<\/p>\n\n\n\n
Za\u010d\u00edn\u00e1 pl\u00ed\u017eiv\u011b a prvotn\u00ed p\u0159\u00edznaky, jako je pobol\u00edv\u00e1n\u00ed b\u0159icha, \u00fanava nebo hubnut\u00ed, nejsou pro v\u011bt\u0161inu lid\u00ed varovn\u00fdm sign\u00e1lem, \u017ee se m\u016f\u017ee jednat o v\u00e1\u017en\u011bj\u0161\u00ed onemocn\u011bn\u00ed. \u0158e\u010d je o Crohnov\u011b chorob\u011b, kter\u00e1 pat\u0159\u00ed mezi idiopatick\u00e9 st\u0159evn\u00ed z\u00e1n\u011bty (IBD). V\u00a0\u010cesku trp\u00ed touto nemoc\u00ed des\u00edtky tis\u00edc lid\u00ed, spr\u00e1vn\u011b ji ozna\u010dit ale \u010dasto trv\u00e1 i m\u011bs\u00edce. Pokud se pacient\u016fm nenasad\u00ed vhodn\u00e1 l\u00e9\u010dba v\u010das, m\u016f\u017ee u nich doj\u00edt k\u00a0nevratn\u00e9mu po\u0161kozen\u00ed st\u0159eva. O tom, za co se \u201eCrohn\u201c \u010dasto schov\u00e1v\u00e1 a jak se omyl\u016fm v\u00a0diagnostice a l\u00e9\u010db\u011b vyhnout, diskutovaly minul\u00fd t\u00fdden v\u00a0Praze stovky odborn\u00edk\u016f na tr\u00e1vic\u00ed trakt \u2013 gastroenterolog\u016f \u2013 na 1. IBD kongresu.<\/strong><\/p>\n\n\n\n \u201eMezi typick\u00e9 IBD choroby pat\u0159\u00ed ulcer\u00f3zn\u00ed kolitida a Crohnova nemoc. Stanoven\u00ed diagn\u00f3zy ulcer\u00f3zn\u00ed kolitidy je relativn\u011b snadn\u00e9. Pacienti se toti\u017e pot\u00fdkaj\u00ed s opakovan\u00fdm nucen\u00edm na stolici. Doch\u00e1z\u00ed u nich k\u00a0vyprazd\u0148ov\u00e1n\u00ed krve a hlen\u016f, tak\u017ee brzy nav\u0161t\u00edv\u00ed l\u00e9ka\u0159e, kter\u00fd tuto nemoc dok\u00e1\u017ee odhalit pom\u011brn\u011b rychle. Hor\u0161\u00ed je to s\u00a0Crohnovou chorobou \u2013 pr\u016fm\u011brn\u00e1 doba od prvn\u00edch obt\u00ed\u017e\u00ed do ur\u010den\u00ed diagn\u00f3zy se v\u00a0tomto p\u0159\u00edpad\u011b pohybuje mezi 12 a 16 m\u011bs\u00edci,\u201c <\/em>\u0159\u00edk\u00e1 gastroenterolog prof.\u00a0MUDr. Milan Luk\u00e1\u0161, prezident kongresu.<\/p>\n\n\n\n \u00a0Nemoc se na za\u010d\u00e1tku projevuje bolestmi b\u0159icha, vy\u010derp\u00e1n\u00edm, nepravidelnou stolic\u00ed a m\u00edrn\u00fdm hubnut\u00edm, co\u017e jsou symptomy, kter\u00e9 mohou souviset i s\u00a0mnoha jin\u00fdmi chorobami. Podrobn\u011bj\u0161\u00ed vy\u0161et\u0159en\u00ed se u pacient\u016f prov\u00e1d\u00ed a\u017e tehdy, kdy\u017e pot\u00ed\u017ee nemiz\u00ed. \u201eP\u0159\u00edznaky Crohnovy choroby b\u00fdvaj\u00ed na za\u010d\u00e1tku v\u00e1gn\u00ed. Pokud p\u0159etrv\u00e1vaj\u00ed, m\u011bl by praktick\u00fd l\u00e9ka\u0159 prov\u00e9st z\u00e1kladn\u00ed laboratorn\u00ed vy\u0161et\u0159en\u00ed v\u010detn\u011b vy\u0161et\u0159en\u00ed stolice. Jestli\u017ee v\u00fdsledky odhal\u00ed chudokrevnost a z\u00e1n\u011btliv\u00e9 parametry, ode\u0161le pacienta do p\u00e9\u010de specialisty,\u201c<\/em> popisuje MUDr.\u00a0Tom\u00e1\u0161 Douda, z\u00e1stupce p\u0159ednosty II. gastroenterologick\u00e9 kliniky Fakultn\u00ed nemocnice Hradec Kr\u00e1lov\u00e9.<\/p>\n\n\n\n Ke zpo\u017ed\u011bn\u00ed ve stanoven\u00ed spr\u00e1vn\u00e9 diagn\u00f3zy doch\u00e1z\u00ed v\u00a0p\u0159\u00edpad\u011b Crohnovy nemoci tak\u00e9 kv\u016fli tomu, \u017ee je k\u00a0jej\u00edmu ur\u010den\u00ed pot\u0159eba v\u00edce vy\u0161et\u0159en\u00ed. Nejenom laboratorn\u00edch a sonografick\u00fdch, ale i endoskopick\u00fdch, pomoc\u00ed CT \u010di magnetick\u00e9 rezonance. \u201eCrohnova choroba m\u016f\u017ee postihnout jakoukoli \u010d\u00e1st tr\u00e1vic\u00ed trubice, a\u0165 u\u017e se jedn\u00e1 o spojen\u00ed tenk\u00e9ho a tlust\u00e9ho st\u0159eva, nebo horn\u00ed \u010d\u00e1sti tlust\u00e9ho st\u0159eva. Proto je v\u00a0jej\u00edm p\u0159\u00edpad\u011b nutn\u00fd komplex mnoha vy\u0161et\u0159en\u00ed,\u201c<\/em> vysv\u011btluje prof. Luk\u00e1\u0161. \u201ePostupn\u011b skl\u00e1d\u00e1me dohromady jednotliv\u00e9 st\u0159\u00edpky, d\u00edky kter\u00fdm dok\u00e1\u017eeme ur\u010dit spr\u00e1vnou diagn\u00f3zu,\u201c <\/em>dopl\u0148uje MUDr. Douda.<\/p>\n\n\n\n Crohnovou chorobou trp\u00ed v\u00a0\u010cesku asi 35\u00a0000 pacient\u016f, u 8\u201310 % z\u00a0nich se projev\u00ed v\u00a0d\u011btstv\u00ed. Nemoc se \u010dasto zam\u011b\u0148uje za akutn\u00ed apendicitidu a v p\u0159\u00edpad\u011b krvav\u00fdch pr\u016fjmovit\u00fdch stolic b\u00fdv\u00e1 myln\u011b pova\u017eovan\u00e1 za infek\u010dn\u00ed onemocn\u011bn\u00ed nebo krv\u00e1cen\u00ed p\u0159i hemeroidech. U d\u011bt\u00ed je varovn\u00fdm p\u0159\u00edznakem porucha r\u016fstu. Nejv\u00fdznamn\u011bj\u0161\u00edm prok\u00e1zan\u00fdm rizikov\u00fdm faktorem je v\u00fdskyt IBD v\u00a0rodin\u011b.<\/p>\n\n\n\n \u201eV\u010dasn\u00e1 diagnostika Crohnnovy choroby je z\u00e1sadn\u00ed \u2013 znamen\u00e1 toti\u017e i v\u010dasnou l\u00e9\u010dbu, kter\u00e1 vede k potla\u010den\u00ed aktivity z\u00e1n\u011btu, a pom\u00e1h\u00e1 tak p\u0159edej\u00edt definitn\u00edmu po\u0161kozen\u00ed st\u0159eva,\u201c<\/em> zd\u016fraz\u0148uje MUDr. Katar\u00edna Mitrov\u00e1, specialistka v oboru d\u011btsk\u00e9 gastroenterologie, hepatologie a v\u00fd\u017eivy z\u00a0FN Motol. IBD u d\u011bt\u00ed podle n\u00ed pat\u0159\u00ed jednozna\u010dn\u011b do rukou d\u011btsk\u00e9ho gastroenterologa ve specializovan\u00e9m centru, kter\u00e9 m\u00e1 zku\u0161enosti nejen s diagnostikou a l\u00e9\u010dbou, ale tak\u00e9 s \u0159e\u0161en\u00edm p\u0159\u00edpadn\u00fdch komplikac\u00ed. Ty mohou u d\u011bt\u00ed i dosp\u011bl\u00fdch nastat zejm\u00e9na tehdy, pokud podstupuj\u00ed m\u00e1lo efektivn\u00ed terapii.<\/p>\n\n\n\n \u201e\u00dastup obt\u00ed\u017e\u00ed nemus\u00ed znamenat, \u017ee u nemocn\u00fdch doch\u00e1z\u00ed ke zhojen\u00ed z\u00e1n\u011btu na tr\u00e1vic\u00ed trubici. P\u0159edev\u0161\u00edm u Crohnovy choroby je d\u016fle\u017eit\u00e9 pacienty dlouhodob\u011b sledovat. Hroz\u00ed jim toti\u017e z\u00e1va\u017en\u011bj\u0161\u00ed komplikace \u2013 z\u00fa\u017een\u00ed tr\u00e1vic\u00ed trubice nebo jej\u00ed prod\u011brav\u011bn\u00ed,\u201c<\/em> upozor\u0148uje prof. Luk\u00e1\u0161. Pacienti tak mohou m\u00edt velk\u00e9 a n\u00e1hl\u00e9 probl\u00e9my s\u00a0pr\u016fchodem potravy. P\u0159i\u00a0prod\u011brav\u011bn\u00ed tr\u00e1vic\u00ed trubice nav\u00edc m\u016f\u017ee z\u00e1n\u011bt prostoupit i do p\u0159ilehl\u00fdch org\u00e1n\u016f. V\u00a0takov\u00e9m p\u0159\u00edpad\u011b je pak nutn\u00e1 operace.<\/p>\n\n\n\n \u201eSna\u017e\u00edme se diagnostiku co nejv\u00edce urychlit, aby k\u00a0uveden\u00fdm komplikac\u00edm nedoch\u00e1zelo. V\u00a0praxi se nav\u00edc m\u016f\u017eeme i myln\u011b domn\u00edvat, \u017ee pacient trp\u00ed Crohnovou chorobou, a ve skute\u010dnosti m\u00e1 p\u0159itom \u00fapln\u011b jin\u00e9 onemocn\u011bn\u00ed. Proto je velmi d\u016fle\u017eit\u00e9, abychom si s\u00a0ostatn\u00edmi specialisty navz\u00e1jem vym\u011b\u0148ovali zku\u0161enosti a mohli se v\u00a0budoucnu podobn\u00fdch omyl\u016f vyvarovat. P\u0159esn\u011b k\u00a0tomu IBD kongres slou\u017e\u00ed,\u201c<\/em> uzav\u00edr\u00e1 prof. Luk\u00e1\u0161.<\/p>\n","protected":false},"excerpt":{"rendered":" Za\u010d\u00edn\u00e1 pl\u00ed\u017eiv\u011b a prvotn\u00ed p\u0159\u00edznaky, jako je pobol\u00edv\u00e1n\u00ed b\u0159icha, \u00fanava nebo hubnut\u00ed, nejsou pro v\u011bt\u0161inu lid\u00ed varovn\u00fdm sign\u00e1lem, \u017ee se m\u016f\u017ee jednat o v\u00e1\u017en\u011bj\u0161\u00ed onemocn\u011bn\u00ed. […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":16059,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-47801","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\/47801","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=47801"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/47801\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/16059"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=47801"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=47801"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=47801"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}