So gastrin dɔɔso dodo wɔ wo yafunu mu? Momma yɛnka (Hypergastrinemia) ho asɛm!

So wotaa te nka sɛ wo yafunu mu yɛ wo yaw, wo ho ayɛ wo ma, anaa aduan mu haw afoforo? Ɛtɔ da bi a nea enti a ɛte saa no betumi ayɛ sɛ hormone bi a wɔfrɛ no `(Gastrin)` a ɛba wo nipadua mu no dɔɔso sen sɛnea ɛte daa. Ɛnnɛ, yɛbɛka saa tebea yi a wɔfrɛ no `(Hypergastrinemia)` ho asɛm kɔ akyiri na ɛnyɛ den koraa.

Dɛn ne `(Hypergastrinemia)`? Momma yɛnte ase pɛpɛɛpɛ!

Sɛ yɛbɛka no tiawa a, `(Hypergastrinemia)` kyerɛ sɛ `(Gastrin)`, hormone bi a ɛboa yɛn nipadua ma ɛyam aduan no dodow dɔɔso sen sɛnea ɛho hia. Saa `(Gastrin)` hormone yi nam nkwammoaa soronko bi a ɛwɔ yafunu fasu a ɛwɔ yɛn yafunu no ase, kyerɛ sɛ, ɛbɛn dwensɔtwaa ketewa no so na ɛyɛ. Yɛfrɛ eyi `(G nkwammoaa)`.

Afei hwɛ, saa `(Gastrin)` hormone yi ne nea ɛka kyerɛ yɛn yafunu sɛ, "Okay, afei yi acid fi mu." Saa yafunu mu acid yi, kyerɛ sɛ `(gastric acid) ho hia yɛn yiye. Efisɛ, saa yafunu mu acid yi boa yɛn ma yɛyam aduan a yedi na yɛtwe aduannuru a ɛwɔ saa aduan no mu, sɛ nhwɛso no `(amino acids)` ne proteins.

Nanso, nea ebetumi asi wɔ `(Hypergastrinemia)` ho no yɛ nea ɛyɛ den kakra. Ɛtɔ da bi a ebetumi ama yafunu mu acid pii (`hyperchlorhydria`), na ɛtɔ da bi nso a ebetumi ama yafunu mu acid kakraa bi aba (`hypochlorhydria`). Enti sɛnea `(Hypergastrinemia)` ka wo no gyina ayaresa tebea afoforo a wowɔ, oprehyɛn a woayɛ, ne nnuru a worenom so.

Hena na ɛda adi sɛ obenya saa tebea yi?

Nokwarem no, saa tebea yi a wɔfrɛ no ``Hypergastrinemia'' betumi aba obiara so, a mfe anaa ɔbarima anaa ɔbea mfa ho. Enti, eye sɛ yɛn nyinaa behu eyi.

Dɛn ne nneɛma a ɛde `(Hypergastrinemia)` ba?

Nneɛma pii betumi de saa tebea yi aba, a nea ɛka ho ne ``Hypergastrinemia.'' Nneɛma bi ma yafunu mu acid a ɛba no so tew, bere a afoforo ma yafunu mu acid a ɛba no yɛ kɛse. Momma yɛnhwɛ abien no wɔ ɔkwan soronko so.

Nneɛma a ɛde yafunu mu acid a ɛso tew ba

Sɛ ``Hypergastrinemia`` ba a, yafunu mu acid a wɔyɛ no sɛnea ɛsɛ no so betumi atew esiane saa nneɛma yi nti:

• Nnuru a ɛko tia komayare anaa GERD (Gastroesophageal Reflux Disease): Sɛ wode nnuru ahorow yi redi dwuma bere nyinaa a , ɛno nso betumi ayɛ nea ɛde ba.
• Chronic atrophic gastritis: Eyi ne bere a yafunu no fasu no yɛ mmerɛw nkakrankakra na bere kɔ so no, ɛyɛ hyew.
• Kokoram a ɛwɔ akyi berɛmo mu: Eyi nso betumi aka.
• `(H. pylori)` yareɛ: `(Helicobacter pylori)` yɛ mmoawa a wɔtumi tena yafunu mu. Saa ɔyare mmoawa yi nso de `(Hypergastrinemia).` ba
• Asaabo a entumi nyɛ adwuma yiye: Saa tebea yi betumi aba bere a asaabo no ntumi nyɛ adwuma yiye no.
• Proton Pump Inhibitors (PPIs) a Wɔde Di Dwuma:PPI nnuru (te sɛ omeprazole) a wɔde di dwuma bere tenten ma yafunu mu yare, acid a ɛsan kɔ nipadua no mu, aduan a wontumi nwe, anaa yafunu mu akisikuru nso yɛ ade titiriw a ɛde ba.
• Vagotomy: Eyi hwehwɛ sɛ woyi vagus ntini no fã bi fi hɔ. Saa ntini yi fi amemene no mu kɔ yafunu no mu na ɛde nsɛnkyerɛnne kɔ koma ne aduan mu. Hypergastrinemia betumi aba wɔ oprehyɛn yi akyi.

Nneɛma a ɛde yafunu mu acid a ɛkɔ soro ba

Afei ma yɛnhwɛ nea ɛma yafunu mu acid a ɛkɔ soro (Hypergastrinemia):

• Antral G-cell hyperplasia (pseudo-Zollinger-Ellison syndrome / Ps-ZES): Eyi yɛ tebea a ɛntaa nsi. Ɛte sɛ Zollinger-Ellison yare no, nanso akisikuru biara nni dwensɔtwaa anaa dwensɔtwaa ketewa (duodenum) no fã a edi kan no mu a ɛma gastrin.
• Gastric outlet obstruction: Saa tebea yi betumi aba bere a ɔkwan a efi yafunu no mu kɔ dwensɔtwaa ketewa no mu no asiw no. Fa no sɛ nsu paipu a asiw.
• Multiple endocrine neoplasia type-1 (MEN-1): Saa tebea yi ma neuroendocrine akisikuru ba wɔ adrenal ntini, thyroid ntini, anaa parathyroid ntini mu.
• Retained antrum syndrome: Sɛ wogyaw yafunu no ase fã ketewaa bi (antrum) wɔ oprehyɛn akyi de yi akisikuru anaasɛ wɔde sa akuru a.
• Zollinger-Ellison syndrome (ZES): Eyi yɛ tebea a ɛma akisikuru yɛ hormone gastrin boro so. Saa tebea yi (ZES) betumi ama yafunu mu akuru aba.

Dɛn ne tebea `(Hypergastrinemia)` no ho sɛnkyerɛnne?

Sɛ wowɔ `(Hypergastrinemia)` a, wobɛtumi anya sɛnkyerɛnne te sɛ:

• Yafunu mu yaw: Ebia wo yafunu mu yɛ wo yaw mpɛn pii.
• Atiridiinini a enni sabea: Atiridiinini a ɛtra hɔ nna pii.
• Pancreatic tumors: Eyinom betumi ayɛ kokoram anaasɛ akisikuru a ɛnyɛ hu.
• Yafunu mu akuru: Akuru a ɛba bere a yafunu no ho ayɛ hyew.
• Esophagitis a emu yɛ den: Ɔfe a emu yɛ den ne ɛyaw a ɛba aduan mu.

Ɔkwan bɛn so na nnuruyɛfo hu saa tebea yi?

Sɛnea ɛbɛyɛ na nnuruyɛfo ahu hypergastrinemia pɛpɛɛpɛ no, ɛsɛ sɛ wohu acid dodow a wo yafunu no reyɛ. Wɔsan nso susuw gastrin dodow a ɛwɔ wo mogya mu.

• Ansa na nhwehwɛmu yi reba no, wo duruyɛfo bɛka akyerɛ wo sɛ di mmuada (nnnidi) bere pɔtee bi .
• Afei nso, sɛ woyɛ ``(PPI)`` dwumadiefoɔ a, .Ɛho behia sɛ wugyae saa aduru no nom bɛyɛ dapɛn biako ansa na wɔayɛ nhwehwɛmu no.
• Afei, wɔfa wo mogya no bi na wɔhwɛ sɛnea wo Gastrin dodow te. Ɛtɔ da bi a, wobetumi agye saa mogya yi mpɛn pii da biara, wɔ nna pii mu, de ahwɛ sɛ wo Gastrin dodow sesa anaa.

Sɛ wo duruyɛfo susuw sɛ hypergastrinemia a, obetumi ahyɛ sɛ wɔnyɛ nhwehwɛmu foforo na ama wɔayi tebea afoforo afi hɔ, a nea ɛka ho ne:

• Secretin stimulation test: Nea ɛka eyi ho ne sɛ wɔde hormone bi a wɔfrɛ no secretin a wo dwensɔtwaa ketewaa no fã a edi kan (duodenum) na ɛyɛ no bɛhyɛ wo mu. Sɛ wo gastrin dodow kɔ soro mpofirim kɛse a, ebetumi ayɛ Zollinger-Ellison yare no ho sɛnkyerɛnne.
• Yafunu mu pH nhwehwɛmu: Eyi hwɛ acid dodow a ɛwɔ wo yafunu mu. Sɛ pH no nnu 2 a, ebetumi nso ayɛ Zollinger-Ellison yare no ho sɛnkyerɛnne.

Ɔkwan bɛn so na wɔsa Hypergastrinemia?

Ayaresa a wɔde sa hypergastrinemia no gyina nea ɛde ba no so.

• Colon kokoram, esophageal a ɛsiw, asaabo mu yare, ne tebea horow te sɛ `(MEN-1)` ne `(ZES)`: Sɛ wɔsa saa tebea horow yi (mpɛn pii no ɛnam oprehyɛn so) a, `(Hypergastrinemia)` ho sɛnkyerɛnne nso gyae.
• Atrophic gastritis (ACG) ne H. pylori yare mmoawa: Wobetumi de nnuru a ekum ɔyare mmoawa asa tebea horow yi.
• Proton-pump inhibitors (PPIs): Sɛ worenom PPI a, mpɛn pii no hypergastrinemia no befi hɔ wɔ nnanu kosi ason mu bere a woagyae aduru no akyi.
• Retained antrum syndrome: Sɛ woyi antral ntini a aka wɔ yafunu no ase no fi hɔ a, ebetumi atew yafunu mu acid a ɛboro so a ɛba no so.

Nea ɛho hia sen biara ne sɛ wo ne wo duruyɛfo bɛkasa afa ayaresa a eye sen biara a wobɛfa so ama wo tebea no ho.

So metumi atew asiane a ɛwɔ `(Hypergastrinemia)` mu no so?

Sɛ woyɛ obi a wode nnuru a ekum asikre anaa PPI di dwuma bere tenten a, asiane wɔ hɔ sɛ wubenya hypergastrinemia. Enti, ɛho hia sɛ wo ne wo duruyɛfo kasa fa sɛnea wubedi asiane yi ho dwuma ho.

Sɛ mewɔ `(Hypergastrinemia)` a, dɛn na metumi ahwɛ kwan? Sɛ wɔansa a, dɛn na ɛba?

Sɛ wɔansa hypergastrinemia yiye a, nipadua no mu gastrin dodow kɔ so yɛ kɛse. Nhwehwɛmufo susuw sɛ ebia eyi na ɛma kokoram nkwammoaa nyin. Nhwɛsoɔ:

• Mogya mu kokoram: te sɛ mogya mu kokoram, lymphoma, ne multiple myeloma.
• Kokoram a ɛwɔ aduan mu
• Kokoram a ɛwɔ dwensɔtwaa mu

Afei nso, bere tenten `(Hypergastrinemia)` betumi ama yafunu mu akisikuru `(yafunu mu carcinoids)` anaa `yafunu mu adenocarcinoma` aba. `(yafunu mu kokoram)` ahorow abien na ɛwɔ hɔ:

• Yafunu mu kokoram a ɛyɛ ɔkwan I: Eyinom ne tebea a ɛma yafunu mu yare a enni sabea no wɔ abusuabɔ.
• Ɛba mmea so kɛse.
• Wotumi hu no wɔ mmeae pii wɔ yafunu no mu.
• Hokwan a ɛwɔ hɔ sɛ obi benya kokoram no sua.
• Yafunu mu kokoram a ɛyɛ Type II: Eyinom ne tebea horow ZES ne MEN-1 wɔ abusuabɔ.
• Ebetumi aba mmarima ne mmea nyinaa so.
• Wotumi hu no wɔ mmeae pii wɔ yafunu no mu.
• Ɛtɔ da bi a ɛbɛtumi adan kokoram (ɛyɛ 7% kɔsi 12%).

Dɛn ne obi a ɔwɔ `(Hypergastrinemia)` no anidaso?

Daakye akwahosan tebea a obi a ɔwɔ ``Hypergastrinemia`` wɔ no gyina nneɛma pii so:

• Nea ɛde yare no ba.
• Awosu mu nneɛma.
• Akwahosan ho abakɔsɛm.
• Asetra kwan.

Nanso, sɛ wɔsa wɔn yare yie a, nnipa a wɔwɔ ``Hypergastrinemia'' no betumi atra ase a ɛyɛ nnam, a ɛfata.

Mewɔ `(Hypergastrinemia)`, mɛyɛ dɛn ahwɛ me ho?

Sɛ worenom nnuru a ekum asikre anaa PPI bere tenten a, ɛho hia sɛ wokɔ aduruyɛ mu nhwehwɛmu daa. Kɔ wo duruyɛfo nkyɛn kɔhwehwɛ afotu.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wuhu saa sɛnkyerɛnne foforo yi bi, anaasɛ wote nka sɛ wo sɛnkyerɛnne a ɛwɔ hɔ dedaw no reyɛ kɛse a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn na woakɔhwɛ wo koraa.

Nneɛma a ɛsɛ sɛ yɛkae wɔ tiawa mu

Okay afei, momma yɛnkae nea yɛkaa ho asɛm no ara kwa:

• Hypergastrinemia yɛ hormone gastrin a ɛkɔ soro wɔ nipadua no mu.
• Saa hormone yi (Gastrin) ka acid dodow a ɛwɔ yafunu no mu (acid betumi akɔ soro anaasɛ ɛso atew).
• Nneɛma pii betumi aba – nneɛma te sɛ `(PPI)`/antacids a wɔde di dwuma daa, `(H. pylori)` ɔyare mmoawa, yafunu mu yare, `(Zollinger-Ellison syndrome)`.
• Nnuruyɛfo hwehwɛ eyi denam ``Gastrin'' dodow a wɔsɔ hwɛ so.
• Ayaresa no gyina nea ɛde ba no so.
• Mmu w’ani ngu sɛnkyerɛnne ahorow no so, efisɛ sɛ wɔansa a, ebetumi abɛyɛ akisikuru ne kokoram! Hwehwɛ nnuruyɛfo afotu ntɛm ara.

Mewɔ anidaso sɛ wubehu sɛ mfaso wɔ saa nsɛm yi so. Kɔ so nya apɔwmuden!

` Hypergastrinemia, Gastrin, Yafunu mu acid, Nnuan a wɔyam, Zollinger-Ellison yare, H. pylori, PPI, Yafunu mu yare, Yafunu mu yare