Patinonzwa kurwadziwa mudumbu kana kuzvimba, tinowanzo funga nezve gastritis. Asi dzimwe nguva chikonzero chekurwadziwa ikoko chinogona kunge chiri chironda chemudumbu kana chironda chemudumbu (Stomach Ulcer / Gastric Ulcer). Kungofanana nechironda paganda redu, ichi chironda chinoumba pamadziro emukati medumbu. Ichi chirwere chinowanzoitika uye chinogona kurapwa uye kurapwa. Zvisinei, kana chikarapwa nemazvo, chinogona kutungamira kuzvirwere zvakakomba. Saka, chii chinonzi chironda chemudumbu? Sei chichiitika? Ndezvipi zviratidzo? Ndedzipi nzira dzekurapa nekudzivirira? Tichataura nezveizvi zvese muchinyorwa chino.

Chii chinonzi chironda chemudumbu ichi? (Ongororo)

Maronda emudumbu anotanga sei?

Dumbu redu rine hydrochloric acid nema enzyme anobatsira kugaya chikafu. Izvi zvakasimba kwazvo. Saka, kudzivirira madziro edumbu kubva kuma acid aya, kune jira remudumbu rinodzivirira rakagadzirwa nematehwe akakora. Asi kana nechikonzero chipi zvacho jira iri rinodzivirira rikakuvara, acid iyoyo yakasimba inogona kudya madziro edumbu. 'Chironda chakavhurika' chinoumbwa nekudya chinonzi chironda chemudumbu.

Zvakajairika sei?

Ichi chirwere chinowanzoitika. Chinowanzoitikawo muSri Lanka. Chikonzero chikuru cheizvi ndechekuti zvikonzero zviviri zvikuru zvemaronda emudumbu zvakajairika munharaunda medu. Izvi ndeizvi:

1. Kushandiswa kwemishonga inoderedza marwadzo inotengeswa kunze kwemutero ( NSAIDs ) kwakapararira.
2. Kuwanda kwehutachiona hweH. pylori .

Maronda emudumbu vs maronda emudumbu

Mazita maviri aya anogona kuvhiringidza. "Peptic Ulcer Disease " chirwere apo chikamu chedumbu kana chikamu chekutanga cheura diki ( duodenum) chinokuvadzwa neacid yemudumbu.) izita rinowanzo shandiswa pakureva maronda. Saka, maronda anoitika mudumbu (Gastric Ulcer / Stomach Ulcer) rudzi rwemaronda emudumbu. Maronda anoitika muchikamu chekutanga cheura anonzi "Duodenal Ulcers". Zvinokonzera uye marapirwo ezvose zvakafanana.

Zviratidzo Nezvikonzero

Ndezvipi zviratidzo zvechironda chemudumbu?

• Chiratidzo chikuru: Kurwadziwa nekupisa : Chiratidzo chikuru chinonzwa nevanhu vazhinji kurwadziwa nekupisa kana kurwadza mudumbu repamusoro (pasi pechipfuva, pamusoro peguvhu, uye kunorema kuruboshwe). Izvi zvinogona kunzwa sekutsva neacid, kana sekunge chimwe chinhu chiri kudyiwa kubva mukati (hunhu hwekuruma). Kunzwa uku hakusi kungonzwa chete, asi chiri kuitika ndechekuti acid nema enzymes ari kudya ronda. Kurwadziwa uku kunogona kuwedzera kana usina chinhu, kunyanya husiku. Vamwe vanhu vanoona kuti kurwadziwa kunoderedzwa nekudya, asi kune vamwe (kunyanya nemaronda emudumbu), kurwadziwa kunogona kuwedzera kana vadya.
• Kusadya zvakanaka uye Kuzara: Vanhu vazhinji vane maronda emudumbu vanowana zviratidzo zvekusadya zvakanaka. Uku kunzwa kupisa mudumbu pamwe nekunzwa kuzara. Unogona kunzwa kuguta paunongotanga kudya, kana kuti unganzwa kuguta kwenguva yakareba mushure mekudya.
• Zvimwe zviratidzo zvakajairika: Pamusoro peizvi, zviratidzo zvine chekuita nemamiriro ezvinhu akakonzera kukuvara zvinogona kusanganisira:
  • Acid reflux uye chirungurira
  • Kusvotwa nekurutsa
  • Kuzvimba, kusviba, uye kurwadziwa negasi
• Maronda Asiri Mukati Uye Zviratidzo Zvematambudziko: Zvinoshamisa kuti vamwe vanhu vane maronda emudumbu asi havanzwi kurwadziwa kana zviratidzo. Aya anonzi "maronda Asiri Mukati." Vangasaziva kuti vane ronda kusvika paitika dambudziko guru, rakadai sekubuda ropa kana kubooka. Tsvaga rubatsiro rwechiremba nekukasika kana uine chimwe chezviratidzo izvi:
  • Kuchenuruka kweganda (Kuchenuruka kweganda)
  • Dzungu, kushaya simba kana kupera simba - zvinogona kukonzerwa nekurasikirwa neropa.
  • Chituru chakasviba, chinononoka - chinokonzerwa neropa rakagayiwa.
  • Kurutsa kunoita sekunge kofi yakakuyiwa - nekuda kweropa rakagwamba mudumbu.
  • Kurwadziwa kwemudumbu kwakakomba kamwe kamwe kusingapere - kunogona kuva chiratidzo chekuboorwa.

Matambudziko acho akakomba zvakadini?

Kana zvikasarapwa, maronda emudumbu anogona kukonzera matambudziko akakomba:

• Maronda Anobuda Muropa: Ronda rinogona kubuda ropa nguva dzose, kungave zvishoma nezvishoma kana kamwe kamwe. Kana rikabuda ropa zvishoma nezvishoma, nekufamba kwenguva, ropa remuviri rinogona kudzikira, zvichikonzera anemia. Kana rikabuda ropa rakawanda, muviri unogona kuvhunduka uye kutofa.
• Maronda Akaboorwa: Dambudziko risingawanzoitika asi rakakomba apo ronda rinoboorwa zvachose nemadziro emudumbu roita buri. Buri iri rinogona kubvumidza acid yemudumbu nemabhakitiriya kupinda mudumbu, zvichikonzera hutachiona hwakakomba (peritonitis). Utachiona uhwu hunogonawo kupararira muropa, zvichikonzera chirwere chinouraya chinonzi sepsis.

Ndezvipi zvinonyanya kukonzera maronda emudumbu?

Zvikonzero zvikuru zviviri zvemaronda emudumbu muSri Lanka nepasi rose ndeizvi:

• Utachiona hweH. pylori (Helicobacter pylori): Utachiona hwehutachiona hunowanzoonekwa nevanhu vakawanda. Zvinofungidzirwa kuti hafu yevanhu pasi rose ine hutachiona uhwu huri mudumbu mavo. Kune vanhu vazhinji, hutachiona uhwu hahukonzeri matambudziko. Zvisinei, mune vamwe vanhu, hutachiona uhwu hunokura zvakanyanya mudumbu uye hunotanga kudya jira rinodzivirira remudumbu. Izvi zvinokonzera kuzvimba kusingaperi, izvo zvinogona kukonzera maronda mudumbu nekufamba kwenguva.
• Kushandiswa kweNSAID inonyaradza marwadzo: NSAID (Nonsteroidal Anti-inflammatory Drugs) imhando yemishonga inouraya marwadzo yatinowanzo tenga ku pharmacy. Mienzaniso inosanganisira Ibuprofen, Naproxen, Diclofenac, Aspirin.Mishonga yakaita seiyi ndeyeboka iri. (Paracetamol haisi mushonga muboka iri). Kana mishonga iyi yeNSAID ikapinda mudumbu, inokonzera kutsamwa kudiki kumadziro edumbu, uye inodzivirirawo kugadzirwa kwemakemikari anodzivirira nekugadzirisa madziro edumbu. Kazhinji, madziro edu edumbu anogona kupora kubva mukukuvadzwa kudiki seizvi. Asi kana tikatora mishonga iyi kakawanda, madziro edumbu haawani nguva yakakwana yekuzvigadzirisa. Zvishoma nezvishoma, jira rekudzivirira rinopera uye maronda anoumbwa.

Zvimwe zvikonzero zvisingawanzoitiki

Kuwedzera kune izvi zvikonzero zvikuru zviviri, maronda emudumbu anogonawo kukonzerwa nezvinotevera, kashoma:

• Zvimwe zvirwere: Kashoma, zvimwe zvirwere zvebhakitiriya, mavhairasi, kana fungus zvinogona kukanganisa dumbu uye kukonzera maronda.
• Zollinger-Ellison syndrome: Ichi chirwere chisingawanzoitiki apo mudumbu munobva maburisa acid yakawanda mudumbu, zvichikonzera kukuvara kwedumbu.
• Kushushikana kwakanyanya mumuviri: Kuchinja kwemahormone nemakemikari kunoitika muviri paunenge uchiedza kupora kubva kuchirwere chinotyisidzira hupenyu (semuenzaniso, kutsva kwakanyanya, kuvhiyiwa kukuru) kana tsaona zvinogona kukonzera acid yemudumbu kuwedzera, zvichikonzera kukura kwe "stress ulcer." Uku hakusi kushushikana kwepfungwa kwatinosangana nako muhupenyu hwezuva nezuva.

Mararamiro anochinja here?

Vanhu vazhinji vanofunga kuti kudya chikafu chine mhiripiri uye kushushikana kunokonzera maronda emudumbu. Chokwadi ndechekuti, mararamiro ezuva nezuva (sezvaunodya uye zvaunonwa, kushushikana kwakajairika) hazvikonzeri zvakananga maronda emudumbu. Zvisinei, kana uchitova neronda remudumbu, zvinhu izvi zvinogona kuwedzera zviratidzo zvako . Izvi zvinodaro nekuti zvinowedzera acidity mudumbu, zvichiita kuti ronda riwedzere.

• Kusvuta
• Kushandisa doro
• Zvokudya zvinonaka
• Zvikafu zvine acidic zvakaita sematomatisi nemichero yecitrus
• Zvinwiwa zvine caffeine zvakaita sekofi netii

Kuongorora uye Kuedzwa

Unoziva sei chironda chemudumbu?

Paunoenda kunoona chiremba, vanotanga vakubvunza nezvezviratidzo zvako, kana uchigara uchitora mishonga yeNSAID, uye kana wakambova nechirwere cheH. pylori. Kana zviratidzo zvako zvichiratidza kuti une ronda remudumbu, vangangoda kuongorora mukati medumbu mako kuti vaone kana paine chirwere ichi.

Ndedzipi mhando dzebvunzo dzamunoita?

Pane zvinhu zviviri zvikuru zvinofanira kuzivikanwa nachiremba :

1. Une chirwere cheH. pylori here?
2. Une chironda chemudumbu here? Chinotaridzika sei?

Nzira yakanakisisa yekuita zvese izvi panguva imwe chete ndeyekushandisa endoscopy .

• Kuongororwa kweEndoscopy yepamusoro / EGD: Izvi zvinosanganisira kuisa chubhu refu, rakatetepa, rinochinjika (endoscope) rine kamera uye chiedza kumagumo kuburikidza nemuromo wako uye pasi pehuro kuti uongorore mukati medumbu rako neura hudiki. Uchapihwa mushonga wekunyaradza kuti unzwe wakasununguka. Chiremba anogona kushandisa kamera kuti aone kana paine maronda kana kubuda ropa mudumbu mako. Anogona zvakare kushandisa mudziyo mudiki kuburikidza nechubhu kutora chidimbu chidiki chenyama (biopsy) kubva munzvimbo inofungirwa kana chironda kuti aongorore mabhakitiriya eH. pylori. Kana paine kubuda ropa kubva muronda, kurapwa kunogona kupihwa kuti kumise kubuda ropa nekukasika (semuenzaniso, kuuraya tsinga yeropa) panguva ye endoscopy iyi.
• Mimwe Miedzo: Kunyange zvazvo endoscopy iriyo nzira yakanakisisa, dzimwe nzira dzingashandiswa dzimwe nguva:
  • Upper GI X-ray series (Barium Swallow): Muizvi, mvura inonzi barium inomedzwa uye mifananidzo yeX-ray inotorwa. Nekuti barium inofukidza dumbu, chero maronda anogona kuonekwa paX-ray. Zvisinei, izvi hazvina kunyatsojeka se endoscopy, uye maronda madiki anogona kushaikwa.
  • Kuongororwa kweH. pylori: Kune bvunzo dzakasiyana dzekutarisa kuvapo kwebhakitiriya:
    • Kuongororwa Kwekufema kweUrea: Unopiwa mvura yakakosha yekunwa, wobva waongororwa mweya wako wekuburitsa mweya.
    • Kuongororwa kweRopa: Izvi zvinoedza ma antibodies ekurwisa H. pylori. Zvisinei, hazvigone kunyatsoziva kana uine hutachiona parizvino kana kuti wakambobatwa nehutachiona.
    • Kuongororwa kweAntigen yetsvina: Muenzaniso wetsvina unoongororwa kuti uone kana paine maantigen ebhakitiriya.

Zvimwe zvirwere zvinogona kufungidzirwa kuti zvine chironda chemudumbu

Kana bvunzo dzikaratidza kuti hauna chironda chemudumbu, chikonzero chezviratidzo zvako chingave chimwe chinhu, chakadai se:

• GERD (Gastroesophageal Reflux Disease): Kana acid inobva mudumbu ikaramba ichidzoka muhuro (acid reflux), inogona zvakare kukonzera zviratidzo zvakaita sechirungurira, kusagadzikana kwekugaya chikafu, uye kuda kurutsa.
• Kusagadzikana Kwemuviri: Ichi chirwere chinowanzoonekwa nezviratidzo zvekusagadzikana kwekugaya chikafu (kurwadziwa mudumbu, chirungurira, kuzara) pasina chikonzero chaicho chemuviri. Kunyangwe zviratidzo zvacho zvakafanana nezvechironda chemudumbu, hapana chironda chinoonekwa mudumbu.
• Gomarara remudumbu: Izvi hazviwanzoitiki, asi zvinogona kukonzera zviratidzo zvakafanana neronda remudumbu (kurwadziwa kwemudumbu, kudzikira kwehuremu, kushaya chido chekudya). Ndosaka zvichikosha kuti upihwe biopsy panguva ye endoscopy.

Kutarisira uye Kurapa

Nzira yekurapa chironda chemudumbu nekukurumidza sei?

Kana chikonzero cheronda chabviswa, dumbu rinotanga kupora zvishoma nezvishoma. Semuenzaniso, kana ronda rako rikakonzerwa neNSAID, kana ukarega kutora mushonga, ronda rinogona kupora pasina kumwe kurapwa. Zvisinei, kana uine hutachiona hweH. pylori, uchafanira kutora mishonga inorwisa mabhakitiriya kuti uuraye mabhakitiriya. Pamusoro pezvo, chiremba anogona kunyora mimwe mishonga inoderedza acid yemudumbu uye inodzivirira dumbu kusvika ronda raparara. Kutora mishonga iyi nemazvo kunogona kubatsira ronda kupora nekukurumidza.

Ndeapi marapirwo aripo?

Kazhinji, maronda emudumbu anorapwa nemishonga yakasiyana-siyana. Mishonga iyi inosanganisira:

1. Inoderedza huwandu hweasidhi mudumbu.
2. Inofukidza, inodzivirira, uye inobatsira ronda kupora.
3. Kana paine hutachiona (H. pylori), huchabviswa.

Kashoma, kurapwa kungadiwa kuti ropa rimire kubuda kana kuvhara buri.

• Mishonga:
  • Mishonga inorwisa mabhakitiriya : Kana uine H. pylori kana imwe hutachiona hwebhakitiriya, chiremba wako angangokupa mishonga miviri kana mitatu panguva imwe chete kwemazuva manomwe kusvika gumi nemana kuti uuraye hutachiona zvachose. Mishonga inonyanya kushandiswa ndeye: Tetracycline, Metronidazole, Clarithromycin, uye Amoxicillin. Zvakakosha kutora mishonga yese yawakanyorerwa nachiremba wako kwenguva yese yekurapa, kana kuti hutachiona hunogona kudzoka.
  • Mishonga inodzivirira dumbu: Mishonga iyi inoshanda nekugadzira jira rekudzivirira (coat) pamusoro pemadziro edumbu, ichiidzivirira kusvika ronda raparara. Inowanzo shandiswa kurapa nekudzivirira maronda anokonzerwa neNSAIDs. Mienzaniso: Sucralfate, Misoprostol, Bismuth subsalicylate.
  • H2 blockers (Histamine receptor blockers / H2 blockers): Dzinovhara kemikari inonzi histamine, iyo inozivisa muviri kuti ugadzire acid mudumbu, uye inoderedza kugadzirwa kweacid. Mienzaniso: Famotidine, Cimetidine, Nizatidine.
  • Proton Pump Inhibitors (PPIs): Iyi mishonga ine simba inoderedza kugadzirwa kweasidhi mudumbu. Inodzivirirawo dumbu uye inokurumidzisa kupora kwemaronda. Iyi ndiyo mishonga inonyanya kushandiswa pamaronda emudumbu. Mienzaniso: Omeprazole, Esomeprazole, Lansoprazole, Pantoprazole, Rabeprazole.
• Maitiro Ekurapa: Ronda rakaomarara (kubuda ropa, kubooka) rinofanira kurapwa zvakananga nachiremba . Izvi zvinogona kuitwa panguva imwe chete ne endoscopy. Ronda rinobuda ropa rinogona kumiswa nekubaya mushonga kana kuupisa. Kana paine kubooka, rinofanira kuvharwa nekuvhiyiwa.
• Kuvhiyiwa kwemaronda asingaperi:Kashoma, maronda emudumbu evamwe vanhu anogona kuramba aripo pasina kurapwa, kana kuti anogona kupora odzoka. Izvi zvinogona kukonzera kurwadziwa kwenguva refu uye mavanga mudumbu. Dzimwe nguva mavanga aya anogona kuvhara nzira inobuda kubva mudumbu kuenda muura. Muzviitiko zvakadaro, kuvhiyiwa kunogona kudiwa, zvakaita se:
  • Kubvisa mavanga kana kuvhura nzira yakavharika (Pyloroplasty).
  • Kubvisa nhengo dzemuviri (Vagotomy) kuchekwa kwetsinga yemudumbu (vagus nerve), iyo inosimudzira kugadzirwa kweacid mudumbu.

Nzira yekudzivirira sei? (Kudzivirira)

Maronda emudumbu angadzivirirwa sei kuti asaumbe kana kudzoka?

Heano mamwe maitiro aungaita kudzivirira chironda chemudumbu kuti chisavepo, kana kuti kudzivirira kuti chisadzoke mushure mekunge chapora:

• Kubviswa kwehutachiona hweH. pylori: Vanhu vazhinji vane hutachiona hweH. pylori asi havazvizivi. Unogona kuziva kana uine hutachiona uhwu nekuongororwa kwekufema kana kutorwa kwetsvina. Kana ukadaro, unogona kuubvisa nemishonga inorwisa mabhakitiriya usati wakonzera matambudziko.
• Kushandisa NSAIDs nemazvo: Kana uchigara uchitora NSAIDs kubva ku pharmacy nekuda kwekurwadziwa kwemuviri nemusoro, iva nechokwadi chekuti hautore zvinopfuura zvakataurwa. Kana ukaramba uchitora NSAIDs nekurairwa nachiremba kune chimwe chirwere (semuenzaniso arthritis), kana zvichibvira, deredza piritsi, chinja kune mumwe mushonga, kana kutaura nachiremba wako nezvekutora mumwe mushonga unodzivirira dumbu (senge PPI) panguva imwe chete.
• Deredza dzimwe tsika dzinokuvadza: Kana uine hutachiona hweH. pylori kana kuti uri kutora mishonga yeNSAIDs, kusvuta nekunwa doro zvinowedzera njodzi yako yekuve nemaronda emudumbu. Saka zvakakosha kurega tsika idzi.

Zvinotora nguva yakareba sei kuti munhu apore? (Maonero / Kufungidzira)

Zvinotora nguva yakareba sei kuti chironda chemudumbu chipore?

Kana ukatora mishonga yako sezvakarairwa uye uchidzivisa zvinhu zvinoita kuti ronda riwedzere kuipa (NSAIDs, kusvuta, doro), ronda racho rinofanira kupora zvachose mukati memavhiki mashoma . Chiremba wako anogona kudzokorora endoscopy kana imwe bvunzo kuti ave nechokwadi chekuti ronda racho rapora zvakakwana uye hutachiona hweH. pylori hwapera zvachose.

Zvirwere zvisingaperi

Vanhu vazhinji vanongoda kurapwa kwenguva pfupi chete. Zvisinei, vamwe vanhu vanogona kunge vaine zvirwere zvisingaperi zvinokonzera maronda emudumbu. Semuenzaniso, mumwe munhu ane chirwere cheZollinger-Ellison, chambotaurwa, ane chirwere chekuti mudumbu munobva maita acid yakawanda. Vanhu ava vangangoda kutora mishonga (yakadai sePPIs) kwenguva yakareba.

Chii chaunofanira kuita kana uchifungidzira kuti une chironda chemudumbu? (Kurarama nechirwere ichi)

Kukosha kwekutsvaga mazano ekurapa

Kana uchifungidzira kuti une chironda chemudumbu, iva nechokwadi chekutsvaga rubatsiro rwechiremba. Mishonga inopihwa nechiremba isina kunyoreswa senge mishonga inorwisa mabhakitiriya kana bismuth subsalicylate inogona kuderedza zviratidzo kwenguva pfupi, asi haizoporese chironda chacho. Kuti chironda chipore , chikonzero chacho (H. pylori kana NSAIDs) chinofanira kurapwa.

Njodzi kana dzikasarapwa

Kunyangwe usina zviratidzo zvakakomba, ronda remudumbu risingarapwe rinogona kukonzera matambudziko akakomba, akadai sekubuda ropa kana kubooka. Panewo njodzi yekenza yemudumbu kana hutachiona hweH. pylori, hunokonzera maronda emudumbu, hukasarapwa kwenguva yakareba.

Unofanira kutsvaga rubatsiro rwekukurumidzira riini?

Kana uine zviratidzo izvi, enda kuchipatara nekukasika (ETU) :

• Marwadzo emudumbu asingatsungiririki, asingatsungiririki.
• Kana uine ropa dema mutsvina yako kana kuti uchirutsa ropa (senge kofi yakakuyiwa).
• Zviratidzo zvekubuda ropa rakawanda (ganda rakachenuruka, dzungu rakanyanyisa, kufenda).

Pakupedzisira

Maronda emudumbu chirwere chinowanzoitika uye chinorapika. Zvikonzero zvikuru ihutachiona hweH. pylori uye kushandiswa kwemishonga inoderedza marwadzo yeNSAID. Kana uine zviratidzo zvakaita sekuzvimba mudumbu, kurwadziwa, uye kusagadzikana kwekugaya chikafu, zvakakosha kutsvaga mazano echiremba pane kungofungidzira kuti igomarara. Zvadaro, chikonzero chinogona kuwanikwa, kurapwa kwakakodzera kunogona kutanga, uye matambudziko akakomba anogona kudzivirirwa. Zvakare, kuderedza kusvuta nekunwa doro, uye kushandisa mishonga yeNSAID chete kana zvichidikanwa, muchiyero chakaderera, kwenguva pfupi inogoneka, zvinogona kubatsira kudzivirira maronda emudumbu. Ramba uine hutano hwakanaka!