Bɛlɛ we de inflamɛns? I kin bi ɔlsa na yu bɛlɛ! (Stomach Ulcer) Lɛ wi tɔk bɔt dis!

Sɔntɛnde yu kin gɛt wan strenj bɔn ɔ pen na yu bɛlɛ? I kin fil lɛk se yu bɛlɛ de kɔmɔt sɔmsay na yu chɛst? Ɔ yu nɔ kin fil fayn we yu bɛlɛ ful-ɔp we yu de it? Sɔntɛm dis na bikɔs ɔf ɔlsa na di bɛlɛ, dat na ɔlsa na di bɛlɛ . Nɔr wɔri, dis na wan sik wae kin afɛkt bɔrku pipul dɛm ɛn dɛn kin trit am. Lɛ wi tɔk bɔt dis ditayli ɛn simpul wan.

Wetin na bɛlɛ ɔlsa?

Fɔ tɔk am simpul wan, bɛlɛ ɔlsa na smɔl wata we de kɔmɔt na di layn na yu bɛlɛ. I tan lɛk se na wund we de na wi skin. Dis na wetin kin mek yu bɛlɛ shap shap pen, bɔku tɛm i kin kam wit bɔn ɔ sting . Bɔt nɔto ɔl di bɛlɛ ɔlsa kin mek pɔsin gɛt big big sayn dɛn, ɛn sɔm kin nɔ tɔk natin.

dis bכdi כlsa na wan kayn כlsa we de insay di big kכtכg we dεn kכl `pεptik כlsa sik`.

Aw kɔmɔn tin dɛn ya kin wund?

Infakt, dɛn bɛlɛ ɔlsa ya kin bɔku pas aw yu tink. Yu no wetin? Tu men tin dɛn de we kin mek dis apin, ɛn dɛn tu tin ya rili kɔmɔn na wi sosayti. Wan na sɔm pan di pen mɛrɛsin dɛn we wi kin bay bɔku tɛm na di famasi we wi kin bay na kɔt. di כda wan na baktri infεkshכn we dεn kכl `H. pylori` (Hɛlikɔbaktɔ paylɔri) . Dɛn tu ya kin mek lɛk naynti nayn pasɛnt pan di ɔlsa dɛn na di bɛlɛ.

Wetin na di sayn dɛm wae de sho se yu gɛt ɔlsa na yu bɛlɛ?

Di men sayn we de sho se yu gɛt ɔlsa na yu bɛlɛ na we yu bɛlɛ de pen. dis kin bi na di say we de bitwin yu bכdi εn yu ribkεj, sכmtεm na di lεft.

Dɛn kin fil dis pen difrɛn we dɛn:

• I tan lɛk we pɔsin de bɔn , lɛk asid we de bɔn insay di bɛlɛ .
• I kin tan lɛk se sɔntin de it yu bɛlɛ .

Dis filin nɔto jɔs filin. Wetin de rili apin na dat di bɛlɛ asid ɛn ɛnzaym dɛn we de na di bɛlɛ de mek di wund wɔs.

Bɔku pipul dɛn kin gɛt di sem tɛm we dɛn nɔ kin it fayn . Dis min se yu de fil se yu ful-ɔp wit yu bɛlɛ we yu de bɔn. Yu kin fil ful jɔs afta yu bigin it, ɔ yu kin fil ful fɔ lɔng tɛm afta yu dɔn it.

Di sayn dɛm wae ɔda pipul dɛm kin ripɔt na:

• Asid riflɔks ɛn at bɔn.
• Nɔs ɛn vɔmit.
• Bloating, belch, ɛn gas pen.

Bɔku tɛm, dɛn sayn ya kin gɛt fɔ du wit di tin dɛn we bin mek yu gɛt ɔlsa na yu bɛlɛ.

Silent injuries ɛn denja simptom dɛm

Bɔt, i sɔprayz fɔ no se sɔm pipul dɛn nɔ kin ivin no se dɛn gɛt dɛn bɛlɛ ɔlsa ya. Wi kin kɔl dɛn tin ya ‘saylent ɔlsa’. Yu nɔ go gɛt ɛni sayn atɔl, ɛn wantɛm wantɛm yu go gɛt siriɔs prɔblɛm lɛk we yu de blɔd ɔ we yu gɛt blɔd.Na we sɔntin lɛk dat kin apin nɔmɔ yu kin no.

If yu gɛt siriɔs kes lɛk dis, kip yu yay fɔ dɛn sayn ya:

• Pale skin kɔlɔ (pallor).
• Diziz, wik, ɔ fɔdɔm.
• If yu gɛt blak blɔd na yu stɔl (dis kin tan lɛk tar).
• If di vɔmit tan lɛk kɔfi grɔn.
• Wan bɛlɛ we kin at wantɛm wantɛm, we kin rili at ɛn we kin kɔntinyu fɔ at.

Impɔtant: If yu gɛt ɛni wan pan dɛn sik ya, yu fɔ go to dɔktɔ wantɛm wantɛm, okay? Dɛn tin ya kin bi sayn fɔ se pɔsin gɛt siriɔs sik.

Aw siriɔs di prɔblɛm dɛn we pɔsin kin gɛt we i gɛt ɔlsa na di bɛlɛ?

If dɛn nɔ trit am, ɔlsa na di bɛlɛ kin kam wit siriɔs prɔblɛm.

• Ɔlsa we de blɔd: Blɔd we de kɔmɔt frɔm ɔlsa kin smɔl ɔ i kin rili bad. If i kɔntinyu fɔ blɔd fɔ lɔng tɛm, anemia kin kam. If i blɔd bɔku wan tɛm, i kin mek pɔsin shɔk ɛn i kin mek i day.
• Ɔlsa we gɛt pɔt: Dis na tin we nɔ kin apin so ɔltɛm, bɔt na mɛdikal imejensi! if di bכdi wכl dכn pwεl εn wan ol de fכm, di bεlε asid εn baktri dεm kin lik kכmכt εn mek infεkshכn na di bכdi kכva. If dis infεkshכn spre to di bכdi, i kin mek yu gεt wan sik we rili denja, we de mek yu layf de pan denja we dεn kכl `sepsis` .

Wetin na di men tin dɛn we kin mek pɔsin gɛt ɔlsa na di bɛlɛ?

As wi bin dɔn tɔk, tu men rizin dɛn de:

1. `H. pylori` baktriyal infεkshכn:

H. pylori (Helicobacter pylori) na wan baktri we rili kɔmɔn. Na lɛk af pan di pipul dɛn na di wɔl gɛt dis bɔdi na dɛn bɛlɛ. Fɔ bɔku pipul dɛn, i nɔ kin kɔz ɛni prɔblɛm. Bɔt sɔmtɛm, dis baktri kin gro tumɔs na di bɛlɛ ɛn bigin fɔ it di bɛlɛ layn. Dis na we di inflamɛns we nɔ de dɔn , we kin mek i gɛt ɔlsa na di bɛlɛ.

2. Yuz pasmak mɛrɛsin fɔ mek yu fil pen (NSAID):

`NSAIDs` (Nonsteroidal anti-inflammatory drugs) na pen kil we wi kin bay ova di kɔwnta na di famasi. εgzampl dεm na `ibuprofen` (Ibuprofen), `naproxen` (Naproxen) εn `aspirin` (Aspirin) . Dɛn drɔgs ya kin afɛkt di layn na di bɛlɛ dairekt wan, we min se dɛn kin mek i vɛks . Dɛn kin blok bak fɔ mek sɔm impɔtant kemikal dɛn we de protɛkt ɛn mek di bɛlɛ layn bak.

Nɔmal wan, dɛn mek wi bɛlɛ layn fɔ protɛkt frɔm dɛn smɔl smɔl wund dɛn ya ɛn fɔ wɛl kwik kwik wan. Bɔt if yu tek bɔku NSAID, di bɛlɛ nɔ kin ebul fɔ mek insɛf. As di layt we de protɛkt am de west, i nɔ kin ebul fɔ mek insɛf igen, ɛn ɔlsa kin kam.

Ɔda rizin dɛn we nɔ kin bɔku:

• Ɔda infεkshɔn: Nɔr kin ɔltɛm, ɔda baktri, vayral, ɔ fεn infεkshכn kin mek bak bεlε inflameshn (erosive gastritis) εn כlsa.
• Zollinger-Ellison syndrome: Dis na wan sik wae nɔr kin bɔrku. insay dis kכndishכn, di bεlε de mek tu mכch gεstrik asid. Dis asid we pasmak de west di bɛlɛ layn ɛn mek ɔlsa.
• Sivεr fysiolojikal strεs: We yu bכdi de strכg fכ rεkכv frכm sik כ injuri we de mek yu layf de pan denja, we min se i de כnda bכku strεs, ‘strεs כlsa’ kin kam. insay tεm dεm lεk dis, di bכdi in pH de chenj εn di bכdi in asid de inkrεs.

Di we aw wi de liv wi layf kin afɛkt di ɔlsa na di bɛlɛ?

Di strɛs lɛvɛl wae wi kin gɛt ɛvride na wi ɛvride layf, ɛn wetin wi kin it ɛn drink, nɔ kin mek wi gɛt ɔlsa na wi bɛlɛ dairekt wan. Dat min se if yu it bɔku ɔ yu strɛs smɔl, dat nɔ go mek yu bɛlɛ gɛt ɔlsa.

Bɔt if yu dɔn gɛt ɔlsa, dɛn tin ya kin mek di sik wɔs. Bikɔs ɛnitin we de mek di bɛlɛ asid bɔku, bad fɔ di ɔlsa ɛn i go mek i wɔs.

I bɛtɛ fɔ tek tɛm wit tin dɛn lɛk dis:

• Fɔ smok
• Rum
• Fɔd dɛn we gɛt spays ɛn we gɛt asid

Aw yu go no if yu gɛt ɔlsa na yu bɛlɛ?

We yu go to dɔktɔ, i go aks yu fɔs bɔt di sik dɛn we yu gɛt ɛn yu mɛdikal istri. Dɛn go tray fɔ no tin dɛn lɛk if yu de yuz NSAID ɔltɛm ɛn if yu bin dɔn gɛt H. pylori infɛkshɔn bifo. If ɛnitin de we yu tink se yu go gɛt ɔlsa, di nɛks tin we yu fɔ du na fɔ luk insay yu bɛlɛ.

Test fɔ no if yu gɛt ɔlsa na yu bɛlɛ

Fɔs, di dɔktɔ go nid fɔ chɛk fɔ si if i gɛt H. pylori infɛkshɔn, dɔn i go luk fɔ ɔlsa insay di bɛlɛ. Bɔku we dɛn de fɔ du dis.

• Ɔpa Ɛndoskopi / EGD tɛst: .

Dis na di we we dɛn kin yuz mɔ ɛn we kin kɔrɛkt pas ɔl. dis involv fכ put sכmכl kεmεra (wan `εndoskop`) na di εnd fכ wan tint, fleksibul tכb tru yu mכt εn dכn yu εsophagus insay yu bεlε εn di fכs pat pan yu sכmכl intestin (duodenum). Dɛn go gi yu mɛrɛsin fɔ mek yu fil lɛk se yu de slip ɔ yu ed layt we yu de du dis, so yu nɔ go fil ɛni prɔblɛm.

Dis kamɛra de mek di dɔktɔ ebul fɔ si insay di bɛlɛ. If ɔlsa de, dɛn kin si am. כlso, dεn kin pas sכm sכm instrכmεnt dεm tru dis tכb εn dεn kin tek sכm sכm tisu (bayopsi) frכm di layn na di bεlε εn tεst fכ H. pylori. Sɔntɛnde, if blɔd de kɔmɔt na di ɔlsa, dɛn kin trit am rayt de.

• Ɔda tɛst dɛn:

pan ɔl we ɛndoskopi na di bɛst we, sɔm tɛm dɛn kin du imej tɛst lɛk ɔpa GI ɛkstrem rayt siriɔs kin no bak se pɔsin gɛt ɔlsa na di bɛlɛ. Bɔt dis nɔ kin kɔrɛkt lɛk ɛndoskopi.

Spɛshal tɛst dɛn de fɔ chɛk fɔ si if yu gɛt H. pylori infɛkshɔn:

• Yuria Briz Tɛst: Dis na tɛst we rili simpul ɛn we nɔ de mek pɔsin fil pen.
• bכdi tεst: Dis de tεst fכ antibodi dεm we dεn prodyuz na di bכdi εgens H. pylori.
• Stul antijen tεst: dεn de tεst wan stכl sεmpl fכ di prεsεns fכ H. pylori baktri dεm.

Ivin if yu tink se na bɛlɛ ɔlsa, wetin ɔda tin go bi?

If yu nɔr gɛt ɔlsa na yu bɛlɛ, ɔda tin dɛn kin bi de mek yu gɛt dis sik, lɛk:

• Gastroesophageal reflux disease (GERD): If asid kɔntinyu fɔ flɔ ɔp na di trot, i kin mek yu at bɔn, i nɔ kin it fayn, ɛn i kin mek yu nɔs.
• Functional dyspepsia: Dis na we yu nɔ de it di it we yu de it ɔltɛm we nɔ gɛt ɛni klia fyzikal kɔz (lɛk ɔlsa ɔ gastritis). Di sayn dɛm kin tan lɛk di wan dɛm we kin gɛt ɔlsa na di bɛlɛ, bɔt nɔto asid kin kam wit am, ɛn ɔlsa nɔ de we pɔsin kin si na di bɛlɛ layn.
• Bɛlɛ kansa (`Bɛlɛ kansa` / `Gastrik kansa`): Pan ɔl we dis nɔ kin apin so ɔltɛm, sɔntɛnde i kin mek yu gɛt sayn dɛn we fiba bɛlɛ ɔlsa (bɛlɛ pen, we yu de lɔs yu wet, yu nɔ kin want fɔ it). Na dat mek i impɔtant fɔ gɛt di rayt diagnosis.

Aw fɔ mɛn ɔlsa na yu bɛlɛ kwik kwik wan?

Di bɛst pat na dat, wans di tin we mek di ɔlsa dɔn go, yu bɛlɛ layn go bigin fɔ wɛl.

Imajin se if di tin we mek yu wund na we yu kɔntinyu fɔ yuz NSAID (pen killers), chans de fɔ mek di injuri wɛl we yu nɔ gɛt ɛni ɔda spɛshal tritmɛnt wans yu dɔn stɔp fɔ tek di mɛrɛsin.

Bɔt if yu gɛt H. pylori infɛkshɔn, yu go mɔs nid fɔ tek antibayɔtik frɔm dɔktɔ fɔ pul am .

Apat frɔm dat, di dɔktɔ kin gi am ɔda mɛrɛsin dɛn fɔ ridyus di asid na di bɛlɛ ɛn fɔ protɛkt di layn we de na di bɛlɛ, we go ɛp di wund fɔ wɛl kwik ɛn bɛtɛ.

Wetin na di tritmɛnt fɔ bɛlɛ ɔlsa?

Bɔku tɛm, dɔktɔ dɛn kin trit ɔlsa wit wan kɔmbayn mɛrɛsin. Dɛn tin ya na mɛrɛsin dɛn we de ridyus di asid na di bɛlɛ, we de kɔba ɛn protɛkt di ɔlsa te i wɛl, ɛn kil ɛni infɛkshɔn, lɛk H. pylori. Na smɔl tɛm nɔmɔ dɛn kin du smɔl tin fɔ stɔp blɔd ɔ fɔ lɔk wan ol na di bɛlɛ.

Di mɛrɛsin dɛn we dɛn kin yuz

Di men kayn mɛrɛsin dɛn we dɛn kin gi fɔ ɔlsa na di bɛlɛ na:

• Antibayɔtik: If yu gɛt H. pylori ɔ ɔda baktri infɛkshɔn, yu dɔktɔ go gi yu wan ɔ mɔ antibayɔtik fɔ kil di baktri, bɔku tɛm fɔ 7 to 14 dez. Di antibayɔtik dɛm we dɛn kin yuz mɔ na:
• `Amoksisilin`
• `Klaritromaysin`
• `Mɛtronidazɔl`
• `Tɛtrasayklin`
• Proton Pɔmp Inhibitɔ dɛn (PPI dɛn): .dis mεdikeshכn dεm de wok bay we dεn de ridyus di bεlε asid prodakshכn bכku bכku wan. Dɛn kin protɛkt di bɛlɛ layn bak ɛn mek di wund wɛl kwik kwik wan. Di PPI dɛm we dɛn kin gi mɔ na:
• `Omeprazol`
• `Lansoprazol`
• `Pantoprazol`
• `Esomeprazol`
• `Rabeprazol`
• `Dɛkslansoprazɔl`
• di histamin (H2) blכk dεm: dεn mεdikeshכn dεm ya de ridyus di bεlε asid prodakshכn bak, bכt dεn nכ strכng lεk PPI dεm. Ɛgzampul dɛn:
• `Famotidin`
• `Simetidin`
• `Nizatidin`
• Saytoprotɛktiv ɛjɛn: Dɛn mɛrɛsin ya de kɔt di layn na di bɛlɛ, we de protɛkt am frɔm asid ɛn ɔda tin dɛn we de ambɔg am. Dɛn kin ɛp di wund fɔ wɛl. Dɛn kin gi dɛn fɔ trit ɛn fɔ mek dɛn nɔ gɛt ɔlsa we dɛn de yuz NSAID. Ɛgzampul dɛn:
• `Sukralfɛt`
• `Misoprostol`
• Bismuth subsalicylate (dεn kin si am na mεdikeshכn dεm lεk Pepto-Bismol) .

Di we aw dɛn kin du mɛrɛsin

If yu gɛt kɔmplikɛt ɔlsa, we min se i de blɔd ɔ yu gɛt ol, yu dɔktɔ go nid fɔ trit am dairekt wan. Bɔku tɛm dɛn kin du dis we dɛn de du ɛndoskopi. Dɛn kin trit ɔlsa we de blɔd bay we dɛn de bɔn di ɔlsa (tɛmal tɛrapi), injekt mɛrɛsin, ɔ klip di ɔlsa. If ol de na di bɛlɛ, dɔktɔ we de du ɔpreshɔn go nid fɔ stich am ɔ fɔ mek am ɔda we.

Nɔr kin bɔrku sɔm pipul dɛn kin gɛt ɔlsa wae nɔr kin wɛl wit tritmɛnt ɛn kin kam bak. Dis kin mek yu kɔntinyu fɔ gɛt pen ɛn skata. dis ska kin blok bak di lכw bכdi כltεt (gastric כltεt). If dis apin, i kin nid fɔ du ɔpreshɔn:

• Rimov di ska tisu ɔ opin di ɔlt (payloroplasty).
• kכt (vagotomy) di nεv we de mek di bכdi asid (vagus nerve) prodyuz.

Aw yu go mek yu nɔ gɛt ɔlsa na yu bɛlɛ ɔ i nɔ go kam bak?

Yu kin du dɛn tin ya fɔ mek yu nɔ gɛt ɔlsa na yu bɛlɛ:

1. Put H. pylori infεkshɔn: Bɔrku pipul nɔr no se dɛn gɛt H. pylori infεkshɔn. Yu kin no if yu gɛt am wit simpul briz tɛst ɔr stɔl tɛst. If yu gɛt am, ivin if yu nɔ gɛt ɛni sayn, fɔ mek dɛn trit am lɛk aw yu dɔktɔ tɛl yu, dat kin ɛp fɔ mek yu nɔ gɛt ɔlsa tumara bambay.

2. Yuz NSAID (pen kil) lɛk aw dɛn tɛl yu ɛn tek tɛm: If yu yus fɔ tek NSAID (e.g. ibuprofen, diclofenac, aspirin) fɔ smɔl pen ɛn pen ɛvride, mek shɔ se yu nɔ tek pas di doz we dɛn tɛl yu fɔ tek.Ɛn na fɔ di shɔt tɛm nɔmɔ we pɔsin kin tek. If yu gɛt fɔ kɔntinyu fɔ tek NSAID fɔ mɛrɛsin, tɔk to yu dɔktɔ bɔt aw fɔ yuz di doz we smɔl pas ɔl, chenj to mɛrɛsin we sef, ɔ tek ɔda mɛrɛsin, lɛk PPI, fɔ protɛkt yu bɛlɛ layn.

3. Ridyus ɔ stɔp ɔda bad abit dɛn: Fɔ smok ɛn drink pasmak rɔm kin mek yu gɛt ɔlsa na yu bɛlɛ, mɔ if yu gɛt H. pylori infɛkshɔn ɔ yu de tek NSAID. So i bɛtɛ fɔ lɛ yu nɔ de nia dɛn abit dɛn ya.

Aw lɔng i kin tek fɔ mek ɔlsa na di bɛlɛ wɛl?

If yu tek yu mɛrɛsin lɛk aw dɛn tɛl yu fɔ tek ɛn avɔyd tin dɛn we de mek di ɔlsa vɛks (lɛk fɔ it tin dɛn we nɔ fayn, fɔ smok, ɛn fɔ drink rɔm), yu ɔlsa fɔ wɛl ɔlsay insay sɔm wiks (bɔku tɛm na 4-8 wik). Yu dɔktɔ kin tɛl yu fɔ du ɔda ɛndoskopi ɔ ɔda tɛst fɔ mek shɔ se di ɔlsa dɔn wɛl ɔl ɛn se di H. pylori infɛkshɔn (if i de) dɔn kɔmɔt kpatakpata.

Bɔrku pipul dɛn kin wɛl if dɛn trit dɛn fɔ shɔt tɛm. Bɔt pipul dɛm wae gɛt sik wae de mek dɛn bɛlɛ asid kɔntinyu fɔ mek, lɛk Zollinger-Ellison syndrome, kin nid fɔ tek mɛrɛsin fɔ lɔng tɛm.

Wetin fɔ du if yu tink se yu gɛt ɔlsa na yu bɛlɛ?

Di tin we impɔtant pas ɔl: If yu ivin tink se yu gɛt ɔlsa na yu bɛlɛ, go mɔs go to dɔktɔ.

Yu kin ebul fɔ kɔntrol di simptom dɛm fɔ sɔm tɛm wit ɔva-di-kɔnta antisid dɛm (e.g. Digene, Gelusil). Bɔt, dɛn nɔ go mɛn di ɔlsa. Yu go nid fɔ trit di men tin we mek yu gɛt dis sik.

Ɔlsa we dɛn nɔ trit, ivin if yu nɔ gɛt ɛni big big sayn, kin mek yu gɛt siriɔs prɔblɛm (lɛk fɔ blɔd ɔ fɔ mek pɔrfyushɔn) as tɛm de go. Dɔn bak, mɛmba se H. pylori infɛkshɔn, we na wan men tin we kin mek yu gɛt bɛlɛ ɔlsa, kin mek yu gɛt bɛlɛ kansa as tɛm de go if dɛn nɔ trit am.

Ustɛm yu fɔ go na Imejɛnsi Tritmɛnt Yunit (ETU) ?

If yu gɛt ɛni wan pan dɛn sayn ya, go na ɔspitul imejensi rum wantɛm wantɛm:

• Wan pen we kin de na yu bɛlɛ ɔltɛm ɛn we pɔsin nɔ kin ebul fɔ bia.
• If di stɔl blak (lɛk tar) wit blɔd, ɔ if di blɔd rɛd.
• If yu vɔmit blɔd (lɛk kɔfi grɔn ɔ fresh blɔd).
• Sayn dεm we de sho se yu blɔd de lɔs bad bad wan (e.g., yu de fil bad bad wan, yu de swet pasmak, yu nɔ de blo fayn, yu de fεnt, yu nɔ de no natin).

So, wetin wi lan frɔm dis stori? (Mɛsej we dɛn kin tek go na os)

Ɔlsa na bɛlɛ kin bɔku, bɔt dɛn nɔ fɔ tek am smɔl. Dɛn kin denja if dɛn nɔ trit dɛn fayn. Sɔntɛnde, ɔlsa kin de we nɔ gɛt ɛni sayn, so if yu gɛt ɛni dawt, i go fayn fɔ mek yu go to dɔktɔ fɔ mek dɛn chɛk yu.

Mɛmba: Yu kin gɛt rilif wit wɛlbɔdi layf chenj (lɛk it, lɛf fɔ smok), bɔt di men tin na fɔ fɛn di ɔndalayn kɔz (lɛk H. pylori, yuz NSAID) ɛn trit am di rayt we.

Bɛlɛ ɔlsa na we yu bɛlɛ in natura asid dɛn de pwɛl di layn we de protɛkt yu bɛlɛ. If dɛn nɔ trit dis sik, i go jɔs wɔs. Yu dɔktɔ kin gi yu di rayt tritmɛnt fɔ yu sik ɛn ɛp yu fɔ wɛl kwik kwik wan. So, nɔ fred ɛn go to dɔktɔ fɔ advays yu nɔ go de te.

` Bɛlɛ ɔlsa, bɛlɛ ɔlsa, gastritis, H. pylori, NSAID, bɛlɛ inflameshɔn, ɛndoskopi