He lāʻau lapaʻau no ka mumū o ka ʻōpū a me ka gastritis! E aʻo pono kākou e pili ana i nā Proton Pump Inhibitors (PPIs)!

Loaʻa pinepine iā ʻoe ka ʻeha puʻuwai a i ʻole ka ʻeha umauma? A i ʻole ua ʻōlelo ke kauka "gastritis"? ʻO kahi ʻano lāʻau lapaʻau a nā kauka e kuhikuhi pinepine ai i ia mau hihia ua kapa ʻia ʻo `(Proton Pump Inhibitors)`. Inā mākou e ʻōlelo pololei, e kapa paha mākou ia he "lāʻau lapaʻau no ka gastritis." No laila, i kēia lā e kamaʻilio mākou e pili ana i `(Proton Pump Inhibitors)` a i ʻole PPIs no ka pōkole.

No ke aha mākou e pono ai i kēia mau PPI? He aha ka mea e hana ʻia i ka waikawa o ka ʻōpū?

I ka ʻōlelo maʻalahi, ʻo `(Proton Pump Inhibitors)` he ʻano lāʻau lapaʻau e hōʻemi ana i ka nui o ka waikawa i hana ʻia i loko o kou ʻōpū, ʻo ia hoʻi, ka nui o ka waikawa ʻōpū . I kēia manawa ke noʻonoʻo nei paha ʻoe, "Auē, he aha ke kumu o ka waikawa ʻōpū? ʻAʻole maikaʻi." ʻAʻole ia he ʻoiaʻiʻo. He mea nui loa ka waikawa ʻōpū no ko kākou kino. ʻO kēia waikawa ke kōkua iā kākou e hoʻoheheʻe i ka meaʻai a kākou e ʻai ai. ʻAʻole wale ia, akā kōkua pū kēia waikawa ʻōpū i ka luku ʻana i nā germs ʻino a kākou e ʻai ai me ka ʻike ʻole.

Eia nō naʻe, i kekahi manawa hoʻomaka nā pilikia ke piʻi nui ka nui o ka waikawa o ka ʻōpū, a i ʻole ke hele ka waikawa i kahi ʻokoʻa ma mua o ka mea e pono ai. Ua like ia me ka ʻōlelo "Inā piʻi ia, e make ka nectar." ʻO ia ka manawa e hiki ai ke ulu nā ʻōpū ʻeha (`ulcers`), a i ʻole e like me kā mākou e kapa nei iā lākou, "gastritis ulcers". Hiki ke loaʻa nā mea ʻē aʻe e like me ka heartburn a me ka ʻono ʻawaʻawa i ka puʻu. ʻO ia ka manawa e kōkua ai kēia mau lāʻau i kapa ʻia ʻo PPI iā mākou. Hoʻohana kūikawā ʻia lākou no nā pilikia lōʻihi e pili ana i ka waikawa o ka ʻōpū.

He aha ke ʻano o nā maʻi e hoʻohana ʻia ai kēia mau PPI?

Hoʻohana nui nā kauka i kēia ʻano lāʻau lapaʻau (Proton Pump Inhibitors) e mālama i nā kūlana e like me ka hōʻino a me ka mumū i nā ʻāpana o kā mākou ʻōnaehana hoʻoheheʻe, ʻo ia hoʻi nā ʻōpū a me ka esophagus, i hoʻokumu ʻia e ka waikawa ʻōpū. E nānā kākou i ke ʻano o lākou:

• ʻO GERD a i ʻole ka maʻi Reflux Acid Mau Loa: Loaʻa pinepine iā ʻoe ka ʻāʻī? He ʻono ʻawaʻawa kou i loko o kou puʻu? ʻO ia ka GERD. I ka ʻōlelo maʻalahi, ʻo ia ka waikawa i loko o kou ʻōpū e piʻi aʻe i loko o kou esophagus. Hiki i kēia ke hōʻino i ka uhi o kou esophagus, i kapa ʻia hoʻi he erosive esophagitis. Hana nā PPI ma ka hōʻemi ʻana i ka hana ʻana o ka waikawa ʻōpū a hāʻawi i kou esophagus i ka manawa e ho'ōla ai.
• ʻO nā ʻōpū peptic a me duodenal: ʻO nā ʻōpū ʻōpū a me duodenal he mau ʻōpū i hiki ke hana ʻia e ka waikawa ʻōpū, hiki ke hōʻino i ka uhi pale o ka ʻōpū. Hiki iā lākou ke hana i nā ʻōpū ma ka ʻāpana mua o ka ʻōpū liʻiliʻi (i kapa ʻia ʻo duodenum). Hiki i nā PPI ke kōkua i ka ho'ōla ʻana i kēia mau ʻōpū. Eia kekahi, ʻo kekahi mau mea hoʻomaha ʻeha, ʻoiai nā lāʻau anti-inflammatory nonsteroidal (NSAID), e pili ana me ka hoʻonui ʻia o ka pilikia o ka ulu ʻana o nā ʻōpū. Hōʻike nā haʻawina e pili ana i ka 30% o ka poʻe e lawe mau ana i nā NSAID e ulu i nā ʻōpū. Hiki i nā PPI ke kōkua i ka pale ʻana a me ka ho'ōla ʻana i nā ʻōpū.
• Ka maʻi H. pylori:He ʻano bacteria kēia e hiki ke noho i loko o ko kākou ʻōpū. Hiki i kēia bacteria ke hana i nā ʻōpū ʻōpū. I ka mālama ʻana i kahi maʻi H. pylori, hāʻawi nā kauka i nā PPI me nā antibiotics. ʻO kēia no ka mea hoʻololi nā PPI i ka pae pH o ka ʻōpū, e maʻalahi ai i nā antibiotics ke pepehi i nā bacteria.
• ʻO ka maʻi Zollinger-Ellison: He maʻi laha ʻole kēia. Ma kēia maʻi, ulu kekahi mau ʻano puʻupuʻu (`puʻupuʻu`) i loko o ke kino a hoʻoulu i ke kino e hana i ka nui o ka hormone e hoʻoulu ai i ka waikawa ʻōpū. ʻO ka hopena, nui loa ka waikawa ʻōpū. Hoʻohana ʻia nā PPI e mālama i kēia maʻi.

Pehea e hana ai kēia mau lāʻau i kapa ʻia ʻo PPI? He mea kupaianaha ia, ʻeā?

E noʻonoʻo ʻoe aia kahi "mīkini" liʻiliʻi i loko o ko kākou ʻōpū e hana ana i ka waikawa. Kāhea mākou i kēia mīkini ʻo ka "pamu hydrogen-potassium ATPase", a i ʻole ka "pamu proton" no ka pōkole. E like me ka huki ʻana o ka pamu wai i ka wai i luna, ʻo kēia pamu proton ka mea e hana i ke kaʻina hana kemika e pono ai e hana i ka waikawa ʻōpū.

No laila, ʻo ka mea a kēia mau `(Proton Pump Inhibitors)` a i ʻole PPIs e hana ai , ʻo ia ke hoʻōki i ka hana o ka pamu proton no kekahi manawa . ʻO ia hoʻi, "kāohi" lākou iā ia, ʻo ia hoʻi, ke hoʻopilikia nei lākou iā ia. A laila emi ka hana ʻana o ka waikawa o ka ʻōpū.

Akā, ʻaʻole kēia e hoʻōki loa i ka hana ʻana o ka waikawa ʻōpū, ʻeā? Loaʻa iā ʻoe ka nui o ka waikawa e koe e hoʻoheheʻe i ka meaʻai. Inā ʻoe e lawe i ka PPI no kahi o ʻelima mau lā i ka lālani, e hoʻemi ʻia ka hana ʻana o ka waikawa ʻōpū ma kahi o 65%. ʻO ke koena o 35% o ka waikawa ua lawa ia e hoʻoheheʻe i ka meaʻai.

He aha kēia mau PPI?

Hiki ke kūʻai ʻia kekahi o kēia mau PPI ma luna o ke kūʻai aku (OTC) ma ka hale kūʻai lāʻau me ke kauoha ʻole ʻia, akā ʻo kekahi o nā mea ikaika aʻe e pono ai ke kauoha mai ke kauka (Rx wale nō).

Nā PPI hiki ke lawe ʻia me a i ʻole me ke kauoha a ke kauka (OTC a me Rx):

• ʻEsomeprazole (Nexium®)
• ʻO Lansoprazole (Prevacid®)
• ʻOmeprazole (Prilosec®)
• ʻOmeprazole/sodium bicarbonate (Zegerid®)

Nā PPI i loaʻa wale me ke kauoha a ke kauka (Rx wale nō):

• ʻO Dexlansoprazole (Dexilant®)
• Pantoprazole (Protonix®)
• ʻO Rabeprazole (AcipHex®)

Pehea e lawe ai au i kēia lāʻau lapaʻau? ʻEhia ka nui e pono iaʻu e lawe?

Loaʻa kēia mau lāʻau lapaʻau ma ke ʻano papa a i ʻole capsule. Lawe ʻoe iā lākou ma ka waha. Loaʻa i kekahi ʻano capsules kahi pauka hiki ke hoʻohui ʻia i loko o ka meaʻai, e like me ka applesauce, a laila lawe ʻia. He kōkua nui kēia no ka poʻe pilikia i ka ale ʻana i nā pila.

Ma mua o ka lawe ʻana i ka lāʻau lapaʻau, pono ʻoe e heluhelu pono i nā kuhikuhi ma ka pūʻolo.ʻO ia ka manawa e loaʻa ai iā ʻoe nā hopena pololei loa. Aia kekahi mau PPI āu e lawe ai i ka hapalua hola a i ʻole hoʻokahi hola ma mua o ka ʻai ʻana, ma ka ʻōpū ʻole. Ke lawe ʻoe iā lākou i kēlā manawa, loaʻa i ka lāʻau ka manawa e hana ai ma mua o ka hoʻomaka ʻana o kou ʻōpū e hana i ka waikawa ke ʻai ʻoe.

ʻO kāu kauka wale nō ke haʻi pololei iā ʻoe i ka nui o ka lāʻau lapaʻau āu e pono ai ('dose`) a me ka nui o nā manawa o ka lā e pono ai ʻoe e lawe. E kuhikuhi ʻo ia i kahi mahele lāʻau e kāohi i kāu mau hōʻailona me ka liʻiliʻi o ka hiki ke loaʻa nā hopena ʻaoʻao. No kekahi poʻe, ua lawa ka lawe ʻana i hoʻokahi pila ma mua o ka ʻaina kakahiaka. No kekahi poʻe, ua lawa paha ka lawe ʻana i ʻelua manawa i ka lā, ma mua o ka ʻaina kakahiaka a ma mua o ka ʻaina ahiahi. I kekahi manawa, ua lawa paha ka lawe ʻana i kēlā me kēia lā ʻē aʻe.

I ka hala ʻana o ka manawa, pono paha ʻoe e hōʻemi i ka nui o kāu lāʻau lapaʻau. E aʻo aku kāu kauka iā ʻoe no kēia.

ʻEhia ka lōʻihi e hana ai kēia mau PPI?

Ma hope o ka lawe ʻana i ka lāʻau PPI, hiki ke hala i 24 mau hola a ʻehā mau lā e ʻike ai i kona hopena piha.

Inā loaʻa koke iā ʻoe ka ʻeha puʻuwai a i ʻole ka ʻeha umauma a pono ʻoe i ka hoʻomaha wikiwiki, ʻoi aku ka maikaʻi o ka hoʻohana ʻana i kahi antacid (e like me Digene, Acidex) a i ʻole kahi mea pale histamine (H2 blocker) (e like me Pepcid® a i ʻole Tagamet®) ma mua o nā PPI. E noʻonoʻo e loaʻa koke iā ʻoe ka ʻeha puʻuwai ma hope o ka ʻai ʻana i kahi meaʻai ʻala. A laila, ʻo ka lawe ʻana i ia lāʻau lapaʻau e hāʻawi i ka hoʻomaha i loko o kekahi mau minuke a i ʻole kekahi mau hola. Eia naʻe, ʻaʻole mau kona hopena e like me nā PPI.

ʻOi aku ka maikaʻi o nā PPI inā loaʻa iā ʻoe nā pilikia waikawa ʻōpū lōʻihi a mau loa.

Aia kekahi mau hopena ʻaoʻao i ka wā e hoʻohana ai i kēia mau PPI?

ʻAʻohe pilikia nui o ka hapa nui o ka poʻe i ka wā e lawe ana i nā PPI. Eia naʻe, e like me nā lāʻau lapaʻau āpau, hiki iā lākou ke hana i kekahi mau hopena ʻaoʻao. ʻO kēia mau mea:

• ʻeha ka ʻōpū
• Ka paʻa ʻana o ka ʻōpū
• Ka maʻi pākī
• Pōʻino
• Waha maloʻo
• Nā ʻeha poʻo
• kuni
• Pehu/Kinoea
• Māmā ke poʻo
• ʻO ka maneʻo a me ka ʻulaʻula
• Ka luaʻi ʻana

ʻOiai ua manaʻo ʻia he palekana nā PPI, ua ʻike nā kānaka noiʻi hiki iā lākou ke hoʻopilikia i kekahi mau pilikia, ʻoiai ke hoʻohana ʻia no ka manawa lōʻihi . E nānā kākou i ke ʻano o lākou:

• ʻO ka maʻi Clostridioides difficile (C. diff): Hiki i nā PPI ke hoʻololi i ke kaulike ma waena o nā bacteria maikaʻi a maikaʻi ʻole i loko o kou ʻōpū, e hoʻonui ana i kou pilikia o ka hoʻomohala ʻana i nā maʻi e like me C. diff.
• Nā Haʻihaʻi: Hiki i nā PPI ke hōʻemi i ka hiki o kou kino ke omo i ka calcium, kahi mineral e kōkua ai i ka hoʻoikaika ʻana i ko mākou mau iwi. Ua ʻōlelo ka U.S. Food and Drug Administration (FDA) e hoʻonui paha nā PPI i ka pilikia o nā haki ma ka ʻūhā, ka pulima, a i ʻole ka iwi kuamoʻo.
• Maʻi puʻupaʻa:Hiki i kēia ke hoʻonui i ka pilikia o ka hoʻomohala ʻana i ka maʻi puʻupaʻa mau loa (CKD), a i ʻole e hoʻonui i nā kūlana e kū nei.
• Ka nele i ka meaʻai: Hiki i nā PPI ke hōʻemi i ka hiki o kou ʻōpū liʻiliʻi ke omo i ka magnesium a i ʻole ka huaora B12. He mineral ka magnesium e kōkua i ko mākou mau ʻiʻo a me nā aʻalolo e hana pono. He mea nui ka Vitamin B12 no kā mākou ʻōnaehana nerve a me nā hunaola koko ʻulaʻula.

Ke aʻo ʻia nei ka pilina ma waena o nā PPI a me kēia mau mea pilikia. Eia nō naʻe, ʻōlelo pinepine nā kauka e hoʻohana i ka mahele haʻahaʻa loa a no ka manawa pōkole loa a hiki i ka hoʻomaikaʻi ʻana o kāu mau hōʻailona. E hōʻemi kēia i ka pilikia o kēia mau mea pilikia.

Āhea wau e ʻike ai i kaʻu kauka?

Inā ua kuhikuhi ke kauka i nā PPI nou, e ʻoluʻolu e nīnau i kāu kauka inā he mau nīnau kāu e pili ana i ka lawe ʻana i ka lāʻau lapaʻau, i ka wā e hoʻōki ai, a pehea e hōʻemi ai i ka nui.

Inā ʻoe e lawe ana i nā PPI ma luna o ke kūʻai aku mai kahi hale kūʻai lāʻau lapaʻau a manaʻo ʻoe e pono ana ʻoe iā lākou i kēlā me kēia lā e kāohi i kāu mau hōʻailona, ​​​​pono ʻoe e ʻike i ke kauka. Hiki iā ia ke aʻo iā ʻoe i ka nui pololei a me ka lōʻihi o ka manawa e lawe ai ʻoe i ka lāʻau.

Eia kekahi, inā loaʻa iā ʻoe kekahi o kēia mau hopena ʻino, e ʻike koke i ke kauka:

• Ka hopena maʻi (ʻili ʻulaʻula, pehu, ʻili palahalaha)
• Nā hōʻailona o ka hōʻino ʻana o nā puʻupaʻa (mimi liʻiliʻi ma mua o ka wā ma mua, pehu ʻana i nā lima a me nā wāwae, nā kuʻekuʻe wāwae)
• Nā hōʻailona o ka nele o ka magnesium (haʻalulu, puʻuwai puʻuwai kūpono ʻole, ʻūlū ʻana o nā ʻiʻo)
• Nā hōʻailona o ka nele o ka vitamin B12 (ʻeha ma nā lima a me nā wāwae, ka numbness, ke kani ʻana, ka dizziness, ka huikau)
• Inā ʻulaʻula ka ʻili, pehu, a i ʻole e like me ka ʻili ʻana
• Inā loaʻa iā ʻoe ka maʻi diarrhea nui
• Inā loaʻa iā ʻoe ke kuni

No laila, he aha ka leka hope loa e lawe ai i ka home?

ʻO ka nui o ka waikawa o ka ʻōpū, a i ʻole ke kau ʻana ma kahi kūpono ʻole, hiki ke ʻeha loa. Hiki iā ia ke hōʻino i kāu ʻōnaehana hoʻoheheʻe. ʻO ka mea pōmaikaʻi, he nui nā lāʻau lapaʻau e hiki ke kōkua inā loaʻa iā ʻoe kēia mau hōʻailona.

No ka hōʻoluʻolu pōkole, ʻoi aku ka maikaʻi o ka antacid a i ʻole ka H2 blocker. Akā inā loaʻa pinepine kou ʻeha puʻuwai a i ʻole he ʻōpū ʻōpū, hiki i kāu kauka ke kuhikuhi i kahi ʻano PPI. Ua mau kēia mau lāʻau lapaʻau no nā makahiki a ua manaʻo ʻia he lāʻau palekana a maikaʻi hoʻi. Loaʻa i ka nui o ka poʻe ka hōʻoluʻolu me kēia mau lāʻau lapaʻau.

ʻO ka mea nui loa, ʻo ia ka hoʻohana ʻana i kēia lāʻau lapaʻau ma lalo o ke aʻo a ke kauka, ma ke ʻano i kuhikuhi ʻia a no ka manawa i kuhikuhi ʻia.Inā ʻoe e hoʻāʻo e hoʻohana iā ia e like me kou makemake, hiki ke kū mai nā pilikia. No laila, he mea naʻauao ke hoʻolohe mau i ka ʻōlelo a ke kauka a lawe i ka lāʻau lapaʻau e like me ia.

ʻO nā PPI, gastritis, mumū o ka ʻōpū, reflux waikawa, ʻōpū ʻeha, omeprazole, pantoprazole