Yɛn nipadua mu ɔbran ketewa: Momma yensua biribiara fa duodenum no ho!

So woasusuw sɛnea aduan a yedi no ma yɛn nipadua nya ahoɔden ne aduannuru ho pɛn? Eyi yɛ akwantu a ɛyɛ den ankasa, ɛyɛ nwonwa a ɛkɔ so wɔ yɛn nipadua mu. Enti, ɔfa ketewa bi wɔ hɔ nanso ɛwɔ tumi paa a ɛdi dwuma titire paa wɔ akwantuo yi mu, nanso ɛtɔ da bi a yɛnka ho asɛm pii. Ɛno ne duodenum no . Sɛ yɛbɛka no tiawa a, eyi ne yɛn dwensɔtwaa ketewa no fã a edi kan. Wɔ asɛm yi mu no, yɛbɛka yɛn aduan mu adwumayɛfo a ɔyɛ komm yi ho asɛm.

Dɛn ne dwumadi titiriw a duodenum no yɛ?

Fa no sɛ duodenum no yɛ beae a adagyew nnim koraa na ɛho hia wɔ aduan no mu. Ɛno ne beae a edi kan a aduan a efi yafunu mu hyia. Dwumadi atitiriw abiɛsa na ɛkɔ so wɔ ha:

1. Aduan a efi yafunu mu ba no acid a ɛso tew:

Sɛ aduan a yedi no kɔ yafunu mu a, ɛne nsu a asikre wom a ɛwɔ hɔ no fra, bubu, na ɛdan akutu a ɛyɛ nsu. Wɔ aduruyɛ mu no, yɛfrɛ eyi ‘chyme’ . Saa ‘chyme’ yi yɛ acidic paa. Enti, sɛ ɛkɔ dwensɔtwaa ketewa no nkae no mu tẽẽ a, ebetumi asɛe. Duodenum no ma hormone bi a wɔfrɛ no ‘secretin’ fi adi . Saa hormone yi kɔ na ɛkyerɛ yɛn dwensɔtwaa no ma ɛma enzyme bi a wɔfrɛ no ‘bicarbonate’ . Te sɛ nea wɔde nsu a wɔde yɛ biribi a acid wom no, saa bicarbonate yi ba mu na ɛtew saa ‘chyme’ a acid wom kɛse no acid so kodu baabi a wotumi gyina ano. Ɛnyɛ sɛ eyi bɔ yɛn dwensɔtwaa ketewaa no ho ban nko, na mmom ɛboa ma ɛtwe aduannuru yiye nso.

2. ‘Chyme’ a wɔdan no aduannuru a nipadua no betumi atwe:

Duodenum no ma hormone foforo a ɛho hia, cholecystokinin (CCK) , fi adi . Saa hormone yi kanyan yɛn mmerɛbo, akisikuru, ne dwensɔtwaa ma ɛde wɔn aduan mu nsu kɔ duodenum no mu.

• Bile a efi mmerɛbo ne akisikuru mu no boa ma srade mu paapae.
• Enzyme ‘lipase’ a efi dwensɔtwaa mu no nso bubu srade. Enzyme ‘amylase’ no bubu carbohydrates, na enzyme ‘protease’ bubu protein ahorow.

Aduannuru a wɔayam no yiye wɔ saa kwan yi so no kɔ yɛn mogya mu.

3. Aduan a wɔayam no a wobɛpia akɔ w’anim:

Wɔpia aduan mu nneɛma nketenkete ne nwura a wɔannye no fi duodenum no mu kɔ dwensɔtwaa ketewa no fã a edi hɔ, jejunum no mu. Eyi ba efisɛ ntini a ɛwɔ duodenum no afasu mu no twetwe na ɛyɛ mmerɛw. Wɔfrɛ saa adeyɛ a ɛte sɛ asorɔkye a ɛma aduan kɔ n’anim yi peristalsis .

Duodenum no kɛse te dɛn? Na ɛhe na ɛwɔ?

Duodenum yɛ yɛn dwensɔtwaa ketewa no afã abiɛsa (duodenum, jejunum, ileum) no mu nea ɛyɛ tiaa sen biara . Ne tenten bɛyɛ nsateakwaa 10.– Ɛno sua kakra sene nan a ɛwɔ sodifoɔ so. Nea ɛyɛ anigye no, Latin asɛmfua "duodenum" kyerɛ "nsateaa 12." Ɛne sɛ, bere bi a atwam no, na wosusuw sɛ ɛne nsateaa 12 a wɔde asisi nkyɛnkyɛn no trɛw yɛ pɛ na esusuw ne tenten.

Fa no sɛ, sɛ yɛtrɛw yɛn dwensɔtwaa ketewa no nyinaa mu a, anka ne tenten bɛyɛ anammɔn 22! Ɛno tenten bɛyɛ sɛ tɛnis abɔnten so. Nanso, duodenum, a ɛyɛ ne tenten nyinaa fã ketewaa bi, bɛyɛ nsateakwaa 10, ne baabi a aduannuru a ɛho hia sen biara a wɔtwe no kɔ so.

Duodenum no wɔ yɛn yafunu ase. Ɛbɔ ne ho akɔneaba sɛnea Borɔfo nkyerɛwde ‘C’, anaa ɔpɔnkɔ nan te no, kɔ nifa, akyi, kɔ fam, na afei ɛkɔ benkum. Pancreas no ti wɔ saa curve a ɛte sɛ ‘C’ yi mu pɛɛ.

Dɛn ne duodenum no afã atitiriw?

Duodenum no wɔ afã atitiriw anan, na wɔtoo din esiane beae a ɛwɔ ne sɛnea ɛte nti.

1. Superior segment: Eyi ne ɔfã a ɛwɔ soro a ɛne yafunu no di nkitaho. Ne tenten bɛyɛ nsateakwaa 2. Wɔsan frɛ baabi a ɛne pylorus, valve a ɛma aduan fi yafunu no mu no di nkitaho tẽẽ no duodenal bulb. Ɛha na akuru taa ba wɔ dwensɔtwaa ketewa no mu, efisɛ ɛda adi kɛse sɛ yafunu mu acid bɛbɔ no.

2. Descending segment: Sɛnea edin no kyerɛ no, eyi ne ɔfã a ɛte sɛ ‘C’ a ɛkɔ fam. Ne tenten bɛyɛ nsateakwaa 4. Saa ɔfã yi nam ntini a ɛde wɔn nsu kɔ no so na ɛka dwensɔtwaa, akisikuru, ne mmerɛbo ho.

3. Horizontal (inferior) segment: Eyi nso tenten bɛyɛ nsateakwaa 4. Ɛtrɛw fi nifa kɔ benkum. Saa ɔfã yi fa aorta ne inferior vena cava a ɛyɛ mogya ntini atitiriw a ɛwɔ yɛn nipadua mu no so.

4. Ascending segment: Eyi ne duodenum no fã ketewaa bi a ne tenten nnu nsateakwaa biako kakra. Ɛkɔ soro kakra na ɛne jejunum no di nkitaho.

Ntini ahorow bɛn na ɛwɔ duodenum no mu?

Te sɛ yɛn aduan mu ntini a aka (GI tract) no, ntini atitiriw anan na ɛyɛ duodenum no. Efi nea ɛwɔ mu no so kosi nea ɛwɔ akyi no so no, eyinom ne:

1. Mucosa: Eyi ne ade a ɛwɔ mu paa. Ntini ne ntini nketenkete a ɛte sɛ nsateaa a wɔfrɛ no ‘microvilli’ . Saa microvilli yi ma duodenum no ani kɛse yɛ kɛse, na ɛma etumi twetwe aduannuru pii sen sɛ na ɛyɛ petee a.

2. Submucosa: Mogya ntini ne ntini a ɛka bom na ɛwɔ saa ɔfa yi mu. Titiriw no, Brunner ntini ahorow no wɔ saa ɔfa yi mu. Saa ntini ahorow yi ma nsu a ɛyɛ hu a ɛtew acid a ɛwɔ chyme no mu no so.

3. Ntini a ɛma nipadua no yɛ adwuma:Ntini a ɛyɛ mmerɛw na ɛyɛ ne fã kɛse no ara. N’adwuma titiriw ne sɛ ɛbɛfrafra na ama aduan akɔ n’anim. Sɛ saa ntini ahorow yi twetwe a, ‘chyme’ no ne enzymes ne bile fra yiye.

4. Serosa: Eyi ne ade a ɛbɔ akyi paa a ɛbɔ duodenum no ho ban. Ɛyɛ nkwammoaa a ɛwɔ nipadua no mu a ɛyɛ squamous epithelial cells.

Ɔhaw ahorow bɛn na ebetumi aba wɔ duodenum no mu?

Esiane sɛ duodenum no bɛn yafunu no nti, sɛ yafunu mu acid dodow kɔ soro a, ɛda adi sɛ ɛbɛsɛe. Saa acid yi betumi ama akuru a wɔsan frɛ no ‘peptic ulcers’ , aba duodenum no mu, ne yafunu no mu nso. Nneɛma atitiriw abien nti na ɛte saa:

• Ɔyare mmoawa bi a wɔfrɛ no H. pylori . Fa no sɛ ɔyare mmoawa ketewaa bi a enye wɔ wo yafunu mu. Ebetumi asɛe yɛn yafunu ne yɛn akyi berɛmo a ɛbɔ yɛn ho ban no na ama yɛanya akuru.
• Nnuru a wɔde kum ɛyaw a wɔfrɛ no ‘NSAIDs’ (nnuru a ɛnyɛ steroid a wɔde ko tia ɔyare mmoawa) a wɔde di dwuma boro so . Ɛno kyerɛ sɛ nnuru te sɛ aspirin ne ibuprofen. Ɛtɔ mmere bi a yɛfa eyinom ma nipadua mu yaw ne tiyɛ. Nanso sɛ yɛfa wɔn dodo na yɛkɔ so no a, saa opira ahorow yi betumi aba.

Nea ɛho hia: Sɛ akuru bi a wɔansa no pae ntini a ɛbɔ ho ban no mu na ɛsɛe mogya ntini a ɛwɔ n’akyi a wɔfrɛ no gastroduodenal artery no a, ebetumi ama mogya atu kɛse. Eyi yɛ tebea a ehia sɛ wɔsa no ntɛm ara.

Nea ɛka ho no, nyarewa pii a ɛtaa ka dwensɔtwaa ketewa no nso betumi aka dwensɔtwaa no. Nhwɛso ahorow bi ne:

• Brunner ntini mu adenomas: Eyinom yɛ akisikuru a ɛnyɛ kokoram (a ɛnyɛ papa).
• Crohn yare: Eyi yɛ yare a ɛma dwensɔtwaa no ho hyehye na ɛhoa.
• Celiac yare: Tebea a ɛde aduan mu haw ba bere a wodi nnuan a gluten wom no.
• Duodenal atresia: Tebea a ɛma duodenum no to mu koraa bere a wɔawo no.
• Duodenal stenosis: Tebea a ɛma duodenum no yɛ teateaa (nanso ɛnto mu koraa) wɔ awo mu.
• Duodenal cancer: Kokoram a efi ase wɔ duodenum mu.
• Duodenal diverticulum: Ade ketewaa bi a ɛpuepue te sɛ kotoku fi duodenum no fasu mu. Mpɛn pii no, eyinom mfa ɔhaw mma anaasɛ enhia ayaresa gye sɛ wɔanya ɔyare mmoawa na wɔayɛ wɔn hyew (diverticulitis).
• Duodenitis: Duodenum a ɛyɛ hyew.
• Dwonku ketewa a ɛsiw: Eyi yɛ aduruyɛ mu asɛm a egye ntɛmpɛ. Dwonku ketewa no fã bi a duodenum ka ho no siw koraa anaa ne fã bi.

Dɛn ne ɔhaw bi a ɛwɔ duodenum no ho ho sɛnkyerɛnne?

Nsɛnkyerɛnne no gyina tebea ko a wowɔ so. Nanso mpɛn pii no, ɔhaw bi a ɛwɔ duodenum mu ho sɛnkyerɛnne te sɛ ɔhaw afoforo a ɛwɔ yɛn aduan mu nhyehyɛe mu (`(GI tract)`) ho sɛnkyerɛnne. Ebia nea ɛka ho ne:

• Yafunu mu yaw
• Ɔhohoro ne gas
• Ayamtim
• Ayamtuo
• Akisikuru ne ɔfe
• Nnuan a wɔmfa nni dwuma yiye bere a wɔadi akyi
• Mogya a wɔfe anaa mogya a wɔde fa nsu mu (eyi betumi ayɛ sɛnkyerɛnne a ɛkyerɛ sɛ mogya retu afi kuru bi mu) .

Dɛn ne nhwehwɛmu ahorow a wɔtaa yɛ de hwɛ sɛnea duodenum no akwahosan te?

Sɛ oduruyɛfo bi susuw sɛ wowɔ ɔhaw bi wɔ wo duodenum ho a, ebia wɔbɛyɛ nhwehwɛmu ahorow te sɛ eyinom:

• Ɔhome mu nhwehwɛmu de hwɛ sɛ ebia H. pylori yare no wɔ hɔ anaa.
• Mfoninitwa akwan a wɔfa so hwehwɛ akuru ne ɔfe a ɛwɔ duodenum no mu – sɛ nhwɛso no, ultrasound, X-ray, CT scan, ne MRI.
• Sɔhwɛ ahorow a ɛfa sɛ wɔde tube a camera (`scope`) wom bɛhyɛ duodenum no mu de ahwɛ mu – te sɛ ``enteroscopy`` ne ``upper endoscopy``.
• Wɔyɛ nipadua mu nhwehwɛmu (a nea ɛka ho ne sɛ wɔfa ntini ketewaa bi na wɔhwehwɛ mu) de hwɛ sɛ ebia nyini a ɛnteɛ te sɛ kokoram anaa.

Dɛn ne ayaresa a wɔtaa de sa duodenal nyarewa?

Ayaresa nso gyina tebea no so. Ayaresa a wɔtaa yɛ ne:

• Wɔde nnuru a ekum ɔyare mmoawa ma wɔ nyarewa te sɛ H. pylori.
• Wɔde corticosteroids ma de tew ɔfe a emu yɛ den so.
• Nnuru a ɛtew acid dodow a ɛwɔ yafunu mu so anaasɛ ɛtew acid a ɛwɔ yafunu mu so – sɛ nhwɛso no , proton pump inhibitors (PPIs) , histamine receptor blockers (H2 blockers) , ne antacids .
• Oprehyɛn a wɔyɛ de siesie nhyehyɛe mu haw ahorow anaasɛ wɔsa kokoram – nhwɛso ne Whipple adeyɛ .

Dɛn na metumi ayɛ na ama me duodenum no ayɛ yiye? (Nkrasɛm a Wɔde Kɔ Fie)

Duodenum no yɛ yɛn aduan mu nneɛma nyinaa fã. Enti, suban pa a ɛma nhyehyɛe no nyinaa nya apɔwmuden nso ye ma duodenum no. Nneɛma a ɛnyɛ den a wubetumi ayɛ ni:

• Paw aduan a ɛboa ma wo aduan mu nhyehyɛe yɛ adwuma yiye.
• Di nnuan a ahoɔdennuru wom pii (nhabannuru, nnuaba, atoko, aburow a wɔayam).
• Nom nsu pii. Eyinom abien nyinaa bɛboa ma wo dwensɔtwaa akɔ so daa na amma wo dwensɔtwaa ketewa no ansiw.
• Nnuan ne nhabannuru a ɛnyɛ asikre a wodi no betumi aboa ma asikre dodow a ɛfata akɔ so ayɛ nea ɛwɔ awotwaa no mu.
• Kwati nneɛma a epira wo dwensɔtwaa.
• Sigaretnom ne nsa pii a yɛbɛnom betumi asɛe yɛn aduan mu akwaa ahorow, a duodenum ka ho.
• Nnuru a wɔde kum ɛyaw te sɛ NSAID a wɔtaa nom dodo na ɛboro so no betumi ama obi anya akuru a ɛyɛ yaw.
• Sɛ wowɔ aduan mu haw ahorow a, mmu w’ani ngu sɛnkyerɛnne ahorow no so.
• Ebia nneɛma te sɛ nsakrae a ɛba wo dwensɔtwaa mu, yafunu a ɛnyɛ wo dɛ, anaa aduan a wuntumi nnya no betumi ayɛ yiye wɔ nna kakraa bi mu. Nanso, ɛtɔ mmere bi a ebetumi ayɛ kɔkɔbɔ sɛnkyerɛnne a ɛkyerɛ sɛ ɛsɛ sɛ woyɛ nsakrae wɔ w’asetra kwan mu anaa wokɔ oduruyɛfo nkyɛn.
• Sɛ wowɔ aduan mu haw a ɛkɔ so daa a ɛnyɛ yiye a, ntwentwɛn wo nan ase sɛ wobɛhwehwɛ mmoa.

Sɛ yɛde rewie a: Yɛn aduan a yɛde di dwuma no ne nea ɛboa yɛn ma yɛyam aduan a yedi, twetwe aduannuru no, na yeyi nneɛma fĩ a aka no fi yɛn nipadua mu. Ɛwom sɛ duodenum yɛ nhyehyɛe yi fã ketewaa bi de, nanso edi dwuma titiriw wɔ saa dwumadi atitiriw no mu abien mu – aduan a wɔyam ne aduannuru a wɔtwe . Enti, hwɛ wo duodenum no so yiye. Ɔkwan a eye sen biara a wobɛfa so ayɛ saa ne sɛ wobɛhwɛ wo aduan mu akwahosan nyinaa so. Ma wo nipadua aduan a ahoɔden wom. Afei duodenum no betumi ayam saa aduan no, atwe, na aboa wo nipadua no ma anya ahoɔden.

` Duodenum, dwensɔtwaa ketewa, aduan a wɔyam, aduannuru a wɔtwe, yafunu, duodenum, nyarewa a ɛwɔ duodenum mu