He mamae puku tonu tōu? Tērā pea he mate puku tēnei (Peptic Ulcer Disease)! Me kōrero tātou mō tēnei.

He maha ngā wā ka rongo koe i te wera o tō puku, i te kore whakamarie rānei? He tokomaha o tātou e wareware ana he mea noa tēnei, e whakaaro ana pea he "gastritis". Heoi, i ētahi wā ka nui ake te kino o tēnei mamae. Koinei te āhua o ngā mate puku, e kiia nei e ngā tākuta, ko te 'Peptic Ulcer Disease (PUD). Nō reira, i tēnei rā ka kōrerohia e tātou tēnei mea me te taipitopito ake, me te mea kei te kōrero tātou ki tētahi hoa. Nā te mea he mea tino nui te mōhio ki tēnei mea māu.

He aha te mate pukupuku peptic? He māmā noa iho...

Ki te whakarapopototanga, he mate puku tuwhera te mate pukupuku e puta ana i te arai o tō tātou pūnaha nakunaku, te wāhanga o te ara nakunaku e nakunaku ai te kai me te inu. Ko te tikanga o te kupu "peptic" he "e pā ana ki te nakunaku." I ahu mai i te kupu "pepsin," he whākōkī nakunaku nui e hangaia ana i roto i tō tātou puku.

Whakaarohia, kei roto i tō tātou puku te waikawa puku me tēnei whākōkī e kiia nei ko te pepsin. Ko ēnei e rua ngā mea e āwhina ana i a tātou ki te wawahi matū i te kai e kainga ana e tātou, me te nakunaku. He tino waikawa tēnei wai, he tika ake, he waikura. I ētahi wā ka uru tēnei wai ki te wāhanga tuatahi o tō tātou whekau iti (duodenum).

Titiro mai, kua whakakikoruatia tō tātou ara nakunaku katoa ki tētahi kiriuhi hūpē tiaki, pērā i te whakangungu rakau e tiaki ana i ngā pakitara mai i ngā mea kino o roto. He tino kaha tēnei kiriuhi tiaki i roto i te puku me te wāhanga tuatahi o te whekau iti. Heoi, i roto i te tangata he mate puku peptic, ka ngoikore tēnei pūnaha tiaki . Kātahi ka taea e aua wai nakunaku kino te kai i ngā pakitara.

He horo te mate puku, he hohonu rawa, ā, ka uru ki roto i ngā paparanga e toru o te arai o te puku. I te nuinga o te wā, ka puta ēnei mate puku i roto i te puku, i te wāhanga tuatahi rānei o te whekau iti (duodenum), nā te mea koinei te wāhi e tino kaha ai ngā wai nakunaku. Engari he onge, ka puta ki ētahi atu wāhi.

Kei hea ēnei patunga e puta ai? He momo?

Ae, ko te nuinga o ēnei mate pukupuku ka puta i roto i tō tātou puku me te wāhanga tuatahi o te whekau iti (duodenum).

• Ngā mate pukupuku duodenal: Koinei ngā mea tino noa, tata ki te 80%.
• Ngā mate puku: Ka kitea ēnei i roto i te 20% o ngā take.

Heoi, i ētahi wā tino onge, ka turuturu te waikawa o te puku ki ētahi atu wāhi, ka puta ai he mate puku. Hei tauira:

• Mate puku o te korokoro: Ko ētahi tāngata he mate pūkahukahu tonu, arā, ko te wā e piki ake ai te waikawa o te puku ki roto i te korokoro. Ki te haere tonu tēnei, ka memeha haere te arai o te korokoro, ka puta he mate puku. Nā te mea kāore te arai o te korokoro i te ātete ki te waikawa pērā i te arai o te puku.
• Te mate pukupuku o te ihu:Ko te jejunum te wāhanga waenga o tō tātou whekau iti. Ka taea e ētahi pokanga (hei tauira, gastrojejunostomy - he pokanga e hono tika ana i te puku ki te jejunum) te whara i tēnei wāhanga.

He pēhea te noa o tēnei āhuatanga?

I te ao whānui, ka pāngia te tangata e te mate puku peptic (PUD) i tētahi wā o ō rātou oranga. Ahakoa ka pāngia e ngā tau katoa, he nui ake te kitea i roto i te hunga pakeke me ngā tāne.

He aha ngā tohu o tēnei? Me pēhea e mōhio ai koe ki tēnei?

He mea whakamiharo, tata ki te 70% o te hunga whai tohumate nei kāore e whakaatu i tētahi tohumate . Heoi, ko ngā mea e tino kōrerohia ana e te hunga whai tohumate ko:

• Mamae epigastric: Hei whakamārama tika, he mamae e puta mai ana i waenganui o te puku , i raro i te uma.
• Te Mate Kōrerokore: He kohinga o ngā mamae o te nakunaku e puta ana i muri i te kai. Kei roto i tēnei ko te mamae i te puku o runga, te werawera , te mākū o te puku i muri i te kai, me te mākū tonu.

He rite tēnei kare wera ki te kare o te waikawa puku me ngā whākōkī e kai ana i te arai o te puku. E whakaahuahia ana e ētahi he "me te mea kei te keri tetahi mea ki roto i te puku." Tērā pea ka taea e koe te tohu i te wāhi tika o te mamae.

Ahakoa he uaua ki te kī tika mēnā kei roto i te puku, kei roto rānei i te whekau iti te mate pukupuku, kei reira ētahi tohu:

• Mena he mate puku tōu , ka kino ake pea te mamae i muri tata i te kai (i roto i te 30 meneti), nā te mea koinā te wā e tukuna ai te nuinga o te wai puku.
• Mēnā he mate puku duodenal , ka memeha pea te mamae i muri i te kai. Heoi, i muri i ngā haora e rua, e toru rānei, ka piki ake anō te mamae i te mea ka uru te kai me ngā wai nakunaku ki roto i te whekau iti. E whakaaro ana ētahi he hiakai tēnei, nā te mea ka whakaora te kai. He mea noa anō hoki te oho ake i te pō nā te mamae i roto i te hunga whai mate puku iti nei.

Haunga tēnei, ka taea hoki e koe te kite i ētahi atu āhuatanga pēnei i:

• Puku pupuhi
• Te pupuhi pinepine, te tupa rānei
• Te ngaronga o te hiahia kai
• Whakapairuaki me te ruaki

Ka aha mēnā ka kore e rongoatia? He aha ngā raruraru?

Ka puta ngā tohu i ētahi tāngata i muri i te whanaketanga o ētahi atu raruraru. Ka puta tēnei mēnā ka roa te wā e kore e rongoatia. Ki te kore, ka tīmata te toto o ngā patunga, ka hohonu ake rānei te pakitara, ka hanga he kōhao .

Mena kei te pāngia koe e te toto i te taha whakarunga o te puku, ka pāngia pea koe e ngā tohu pēnei i:

• Toto i roto i te tūtae ( tūtae pango, tūtae kawa )
• Ruaki kawhe whenua
• Pōuriuri, ngoikore rānei
• Te kiri mā (Pallor)
• Te tere o te manawa

Mena ka puta he kōhao i roto i te ara kai (puku gastrointestinal), ka puta ngā tohu pēnei i:

• Te mamae puku ohorere, kino, koi
• Te pupuhi o te puku me te mamae e kore e taea te tohe
• Te kirika me te makariri

Ki te kore e rongoatia mō te wā roa, ka ora pea ngā mate pukupuku, kātahi ka hoki anō. Mō ētahi tāngata, ka nui haere te kiriuhi me te pupuhi i roto i te ara nakunaku, ka ārai i te puku . Ka puta pea ngā tohu pēnei i:

• Te pupuhi, te pupuhi, me te mamae
• Whakapairuaki me te ruaki
• Te ngaronga o te hiahia kai me te mate taimaha
• Te kore e taea te pupuri i te mana o te puku me te mate puku

He aha tātou ka pāngia ai e ēnei mate puku? He aha ngā tino take?

Kua hangaia te arai tiaki o tō tātou ara nakunaku kia ātete ki ngā waikawa me ngā whākōkī kino, ā, kia taea ai te whakatika i a ia anō mēnā kua pakaru. He pono rawa tēnei i roto i te puku me te wāhanga tuatahi o te whekau iti. Heoi, ka puta ngā mate pukupuku ina whakararuraru tetahi mea i ēnei parenga taiao.

Kia whakaitihia ai tēnei parenga, kia hohonu ai te puku kia uru ki roto i te kiriuhiuhi, me puta he āhuatanga roa, he āhuatanga tonu rānei . Kua tautuhia e ngā kaipūtaiao ngā take matua e rua e whai kawenga ana mō te nuinga o ēnei PUD:

1. Mate Pukupuku H. pylori (Helicobacter pylori): Kei roto i te puku me/ranei i te whekau iti o te tata ki te haurua o te taupori o te ao tēnei huakita. Mō te nuinga o te tangata, kāore he raruraru e pā mai ana. Heoi, ki te nui rawa ngā huakita, ka taea e ia te whakararuraru i te taurite o ētahi atu moroiti i reira, ā, ka puta he urupare mumura . Ka ngoikore te pakitara i tēnei mumura roa, ā, ka whakaiti i tōna kaha ki te whakatika i a ia anō. I ētahi wā, ka taea e ngā huakita te whakaeke tika i te pakitara.

2. Te whakamahi nui i ngā rongoā anti-inflammatory kore-steroidal (NSAID): Koinei ngā rongoā whakamamae mamae e hokona ana e tātou i te whare rongoā me te kore he whakahaunga, pērā i te aspirin me te ibuprofen. Nā te mea ka tangohia ēnei me te kore he tohutohu hauora, he maha ngā tāngata e tango ana i ēnei i te nuinga o te wā i tā rātou e hiahia ana. Ka pā tēnei ki te taurite matū i roto i tō tātou puku me te whekau iti. Ka mahi ngā NSAID mā te whakaiti i te hanga o ngā matū e kiia nei ko ngā prostaglandin, e whakatika ana i ngā kino o te arai o te ara nakunaku.

Haunga ēnei take matua e rua, kei reira anō ētahi atu take kāore i te tino kitea:

• Ētahi atu mate urutā
• Te whakahekenga o te rere o te toto (`Ischemia`)
• Te ahotea tinana nui (he maha ngā wā nā te mate, nā te aituā rānei e morearea ai te ora)
• Te rongoā matū, te rongoā irahiko rānei
• Te mate Zollinger-Ellison - he āhuatanga e nui rawa ai te waikawa e puta mai ana i te puku
• Te mate a Crohn - he mate mumura o te ara kai
• Matepukupuku puku

Ko wai kei te nui ake te mōrearea ki te whakawhanake i tēnei mate?

Mena kei a koe te mate H. pylori, kei te whakamahi auau rānei koe i ngā NSAID, ka nui ake te tūponotanga ka pāngia koe e ēnei mate puku. He nui rawa te mōrearea mena kei a koe ēnei āhuatanga mōrearea e rua.

Hei tāpiritanga, ko te momi hikareti, te inu waipiro, me ētahi atu rongoā ka tangohia e koe ka whai wāhi atu ki tēnei. Ahakoa kāore ēnei mea anake e kaha ki te whakaputa mate puku, ina honoa ki te mate H. pylori, ki te whakamahi NSAID rānei, ka piki ake te tūponotanga o te whakawhanake i ngā mate puku.

Me pēhea te tautuhi a ngā tākuta i tēnei?

Mena kei te whakapae tō tākuta he mate puku kei roto i te puku i runga i ō tohu me ngā āhuatanga mōrearea, ka tirohia tuatahitia e rātou tō korokoro mō ngā mate puku. Ka whakamātauria hoki e rātou te mate H. pylori.

Mō te tini o te tangata, ko te tirotiro i te esophagus o runga (whakamātautau EGD) te tātaritanga whakamutunga. Ko te whakauru i tētahi ngongo angiangi me tētahi kāmera iti i te pito mā roto i te waha, me te tirotiro i te esophagus, te puku, me te wāhanga tuatahi o te whekau iti. I tēnei wā, ka tangohia pea tētahi wahi kiko iti (he koiora) mai i te puku hei tirotiro mō te aroaro o H. pylori.

He tino whai hua te Endoscopy nā te mea ehara i te mea ka taea e koe te kite i ngā whakaahua anake, engari ka taea hoki e koe te tuku i ngā taputapu mā roto i te ngongo mēnā e tika ana, me te mahi maimoatanga. Hei tauira, mēnā kei te toto te patunga, ka taea e koe te rongoā tonu kia mutu ai.

Ētahi atu whakamātautau:

• Tērā pea ka mahia he `karapa CT (karapa Tomography Rorohiko)` he `whakamātautau hihi-X raupapa GI` rānei hei kimi i ngā whara nunui ake.
• Ka taea te whakahaere i te "whakamātautau manawa urea" me te "whakamātautau tūtae" hei kite i te mate "H. pylori".

He aha ngā maimoatanga?

Ko te rongoā matua mō ngā mate puku he huinga rongoā hei whakaiti i te waikawa o te puku, hei tiaki i te arai, hei āwhina hoki i tōna whakaora . Mena he mate pāwera tōu, me rongoā pea koe i ngā paturopi . Ko te mea nui ko te kimi me te rongoā i te pūtake o te mate puku.

I te nuinga o te wā, ka taea te whakaora i ngā patunga mā te rongoā anake. Heoi, ki te mea he raruraru, pērā i te patunga toto, i te patunga poka rānei, me whai maimoatanga tāpiri pea. He maha o ēnei raruraru ka taea te whakahaere mā te whakamahi i ngā tikanga hauora māmā, pērā i te endoscopy.

Ngā rongoā

• Ngā rongoā paturopi: Mena kei a koe te mate H. pylori, tētahi atu huakita rānei, ka tohua e tō tākuta he huinga o ngā rongoā paturopi hei patu i ngā huakita. (Tauira: Amoxicillin, Clarithromycin, Metronidazole)
• Ngā rongoā tiaki pūtau: Ka mahi ēnei rongoā mā te pani me te tiaki i te arai o te puku kia ora rā anō. (Hei tauira: 'Sucralfate', 'Misoprostol', 'Bismuth subsalicylate')
• Ngā aukati i te kaiwhakawhiwhi histamine (ngā aukati H2): Ka whakaitihia e ēnei rongoā te waikawa mā te aukati i te matū e tohu ana i te puku kia whakaputa waikawa. (Hei tauira: `Famotidine`, `Cimetidine`)
• Ngā aukati papu pūwero (PPI): Ka whakaitihia e ēnei rongoā te waikawa o te puku, ā, ka āwhina i te arai o te puku kia ora mā te tiaki i a ia. (Hei tauira: Omeprazole, Pantoprazole, Esomeprazole)
• Ngā rongoā mamae rerekē hei utu mō ngā NSAID: Mena he maha āu rongoā NSAID e whakamahia ana, me kōrero pea koe ki tō tākuta mō tētahi atu rongoā. Ko te Acetaminophen (paracetamol) he rongoā ehara i te NSAID, ā, kāore e rite te pānga ki te arai o te puku.

Ngā tikanga hauora

Mena he patunga uaua, he patunga toto tōu, me rongoā tika e tō tākuta. He maha ngā wā ka taea tēnei i te wā o te endoscopy. Ka mutu te toto mā te tahu i te patunga, mā te werohanga rongoā rānei. Mena he kōhao, ka tuia kia kati.

He onge noa iho, mēnā kua āraia te korokoro e te mate puku, me mahi pea ngā mahi hei whakatuwhera anō. Tērā pea ka momihia ngā mea o roto o te puku, ka pokanga rānei, he onge noa iho.

Me aha tātou hei tiaki i a tātou anō i tēnei āhuatanga? (Te Ārai)

Ko ngā mea tino nui ka taea e koe te mahi hei tiaki i a koe mai i te mate pukupuku peptic ko:

1. Whakamātauria mō te mate H. pylori, ā, rongoātia: He tokomaha te hunga e pangia ana e te mate H. pylori, engari kāore i te mōhio. Ka taea e koe te kimi mēnā kei a koe mā te whakamātautau manawa urea ngāwari. Ki te pēnā, me rongoā koe i mua i te puta o ngā raruraru. Ahakoa kua rongoātia koe i mua, he mea pai kia whakamātauria anō, nā te mea ka hoki mai anō i ētahi wā.

2. Whakamahia ngā NSAID kia rite ki ngā tohutohu: Mena kua taunga koe ki te tango i ngā NSAID mō ngā mamae iti i ia rā, kia tūpato kei nui atu i te horopeta kua tohua. Mena he hītori mate puku tōu, he pai ake te karo i te whakamahi. Mena e tika ana, tangohia me tētahi atu rongoā hei tiaki i te arai o te puku.

Ka ora rānei ēnei patunga me te kore he rongoā?

Ki te tangohia te pūtake o te mate puku, tera pea ka ora te mate puku. Heoi, me tirotirohia te tinana kia kitea ai te pūtake. Mena he mate H. pylori, he mate hauora rānei te pūtake, me rongoā hei whakakore.

Mena he NSAID noa iho te take, ka ora pea te mate pukupuku i a ia anō mena ka mutu te tango. Heoi, me toro atu koe ki te tākuta hei whakaū i tēnei. Tērā pea kei a koe te mate H. pylori, ā, ka taea e ngā NSAID te whakararu i tētahi mate kāore i te kino i mua.

He aha ngā mea ka tupu i muri i te maimoatanga? Kia pēhea te roa o te wā e ora ai?

Ka ora te nuinga o ngā mate puku i roto i ētahi wiki . Me tango e te nuinga o te tangata te rongoā mō te rua marama pea. He tino whai hua tēnei rongoā. Heoi, ko te hunga he mate roa pēnei i te mate Zollinger-Ellison, me tango pea i te rongoā mō te toenga o ō rātou oranga.

I muri i te maimoatanga, ka whakahaerehia e te tākuta ētahi whakamātautau whai muri hei whakarite kua ora katoa te mate pukupuku, ā, kua kore te mate. He huakita uaua te H. pylori, ā, ka hoki mai anō i ētahi wā. Waihoki, ki te haere tonu ngā āhuatanga i puta ai te mate pukupuku, ka hoki mai anō te mate pukupuku.

He tino onge te pānga o ngā mate puku pumau ki ētahi tāngata, kāore e ora i te rongoā. Ka pā mai pea ēnei raruraru pēnei i te mamae roa me te whara nui. I roto i ēnei āhuatanga, me mahi pokanga pea (hei tauira, te tango i te kiko whara (pyloroplasty), te tapahi rānei i te io e whakahaere ana i te hanga waikawa o te puku (vagotomy)).

Me huri koe i tō kai me tō momo noho?

Kāore te kai me te inu e puta ai ngā mate puku, engari ki te mea he mate puku tōu, ka taea e ētahi kai me ngā inu (ina koa ko ngā kai kawa, ngā kai raukikī) te whakanui ake i te kino o ēnei tohu . Mena kei a koe ngā tohu, kua pāngia rānei koe e ngā mate puku i mua, me karo rawa koe i te waipiro me te momi hikareti .

Kōrero ki tō tākuta mō ngā rongoā katoa e tangohia ana e koe (ina koa ko ngā NSAID). Ka raru pea ētahi rongoā ina tangohia ngātahi.

Kāore e taea te rongoā i tēnei mā te whakamahi i ngā rongoā antacid i te kāinga?

Ka mahi ngā antacid mā te whakakore i te waikawa me te whakaiti i ngā tohu pēnei i te mamae o te puku, te mamae o te puku, me te koretake o te kai. Tērā pea ka pai ake te ahua o te mate puku mō te wā poto, engari kāore e ora te mate puku . Mēnā kua pāngia koe e ngā mate puku i mua, ka āwhina pea ngā antacid ki te aukati i te hokinga mai o aua tohu.

He aha ngā wā pai rawa atu hei toro atu ki te tākuta?

Ki te whakapae koe he mate puku tōu, kia kite koe i te tākuta . Ahakoa ka taea e ngā rongoā ka hokona kore-tohu te whakahaere i ō tohumate mō te wā poto, e kore e taea te whakaora i te mate puku. Me tautuhi me te rongoā te pūtake.

Ahakoa kāore he tohu kino o te mate puku, ka pā mai pea he raruraru nui ki te kore e rongoatia. Ko te mate H. pylori, te tino take o ngā mate puku, ka pā mai pea ētahi atu raruraru (pērā i te mōrearea o te mate pukupuku puku).

Mena ka kite koe i ngā tohu o ngā raruraru nui pēnei i ēnei, haere tonu ki te rūma whawhati tata:

• He mamae nui, pumau.
• Ngā tohu o te toto i roto i te tūtae (ngā tūtae mangu) te ruaki toto rānei.
• Ngā tohu o te toto nui e ngaro ana (te kiri mā, te ngoikore).

Ngā mea tino nui hei maumahara mā tātou (Karere hei tango ki te kāinga)

He mate kino te mate pukupuku peptic e pā ana ki tō pūnaha nakunaku. Ka puta mai ina ngoikore tō pūnaha parepare taiao. Ka roa te wā e whanake ai tēnei mate, ā, me rongoā hauora kia ora ai.

He mate noa te mate puku, ā, ka taea te rongoā. Heoi, he mea nui kia rapu rongoā ahakoa kāore he tohu kino.Ki te kore e rongoatia, ka hohonu ake, ka kino ake ngā patunga. Nō reira, kaua e whakaroa ki te kōrero ki te tākuta mō ō tohumate. He mea nui te hauora!

Ngā mate puku, ngā mate pēpi, te mumura o te puku, te H. pylori, te NSAID, te gastritis, te koretake o te kai