{"id":42153,"date":"2023-09-14T13:58:05","date_gmt":"2023-09-14T11:58:05","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=42153"},"modified":"2023-09-14T13:58:05","modified_gmt":"2023-09-14T11:58:05","slug":"zanety-strev-omezuji-tisice-lidi-v-praci","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=42153","title":{"rendered":"Z\u00e1n\u011bty st\u0159ev omezuj\u00ed tis\u00edce lid\u00ed v pr\u00e1ci"},"content":{"rendered":"\n

Modern\u00ed l\u00e9\u010dba se dostane pouze k mal\u00e9\u00a0\u010d\u00e1sti pacient\u016f<\/em>. Bolen\u00ed b\u0159icha, \u010dast\u00e9 pr\u016fjmy nebo nechutenstv\u00ed \u2013 to jsou jen n\u011bkter\u00e9 z\u00a0projev\u016f chronick\u00fdch st\u0159evn\u00edch z\u00e1n\u011bt\u016f, se kter\u00fdmi mus\u00ed ka\u017ed\u00fd den bojovat tis\u00edce pacient\u016f. Nemoc\u00ed jako Crohnova choroba nebo ulcer\u00f3zn\u00ed kolitida p\u0159itom v\u00a0\u010cesku trp\u00ed p\u0159es 70 000 lid\u00ed a\u00a0ka\u017edoro\u010dn\u011b dal\u0161\u00ed tis\u00edce p\u0159ib\u00fdvaj\u00ed. <\/strong><\/p>\n\n\n\n

A\u017e 40 % pacient\u016f chronick\u00e9 z\u00e1n\u011bty st\u0159ev (IBD) nav\u00edc omezuj\u00ed tak, \u017ee nemohou naplno pracovat, 10 % dokonce z\u00a0pr\u00e1ce vy\u0159azuj\u00ed \u00fapln\u011b. <\/strong><\/p>\n\n\n\n

Dopad nemoci na jejich \u017eivot m\u016f\u017ee v\u00fdrazn\u011b zm\u00edrnit modern\u00ed biologick\u00e1 l\u00e9\u010dba \u2013 na tu v\u0161ak v \u010cesku dos\u00e1hne mnohem m\u00e9n\u011b pacient\u016f, ne\u017e je obvykl\u00e9 na Z\u00e1pad\u011b. I o tom budou diskutovat stovky 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

Crohnova choroba a ulcer\u00f3zn\u00ed kolitida se v\u00a0\u010cesku vyskytuj\u00ed v\u00a0p\u0159ibli\u017en\u011b stejn\u00e9m pom\u011bru. Po\u010det pacient\u016f s\u00a0\u201eCrohnem\u201c v\u0161ak roste rychleji \u2013 asi o 4 % ro\u010dn\u011b. P\u0159\u00edpad\u016f ulcer\u00f3zn\u00ed kolitidy pak za rok p\u0159ib\u00fdv\u00e1 zhruba o 3 %. \u201eV absolutn\u00edch \u010d\u00edslech po\u010dty pacient\u016f dlouhodob\u011b stoupaj\u00ed, proto\u017ee chronick\u00e9 st\u0159evn\u00ed z\u00e1n\u011bty jim nezkracuj\u00ed d\u00e9lku \u017eivota. To samoz\u0159ejm\u011b klade st\u00e1ly vy\u0161\u0161\u00ed n\u00e1roky na zdravotn\u00ed p\u00e9\u010di. Bohu\u017eel v\u0161ak po\u010det za\u0159\u00edzen\u00ed a l\u00e9ka\u0159\u016f nijak prudce nenar\u016fst\u00e1, zat\u00edmco pacient\u016f je \u010d\u00edm d\u00e1l v\u00edce,\u201c<\/em> \u0159\u00edk\u00e1 prof. MUDr. Milan Luk\u00e1\u0161, p\u0159edn\u00ed \u010desk\u00fd gastroenterolog. \u010cerstv\u00e9 odhady nav\u00edc podle n\u011bj hovo\u0159\u00ed o tom, \u017ee v\u00a0rozvinut\u00fdch zem\u00edch sv\u011bta bude m\u00edt v\u00a0roce 2035 chronick\u00fd st\u0159evn\u00ed z\u00e1n\u011bt a\u017e 1\u00a0%\u00a0populace, co\u017e p\u0159edstavuje stovky tis\u00edc lid\u00ed ro\u010dn\u011b nav\u00edc.<\/p>\n\n\n\n

L\u00e9ka\u0159i upozor\u0148uj\u00ed i na to, \u017ee velk\u00e1 \u010d\u00e1st pacient\u016f s\u00a0chronick\u00fdm st\u0159evn\u00edm z\u00e1n\u011btem dlouhodob\u011b nem\u016f\u017ee v\u016fbec pracovat, nebo pouze s\u00a0omezen\u00edm. \u201eAsi u 50 % pacient\u016f se n\u00e1m da\u0159\u00ed uv\u00e9st chorobu do stavu remise, pacienti pak mohou \u017e\u00edt prakticky plnohodnotn\u00fd \u017eivot. A\u017e 40 % pacient\u016f se v\u0161ak t\u00fdk\u00e1 fenom\u00e9n absentismu, co\u017e znamen\u00e1, \u017ee mohou pracovat, ale pouze omezen\u011b, nap\u0159\u00edklad na zkr\u00e1cen\u00fd \u00favazek. A 10\u201315 % pacient\u016f nemoc pr\u00e1ci znemo\u017e\u0148uje \u00fapln\u011b,\u201c <\/em>vypo\u010d\u00edt\u00e1v\u00e1 prof. Luk\u00e1\u0161. I\u00a0s\u00a0t\u00edm by v\u0161ak podle n\u011bj pomohla v\u011bt\u0161\u00ed dostupnost modern\u00edch l\u00e9\u010debn\u00fdch postup\u016f, zejm\u00e9na biologick\u00e9 l\u00e9\u010dby. V\u00a0jej\u00edm nasazov\u00e1n\u00ed toti\u017e \u010cesko pom\u011brn\u011b v\u00fdrazn\u011b zaost\u00e1v\u00e1 za dal\u0161\u00edmi st\u00e1ty z\u00e1padn\u00ed Evropy, nap\u0159\u00edklad za Holandskem nebo Belgi\u00ed. <\/p>\n\n\n\n

\u201eV t\u011bchto st\u00e1tech je standardem, \u017ee a\u017e polovina pacient\u016f s\u00a0Crohnovou chorobou u\u017e\u00edv\u00e1 biologickou l\u00e9\u010dbu, v\u00a0p\u0159\u00edpad\u011b ulcer\u00f3zn\u00ed kolitidy je to pak asi 20\u00a0%\u00a0pacient\u016f. V\u00a0\u010cesku je to v\u00a0obou p\u0159\u00edpadech m\u00e9n\u011b, dosahujeme zhruba polovi\u010dn\u00ed prol\u00e9\u010denosti ve srovn\u00e1n\u00ed s\u00a0t\u011bmito zem\u011bmi. Nav\u00edc n\u00e1m chyb\u00ed v\u00edce specializovan\u00fdch center pro l\u00e9\u010dbu chronick\u00fdch z\u00e1n\u011bt\u016f, v nich\u017e by pacienti m\u011bli k\u00a0dispozici multidisciplin\u00e1rn\u00ed t\u00fdmy s odborn\u00edky ze\u00a0v\u0161ech pot\u0159ebn\u00fdch oblast\u00ed. To znamen\u00e1 vedle gastroenterolog\u016f nap\u0159\u00edklad endoskopisty, imunology, nutri\u010dn\u00ed specialisty nebo psychology. Takov\u00fdch komplexn\u00edch IBD center je v\u00a0\u010cesku pouze n\u011bkolik,\u201c <\/em>upozor\u0148uje prof.\u00a0Luk\u00e1\u0161. <\/p>\n\n\n\n

P\u0159esto se v\u0161ak v\u011bdc\u016fm a l\u00e9ka\u0159\u016fm da\u0159\u00ed zav\u00e1d\u011bt nov\u00e9 zp\u016fsoby l\u00e9\u010dby. \u201eNa\u0161t\u011bst\u00ed se u\u017e b\u011b\u017en\u00fdm postupem st\u00e1vaj\u00ed laparoskopick\u00e9 operace z\u00e1n\u011bt\u016f, co\u017e pro pacienta p\u0159edstavuje v\u00fdrazn\u011b men\u0161\u00ed z\u00e1sah do organismu, ne\u017e b\u00fdvalo zvykem. Brzy se do\u010dk\u00e1me i robotick\u00e9 chirurgie. Prob\u00edhaj\u00ed tak\u00e9 studie na pou\u017eit\u00ed kmenov\u00fdch bun\u011bk pro l\u00e9\u010dbu tzv. p\u00ed\u0161t\u011blov\u00fdch trakt\u016f u Crohnovy choroby. To je zat\u00edm sice velmi n\u00e1kladn\u00e1, ale z\u00e1rove\u0148 velmi slibn\u00e1 terapie,\u201c <\/em>\u0159\u00edk\u00e1 prof. Luk\u00e1\u0161. <\/p>\n\n\n\n

P\u0159esnou p\u0159\u00ed\u010dinu vzniku chronick\u00fdch st\u0159evn\u00edch z\u00e1n\u011bt\u016f se v\u011bdc\u016fm odhalit zat\u00edm nepoda\u0159ilo, podle odborn\u00edk\u016f se jedn\u00e1 o komplex faktor\u016f, jako jsou nevhodn\u00e1 strava s\u00a0vy\u0161\u0161\u00edm obsahem rafinovan\u00fdch cukr\u016f a tuk\u016f, m\u00e9n\u011b pohybu nebo stres. \u201eU ka\u017ed\u00e9ho pacienta je to individu\u00e1ln\u00ed. Shodujeme se, \u017ee z\u00e1n\u011bty jsou tak\u00e9 geneticky podm\u00edn\u011bn\u00e9, nicm\u00e9n\u011b se bav\u00edme o p\u0159ibli\u017en\u011b 200 gen\u016f, kter\u00e9 mohou onemocn\u011bn\u00ed spustit. Nem\u016f\u017eeme tak p\u0159edem \u0159\u00edci, \u017ee d\u00edt\u011b rodi\u010d\u016f s\u00a0chronick\u00fdm st\u0159evn\u00edm z\u00e1n\u011btem bude nemoc\u00ed trp\u011bt tak\u00e9,\u201c<\/em> popisuje prof. Luk\u00e1\u0161.<\/p>\n\n\n\n

Pro vy\u0161\u0161\u00ed v\u00fdskyt t\u011bchto chorob je v\u0161ak podle n\u011bj spole\u010dn\u00e1 socioekonomick\u00e1 \u00farove\u0148 zem\u00ed. Nemoci se nejv\u00edce vyskytuj\u00ed v severn\u00ed a z\u00e1padn\u00ed Evrop\u011b, kde populace sice trp\u00ed m\u00e9n\u011b infek\u010dn\u00edmi chorobami, ale o to v\u00edce se zde vyskytuj\u00ed nemoci autoimunitn\u00ed.<\/p>\n\n\n\n

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

Modern\u00ed l\u00e9\u010dba se dostane pouze k mal\u00e9\u00a0\u010d\u00e1sti pacient\u016f. Bolen\u00ed b\u0159icha, \u010dast\u00e9 pr\u016fjmy nebo nechutenstv\u00ed \u2013 to jsou jen n\u011bkter\u00e9 z\u00a0projev\u016f chronick\u00fdch st\u0159evn\u00edch z\u00e1n\u011bt\u016f, se kter\u00fdmi […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14888,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-42153","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\/42153","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=42153"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/42153\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14888"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=42153"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=42153"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=42153"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}