Yiniyi Koloni (Amathumbu) Umdlavuza Uyini? Yiziphi Izimpawu Zawo? Kubangelwa Yini?
I-Colon (Amathumbu) Umdlavuza: Izimpawu, Izimbangela, Ukuhlolwa Nezindlela Zokwelapha
Umdlavuza wamathumbu amakhulu, utholakala esigabeni esibalulekile ohlelweni lokugaya ukudla, uyisifo esinzima. Imvamisa uqala ngokukhula kwamapholiphu ebusweni bamathumbu, lawo aphenduka umdlavuza ngokuhamba kwesikhathi. Izimpawu zesifo, izimbangela kanye nokwelashwa kuncike esigabeni somdlavuza kanye nesimo jikelele sempilo yesiguli. Ukutholwa kusenesikhathi, njengazo zonke izinhlobo zomdlavuza, kunikeza inzuzo enkulu ekulweni nomdlavuza wamathumbu.
Uyini Umdlavuza We-Colon (Amathumbu)?
Umdlavuza wamathumbu amakhulu uqala esigabeni samathumbu amakhulu futhi ungomunye wemidlavuza evame kakhulu emhlabeni jikelele. Lesi sifo sivame kakhulu kubantu abaneminyaka engaphezu kwengu-50, kodwa singavela kunoma yimuphi umuntu. Uma sikhuluma ngohlelo lwamathumbu amakhulu, lude cishe ngo-1.5–2 amamitha, luhlukaniswe izingxenye ezimbili eziyinhloko: i-colon kanye nerectum. I-rectum iyingxenye yokugcina eseduze kakhulu nomhlathi, lapho indle igcinwa khona ngaphambi kokuphuma emzimbeni. I-colon ibhekisela engxenyeni enkulu yamathumbu ngaphambi kwe-rectum. Uma ukudla sekudlule emathunjini amancane, kufika e-colon lapho amanzi namaminerali emuncwa khona, bese imfucuza igcinwa e-rectum.
Umdlavuza wamathumbu uqala kumangqamuzana esendlalelo se-mucosa esimboza ingaphakathi lamathumbu amakhulu.
Umdlavuza uvame ukutholakala kulezi zindawo;
I-Sigmoid colon (ingxenye yokugcina emise okwe-S) : Ingxenye yamathumbu amakhulu exhuma ne-rectum. Iyindawo evame kakhulu ukutholakala kuyo umdlavuza. Lapha indle iba lukhuni, okwenza amaseli ahlale isikhathi eside ekhona emfucuzweni, okwandisa ubungozi.
I-Rectum : Ingxenye yamathumbu eseduze kakhulu nomhlathi. Umdlavuza okhula lapha ubizwa ngomdlavuza we-rectum, kodwa imvamisa kubizwa ngokuthi “umdlavuza we-colorectal”.
I-Colon ephumayo (kwesokudla): Ingxenye yokuqala lapho imfucuza ewuketshezi esuka emathunjini amancane ifika khona. Imvamisa imidlavuza lapha ibonakala sekwephuzile, ngoba indle iseyiwuketshezi. Yingakho imidlavuza ye-colon yesokudla ivame ukutholakala esigabeni esithuthukile.
I-Colon evundlile (transverse) : Ingxenye eqondile exhumanisa i-colon yesokudla neyesobunxele. Umdlavuza ungavela nalo, kodwa awuvamile njengezinye izindawo.
I-Colon eyehlayo (kwesobunxele): Ingxenye lapho imfucuza ihamba iye emhlathini. Imidlavuza lapha imvamisa ibonakala ngokukhishwa kwendle okuncane, ukuncipha kobubanzi bendle, noma ukopha njengokokuqala kwezimpawu.
Cishe u-40–50% wezigameko zitholakala ku-sigmoid colon kanye ne-rectum, cishe u-20% (kwesokudla, ephumayo) ku-colon, kanti okusele kutholakala ku-colon evundlile (transverse) kanye neyehlayo (kwesobunxele).
Uyini Umdlavuza We-Colorectal?
Umdlavuza we-colorectal uhlanganisa imidlavuza ethinta kokubili i-colon ne-rectum. Uvela engxenyeni engezansi yohlelo lokugaya ukudla, ngenxa yokwanda okungajwayelekile kwamangqamuzana. Imvamisa uqala ngamapholiphu angenabungozi aphenduka umdlavuza ngokuhamba kwesikhathi. Uma utholakala kusenesikhathi, amathuba okwelashwa aphakeme kakhulu.
Yiziphi Izimpawu Zomdlavuza We-Colon?
Imvamisa umdlavuza wamathumbu awubangeli zinkinga ezicacile esigabeni sokuqala. Izimpawu zivela njengoba umdlavuza ukhula futhi zingafingqwa kanje:
Ubuhlungu besisu noma imivimbo
Isifo sohudo eside, ukungakwazi ukukhishwa kwendle noma izinguquko ekubunjweni kwendle
Ukuba negazi endleni noma indle emnyama (efana nothuli lwamalahle)
Ukwehla kwesisindo okungachazeki
Ukukhathala okuqhubekayo nokuphelelwa amandla
Ukuzizwa isisu sivuvukele noma sigcwele
Lezi zimpawu zingase zibonise nezinye izinkinga zempilo. Ngakho-ke kubalulekile ukubonana nochwepheshe bezempilo uma izinkinga zingapheli noma zingachazeki.
Izimbangela Nezinto Ezikhuphula Umdlavuza We-Colon
Nakuba imbangela eqondile yomdlavuza wamathumbu ingaziwa, kunezinto eziningi ezitholakele ezikhuphula ubungozi:
Ubudala: Ubungozi bukhuphuka kubantu abaneminyaka engaphezu kwengu-50.
Umlando womndeni: Uma kunomdlavuza wamathumbu kumalungu omndeni abaseduze, ubungozi buphakeme; kulokhu, ukuhlolwa kusenesikhathi kuyelulekwa.
Amapholiphu: Amapholiphu odongeni lwamathumbu angaphenduka umdlavuza ngokuhamba kwesikhathi, yingakho kubalulekile ukuwathola nokuwelapha.
Izifo ezizuzwe ngokuzalwa: Ikakhulukazi i-Lynch syndrome (HNPCC) nezinye izifo ezitholakala emndenini zingakhuphula ubungozi.
Izifo zamathumbu ezivuthayo: Izifo ezinjenge-Crohn's disease kanye ne-ulcerative colitis zikhuphula ubungozi.
Izindlela zokuphila: Ukudla okune-fiber ephansi, okunamafutha amaningi, ukukhuluphala ngokweqile, ukungazivocavoci, ukubhema kanye nokuphuza utshwala ngokweqile kukhuphula ubungozi.
Ezinye izimo zempilo: I-Type 2 diabetes nayo ikhuphula ubungozi bomdlavuza wamathumbu.
Umdlavuza We-Colon Uhlolwa Kanjani?
Namuhla, izindlela zokuhlola ezisebenzisa i-endoscopy zisebenza kakhulu ekutholeni imidlavuza ye-colon ne-rectum. Indlela evamile, i-colonoscopy, ivumela ukubona ngqo ingaphakathi lamathumbu kanye nokukhipha amapholiphu asolwayo. Ukuze kutholakale impendulo eqondile, kuthathwa isampula yeseli (biopsy) ukuze ihlolwe ngaphansi kwe-microscope. Ukuze kuhlolwe ubukhulu bomdlavuza noma ukusabalala kwawo, kusetshenziswa izindlela ezifana ne-computed tomography (CT). Ukuhlolwa kwegazi eliyimfihlo endleni nakho kuvame ukusetshenziswa njengesivivinyo sokuhlola.
Iziteji Zomdlavuza We-Colon Nezimpawu Zazo
Isigaba 0 (Carcinoma in situ): Umdlavuza usengaphakathi kuphela, awukabi khona kwezinye izingxenye. Imvamisa azikho izimpawu.
Isigaba 1: Umdlavuza usengaphakathi kwezindonga zamathumbu. Kungase kube nobuhlungu besisu obuncane, izinguquko ekukhishweni kwendle noma igazi elincane endleni.
Isigaba 2: Umfutho ungadlula odongeni lwamathumbu kodwa awukafiki emaqenjini ama-lymph. Kungase kube nobuhlungu besisu, izinguquko ezinkulu ekukhishweni kwendle, ukwehla kwesisindo kanye nokuvuvukala.
Isigaba 3: Umdlavuza ususabalale emaqenjini ama-lymph aseduze. Ubuhlungu besisu, ukuphelelwa amandla, ukulahlekelwa yisifiso sokudla kanye negazi endleni kuyabonakala kakhulu.
Isigaba 4: Umdlavuza ususabalale ezifweni ezikude njengebhodlela noma umoya-mpilo (metastasis). Ukukhathala okukhulu, ubuhlungu besisu obungapheli, ukuvinjelwa kwamathumbu kanye nokwehla kwesisindo okusheshayo kungavela.
Kwenziwa Ngani Umdlavuza We-Colon?
Inqubo yokuthuthuka komdlavuza wamathumbu imvamisa iqala ngamapholiphu angenabungozi aphenduka umdlavuza ngokuhamba kwesikhathi. Izinguquko kumagciwane amaseli zidlala indima; kodwa nezinto zemvelo nezendlela yokuphila zibalulekile. Nakuba imbangela ethile ingakhonjwa, ukugwema izinto ezikhuphula ubungozi nokubamba iqhaza ezinhlelweni zokuhlola kungaba yisivikelo.
Umdlavuza We-Colon Uthuthuka Kanjani Ngokuhamba Kwesikhathi?
Imvamisa umdlavuza wamathumbu uthuthuka kancane, kuthatha iminyaka eminingi. Ukuguquka kwepholiphu kube umdlavuza kungathatha iminyaka engu-10–15. Yingakho ukuhlolwa njalo kubalulekile, ikakhulukazi kwabangaphansi kobungozi obuphezulu.
Izinhlobo Zomdlavuza We-Colon
Iningi lemidlavuza yamathumbu amakhulu i-adenocarcinoma; le mihlathi iqala kumaseli ezindlala ezimboza ingaphakathi lamathumbu. Kwezinye izikhathi, kungavela izinhlobo ezifana ne-lymphoma, sarcoma, carcinoid noma i-gastrointestinal stromal tumor (GIST). Izindlela zokuthola nokwelapha zihluka kuye ngohlobo lomdlavuza.
Izindlela Zokwelapha Umdlavuza We-Colon
Ukwelashwa kuhlelwa ngokwezinga lesifo, isimo jikelele sesiguli kanye nezici zomdlavuza. Esigabeni sokuqala, ukuhlinzwa kuvame ukwanele; kuhloswe ukususa amapholiphu kanye nendawo enomdlavuza. Uma isifo siqhubeka...
ezimweni zomsebenzi, imithi yokwelapha, kwesinye isikhathi imisebe yokwelapha kanye namuhla kwezinye iziguli izindlela eziqondiswe eqondile noma imithi yokuvuselela amasosha omzimba zingangezwa. Ukuqapha nokwelashwa kufanele kuphathwe ithimba lochwepheshe. Ukuhlinzwa Komdlavuza Wekholoni Ukuhlinzwa kuyindlela eyinhloko yokwelapha umdlavuza wekoloni. Inqubo esetshenziswayo iyahlukahluka ngokuya ngendawo nomkhawulo womdlavuza; ezigabeni zakuqala kungasuswa kuphela ipholiphu, kanti ezimweni eziphambili kungenziwa i-partial colectomy (ukususwa kwengxenye yekholoni kanye namasosha omzimba aseduze). Ububanzi bokuhlinzwa kanye nesikhathi sokululama kwesiguli kuncike esigabeni sesifo nasezicini zomuntu ngamunye. Izingozi Ezingaba Khona Zokuhlinzwa Komdlavuza Wekholoni Njengazo zonke izinqubo zokuhlinzwa, ukuhlinzwa komdlavuza wekoloni nakho kungaba nezingcuphe nezinkinga ezithile. Lezi zifaka phakathi ukopha, ukulimala kwezitho (isibonelo imigudu yokuchama, ibhande, isibindi, ispancreas noma amathumbu), ukuvuleka kwezibopho zamathumbu, ukutheleleka endaweni yokuhlinzwa kanye nokulimala kwemithambo yegazi. Lezi zingozi zizanywa ukuncishiswa ngokulandela isiguli ngaphambi nangemva kokuhlinzwa. Izinto Okufanele Zicatshangelwe Ngemva Kokuhlinzwa Esikhathini esilandelayo sokuhlinzwa, isiguli singase sibe nobuhlungu obulingene noma obuphakathi, kwesinye isikhathi kube nokutheleleka noma ukopha. Imithi enconywa udokotela isetshenziswa ebuhlungwini futhi kunganikezwa amanye amakhambi okulwa namagciwane ukuvimbela ukutheleleka. Ukukhuthaza ukuhamba kwegazi ngokunyakaza (isibonelo ukuhamba kusenesikhathi nokuzivocavoca) kanye nokuphuza amanzi okwanele kubalulekile ekuvimbeleni izinkinga. Kufanele kulandelwe izincomo zikadokotela futhi kunakwe izeluleko zokudla ngesikhathi sokululama. Inqubo Yokululama Nesikhathi Sokuhlala Esibhedlela Ngemva kokuhlinzwa komdlavuza wekoloni, isiguli singadinga ukuhlala esibhedlela izinsuku eziphakathi kuka-5 no-10. Ngisho nangemva kokukhishwa esibhedlela, isikhathi sokululama singathatha inyanga eyodwa noma ezimbili. Kulesi sikhathi, kubalulekile ukulandela izincomo zokudla, ukusebenzisa imithi njalo nokungaphuthelwa imihlangano yokuhlolwa ukuze inqubo ihambe kahle. Yini Engenziwa Ukuze Kuvikelwe Umdlavuza Wekholoni? Ukudla okunothe ngofuzo futhi okulinganiselayo, ukuthatha i-calcium eyanele kanye ne-vitamin D, ukugcina isisindo esinempilo, ukuzivocavoca njalo, ukugwema ukubhema nokusebenzisa utshwala ngokweqile kuyizinto ezibalulekile zokuvikela. Ikakhulukazi ngemva kweminyaka engama-50, ukwenza izivivinyo zokuhlola njalo kusiza ukuthola isifo kusenesikhathi futhi kuthuthukise imiphumela yezempilo. Ubani Osengozini Yokuthola Umdlavuza Wekholoni? Emhlabeni jikelele, umdlavuza wekoloni utholakala kakhulu kubantu abaneminyaka engaphezu kwengu-50. Kulabo abane umlando womdlavuza wekolorektali emndenini, kunconywa ukuthi baqale ukuhlolwa besebancane. Izifundo ezahlukene zikhombisile ukuthi ukudla okune-fiber ephansi nokuphezulu kwephrotheni, ukuswela i-vitamin D kanye nezinkinga zempilo ezifana nesifo sikashukela nakho kwandisa ingozi. Ubuhlungu bomdlavuza wekoloni ngokuvamile buzizwa kuphi? Bungazwakala ezingxenyeni eziphansi noma eziseceleni zesisu, kwesinye isikhathi njengobuhlungu obusabalele esiswini sonke. Ingabe ukuhlolwa kwegciwane egunjini lokuphuma kuyisibonakaliso somdlavuza wekoloni? Imiphumela emihle yokuhlolwa kwegazi elifihlekile ezindlini ingakhombisa ukopha emathunjini, okuhlanganisa nomdlavuza wekoloni. Ukuqinisekiswa kudinga ukuhlolwa okwengeziwe. Ingabe umdlavuza wekoloni ungatholakala nge-ultrasound? I-ultrasound ngokuvamile ayanele ukuthola umdlavuza ngaphakathi kwamathumbu. Izindlela ezifana ne-colonoscopy ne-CT scan zisebenza kangcono ekutholeni isifo. Ingabe ukuhlinzwa komdlavuza wekoloni kuyingozi? Njengazo zonke izinqubo zokuhlinzwa kunezingozi ezithile, kodwa lezi zingancishiswa ngethimba elinolwazi kanye nokuqapha okufanele. Yiliphi igatsha okufanele libhekwe uma kukhona umdlavuza wekoloni (amathumbu)? Izigaba ze-General Surgery kanye/okanye i-Gastroenterology yizona ezikhethekile okufanele zixhumane nazo ukuthola ukuxilongwa nokwelashwa. Ukuhlinzwa komdlavuza wekoloni kuthatha isikhathi esingakanani? Kuncike endaweni nomkhawulo womdlavuza, kodwa ngokwesilinganiso kuthatha amahora angu-2 kuya kwayi-3. Ingabe umdlavuza wekoloni ungaphathwa ngemithi? Ezingeni eliphambili, imithi yokwelapha 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? Ukuqapha okuvamile ngemva kokwelashwa kubalulekile. Kwezinye izimo, isifo singaphinda, ngakho kufanele kulandelwe izincomo zikadokotela. Ingabe umdlavuza wekoloni no-rektamu kuyafana? Nakuba umdlavuza wekoloni nowerektamu benobunye ubunjalo, indlela yokwelapha nokuphathwa kuncike endaweni yesifo. Zombili zibizwa ngokuthi "umdlavuza wekolorektali". Imithombo - Inhlangano Yezempilo Yomhlaba (WHO) – Ikhasi Lolwazi Lomdlavuza Wekolorektali - American Cancer Society – Colorectal Cancer Guidelines - European Society for Medical Oncology (ESMO) – Colorectal Cancer Clinical Practice Guidelines - US Centers for Disease Control and Prevention (CDC) – Colorectal Cancer Information - The Lancet, New England Journal of Medicine – Ucwaningo Lwakamuva Ngomdlavuza Wekolorektali Sifinyelele ekugcineni kwendatshana yethu. Mhlawumbe wena noma othandekayo wakho nibhekene nalesi sifo. Njengoba umhlaba uqukethe okuhle nokubi; ubuhle nobubi; uLeyla noMecnun, uphinde uqukathe isifo nesiphetho. Okuzohlangana nawe, akube yisiteshi sokululama ohambweni lwakho. Ulwazi luyamandla. Kuwo wonke umkhuhlane, isinyathelo osithathayo ngolwazi siyindlela enhle kakhulu eya ethembeni. Ngifisela wena nabathandekayo bakho impilo enempilo…