Mankhwala ochizira kutupa m'mimba ndi gastritis! Tiyeni tiphunzire bwino za Proton Pump Inhibitors (PPIs)!

Kodi nthawi zambiri mumamva kutentha pamtima kapena kupweteka pachifuwa? Kapena dokotala anati "gastritis"? Mtundu wa mankhwala omwe madokotala nthawi zambiri amapereka pazochitika zotere amatchedwa `(Proton Pump Inhibitors)`. Tikadanena mosapita m'mbali, mwina tingatchulenso kuti "mankhwala a gastritis." Chifukwa chake, lero tikambirana mwachidule za `(Proton Pump Inhibitors)` kapena PPIs .

N’chifukwa chiyani timafunikira ma PPI amenewa? Kodi chimachitika n’chiyani ndi asidi m’mimba?

Mwachidule, `(Proton Pump Inhibitors)` ndi mtundu wa mankhwala omwe amachepetsa kuchuluka kwa asidi wopangidwa m'mimba mwanu, kutanthauza kuchuluka kwa asidi m'mimba . Tsopano mwina mukuganiza kuti, "Kodi cholinga cha asidi m'mimba n'chiyani? Sichabwino." Sizowona. Asidi m'mimba ndi wofunika kwambiri m'matupi athu. Ndi asidi uyu amene amatithandiza kugaya chakudya chomwe timadya. Sikuti kokha, komanso asidi m'mimba uyu amathandizanso kuwononga tizilombo toyambitsa matenda tomwe timadya ndi chakudya mosadziwa.

Komabe, nthawi zina mavuto amayamba pamene kuchuluka kwa asidi m'mimba kumawonjezeka kwambiri, kapena pamene asidiyo imapita kumalo ena mosiyana ndi momwe iyenera kukhalira. Zili ngati mwambi wakuti "Ngati iwonjezeka, ngakhale timadzi tokoma tidzakhala ndi poizoni." Pamenepo ndi pamene zilonda zam'mimba (`ulcers`), kapena monga momwe timazitchulira, "zilonda zam'mimba" zimatha kuyamba. Zinthu zina monga kutentha pamtima ndi kukoma kowawa pakhosi zimathanso kuchitika. Pamenepo ndi pamene mankhwala otchedwa PPI amatithandiza. Amagwiritsidwa ntchito makamaka pamavuto a nthawi yayitali okhudzana ndi asidi m'mimba.

Kodi ma PPI amenewa amagwiritsidwa ntchito pa matenda amtundu wanji?

Madokotala amagwiritsa ntchito kwambiri mankhwala amtunduwu (Proton Pump Inhibitors) pochiza matenda monga kuwonongeka ndi kutupa kwa ziwalo za m'mimba mwathu, monga matumbo ndi mmero, zomwe zimachitika chifukwa cha asidi m'mimba. Tiyeni tiwone zomwe zili:

• GERD kapena Matenda Osatha a Acid Reflux: Kodi nthawi zambiri mumakhala ndi kutentha pamtima? Kodi mumakhala ndi kukoma kowawa pakhosi panu? Ndicho chimene GERD ili. Mwachidule, ndi asidi m'mimba mwanu amene amakwera m'mero. Izi zitha kuwononga mkati mwa mmero wanu, womwe umatchedwanso erosive esophagitis. Ma PPI amagwira ntchito pochepetsa kupanga asidi m'mimba ndikupatsa mmero wanu nthawi yochira.
• Zilonda za m'mimba ndi m'matumbo: Zilonda zam'mimba ndi m'matumbo ndi zilonda zomwe zingayambitsidwe ndi asidi m'mimba, zomwe zingawononge chitetezo cha m'mimba. Zingayambitsenso zilonda m'chigawo choyamba cha m'mimba waung'ono (chotchedwa duodenum). Ma PPI angathandize kuchiritsa zilondazi. Kuphatikiza apo, mankhwala ena ochepetsa ululu, makamaka mankhwala oletsa kutupa (NSAIDs), amagwirizanitsidwa ndi chiopsezo chowonjezeka cha zilonda. Kafukufuku akusonyeza kuti pafupifupi 30% ya anthu omwe amamwa mankhwala a NSAID nthawi zonse amakhala ndi zilonda. Ma PPI angathandize kupewa ndikuchiritsa zilonda.
• Matenda a H. pylori:Uwu ndi mtundu wa mabakiteriya omwe amakhala m'mimba mwathu. Mabakiteriyawa amathanso kuyambitsa zilonda zam'mimba. Pochiza matenda a H. pylori, madokotala amapereka ma PPI pamodzi ndi maantibayotiki. Izi zili choncho chifukwa ma PPI amasintha pH ya m'mimba, zomwe zimapangitsa kuti maantibayotiki aphe mabakiteriya mosavuta.
• Matenda a Zollinger-Ellison: Uwu ndi matenda osowa kwambiri. Pa vutoli, mitundu ina ya zotupa (`zotupa`) imakula m'thupi ndipo zimapangitsa kuti thupi lipange mahomoni ambiri omwe amayambitsa asidi m'mimba. Izi zimapangitsa kuti asidi m'mimba akhale wambiri. Ma PPI amagwiritsidwanso ntchito pochiza vutoli.

Kodi mankhwala otchedwa PPI amagwira ntchito bwanji? N'zodabwitsa, sichoncho?

Tangoganizani kuti pali "makina" pang'ono m'mimba mwathu omwe amapanga asidi. Timatcha makinawa kuti "hydrogen-potassium ATPase pump", kapena "proton pump" mwachidule. Monga momwe pampu yamadzi imakokera madzi, pampu iyi ya proton ndiyo imachita njira ya mankhwala yofunikira kuti pakhale asidi m'mimba.

Kotero, zomwe `(Proton Pump Inhibitors)` kapena ma PPI amachita ndikuletsa kwakanthawi kugwira ntchito kwa proton pump . Ndiko kuti, "amaletsa", ndiko kuti, amasokoneza. Kenako kupanga asidi m'mimba kumachepa.

Koma izi sizimaletsa kwathunthu kupanga asidi m'mimba, sichoncho? Muli ndi asidi wokwanira kugaya chakudya. Ngati mutenga PPI kwa masiku asanu motsatizana, kupanga asidi m'mimba kudzachepa ndi pafupifupi 65%. 35% yotsala ya asidi ndi yokwanira kugaya chakudya.

Kodi ma PPI awa ndi chiyani?

Ma PPI ena amatha kugulidwa pa malo ogulitsira mankhwala (OTC) ku pharmacy popanda mankhwala, koma ena olimba amafunika mankhwala ochokera kwa dokotala (Rx yokha).

Ma PPI omwe angatengedwe ndi kapena popanda mankhwala a dokotala (OTC ndi Rx):

• Esomeprazole (Nexium®)
• Lansoprazole (Prevacid®)
• Omeprazole (Prilosec®)
• Omeprazole/sodium bicarbonate (Zegerid®)

Ma PPI omwe amapezeka pokhapokha ngati dokotala walemba mankhwala (Rx yokha):

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

Kodi ndimwa bwanji mankhwala awa? Ndiyenera kumwa angati?

Mankhwalawa amabwera mu mawonekedwe a piritsi kapena kapisozi. Mumawamwa pakamwa. Mitundu ina ya makapisozi imakhala ndi ufa womwe ungasakanizidwe mu chakudya, monga applesauce, kenako n’kumwedwa. Izi ndi zothandiza kwambiri kwa anthu omwe ali ndi vuto lomeza mapiritsi.

Musanamwe mankhwala, muyenera kuwerenga mosamala malangizo omwe ali pa phukusi.Pamenepo ndi pomwe mudzalandira zotsatira zolondola kwambiri. Pali ma PPI ena omwe muyenera kumwa theka la ola kapena ola musanadye, muli ndi njala m'mimba. Mukawamwa panthawiyo, mankhwalawa amakhala ndi nthawi yogwira ntchito m'mimba mwanu musanayambe kupanga asidi mukamadya.

Dokotala wanu yekha ndi amene angakuuzeni kuchuluka kwa mankhwala omwe mukufuna (`dose`) ndi kangati patsiku komwe muyenera kumwa. Iye adzakupatsani mlingo womwe ungachepetse zizindikiro zanu popanda chiopsezo chachikulu cha zotsatirapo zoyipa. Kwa anthu ena, kumwa piritsi limodzi musanadye chakudya cham'mawa ndikokwanira. Kwa ena, kumwa kawiri patsiku, musanadye chakudya cham'mawa komanso musanadye chakudya chamadzulo, kungakhale kokwanira. Nthawi zina, kumwa tsiku lililonse kungakhale kokwanira.

Pakapita nthawi, mungafunike kuchepetsa mlingo wa mankhwala anu. Dokotala wanu adzakulangizaninso pa izi.

Kodi ma PPI awa amatenga nthawi yayitali bwanji kuti agwire ntchito?

Pambuyo pomwa mankhwala a PPI, zingatenge maola 24 mpaka masiku anayi kuti mumve mphamvu zake zonse.

Ngati mwadzidzidzi mukumva kupweteka pamtima kapena pachifuwa ndipo mukufuna mpumulo wachangu, ndi bwino kugwiritsa ntchito mankhwala oletsa asidi (monga Digene, Acidex) kapena histamine blocker (H2 blocker) (monga Pepcid® kapena Tagamet®) kusiyana ndi ma PPI. Tangoganizirani kuti mwadzidzidzi mukumva kupweteka pamtima mutadya chakudya chokometsera. Kenako, kumwa mankhwala otere kudzakuthandizani pakatha mphindi zochepa kapena maola ochepa. Komabe, mphamvu yake siimatenga nthawi yayitali ngati ma PPI.

Ma PPI ndi abwino kwambiri ngati muli ndi vuto la asidi m'mimba kwa nthawi yayitali.

Kodi pali zotsatirapo zilizonse zoyipa mukamagwiritsa ntchito ma PPI awa?

Anthu ambiri sakhala ndi mavuto aakulu akamamwa ma PPI. Komabe, monga mankhwala ena aliwonse, amatha kuyambitsa zotsatira zina zoyipa. Izi zikuphatikizapo:

• Kuwawa kwam'mimba
• Kudzimbidwa
• Kutsegula m'mimba
• Chizungulire
• Pakamwa pouma
• Mutu
• Malungo
• Kutupa/Gasi
• Mutu wopepuka
• Kuyabwa ndi ziphuphu
• Kusanza

Ngakhale kuti ma PPI nthawi zambiri amaonedwa kuti ndi otetezeka, ofufuza apeza kuti akhoza kukhala ndi zoopsa zina, makamaka akagwiritsidwa ntchito kwa nthawi yayitali . Tiyeni tiwone zomwe zili:

• Matenda a Clostridioides difficile (C. diff): Ma PPI amatha kusintha kusiyana pakati pa mabakiteriya abwino ndi oipa m'matumbo mwanu, zomwe zimawonjezera chiopsezo chanu chotenga matenda monga C. diff.
• Kusweka kwa mafupa: Ma PPI amachepetsa mphamvu ya thupi lanu yoyamwa calcium, mchere womwe umathandiza kuti mafupa athu akhale olimba. Bungwe la U.S. Food and Drug Administration (FDA) lachenjeza kuti ma PPI angapangitse kuti mafupa asweke m'chiuno, pachikhatho, kapena msana.
• Matenda a impso:Izi zitha kuwonjezera chiopsezo chotenga matenda osatha a impso (CKD), kapena kupangitsa kuti matenda omwe alipo aipireipire.
• Kusowa zakudya: Ma PPI amatha kuchepetsa mphamvu ya matumbo anu ang'onoang'ono yoyamwa magnesium kapena vitamini B12. Magnesium ndi mchere womwe umathandiza minofu ndi mitsempha yathu kugwira ntchito bwino. Vitamini B12 ndi yofunika kwambiri pa dongosolo lathu la mitsempha ndi maselo ofiira a magazi.

Kugwirizana pakati pa ma PPI ndi zinthu zoopsazi kukuphunziridwabe. Komabe, madokotala nthawi zambiri amalimbikitsa kugwiritsa ntchito mlingo wochepa kwambiri komanso kwa nthawi yochepa kwambiri mpaka zizindikiro zanu zitachepa. Izi zichepetsa chiopsezo cha zinthu zoopsazi.

Ndiyenera kupita liti kwa dokotala wanga?

Ngati dokotala wakupatsani mankhwala a PPI, onetsetsani kuti mwafunsa dokotala wanu ngati muli ndi mafunso okhudza kumwa mankhwalawo, nthawi yoti musiye kumwa, kapena momwe mungachepetsere mlingo.

Ngati mukumwa ma PPI kuchokera ku pharmacy ndipo mukumva kuti mukuwafuna tsiku lililonse kuti muchepetse zizindikiro zanu, muyenerabe kuonana ndi dokotala. Iye angakupatseni malangizo pa mlingo weniweni ndi nthawi yomwe muyenera kumwa mankhwalawa.

Komanso, ngati mukukumana ndi zotsatirapo zoopsa izi, pitani kwa dokotala nthawi yomweyo:

• Matenda a ziwengo (matuza pakhungu, kufiira, kutupa)
• Zizindikiro za kuwonongeka kwa impso (kukodza pang'ono kuposa kale, kutupa m'manja ndi mapazi, akakolo)
• Zizindikiro za kusowa kwa magnesium (kunjenjemera, kugunda kwa mtima kosakhazikika, kugwedezeka kwa minofu)
• Zizindikiro za kusowa kwa vitamini B12 (kupweteka m'manja ndi m'mapazi, dzanzi, kumva kuwawa, chizungulire, kusokonezeka)
• Ngati khungu lifiira, matuza, kapena likuwoneka ngati likutuluka
• Ngati muli ndi kutsegula m'mimba kwambiri
• Ngati muli ndi malungo

Ndiye, uthenga womaliza woti mutenge kunyumba ndi uti?

Kukhala ndi asidi wambiri m'mimba, kapena kukhala nayo pamalo osayenera, kungakhale kopweteka kwambiri. Kungawonongenso dongosolo lanu logaya chakudya. Mwamwayi, pali mankhwala ambiri omwe angakuthandizeni ngati muli ndi zizindikiro izi.

Kuti munthu apeze mpumulo wa kanthawi kochepa, mankhwala oletsa asidi kapena H2 blocker ndi abwino kwambiri. Koma ngati muli ndi kutentha pamtima pafupipafupi kapena muli ndi zilonda zam'mimba, dokotala wanu angakulembeni mtundu wa PPI. Mankhwalawa akhalapo kwa zaka zambiri ndipo amaonedwa kuti ndi mankhwala otetezeka komanso othandiza. Anthu ambiri amapeza mpumulo ndi mankhwalawa.

Chofunika kwambiri ndichakuti mankhwalawa azigwiritsidwa ntchito pokhapokha ngati dokotala walangiza, mu mlingo wovomerezeka komanso kwa nthawi yomwe wapatsidwa.Ngati muyesa kugwiritsa ntchito momwe mukufunira, mavuto angabuke. Chifukwa chake, ndi bwino kumvera nthawi zonse zomwe dokotala akunena ndikumwa mankhwala moyenerera.

Ma PPI, gastritis, kutupa m'mimba, acid reflux, zilonda zam'mimba, omeprazole, pantoprazole