Ese ukunda kubabara mu gifu? Ibi bishobora kuba igisebe cyo mu gifu (Indwara y'ibisebe byo mu gifu)! Reka tubiganireho.

Ese ukunze kumva ubushye mu nda, cyangwa se ukumva umerewe nabi mu nda? Benshi muri twe twibagirwa ko ibi ari ibintu bisanzwe, wenda tukibwira ko ari "gastrite". Ariko, rimwe na rimwe ubu burwayi bushobora kuba ikintu gikomeye kurushaho. Iyo ni yo ndwara y'ibisebe byo mu gifu, cyangwa nk'uko abaganga babyita, `Indwara y'ibisebe byo mu gifu (PUD). Rero, uyu munsi turaganira kuri ibi mu buryo burambuye, nk'aho twaba tubibwiye inshuti. Kuko kubimenya bishobora kuba ingenzi cyane kuri wewe.

Indwara y'ibisebe byo mu gifu ni iki? Mu magambo make...

Mu magambo make, indwara y'igisebe cy'igifu ni igisebe gifunguye gikorera ku gice cy'igogora ryacu, igice cy'inzira y'igogora aho turya n'ibyo tunywa. Ijambo "peptic" risobanura "bifitanye isano no gusya." Rikomoka ku ijambo "pepsin," ari ryo enzyme ikomeye ikorerwa mu gifu cyacu.

Tekereza, mu nda yacu dufite aside yo mu gifu n'iyi enzyme yitwa pepsin. Ibi bibiri ni byo bidufasha gusenya ibiryo turya no kubisya mu buryo bwa shimi. Uyu mutobe ni aside cyane, mu by'ukuri, urangiza. Uyu mutobe rimwe na rimwe ujya mu gice cya mbere cy'amara yacu mato (duodenum).

Noneho reba, inzira yacu yose y’igogora irinzwe n’ururenda rurinda inkuta, nk’igikingirizo kirinda inkuta ibintu bikomeye biri imbere. Uru rurenda rurinda inkuta rukomeye cyane mu gifu no mu gice cya mbere cy’amara mato. Ariko, ku muntu urwaye ibisebe byo mu nda, ubu buryo bwo kwirinda buragabanuka . Hanyuma iyo mitobe ikomeye y’igogora ishobora kurya inkuta.

Igisebe ni isuri igera mu burebure buhagije kugira ngo yinjire mu bice bitatu by'igifu. Akenshi, ibi bisebe biba mu gifu cyangwa igice cya mbere cy'amara mato (duodenum), kuko ariho imitobe y'igogora ikora cyane. Ariko gake cyane, bishobora kugaragara ahandi hantu.

Ese ibi bikomere bishobora kuboneka he? Hari ubwoko ubwo aribwo bwose?

Yego, ibi bisebe bikunze kugaragara mu gifu cyacu no mu gice cya mbere cy'amara mato (duodenum).

• Ibisebe byo mu gifu: Ibi ni byo bikunze kugaragara cyane, bigera kuri 80%.
• Ibisebe byo mu gifu: Ibi bigaragara ku bantu bagera kuri 20%.

Ariko, mu bihe bidasanzwe cyane, aside yo mu gifu ishobora kwinjira mu bindi bice, igatera ibisebe. Urugero:

• Igisebe cyo mu nda: Hari abantu bagira ikibazo cyo kubura aside mu nda, ari na cyo gihe aside yo mu nda izamuka mu muhogo. Iyo ibi bikomeje, igice cy'umuyoboro w'amaraso gishobora kwangirika buhoro buhoro, bigatera igisebe. Ibi biterwa n'uko igice cy'umuyoboro w'amaraso kidahangana na aside nk'igice cy'umuyoboro w'amaraso.
• Igisebe cyo mu bwoko bwa Jejunal:Jejunum ni igice cyo hagati cy'amara yacu mato. Kubaga bimwe na bimwe (urugero: gastrojejunostomy - kubaga bihuza igifu na jejunum) bishobora gutera imvune kuri iki gice.

Iyi ndwara ikunze kugaragara gute?

Ku isi yose, hagati ya 5% na 10% by'abantu bazarwara indwara y'ibisebe byo mu gifu (PUD) mu gihe runaka mu buzima bwabo. Nubwo ishobora kubaho mu myaka iyo ari yo yose, ikunze kugaragara cyane ku bantu bafite imyaka yo hagati n'abagabo.

Ni ibihe bimenyetso by'ibi? Ubimenya ute?

Igitangaje ni uko abantu bagera kuri 70% bafite iyi ndwara nta bimenyetso bagaragaza . Ariko ibintu abantu bakunze kugaragaza ni ibi bikurikira:

• Ububabare bwo mu nda: Mu by'ukuri, ni ububabare buturuka hagati mu nda , munsi y'igituza.
• Dyspepsia: Uruhererekane rw'ibibazo byo mu gifu bivuka nyuma yo kurya. Ibi birimo kubabara mu nda yo hejuru, gushya , kumva wuzuye nyuma yo kurya, no kumva wuzuye igihe kirekire.

Uku gushyuha ni nko kumva aside yo mu gifu na enzymes birya igice cy'igifu. Hari abantu babivuga nk'aho "hari ikintu kirimo gucukura imbere mu gifu." Ushobora no kumenya aho ububabare buherereye neza.

Nubwo bigoye kumenya neza niba igisebe kiri mu gifu cyangwa mu mara mato, hari ibimenyetso bimwe na bimwe:

• Niba ufite igisebe mu gifu , ububabare bushobora kwiyongera nyuma gato yo kurya (mu minota 30), kuko ari bwo umutobe mwinshi mu gifu uba usohoka.
• Mu gihe cy'igisebe cyo mu mara , ububabare bushobora kugabanuka nyuma yo kurya. Ariko, nyuma y'amasaha abiri cyangwa atatu, ububabare bushobora kongera kwiyongera uko ibiryo n'imitobe y'igogora binyura mu mara mato. Hari abantu bibeshya ko ibi ari inzara, kuko kurya bitanga ubutabazi. Kubyuka nijoro bitewe n'ububabare ni ibintu bisanzwe ku bantu bafite ibi bisebe byo mu mara mato.

Uretse ibi, ushobora kandi kubona ibindi bintu nka:

• Inda yabyimbye
• Guturika cyangwa gushyuha kenshi
• Kubura ubushake bwo kurya
• Isesemi no kuruka

Bigenda bite iyo idavuwe? Ni izihe ngorane zibaho?

Hari abantu bagaragaza ibimenyetso nyuma y’uko iyo ndwara igize izindi ngorane. Ibi bibaho iyo idavuwe igihe kirekire. Bitabaye ibyo, ibikomere bishobora gutangira kuva amaraso , cyangwa urukuta rukagira urwinshi rugakora umwobo .

Niba urwaye amaraso yo mu gifu cyo hejuru, ushobora kugira ibimenyetso nk'ibi bikurikira:

• Amaraso mu gitereko ( umukara, igitereko cya tarry )
• Isukari ya kawa
• Kuzungera cyangwa gucika intege
• Uruhu rurahinduka umukara (Umukara)
• Umutima utera cyane

Iyo hagaragaye umwobo mu nzira y'igogora (gutobora igifu), ibimenyetso nka:

• Ububabare butunguranye, bukomeye, kandi bukabije bwo mu gifu
• Kubyimba inda n'ububabare bukabije
• Umuriro n'ubukonje

Iyo bitavuwe igihe kirekire, ibisebe bishobora gukira hanyuma bigasubira. Kuri bamwe, inkovu no kubyimba mu nzira y'igogora bishobora kwiyongera, bigatera kuziba kw'igifu . Ibi bishobora gutera ibimenyetso nka:

• Kubyimba, kubyimba, no kubabara
• Isesemi no kuruka
• Kubura ubushake bwo kurya no kugabanya ibiro
• Kunanirwa kwihagarika no kutagira impatwe

Kuki turwara ibi bisebe byo mu gifu? Ni izihe mpamvu nyamukuru zibitera?

Uduce duto tw’igogora dukingira umubiri wacu twagenewe kwihanganira aside na enzymes zikomeye no kwisana iyo byangiritse. Ibi ni ukuri cyane cyane mu gifu no mu gice cya mbere cy’amara mato. Ariko, ibisebe bibaho iyo hari ikintu kibangamiye ubwo bwirinzi karemano.

Kugira ngo ubu burinzi bugabanuke kandi igisebe kigere mu nda, hagomba kubaho indwara y'igihe kirekire cyangwa ihoraho . Abahanga mu bya siyansi bagaragaje impamvu ebyiri z'ingenzi zitera iyi ndwara ya PUD nyinshi:

1. Indwara ya bagiteri ya H. pylori (Helicobacter pylori): Iyi bagiteri iba mu gifu cyangwa mu mara mato hafi kimwe cya kabiri cy'abatuye isi. Ku bantu benshi, ntabwo itera ikibazo. Ariko, iyo bagiteri ibaye nini cyane, ishobora kwangiza uburinganire bw'utundi dukoko duto duhari ndetse igatera indwara yo kubyimba . Uku kubyimba igihe kirekire bigabanya imbaraga z'urukuta kandi bikagabanya ubushobozi bwarwo bwo kwisana. Hari igihe bagiteri zishobora no kwibasira urukuta mu buryo butaziguye.

2. Gukoresha imiti igabanya ububabare itari iya steroide (NSAIDs): Iyi ni imiti igabanya ububabare tugura muri farumasi nta muganga wanditse, nka aspirine na ibuprofen. Kubera ko bayinywa nta nama ya muganga, abantu benshi bayinywa kenshi kurusha uko bakeneye. Ibi bigira ingaruka ku kuringaniza kwa shimi mu gifu cyacu no mu mara mato. NSAIDs zikora mu kugabanya ikorwa ry'imiti yitwa prostaglandins, isana ibyangiritse ku gice cy'igogora.

Uretse izi mpamvu ebyiri z'ingenzi, hari izindi mpamvu zidakunze kugaragara:

• Izindi ndwara
• Kugabanuka kw'amaraso (`Ischemia`)
• Imihangayiko ikomeye y'umubiri (akenshi iterwa n'indwara cyangwa impanuka ishobora gushyira ubuzima mu kaga)
• Kuvura hakoreshejwe imiti ikoreshwa mu gukamura imirasire cyangwa ubuvuzi bushingiye ku mirasire
• Zollinger-Ellison syndrome - indwara ituma igifu kibyara aside nyinshi cyane
• Indwara ya Crohn - indwara yo kubyimba mu nzira y'igogora
• Kanseri y'igifu

Ni nde uri mu kaga gakomeye ko kurwara iyi ndwara?

Niba ufite ubwandu bwa H. pylori cyangwa ukunda gukoresha imiti igabanya ubukana bwa NSAID, ushobora kurwara ibi bisebe byo mu gifu. Ingaruka ziba nyinshi cyane cyane iyo ufite ibi bintu byombi bishobora gutera ububabare.

Byongeye kandi, kunywa itabi, kunywa inzoga, n'indi miti ufata nabyo bishobora kugira uruhare muri ibi. Nubwo ibi bintu byonyine bidahagije kugira ngo bitere ibisebe, iyo bihujwe n'ubwandu bwa H. pylori cyangwa imiti igabanya ubukana bwa NSAID, byongera amahirwe yo kurwara ibisebe byo mu gifu.

Abaganga bapima iki kibazo gute?

Niba muganga wawe akeka ko hari igisebe cyo mu gifu bitewe n'ibimenyetso byawe n'ibintu bishobora gutera ibyago, azabanza arebe ko hari ibisebe mu muhogo wawe. Azanapima ubwandu bwa H. pylori.

Ku bantu benshi, ikizamini cya nyuma cyo gusuzuma indwara yo mu gifu (EGD test) ni cyo gipimo cya nyuma. Ibi bisaba gushyiramo umuyoboro muto ufite kamera nto ku iherezo binyuze mu kanwa no gusuzuma umwobo, igifu, n'igice cya mbere cy'amara mato. Muri iki gihe, agace gato k'umubiri (biopsy) gashobora no gukurwa mu gifu kugira ngo harebwe niba H. pylori ihari.

Endoskopiya ni ingirakamaro cyane kuko itagufasha kubona amashusho gusa, ahubwo inagufasha kohereza ibikoresho mu muyoboro w'amaraso mu gihe bibaye ngombwa no kuvura. Urugero, niba igisebe kiri kuva amaraso, ushobora kugivura ako kanya kugira ngo gihagarare.

Ibindi bizamini:

• Isuzuma rya `CT scan (Computed Tomography scan)` cyangwa `GI series X-ray` rishobora gukorwa kugira ngo hamenyekane ibikomere binini.
• Ikizamini cyo guhumeka urea cyangwa "icyiciro cy'umwanda" gishobora gukorwa kugira ngo hamenyekane ubwandu bwa "H. pylori".

Ni ubuhe buryo bwo kuvura?

Uburyo bw'ingenzi bwo kuvura ibisebe byo mu gifu ni uruvange rw'imiti igabanya aside yo mu gifu, ikarinda ururenda rw'imbere, kandi ikarufasha gukira . Niba ufite ubwandu, ushobora no gukenera imiti irwanya udukoko. Icy'ingenzi ni ukumenya no kuvura icyateye igisebe.

Akenshi, ibikomere bishobora gukira hakoreshejwe imiti gusa. Ariko, iyo hari ingorane, nko kuva amaraso cyangwa igikomere gifite icyuho, hashobora kuba hakenewe ubundi buvuzi. Ibyinshi muri ibyo bibazo bishobora gukemurwa hakoreshejwe uburyo bworoshye bwo kwa muganga, nka endoscope.

Imiti

• Antibiyotike: Niba ufite ubwandu bwa H. pylori cyangwa indi bagiteri, muganga wawe azaguha imiti ivanze ya antibiyotike kugira ngo wice bagiteri. (Urugero: Amoxicillin, Clarithromycin, Metronidazole)
• Imiti irinda indwara ya cyto: Iyi miti ikora mu gutwikira no kurinda igifu kugeza gikize. (Urugero: `Sucralfate`, `Misoprostol`, `Bismuth subsalicylate`)
• Imiti igabanya aside ibuza igifu gukora aside. (Urugero: `Famotidine`, `Cimetidine`)
• Indabyo zo mu gifu zigabanya aside mu gifu kandi zigafasha igifu gukira binyuze mu kukirinda. (Urugero: Omeprazole, Pantoprazole, Esomeprazole)
• Imiti igabanya ububabare aho gufata imiti igabanya ububabare ya NSAID: Niba usanzwe ufata imiti igabanya ububabare ya NSAID, ushobora kuvugana na muganga wawe ku yindi miti. Acetaminophen (parasetamol) ntabwo ari NSAID kandi nta ngaruka igira ku gice cy'inda.

Uburyo bwo kwa muganga

Niba ufite igikomere kigoye kandi kiva amaraso, muganga wawe azakenera kugivura mu buryo butaziguye. Ibi bishobora gukorwa kenshi mu gihe cyo gupima indwara. Kuva amaraso bihagarikwa no gutwika igikomere cyangwa gutera imiti. Iyo hari umwobo, uradodwa.

Ni gake cyane, iyo igisebe cyazibye umwobo, hashobora kuba ngombwa ko habaho ingamba zo kuwufungura. Ibi bishobora kuba birimo gukurura ibiri mu gifu cyangwa, gake cyane, kubagwa.

Ni iki twakora kugira ngo twirinde iki kibazo? (Kwirinda)

Ibintu by'ingenzi ushobora gukora kugira ngo wirinde indwara y'ibisebe byo mu gifu ni ibi bikurikira:

1. Suzuma ubwandu bwa H. pylori hanyuma uvurwe: Abantu benshi bafite ubwandu bwa H. pylori ariko ntibabizi. Ushobora kumenya niba ufite ubu bwandu ukoresheje ikizamini cyoroshye cyo guhumeka urea. Iyo ubufite, vurwa mbere yuko ibibazo bibaho. Nubwo waba warigeze kuvurwa mbere, ni byiza kongera kwipimisha, kuko rimwe na rimwe bushobora kugaruka.

2. Koresha imiti igabanya ububabare nk'uko byavuzwe gusa: Niba umenyereye gufata imiti igabanya ububabare buto buri munsi, witondere kutarenza urugero rwagenwe. Niba ufite amateka yo kurwara ibisebe byo mu gifu, ni byiza kwirinda kuyikoresha. Niba bibaye ngombwa, uyifate n'undi muti urinda igifu.

Ese ibi bikomere bizakira nta muti?

Iyo icyateye igisebe gikuweho, igisebe gishobora gukira. Ariko, ubusanzwe hakenewe isuzuma rya muganga kugira ngo hamenyekane icyateye. Niba icyateye ari ubwandu bwa H. pylori cyangwa indi ndwara, hazakenerwa ubuvuzi kugira ngo gikureho.

Niba impamvu ari imiti igabanya ubukana bw’indwara za NSAID, igisebe gishobora gukira ubwacyo niba uhagaritse kuyifata. Ariko, ugomba kureba muganga kugira ngo abyemeze. Ushobora kandi kuba ufite ubwandu bwa H. pylori, kandi imiti igabanya ubukana bw’indwara za NSAID ishobora kongera ubwandu bwari busanzwe butagira ingaruka mbi.

Bigenda bite nyuma yo kuvurwa? Bifata igihe kingana iki kugira ngo umuntu akire?

Ibisebe byinshi byo mu gifu bikira mu byumweru bike . Abantu benshi bagomba gufata imiti mu gihe cy'amezi abiri. Uyu muti urakora cyane. Ariko, abantu bafite indwara z'igihe kirekire nka Zollinger-Ellison syndrome bashobora gukenera gufata uyu muti ubuzima bwabo bwose.

Nyuma yo kuvurwa, muganga azakora ibizamini byo gukurikirana kugira ngo arebe neza ko igisebe cyakize neza kandi ko ubwandu bwashize. H. pylori ni bagiteri ikomeye kandi rimwe na rimwe ishobora kugaruka. Nanone, niba indwara zateye igisebe zikomeje, igisebe gishobora kugaruka.

Ni gake cyane, hari abantu bashobora kugira ibisebe byo mu gifu bidakira iyo bivuwe. Ibi bishobora gutera ingorane nko kubabara igihe kirekire no kugira inkovu nyinshi. Muri ibyo bihe, kubagwa bishobora kuba ngombwa (urugero: gukuraho inkovu (pyloroplasty), cyangwa gukata imitsi igenzura ikorwa ry’aside yo mu gifu (vagotomy)).

Ese ukeneye guhindura imirire yawe n'imibereho yawe?

Ibiryo n'ibinyobwa ntabwo bitera ibisebe mu gifu, ariko niba ufite ibisebe, bimwe mu biribwa n'ibinyobwa (cyane cyane ibiryo biryoshye kandi bikarishye) bishobora gutuma birushaho kuba bibi . Niba ufite ibimenyetso cyangwa wigeze kugira ibisebe mu gifu, ugomba kwirinda burundu inzoga n'itabi .

Vugana na muganga wawe ku miti yose ufata (cyane cyane NSAIDs). Imiti imwe ishobora guteza ibibazo iyo uyifashe hamwe.

Ese ibi ntibishobora kuvurwa hakoreshejwe imiti igabanya aside mu rugo?

Aside igabanya aside kandi ikagabanya ibimenyetso nko kuribwa mu gifu, kuribwa mu gifu no kutagira impumuro nziza. Ishobora gutuma igisebe kimera neza by'igihe gito, ariko ntikiza igisebe . Niba warigeze kugira ibisebe mu gifu mbere, aside igabanya aside ishobora kugufasha kubikumira ngo bitagaruka.

Ni ibihe bihe byiza byo kujya kwa muganga?

Niba ukeka ko ufite igisebe cyo mu gifu, menya neza ko wagiye kwa muganga . Nubwo imiti igurishwa ku giciro gito ishobora kugabanya ibimenyetso byawe by'agateganyo, ntabwo izakiza igisebe. Impamvu nyamukuru igomba kumenyekana no kuvurwa.

Igisebe kitavuwe, nubwo waba udafite ibimenyetso bikomeye, gishobora gutera ingorane zikomeye. Kwandura H. pylori, ari nayo mpamvu nyamukuru itera ibisebe byo mu gifu, bishobora no gutera izindi ngorane (nk'ibyago byo kurwara kanseri yo mu gifu).

Niba ubonye ibimenyetso by'ingorane zikomeye nk'izi, jya mu cyumba cy'ubutabazi bwihuse:

• Ububabare buhoraho kandi bukomeye.
• Ibimenyetso by'amaraso mu muyoboro w'inyirabura cyangwa kuruka amaraso.
• Ibimenyetso byo gutakaza amaraso menshi (guhinduka umutuku, gucika intege).

Ibintu by'ingenzi tugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Indwara y'ibisebe byo mu gifu ni indwara ikomeye igira ingaruka ku buryo bworoshye mu igogora. Ibaho iyo ubwirinzi bw'umubiri wawe busanzwe bucitse intege. Iyi ndwara ifata igihe kugira ngo ikure kandi akenshi isaba ubuvuzi kugira ngo ikire.

Ibisebe byo mu nda ni indwara ikunze kugaragara kandi ishobora kuvurwa. Ariko, ni ngombwa gushaka ubuvuzi nubwo nta bimenyetso bikomeye ufite.Iyo bitavuwe, ibikomere bishobora kwiyongera cyane. Rero, ntutinde kuvugana na muganga ku bimenyetso byawe. Ubuzima bwawe burakwiye!

Ibisebe byo mu gifu, ibisebe byo mu gifu, kubyimba mu gifu, H. pylori, NSAID, indwara y'igifu, kutagira ingano mu gifu