So wo yafunu nso yɛ wo yaw bere a wudidi? Wontumi nhu nea enti a ɛte saa? Momma yɛnka (Functional Dyspepsia) ho asɛm!

So wotaa te nka sɛ wo ho ayɛ wo ma, wo yafunu mu hyew, anaasɛ wote nka sɛ ɛhaw wo ara kwa bere a woadi awie no? Ɛtɔ da bi mpo a wuntumi nhu nea enti a ɛte saa, ɛnte saa? Bere a wɔakɔ oduruyɛfo nkyɛn na wɔayɛ nhwehwɛmu ahorow pii mpo akyi no, ebia wɔbɛka sɛ, "Wonyɛ yare." Nnipa pii wɔ osuahu ahorow a ɛte sɛɛ. Ɛno ne nea yɛfrɛ no ``Functional Dyspepsia'', aduan mu yare a ɛyɛ den sɛ wobenya nea ɛde ba pefee.

Dɛn ne `(Functional Dyspepsia)`? Sɛ yɛbɛka no tiawa a...

Sɛ yɛbɛka no tiawa a, ``Functional Dyspepsia`` yɛ tebea a ɛma wunya aduan a ɛnyɛ den bere tenten, nanso wontumi nhu nea ɛde ba pefee. ``Dyspepsia`` yɛ asɛmfua foforo a ɛkyerɛ aduan a wɔmfa nni dwuma yiye. Ɛyɛ sɛnkyerɛnne ahorow a ɛbom ba bere a wɔadidi akyi ne bere a wɔreyɛ aduan no. ``Functional`` kyerɛ sɛ worentumi mfa wo indigestion sɛnkyerɛnne no mfi nipadua mu nneɛma a wɔtaa de ba no mu biara (te sɛ akuru anaa yafunu mu yare).

Ebia wo sɛnkyerɛnne ahorow no bɛyɛ te sɛ nea ɛfa peptic ulcer disease anaa gastroesophageal reflux disease (GERD) ho . Nanso, sɔhwɛ ahorow kyerɛ sɛ nnipa kakraa bi pɛ na wɔwɔ saa tebea horow yi. Wɔn a wɔaka no wɔ nea wɔfrɛ no Functional Dyspepsia.

Fa no sɛ, wo kar no engine reyɛ dede, nanso mfiridwumayɛfo no ntumi nhu mfomso biara. Sɛ wohwɛ biribiara a, ɛte sɛ nea eye, nanso biribi anyɛ yiye.

So eyi ahorow ahorow wɔ hɔ?

Functional Dyspepsia yɛ ɔyare mmoawa sen yare biako pɛ. Eyi kyerɛ sɛ ɔkwan a ɛfa so ka onipa biara ne sɛnkyerɛnne ahorow a onya no betumi ayɛ soronko. Nnuruyɛfo akyekyɛ mu ayɛ no ahorow atitiriw abien:

1. Epigastric pain syndrome: Wɔte ɛyaw yi nka wɔ yafunu no atifi titiriw na ɛte sɛ komayare . Ɛnyɛ bere nyinaa na ɛfa aduan ho. Ɛtɔ mmere bi a, ebetumi aba bere a yafunu da mpan. Eyi te sɛ GERD ho sɛnkyerɛnne ahorow no kakra.

2. Postprandial distress syndrome: Eyi yɛ tebea a ɛma yafunu mu yɛ no yaw bere a wadidi awie no. Sɛ nhwɛso no, sɛ obi te nka sɛ ɔmene bere a wadi kakraa bi mpo a (adidi ntɛm), ɔte nka sɛ ɔmene, ne ho popo, na ne yafunu mu yɛ no yaw bere a wadidi awie no. Eyi te sɛ yafunu mu akuru ho sɛnkyerɛnne ahorow no kakra.

Ɛnyɛ obiara na ɔfata wɔ saa akuw abien yi mu biara mu. Ebia nnipa binom benya abien no nyinaa afrafra, anaasɛ wobetumi anya abien no nyinaa a wɔaka abom.

Dɛn ne eyi ho sɛnkyerɛnne atitiriw?

Sɛ wowɔ ``Functional Dyspepsia'' a, wobɛtumi anya nsɛnkyerɛnneɛ a ɛdidi soɔ yi mu baako anaa nea ɛboro saa:

• Ɛyaw a ɛba yafunu no atifi (epigastric pain): .Ɛyaw wɔ yafunu no atifi, wɔ mparow no ase pɛɛ. Wɔfrɛ saa beae yi ``epigastrium''. Ɛha na wo yafunu, dwensɔtwaa, duodenum (dwensɔtwaa ketewaa no fã a edi kan), ne wo mmerɛbo no fã bi wɔ.
• Yafunu a ɛho ayɛ fĩ: Ɔte nka sɛ ne ho nyɛ no dɛ na ne yafunu no ayɛ ma bere a wadidi awie no. Mpɛn pii no, eyi ne gas, akisikuru, ne nneɛma afoforo te sɛ gas wɔ abusuabɔ. Ebetumi nso ayɛ te sɛ nea wo yafunu retwe.
• Aduan a obi bedi ne aduan ho akɔnnɔ a ɛyera: Sɛ obi te nka sɛ ɔmene bere a ɔredidi, bere a woadi awie, anaasɛ mpo bere a onnidi pii (a wodi ntɛm) . Ɛtɔ mmere bi a, aduan ho akɔnnɔ a ɛyera betumi aba ansa na wadidi mpo.
• Ɔhyew: Ɔhyew a ɛba koko mu, a wɔsan frɛ no "komayare" no taa ba saa sɛnkyerɛnne ahorow a ɛkyerɛ sɛ aduan a wɔmfa nni dwuma yiye yi mu. Mpɛn pii no, yafunu mu acid a ɛba wo menewam (acid reflux) na ɛde eyi ba. Ebia wobɛte nka sɛ wo yafunu mu hyew nso.

Eyi akyi no, wobetumi ahu nneɛma afoforo te sɛ eyinom nso:

• Belching a ɛboro so
• Akisikuru anaasɛ anom a ɛyɛ den
• Sɛ wowɔ IBS (irritable bowel syndrome) a, wo sɛnkyerɛnne ahorow (e.g. wo taa kɔ wo dwensɔtwaa mu anaasɛ wo ho yɛ wo yaw) nso betumi akɔ soro.
• Adwennwen anaa nkate mu ahotɔ a wɔte nka.

Dɛn nti na eyi `(Functional Dyspepsia)` ba? Dɛn na ɛde ba?

Nnuruyɛfo frɛ "adwuma" yare sɛ ɔhaw a enni nea ɛde sɛnkyerɛnne ahorow ba tẽẽ, a ɛda adi pefee. Ebia ade biako nti a ɛte saa ne abusuabɔ a emu yɛ den a ɛda wo dwensɔtwaa ne w’amemene (gut-brain axis) ntam . Ɛte sɛ nea dwumadi mu ɔhaw ahorow yi fa wo ntini ahorow ne ɔkwan a wofa so hu ɛyaw anaa wo ho nyɛ wo dɛ na wote nka no ho.

Ɛwom sɛ biribiara nni hɔ a ɛde ``Functional Dyspepsia'' ba de, nanso nneɛma pii betumi aboa:

• Visceral hypersensitivity: Fa no sɛ wo ntini ahorow no yɛ mmerɛw dodo kakra. Ɛda adi sɛ wobɛyɛ w’ade wɔ honam fam wɔ adwennwen ho. Ebia woreyɛ wo ntini mu den a wunnim, anaasɛ ebia wo aduan mu nneɛma brɛ ase esiane adwennwen nti. Ebia wo nso wobɛte nka kɛse wɔ nneɛma a ɛteɛ a ɛrekɔ so wɔ w’akwaa mu no ho. Eyi betumi ama aduan a wɔyam no ate nka sɛ ɛnyɛ dɛ bere mpo a ɛrekɔ so yiye no.
• Nkwammoaa a ɛma obi tumi keka ne ho wɔ aduan mu:Eyi kyerɛ sɛ ɔhaw ahorow wɔ ɔkwan a aduan fa so fa wo digestive system (GI tract) mu no mu. Eyi nso betumi afi nkitahodi a enye a ɛda w’amemene ne w’adidi nhyehyɛe ntam no mu aba. Ebia ntini ne ntini a ɛwɔ wo aduan mu no rentumi nyɛ adwuma yiye. Eyi betumi ama aduan akɔhyɛ baabi biako, anaasɛ ebia akwaa ahorow no renhome koraa na ɛremma aduan mfa mu.
• Gut dysbiosis: Sɛ mmoawa nketenkete a ɛwɔ wo dwensɔtwaa mu (a wɔfrɛ no wo microbiome) no nkari pɛ a, ebetumi ama woanya sɛnkyerɛnne ahorow a ɛkyerɛ sɛ ɛyɛ adwuma a ɛnyɛ adwuma yiye. Sɛ nhwɛso no, mmoawa a wɔfrɛ wɔn H. pylori betumi asɛe wo yafunu no mu nneɛma, na ama wo ho ayɛ wo hyew na ama ayɛ mmerɛw kɛse wɔ yafunu mu acid ho. Afei nso, sɛ mmoawa nyin dodo wɔ dwensɔtwaa ketewa no mu a, ebetumi ama obi ho ayɛ den na ayɛ den sɛ ɔbɛyam srade.
• Eosinophilic duodenitis: Wɔahu sɛ nnipa binom a wɔwɔ functional dyspepsia no wɔ mogya mu nkwammoaa fitaa bi a wɔfrɛ no eosinophils a ɛboro so wɔ dwensɔtwaa ketewa (duodenum) no fã a edi kan no mu. Eyi betumi ama ɔfe a ɛtra hɔ kyɛ (duodenitis) aba. Saa eosinophils yi wɔ hɔ sɛ ɛbɛbɔ wo ho ban afi wo nipadua mu ahoɔden a ɛko tia nyarewa, ɔyare mmoawa, ne nneɛma a ɛma wo ho yɛ wo hyew ho. Ebia eyi fi ɔyare mmoawa bi a wadi kan anya anaasɛ aduan a ne ho nyɛ no dɛ.

Dɛn ne asiane ahorow a ɛde tebea yi ba?

Nneɛma afoforo pii wɔ hɔ a ɛma asiane a ɛwɔ hɔ sɛ obi benya ``Functional Dyspepsia`` no yɛ kɛse:

• Adwene mu nneɛma: Adwene mu tebea horow te sɛ dadwen, adwenemhaw (adwene mu haw), anaa nsɛm a ɛyɛ hu anaa ayayade a wɔahyia wɔ bere a atwam no mu.
• Abusua abakɔsɛm: Abusua abakɔsɛm a ɛfa ntini mu yare anaa GI mu ɔhaw afoforo a ɛyɛ adwuma te sɛ IBS ho.
• Aduan ho nkate: Nnuan bi ho nkate (e.g., nnuan a ɛka `(FODMAPs)` kuw no ho) anaasɛ nnuan bi a wontumi nnye ntom (e.g., `(lactose a wontumi nnye ntom)` - ɛyɛ den sɛ wobɛyam nufusu ne nufusu mu nneɛma).
• Atopy: Eyi kyerɛ sɛ wowɔ tebea horow pii a ɛma obi ho yɛ no hyew, te sɛ ayamtu, akisikuru, ne sare atiridii.

Ɔkwan bɛn so na nnuruyɛfo hu eyi pɛpɛɛpɛ?

Nnuruyɛfo hu `(Functional Dyspepsia)` bere a wɔasi wo sɛnkyerɛnne ahorow no so dua na wɔapow nneɛma afoforo a ɛde ba no akyi (e.g. `(GERD)`, `(Peptic Ulcer Disease)`). Ɛtɔ da bi a, ebia wowɔ saa tebea horow yi mu biako dedaw na wɔasa wo yare. Nanso, sɛ saa ayaresa ahorow no ntew wo aduan a ɛnyɛ dɛ ho sɛnkyerɛnne so a, ɛnde ɛsɛ sɛ woda so ara susuw `(Functional Dyspepsia)` ho.

``Functional Dyspepsia'' ho sɛnkyerɛnne no nni hɔ bere nyinaa na ebetumi aba na akɔ. Nnuruyɛfo nam nneɛma a edidi so yi a wosusuw ho so hu:

• So anyɛ yiye koraa no, yare no ho sɛnkyerɛnne no akɔ so asram abiɛsa ?
• Anyɛ yiye koraa no, so asram asia ni fi bere a edi kan a yare no ho sɛnkyerɛnne no fii ase?
• So saa sɛnkyerɛnne ahorow yi ntumi mfi hɔ denam mene, mframa a wɔde fa mu (akisikuru), anaa dwensɔtwaa a obi bɛkɔ so no so?
• So saa sɛnkyerɛnne ahorow yi ne ɛyaw a akisikuru mu abo (biliary colic) anaa akisikuru mu yaw afoforo de ba no nni abusuabɔ?

Sɛ nnuruyɛfo si so dua sɛ wowɔ aduan a ɛnyɛ yiye (dyspepsia) wie a, wɔbɛhwehwɛ honam fam ade a ɛde ba (e.g., akuru, ɔyare mmoawa). Ebia wɔbɛyɛ sɔhwɛ ahorow te sɛ eyinom:

• Mogya mu nhwehwɛmu: Hwɛ sɛ ɔyare mmoawa ne tebea horow a ɛtaa ba anaa.
• Ɔhome mu nhwehwɛmu: Sɛ nhwɛso no, urea home nhwehwɛmu no betumi ahwɛ sɛ ɔyare mmoawa H. pylori wɔ hɔ anaa. Hydrogen home sɔhwɛ no betumi ahwɛ sɛ mmoawa nyin wɔ ɔkwan a ɛnteɛ so wɔ dwensɔtwaa no mu anaa.
• Gastric emptying studies: Hwɛ sɛnea aduan fi wo yafunu mu kɔ dwensɔtwaa ketewa no mu ntɛmntɛm/brɛoo.
• Upper endoscopy: Wɔde afiri teateaa bi fa ano no mu de hwɛ yafunu no mu, esophagus , ne dwensɔtwaa ketewa no fã a edi kan. Wɔyɛ eyi de hwɛ sɛ biribi a ɛyɛ soronko te sɛ akuru bi wɔ hɔ anaa. Sɛ ɛho hia a, wobetumi afa ntini ketewaa bi (biopsy) akɔyɛ mu nhwehwɛmu.

Dɛn ne ayaresa a wɔde sa eyi?

Sɛ nhwehwɛmu ahorow da biribi a ɛde ba adi (sɛ nhwɛso no, mmoawa a nyin boro so, ɔhaw a ɛma obi tumi keka ne ho) a, wo duruyɛfo no bedi kan asa saa. Nanso, mpɛn pii no, bere a woasa saa nneɛma a ɛde ba yi akyi mpo no, wo ``Functional Dyspepsia'' ho sɛnkyerɛnne no nkɔ koraa. Enti, wo duruyɛfo bɛkyerɛ ayaresa afoforo a ɛbɛboa ma woadi wo sɛnkyerɛnne ahorow no so. Mpɛn pii no eyi yɛ ayaresa ahorow pii a wɔaka abom .

Nnuru bi a wɔde yɛ ``Functional Dyspepsia``:

• Sɛ ɔyare mmoawa bi wɔ hɔ a , wɔkyerɛw nnuru a ekum ɔyare mmoawa ma .
• Prokinetics yɛ nnuru a ɛkanyan aduan mu ntini no ma ɛkɔ baabiara.
• Nnuru a ɛtew yafunu mu acid so: proton pump inhibitors (PPIs) (e.g. omeprazole) anaa H2 blockers (e.g. Ranitidine).
• Tricyclic nnuru a wɔde kum adwenemhaw a wɔde di dwuma kakraa bi na ama ntini ahorow no adwo na ɛtew ɛyaw so (ɛwom sɛ eyinom yɛ nnuru a wɔde ma adwenemhaw de, nanso wɔde di dwuma kakraa bi nso ma tebea horow a ɛte sɛɛ).

Nea ɛka ho no, akwan horow a wɔfa so sa nnuru a wɔde boa ne nea wɔde si ananmu nso wɔ hɔ:

• Nnuru a wɔde afifide yɛ: Sɛ nhwɛso no, nnuru a wɔde yɛ aduru a peppermint ne caraway ngo wom, anaasɛ nhabannuru a wɔde afra te sɛ Iberogast® (ɛho behia sɛ wubisa wo duruyɛfo sɛ eyinom wɔ Sri Lanka anaa).
• Adwene ne nipadua ahomegye ayaresa ahorow:Adwendwene, yoga, biofeedback (ɔkwan a wɔfa so hu nipadua no dwumadi na wosua sɛnea wobedi so), adwene mu ayaresa.
• Nsakrae a ɛba aduan mu: Hu nnuan a ɛnyɛ papa mma wo na ɛrema wo sɛnkyerɛnne no ayɛ kɛse denam ``Elimination diet`` a wobɛyɛ (a wubegyae na woahwɛ aduan kuw biako bere koro mu) na woayɛ nsakrae wɔ wo da biara da aduan mu sɛnea ɛfata.
• Acupuncture: Nhwehwɛmu ahorow bi ada no adi sɛ saa kwan yi nso ma ahotɔ kakra.

Sɛ wowɔ `(Functional Dyspepsia)` a, dɛn na ɛba? Dɛn na wubetumi ahwɛ kwan?

Wɔ nnipa pii fam no, Functional Dyspepsia yɛ tebea a enni sabea a ɛsan ba bio wɔ wɔn nkwa nna nyinaa mu. Ebetumi agye bere kakra, ne sɔhwɛ ne mfomso kakra, na woahu ayaresa ne suban ahorow a ɛyɛ adwuma ma wo na ɛtew wo sɛnkyerɛnne ahorow so. Ebia wubenya ahotɔ kakra, nanso ebia ɛrenkɔ koraa. Nanso, nea ɛho hia sen biara no, ɛnyɛ aniberesɛm. Enti mma ɛnhaw wo.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Akyinnye biara nni ho sɛ ɛsɛ sɛ wohwehwɛ aduruyɛ mu afotu sɛ wowɔ:

• Sɛ wonnya nyɛɛ wo ho nhwehwɛmu sɛ wowɔ nyarewa a ɛwɔ digestive system mu a.
• Sɛ wo yare no ho sɛnkyerɛnne sesa anaasɛ ɛda adi pefee sɛ ɛyɛ kɛse a.
• Sɛ wotaa fe a.
• Sɛ wo mu duru so retew a ntease biara nnim a.

Esiane sɛ wonni nea ɛde ba pefee anaasɛ ayaresa pɔtee biara nti, ``Functional Dyspepsia'' a wobehu no betumi ayɛ basaa kakra ama wɔn a wɔrehwehwɛ mmuae no. ``Functional GI disorders'' yɛ nea ɛyɛ den kakra. Ɛfa w’amemene, wo ntini ahorow, w’aduan, w’asetra kwan, ne ɛtɔ mmere bi mpo a nneɛma a ɛde ba wɔ wo nipadua mu ho. Ɛno nti na ebetumi ayɛ den kakra sɛ wobedi wɔn ho dwuma no.

Aduruyɛ mu nhwehwɛmu betumi aboa ma wɔahu nneɛma bi a ɛde ba na wɔayi afi hɔ. Nanso awiei koraa no, wo nkutoo na wubetumi ate nea ɛma wo sɛnkyerɛnne ahorow no yɛ yiye ne nea ɛma ɛyɛ kɛse no ase ankasa. Bere a wosɔ ayaresa ahorow hwɛ na wuhu nea ɛkanyan wo no, wubehu w’ankasa ɔkwan soronko a wobɛfa so de Functional Dyspepsia atra ase.

Fa nkrasɛm kɔ fie

• ``(Functional Dyspepsia)`` yɛ ɔhaw ankasa a wote nka. Ɛnyɛ "wɔ w'adwene mu kɛkɛ."
• Wɔnam yare no ho sɛnkyerɛnne ahorow a wodi so, a asetra mu nsakrae, aduan a wodi, ne ebia nnuru betumi aboa no so di eyi ho dwuma.
• Ɛho hia yiye sɛ wo ne oduruyɛfo yɛ adwuma. Ka wo yare no ho sɛnkyerɛnne, nea wote nka, ne nea woasɔ ahwɛ no ho asɛm pefee.
• Mma anidasoɔ nnyae. Nnipa pii nya akwan a wɔbɛfa so de tebea yi atra ase yiye. Ɛnyɛ wo nko ara!

` Functional dyspepsia, aduan a ɛnyɛ yiye, yafunu mu yaw, ahurututu, koko mu ɔfe, aduan mu nhyehyɛe, adwennwen