Disama dikole dia tshiadi, Disama dia mashi dia bendakana, ne dipingaja dia mâyi ku mishiku dia OMS mu matunga makuabu¶

Disama dia mu tshifu didi disama dia tshimpitshimpi didi ditamba kunyanga benyi ba mu matunga makuabu, didi dikuata 30 too ne ku 70 pa lukama ya benyi mu bitupa bidi bienda bikola anyi bia mu matunga a mashika mu mbingu ibidi ya kumpala ya difika. Nansha mudi Travellers' Diarrhea (udibu batamba kuenza kudi Enterotoxigenic Escherichia coli anyi norovirus) muikale bualu budi kabuyi buimpe bua mêba 48, bilumbu bibidi bia tshimpitshimpi bia mu tshifu bidi mu matunga makuabu bidi mua kulua njiwu ya lufu mu mêba 6 too ne ku 24: tshia kumpala Amoterial anyi bacterial invasive Dysentery (Campylobacter jejuni, Shigella, Salmonella, Shiga-toxin-producing E. coli, anyi Entamoeba histolytica), mudi bipupu bibuela ne bikuata tshitupa tshia munda tshia tshifu, bipatuisha mashi adi amueneka ne mushipa mu tshifu, luya lua bungi kupita 385 C. (101.3 degrees Fahrenheit), ne disama dikole dia mu difu; tshibidi, Profuse Secretory ("Rice-Water") Diarrhea / Cholera (Vibrio cholerae anyi mishindu mikole ya enterotoxigenic), idi mua kumbusha 500 to 1,000 millilitres (0.5 to 1 quart) ya isotropic fluid ne electrolytes ku dîba, idi mua kufikisha muntu mukulumpe anyi hypomic mu hick, cholera disama dia tshiadi, ne disama dia mutshima didi difumina ku dijimija dia potassium ne bicarbonate mu mêba makese menemene a 12.

Tshidi tshitambe kuikala ne njiwu ntshia se: tshilema tshia kudiondopa tshidi benda benza mu nzubu ya dipa ya mu otele ya ku babende: kumina manga adibu bapanyisha ku tshisalu (loperamide / Imodium anyi diphenoxylate) mu tshikondo tshia disama dia tshiadi tshia mashi anyi disama dia Shiga-toxin**. Dinyanguka dia tshitupa tshia munda tshia mala padi bactérie idi ibuela mu mala idi yenza mudimu mukole bua kunyangakaja tshimanu tshia mala idi ikuata cytotoxines munda mua mala, idi ifila Megacolon toxique, dibutuka dia mala, bacteremie, anyi syndrome hémolytique urémique fatal (HUS dipanga dia mfyo). Kumanya mua kulongolola bimanyinu biebe mu masekonde 60, mushindu wa kusanganya World Health Organization (OMS) Reduced-Osmolarity Oral Rehydration Salts (ORS) formule wa mu tshibombi anyi wa mu tshikuku tshia mu otele ne sukadi, dîba dia kulama loperamide, ne dîba dia kutuadija diakamue dibueja dia mâyi a IV mu lupitadi didi disungila mioyo.

Enza nunku mpindieu¶

1. TANGILA MU MUTU NE UTANGILE BUA KUDI MUOYO KUMPALA KUA KUNUA LUPILU LONSO LUA KUDILULA (LOPERAMIDE / IMODIUM):
2. **Wewe mumone mashi makunze, bipese bia maroon bifiike, anyi pus/mucus munene mu tshifu, NANSHA wewe ne fièvre wa 38.5°C (101.3°F) anyi kupita apu, KUANGATA LOPERAMIDE (Imodium), DIPHENOXYLATE (Lomotil]. Kutekesha lubilu lua tshifu ne loperamide udi ukuata bishi bidi bibutula bitupa bia mubidi (Shigella, Campylobacter, Salmonella, anyi STEC) munda mua tshifu tshiebe ne udi mua kujula megacolon udi ne toxique anyi disama dia tshiadi (HUS).
3. TUANGA KUDIMUENA MU MUNA DIAMUE NE KUENZA MUSHINDU WA "SODIUM-GLUCOSE COTRANSPORT" (KI MÂYI A BUALU ANYI SODA KAYI MUDILUE): Kunua mayi a mu milondo nkayawu mu tshikondo tshia disama dia tshiadi tshikole kudi kunyangakaja sodium (hyponatremie) mu mashi ebe paudi unua maluvu adi kaayi malelela mayi a pome, cola, anyi maluvu a manaya adi akoka mayi a bungi mu mashi ebe bua kuya nawu mu mala ku diambuluisha dia disama dia osmotic diarrhea.
4. Mushindu mutambe buimpe: Sangila tshibombi tshimue tshia World Health Organization (OMS) Reduced-Osmolarity Oral Rehydration Salts (ORS / Suero Oral / SRO / Oresol) mu bungi bulelela bua mayi mimpe, makanga/mafuka adibu bafunde pa tshibombi (pa tshibidilu 1.0 litre / 33.8 fl oz).
5. Mushindu wa kudia wa WHO wa ku nzubu wa tshimpitshimpi (Wewe kuyi mua kufika ku farmasi mpindieu): Kuela 1 Litre (4.2 ya makopo a mu États-Unis) wa mayi mimpe a mu milondo anyi a mu tshisuku + 6 ya mayi a tshiayi (25 to 30 grams) wa nsukadi mutoke wa ku mesa + ½ wa lupwa lua tshiayi (2.5 to 3.0 grams) wa mukele wa ku mesa too ne padiye unyanguka. Nua 200 to ne ku 400 mL (1 to ne 2 nkopo) kunyima kua tshisuku tshionso.
6. MANYI "CHOLERA / SECRETORY RICE-WATER DIARRHEA" NE KEBA DIAMU DIA MAYI A MU MUTU PIkala BUNENE BUA MUTU BUPITE 3 TO 4 KU DÎBA: Bikala disama dia mu tshifu dilua dia tshimpitshimpi kadiyi ne kanyinganyinga, dia mu tshimpitshimpi, dia matutu matoke ne matutu matoke bu mayi (loking bu mayi) udi mupuekesha mpunga mutoke), ne udi ununka bu mushipa pamutu pa mupuya wa tuishi, udi wela meji ne: Cholera (Vibrio cholerae) anyi disama dikole dia enterotoxigène. Bualu babedi ba kolera badi mua kujimija 10 to ne 15 Litres (2.5 to 4 gallons) ya mayi ku dituku, ndaku diakamue ku tshibambalu tshia malu a lukasa bua kupeta Intravenous Ringer's Lactate (Hartmann's Solution) ku luseke lua mukana ORS (tangila malu a luondapu ne dipatuka mu matunga makuabu).
7. BIkala KUTUTA KUKANDA BUA KULAMA MANYI: Enza mudimu ne "5-Milliliter (1-Teaspoon) Every 2 Minutes" Micro-Sip Technique. Kunua tshitupa tshia dikopo dia mayi musangu umua kudi kukolesha tshimanu tshia tshifu tshidi tshisama ne kudi kujula diakamue (gastro-emetic reflex). Nansha muntu mukulumpe anyi muana udi ne tshiji tshikole udi mua kunua 90 pa lukama ya mâyi a mukana padibu bamupesha anu lupongo lumue lua tshiayi (5 mL) ku diambuluisha dia tshibombi, dikopo dia manga, anyi tshiamu tshia kuela natshi mukana kunyima kua minite 1 anyi 2 katuyi tujika.
8. KEBA BUALU BUA LUPIKA KU LUPITU (BIKILA MU MUSOKO NUMERO YA LUPILU ANYI MUSHINDU WA KUENZA LUENDU LUA 24/7) BUA BIMANYILU 6 BIDI BIKUATA:
9. Dipanga dia mayi mu mubidi / Disama dia hypovolemic: Dipanga dia mutu dikole anyi dijimija dia lungenyi padi muntu wimana (orthostatic syncope), dipanga dia lungenyi/dipanga dia lungenyi, mêsu mabuikila, ludimi luume, anyi kuela mashi nansha kakese bua mêba 8+ (mêba 6+ kudi muana).
10. Frank Bloody Stools (Dysentery) anyi Black Tarry Stools (Melena) ne kapia kakole, mashika, anyi disama dikole dia mu difu.
11. Difuka didi kadiyi dijika didi dipangisha bua kulama nansha 1-teaspoon sips ya ORS panshi bua meba mapite pa 4.
12. Babedi badi mu njiwu mikole: Bana batyetye ne bana bakese, bena ngendu badi ne difu, bantu bakole badi ne bidimu bipite pa 65, anyi muntu yonso udi unua diuretics, ACE inhibitors/ARBs, SGLT2 inhibitors, anyi lithium (badi bapeta disama dia lukasa dia mifuba ne hyperkalemie anyi lithium mu tshikondo tshia dijimija dia mâyi).
13. KONKA MUANGA BUA BUALU BUA BUALU BUA BUALU BUA KUENZA (EPEKA FLUOROQUINOLONES MU ASIE WA KU SUD-EST NE EPEKA BIDIMU BIDI BIKEBA STEC): Nansha mudi disama dia tshiadi dikole didi dilomba buanga bua luondapu (pa tshibidilu Azithromycin, udi tshintu tshia kumpala tshidibu balomba kudi CDC Yellow Book ne International Society of Travel Medicine mu Asie wa ku Sud-Est ne pa buloba bujima bua dipanga dia Campylobactericin ku ciblodycine), disama dia tshiadi kakuyi luya didi mua kufumina ku Shiga-toxin-producing E. coli (STEC / E. coli O157:H7), mudi difila dia manga a lufu dishipa bactérie, dipatula tshipupu tshinene tshia Shiga toxin, ne dijula Hemolytic Uremic Syndrome (HUS). Misangu yonso lomba munganga bua kukonkonona disama dia tshiadi tshia mashi kumpala kua kutuadija kuangata manga a lufu.

flowchart TD
    A["Disama dia munda dikole / Disama dia tshimpitshimpi padi muntu wenda mu ditunga dikuabu"] --> B{"Tshitupa 1: Tangila tshimuenekelu tshia tshitanda, bunene ne luya lua mubidi"}
    B -->|"Tshintu tshia mayi/tshidi katshiyi tshienda ANYI; KAKUENA mashi adi amueneka to; KAKUENA kapepe kakole (Muinshi mua 38.5C / 101.3F)"| C["Disama dia tshiadi tshia mu mayi didi kadiyi dinyanguka (ditekete anyi dia pa tshibidilu)"]
    B -->|"MASHI MAKUKA adi amueneka anyi mutoyi mukola mu tshifu anyi Kapia kakole (38.5C+ / 101.3F+) ne bipupu bikole"| D["INVASIVE DYSENTERY (Shigella / Campylobacter / Salmonella / Amoebic) OR STEC:<br/>STOP: KUENA LOPERAMIDE (IMODIUM) OR LOMOTIL"]
    B -->|"Tshintu tshikole, katshiyi ne kanyinganyinga, tshitoka tshia 'Mayi a mpunga' (500-1,000 mL/hr) + butekete bua lukasa"| E["MUSHINDU WA KUJIKIJA WA COLERA / MUTU WA MUTU WA MUTU:<br/>DIJIMIJA DIA MANYI DIDI MU NYIKA; Ndaku diakamue ku lupitadi lua ER bua IV Ringer's Lactate + ORS"]
    C --> F["Kupingaja mâyi mu mubidi diakamue:<br/>Tuadija WHO Oral Rehydration Salts (ORS) anyi 1L ya mâyi a ku nzubu + 6 tsp ya sukadi + 1/2 tsp ya Mukele (Kunua 200-400 mL panyima pa dipatuka dionso dia tshifu)"]
    D --> F
    E --> F
    F --> G{"Bimanyinu bia dipanga dia mayi mu mubidi bidiku anyi? (Kujimija lungenyi padi muntu muimane, kayi ne mashi >8h, dipanga dia lungenyi, disama dia nsukadi didi kadiyi dijika, muana mutekete/mufu/mukulumpe)"}
    G -->|"EYOWA: Dipanga dia mayi mu mubidi anyi disama dia tshiadi"| H["Bikila tshishimbi tshia ngendu 24/7 / EMS wa muaba unudi; Dibuela mu lupitadi bua IV Crystalloids, Stool PCR/Microscopy & Physician-Directed Therapy"]
    G -->|"NO: Kulama ORS panshi (1 tsp kunyima kua 1-2 min) ne kuela nsongo"| I["Shi udi ne disama dia tshiadi (Mashi/Kapia): Tangila munganga wa mu lupitadi bua kuenza tshikebelu tshia tshifu ne dikonkonona dia malu a luondapu (Kakuyi Loperamide)<br/>Bikala anu ne mayi (Kakuyi mashi/kapia): Tungunuka ne ORS + amidons mipepele; Bismuth anyi Loperamide udi ne bukubi anu padiye kayi unyanguka"]

Clinical Triage Matrix: Watery Travellers' Diarrhea vs. Bacterial Dysentery vs. STEC vs. Cholera vs. Amoebiasis¶

Ditapulula dia masama atanu manene a disama dia tshiadi mu matunga makuabu didi dileja ni manga adi apangisha dienda dia mubidi anyi manga adi anyanga tuishi adi mua kukuambuluisha anyi kukuteka mu nzubu wa luondapu lua bantu badi ne masama makole:

Tshitupa 1: Mushindu wa kupeta, kusanganya, ne kufila OMS Oral Rehydration Salts (ORS) Muaba wonso pa buloba¶

Bualu dipanga dia mayi mu mubidi, ki mbua tuishi nkayatu to, ke didi difikisha ku dijimija lungenyi, ku dipanga dia mifuba, ne ku lufu padi muntu ne disama dia tshiadi tshikole mu ditunga dikuabu, kulonga mua kupingaja mayi ku mishiku ke tshintu tshia kumpala tshia kudikuba natshi.

1. Tshia kulomba ku farmasi yonso wa ku babende (Global ORS Names)¶

Mu farmasi yonso, mu nzubu wa luondapu wa mu misoko, ne munganga wa mu nseke yonso ya buloba, badi ne bibombi bia mushinga mukese bia World Health Organization Reduced-Osmolarity Oral Rehydration Salts (245 mOsm/L, udi ne glucose udi kayi ne mâyi 13.5 g/L, sodium chloride 2.6 g/L, potassium chloride 1.5 g/L, ne trisodium citrate 2.9 g/L). Lomba muena manga bua: - International / English: "WHO Oral Rehydration Salts (ORS)" anyi Dioralyte / Pedialyte / Hydralyte / DripDrop. - Tshiena-Espagne (Mexique, Amerika wa pankatshi ne wa ku Sud, Espagne): "Vida Suero Oral" / "Suero Oral OMS" / "Sales de Rehidratación Oral (SRO)" (anyi Electrolit / Pedialyte mu mulondo). - Mfualansa (France, Ouest/Nord Afrique, Polynésie): "Soluté de Réhydratation Orale (SRO)" (e.g., Adiaril). - Portugal (Brésil, Portugal): "Soro Caseiro / Sais de Reidratação Oral (SRO)". - Azia wa ku Sud-Est: "Oresol" (Vietnam), "Dechamp / ORS Powder" (Thailand), "Oralit" (Indonésie).

2. Mushindu mulelela wa WHO wa kuondopa mâyi ku mishiku (Paudi mukuatshike mu nzubu wa tshilala benyi butuku)¶

Shi udi mukuatshibue pa dîba 01:00 wa dinda ne kuyi ne tshimanyishilu ORS tshibombi mu tshibombi tshiebe tshia diambuluisha dia kumpala, udi mua kusanganya Sodium-Glucose Cotransport Solution udi ne bukole bua mubidi ne bintu bia mu restoran yonso wa mu otele anyi mu tshibombi tshia mudimu wa mu nzubu:

• Netuambe tshinyi shi udi anu ne tshia kunua tshia manaya tshia mushinga (Gatorade / Powerade) anyi mayi a pomme mu mini-bar wa hotele?
• Maluvu a manaya ne maluvu a soda adi ne sukadi wa bungi menemene (6% to 11% carbohydrate, osmolarity mukola 330 to 700 mOsm/L) ne sodium mukese menemene (only -20 mEq/L vs. 75 mEq/L mu WHO ORS). Kunua maluvu a manaya anyi jus mu tshikondo tshia disama dia tshiadi tshikole kudi kukoka mayi mu mala ne kukolesha disama dia tshiadi.
• Dishintulula dia mu nzubu wa tshilala benyi wa tshimpitshimpi: Ela tshitupa tshimue tshia maluvu a manaya (anyi mâyi a pomme) ne tshitupa tshimue anyi bibidi bia mâyi a mu milondo mimpe, ne ela ½ wa lupwa lua tshiayi lua mâyi a mu mesa mu litre wa mâyi onso.

3. Bungi kayi ORS bua kunua (Volume-for-Volume Replacement Rule)¶

1. Mêba 4 a kumpala (Kulongolola dipanga dia mâyi mu mubidi):
2. Muntu mukulumpe (60 to 80 kg / 130 to 175 lbs) udi ne dipanga dia mayi mu mubidi (nyota, mukana muume, mashi a mubidi wa jaune mufike, mutu mutoke) udi mujimije 2.0 to ne 4.0 Litres ya mayi a mubidi. Nua 2,000 to ne 3,000 mL (2 to ne 3 Litres) ya ORS mu meba 4 a kumpala (roughly 125 to 200 mL every 15 minutes).
3. Dilongolola didi ditungunuka (Kupingaja tshibasa tshionso):
4. Nua 250 too ne ku 350 mL (1 too ne ku 1,5 nkopo) ya ORS kunyima kua tshintu tshionso tshidi tshipatuka ne kunyima kua tshikondo tshionso tshia dibutuka.
5. Mushindu kayi wa kumanya ne: dipingaja dia mâyi mu mubidi diebe didi dienza mudimu (Dikala dia mashi ne dikonkonona dia tshidi tshipatuka):
6. Tshipatshila tshieba ntshia kuela manyi nansha musangu umua kunyima kua mêba 3 anyi 4, ne manyi adi apingana ku dikala dia ambre/apple-juice too ne ku pale straw yellow.

Tshitupa 2: Kukonkonona bunene bua dipanga dia mâyi mu bantu bakole ne bana (The WHO 3-Stage Triage Scale)¶

Bualu babedi badi kabayi ne mâyi mu mubidi, nangananga bana batekete ne bakulumpe, badi mua kumbuka ku ditshioka dikese ne kulua ku dipanga dia kuandamuna mu mêba makese, tangila bimanyinu bitanu ebi bia ku mubidi kunyima kua mêba 2 onso:

Tshitupa 3: manga adi kaayi ne njiwu ne adi ne njiwu, dilongolola dia biakudia, ne dikuba dia nzubu ya luondapu ya IV idi kayiyi ne bukubi¶

1. Mikenji ya manga a diluisha disama dia tshiadi adibu bapana ku tshisalu¶

1. Bismuth Subsalicylate (Pepto-Bismol / Kaopectate):
2. Mushindu udiwu wenza mudimu: Udi ne bukole bukese bua kuluisha tuishi tua masama, bua kuluisha bintu bidi bipatuka, ne bua kulamakaja bintu bidi bikuata munda mua mala kayi upangisha mala bua kuendakana to.
3. Bipeta bibi bia mushinga bia kumanya: Bismuth udi wenza mudimu ne sulfure udi mu mate eba ne mu tshifu bua kuenza bismuth sulfure, udi wenza bua tshitupa tshîpi ludimi luebe ne tuishi tuebe bikale bifiike. Kufuanyikiji tshintu tshia bismuth tshifiike tshidi katshiyi ne njiwu ne melena (upper GI bleeding) shi uvua mudie manga a bismuth a rose. (Kabiena bikumbana kudi bana/bansonga badi buondopibua ku disama dia virus bua njiwu ya disama dia Reye, bakaji badi ne difu, ne babedi badi banua manga a aspirine/anticoagulants).
4. Loperamide (Imodium), Padibi biambuluisha ne padibi bishipa:
5. Padibi kabiyi ne njiwu: Anu mu disama dia munda didi kadiyi dibuelakana, dia mâyi didi kadiyi dimueneka, kadiyi ne mashi adi amueneka, kadiyi ne pus/mucus, ne KAIYI kapepe (<38.5°C / 101.3°F), tshilejilu, paudi ne disama dia tshiadi tshia mayi ne udi ne tshia kuikala ne muoyo mu mashinyi a ku tshipalu tshia ndeke anyi mu ndeke kayi ne tshina tshia kuowela mâyi mu mêba 4, anyi paudi munganga mukufundile pamue ne manga adi ambuluisha bua kuondopa disama dia tshiadi dia bendakana badi kabayi ne mashi.
6. Paudi kuyi ne bua kuangata nansha kakese: Kupeshi nansha kakese loperamide kudi bana ba muinshi mua bidimu 2 (ne pa tshibidilu kuepuka muinshi mua bidimu 6), ne kuena mua kunua nansha kakese pikala ne mashi a munda, kapia kakole, disama dikole dia mu difu, anyi wela meji ne Clostridioides difficile / Shiga-toxin E. coli.
7. Ikala mudimuke bua manga a "Combo Anti-Diarrhea" a ku babende adi ne njiwu (Chloramphenicol, Diphenoxylate-Atropine, anyi Clioquinol / Entero-Vioform):
8. Mu matunga a bungi adi enda akola, nzubu ya manga ya mu nseke itu isumbisha bipese bia manga adi kaayi ne tshimanyinu adi ne bintu bidi bipangisha anyi bidi ne buanga bu mudi Chloramphenicol (udi mua kufikisha ku lufu lua aplastic anemia), Clioquinol (udi mua kufikisha ku subacute myelo-optic neurondness /**amile, anyi metzoleDipyrone). Kumina nansha kakese manga a farmasi a ku babende adi kaayi mafunda; misangu yonso ikala utangila kazubu ka tshiapu kadi kakanga bua kumanya dîna dia pa buloba bujima didi kadiyi dia pa buloba bujima (INN).

2. Tshia kudia (ne tshia kuepuka) patudi tukola¶

• Kudishipi ne nzala to ("Kuikisha mala" i nkindi): Mateta a mu lupitadi a Bulongolodi bua malu a bukola bua mubidi pa buloba bujima adi aleja ne: kutungunuka ne kudia biakudia bikese bia misangu ne misangu bia bintu bidi bikolesha mubidi (mupunga mutoke, mupuya wa mpunga, bimuma bia mvinyo, bimuma bia mvinyo, bimuma bia mvinyo, bimuma bia mvinyo, nzolo ne mâyi a mukele) udi udisha enterocytes ya mu mala idi ikola (villi) ne udi wenza bua diondopangana dia lukasa, bualu dijimija dia amidon didi difila molecule ya glucose mikuabu bua kukolesha SGLT1 Pompe wa dikuata dia mayi a sodium.
• Epuka matuku 5 to ne 7:
• Bintu bionso bia mabele (Mabele, Fromaje, Creme, Creme glacée): Disama dia gastro-enterite dikole didi diumbusha bua tshitupa tshîpi enzyme wa lactase ku muelelu wa mala ebe makese (secondary transient lactose intolerance), nunku kunua mabele anyi kudia fromaje kudi kujula kapepe kakole, disama dia tshiadi, ne disama dia tshiadi munkatshi mua mbingu 1 anyi 2 kunyima kua disama.
• Maluvu, Kafeyine, Biakudia bia mafuta/bia kuosha, ne Maluvu/Soda adi ne Fructose wa bungi.

3. Kujadika Nshinga idi kayiyi ne disama pikalabi bikengela kuela mu mushipa (IV) Mashi mu lupitadi lua kule¶

Shi udi mupangile mayi mu tshitupa tshia kule anyi muaba udi bintu bikese ne udi dijinga ne Intravenous (IV) tshintu tshia Ringer's Lactate anyi 0.9% Normal Saline: - Tangila munganga anyi munganga udi ulongolola tshiamu tshia IV: ikala ujadika ne: tshiamu tshia tshiamu tshia IV tshia plastique tshidi katshiyi ne disama, tshiamu tshia IV tshia plastique, ne tshibombi tshia 1000-mL tshia Ringer's Lactate / Saline mbipatuke mu tshibombi tshipiatshipia, tshikanga ku tshiapu kumpala kua mêsu ebe, ne tshibombi tshidi tshitoke ** 100 pa lukama (kakuyi matutu) ne dituku didi kadiyi dijika difunda pa tshibombi.

Nkonko itubu bela misangu ya bungi¶

Bua tshinyi bidi ne njiwu bua kunua Imodium (loperamide) pandi ne disama dia tshiadi tshia mashi anyi tshipepele tshikole ku babende?¶

Disama dia mashi anyi dia mutoyi didi dienda pamue ne luya lua pa mutu pa 38,5 degrés Celsius (101,3 degrés Fahrenheit) didi dileja disama dia tshiadi didi dibuela, mbuena kuamba ne: tuishi bu mudi Shigella, Campylobacter, anyi Salmonella (anyi tuishi bu mudi Entamoeba histolytica) tudi tuenza mudimu bikole ne tuenza mudimu mu tshimanu tshia mifuba yebe tshifu, anyi ne Shiga-toxin-producing E. coli (STEC) udi upatula cytotoxins mu tshifu tshiebe. Loperamide udi wenza mudimu pa kupangisha dikokangana dia misunya (peristalsis) ya mala ebe. Nansha mudibi bipepele bua kutekesha mala mu tshikondo tshia disama dia tshiadi tshia mayi tshidi katshiyi tshikuata muntu, dipangisha dia mala mu tshikondo tshia disama dia tshiadi didi dipangisha mubidi webe bua kupatula bactérie ne bintu bidi bibutula bitupa bia mubidi, ne bidi bikuata ku tshimanu tshia mala tshidi ne mputa. Bidi mua kufikisha ku ntatu idi mua kushipa muntu bu mudi Toxic Megacolon, dibutuka dia mala, sepsis wa mu mashi, anyi Hemolytic Uremic Syndrome (HUS, acute kidney failure).

Mmunyi mundi mua kuenza tshiamu tshia Oral Rehydration Solution (ORS) tshia lukasa mu nzubu wanyi wa otele meme tshiyi ne mikanda ya ORS ya farmasi?¶

Ubwanya kuenza tshintu tshia ku nzubu tshia Bulongolodi bua Bukola bua Bukola bua Bukola bua Buloba bujima (OMS) ku diambuluisha dia bintu bisatu bipepele: wangate 1.0 Litre (pabuipi ne makopo 4.2 a mu États-Unis anyi milondo ibidi ya 500-mL) ya mayi a mu milondo mimpe, mikanga ku tshiapu (anyi mayi a mu pompi adibu bafuimisha mu minite 1 ne balengeja mu tshipiminu tshia tshiayi tshia 256). 30 grame) ya sukadi mutoke wa ku mesa, ne wela 1/2 wa lupwa lua tshiayi (pabuipi ne 2.5 too ne ku 3.0 grame) ya mukele wa ku mesa wa pa tshibidilu too ne padiwu ajika. Kupinganyi tshipiminu tshia mukele ne nsukadi nansha kakese, ne elabi misangu yonso tshisambakaja kumpala kua kutshinua; kena ne tshia kuikala ne mukele kupita binsonji bia muntu to. Bungi bulelela bua glucose (sukadi) ne sodium (mukele) budi buenza bua SGLT1 sodium-glucose cotransporter pump ikale mu mala ebe makese, bienza bua mubidi webe wikale mua kunua mâyi nansha padiku disama dia tshiadi tshikole.

Bua tshinyi tshiena mua kunua anu mayi a mu milondo anyi maluvu a manaya adi kaayi malengeja ne soda pandi ne disama dia munda dikole?¶

Mu tshikondo tshia disama dia tshiadi tshikole (bu mudi kolera anyi E. coli wa enterotoxigène mukole), bintu bidi bifumina ku bactérie bidi bikanga njila ya chloride ya mu mala ebe bua mâyi ne electrolytes bipatuke mu mashi ebe ne bibuele mu mala ebe. Mâyi a patupu kaena ne sodium anyi glucose to, nunku kaena mua kuenza mudimu ne pompe wa SGLT1 wa mu mala to; udi upitshila buludiludi mu bitupa biebe bia munda eku wenda ukepesha sodium udi mushale mu mashi ebe (udi ukebesha disama dia hyponatremie dia njiwu). Kadi, maluvu a soda adi kaayi malengeja, mayi a bimuma, ne maluvu a manaya adibu bapanyisha adi ne sukadi wa bungi ne mukele mukese menemene; bungi bua nsukadi ebu budi buenza bua se osmotic pull ikale ukoka mayi a bungi mu mashi eba bua kuya mu mala ebe, ne udi wenza bua disama dia tshifu dikale dikole. Shi udi anu ne tshia kunua tshia manaya tshia mu tshisalu, tshilengeje 1-ku-1 ne mayi mimpe ne welamu tshitupa (1/2 tshia lupwa lua tshiayi ku litre) tshia mukele wa ku mesa.

Mmunyi mundi mua kulama mayi a dilengeja mubidi panshi meme ntua mishiku misangu yonso indi nnua maluvu?¶

Bantu badi ne disama dia gastroenterite dikole batu batamba kuela nsukadi bualu batu bindile too ne padibu badiumvua baume ne pashishe kunua 150 too ne ku 250 mL (tshitupa tshia dikopo) dia mâyi musangu umue, adi avula mu tshimpitshimpi tshimanu tshia tshifu tshidi tshisama ne adi asaka muntu bua kuela nsukadi diakamue. Nansha mu tshikondo tshia nsukadi, mala makese adi atungunuka ne kunua mayi lukasa pikala tshifu katshiyi tshitambakane. Wenza mudimu ne manga a bana ne a njiwu "Micro-Sip Method": wangate anu lupongo lumue (5 millilitres) lua Oral Rehydration Solution kunyima kua minite 1 anyi 2 kuyi wimana. Ku lubilu lua 5 mL mu minite 2 yonso, neupete 150 mL ya mayi adi mua kusungila muoyo pa dîba dionso kuyi wenza bua tshifu tshipatuke.

Miaba mifumina¶

• Bulongolodi bua malu a bukola bua mubidi pa buloba bujima (OMS) ne UNICEF: Dilama dia disama dia tshifu tshikole: Mukele wa dilengeja dia mâyi mukana (245 mOsm/L ORS) Dilongolola, mikenji ya dienza dia sukadi ne mukele, ne kasumbu ka mudimu ka pa buloba bujima ka diluisha disama dia kolera (GTFCC) Mikenji ya diondapangana.
• Bibambalu bia diluisha ne dikuba dia masama (CDC) (États-Unis): Mukanda wa jaune wa CDC (Malu a malu a bukola bua mubidi bua ngendu ya pa buloba bujima): Disama dia munda dia benyi, disama dia tshiadi tshidi tshibuelakana (Campylobacter / Shigella), Azithromycin vs. Fluoroquinolone Resistance Profiles, and Contraindications to Anti-Motility Agents in Bloody Diarrhea / STEC.
• International Society of Travel Medicine (ISTM) & Journal of Travel Medicine: Mibelu ya buobumue ya bamanyi pa bidi bitangila dikuba ne diondapa dia disama dia tshiadi tshia benyi (dilongolola dia bunene, tshidi tshifikisha ku bintu bidi ne muoyo, ne dilama dia malu adi kaayi makane).
• Infectious Diseases Society of America (IDSA) (United States): Mibelu ya mudimu wa luondapu bua kumanya ne kulama disama dia tshiadi (Dikuba dia disama dia hemolytic uremic Syndrome mu Shiga-Toxin-Producing E. coli).

Malu adi apetangana¶

• Malu a tshimpitshimpi a luondapu ne dipatuka mu matunga makuabu
• Lupitadi lua ku babende lukuate mukanda weba wa dibuela anyi lubenga kukupatula mu lupitadi
• Maluvu a dishima, maluvu adi ne methanol, ne maluvu adi kaayi ne njiwu mu matunga makuabu
• Dikuba dia mayi, mamanyisha a mayi a kutokesha, ne dishipa dia masama mu tshimpitshimpi
• Nomba ya njiwu bilondeshile ditunga