{"id":42151,"date":"2023-09-14T14:01:04","date_gmt":"2023-09-14T12:01:04","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=42151"},"modified":"2023-09-14T14:01:05","modified_gmt":"2023-09-14T12:01:05","slug":"mladych-pacientu-s-chronickymi-zanety-strev-pribyva","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=42151","title":{"rendered":"Mlad\u00fdch pacient\u016f s\u00a0chronick\u00fdmi z\u00e1n\u011bty st\u0159ev p\u0159ib\u00fdv\u00e1"},"content":{"rendered":"\n

\u010casto trp\u00ed z\u00e1va\u017en\u011bj\u0161\u00edmi formami nemoci ne\u017e dosp\u011bl\u00ed<\/em>. <\/p>\n\n\n\n

Autoimunitn\u00edch chorob v\u00a0posledn\u00edch letech p\u0159ib\u00fdv\u00e1 a nevyh\u00fdbaj\u00ed se ani \u010derstv\u011b dosp\u011bl\u00fdm \u010di d\u011btem. Jedn\u00edm z\u00a0typ\u016f t\u011bchto chorob jsou tzv. nespecifick\u00e9 st\u0159evn\u00ed z\u00e1n\u011bty (IBD), mezi kter\u00e9 pat\u0159\u00ed nap\u0159\u00edklad Crohnova nemoc nebo ulcer\u00f3zn\u00ed kolitida. Ty doprov\u00e1z\u00ed \u010dlov\u011bka po cel\u00fd \u017eivot. Proto se l\u00e9ka\u0159i sna\u017e\u00ed co nejd\u0159\u00edve nemoc zklidnit, a p\u0159edej\u00edt tak nevratn\u00e9mu posti\u017een\u00ed st\u0159eva nebo vzniku komplikac\u00ed, kter\u00e9 by mlad\u00e9 pacienty v\u00fdznamn\u011b omezovaly v\u00a0b\u011b\u017en\u00e9m \u017eivot\u011b. <\/strong><\/p>\n\n\n\n

P\u0159esto\u017ee je v\u00a0sou\u010dasn\u00e9 dob\u011b k\u00a0dispozici st\u00e1le v\u00edce modern\u00edch l\u00e9k\u016f i chirurgick\u00fdch postup\u016f, ne v\u017edy se da\u0159\u00ed dostat nemoc pod kontrolu. I to bude t\u00e9matem diskuse gastroenterolog\u016f na konferenci Biologick\u00e1 l\u00e9\u010dba IBD a pokroky v chirurgick\u00e9 l\u00e9\u010db\u011b IBD, kter\u00e1 startuje 21. z\u00e1\u0159\u00ed v\u00a0Praze.<\/strong><\/p>\n\n\n\n

Podle odborn\u00edk\u016f trp\u00ed v\u00a0sou\u010dasn\u00e9 dob\u011b nespecifick\u00fdmi st\u0159evn\u00edmi z\u00e1n\u011bty v \u010cesku t\u00e9m\u011b\u0159 70\u00a0000 lid\u00ed. Zna\u010dn\u00e1 \u010d\u00e1st pacient\u016f onemocn\u00ed je\u0161t\u011b p\u0159ed dovr\u0161en\u00edm dosp\u011blosti. \u201eP\u0159esto\u017ee se z\u00e1n\u011btliv\u00e1 st\u0159evn\u00ed onemocn\u011bn\u00ed charakteru IBD nej\u010dast\u011bji poprv\u00e9 projevuj\u00ed v\u00a0adolescentn\u00edm v\u011bku, nen\u00ed ji\u017e v\u00fdjimkou jejich v\u00fdskyt u\u00a0batolat nebo u kojenc\u016f,\u201c <\/em>\u0159\u00edk\u00e1 MUDr. Katar\u00edna Mitrov\u00e1, z odd\u011blen\u00ed\u00a0d\u011btsk\u00e9 gastroenterologie ve Fakultn\u00ed nemocnici v\u00a0Motole. <\/p>\n\n\n\n

Nemoci jako Crohnova nemoc nebo ulcer\u00f3zn\u00ed kolitida jsou tzv. imunitn\u011b podm\u00edn\u011bn\u00e1 onemocn\u011bn\u00ed, tedy zp\u016fsobuje je vlastn\u00ed imunitn\u00ed syst\u00e9m pacienta. \u201eP\u0159esto\u017ee jednozna\u010dnou p\u0159\u00ed\u010dinu nezn\u00e1me, uplat\u0148uj\u00ed se zde jak faktory genetick\u00e9, tak i\u00a0faktory vn\u011bj\u0161\u00edho prost\u0159ed\u00ed. U obou nemoc\u00ed byly prok\u00e1z\u00e1ny genetick\u00e9 dispozice, kter\u00e9 jsou daleko siln\u011bji vyj\u00e1d\u0159eny u Crohnovy choroby. \u010c\u00edm siln\u011bj\u0161\u00ed je genetick\u00e1 vloha, t\u00edm \u010dasn\u011bji se choroba projev\u00ed a\u00a0obvykle tak\u00e9 prob\u00edh\u00e1 agresivn\u011bji,\u201c<\/em> prof. MUDr. Milan Luk\u00e1\u0161, p\u0159ednosta kliniky ISCARE.\u00a0 <\/p>\n\n\n\n

\u00a0Nej\u010dast\u011bji se IBD projevuj\u00ed bolestmi b\u0159icha, pr\u016fjmy nebo krv\u00ed ve stolici. U d\u011bt\u00ed v\u0161ak m\u016f\u017ee b\u00fdt, na rozd\u00edl od dosp\u011bl\u00fdch pacient\u016f, jedin\u00fdm projevem porucha r\u016fstu. \u201eD\u011btsk\u00fd v\u011bk je obdob\u00edm neust\u00e1l\u00e9ho r\u016fstu, proto je nutn\u00e9 pomoc\u00ed vhodn\u00e9 terapie z\u00e1n\u011btlivou aktivitu nemoci co nejd\u0159\u00edve zklidnit, aby nedo\u0161lo k\u00a0negativn\u00edmu ovlivn\u011bn\u00ed v\u00fdvoje mal\u00e9ho pacienta. Ze stejn\u00e9ho d\u016fvodu mus\u00edme tak\u00e9 citliv\u011b volit l\u00e9\u010dbu, aby v\u00fdvoj negativn\u011b neovliv\u0148ovala,\u201c<\/em> vysv\u011btluje MUDr. Mitrov\u00e1. <\/p>\n\n\n\n

P\u0159esto\u017ee maj\u00ed l\u00e9ka\u0159i k\u00a0dispozici naprostou v\u011bt\u0161inu l\u00e9k\u016f, kter\u00e9 jsou ur\u010deny i k\u00a0l\u00e9\u010db\u011b dosp\u011bl\u00fdch, vy\u017eaduje l\u00e9\u010dba mlad\u00fdch pacient\u016f zvl\u00e1\u0161tn\u00ed p\u0159\u00edstup. K\u00a0potla\u010den\u00ed Crohnovy nemoci nap\u0159\u00edklad l\u00e9ka\u0159i pou\u017e\u00edvaj\u00ed m\u00edsto kortikosteroid\u016f tzv. v\u00fdlu\u010dnou enter\u00e1ln\u00ed v\u00fd\u017eivu, co\u017e je roztok obsahuj\u00edc\u00ed cukry, tuky, b\u00edlkoviny, ionty, vitaminy, stopov\u00e9 prvky a vodu. Ten pacienti do tr\u00e1vic\u00edho traktu dost\u00e1vaj\u00ed pop\u00edjen\u00edm nebo sondou. U\u00a0t\u011b\u017e\u0161\u00edch p\u0159\u00edpad\u016f je pak d\u016fle\u017eit\u00e9 \u010dasn\u00e9 zah\u00e1jen\u00ed imunosupresivn\u00ed \u010di biologick\u00e9 l\u00e9\u010dby nebo jejich kombinace. Tou se l\u00e9ka\u0159i sna\u017e\u00ed p\u0159edej\u00edt definitivn\u00edmu po\u0161kozen\u00ed st\u0159eva. <\/p>\n\n\n\n

\u201eV sou\u010dasn\u00e9 dob\u011b se m\u011bn\u00ed tak\u00e9 p\u0159\u00edstup k\u00a0chirurgick\u00fdm z\u00e1krok\u016fm, kter\u00e9 ji\u017e neslou\u017e\u00ed jenom k \u0159e\u0161en\u00ed komplikac\u00ed nebo jako \u201aposledn\u00ed mo\u017enost\u2018 po selh\u00e1n\u00ed l\u00e9k\u016f. Optim\u00e1ln\u00ed na\u010dasov\u00e1n\u00ed operace u d\u011btsk\u00fdch pacient\u016f m\u016f\u017ee pozitivn\u011b ovlivnit jejich dal\u0161\u00ed vyhl\u00eddky a \u010dasto i odpov\u011b\u010f organismu na dal\u0161\u00ed l\u00e9\u010dbu,\u201c<\/em> \u0159\u00edk\u00e1 MUDr.\u00a0Mitrov\u00e1. P\u00e9\u010de je tak podle n\u00ed v\u00a0\u010cesku srovnateln\u00e1 s\u00a0nejlep\u0161\u00edmi pracovi\u0161ti na sv\u011bt\u011b, obor v\u0161ak bohu\u017eel trp\u00ed nedostatkem l\u00e9ka\u0159\u016f i sester, co\u017e bude s\u00a0nar\u016fstaj\u00edc\u00edm po\u010dtem pacient\u016f v\u00a0budoucnu st\u00e1le v\u011bt\u0161\u00ed probl\u00e9m. U\u017e nyn\u00ed jsou na n\u011bkter\u00fdch pracovi\u0161t\u00edch \u010dekac\u00ed lh\u016fty v\u00a0\u0159\u00e1dech m\u011bs\u00edc\u016f. IBD u d\u011bt\u00ed a\u00a0mlad\u00fdch dosp\u011bl\u00fdch jsou podle l\u00e9ka\u0159\u016f velmi specifick\u00e9 i proto, \u017ee se s nimi mus\u00ed nau\u010dit \u017e\u00edt v\u00a0obdob\u00ed nejrychlej\u0161\u00edho fyzick\u00e9ho a psychick\u00e9ho v\u00fdvoje. <\/p>\n\n\n\n

\u201eJe d\u016fle\u017eit\u00e9 d\u011btem i mlad\u00fdm dosp\u011bl\u00fdm o jejich nemoci nelhat, komunikovat otev\u0159en\u011b a postupn\u011b je p\u0159ipravovat na to, aby byli schopni nemoc p\u0159ijmout a\u00a0jednou tak\u00e9 p\u0159evz\u00edt spoluodpov\u011bdnost za sv\u016fj zdravotn\u00ed stav. V\u00a0tom je kl\u00ed\u010dov\u00e1 role cel\u00e9 rodiny, jej\u00ed\u017e fungov\u00e1n\u00ed nemoc nepochybn\u011b ovliv\u0148uje tak\u00e9,\u201c<\/em> popisuje MUDr. Mitrov\u00e1. I obdob\u00ed p\u0159echodu pacient\u016f od d\u011btsk\u00fdch gastroenterolog\u016f k\u00a0t\u011bm pro dosp\u011bl\u00e9 m\u016f\u017ee b\u00fdt citliv\u00e9 a mus\u00ed k\u00a0n\u011bmu p\u0159istupovat obez\u0159etn\u011b. <\/p>\n\n\n\n

\u201eNav\u00e1z\u00e1n\u00ed d\u016fv\u011bry mezi n\u00e1mi a pacientem a \u010dasto i jeho rodi\u010di je velice d\u016fle\u017eit\u00e9,\u201c<\/em> \u0159\u00edk\u00e1 prof. Luk\u00e1\u0161. Podle jeho zku\u0161enost\u00ed funguje\u00a0p\u0159ed\u00e1v\u00e1n\u00ed\u00a0pacient\u016f do p\u00e9\u010de gastroenterolog\u016f pro dosp\u011bl\u00e9 velmi dob\u0159e, co\u017e v\u011bt\u0161inou vych\u00e1z\u00ed ze spolupr\u00e1ce\u00a0pracovi\u0161\u0165 pro d\u011bti i dosp\u011bl\u00e9. Pacient v\u017edy dost\u00e1v\u00e1 mo\u017enost v\u00fdb\u011bru centra, kter\u00e9 se problematikou IBD zab\u00fdv\u00e1 a kter\u00e9 mu nejv\u00edce vyhovuje.<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

\u010casto trp\u00ed z\u00e1va\u017en\u011bj\u0161\u00edmi formami nemoci ne\u017e dosp\u011bl\u00ed. Autoimunitn\u00edch chorob v\u00a0posledn\u00edch letech p\u0159ib\u00fdv\u00e1 a nevyh\u00fdbaj\u00ed se ani \u010derstv\u011b dosp\u011bl\u00fdm \u010di d\u011btem. Jedn\u00edm z\u00a0typ\u016f t\u011bchto chorob jsou […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":40837,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-42151","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/42151","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=42151"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/42151\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/40837"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=42151"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=42151"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=42151"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}