Insttitial cystitis: he aha ia?

La kamaika interstitial he maʻi maʻi ʻōpū laha ʻole akā ka hōʻino ʻana i hoʻololi i kona inoa. Kāhea ʻia ia manawa he maʻi maʻi bladder. Kuhi ʻia ia e ka ʻeha ma ka ʻōpū o lalo a koi pinepine e mimi, ka lā a me ka pō. ʻO kēia mau ʻeha a me kēia mau koi e mimi pinepine pinepine ia, i kekahi manawa ʻaʻole hiki ke hoʻomanawanui, a hiki i kahi e hiki ai i ka cystitis interstitial ke lilo i kahi kīnā pili kaiaulu maoli, e pale ana i ka poʻe mai ka haʻalele ʻana i ko lākou mau home. Hiki i ka ʻeha ke hoʻopili i ka urethra (ke kahawai e halihali i ka mimi mai ka ʻai a i waho) a, i nā wahine, ka ʻōpala (ʻike i ke kiʻi). Urencing (ka mimi) hoʻomaha hapa a hoʻopau loa paha i kēia mau ʻeha. Hoʻopili ka cystitis interstitial ʻo ka wahine paha. Hiki ke hōʻike ʻia i kēlā me kēia makahiki mai 18 mau makahiki. I kēia manawa, ʻaʻohe lāʻau lapaʻau no kēia ʻano, i manaʻo ʻia he maʻi.

E akahele o huikau kamaika interstitial et cystitis : "Maʻamau" ka cystitis kahi maʻi maʻi urinary i hoʻokumu ʻia e nā bacteria; ʻaʻole ka cystitis interstitial ʻaʻole maʻi a o kana kumu i ike ole ia.

ʻO ke kuhikuhina

Wahi a ka Interstitial Cystitis Association o Quebec, ma kahi o 150 mau Kanada i hoʻopilikia ʻia e kēia maʻi. Me he mea lā ka kamaika interstitial ʻoi aku ka liʻiliʻi ma ʻEulopa ma mua o ʻAmelika ʻAkau. Eia nō naʻe, paʻakikī e kiʻi i kahi kuhi pololei o ka helu o ka poʻe i hoʻopilikia ʻia, no ka mea, ʻike ʻia ka maʻi. Ua manaʻo ʻia aia ma waena o 1 a me 7 mau kānaka me ka cystitis interstitial no 10 poʻe ma ʻEulopa. Ma ʻAmelika Hui Pū ʻIa, pili kēia maʻi ʻoi aku ka nui i hoʻokahi ma 000 mau kānaka.

Hoʻopili ka cystitis interstitial ma kahi o 5 a 10 mau manawa ʻoi aku ka nui o nā wahine ma mua o nā kāne. Hoʻomaopopo pinepine ʻia e pili ana i nā makahiki 30 a 40, a 25% o ka poʻe i hoʻopili ʻia aia ma lalo o 30.

Nā kumu

I ka cystitis interstitial, ʻo ka paia o loko o ka bladder ke kahua o nā mea ʻino e ʻike ʻia. Hiki i nā ʻeha liʻiliʻi ma kēia paia ma loko o ka pāpaʻi ke kulu i kahi koko liʻiliʻi a hōʻeha i ka ʻeha a me ka ʻiʻini e hoʻolei i ka ʻai o ka mimi acidic.

Ke kumu o ka pehu i mālama ʻia i loko o ka kamaika interstitial ʻaʻole maopopo leʻa. Hoʻohui kekahi poʻe i ka hoʻomaka ʻana i ke ʻoki, hānau keiki, a i ʻole he maʻi maʻi palahū koʻikoʻi, akā i nā manawa he nui me he mea ʻole ke kumu. ʻO ka cystitis interstitial paha kahi maʻi maʻi multifactorial, pili i kekahi mau kumu.

Many kuhiakau ke nānā ʻia nei. Hoʻokū ka poʻe noiʻi i kahi o ka hopena ʻino, kahi hopena autoimmune a i ʻole kahi pilikia neurological i ka paia o ka bladder. ʻAʻole ia e kāpae ʻia e hāʻawi pū nā mea hoʻoilina iā ia.

Eia nā ala i haʻi pinepine ʻia:

• Ka loli ʻana o ka paia bladder. No kekahi kumu, hoʻopili ʻia ka pale pale i loko o ka bladder (nā hunaola a me nā protein) i nā poʻe he nui me ka cystitis interstitial. Pale maʻamau kēia papa i nā mea hoʻonāukiuki i ka mimi mai ke komo pololei ʻana me ka paia o ka maʻi ʻaʻa.
• ʻOi aku ka maikaʻi o ka pale pale intravesical. I ka poʻe me ka cystitis interstitial, e hana iki kēia pale pale. No laila hiki i ka mimi ke hoʻonāukiuki i ka puhū a hoʻoulu i ka huhū a me ke ahi wela, e like me ke kau ʻana o ka wai ʻona i kahi ʻeha.
• Kāhea ʻia kahi mea AFP a antiproliferative kumu paha loaʻa i ka mimi o ka poʻe me ka cystitis interstitial. ʻO ia paha ka hewa, no ka mea, he mea ia e kāohi ai i ka hoʻohou maoli a me ka maʻamau o nā hunaola e uhi ana i ka loko o ka pale.
• ʻO ka maʻi Autoimmune. Hiki ke hoʻoulu ʻia ka bladder e ke alo o nā mea ʻino kūpilikiʻi e kūʻē i ka paia o ka puhā (autoimmune react). Ua loaʻa nā ʻano ʻino i loko o kekahi poʻe me ka cystitis interstitial, me ka ʻike ʻole ʻia o lākou ke kumu a i ʻole ka hopena o ka maʻi.
• Hypersensitivity o nā aʻalolo i loko o ka puhū. ʻO ka ʻeha i ʻike ʻia e nā poʻe me ka cystitis interstitial hiki ke lilo i ʻeha "neuropathic", ʻo ia hoʻi, ka ʻeha i hoʻokumu ʻia e ka hana ʻole o ka ʻōnaehana ʻōiwi o ka pūpū. No laila, ʻo ka liʻiliʻi loa o ka mimi e lawa ia e "hoʻonāukiuki" i nā aʻalolo a hoʻonāukiuki i nā hōʻailona ʻeha ma mua o ka manaʻo kaomi wale.

Evolution

Ke holo nei ka maʻi ʻokoʻa i kēlā me kēia kanaka. I ka hoʻomaka, ka nā hōʻailona helehelena e puka a laila nalo ma o lākou iho. Nā wā o kala kala hiki ke mau no kekahi mau mahina. ʻOi aku ka maikaʻi o nā ʻōuli ma nā makahiki. I kēia hihia, hoʻonui ka ʻeha a ʻoi aku ka pinepine o ka makemake e mimi.

I nā hihia ʻoi loa, ka pono e mimi hiki ke hana i 60 mau manawa i 24 mau hola. Hoʻopilikia nui ʻia ke ola pilikino a pilikino. ʻOi aku ka ʻeha i kekahi manawa i hiki i ka hoʻonāwaliwali a me ka huhū ke alakaʻi i kekahi poʻe i ke kaumaha, a i ke kaumaha hoʻi. suicide. ʻO ke kākoʻo mai nā mea aloha ka mea nui nui.

PalekanaEND_LINK

Wahi a ka Mayo Clinic i ʻAmelika Hui Pū ʻIa, ʻo ka poʻe me kamaika interstitial loaʻa kā lākou hōʻoia ma ka awelika 4 mau makahiki ma hope o ka hoʻomaka ʻana o ka maʻi. Ma Palani, ua hōʻike ʻia kahi noiʻi i mālama ʻia i ka makahiki 2009 ua ʻoi aku ka lōʻihi o ka lohi diagnostic a ua like ia me 7,5 mau makahiki²¹. ʻAʻole kēia he mea kupanaha ma muli o ka huikau o ka cystitis interstitial me nā pilikia olakino ʻē aʻe: maʻi maʻi urinary, endometriosis, maʻi chlamydial, maʻi ʻōpala, kahi "overactive" bladder, etc.

Le PalekanaEND_LINK paʻakikī e hoʻokumu a hiki ke hōʻoia wale ma hope o ka pau ʻana o nā kumu ʻē aʻe āpau. Eia kekahi, he aloha hou ʻike ʻole ʻia nā kauka. Ke hana nei nō ia ua kūpono ia ma ke ʻano he "pilikia psychological" a i ʻole nā ​​manaʻo kauka o kekahi mau kauka ma mua o ka hana ʻia ʻana o ke kuhi, ʻoiai ke hōʻike nei ka ʻaoʻao i loko o ka maʻi bladder.

Eia nā hoʻokolohua maʻamau e hana ai e kuhikuhi i ka cystitis interstitial:

• Urinalysis. Hiki i ka moʻomeheu a me ke kālailai ʻana i kahi laʻana mimi ke hoʻoholo inā aia he UTI. Ke hiki mai i ka cytititis interstitial, ʻaʻohe microbes, he mole ka mimi. Akā hiki i ke koko i loko o ka mimi (hematuria) i kekahi manawa a liʻiliʻi loa (microscopic hematuria kahi e ʻike ai mākou i nā hunaola ʻulaʻula ma lalo o ka microscope, akā ʻaʻohe koko me ka maka ʻōlohelohe). Me ka cystitis interstitial, hiki ke ʻike ʻia nā hunaola keokeo i ka mimi.

• ʻO ka cystoscopy me ka hydrodistension o ka bladder. He hoʻāʻo kēia e nānā i ka paia o ka puhā. Hana ʻia kēia hoʻokolokolo ma lalo o ka anesthesia ākea. Hoʻopiha mua ʻia ka ʻōmole i ka wai i mea e pale aku ai ka paia. A laila, hoʻokomo ʻia kahi catheter me kahi pahu paʻi kiʻi i ka urethra. Nānā ke kauka i ka mucosa e ka nānā ʻana ma ka pakuhi. Nānā ʻo ia i ke kū mai o nā māwae maikaʻi a i ʻole nā ​​hemorrhages liʻiliʻi. Kāhea ʻia ʻōlinolino, ʻo kēia mau kahe liʻiliʻi e kū i ke ʻano o ka cystitis interstitial a i 95% o nā hihia. I kekahi mau hihia liʻiliʻi, aia nō kekahi ʻeha maʻamau i kapa ʻia Huncer's ulcer. I kekahi manawa e hana ke kauka i kahi biopsy. A laila nānā ʻia nā mea i lawe ʻia ma lalo o kahi microscope no ka loiloi hou aʻe.
• ʻO ka loiloi urodynamic me uhana cystometry a me urodynamic ninaninau hiki ke hoʻokō pū ʻia, akā ʻo kēia mau hoʻokolokolo ʻana he mea liʻiliʻi ia a me ka liʻiliʻi o ka hana ʻana, no ka mea ʻaʻole kikoʻī loa a no laila ʻaʻole maikaʻi loa a ʻeha mau hoʻi. I ka hihia o ka cystitis interstitial, ʻike mākou me kēia mau hoʻokolohua e hoʻemi ʻia ka mana volumetric o ka pākeke a ʻike ʻia ka makemake e mimi a ʻeha ka ʻeha no kahi haʻahaʻa haʻahaʻa ma mua o kahi kanaka e ʻeha ʻole nei i ka cystitis interstitial. Eia nō naʻe kēia mau hoʻokolohua ʻana e hiki ai ke ʻike i nā hyperactivities o ka puhā (bladder overactive) kahi maʻi hana ʻē aʻe e hoʻonāukiuki ana hoʻi.
• ʻO ka hoʻāʻo ʻana o ka potassium. ʻOi aku ka liʻiliʻi a me ka liʻiliʻi o ka hana ʻana, no ka mea ʻaʻole kikoʻī loa me 25% mau maikaʻi ʻole wahaheʻe (hōʻike ka hōʻike ʻaʻohe o ke kanaka cystitis interstitial ʻoiai aia ma 25% o nā hihia.) cystitis ke hana ʻole lākou).

Ke hoʻohana nei i kahi catheter i hoʻokomo ʻia i loko o ka urethra, hoʻopiha ʻia ka ʻai i ka wai. A laila, hoʻolei ʻia ia a hoʻopiha ʻia me kahi hopena potassium chloride. (Hoʻohana mua ʻia ka gel Lococaine a puni ka wehe o ka urethra e hoʻoliʻiliʻi i ka ʻeha o ka hoʻokomo ʻana i ka catheter.) Ma kahi pālākiō o 0 a 5, hōʻike ke kanaka i ka wikiwiki o ko lākou manaʻo. urencing a me ka ikaika o ka ʻeha. Inā hoʻonui ʻia nā ʻōuli ke hoʻāʻo ʻia me ka hopena potassium chloride, he hōʻailona paha ia o ka cystitis interstitial. ʻO ka maʻamau, ʻaʻohe ʻokoʻa e ʻike ʻia ma waena o kēia hopena a me ka wai.