorectal uhlanganisa imidlavuza ethinta kokubili i-colon kanye ne-rectum. Uvela engxenyeni engezansi yohlelo lokugaya ukudla, lapho amaseli ekhula ngendlela engajwayelekile. Imvamisa uqala ngokuthi amapholiphu angabi nawo umdlavuza aphenduke umdlavuza ngokuhamba kwesikhathi. Umdlavuza we-colorectal, uma utholakala kusenesikhathi, amathuba okwelashwa akhula kakhulu.

Yiziphi Izimpawu Zomdlavuza We-Colon?

Imvamisa umdlavuza we-colon awubangeli izikhalo ezicacile esigabeni sokuqala. Izimpawu zivame ukuvela njengoba umdlavuza ukhula futhi zingahlanganiswa kanje:

• Ubuhlungu besisu noma imivimbo

• Isifo sohudo eside, ukubambezeleka kwendle, noma izinguquko ekubunjweni kwendle

• Ukuba negazi endleni noma indle emnyama (efana nothuli lwamalahle)

• Ukwehla kwesisindo okungachazeki

• Ukukhathala okuqhubekayo nokungabi namandla

• Ukuzizwa isisu sivuvukele noma sigcwele

Lezi zimpawu zingase zibonise nezinye izinkinga zempilo. Yingakho kubalulekile ukubonana nochwepheshe bezempilo uma izinkinga zingapheli noma zingachazeki.

Izimbangela Nezinto Ezikhulisa Umdlavuza We-Colon

Noma izimbangela zomdlavuza we-colon zingaziwa ngokuphelele, kunezinto eziningi ezikhulisa ubungozi:

• Ubudala: Ubungozi bukhula kubantu abaneminyaka engaphezu kwengu-50.

• Umlando womndeni: Uma kukhona umdlavuza we-colon emndenini oseduze, ubungozi bukhula; kulokhu, kunconywa ukuqala ukuhlolwa kusenesikhathi.

• Amapholiphu: Amapholiphu akhula odongeni lwamathumbu angaphenduka umdlavuza ngokuhamba kwesikhathi, yingakho kubalulekile ukuwathola nokuwelapha.

• Izifo ezidluliselwa ngokofuzo: Ikakhulukazi izifo ezifana ne-Lynch syndrome (HNPCC) zingakhulisa ubungozi.

• Izifo zamathumbu ezivuthayo: Izifo ezinjenge-Crohn's disease kanye ne-ulcerative colitis zikhulisa ubungozi bomdlavuza.

• Izindlela zokuphila: Ukudla okune-fiber ephansi, okunamafutha amaningi, ukukhuluphala ngokweqile, ukungazivocavoci, ukubhema kanye nokuphuza utshwala ngokweqile kukhulisa ubungozi.

• Ezinye izimo zempilo: Uhlobo lwesibili lwe-diabetes lukhulisa ubungozi bomdlavuza we-colon.

Umdlavuza We-Colon Uhlolwa Kanjani?

Namuhla, izindlela zokuhlola ezisebenzisa i-endoscopy zisebenza kakhulu ekutholeni imidlavuza ye-colon kanye ne-rectum. Indlela ejwayelekile, i-colonoscopy, ivumela ukubona ngqo ingaphakathi lamathumbu kanye nokukhipha amapholiphu asolwayo. Ukuze kutholakale impendulo eqinisekile, kwenziwa i-biopsy (ukuthatha isampula yethishu ukuze ihlolwe ngaphansi kwe-microscope). Ukuhlola ubungozi bokwanda komdlavuza noma ukusabalala, izindlela zokuthwebula izithombe ezifana ne-computed tomography (CT) nazo ziyasetshenziswa. Ukuhlolwa kwegazi eliyimfihlo endleni nakho kuvame ukusetshenziswa njengesivivinyo sokuhlola.

Izigaba Zomdlavuza We-Colon Nezimpawu Zazo

• Isigaba 0 (Carcinoma in situ): Umdlavuza usengaphakathi lodonga lwamathumbu kuphela. Imvamisa azikho izimpawu ezibonakalayo.

• Isigaba 1: Umdlavuza usezingqimbeni zangaphakathi zodonga lwamathumbu. Kungase kube nobuhlungu obuncane besisu, izinguquko ekuziphatheni kwendle noma igazi elincane endleni.

• Isigaba 2: I-tumor ingadlulela ngaphandle kodonga lwamathumbu kodwa ayikashoni emaqenjini ama-lymph. Kungase kube nobuhlungu besisu, izinguquko ezibonakalayo ekuziphatheni kwendle, ukwehla kwesisindo kanye nokuvuvukala.

• Isigaba 3: Umdlavuza ususabalale emaqenjini ama-lymph aseduze. Ubuhlungu besisu, ukungabi namandla, ukulahlekelwa isifiso sokudla kanye negazi endleni kuba sobala kakhulu.

• Isigaba 4: Umdlavuza ususabalale ezifweni ezikude njengamafutha noma izibindi (metastasis). Ukukhathala okukhulu, ubuhlungu besisu obungapheli, ukuvinjelwa kwamathumbu kanye nokwehla kwesisindo okusheshayo kungavela.

Kwenziwa Kanjani Umdlavuza We-Colon?

Inqubo yokuthuthuka komdlavuza we-colon imvamisa iqala ngamapholiphu angabi nawo umdlavuza aphenduka umdlavuza ngokuhamba kwesikhathi. Izinguquko zofuzo kumaseli zidlala indima; kodwa nezinto zemvelo nezendlela yokuphila zibalulekile. Nakuba kungakhonjiswa imbangela ethile, ukugwema izinto ezikhulisa ubungozi nokubamba iqhaza ezinhlelweni zokuhlola kungaba yindlela yokuvikela.

Umdlavuza We-Colon Uthuthuka Ngokushesha Kangakanani?

Imvamisa umdlavuza we-colon uthuthuka kancane, kuthatha iminyaka eminingi. Ukuguquka kwepholiphu kube umdlavuza kungathatha iminyaka engu-10–15. Yingakho ukuhlolwa njalo kubalulekile, ikakhulukazi kulabo abasengozini enkulu.

Izinhlobo Zomdlavuza We-Colon

Iningi elikhulu lemidlavuza ye-colon ingama-adenocarcinoma; lawa ma-tumor aqala kumaseli ama-gland ahlanganisa ingaphakathi lamathumbu. Kwezinye izikhathi, kungavela izinhlobo ezinjenge-lymphoma, sarcoma, carcinoid noma i-gastrointestinal stromal tumor (GIST). Izindlela zokuhlola nokwelapha zingahluka kuye ngohlobo lwe-tumor.

Izindlela Zokwelapha Umdlavuza We-Colon

Ukwelashwa kuhlelwa ngokwezinga lesifo, isimo jikelele sesiguli kanye nezici ze-tumor. Esigabeni sokuqala, ukuhlinzwa kuvame ukwanele; kuhloswe ukususa amapholiphu kanye nethishu enomdlavuza. Ezimweni ezithuthukile, i-chemotherapy, kwesinye isikhathi i-radiotherapy, futhi kwezinye iziguli namuhla, izindlela eziqondiswe eqondile noma i-immunotherapy zingangezwa. Ukuqapha nokwelapha kufanele kuphethwe ithimba lochwepheshe.

Ukuhlinzwa Komdlavuza We-Colon

Ukuhlinzwa kuyindlela eyinhloko ekwelapheni umdlavuza we-colon. Inqubo esetshenziswayo incike endaweni ye-tumor kanye nokusabalala kwayo; ezigabeni zokuqala kungasuswa kuphela iphoyiphu, kanti ezimweni ezinzima kungenziwa i-partial colectomy (ukususwa kwengxenye ye-colon kanye nama-lymph nodes aseduze). Ububanzi bokuhlinzwa kanye nesikhathi sokululama kuncike esigabeni sesifo kanye nezici zomuntu ngamunye.

Izingcuphe Ezingaba Khona Zokuhlinzwa Komdlavuza We-Colon

Njengoba kunjalo kunazo zonke izinqubo zokuhlinzwa, ukuhlinzwa komdlavuza wekoloni nakho kungaba nezinye izingozi kanye nezinkinga. Lezi zifaka phakathi ukopha, ukulimala kwezitho (isibonelo izindlela zokuchama, ibhaluni, isifuba, isibindi, i-pancreas noma amathumbu), ukuvuleka kwezibopho zamathumbu, ukutheleleka endaweni yokuhlinza kanye nokulimala kwemithambo yegazi. Lezi zingozi zizanywa ukuncishiswa ngokulandela nokunakekela isiguli ngaphambi nangemva kokuhlinzwa.

Izinto Okufanele Uzinake Ngemva Kokuhlinzwa

Esikhathini esilandelayo sokuhlinzwa, isiguli singase sibe nobuhlungu obuphakathi nendawo noma obuncane, kwesinye isikhathi kube nokutheleleka noma ukopha. Imithi enconywa udokotela isetshenziswa ebuhlungwini futhi kunganikezwa ama-antibiotic ukuvimbela ingozi yokutheleleka. Ukusekela ukujikeleza kwegazi ngokunyakaza (isibonelo ukuhamba kusenesikhathi nokuzivocavoca) kanye nokuthatha amanzi anele kubalulekile ekuvimbeleni izinkinga. Kufanele kulandelwe izincomo zodokotela futhi kunakwe izeluleko zokudla ngesikhathi sokululama.

Inqubo Yokululama Nesikhathi Sokuhlala Esibhedlela

Ngemva kokuhlinzwa komdlavuza wekoloni, isikhathi esijwayelekile sokuhlala esibhedlela singaba yizinsuku ezingu-5 kuya kwezi-10. Ngisho nangemva kokukhishwa esibhedlela, isikhathi sokululama singathatha inyanga eyodwa noma ezimbili. Kule nkathi, kubalulekile ukulandela izincomo zokudla, ukusebenzisa imithi njalo nokungaphuthelwa izikhathi zokuhlolwa ukuze inqubo ihambe kahle.

Yini Engenziwa Ukuze Kuvikelwe Umdlavuza Wekoloni?

Ukudla okunothe ngofuzo futhi okulinganiselayo, ukuthatha i-calcium eyanele kanye ne-vitamin D, ukugcina isisindo esinempilo, ukuzivocavoca njalo, ukugwema ukubhema nokuphuza utshwala ngokweqile kuyizinto ezibalulekile zokuvikela. Ikakhulukazi ngemva kweminyaka engama-50, ukwenza izivivinyo zokuhlola njalo kusiza ukuthola lesi sifo kusenesikhathi futhi kuthuthukise imiphumela yezempilo.

Ubani Osengozini Yokuthola Umdlavuza Wekoloni?

Emhlabeni jikelele, umdlavuza wekoloni utholakala kakhulu kubantu abaneminyaka engaphezu kwengu-50. Kulabo abanomlando womdlavuza wekolorektali emndenini, kunconywa ukuthi baqale ukuhlolwa kusenesikhathi. Ukudla okune-fiber ephansi kanye ne-protein ephezulu, ukuswela i-vitamin D kanye nezinkinga zempilo ezifana nesifo sikashukela nakho kuboniswe ezifundweni ezahlukene ukuthi kwandisa ingozi.

Ubuhlungu bomdlavuza wekoloni buvame ukuzwakala kuphi?

Bungazwakala ezingxenyeni eziphansi noma eziseceleni zesisu, kwesinye isikhathi njengobuhlungu obusabalele esiswini sonke.

Ingabe ukuhlolwa kwegciwane egunjini lokuphuma kuyisibonakaliso somdlavuza wekoloni?

Uma ukuhlolwa kwegazi elifihlekile ezindlebeni kuphume ku-positive, kungase kubonise ukopha emathunjini okubandakanya nomdlavuza wekoloni. Ukuze kutholakale isiqinisekiso, kudingeka ukuhlolwa okwengeziwe.

Ingabe umdlavuza wekoloni utholakala nge-ultrasound?

I-ultrasound ayivamile ukwanele ukuthola umdlavuza ongaphakathi kwamathumbu ngokuqondile. Izindlela ezifana ne-colonoscopy ne-CT scan zisebenza kangcono ekutholeni lesi sifo.

Ingabe ukuhlinzwa komdlavuza wekoloni kuyingozi?

Kukhona izingozi ezithile njengazo zonke izinqubo zokuhlinzwa, kodwa lezi zingozi zingancishiswa uma kwenziwa ithimba elinolwazi nokunakekela okufanele.

Yisiphi isigaba okufanele sihanjelwe uma kunomdlavuza wekoloni (amathumbu)?

Izigaba ze-General Surgery kanye/noma i-Gastroenterology yizindawo zobuchwepheshe okufanele zixhunywe ukuze kutholakale ukuxilongwa nokwelashwa.

Ukuhlinzwa komdlavuza wekoloni kuthatha isikhathi esingakanani?

Kuncike endaweni yomdlavuza nasekusabalaleni kwawo, kodwa ngokwesilinganiso kungathatha amahora angu-2 kuya kwangu-3.

Ingabe umdlavuza wekoloni ungaphathwa ngemithi?

Ezingeni eliphambili, imithi efana ne-chemotherapy ingasetshenziswa. Kodwa ezingeni eliphansi, indlela eyinhloko yokwelapha ukuhlinzwa.

Ingabe umdlavuza wekoloni uyadluliselwa ngokofuzo?

Kulabo abanomlando womdlavuza wekoloni emndenini, ingozi iphakeme ngenxa yokuthambekela kofuzo, kodwa akuwona wonke amacala adluliselwa ngokofuzo.

Ingabe umdlavuza wekoloni uyaphinda?

Ukulandela njalo ngemva kokwelashwa kubalulekile. Kwezinye izimo, lesi sifo singaphinda, ngakho-ke kufanele kulandelwe izincomo zodokotela.

Ingabe umdlavuza wekoloni no-rektamu kuyafana?

Yize umdlavuza wekoloni nowe-rektamu benobunjalo obufanayo, indlela yokwelapha nokusondela kungahluka ngokuya ngendawo. Kokubili kubizwa ngokuthi "umdlavuza wekolorektali".

Imithombo

• Inhlangano Yezempilo Yomhlaba (WHO) – Ikhasi Lolwazi Lomdlavuza Wekolorektali

• https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer

• Inhlangano Yomdlavuza YaseMelika (American Cancer Society) – Imihlahlandlela Yomdlavuza Wekolorektali

• https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html#:~:text=The%20American%20Cancer%20Society%20recommends,rectum%20(a%20visual%20exam).

• Inhlangano Yezokwelapha YaseYurophu (ESMO) – Imihlahlandlela Yokwelapha Umdlavuza Wekolorektali

• Izikhungo Zokulawula Nokuvimbela Izifo e-USA (CDC) – Ulwazi Lomdlavuza Wekolorektali

• The Lancet, New England Journal of Medicine – Ucwaningo Lwakamuva Ngomdlavuza Wekolorektali

Sifikile ekugcineni kwendatshana yethu. Mhlawumbe wena noma umuntu omthandayo ningase nibhekane nalesi sifo.
Umhlaba, njengoba uqukethe okuhle nokubi; okuhle nokubi; uLeyla noMecnun, uqukethe nesifo kanye nokuphulukiswa.
Ozolubhekana nakho, akube isiteshi sokuphulukiswa esilandelayo ohambweni lwakho.

Ulwazi luyamandla. Isinyathelo ngasinye osithathayo ngolwazi kunoma yiluphi uhlobo lwesifo, sizoba indlela enhle kakhulu eya ethembeni.

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