Esophageal varices chungchanga i hriat tur chu!

I ka atanga i pum thlenga ei tur phurtu tube i esophagus-a thisen kalna kawngte chu a lo hring a, a lo lian tawh em? He thu hi i hre lo pawh a ni mai thei. Mahse he dinhmun, Esophageal Varices tia koh hi a ngawi reng thei a, rang takin a hlauhawm thei bawk. Chuvangin vawiin hian a chanchin zawng zawng hi awlsam takin, kan thianpa nen kan inbia ang maiin i zir vek ang u.

A awlsam zawngin, esophageal varices chu eng nge ni?

Ngaihtuah teh, a châng chuan kan keah hian thisen zam a hring, a inzawm khawm? ‘Varicose veins’ kan ti thin. Kan gullet chhungah pawh chutiang bawk chu a thleng thin. Heng vein te bang hi a chak lo hle a ni. Chuvangin an chhung atangin thisen a chhuah theihna chance a sang hle a, a nih loh leh a puak darh nghal a, thisen a chhuah theihna chance a sang hle. He taksa chhunga thisen chhuak hi a rang thei a, a na hle a, nunna pawh a tichhe thei bawk.

Hetiang dinhmun hi liver leh a kaihhnawih vein dang kal tlanga thisen kalna kawngpui (Portal Hypertension) a pressure sang vang a ni tlangpui. Hetiang pressure pangngai lo hian thin (liver) chhunga vein te te chu a ti hring a, a ti lian a ni. Hetiang dinhmun hi thin natna nei te zingah hmuh tur a tam ber.

He dinhmun hi engtiang chiahin nge a pawi?

Portal vein thrombosis hlauhawm ber chu thisen chhuah hi a ni . Mi zawng zawng hian thisen an chhuak vek lo a, mahse mi 50% vel chu an hlauhawm hle. Portal hypertension a san poh leh thisen chhuah theihna a sang zawk. He pressure hi liver natna, a bik takin cirrhosis .

Liver cirrhosis na tak nei te hian heng veins swelling bakah hian harsatna dang an nei thei bawk. Amaherawhchu damdawi ina awm leh thihna chhan ber chu heng vein te hi a rupture a, thisen a chhuah vang a ni. Hetianga vawi khat thisen i chhuah chuan thihna chance hi 20% vel a ni. Tin, thisen chhuah hi a lo chhuak leh fo thei bawk.

Hetiang natna lan chhuah dan hi engte nge ni?

Heng vein te hi taksa chhungah a awm avangin kea vein angin a lang lo. Chaw i ei lai pawhin i hre lo mai thei. Dik tak chuan, thisen chhuah ṭan hma loh chuan chhinchhiahna engmah an nei lo mai thei .

Mahse, doctor chuan liver disease emaw portal hypertension emaw i neih theihna tur symptom dang a hmuh chuan hei pawh hi an ringhlel thei bawk.

Engvangin nge heng veins te hi an lo hring chhuak? Eng nge a chhan?

Kan sawi tawh ang khan a chhan ber chu ``Portal Hypertension.`` tih hi a ni.Hei hi a awlsam zawkin tlem han hrethiam ila.

Kan liver hi filter lian tak angin han ngaihtuah teh. Pum chhunga chaw atanga thisen lo chhuak chu thin (liver) kal tlangin a kal a, chuta tang chuan a fai a, chumi hnuah thinlung lamah a kal leh thin. He thisen hi liver-a thlentu vein ber chu ``Portal Vein`` an ti a.

Tunah chuan, cirrhosis ang natna avanga liver chu a hliam a, a khauh a nih chuan , chu thisen chu awlsam takin liver a paltlang thei lo. Kawngpuiah traffic jam lian tak a awm ang mai a ni. Hei hian portal vein chhunga thisen sang a tisang nasa hle.

Taksa chuan he pressure sang tak hi compensate tumin thisen chu vessel te zawk (vein te zawk) hmangin a divert thin a ni. Ureter chhunga veins te hi chutiang vessel te tak te chauh an ni. Mahse heng vein te te hian thisen leh pressure tam tak chu an tuar thei lo. Chumi avang chuan an lo hring a, an lian a, engtik lai pawhin an puak thei bawk.

Liver cirrhosis awm chhan ber chu:

• Zu in tam lutuk.
• Thin thau tak (Nonalcoholic Steatohepatitis) a ni.
• Hun rei tak chhunga viral hepatitis natna vei tawh.
• Taksa ngeiin a taksa a venghimtu (immune system) hian thin (liver) (Autoimmune Hepatitis) a rawn bei a.
• A chhan dang, thisen zam, parasitic infection (Schistosomiasis) etc.

Engtin nge he natna hi i nei tih i hriat theih ang?

A tam zawkah chuan doctor-in a enfiah hnuah chauh he thu hi i hre thei a ni. Liver cirrhosis i neih tawh chuan i doctor chuan hetiang vein swelling chi hi screening neih a rawt fo ang.

Test ber chu Upper Endoscopy emaw EGD test emaw a ni .

Hei hian i hmui hmanga camera dahna tube te tak te, flexible tak dah a, i chaw kawng, i pum leh i ril te tak te bul tanna te enfiah a huam a ni. Hei hian i doctor chuan i thisen zam a hring em tih te, a lian zia te, thisen chhuah hlauhawmna a awm leh awm loh te chiang takin a hmu thei a ni.

Hei hi eng enkawlna nge ni?

Vanneihthlak takin thisen chhuahna control leh thisen chhuah leh tur venna tur enkawlna chi hrang hrang a awm a. Enkawlna atana thil tum berte chu:

• Active bleeding a awm chuan control rawh.
• Nakin lawka thisen chhuak tur venna.
• A theih chuan `(Portal Hypertension)` tih hi tihhniam tur a ni.

1. Thisen chhuah (emergency) control .

Hei hi medical emergency a ni. Damdawi inah chuan IV fluid pek i ni ang a, a tul chuan thisen pek i ni ang a, i dinhmun a lo nghet tawh hnuah endoscopy pek i ni bawk ang. Sawtah:

• Varicose Band Ligation: Instrument te tak te endoscope kaltlangin rubber band te tak te chu varicose vein vel ah dah a ni. Hei hian vein-a thisen kal chu a titawp a, thisen chhuah pawh a control bawk.
• Damdawi: Thisen sang tihhniamtu leh thisen kalna kawng tikhawtlai thei damdawi (Octreotide, Vasopressin) chu vein kaltlangin pek thin a ni.

2. Thisen chhuak leh tur venna

Thisen chhuak a awm emaw awm lo emaw, thisen chhuah theihna a awm chuan doctor chuan invenna (preventive treatment) a tan ang.

• Beta-blockers: Hetiang damdawi chi hi thisen sang tan pek a ni a, thisen chhuah theihna chu 50% velin a tihniam thei a ni.
• Band Ligation: Hetiang hmanrua hi mi thenkhat tan chuan invenna atan pawh hman a ni.

3. A chhan bulpui ber enkawl

A chunga kan sawi takte hian thisen chhuah theihna a tihziaawm loh chuan i doctor chuan ``Portal Hypertension'' natna hi direct-a tihziaawmna tur kawng dang a rawn rawt thei ang.

• Transjugular Intrahepatic Portal-Systemic Shunt (TIPS): Hei hi zai chi a ni lo. Hetiang tih danah hian liver chhunga vein pakhatah tube te tak te (stent) dahin, chu chuan portal vein atanga thisen a phur a, chu chuan connection thar, a nih loh leh "shortcut" a siam a ni. Hei hian pressure nasa takin a tihziaawm a ni.
• Surgery: Surgery tih dan ``Distal Splenorenal Shunt (DSRS)`` te pawh hian thisen kal dan tur a tidanglam a, pressure a ti tlem bawk.