Yoğun bağırsaq şişlərinin səbəbləri və risk faktorları

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Op. Dr. Kamran Beydullayev, MRCS İngiltərə, Ümumi və Transplant Cərrah, 0504063853

Yoğun bağırsaq şişləri həm kişilərdə həm də qadınlarda geniş yayılmışdır. Bu xəstəlik xərcəng səbəbi ilə ölümlər arasında dünyada 3 cü yerdədir. Statistikada Amerika əhalisinin 5%-ə qədəri ömrünün hansısa mərhələsində bu xəstəliklə üzləşir. Bu xəstəliyə tutulanların da təqribən 30% elə bu səbəbdən də vəfat edir. Bu xəstəliyə tutulmanın risk faktorlarını bilməklə və vaxtı çatanda müntəzəm yoxlamalardan keçmənin əhəmiyyətini anlamaqla yuxarıda deyilən xoşagəlməz nəticələrdən qurtarmaq olar. Yoğun bağırsaq şişinin müalicəsinin nəticəsi onun aşkar edilmə vaxtından çox asılıdır. Əgər diaqnoz qoyulan anda şiş yayılıbsa o zaman xəstəlikdən birdəfəlik qurtarmaq şansları çox çox aşağı olur. Ümumilikdə 50 yaşdan etibarən insanların yoğun bağırsaq şişinə görə müntəzəm yoxlanması məsləhət görülür. Yoğun bağırsağın şişə görə skriin məqsədi ilə yoxlanması kolonskopla həyata keçirilir ki, bu müayinə metodunun da həssaslığı çox yüksəkdir. Bu o deməkdir ki, bu yolla yoğun bağırsaq şişi vaxtında aşkar edilir, və radikal müalicəyə yararlı olur. Bu yolla həm də şişönü vəziyyətləri aşkar etmək olar və vaxtında qarşısını almaq olar. Məsələn, bağırsaq poliplərinin aşkar edilməsi və elə endoskopla da çııxarılması buna aiddir.

Aşağıda sadalanan risk faktorları olan insanların bir qrupu 50 yaş deyil daha əvvəl bağırsaq şişinə görə yoxlanmalıdır. Ailədə bağırsaq şişi tarixçəsinin olması risk faktor olsa da nəzərə almaq lazımdır ki, yoğun bağırsaq xərçənginin əksəriyyəti əvvəllər ailəsində bağırsaq şişi olmayan insanlarda əmələ gəlir.

  1. Yaş– ən birinci risk faktorudur. Yoğun bağırsaq şişlərinin 81%-i yaşı 45 dən yuxarı olan insanlarda baş verir. Bunların da 65%-i 65-85 yaş arasında olan xəstələrdir.
  2. Alkoqol istifadəsi. Hal hazırda alkoqol kolorektal şişlər üçün major risk faktoru hesab edilir. Risk alkoqolun qəbulunu miqdarı ilə birbaşa xətti asılıdır. Hətta orta miqdarda alkoqol qəbulu insanı bu xəstəlik üçün risk altına qoyur.
  3. Şəkərli diabet. Bir neçə tədqiqat göstərmişdir ki, şəkərli diabetlə yoğun bağırsaq şişləri arasında əlaqə vardır. Şəkərli xəstələrin  digərlərindən 40% daha çox kolorektal şişlərə tutulmaq ehtimalı var. Başqa tədqiqatlar da bunun şəkərli xəstələrin qəbul etdiyi dietlə heç bir əlaqəsinin olmadığını göstərmişdir. Yəni şəkərli diabet sərbəst risk faktordur.
  4. Xüsuli ilə heyvan mənşəli yağlarla və xolestrolla zəngin qidaların yoğun bağırsaq şişləri ilə bağlılığı aşkarlanmışdır. Hesab olunur ki, yüksək yağlı qidalar bağırsaq hüceyrələrini kök hüceyrələrinə çevirə bilir ki, onlar da sonradan şiş hüceyrələrinə çevrilir. Fibrinlərlə, meyvə və tərəvəzlə zəngin olmayan qidalar da yüksəlmiş risklə bağlıdır.
  5. Etnik qruplar və irqlər. Etnosun da yoğun bağırsaq şişləri ilə bağlılığı sübut edilmişdir. Məsələn Amerikanın Afrikalı vətəndaşlarında bu xəstəlik digərlərindən 40% daha artıq rast gəlinir. Asiyalılarda isə bu müqayisədə bu xəstəlik daha az az olur.
  6. Ailə tarixçəsi. Əgər bir kəsin yaxın qohumu bağırsaq xərcəngi ilə xəstə olubsa, bu onun artıq bağırsaq xərcənginə tutulmaq riskinin digərlərindən daha artıq olması deməkdir. Əgər bu birinci dərəcəli qohumdursa bu risk iki dəfə və hətta 3 dəfə yüksəlir.
  7. Genetk faktor. Alimlər aşkar ediblər ki, hər 4 kolorektal şiş olan xəstənin birində genetik faktorun rolu var. Ən çox rast gəlinən irsi faktorlara ailəvi adenomatoz polipoz (FAP – familial adenomatouz poliposis)   xəstəliyini və İrsi polipoz olmayan bağırsaq xərcəngini  (HNPCC –hereditary non-polyposis colon canceer) göstərmək olar.
  8. İltihabi bağırsaq xəstəlikləri. Söhbət qeyri spesifik xoralı kolitdən və Kron xəstəliyindən gedir. Xəstələr nə qədər uzun müddət bu xəstəliklə xəstədirlərsə yoğun bağırsaq xərçənginin əmələ gəlmə riski bir o qədər yüksəkdir.
  9. Artıq çəki. Artıq çəki ilə bağırsaq şişi arasında əlaqə çox güclüdür. Artıq çəkili adamlar digərlərindən 30% artıq risk daşıyırlar.
  10. Xərcəngönü poliplər. Poliplər bağırsaq divarından mənfəzinə doğru inkişaf edən hüceyrə yığıntılarından ibarət bir törəmədir. Demək olar ki, bütün bağırsaq xərçəngləri normal hüceyrələrdən təşkil olunmuş adenomatoz pliplərdən inkişaf edir. Bu hüceyrələr sonralar dəyişərək bədxassəli olur və böyüməyə başlayır.
  11. Bu nəinki bağırsaqlar demək olar ki, bədəndə bütün orqan və sistemlərə təsir edir.

50 yaşına çatmış bütün insanlar yoğun bağırsaq şişlərinə görə müayinə olunmalıdır. Əgər sizdə bu şişlərin əmələgəlmə riskini artıran faktorlar varsa o zaman bağırsaq şişinə görə skriiningi daha erkən yaşda başlamaq üçün öz doktorunuza  müraciət edin.

Sizə həm də maraqlı ola bilər

Kron xəstəliyi

Qeyri Spesifik xoralı kolit

 

 

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