Casharka 50aad

 Habdhiska dheefshiidka. 

Casharka 50aad

Fecal incontinence 

Waa awood li'ida ama xakameyn la'aanta dhaqdhaaqa xiidmaha, taasoo keeneysa qofka inuu xakameyn waayo saxarada ama hawada(aariyada). Saxarro baxsadka waxa uu ku yimaadaa hannaan badan oo shaqo gaba ah, sida caadiga saxarada soo bixisteeda waxa isku dheellitira  muruqa iyo dareensidaha malaxwadka(rectum), cillada labadaas dhan ayay ka jirri jartaa. Waxa jirra waxyaabo dhowr oo qeyb ka ah mid mid ayaanu u sharxeynaa.

1:Muruqa guddaha, waa muruq aan qofka xakameyn karin caadiyan waxa uu sameeyaa isku urur, si markaasi u ilaalsho marrinka saxarada iridkeeda u xirmo, marka qofka uu rabbana inuu saxarroodo waa uu dabcaa.

Muruqa dibbada qofka waxa uu awooddaa inuu xakameeyo taasoo u oggolaaneysa qofka in badan uu saxarada ceshado muddo. Haddii labadaasi muruq ay dhaqadooda gabaan, ama ay daciifaan ama dhaawac uu soo gaaro qofka waxa ku imanaya inuu xakameyn waayo saxarada. Iyo aariyada. Haddii  dareensidaha xakameeya furanka iyo xiritaanka marrinka saxarada uu dhaawacmo waxa lumaya macaamilka u dhexeeyaa maskaxda iyo muruqa marrinka saxa xakameeya, sidaas waxa ku imanaya inuu qofka saxarada ceshan waayo.

2:Rectal compliance: waa awoodda uu malawadka ku kala baxo si markaasi saxarada ugu soo ururto.  Haddii malawadka uu noqdo mid jilcan  ama nabar leh ( waxa ugu wacan shucaac lagu daaweyay, olol ku dhacay, ama qaliin loo sameeyay) malawadka ma awooddayo inuu u kala jiidmo si qumman.

3:Xaddiga malawadka waa cadadka uu hayn karro saxarada  ka hor inta aanu qofka suuliga aadin.  Haddii malaxwadku xadigiisa ka yaraado waxa ku imanaya cadaadis xooggan, waxa ugu wacan qofka oo qaliin lagu sameeyo,ama nabar ka soo baxa, taasoo keeneysa in uu saxarada xakameyn waayo qofka.

4:Neurological Factors: hannaanka saxarada waxa xakameeya dareensidayaal qaabilsan, haddii dareen sidahaasi uu dhaawacmo sida haddii uu qofka uu leeyahay xanuunka macaanka, haddii xangulaha uu dhaawac ka soo gaadho intaas ayaa keeni kara dhaawacanka dareen sidaha.

5:Saxarada adag waxay keeni kartaa baxsadka Saxarada,  iyadoo xidheysa malawadka,  kaddib waxay keeneysaa in ay murqaha dabcaan, sidaasna lagu waayo xakameynta Saxarada. 

Maxaa keenna?

1:Obstetric Trauma:  xilliga hooyada uurka ay leedahay ama dhalmadeeda la gaadho jugta soo gaadha  gaar ahaan marka la jarrayo(episiotomy)waxa uu dhaacwac gaarsiinayaa muruqa marrinka saxarada iyo dareensidaha quudsha. Sidaasina uu qofka awooddi waayo inuu saxarada xakameeyo.

2:Age-Related Changes:  waxa keenna isbeddelka da'ada ah, muruqa marrinka saxarada waxa uu noqdaa mid daciifa,iyo shaqada dareensidaha oo hoos u dhacda, taasina waxay keeneysaa in qofka saxarada xakameyn waayo.

3:Surgery: Waxa keenna qaliinnada qaar qofka looga sameeyo aaga marrinka saxarada ama mawladka, waxay dhaawici karaan muruqa iyo dareensidaha marrinka saxarada. 

4:Chorinic diarrhea: shubanka ragga ee muddada dheer waxa uu luminayaa hoore badan oo jirka u baahnaa,  shubanka biya ah waa ay adkaaneysaa in ay xakameyn waayaan murqaha marrinka saxarada. Muruqa marrinka saxarada ma awooddayo markaasi inuu xakameeyo saxarada adag. Kala baxa xad-dhaadhka muruqa waxay qofka ku keeneysaa in qofka uu saxarada  suuliga la gaari waayo. 

5:Rectal prolapse: raacsanka malawadka badanaa waxa uu la xidhiidhaa dabaca murqaha miskaha,  kuwaasoo door muhiim ah ka qaata socodka xiidmaha. Goorta ay dabcaan murqahan waxay awooddi waayaan ay saxarada ceshan waayaa, saxarada cadaadis badan ayay keeneysaa.

Xaaladan  ee daba dheeraada raacsanka malawadka waxa uu dhaawaca murqaha xakameeya saxarada, taasoo diideysa inuu muruqa isku soo ururo si qumman.

6: Calool fadhiga raagga: caloosha oo waqti dheer qofka fadhisa waxay keentaa in malwadka uu noqdo mid aad u kale baxa, taasoo ugu wacan cadaadiska xooggan ee fuulaya, kala baxaasi waxa uu hoos u dhiggayaa awoodda malawadka taasoo keeneysaa inu dhaawaco muruqa, sidaasina qofka uu saxarada ku xakameyn waayo.

 Calaamadaha. 

1: Qofka saxarada xakameyn waayo.

2:Qofka oo dagdag suuliga ugu baahda.

3:Shubban.

4: Calool fadhi.

5: Aariyo.

6: Qofka oo malawadka xanuun ka dareema.

7: Qulub oo qofka haleelo.

Baadhitaanka. 

1:Endoanal Ultrasonography: hubbintani waxa lagu qiimeynayaa qaabdhiska muruqa marrinka saxarada ee dhaawaca soo gaaray.

2;Anorectal Manometry: waxa lagu cabbirayaa cadaadiska malawadka iyo marrinka saxarada si markaasi loo helo warbixin ku saabsan shaqada muruqa marrinka saxarada. 

3: Electromyography (EMG): waxa lagu qiimeynayaa muruqa marrinka saxarada iyo miskaha si markaasi loo qiimeeyo shaqada dareen sidaha.

Daaweynta. 

1:Dietary Modifications:  qofka waxa la siinayaa cunnooyinka qolofta leh si markaasi ay saxarada u jilciyaan. Waxa uu qofka ka fogaanayaa cunnooyinka ka qeyb qaata in ay shubban keenaan.

2:Antidiarrheal Agents: waxa la siinayaa dawooyinka liddiga shibanka si markaasi u yareeyaan shubbanka sida  Loperamide ama Cholestyramine,

3: Pelvic Floor Muscle Training: bukaanka waxa loo sameynayaa tabbabar murqaha miskaha adkeynaya sida jimcisiga kegel.

4: Sphincteroplasty:  waxa dayactir loo sameynayaa dhaawaca soo gaadhay muruqa marrinka saxarada, haku yimaado dhalmo,  am jug.

5:Sacral Nerve Stimulation (SNS): waxa la galinayaa aalad markaasi carineysa dareensidaha  si markaasi u wanaagsanaado xakameyn muruqa.

 6:Artificial Bowel Sphincter:  waa aalad macmal ah la dhigayo aaga marrinka saxarada si markaasi u caawiyo xakameyn  dhaqdhaaqa xiidmaha.

References

Books:

Sleisenger and Fordtran's Gastrointestinal and Liver Disease - This comprehensive text provides detailed information on the diagnosis and management of fecal incontinence.Shackelford's Surgery of the Alimentary Tract - This book includes surgical approaches to treating fecal incontinence.Cecil Essentials of Medicine - Offers a broad overview of the pathophysiology and management of fecal incontinence.

Websites:Mayo Clinic: 

Offers patient-friendly overviews on the causes and treatments of fecal incontinence.Cleveland Clinic: Provides detailed explanations of diagnostic procedures and treatment options.Medscape: An excellent resource for healthcare professionals, offering in-depth articles on the latest advances in the management of fecal incontinence

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