Saamaynta Saxarada Daran ee Dadka Waayeelka ah: Waa maxay sababta dareeraha "shubanka qulqulaya" uu maaskaro u daboolaa xannibaad adag oo dhagax ah iyo khatarta ah daloolista mindhicirka¶

Marka tabar daran, sariirta, qalliinka ka dib, waallida, ama opioid-daaweeyay waayeel si lama filaan ah u bilaabo inuu yeesho walxaha qarxa, ur xun, dareere bunni biyo leh oo si aan la xakamayn karin ugu daadanaya qaangaarkooda 30kii daqiiqoba, daryeelayaasha qoyska iyo xitaa kalkaaliyayaasha kalkaalinta aan khibrada lahayn waxay had iyo jeer gaaraan isla ogaanshaha isku midka ah: jooji inaad siiso wixii saxaro jilcisa.”*

Daawada gabowga, qaladkaas wuxuu noqon karaa mid dilaa ah. Ilaa ** 70 boqolkiiba guryaha dadka lagu xanaaneeyo iyo waayeelka guriga ku socda , saxaro la'aanta degdega ah ee biyaha, gaar ahaan ka dib 4 ilaa 10 maalmood oo saxaro yar, adag, ama maqan, waa ** is barbar dhig " Shuban-dhaaf ah " si adag u goglan gudaha malawadka ama xiidanka sigmoid sida guf dhalada ku jira. Sababtoo ah saxarada adagi ma dhaafi karto xannibaadda, bakteeriyada xuubka leh ayaa khamiiraya saxarada ku xayiran ee ka sarreysa fiilada waxayna gelisaa gaas dareere ah oo wasakh ah iyo xab, kaas oo ku tuujiya cidhifyada dhagax adag oo si aan ikhtiyaar ahayn u soo daadanaya. Haddii aad siiso waayeelkaas loperamide (Imodium si aad u curyaamiso mindhicirka, ama haddii aad ku shubto ** dawooyinka kicinta afka ee xooggan (senna, bisacodyl, magnesium citrate) calooshooda xagga sare ka soo galaan si ay mindhicirka sare ugu qasbaan inay si xoog leh ula dagaallamaan dhagax malawadka ah oo aan dhaqaaqi karin, gidaarka ischemic, warqad dhuuban xiidan oo si adag ugu fidsan saxarada engegan ayaa dillaaci karta Haddii qof weyn oo ka weyn oo looga shakisan yahay calool-istaagga ama shuban-ka-soo-baxa uu ka soo baxo calool adag / loox-u eg, calool xanuun daran, matag (gaar ahaan cagaar madow madow ama matag saxaro ah), dhiig-baxa malawadka, hypotension, ama jahawareer/ caajisnimo ba'an, wac lambarka degdegga ah ee degaankaaga (911 Maraykanka iyo Kanada, 112 guud ahaan Midowga Yurub, 999 gudaha Boqortooyada Ingiriiska) ama la tasho annaga nambarada degdega ah hagaha. Xaaladaha degdega ah ee caafimaadka waayeelka ee la xidhiidha, eeg jahawareerka degdega ah ee waayeelka: aamusnaanta UTI urosepsis vs. istaroogga iyo sababta bukaannada waayeelka ah ay u la'yihiin qandho, delirium isbitaalka iyo u doodista caafimaadka ee waayeelkaiyo polypharmacy, daawada xad dhaafka ah, qiyaasaha la seegay, iyo khaladaadka qabanqaabiyaha kiniinka.

Hadda samee tan¶

1. ** Waligaa ha siin daawada shubankaImodium / loperamide, Lomotil / diphenoxylate-atropine, ama Pepto-Bismol / bismuth) ku socota waayeelka soo baxa saxaro degdeg ah oo biyo leh ilaa uu takhtarku ka hubiyo saxarada saxarada.** Bixinta Imodium Bukaanka qaba shuban xad dhaaf ah ayaa si buuxda u curyaamiya dhaqdhaqaaqa xiidanka, isaga oo u beddelaya qayb saxaro ah oo xidhma mindhicir-weyn oo dhamaystiran ama megacolon sun ah.
2. **Weligaa ha siin kiciyeyaasha afka ee xooggan ama calool-jileelayaasha osmotic mugga sarreeya (Senna, Dulcolax / kiniinka bisacodyl ee afka laga qaato, Magnesium Citrate dhalooyin, Castor Oil, ama Golytely / qiyaasta sare ee PEG-3350) ee kor ka ah KA HOR inta aan la eegin futada hoose ee futada hoose lagana nadiifiyo Xeerka Geriatric Gastroenterology: Had iyo jeer ka nadiifi saamaynta saxarada fog ee HOOSE marka hore (lubricated digital disimpaction + oil-retention/warm-water enema) ka hor inta aan la siin dawooyinka afka laga qaato ee xagga sare.
3. ** Hubi 5 "Stercoral Colitis / Calannada Degdegga ah ee mindhicirka ee u baahan safar degdeg ah oo ambalaas ah Isbitaalka ER si loo baaro CT-ga caloosha:**
4. Calool xanuun daran, ka sii daraya ama calool xanuun fiiqan ama miskaha, ama calool adag, qallafsan, jilicsan (** ilaalinta peritoneal**).
5. Lalabbo iyo matag joogto ah (aan awoodin in ay hoos u dhigaan dareeraha, ama matag bile cagaaran madow ama dareere ur xun oo bunni ah).
6. Dhiig guduudan oo dhalaalaya ama xinjiro madow oo maroon ah oo ka soo gudbaya dabada
7. Awood la'aan buuxda inuu dhaafo xitaa gaaska (flatus) oo ay weheliso barar iyo neefsasho gacmeed oo degdeg ah.
8. Jahawareer degdeg ah oo degdeg ah, garaaca wadnaha oo degdeg ah (>100 bpm), cadaadis dhiig oo hooseeya, qandho, ama hypothermia (<36.0°C / 96.8°F).
9. Hubi in qofka waayeelka ah uu sidoo kale leeyahay "Caadi-hayn" ba'an (oo aan awoodin in uu fiiqo ama dilo qadar yar oo kaadi ah) oo ay la socoto arrinta mindhicirka. (kalyaha oo kaydiya).
10. ** Codso sariir yar oo jilicsan "Imtixaan malawadka dhijitaalka ah (DRE)" by kalkaalisada caafimaadka guriga, dhakhtarka soo booqda, ama daryeelka degdega ah / ER rugta maanta. malawadka oo gaadhi karta far galoofaysan, halka boqolkiiba 30 ay fadhiistaan meel ka saraysa sigmoid colon waxayna u baahan yihiin raajada caloosha ama CT scan si loo arko).
11. ** Haddii bukaanku uu leeyahay cudur wadne, wadne-sameeye/arrhythmia, ama uu qaato beta-blockers, la soco "Vasovagal Drop" ( garaaca wadnaha degdega ah iyo miyir beelka ) inta lagu jiro malawadka, marna ha isticmaalin "Fleet Sodium Phosphate Enema" oo aan farmashiyaha laga iibsan karin qof kasta oo ka weyn da'da 65.

Geedka go'aanka: Kala soocida badbaadada leh ee looga shakisan yahay saamaynta saxarada vs. shuban faafa¶

flowchart TD
    A["Waayeelku wuxuu ku dhacaa saxaro biyo ah oo degdeg ah ('shuban'), calool xanuun, caloolxumo, ama aan ku gudbin saxaro dhamaystiran 4+ maalmood gudahood"] --> B{"Calan cas ma jiraa? (Caloosho xanuun daran, caloosha oo qallafsan, matag, dhiigbax malawadka, qandho, ama hypotension)"}
    B -->|"HAA: Mid kasta oo 1 calan cas ah oo la joogo"| C["Wac 911 / isla markiiba u tag isbitaalka"]
    C --> D["Hab-maamuuska ER: Kala-duwan la'aanta/IV-is-barbardhigga CT Scan ee Caloosha & Misigta si uu meesha uga saaro Stercoral Colitis, Volvulus, ama Perforation -> Dheecaannada IV, Kala-baxa NG, & Kala-baxa La Socda"]
    B -->|"MAYA: Caloolku waa jilicsan yahay/aan jilicsanayn, matag ma jiro, dhiig-bax la'aan, waxyaabaha muhiimka ah ayaa deggan"| E["Shakiga Shuban Biyoodka Daad-dhaafka ah ee ku xeeran Saamaynta Saxarada (gaar ahaan haddii aad qaadato Opioids, Iron, Calcium, ama Anticholinergics)"]
    E --> F["Hayso Kalkaaliso ama Dhakhtar Sameeya Imtixaan Dijital ah oo Jilicsan (DRE)"]
    F -->|"1. Saxaro Adag oo laga Dareemay Vault (Saamaynta Fog - 70% Kiisaska)"| G["TALLAABADA 1 (HOOS KA HOOS): Codso 2% Lidocaine Jelly -> Jajabka Dijitaalka ah ee fudud + Saliida Macdanta (waxaa la socda 1-2 saacadood ka dib cusbada diiran/Tap-Biyaha Enema; WELIGAA Sodium Phosphate)"]
    F -->|"2. Malawadka Malawadka, Laakin Caloosha ayaa ka Buuxa Saxarada Palpation/X-ray (Saamaynta Sigmoid Sare - 30% Kiisaska)"| H["Hab-maamuuska Jilicsanaanta Dhakhtarku Hagayo: Biyo Diirimaad leh oo Fadhi-sare leh/Saliida Macdanta ah ama Qaybsan Polyethylene Glycol (PEG-3350) Marka Caqiidada Dhamaystiran lagu xukumo X-ray"]
    G --> I["TALLAABADA 2 (SARE - KALIYA KA DIB MARKII ALAAB DAWLADA LA NAXO): Bilow Dayactirka Maalinlaha ah ee Polyethylene Glycol (MiraLAX 17g) + Senna (Haddii Opioids ku jirto) si aad uga hortagto soo noqoshada"]
    H --> I

Is barbar dhig "shubanka buuxdhaafay" vs. Shubanka Caafimadka dhabta ah: Sida loo kala saaro¶

Kahor intaadan waligaa siinin kaniini kaniini ah si uu u joojiyo shubanka, ama dawooyinka caloosha jilcisa si loo nadiifiyo calool istaagga, isticmaal miiskan ogaanshaha kiliinikada si aad u kala saartid Kas-qaadid la'aanta xad-dhaafka ah ee cillad-la'aanta ee gastroenteritis ba'an ama C. dhib badan colitis:

Waa maxay sababta Saamaynta Saxarada u disho: "Stercoral Colitis" iyo "Stercoral Perforation"¶

Dad badan ayaa u haysta calool-istaagga inuu yahay xanaaq aan dhib lahayn. Qof weyn oo 80 jir ah, saxarada aan la daweynin waa bam waqtiga qalliinka ah oo sax ah ** kaas oo u gudba saddex marxaladood oo dilaa ah:

flowchart TD
    A["Marxaladda 1: Samaynta Fecaloma (Maalmaha 4 ilaa 10)"] --> B["Biyaha ayaa si joogto ah dib looga soo nuugaa saxarada ku xayiran malawadka iyo xiidanka sigmoid -> Saxarada waxay ku adkaataa calcified, dhagax u eg 'Stercoraceous Fecaloma' oo aan ka gudbi karin kanaalka futada."]
    B --> C["Marxaladda 2: Stercoral Colitis & Cadaadiska Ischemia (Maalmaha 7 ilaa 14)"]
    C --> D["Fekaloma dhagaxa adag ee balaadhaya waxay ku cadaadisaa gidaarka xabka ee xiidmaha rectosigmoid oo leh cadaadis ka badan qulqulka dhiiga ee xididka (>32 mmHg)"]
    D --> E["Marxaladda 3: Perforation stercoral & Saxarka Peritonitis (35-50% Dhimashada)"]
    E --> F["Haddii qof uu siiyo dawooyin kiciya afka oo xoog leh oo xagga sare ka yimid (ama bukaanku si xoog leh u xanuunsado), derbiga mindhicirka necrotic ee khafiifka ah ayaa dillaaca -> Saxarada dareeraha ah waxay ku shubtaa daloolka xuubka xuubka -> Rapid Gram-negative/anaerobic shock septic"]

Sida ay dhakhaatiirtu u ogaadaan "Stercoral Colitis" ee ER CT Scan¶

Haddii qofka aad jeceshahay uusan sameynin saxaro dhab ah usbuuc gudihiis oo uu yeesho calool xanuun, wareer, qandho, ama unug dhiig oo sarreeya ama heerka lactic acid, ** ku adkeyso Baadhitaanka aan Isbarbardhigga ahayn (ama IV-Contrast) CT Scan ee Caloosha iyo Misigta** ee Waaxda Gurmadka, ma aha oo kaliya raajo simanKUB).

• Baadhista CT-gu waxay daaha ka qaadaysaa saddexda calaamood ee shucaaca caadiga ah ee *Stercoral Perforation ee soo socda:
• ** Kala fogaanshiyaha Fecaloma ee weyn:** Xun weyn, cufan, oo inta badan la kala kaxayn karo saxarada oo u qaybisa xiidanka rectosigmoid ilaa >6 cm (2.4 in) dhexroorka.
• ** Dhumucda gidaarka mindhicirka>3 mm):** Barar leh, gidaar gumaysi oo bararsan oo si adag ugu duudduubay saxarada.
• ** Xadhkaha Dufanka Dufanka leh & Joojinta Xuubabka:** Caabuq ku soo daadanaya baruurta ku wareegsan xiidmaha (ama xumbo yaryar oo hawo xor ah oo ka baxsan taasoo muujinaysa in xiidanka uu mar hore dalool yar sameeyay).
• Sababta aqoonsiga Stercoral Colitis ay wax walba u beddesho:** Marka Stercoral Colitis uu ku jiro CT scan, **Xidhiyeyaasha kalkaalinta ee sariirta dhinaceeda aan la kormeerin ama baaritaan dhijitaal ah oo indho la'aan ah ayaa si toos ah uga soo dhex milmi kara gidaarka mindhicirka necrotic. qalliinka/gastroenterology-ku hagayo qallafsanaan lagu hagayo goob la kormeeray, ama laparotomi degdeg ah haddii hawo/daloolin bilaash ah ay jirto.

Hab-maamuuska caafimaad ee badbaadada leh: Sida saxarada fog ee saamaynta saxarada loo nadiifiyo¶

Marka takhtarka ama kalkaalisada booqata ay xaqiijiso saamaynta saxarada fog ee malawadka IYADOO aan lahayn calamadaha dalool, peritonitis, ama dhiigbax, halkan waa badbaadada, borotokoolka caafimaad ee tillaabo-tallaabo ah ee ay isticmaalaan dhakhaatiirta waayeelka iyo kalkaaliyayaasha hospice si ay u nadiifiyaan xannibaadda si badbaado leh:

Talaabada 1: Kahor daawo oo mari saliida suuxinta jirka la mariyo (Ka hortagga xanuunka iyo Vasovagal Syncope)¶

• Sababta aadan waligaa u oggolaan qofna inuu sameeyo "qalalan" ama cillad aan la tirin karin: Fidinta kanaalka dabada iyo malawadka waxay kicisaa ** miskaha parasympathetic faylalka neerfaha vagus**. Qofka waayeelka ah ee daciifka ah, kala-baxa malawadka ee xanuunka leh wuxuu kiciyaa markiiba Vasovagal Reflex: garaaca wadnuhu wuxuu hoos ugu dhacaa 30ssevere bradycardia), Cadaadiska dhiigga ayaa hoos u dhacaya, bukaankuna wuu suuxdi karaa ama ku dhici karaa wadne arrhythmia isla sariirta.
• Diyaarinta Badbaado leh:
• U dhig bukaanka si raaxo leh ** Booska Sims ee Bidix *** (u jiifa ** dhinacooda bidix** jilibka midigna u foorarsado xagga laabta, kaas oo toosiya qalooca dabiiciga ah ee malawadka iyo xiidanka soo degaya).
• Hubi heerka asaasiga ah ee garaaca wadnaha iyo cadaadiska dhiigga ka hor inta aanad bilaabin.
• Ku dheji 5 to 10 mL Madhalays ah 2% Lidocaine Hydrochloride Jelly (Suuxinta Suuxinta) geli kanaalka futada iyo malawadka hoose iyadoo la isticmaalayo caarad irbad aan cirbad lahayn ama far galoofaysan, iyo ** sug 5 ilaa 10 daqiiqo oo buuxa** suuxinta gudaha si ay u kabuubiso xuubka futada oo ay u nasato xiiqsan ka hor inta aanad isku dayin inay kala-baxdo.

Talaabada 2: Jilci cuf-dhagax-adag ka hor inta aanad jebin¶

• Haddii farta galoofiska ah ee takhtarku ay ku dhufato saxaro u adag sida dhoobada qallalan ama sibidhka oo aad u weyn oo ay dhaafi karto sfincter-ka oo sinaba, ** waligaa ha isku dayin inaad xoog ku muquuniso kubbad weyn oo dhagax adag ah** (taas oo jeexjeexaysa xuubka futada iyo xuubka malawadka).
• Taxane Labada Marxaladood Xabagta (Salida Koowaad, Biyo Diiran Labaad):
• ** Marka hore, Ku beer Xakamaynta Saliida Macdanta (100 to 150 mL saliid diiran oo macdan ah ama saliid saytuun):** Bukaanku ha ku qabo saliidda malawadka 30 ilaa 60 daqiiqo. Saliiddu waxay gasho dildilaaca saxarada qalalan, waxay saliidaysaa gidaarada malawadka, waxayna u beddeshaa sibidh adag dhoobo jilicsan.
• Labaad, Jajabka Dijital ah ee dabacsan ("Maqas / Scooping"): Xidhashada galoofyada laba jibaaran oo si deeqsinimo leh loogu saliiday saliid biyo-milmi leh (Surgilube / K-Y) ama 2% Lidocaine jelly, takhtarku waxa uu si tartiib ah u galinayaa hal farta mudista ah si tartiib ah dhanka gidaarka malawadka ,waxa uu isticmaalaa dhaqdhaqaaq dabacsan si uu u kala jebiyo qaybo yaryar,waxana uu u soo saaraa xoogaa xoogaa ah,*
• Saddexaad, Biyo Diiran oo Mug-hooseeya, Cusbada Caadiga ah, ama Warqad (Docusate)EnemeezEnema: Marka furka hoose ee ugu weyn la jebiyo, cadaadis hoose oo khafiif ah Saline caadi ah oo diirran (0.9% NaCl) ama Xabagta-Biyaha Diirin250 to 500 mL, wax ka laadlaadsan 30 to 45 cm [12 to 18 in] miskaha ka sarreeya), ama a 5 mL **Docusate Sodium (Enemeez) mini-enema **, waxay si habsami leh u nadiifisaa jajabyada haray. * (Weligaa ha isticmaalin soapsuds enemas, hydrogen peroxide enemas, ama sodium phosphate enemas, kuwaas oo dhamaantood sababa colitis kiimikaad)

Talaabada 3: Ka Bilaabida "Nidaamka Mindhicirka Maalinlaha ah ee Kor" (KALIYA kadib marka wadada hoose ay caddahay)¶

Marka malawadka malawadka uu gabi ahaanba maro oo bukaanku saxaro jilicsan iyo gaas si xor ah u dhaafo, waa inaad isla markiiba bilawdaa ** Nidaamka Ka-hortagga Mindhicirka Maalinlaha ah** sababtoo ah fidsan, malawadka atonic (megarectum) waxay dib u saameyn doontaa 5 maalmood gudahood haddii aan la daweyn.

Is barbar dhig daawooyinka mindhicirka afka ee shaqeeya, iyo kuwa aan waxtar lahayn ama khatarta ah, ee dadka waaweyn:

Lambarada degdega ah ee gobolka iyo borotokoolka wakaalada¶

Adeegso xaaladaha degdegga ah ee rasmiga ah, kala soocidda gabowga, iyo adeegyada kalkaalinta guriga marka qof weyni uu yeesho shaki laga qabo saxarada, shuban-qulqulaya, ama calamada cas ee caloosha:

• Mareykanka:
• ** Gurmadka Degdega ah (Loogu talagalay Calool adag, Xanuun daran, Matag, Dhiigbax Malaweed, ama Sebsiis):** Wac 911.
• ** Booqashada Kalkaalisada Xirfadda leh ee Hoyga / Hospice-ka:** Haddii waalidkaa uu ka diiwaangashan yahay Medicare Home Health Care ama Hospice, wac wakaaladda 24/7 Khadka Kalkaaliyaha Wacitaanka ee Diiwaangashan (RN) ka hor intaadan tagin ER si aad u hesho saameyn fog; caafimaadka guriga ee xirfada leh ama hospice RN waxa uu samayn karaa baadhis dhijitaal ah oo sariirta dhinaceeda ah, waxa uu maamuli karaa saliid macdan ah/saline enema ama Enemeez mini-enema, oo ka hubi haynta kaadida sawir qaade kaadiheysta la qaadi karo oo ku jira qolka jiifka ee waalidka.
• FDA MedWatch Digniin ku Saabsan Alaabta Sodium Fosfate: Dib u eeg xidhiidhka Badbaadada Dawooyinka ee FDA (Dawada afka iyo malawadka ee ka-hortagga Counter Sodium fosfate-daroogada: Khataraha halista ah ee fuuq-baxa iyo sunta kelyaha/wadnaha ee dadka waaweyn) at fda.gov.
• Kanada:
• ** Gurmad:** Wac 911.
• ** Kala soocida Kalkaaliyaha Gobolka 24/7 & Kalkaaliyaha Daryeelka Guriga (811):** Wac 811 (Health811 gudaha Ontaariyo, Info-Santé ee Quebec, HealthLink BC) ama gobolkaaga ** Adeegyada Taageerada Daryeelka Guriga iyo Bulshada** kooxda kalkaalinta jawaabta degdega ah si ay u codsadaan qiimaynta mindhicirka kalkaalinta ee guriga iyo kaadiheysta.
• Uk:
• ** Gurmad:** Wac 999 calamadaha caloosha oo ba'an/dalool, ama wac NHS 111 (24/7) in loo diro ** Kalkaaliyaha Degmadda / Kooxda Daryeelka Degdegga ah ee Bulshada (Jawaabta Degdegga ah ee Bulshada 2-saac - UCR)** guriga waayeelka.
• ** Tilmaamaha Kiliinikada ee NICE ee Saxarada Saxarada iyo Saamaynta La'aanta (CG49):** Hoosta ** Tilmaamaha NICE CG49 (* Saxarada ceshad la'aanta dadka waaweyn*)** iyo Royal College of Nursing (RCN) Xasaasiyadda lowska marka hore) ama xajinta saliidda saytuunka ** / ** sodium citrate (Micralaxmicro-enemas, ama bilow MacrogolMovicol / Cosmocol / Laxido) nidaamka qallafsanaanta ee sii kordhaya (ilaa 8 kiish oo maalintii lagu milmo 1 liter biyo ka badan 6 saacadood marka mindhicirku xidhmo/daloolin dhamaystiran laga saaro).
• Midowga Yurub:
• ** Gurmad:** Wac 112 (ama 116 117 gudaha Jarmalka oo loogu talagalay Ärztlicher Bereitschaftsdienst dhakhtarka-guriga, 15 / SOS Médecins ee Faransiiska). Marka loo eego heerarka daawaynta ee Yurubta, Macrogol 3350/4000 waa dayactirka caadiga ah iyo daawaynta qallafsanaanta aan daloolin oo ay weheliso malawadka Clyss-Go / Normacol >65 ama kelyaha oo daciifa).
• Australia iyo New Zealand:
• ** Gurmad:** Wac 000 (Australia) ama 111 (New Zealand).
• Daryeelka da'da deegaanka ee Gaadhida / Kalasoocida Kalkaaliyaha Bulshada: Australia, wac healthdirect at 1800 022 222 ama cisbitaalka xaafadaada ** Qiimaynta Degdega ah ee Geriatric iyo Daaweynta (GREAT) / Cisbitaalka Guriga (HITH)** kooxda kalkaalinta wareega; New Zealand, kala xidhiidh ** Khadka Caafimaadka at 0800 611 116** ama adeega kalkaalisada degmadaada ee niyad jabka guriga adoo isticmaalaya Microlax (sodium citrate/lauryl sulfoacetate* ama Macrogol (Movicol).
• Hindiya iyo Aasiya-Baasifik:
• ** Gurmad:** Wac 112 ama 108. Dadka waayeelka ah ee ku nool magaalooyinka Hindiya, kooxaha daryeelka guriga ee isbitaalku waxay samayn karaan kaadida sariirta sariirta si ay u nadiifiyaan kaadida kaadida iyo si tartiib ah ** dareeraha Paraffin / Saliida Saytuun ** oo ay ku xigto ** Glycerin ama Proctoclyss (kaliya haddii shaqada kelyaha ay caadi tahay; doorbido cusbada diiran / saliidda waayeelka)** enema, iyo u gudubka bukaanka maalinlaha ahPegmove / Looz-PEG*** ama LactuloseDuphalac).

Su'aalaha soo noqnoqda¶

Sidee waalidkay calool-istaagga daran ugu dhici karaa markay qabaan shuban dareere ah 6 jeer maalintii?¶

Xaaladdan waxaa loo yaqaan shuban-socod-dhaaf ah (ama kaadi-ceshan la'aanta xad-dhaafka ah), waana sababta ugu badan ee saxarada dareeraha ah ee degdega ah ee jilicsan, sariirta, ama waayeelka la daweeyay opioid. Marka saxaro weyn oo fuuqbaxsan (fecaloma) ay noqoto mid la jeexjeexay sida guf dhagax adag oo gudaha malawadka ah, saxaro adagi kama gudbi karto. Bakteeriyada mindhicirka ah ee ka sarreysa xannibaadda waxay u daadisaa qashinka ku xanniban dareere bunni ah oo ur xun iyo xab, kaas oo tuujiya hareeraha cidhifyada furka adag ee dhagaxa oo si aan la xakamayn karin u soo daadanaya sababtoo ah cufku waxa uu qabtaa futada gudaha ee futada oo fidsan.

Waa maxay sababta ay khatar u tahay in la siiyo Imodium (loperamide) ama dawooyinka afka ee adag ee waayeelka leh shuban xad dhaaf ah?¶

Siinta dawada ka hortagga shubanka sida Imodium (loperamide) ee qofka waayeelka ah ee shubankiisu dhab ahaantii ka soo daadanayo saxarada ayaa curyaamiya murqaha xiidanka, taas oo u beddeleysa xannibaad qayb ah oo nafta halis gelisa xidhidh saxaro ah oo dhammaystiran ama megacolon sun ah. Taa beddelkeeda, siinta dawooyinka kicinta afka ee xooggan (sida qiyaasta sare ee senna, kiniinnada bisacodyl, ama magnesium citrate) ka hor inta aan la nadiifin malawadka ayaa ku qasbaya mindhicirka sare inuu si xoog leh ula dagaallamo dhagaxa ma guurto ah, kaas oo dillaaci kara fidsan, derbiga xiidanka dhiig-baxa ( stercoral perforation).

Waa maxay sababta Fleet (Sodium Phosphate) enemas-ka caadiga ah looga mamnuucay dadka waaweyn?¶

Dukaanka caadiga ah ee dawada Fleet enemas waxay ka kooban tahay sodium phosphate hypertonic. Marka qof weyn oo daciif ah, gaar ahaan qof leh shaqadii kelyaha oo yaraatay, wadna xanuun, fuuq-bax, ama malawad xanniban oo dabinaysa dareeraha enema gudaha, waxay helayaan enema sodium phosphate, phosphate iyo sodium waxay si toos ah u galaan dhiigga. Saacado gudahood, waxay kicin kartaa hyperphosphatemia dilaa ah, dhibco daran oo calcium ah oo dhiiga ah (taasoo keenta wadne istaag iyo teetano), iyo kelyaha oo joogto ah. Had iyo jeer isticmaal enema kaydinta saliidda macdanta, biyo diirran oo diirran oo qasabad ah ama enema cusbada caadiga ah, Docusate (Enemeez) mini-enema, ama beddelka glycerin/bisacodyl suppository.

Waa maxay stercoral Colitis, goormaan u baahanahay inaan waalidkay u kaxeeyo Cusbitaalka ER isla markiiba?¶

Stercoral colitis waxay dhacdaa marka saxarada dhagxaanta adag ay si adag ugu cadaadiso darbiga malawadka ama xiidanka sigmoid taas oo gooysa qulqulka dhiigga ee unugyada mindhicirka, taasoo abuureysa boogaha cadaadiska necrotic ee gudaha xiidanka oo qarka u saaran inuu dillaaco (daloosha stercoral). Wac 911 oo u tag cisbitaalka ER isla markiiba, adigoon waxba afka ka siinin, haddii qof weyn oo calool-istaaggu uu ku dhaco calool xanuun daran ama ka sii daraya, caloosha oo adag ama qallafsan, matag, casaan dhalaalaya ama maroon dhiigbax, qandho, garaaca wadnaha oo degdeg ah, ama caajisnimo degdeg ah iyo jahawareer.

Muxuu waalidkay u joojiyey inuu kaadin karo isla markaana ay saamaysay saxarada?¶

Malawadka iyo kaadi haysta qoortu / kaadi mareenku waxay si toos ah iskaga hor fadhiyaan gudaha miskaha lafaha cidhiidhi ah. Marka feedho weyn oo dhagax adag ah ay buuxiso khasnadda malawadka, hore ayay u riixdaa oo jidh ahaan ayay qanjisaa kaadi mareenka iyo kaadiheysta kaadiheysta oo ka xirta lafta cambarka. Tani waxay sababtaa kaadi-haysasho degdeg ah (kaadi-haysta xanuun badan, buux-dhaaftay oo kaliya ku daadi kara dhibcaha kaadida oo dhabarka ka riixaysa ilaa kelyaha), taas oo markaa kicisa delirium heerka cisbitaalka degdega ah ee waayeelka. Nadiifinta saxarada saxarada ayaa inta badan soo celisa kaadida caadiga ah daqiiqado gudahood.

Waa maxay sababta kaniiniyada Colace (docusate) ee maalinlaha ah ama fiber Metamucil ay uga hortagi waayeen saameynta saxarada waalidka?¶

Tijaabooyin caafimaad ayaa si isdaba joog ah u caddeeyey in kaabsoosha Docusate Sodium ee afka laga qaato (Colace) aanay ka waxtar badanayn placebo si looga hortago ama loo daweeyo calool-istaagga dadka waaweyn ee waaweyn ama bukaannada qaata dawooyinka xanuunka opioid. Xitaa waxaa ka sii daran, budada fiber-samaynta badan sida Metamucil (psyllium) waxay u baahan yihiin xaddi badan oo biyo maalinle ah si ay ugu gudbaan mindhicirka; Qofka waayeelka ah ee sariirta ku jira ee cabba dareere yar ama leh dhaqdhaqaaqa mindhicirka oo gaabis ah oo ka yimaada opioids ama cudurka Parkinson, fiber psyllium ayaa dhumuc weyn u yeelata gudaha xiidanka waxayna si firfircoon u keentaa saxarada. U beddel maalin kasta Polyethylene Glycol 3350 (MiraLAX) oo lagu lammaaniyo Senna haddii aad qaadato opioids.

Tilmaamaha la xidhiidha¶

• Jahwareerka degdega ah ee waayeelka: aamusnaanta UTI urosepsis vs. istaroogga iyo sababta bukaannada waayeelka ah ay u la'yihiin qandho
• Delirium isbitaalka iyo u doodista caafimaadka ee waayeelka
• Polypharmacy, daawada xad dhaafka ah, qiyaasaha la seegay, iyo khaladaadka qabanqaabiyaha kiniinka
• Bukaanka Parkinson ee cisbitaalka: sababta uu u waayay Sinemet/levodopa ama helitaanka Haldol waxay sababtaa qallafsanaan dhimasho leh

Ilaha iyo hanuuninta rasmiga ah¶

• Maamulka Cuntada iyo Dawooyinka ee Maraykanka (FDA): Xidhiidhinta Badbaadada Maandooriyaha FDA: Digniin Ku Saabsan Khatarta Naadirka Ah Balse Khatarta Adag ee Fuuqbaxa, Kalyaha oo Fashilmay, iyo Dhimashada Ka-hortagga Sodium Phosphate Laxative/Enema ee Dadka Waaweyn.
• American Geriatrics Society (AGS): Cusbooneysii AGS Beers Shuruudaha loogu talagalay Isticmaalka Daawooyinka Aan Haboonayn ee Dadka Waaweyn (Ka Fogaanshaha Sodium Phosphate Enemas, Anticholinergics, iyo Opioids Aan La Hortagin Iyadoo Aan Lahayn Kiciyeyaasha/Osmotic Bowel Prophylaxis).
• Kulliyadda Maraykanka ee Gastroenterology (ACG) & Ururka Gastroenterological Association (AGA): * Tilmaamaha Dhaqanka Kiliinikada ee Maareynta Calool-istaagga Daba-dheerta, Calool-istaagga Opioid-ku-abuuray, iyo Saamaynta Saxarka Fog*.
• Machadka Qaranka ee Caafimaadka iyo Daryeelka Sare ee UK (NICE) & Royal College of Nursing (RCN): *NICE Guideline Clinical CG49 ( Saxarada Saxarada La'aanta iyo Culayska Saxarada ee Dadka Waa wayn
• Bulshada Adduunka ee Qalliinka Degdegga ah (WSES): * Tilmaamaha Caafimaadka ee ogaanshaha Degdegga ah iyo Maareynta Qalliinka/Caafimaadka ee Stercoral Colitis iyo Perforation Stercoral ee xiidan*.