Gudawa/Zawo

Diarrhea (Turanci na Amurka), wanda kuma ake kira diarrhoea ko diarrhœa (Turancin Burtaniya), shine yanayin samun akalla motsi uku, ruwa, ko motsi na ruwa a rana.[1] Sau da yawa yana ɗaukar 'yan kwanaki kuma yana iya haifar da rashin ruwa saboda asarar ruwa.[1] Alamun rashin ruwa sau da yawa suna farawa tare da asarar shimfida jiki na yau da kullun da kuma halayyar rashin jin daɗi.[1] Wannan na iya ci gaba zuwa rage fitsari, asarar launi na fata, saurin bugun zuciya, da raguwar amsawa yayin da ya zama mafi tsanani.[1] Rashin kwanciya amma ba na ruwa ba a cikin jarirai waɗanda aka shayarwa da su kawai, duk da haka, na al'ada ne.[1]

The most common cause is an infection of the intestines due to a virus, bacterium, or parasite—a condition also known as gastroenteritis.[1] These infections are often acquired from food or water that has been contaminated by feces, or directly from another person who is infected.[1] The three types of diarrhea are: short duration watery diarrhea, short duration bloody diarrhea, and persistent diarrhea (lasting more than two weeks, which can be either watery or bloody).[1] The short duration watery diarrhea may be due to cholera, although this is rare in the developed world.[1] If blood is present, it is also known as dysentery.[1] A number of non-infectious causes can result in diarrhea.[2] These include lactose intolerance, irritable bowel syndrome, non-celiac gluten sensitivity, celiac disease, inflammatory bowel disease such as ulcerative colitis, hyperthyroidism, bile acid diarrhea, and a number of medications.[2][3][4] In most cases, stool cultures to confirm the exact cause are not required.[5]

Ana iya hana zawo ta hanyar inganta tsabtace muhalli, ruwan sha mai tsabta, da wanke hannu da sabulu.[1] Ana kuma ba da shawarar shayarwa na akalla watanni shida da rigakafin rotavirus.[1] Maganin sake ruwa na baki (ORS) - ruwa mai tsabta tare da ƙananan gishiri da sukari - shine maganin da aka zaɓa.[1] Ana kuma ba da shawarar Allunan Zinc.[1] Wadannan jiyya an kiyasta sun ceci yara miliyan 50 a cikin shekaru 25 da suka gabata.[2] Lokacin da mutane ke fama da zawo ana ba da shawarar cewa su ci gaba da cin abinci mai kyau, kuma jarirai suna ci gaba da shayar da su.[1] Idan ba a samun ORS na kasuwanci ba, ana iya amfani da mafita na gida.[3] A cikin waɗanda ke da matsanancin rashin ruwa, ana iya buƙatar Ruwa mai narkewa.[1] Yawancin lokuta, duk da haka, ana iya sarrafa su da kyau tare da ruwa ta baki.[4] Ana iya ba da shawarar maganin rigakafi, yayin da ba a yi amfani da su sosai ba, a wasu lokuta kamar waɗanda ke da zubar da jini da zazzabi mai tsanani, waɗanda ke da mummunan zubar da ciki bayan tafiya, da waɗanda ke shuka takamaiman ƙwayoyin cuta ko kwayar cuta a cikin kujerarsu.[5] Loperamide na iya taimakawa wajen rage yawan motsi na hanji amma ba a ba da shawarar ga waɗanda ke da mummunar cuta ba.[5]

Kimanin lokuta biliyan 1.7 zuwa 5 na zawo suna faruwa a kowace shekara.[1][2][3]  Ya fi yawa a Kasashe masu tasowa, inda yara ƙanana ke samun zawo a matsakaita sau uku a shekara.[1] Jimlar mutuwar daga zawo an kiyasta a miliyan 1.53 a cikin 2019 - ƙasa daga miliyan 2.9 a cikin 1990.  A cikin shekara ta 2012, ita ce ta biyu mafi yawan mutuwar yara da ba su kai biyar ba (0.76 miliyan ko 11%). [1] [4] Sauye-sauye na zawo ma sanarwa ce ta Rashin abinci mai gina jiki kuma sanarwa ce a cikin waɗanda ba su kai shekaru biyar ba.[1] Sauran matsalolin dogon lokaci waɗanda zasu iya haifar sun haɗa da ci gaban da ba shi da kyau.[4]

## Kalmomi
Kalmar gudawa ta fito ne daga tsohuwar Girkanci  daga  **' "ta" da kuma  **' "zuwa".

*Diarrhea* shine rubutun da aka rubuta a cikin Ingilishi na Amurka, yayin da *gudawa* shine rubutun Turanci .

Sharuɗɗan ƙira don yanayin sun haɗa da "gudu," "squirts" (ko "squits" a Biritaniya  ), " Hershey squirts," " Montezuma 's Revenge," da " trots ".  

Ana yawan furta kalmar / / ˌ d aɪə ˈr iːə / DY -ə- REE -ə .

## Ma'anarsa

Hukumar Lafiya ta Duniya ta ayyana cutar gudawa a matsayin samun sabulun wanka ko ruwa guda uku ko sama da haka a kowace rana, ko kuma yana da yawan stools fiye da yadda aka saba ga mutumin. 

Ana ayyana gudawa mai saurin gaske azaman fitowar da ba a saba da shi ba na al'amuran da ba a saba gani ba daga hanji, wanda bai wuce kwanaki 14 ba, ta Ƙungiyar Gastroenterology ta Duniya .  Zawo mai tsauri wanda ke da ruwa ana iya saninsa da AWD (Zawayen Ruwa.) 

### Sakatare
Zawo na sirri yana nufin ana samun karuwa a cikin sirrin aiki, ko kuma akwai hana sha. Babu kadan zuwa rashin lalacewar tsarin. Mafi yawan abin da ke haifar da irin wannan nau'in gudawa shine ƙwayar cutar kwalara da ke motsa fitar da anions, musamman ma'adinan chloride (Cl - ). Sabili da haka, don kula da ma'auni na caji a cikin gastrointestinal tract, ana ɗaukar sodium (Na + ) tare da shi, tare da ruwa. A cikin irin wannan nau'in zawo ruwan hanji yana fitar da isotonic tare da plasma ko da lokacin azumi. [1] [2] Yana ci gaba ko da lokacin da babu abincin baki.

### Osmotic
Zawowar osmotic yana faruwa lokacin da aka jawo ruwa da yawa a cikin hanji. Idan mutum ya sha maganin da ke da sukari mai yawa ko gishiri mai yawa, waɗannan na iya jawo ruwa daga jiki zuwa cikin hanji kuma su haifar da zawo na osmotic. [1] [2] Hakanan zawo na osmotic na iya haifar da rashin narkewar abinci (misali, cutar pancreatic ko cutar celiac ) wanda aka bar abubuwan gina jiki a cikin lumen don jan ruwa. Ko kuma ana iya haifar da shi ta hanyar osmotic laxatives (wanda ke aiki don rage maƙarƙashiya ta hanyar jawo ruwa a cikin hanji). A cikin mutane masu lafiya, yawancin magnesium, bitamin C ko lactose mara narkewa na iya haifar da zawo na osmotic da ƙumburi na hanji. Mutumin da ke da rashin haƙuri na lactose zai iya samun wahalar sha lactose bayan yawan cin kayan kiwo na ban mamaki. A cikin mutanen da ke da fructose malabsorption, yawan cin fructose yana iya haifar da zawo. Abincin fructose mai girma wanda kuma yana da babban abun ciki na glucose sun fi sha kuma ba su iya haifar da gudawa. Sugar barasa irin su sorbitol (sau da yawa ana samun su a cikin abinci marasa sukari) suna da wahala ga jiki ya sha kuma, a cikin adadi mai yawa, na iya haifar da zawo na osmotic. [3] A mafi yawan waɗannan lokuta, zawo osmotic yana tsayawa lokacin da aka dakatar da abin da ya aikata laifi (misali, madara ko sorbitol).

### Exudative
Zawo na exudative yana faruwa tare da kasancewar jini da mugunya a cikin stool. Wannan yana faruwa tare da cututtukan hanji mai kumburi, irin su cutar Crohn ko ulcerative colitis, da sauran cututtuka masu tsanani irin su E. coli ko wasu nau'in guba na abinci. [1] [2]

### Mai kumburi
Zawo mai kumburi yana faruwa ne lokacin da aka sami lahani ga rufin mucosal ko kan iyakar goga, wanda ke haifar da asarar ruwa mai wadatar furotin da raguwar iya ɗaukar waɗannan ruwan da suka ɓace. Ana iya samun siffofi na duka uku na sauran nau'in gudawa a cikin irin wannan nau'in gudawa. [1] Ana iya haifar da shi ta hanyar cututtukan ƙwayoyin cuta, cututtukan ƙwayoyin cuta, cututtukan ƙwayoyin cuta, ko matsalolin autoimmune kamar cututtukan hanji mai kumburi. Hakanan ana iya haifar da shi ta hanyar tarin fuka, kansar hanji, da ciwon ciki. [2]

### Ciwon mara
Idan akwai jini a bayyane a cikin stools, an kuma san shi da dysentery . Jini alama ce ta mamaye ƙwayar hanji. Dysentery alama ce ta, da sauransu, Shigella, Entamoeba histolytica, da Salmonella . [1]

## Tasirin lafiya
Cutar zawo na iya yin mummunan tasiri a kan lafiyar jiki da ci gaban tunani. "Rashin abinci mai gina jiki na farko na yara wanda ke haifar da kowane dalili yana rage lafiyar jiki da kuma yawan aiki a cikin manya", [1] kuma gudawa shine babban dalilin rashin abinci mai gina jiki na yara. [2] Bugu da ari, shaidu sun nuna cewa cutar zawo yana da tasiri mai mahimmanci ga ci gaban tunani da lafiya; An nuna cewa, ko da lokacin da ake kula da kamuwa da cutar helminth da farkon shayarwa, yaran da suka kamu da zawo mai tsanani sun sami raguwa sosai a jerin gwaje-gwaje 0na hankali. [1] [3]

Zawo na iya haifar da rashin daidaituwa na electrolyte, raunin koda, rashin ruwa, da rashin amsawar tsarin rigakafi . Lokacin da aka yi amfani da kwayoyi na baka, ingancin maganin shine don samar da sakamako na warkewa kuma rashin wannan tasirin na iya zama saboda maganin da ke tafiya da sauri ta hanyar tsarin narkewa, yana iyakance lokacin da za a iya sha. Likitocin asibiti suna ƙoƙarin magance gudawa ta hanyar rage adadin magunguna, canza jadawalin allurai, dakatar da maganin, da kuma sake samun ruwa. Hanyoyin magance zawo ba su da tasiri sosai. Zawo na iya yin tasiri sosai akan ingancin rayuwa saboda rashin natsuwa na ɗaya daga cikin abubuwan da ke haifar da sanya tsofaffi a wuraren kulawa na dogon lokaci (gidajen jinya). [1]

## Dalilai

A cikin matakai na ƙarshe na narkewar ɗan adam, kayan da aka ci suna cika da ruwa da ruwaye masu narkewa kamar su gastric acid, bile, da enzymes na narkewa don karya su cikin abubuwan da suke da su na gina jiki, wanda sai a shiga cikin jini ta hanyar hanji a cikin ƙananan hanji. Kafin yin bayan gida, babban hanji yana sake shayar da ruwa da sauran abubuwan narkewar narkewar abinci a cikin kayan sharar don kiyaye ruwa mai kyau da daidaito gabaɗaya. [1] Zawo yana faruwa ne lokacin da aka hana babban hanji, saboda wasu dalilai masu yawa, daga isassun shayar da ruwa ko wasu ruwayen narkewar abinci daga najasa, wanda ke haifar da ruwa, ko "sako", motsin hanji. [2]

Mummunan zawo ya fi yawa saboda cutar gastroenteritis mai hoto tare da rotavirus, wanda ke da kashi 40% na lokuta a cikin yara a karkashin shekaru biyar. [1] A cikin matafiya, duk da haka, cututtukan ƙwayoyin cuta sun fi yawa. [2] Guba daban-daban kamar guba na naman kaza da magunguna kuma na iya haifar da zawo mai tsanani.

Zawo na yau da kullun na iya zama ɓangaren gabatarwar yawancin yanayin kiwon lafiya na yau da kullun da ke shafar hanji. Dalilan da suka fi dacewa sun haɗa da ulcerative colitis, cutar Crohn, ƙananan ƙwayoyin cuta, cutar celiac, ciwon hanji mai banƙyama, da kuma bile acid malabsorption . [1]

### Cututtuka
 
Akwai dalilai da yawa na kamuwa da gudawa, waɗanda suka haɗa da ƙwayoyin cuta, ƙwayoyin cuta da ƙwayoyin cuta. [1] Zawo mai kamuwa da cuta ana kiransa gastroenteritis akai-akai. [2] Norovirus ita ce mafi yawan abin da ke haifar da gudawa ta kwayar cuta a cikin manya, [3] amma rotavirus shine mafi yawan sanadin yara 'yan kasa da shekaru biyar. [4] Adenovirus iri 40 da 41, [5] da astroviruses suna haifar da adadi mai yawa na cututtuka. [6] Shiga-toxin yana samar da Escherichia coli, irin su E coli o157:h7, sune mafi yawan sanadin cutar gudawa na jini a Amurka. [7]

*Campylobacter* spp. sune sanadin cutar gudawa na kwayan cuta, amma cututtuka ta *Salmonella* spp. , *Shigella* spp. da kuma wasu nau'ikan *Escherichia coli* suma suna da yawa. 

A cikin tsofaffi, musamman waɗanda aka yi wa maganin rigakafi don cututtukan da ba su da alaƙa, toxin da *Clostridioides difficile* ke samarwa yakan haifar da zawo mai tsanani. 

Parasites, musamman protozoa misali, Cryptosporidium spp. , Giardia spp. , Entamoeba histolytica, Blastocystis spp. , Cyclospora cayetanensis, akai-akai shine dalilin zawo wanda ya shafi kamuwa da cuta na yau da kullum. Babban wakili na antiparasitic nitazoxanide ya nuna inganci akan yawancin cututtukan da ke haifar da gudawa. [1]

Sauran cututtuka masu yaduwa, irin su parasites ko gubobi na kwayan cuta, na iya tsananta bayyanar cututtuka. [1] A cikin yanayin tsaftar muhalli inda akwai wadataccen abinci da wadataccen ruwa mai tsafta, mai lafiya in ba haka ba yakan warke daga kamuwa da cututtuka a cikin 'yan kwanaki. Duk da haka, ga marasa lafiya ko rashin abinci mai gina jiki, gudawa na iya haifar da rashin ruwa mai tsanani kuma yana iya zama barazana ga rayuwa. [2]

#### Tsaftar muhalli

Yin bayan gida a fili shine babban sanadin kamuwa da gudawa da ke kai ga mutuwa. 

Talauci alama ce mai kyau na adadin gudawa mai yaduwa a cikin jama'a. Wannan kungiya ba ta samo asali daga talauci ba, sai dai daga yanayin da talakawa ke rayuwa. Rashin wasu albarkatu yana kawo cikas ga iyawar talakawa na kare kansu daga kamuwa da cutar gudawa. “Talauci yana da nasaba da rashin gidaje, cunkoson jama’a, datti, rashin samun ruwa mai tsafta ko zubar da shara ( tsaftar muhalli ), zaman tare da dabbobin gida da ka iya daukar kwayoyin cutar dan Adam, da rashin ajiye na’urar sanyaya abinci, wanda hakan ke kara yawan kamuwa da gudawa. ... Har ila yau, talauci yana ƙuntata ikon samar da abincin da ya dace da shekaru, daidaitaccen abinci mai gina jiki ko kuma canza tsarin abinci lokacin da gudawa ya taso don ragewa da gyara asarar kayan abinci. Tasirin yana kara ta'azzara saboda rashin isassun isassun magunguna, samuwa, da araha mai araha." [1]

Ɗaya daga cikin abubuwan da ke haifar da gudawa mai yaduwa shine rashin ruwa mai tsabta. Sau da yawa, zubar da ciki mara kyau yana haifar da gurɓataccen ruwan ƙasa. Wannan na iya haifar da kamuwa da cuta a tsakanin jama'a, musamman idan babu tacewa ko tsarkakewa. Najasar ɗan adam ta ƙunshi nau'ikan cututtukan cututtukan ɗan adam masu illa. 

#### Abinci mai gina jiki
Kyakkyawan abinci mai gina jiki yana da mahimmanci ga lafiya da aiki, gami da rigakafin kamuwa da gudawa. Yana da mahimmanci ga yara ƙanana waɗanda ba su da cikakkiyar tsarin rigakafi. Rashin Zinc, yanayin da ake samu sau da yawa a cikin yara a cikin kasashe masu tasowa na iya, ko da a lokuta masu laushi, suna da tasiri mai mahimmanci ga ci gaba da aiki mai kyau na tsarin rigakafi na mutum. [1] [2] Lallai, wannan alaƙar da ke tsakanin rashi na zinc da rage aikin rigakafi ya yi daidai da ƙara tsananin cutar gudawa. Yaran da suka rage matakan zinc suna da mafi yawan lokuta na zawo, zawo mai tsanani, da gudawa masu alaƙa da zazzabi. [3] Hakazalika, rashi na bitamin A na iya haifar da karuwa a cikin tsanani na zawo. Duk da haka, akwai wasu bambance-bambance idan ya zo ga tasirin rashin bitamin A akan yawan cututtuka. Yayin da wasu ke jayayya cewa dangantaka ba ta wanzu tsakanin adadin cututtuka da matsayi na bitamin A, [4] wasu suna nuna karuwa a cikin adadin da ke hade da rashi. [5] Ganin cewa alkalumman sun nuna cewa yara miliyan 127 a duniya suna da karancin bitamin A, wannan adadin yana da yuwuwar haɗarin kamuwa da cuta. [6]

### Malabsorption

Malabsorption shine rashin iya ɗaukar abinci gabaɗaya, galibi daga cuta a cikin ƙananan hanji, amma kuma saboda rashin narkewar abinci daga cututtukan pancreas .

Dalilan sun hada da:

* *ƙarancin enzyme ko rashin daidaituwa na mucosal*, kamar yadda a cikin rashin lafiyar abinci da rashin haƙuri na abinci, misali cutar celiac (rashin haƙuri na glucose), rashin haƙuri ga lactose (rashin haƙuri ga sukarin madara, na kowa a cikin waɗanda ba Turai ba), da fructose malabsorption .
* *cutar anemia mai lalata*, ko rashin aikin hanji saboda rashin iya sha bitamin  ;
* *asarar ɓoye na pancreatic*, wanda zai iya zama saboda cystic fibrosis ko pancreatitis .
* *lahani na tsari*, kamar gajeriyar ciwon hanji (an cire hanji ta tiyata) da fibrosis na radiation, kamar yawanci ya biyo bayan maganin ciwon daji da sauran kwayoyi, ciki har da jami'ai da ake amfani da su a chemotherapy ; kuma
* *wasu kwayoyi*, kamar orlistat, wanda ke hana ƙwayar mai.

### Cutar kumburin ciki
Nau'o'i biyu masu haɗuwa anan ba a san asalinsu ba:

* Ciwon ulcerative colitis yana da alaƙa da gudawa mai tsanani da kuma kumburi galibi yana shafar babban hanji kusa da dubura .
* Cutar Crohn yawanci tana shafar sassan hanji da aka ware sosai a cikin hanji kuma galibi tana shafar ƙarshen ƙaramin hanji.

### Cutar hanji mai saurin fushi
 
Wani abin da zai iya haifar da gudawa shine ciwon hanji mai ban haushi (IBS), wanda yawanci yana nuna rashin jin daɗi na ciki da aka saki ta hanyar bayan gida da kuma rashin kwanciyar hankali (zawo ko maƙarƙashiya ) na akalla kwanaki uku a mako a cikin watanni uku da suka gabata. [1] Ana iya sarrafa alamun gudawa-mafi rinjayen IBS ta hanyar haɗuwa da canje-canje na abinci, abubuwan da ake amfani da su na fiber mai narkewa da magunguna irin su loperamide ko codeine . Kimanin kashi 30% na marasa lafiya masu fama da gudawa-mafi rinjaye IBS suna da malabsorption na bile acid da aka gano tare da gwajin SeHCAT mara kyau. [2]

### Sauran cututtuka
Gudawa na iya faruwa ne sakamakon wasu cututtuka da yanayi, wato:

* Ciwon ethanol na yau da kullun 
* Hyperthyroidism 
* Wasu magunguna 
* Bile acid malabsorption 
* Ciwon hanji na ischemic : Wannan yawanci yana shafar tsofaffi kuma yana iya zama saboda toshewar arteries.
* Microscopic colitis, irin nau'in cututtuka na ciwon ƙwayar cuta inda ake ganin canje-canje kawai a kan nazarin tarihi na biopsies na colonic.
* Bile gishiri malabsorption ( primary bile acid gudawa ) inda yawan bile acid a cikin hanji ya haifar da zawo na sirri.
* Ciwace-ciwacen da ke ɓoye Hormone: wasu hormones, misali serotonin, na iya haifar da gudawa idan an ɓoye su da yawa (yawanci daga ƙari).
* Zawo mai laushi na yau da kullun a cikin jarirai da yara ƙanana na iya faruwa ba tare da bayyanannen dalili ba kuma ba tare da wata illa ba; wannan yanayin ana kiransa zawo .
* Environmental enteropathy
* Radiation enteropathy biyo bayan jiyya don ciwon daji na pelvic da na ciki.
* Mast cell activation syndrome (MCAS)   

### Magunguna
Sama da magunguna 700, irin su penicillin, an san suna haifar da gudawa. [1] [2] Azuzuwan magungunan da aka sani suna haifar da gudawa sune maganin laxatives, antacids, magungunan ƙwannafi, maganin rigakafi, magungunan neoplastic, maganin kumburi da yawancin abubuwan abinci. [3]

## Pathophysiology

### Juyin Halitta
A cewar masu bincike guda biyu, Nesse da Williams, zawo na iya aiki a matsayin tsarin kariya na korar da aka samo asali. A sakamakon haka, idan an dakatar da shi, za a iya samun jinkirin dawowa.  Sun yi nuni da goyon bayan wannan bincike na muhawara da aka buga a 1973 wanda ya gano cewa maganin *Shigella* tare da maganin zawo (Co-phenotrope, Lomotil ) ya sa mutane su kasance masu zazzaɓi sau biyu muddin waɗanda ba a kula da su ba. Masu binciken da kansu sun lura cewa: "Lomotil na iya zama contraindicated a shigellosis. Cutar zawo na iya wakiltar tsarin tsaro". 

## Hanyar bincike
Nau'in gudawa masu zuwa na iya nuna ana buƙatar ƙarin bincike:

* A cikin jarirai
* Zawo mai matsakaici ko mai tsanani a cikin yara ƙanana
* Haɗe da jini
* Ci gaba fiye da kwanaki biyu
* Haɗe da ciwon ciki mara ƙima, zazzabi, asarar nauyi, da sauransu.
* A cikin matafiya
* A cikin masu sarrafa abinci, saboda yuwuwar kamuwa da wasu;
* A cikin cibiyoyi irin su asibitoci, cibiyoyin kula da yara, ko gidajen geratric da ƙorafi.

Ana amfani da maki mai tsanani don taimakawa ganewar asali a cikin yara. 

Lokacin da gudawa ya wuce fiye da makonni hudu ana iya ba da shawarar ƙarin gwaje-gwaje da suka haɗa da: 

* Cikakkun adadin jini da ferritin idan akwai anemia
* Thyroid stimulating hormone
* Tissue transglutaminase don cutar celiac
* Fecal calprotectin don ware cututtukan hanji mai kumburi
* Gwajin stool na ova da parasites da na *Clostridioides difficile*
* A colonoscopy ko fecal immunochemical gwajin ga ciwon daji, ciki har da biopsies don gano microscopic colitis
* Gwajin zawo na bile acid tare da SeHCAT, 7a-hydroxy-4-cholesten-3-one ko fecal bile acid dangane da samuwa.
* Gwajin numfashin hydrogen yana neman rashin haƙurin lactose
* Ƙarin gwaje-gwaje idan rashin ƙarfi na rigakafi, cutar radiation pelvic ko ƙananan ƙwayoyin cuta na hanji da ake zargi.

Jagoran 2019 ya ba da shawarar cewa gwajin ova da parasites ana buƙatar kawai a cikin mutanen da ke cikin haɗari mai yawa kodayake suna ba da shawarar gwajin yau da kullun don giardia .  Ba a ba da shawarar rage yawan lalatawar Erythrocyte (ESR) da furotin C-reactive (CRP). 

## Yaduwar cututtuka

A duk duniya a cikin 2004, kimanin mutane biliyan 2.5 sun kamu da cutar gudawa, wanda ya yi sanadiyar mutuwar mutane miliyan 1.5 a tsakanin yara 'yan kasa da shekaru biyar.  Fiye da rabin waɗannan sun kasance a Afirka da Kudancin Asiya.  Wannan ya ragu daga adadin mutuwar miliyan 4.5 a cikin 1980 don ciwon gastroenteritis.  Zawo ya kasance babban sanadin mutuwar jarirai (16%) bayan ciwon huhu (17%) a wannan rukunin shekaru. 

Galibin irin wadannan matsalolin na faruwa ne a kasashe masu tasowa, inda sama da rabin adadin wadanda aka yi fama da cutar zawo na yara ke faruwa a Afirka da Asiya, tare da miliyan 696 da biliyan 1.2, bi da bi, idan aka kwatanta da miliyan 480 kacal a sauran kasashen duniya. 

Cutar gudawa ta haifar da mutuwar kimanin yara miliyan 0.7 a cikin yara 'yan kasa da shekaru biyar a cikin 2011 kuma miliyan 250 sun ɓace kwanakin makaranta.   A cikin Amurka, cutar gudawa ta kai kashi 10% na mace-macen yara masu shekaru 1-59 yayin da a Kudancin Gabashin Asiya, ke da kashi 31.3% na mace-mace.  An kiyasta cewa kusan kashi 21% na mace-macen yara a kasashe masu tasowa na faruwa ne sanadiyyar cutar gudawa. 

Hukumar lafiya ta duniya ta bayar da rahoton cewa "mutuwar cutar gudawa ta ragu da kashi 45%, daga na shida da ke haddasa mutuwar a shekarar 2000 zuwa na goma sha uku a shekarar 2021." 

Duk da cewa cutar gudawa ta fi shahara a cikin mutane, tana shafar wasu nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan iri ne.  Shafi na cecal, lokacin da yake nan, yana bayyana yana ba da kariya ga zawo ga matasa primates. 

## Rigakafi

### Tsaftar muhalli
 
Yawancin bincike sun nuna cewa ingantawar ruwan sha da tsaftar muhalli ( WASH ) yana haifar da raguwar haɗarin gudawa.  Irin waɗannan haɓakawa na iya haɗawa da misali amfani da matatun ruwa, samar da ingantaccen ruwan famfo da haɗin magudanar ruwa . 

A cikin cibiyoyi, al'ummomi, da gidaje, ayyukan da ke inganta wanke hannu da sabulu yana haifar da raguwa mai yawa a cikin kamuwa da cutar gudawa.  Hakanan ya shafi hana yin bayan gida a fili a matakin al'umma da samar da hanyoyin inganta tsafta .   Wannan ya haɗa da yin amfani da bayan gida da aiwatar da duk sarkar tsaftar da ke da alaƙa da bandakuna (tattara, jigilar kaya, zubarwa ko sake amfani da fitar ɗan adam ).

Akwai ƙayyadaddun shaida da ke nuna amintaccen zubar da yara ko babba najasa na iya hana cutar gudawa.  

#### Wanke hannu
Dabarun tsaftar muhalli na asali na iya yin tasiri sosai kan yada cutar gudawa. Aiwatar da aiwatar da wanke hannu ta hanyar amfani da sabulu da ruwa, alal misali, an gwada gwaji don rage yawan cutar da kusan 30-48%.    Wanke hannu a kasashe masu tasowa, duk da haka, talauci yana fuskantar matsala kamar yadda CDC ta amince: "Wanke hannu yana da mahimmanci ga rigakafin cututtuka a duk sassan duniya; duk da haka, samun sabulu da ruwa yana da iyaka a cikin kasashe masu tasowa. Magani ga wannan shingen yana buƙatar aiwatar da shirye-shiryen ilimi waɗanda ke ƙarfafa halayen tsafta. 

#### Ruwa
Ganin cewa gurbacewar ruwa babbar hanya ce ta yada cutar gudawa, kokarin samar da tsaftataccen ruwan sha da ingantacciyar tsafta na iya rage yawan kamuwa da cututtuka. A gaskiya ma, an ba da shawarar cewa muna iya tsammanin raguwar 88% na mace-macen yara a sakamakon cutar gudawa sakamakon ingantacciyar tsaftar ruwa da tsafta.   Hakazalika, ƙididdige ƙididdiga na ƙididdiga masu yawa game da inganta samar da ruwa da tsaftar muhalli ya nuna raguwar 22-27% na kamuwa da cututtuka, da kuma raguwar 21-30% na yawan mace-mace da ke hade da cutar gudawa. 

Maganin Chlorine na ruwa, alal misali, an nuna yana rage haɗarin cutar gudawa, da kuma gurɓataccen ruwan da aka adana tare da cututtukan cututtuka. 

### Alurar riga kafi
Yin rigakafi daga cututtukan cututtukan da ke haifar da cutar zawo shine dabarun rigakafin da za a iya amfani da su, duk da haka yana buƙatar yin niyya ga wasu ƙwayoyin cuta don yin rigakafi. A cikin yanayin Rotavirus, wanda ke da alhakin kusan kashi 6% na cututtukan gudawa da kuma kashi 20% na mutuwar cututtuka a cikin yara na kasashe masu tasowa, amfani da maganin rigakafin Rotavirus a gwaji a 1985 ya haifar da raguwa kadan (2-3%) a cikin jimlar cutar gudawa, yayin da rage yawan mace-mace da 6-10%. Hakazalika, allurar rigakafin cutar kwalara ta nuna raguwar cututtuka da mace-mace, duk da cewa tasirin allurar rigakafin ya yi kadan kasancewar kwalara ba ta daya daga cikin manyan cututtukan da ke haifar da cutar gudawa.  Tun daga wannan lokacin, an samar da ingantattun alluran rigakafin da ke da yuwuwar ceton dubban rayuka a kasashe masu tasowa, tare da rage yawan kudin magani, da tsadar al'umma.  

Alurar rigakafin rotavirus yana rage yawan zawo a cikin yawan jama'a.   Sabbin alluran rigakafin cutar rotavirus, *Shigella*, Enterotoxigenic Escherichia coli (ETEC), da kwalara suna ci gaba da haɓakawa, da sauran abubuwan da ke haifar da gudawa. &#x5B; ** &#x5D;

### Abinci mai gina jiki
Ana iya magance ƙarancin abinci a ƙasashe masu tasowa ta hanyar haɓaka ingantattun hanyoyin cin abinci. Ƙarin Zinc ya tabbatar da nasara yana nuna raguwa mai yawa a cikin cututtukan cututtuka idan aka kwatanta da ƙungiyar kulawa.   Yawancin wallafe-wallafen sun nuna cewa karin bitamin A yana da fa'ida wajen rage cututtukan cututtuka.  Ya kamata a yi la’akari da cewa ƙarar bitamin A ba ta da tasiri wajen rage cutar gudawa idan aka kwatanta da bitamin A da ƙarin zinc, kuma an kiyasta cewa dabarar ta ƙarshe ta fi tasiri sosai. 

#### Shayarwa
An nuna ayyukan shayarwa na yin tasiri mai ban sha'awa kan yadda cutar zawo a cikin jama'a marasa galihu. Wani bincike da aka gudanar a kasashe masu tasowa da dama ya nuna cewa wadanda suka sha nonon uwa zalla a cikin watanni 6 na farkon rayuwarsu sun fi samun kariya daga kamuwa da cututtukan gudawa.  Wani bincike da aka yi a Brazil ya gano cewa jariran da ba su sha nono sun fi mutuwa sau 14 fiye da jarirai masu shayarwa kadai.  A halin yanzu ana ba da shawarar shayarwa na musamman don watanni shida na farkon rayuwar jariri ta WHO,   tare da ci gaba da shayarwa har zuwa akalla shekaru biyu. 

### Wasu
Magungunan rigakafi suna rage haɗarin gudawa a cikin masu shan maganin rigakafi .  Yin feshin maganin kwari na iya rage adadin gardawa da haɗarin gudawa a cikin yara a cikin yanayin da ake samun bambance-bambancen yanayi na adadin gardawa a duk shekara. 

## Gudanarwa
A lokuta da yawa na gudawa, maye gurbin ruwan da aka rasa da gishiri shine kawai maganin da ake buƙata. Wannan yawanci ana amfani da shi ta baki - maganin sake shayar da ruwa ta baki - ko kuma, a cikin mawuyacin hali, ta hanyar jijiya .  Ba a ba da shawarar ƙuntatawa kan abinci kamar abincin BRAT ba.  Bincike bai goyi bayan iyakance madara ga yara ba saboda yin hakan ba shi da tasiri ga tsawon lokacin gudawa.  Akasin haka, WHO ta ba da shawarar cewa yara masu gudawa su ci gaba da cin abinci saboda yawancin abinci mai gina jiki ana sha don tallafawa ci gaba da girma da ƙaruwar nauyi, kuma ci gaba da cin abinci yana hanzarta murmurewa daga aikin hanji na yau da kullun.  CDC ta ba da shawarar cewa yara da manya masu fama da kwalara suma su ci gaba da cin abinci.  Babu wata shaida da ke nuna cewa sake ciyar da yara da wuri na iya haifar da ƙaruwar amfani da ruwa mara kyau na jijiya, lokutan amai, da haɗarin kamuwa da gudawa mai ɗorewa. 

Magunguna kamar loperamide (Imodium) da bismuth subsalicylate na iya zama da amfani; duk da haka ana iya hana su a wasu yanayi. 

### Ruwa

Ana iya amfani da maganin sake shaƙar ruwa ta baki (ORS) (ruwan da aka ɗan yi zaki da gishiri) don hana bushewar jiki. Ana iya bayar da maganin gida na yau da kullun kamar ruwan shinkafa mai gishiri, abubuwan sha na yogurt mai gishiri, miyar kayan lambu da kaza tare da gishiri. Ana iya samun mafita a gida kamar ruwan da aka dafa hatsi a ciki, miyar da ba ta da gishiri, ruwan kwakwa kore, shayi mai rauni (mara daɗi), da ruwan 'ya'yan itace sabo marasa zaki za a iya ƙarawa daga rabin cokali zuwa cikakken cokali na gishiri (daga gram ɗaya da rabi zuwa gram uku) a kowace lita. Ruwa mai tsabta kuma yana iya zama ɗaya daga cikin ruwaye da yawa da aka bayar.  Akwai mafita na kasuwanci kamar Pedialyte, kuma hukumomin agaji kamar UNICEF suna rarraba fakitin gishiri da sukari sosai. Wata mujallar WHO ga likitoci ta ba da shawarar yin ORS na gida wanda ya ƙunshi lita ɗaya na ruwa tare da cokali ɗaya na gishiri (gram 3) da cokali biyu na sukari (gram 18) da aka ƙara  (kimanin "ɗanɗanon hawaye"  ). Aikin Rehydration Project ya ba da shawarar ƙara adadin sukari iri ɗaya amma rabin cokali na gishiri kawai, yana mai cewa wannan hanyar da ta fi laushi ba ta da haɗari sosai tare da ƙarancin asarar inganci.  Dukansu sun yarda cewa abubuwan sha masu yawan sukari ko gishiri na iya ƙara ta'azzara bushewar jiki.  

Ya kamata a ƙara adadin zinc da potassium masu dacewa idan akwai. Amma samuwar waɗannan bai kamata ya jinkirta sake sha ruwa ba. Kamar yadda WHO ta nuna, abu mafi mahimmanci shine a fara hana bushewa da wuri-wuri.  A wani misali na gaggawa na ORS da fatan hana bushewa, CDC ta ba da shawarar a ci gaba da ba da Maganin Cire Ruwa daga Jiki a baki yayin tafiya zuwa asibiti. 

Amai yakan faru ne a cikin awa ɗaya ko biyu na farko na magani da ORS, musamman idan yaro ya sha maganin da sauri, amma wannan ba kasafai yake hana samun ruwa mai kyau ba tunda yawancin ruwan har yanzu yana sha. WHO ta ba da shawarar cewa idan yaro ya yi amai, ya jira minti biyar ko goma sannan ya fara ba da maganin a hankali. 

Ba a ba da shawarar shan abin sha mai yawan sukari mai sauƙi, kamar abubuwan sha masu laushi da ruwan 'ya'yan itace, ga yara 'yan ƙasa da shekara biyar domin suna iya *ƙara* bushewar jiki. Maganin da ya yi yawa a cikin hanji yana fitar da ruwa daga sauran jiki, kamar dai mutum zai sha ruwan teku.   Ana iya amfani da ruwa mai sauƙi idan ba a sami takamaiman shirye-shiryen ORT masu inganci ba ko kuma ba su da daɗi.  Bugu da ƙari, ana iya ba wa mutum ɗaya gauraye na ruwa mai sauƙi da abin sha mai yawan sukari da gishiri, da nufin samar da matsakaicin adadin sodium gabaɗaya.  Ana iya amfani da bututun nasogastric ga yara ƙanana don ba da ruwa idan ya cancanta. 

### Cin abinci
WHO ta ba da shawarar a ci gaba da ciyar da yaro mai gudawa. Ci gaba da ciyarwa yana hanzarta murmurewa daga aikin hanji na yau da kullun. Sabanin haka, yaran da abincinsu ya takaita suna da gudawa na dogon lokaci kuma suna dawo da aikin hanji a hankali. WHO ta ce " *Bai* kamata a taɓa hana abinci ba kuma *kada* a narkar da abincin da yaron ya saba ci. Ya kamata a ci gaba da shayarwa *koyaushe* ."  A cikin takamaiman misalin cutar kwalara, CDC ta ba da irin wannan shawarar.  Jarirai masu shayarwa da gudawa galibi suna zaɓar shayarwa fiye da kima, kuma ya kamata a ƙarfafa su su yi hakan.  A cikin ƙananan yara waɗanda ba a shayar da su nono kuma suna zaune a cikin ƙasashe masu tasowa, cin abinci mara lactose na iya zama da amfani don hanzarta murmurewa.  Cin abinci mai ɗauke da zare mai narkewa na iya taimakawa, amma zare mara narkewa na iya ƙara ta'azzara shi. 

### Magunguna
Ana iya rarraba magungunan gudawa zuwa ƙungiyoyi huɗu daban-daban: maganin hana motsi, maganin hana fitar ruwa, maganin shaye-shaye, da kuma maganin kamuwa da cuta.  Duk da cewa maganin rigakafi yana da amfani a wasu nau'ikan gudawa mai tsanani, yawanci ba a amfani da su sai a wasu yanayi na musamman.   Akwai damuwa cewa maganin rigakafi na iya ƙara haɗarin kamuwa da cutar uremic hemolytic a cikin mutanen da suka kamu da cutar Escherichia coli O157:H7 .  A ƙasashe masu ƙarancin albarkatu, magani da maganin rigakafi na iya zama da amfani.  Duk da haka, wasu ƙwayoyin cuta suna haɓaka juriya ga maganin rigakafi, musamman *Shigella* .  Magungunan rigakafi na iya haifar da gudawa, kuma gudawa mai alaƙa da maganin rigakafi ita ce mafi yawan tasirin da ake samu a jiyya da maganin rigakafi na gabaɗaya.

Duk da cewa sinadaran bismuth ( Pepto-Bismol ) suna rage yawan hanjin da ke shiga cikin waɗanda ke fama da gudawa, amma ba sa rage tsawon lokacin rashin lafiya.  Magungunan hana motsi kamar loperamide suma suna da tasiri wajen rage yawan bayan gida amma ba tsawon lokacin da cutar ke ɗauka ba.  Ya kamata a yi amfani da waɗannan magunguna ne kawai idan gudawa mai jini ba ta nan. 

Diosmectite, wani yumbu na aluminomagnesium silicate na halitta, yana da tasiri wajen rage alamun gudawa mai tsanani a cikin yara,  kuma yana da wasu tasiri a cikin gudawa mai aiki na yau da kullun, gudawa da radiation ke haifarwa, da gudawa da chemotherapy ke haifarwa.  Wani maganin shaye-shaye da ake amfani da shi don maganin gudawa mai sauƙi shine kaopectate .

Ana iya amfani da Racecadotril, maganin hana zawo a cikin yara da manya, don magance gudawa.  Yana da juriya mafi kyau fiye da loperamide, domin yana haifar da ƙarancin maƙarƙashiya da kumburin ciki .  Duk da haka, ba shi da wani amfani wajen inganta gudawa mai tsanani a cikin yara. 

Magungunan hana bile acid kamar cholestyramine na iya yin tasiri a cikin gudawa mai ɗorewa saboda rashin shaye-shaye na bile acid . Gwaje-gwajen warkewa na waɗannan magunguna ana nuna su a cikin gudawa mai ɗorewa idan ba za a iya gano rashin shaye-shayen bile acid tare da takamaiman gwaji ba, kamar riƙe SeHCAT . 

### Madadin hanyoyin magancewa
Karin sinadarin zinc zai iya amfanar da yara 'yan sama da watanni shida da ke fama da gudawa a yankunan da ke da yawan rashin abinci mai gina jiki ko ƙarancin sinadarin zinc.  Wannan yana goyon bayan ka'idojin Hukumar Lafiya ta Duniya game da sinadarin zinc, amma ba a lokacin ƙanana ba.

Wani Binciken Cochrane daga 2020 ya kammala da cewa probiotics ba su da wani tasiri ko kaɗan ga mutanen da ke fama da gudawa na tsawon kwana 2 ko fiye, kuma babu wata shaida da ke nuna cewa suna rage tsawon lokacinsa.  Probiotic lactobacillus lactobacillus na iya taimakawa wajen hana gudawa da ke da alaƙa da maganin rigakafi ga manya amma wataƙila ba yara ba.  Ga waɗanda ke fama da rashin haƙuri ga lactose, shan enzymes na narkewar abinci waɗanda ke ɗauke da lactase lokacin cin kayayyakin kiwo sau da yawa yana inganta alamun.

## Duba kuma
 

* Dysentery – Intestinal inflammation causing bloody diarrhea
* Fernando Mazariegos – Guatemalan scientist (1938–2018)
* Mucorrhea – Discharge of mucus

## Nassoshi

## Hanyoyin haɗi na waje
 

* Takardar bayanai ta WHO game da cutar gudawa