Bayani game da ɗan kanoma/basir mai tsiro da yadda ake maganin shi a asibiti (Haemorrhoid)

Gabatarwa:

Bincike ya nuna cewa dankanoma yana damuwar mutum daya a duk cikin mutum ashirin na mutanen Amurka. Haka zalika yana damuwar mutane da yawa a cikin al'ummar Hausawa, duk da cewa bamu samu wani ingantaccen binciken da ya nuna adadin dankanoma a cikin al'ummar Hausawa ba amma wani bincike da  Malam Yashi Garda Nassa da abokan aikinsa suka gudanar a jihar Kaduna, Nigeria ya tabbatar da cewa kashi 90.5% cikin 100 na yan achaba suna fama da wannan cutar ta dan kanoma/basir mai tsiro. Wannan cutar anfi samun ta ga mata musamman masu kiba da kuma waɗanda suka yi haihuwa dayawa, kuma anfi samun ta ga manya da tsofaffi sama da yara(1).

Mene ne dan kanoma ko basir mai tsiro?

Dan kanoma mai tsiro wani kumburi ne ko ƙololo dake fitowa daga cikin gefen duburar dan adam. Wannan kumburin yana faruwa ne sakamakon mummunar kumburar wasu jijiyoyin jini(1). Wadannan jijiyoyi su ne masu kula da daukar jini daga dubura domin mayar wa a cikin ciki daga ƙarshe zuwa zuciya. Cikar jijiyoyin da jini shi zai haifar da kumburi wanda har zai iya fitowa ta wajen duburar idan abin ya ɗau ɗan lokaci. Watarana jini yakan taru ya dasƙare a cikin jijiyoyin, al'amarin da kesa kumburin dankanoman yayi ƙarfi sosai kuma ya haifar da masifaffen ciwo a dubura(2).

Likitoci masana ilimin tiyata sun kasa ɗan kanoma mai tsiro gida biyu (2) yayin da suka yi la'akari da wurin da yake fitowa.

1. Kashi na farko shi ne wanda yake fitowa chan cikin dubura baya fitowa zuwa waje. Wannan shi bature yake kira internal hemarrhoids.

2. Kashi na biyu (2) shi ne ya ke tsiro har ya fito a wajen dubura yanda mutum zai iya taɓa shi ko ya ganshi ta hanyar amfani da madubi. Wannan shi bature yake kira external hemarrhoids.

Masana tiyata sunyi amfani da wata alama da ke cikin dubura mai kama da layin zig-zag wadda ake kira layin dentet (dentate line a turance) domin bambanta dankanoma kashi na farko da kashi na biyu. Kashi na farko shi ne ke fitowa sama ga layin dentet a yayin da takwaransa kashi na biyu yake fitowa ƙasa da layin(3).

A lura cewa, mafi akasarin dan kanoma mai tsiro yana fitowa ta ƙasa ga layin dentate, kuma shi ne mafi illa, shi ne yake fitowa har ta wajen duburar dan adam, kuma shi ne yake da mummunan ciwo. Shi kuma mai fitowa sama ga layin babbar alamar da yake nuna wa ita ce zubar jini yayin ban haya, kuma baya da ciwo  saboda a inda yake fitowa (sama ga layin dentet) akwai ƙarancin jakadu masu kaiwa ƙwaƙwalwa saƙon ciwo (sensory nerve fibers)(3).

Abubuwan da ke kawo dan kanoma/basir mai tsiro

Har ila wayau masana ilimin likitanci basu gano takamaiman abinda ke haifar da wannan cutar ba, amma sun gano cewa tabbas ana gadon ta sosai, ma'ana idan ɗaya daga cikin mahaifa na fama da wannan cutar to za'a iya samu cikin ɗiyansu wani ya gada(3).

 Haka zalika masana sun fitar da wasu abubuwan da ke sa mutum yayi saurin kamuwa da wannan cuta. Abubuwan su ne kamar haka(3).

1. Idan ɗaya daga cikin mahaifanka yayi fama da wannan cutar, musamman mahaifiya.

2. Yawaita yunƙuri a lokacin ban haya.

3. Chin abubuwan dake sanya ban hayan mutum yayi ƙarfi ko kuma mutum ya daɗe bai yi ban haya ba, kamar su dankalin hausa.

4. Daɗewa a zaune, kamar masu aikin tela, achaɓa da kuma direbobin mota.

5. Yawan ɗaukar abubuwa masu nauyi, kamar masu ɗaukar ƙarafan jimmin (gymming) da kuma 'yan dako.

6. Yawan yin tari.

7. Jima'i da mutum ta hanyar dubura. 

8. Yawan chin abincin zamani dake da ƙarancin sinadarin faiba (fiber), kamar su indomie, chocolate, mutum ya maida su sune abincinsa safe da rana.

9. Dadewa a yayin ban haya ko kuma yawan gudawa.

10. Yawan daɗewa ba'a yi bayan gari ba.

11. Tsufa

12. Masu ƙiba

13. Yana iya faruwa sanadiyar juna biyu da kuma yawan haihuwa.

Alamomin cutar dankanoma mai tsiro / basir

Masu fama da wannan cutar sukan ji alamomi daban-daban kwatankwacin dadewa da kuma illar da wannan cutar ta yiwa jikin mutum(2).

1. Zubar jini yayin ban haya, da farko jinin yana fitowa ba tare da mutum yana jin ciwon komai ba. Daga baya sai ya fara jin ciwo.

2. Jin ƙaiƙayi a gefe ko cikin dubura.

3. Kashin jini da majina.

4. Fitowar kumburi a gefe ko cikin dubura. A lura anan, watarana kumburin zai iya sauka ko kuma ya succe gaba ɗaya sai mutum yaga kamar ya warke amma daga baya zai ƙara dawowa.

5. Jin ciwo a lokacin ban haya.

6.  Yawan yunƙuri a lokacin ban haya; watarana mutum zai ji yana jin ban haya amma ko yaje ba zai fito ba sai yayi ta yunƙuri.

Ire-iren Dankanoma/Basir Mai Tsiro

Masana kiwon lafiya sun kasa dankanoma mai tsiro kashi huɗu (4) yayin da suka yi duba zuwa ga tsananin girmansa(3).

1. Kashi na ɗaya (grade 1): Dan kanoman ya tsiro amma yana ciki bai fito daga wajen dubura ba.

2. Kashi na biyu (grade 2): Dan kanoman ya tsiro kuma yana fitowa daga wajen dubura yayin da mai shi yake ban haya amma yakan koma cikin dubura da kansa in mai shi ya gama ban haya.

3. Kashi na 3 (grade 3): Dan kanoman ya tsiro kuma yana fitowa wajen dubura yayin da mai shi yake ban haya amma baya komawa da kansa in an gama ban haya, sai mai shi ya mayar da shi ta hanyar tura shi a ciki da hannun sa.

4. Kashi na huɗu (grade 4): Dan kanoman ya tsiro, ya fito daga wajen dubura kuma baya komawa a cikinta ko mai shi ya tura shi a ciki da hannunsa.

Yanda ake kula da mai dan kanoma/basir mai tsiro a asibiti

 Da farko dai likitan da zai duba mai irin wannan rashin lafiyar zai tambaye shi tambayoyi masu zurfi game da lafiyar sa da kuma yanda cutar ta fara(3). 

Haka zalika zai duba marar lafiya ciki da waje akan gadon dubawa na asibiti, sannan ya tura shi a lab (laboratory) wajen masu awo domin yin wasu gwaje-gwaje kamin a san yanda za'a fara maganin wannan cutar(4). 

Dubawa ta musamman da za'a yi a kan gadon asibiti itace duba yanayin duburar marar lafiya ta hanyar sanya yatsa (Digital Rectal Examination). Za ayi wannan duban ne domin tabbatar da cewa dankoma mai tsiro ne ke damun marar lafiya, da kuma gane girman dan kanoman da irin illolin da yayi wa marar lafiya.

Gwaje-gwajen da za'a yi wa mai ɗankanoma mai tsiro a ɗakin awo (laboratory)

Ana yiwa mai ɗan kanoma mai tsiro gwaje-gwaje a ɗakin awo na asibiti, yawan gwaje gwajen da kuma kalan su ya danganta da irin  illar da ya yiwa marar lafiya. Muhimmai daga cikin su sun haɗa da(3):

1. PCV; Wannan gwaji ne da zai nuna kwatankwacin yawan jinin mutum. Ana son yin sa saboda dan kanoma mai tsiro yana sanya zubar da jini kamar yanda muka gani a baya.

2. Hoton dubura (Anoscopy): Wannan gwaji ne dai zai nuna hoton bidiyo na dubura da kuma duk abinda ke cikinta.

Yadda ake maganin ɗan kanoma mai tsiro/basir a asibiti.

Likitoci masana ilimin tiyata suna kasa maganin ɗan kanoma mai tsiro zuwa matakai(4).

1. Mataki na ɗaya shi ne abubuwan da za'a iya yi a gida ba tare da shan kwayoyin magani ba.

2. Mataki na biyu shi ne yin mataki na farko  tare da baiwa marar lafiya magani.

3. Mataki na uku shi ne yin mataki na farko da mataki na biyu tare da yin allurar wasu sinadarai a jikin tsiron

4. Mataki na huɗu (4) shi ne ɗaure tsiron da roba

5. Mataki na ƙarshe shi ne yin mataki na ɗaya da na biyu tare da yin tiyata.

Har wa yau kalar maganin da za'a yi wa marar lafiya ya danganta da girman dan kanomansa, da kuma illolin da yayi wa marar lafiya(4).

Abubuwan da za'a iya yi a gida

1. Gashi da ruwan gishiri: Yanda ake gashin ɗan kanoma mai tsiro shi ne mutum ya samu baho da ruwan zafi irin wanda zai iya zama a cikin sa ba tare da matuƙar takura ba. Sai ya zuba gishiri mai ɗan yawa a cikin ruwan yana motsawa har sai gishirin ya daina narkewa a ruwan ya fara kwantawa a ƙasan bahon, sannan sai ya zauna a ciki na kamar minti talatin (20). A lura, maza su sanya hannu su tallabe ya'yan marinarsu (testes) daga cikin ruwan zafi yayin da suke zaune a cikin baho saboda ya'yan marinar basu son zafi sosai. Ana yin gashi a ƙalla sau biyu(2) a yini kullum. Ana iya yin gashi da ruwan banza in ba gishiri amma yi da gishiri shi yake magani.

2. Gashi da ƙanƙara: Yanda ake gashi da ƙanƙara shi ne mutum ya samu tsumma ko ragga yasa ƙanƙarar a ciki sannan ya danna ƙanƙarar a duburar sa a jikin tsiron ɗan kanoma, anaso ƙanƙarar tayi kamar minti goma zuwa sha biyar. Ba'a son gashin ƙanƙara ya wuce minti sha biyar (15).

3. Yin amfani da man shafawa  masu ɗauke da wasu sinadarai. Kamar irin man Anusol (Anusole Cream), man nitroglycerin (0.4% Nitroglycerin Ointments), man da ke ɗauke da sinadarin nifedifine, da kuma man diklofenak (Topical diclofenac) domin rage raɗaɗin ciwo.

Abubuwan da za'a yi a asibiti

Matakin maganin dankanoma na biyu shi ne yin dukan matakan farko da muka ambata a baya tare da shan kwayoyin magani masu rage ciwo da kuma masu matse jijiyoyin dake maida jini daga dubura zuwa ciki. Magungunan sun haɗa da kwayar maganin diclofenac (oral diclefenac), paracetamol, daflon da dai sauransu(5).

Mataki na uku shi ne yin mataki na farko dana biyu sannan ayi wa tsiron ɗan kanoman allurar wasu sinadarai da zata sa ya zuƙe. A lura wannan allurar ba'a yinta a ko'ina sai a asibiti a hannun kwararen likita. Sannan ana yinta ne a lokacin da tsiron yake ƙarami sosai wanda girman sa bai wuce matakin girma na biyu (grade 2) cikin matakan girman dan kanoma da muka ambata a baya ba. Idan ya wuce ba'a yi sai dai ayi tiyata kawai ita ce mafita(5).

Mataki na gaba shi ne ɗaurewa da roba. (Rubber band ligation): Ƙaramin tsiron ɗan kanoma wanda bai wuce matakin girma na biyu ba, likitoci su kan yi wata dabarar ɗaure tsiron da roba. Wannan ɗaurin zai hana tsiron samun isashshen jini wanda hakan zai yi sanadiyyar mutuwar sa. A lura sai likitan da ya ƙware a fannin ne kaɗai zai iya wannan ɗauri.

Yin tiyata shi ne mataki na ƙarshe a maganin ɗankanoma na asibiti. Za'a yi wannan tiyatar ne domin cire ɗan kanoman.

Illolin dan kanoma mai tsiro

1. Haifar wa mutum da mummunan ciwo a dubura (Hemorrhoids attack): Wannan yana faruwa ne lokacin da jinin da ya taru ya dasƙare a cikin jijiyoyin dan kanoman. A wannan lokacin tsiron zai yi kumburi mai ƙarfi tare da mummunan ciwon da zai iya hanawa mutum zama dakyau ko tsayi ko tafiya ko makamancin haka(2).

Maganin wannan illar shi ne a garzaya asibiti da sauri domin likita ya fasa wannan kumburi ya matse jinin da ya taru sannan a bada maganin kashe ciwo. Idan anason fashe dasƙararren kumburin to ayi shi cikin kwanaki 2 na farko da farawan ciwon. 

Idan ya wuce kwanaki 2 da farawa to yafi kyau kar a fasa a bari ya succe da kanshi. Yayin jira, sai marar lafiya ya sha magungunan rage ciwo irin waɗan da muka ambata a baya sannan kuma ya haɗa da maganin daflon kullum ya sha sau biyu a rana (Cap daflon 500mg bd), sai kuma ya kula da yin gashi a cikin ruwan gishiri kamar yanda muka ambata. Daflon magani ne mai matse jijiyoyi yana da amfani sosai wajen rage kumburi da raɗaɗin ciwon dan kanoma(3).

2. Haifar wa mutum da ƙarancin jini: Dan kanoma ya kan iya fashewa ya fara zubar da jini da majina, wannan zai iya kawowa mutum ƙarancin jini a jikin sa

3. Haifar wa mutum da cututtuka (Infections)

Yadda mutum zai kare kansa da kamuwa da cutar basir/dan kanoma mai tsiro

Duk da cewa dan kanoma mai tsiro mafi yawancin sa na gado ne, amma akwai hanyoyin da za'a bi domin a rage saurin  kamuwa da wannan cutar ko da kuwa mutum ya gade ta. Waɗannan hanyoyin sune kamar haka(3):

1. A daina yin  yunƙuri yayin da mutum ke ban haya.

2. Daina ɗaukar kaya masu mugun nauyi.

3. A daina dadewa ba ayi ban haya ba, har kashi ya bushe a ciki yayi ƙarfi.

4. A yawaita cin 'ya'yan itace masu ruwa, kamar su lemu, aiba da kankana.

5. A yawaita chin abinci wanda yake ɗauke da sinadarin faiba (high fiber diet), kamar  Irin su kayan lambu, alkama, kayan gwari da dai sauransu.

6. Rage yawan dadewa zaune.

7. Yawan shan ruwa

Kammalawa

Dan kanoma/basir mai tsiro ciwo ne dake damuwar mutane da yawa a cikin al'umma. Yana faruwa ne a lokacin da jijiyoyin dake cikin dubura masu maida jini suka kumbura. Duk da cewa akwai abubuwa da dama da kan iya kawo shi anfi ɗorawa gado alhakin faruwar wannan cutar. Anason mai wannan cutar ya kiyaye yin gashi da ruwan zafi da kuma chin 'ya'yan itace da yawan shan ruwa.

Idan kuna da tambaya sai kuyi a cikin akwatin sharhi dake ƙasa, Insha Allah zamu karba ba tare da jinkiri ba. Haka kuma zaku iya shiga group dinmu na WhatsApp domin kasancewa damu damu a koda yaushe da kuma samun ingantattun bayanan mu a cikin sauki. Ku danna wannan domin shiga: Lafiyata Group 3. .

Mungode!

Gargaɗi

Wannan rubutu anyi shi ne kawai saboda ilmantar wa, saboda haka rubutun bazai taɓa maye gurbin ganin likita ko zuwa asibiti ba. Bugu da ƙari, marubucin ya barranta kansa ga duk wani kuskure da ya faru ga wanda ya ɗauki magani a hannun sa. Haka zalika ba'a yadda wani wanda ba likita ba yayi amfani da wannan rubutu yana bada magani. Ba'a kuma yarda wani ya saci wani sashe na wannan rubutu ya wallafa wani wuri ba tare da izinin ainihin marubuci ba. 

Nassoshi

1. The Evaluation and Treatment of Hemorrhoids: A Guide for the Gastroenterologist Robert A. Ganz Published:January 18, 2013

2. Hemorrhoids Symptoms, Causes and Treatment

3. Hemorrhoids background, anatomy, pathophysiology and treatment

4. Treatment of hemorrhoids: A coloproctologist’s view World J Gastroenterol. 2015 Aug 21; 21(31): 9245–9252. Published online 2015 Aug 21.

5. T. Higuero, L. Abramowitz, A. Castinel, N. Fathallah, P. Hemery, C. Laclotte Duhoux, F. Pigot, H. Pillant-Le Moult, A. Senéjoux, L. Siproudhis, G. Staumont, J.M. Suduca, B. Vinson-Bonnet, Guidelines for the treatment of hemorrhoids (short report), Journal of Visceral Surgery, Volume 153, Issue 3, 2016, Pages 213-218, ISSN 1878-7886