Unowanzo batwa nemaronda emudumbu here kana gastritis? Une maronda emudumbu anogara achienderera mberi asingavandudzike pasinei nekurapwa here? Une manyoka here? Dzimwe nguva tinoona izvi sezvinhu zvakajairika, asi nhasi tichataura nezvechirwere chisingawanzoitiki chakavanzika kuseri kweizvi, asi chinogona kunge chakakomba zvishoma. Izvi zvinonzi Zollinger-Ellison Syndrome.
Zvichitaurwa zviri nyore, chii chinonzi Zollinger-Ellison Syndrome (ZES)?
Fungidzira kuti pane shanduko mudumbu medu inodzora kugadzirwa kweasidhi. Homoni inonzi gastrin inoshanda seiyo shanduko. Kazhinji, patinodya, iyi hormone inoburitswa, zvichiita kuti mudumbu mubudise asidhi inobatsira kugaya chikafu. Kana basa rapera, kugadzirwa kweasidhi kunodzorwa.
Zvisinei, muvanhu vane Zollinger-Ellison Syndrome (ZES), mhando yebundu rinonzi gastrinoma rinokura mumuviri. Bundu iri rinowanzo buda mupancreas kana chikamu chepamusoro cheura hudiki (duodenum). Chinoita bundu iri kugadzira gastrin yakawandisa pasina kudzora. Zvinoita sekunge switch yacho inogara 'yakabatidzwa'.
Kana tiine gastrin yakawandisa, dumbu redu rinotanga kuburitsa acid yakawandisa. Asidhi iyi yakawandisa ndiyo inokonzera maronda emudumbu akakomba (peptic ulcers) uye manyoka asingaperi.
Inenge 60% yezvirwere izvi zvinogona kunge zvine kenza , saka zvakakosha kuzviongorora nekurapa nekukurumidza.
Ndezvipi zviratidzo zvechirwere ichi? Tinozviziva sei?
Dzimwe nguva, ZES ingasaratidze zviratidzo pakutanga. Asi kana zviratidzo zvikaonekwa, zvinogona kunge zvakanyanya kupfuura gastritis yenguva dzose. Kuoma kwezviratidzo kunosiyana zvichienderana nehukuru uye huwandu hwemamota mumuviri wako.
Ngatitsanangurei izvi zvakare mutafura iri pazasi.
| Chiratidzo | Tsananguro iri nyore |
|---|---|
| Kurwadziwa kwakanyanya mudumbu kana kuzvimba | Marwadzo aya anoitika kana madziro edumbu neura akakuvadzwa neacid yakawanda mudumbu. |
| Manyoka asingaperi | Kana acid yakawandisa ikapinda mudumbu, inokanganisa mashandiro ema enzymes aripo, zvichikonzera manyoka uye chikafu chisagayiwe zvakanaka. |
| Kurutsa kana kubuda ropa mutsvina | Izvi ndizvo zvinogona kuitika kana ropa richibva mumaronda mudumbu. Kurutsa kunogona kuita dema sekofi yakakuyiwa kana tsvina inogona kuita dema setara. |
| Zvituru zvine mafuta, zvinoyangarara | Kana kugaya mafuta kwava kukanganiswa nekuda kweacid yakawandisa, mafuta asina kugayiwa anobuda mutsvina. |
| Chirungurira chinowanzoitika | Dambudziko iri rinokonzerwa nekuti acid yakawanda mudumbu inopinda mudumbu (acid reflux). |
| Anorexia uye kuderedza uremu | Kurwadziwa nguva dzose nematambudziko ekugaya chikafu zvinogona kukonzera kudzikira kwechido chekudya uye kudzikira kwehuremu. |
| Kuneta uye kushaya simba | Sezvo maronda emudumbu achibuda ropa zvishoma nezvishoma, unganzwa kuneta nekuda kwekushaya ropa. |
Mune zvimwe zviitiko, kana mapundu aya akapararira kuchiropa (metastasis) , anogonawo kuratidza zviratidzo zvegomarara rechiropa. Semuenzaniso, panogona kuva nekukwenya, kutsvuka kwemaziso neganda (jaundice).
Sei chimwe chinhu chakadai chichiitika?
Kazhinji, ZES inoitika nguva nenguva , zvichireva kuti zvinongoitika chete.
Asi vanenge 25% yevarwere vanowana chirwere ichi chinonzi MEN Type 1 (Multiple Endocrine Neoplasia Type 1).Nechirwere chemajini chinonzi ZES. Zvichitaurwa zviri nyore, ichi chirwere chemajini chisingawanzoitiki. Muizvi, pane njodzi yekuti bundu riumbwe mumagland akawanda anogadzira mahormone mumuviri wedu panguva imwe chete. ZES ingori imwe chete yacho.
Ndedzipi bvunzo dzinoitwa kuti dzionekwe sedziri kuitika?
Kana uine zviratidzo zvataurwa pamusoro apa, chiremba wako angangoda kuongororwa kakawanda kana vachifungidzira kuti une ZES.
Miedzo yekutanga
- Kuongororwa kweRopa: Izvi zvinoongorora huwandu hwehomoni inonzi gastrin muropa rako. Kana uine ZES, huwandu uhwu huchava hwakakwira zvisingaite . Izvi zvinonzi hypergastrinemia.
- Kuyedza mazinga eacid mudumbu: Chubhu inopinzwa nemhino mudumbu uye sampuro yeacid inotorwa yoedzwa. MuZES, mazinga eacid aya akakwira zvikuru.
- Miedzo yeKufungidzira: Kuongororwa kweCT kana MRI kunoitirwa kutarisa bundu riri mupancreas kana muura.
Mimwe miedzo kana bundu rakasimbiswa
Mimwe miedzo iri kuitwa kuti zvionekwe kuti mabundu aya ari kupi chaizvo, saizi yawo, uye kuti ane kenza here kana kuti kwete.
- Endoscopy: Chubhu yakatetepa ine kamera inopinzwa nemuromo kuti iongorore dumbu nechikamu chepamusoro cheura hudiki. Izvi zvinogona kubatsira kuona kana paine maronda emudumbu.
- Endoscopic Ultrasound: Uyu musanganiswa we endoscopy ne ultrasound scan. Inogona kuona kunyange bundu diki riri mupancreas.
- ERCP: Uku kuskena kwakasarudzika zvakare.
- Biopsy (Kufema netsono): Kanyama kadiki kanotorwa kubva mubundu roongororwa nemaikorosikopu kuti vaone kana kaine masero ekenza.
Ndezvipi zvinorapwa izvi?
Nzira dzekurapa dzinoenderana nekuoma kwezviratidzo zvako uye kuti bundu racho rine kenza here kana kuti kwete. Kune nzira nhatu huru dzekurapa.
| Nzira yekurapa | Tsananguro |
|---|---|
| Mishonga | Mishonga inonyanya kushandiswa inonzi proton pump inhibitors (PPIs).Iyi mishonga inodzora kugadzirwa kweasidhi mudumbu. Ungangofanira kunwa mishonga iyi kweupenyu hwako hwese. |
| Kuvhiya | Kana bundu richigona kubviswa, kuvhiyiwa kunokurudzirwa. Rudzi rwekuvhiyiwa runosiyana zvichienderana nenzvimbo yebundu (semuenzaniso, Pancreatectomy - kubviswa kwechikamu chepancreas, Duodenectomy - kubviswa kwechikamu cheura hudiki). |
| Kurapa Kenza | Kana bundu iri riri rekenza uye rapararira kune dzimwe nhengo dzemuviri, mishonga yakaita sechemotherapy inopihwa. Izvi zvinoshanda kudzora kukura kwemasero ekenza uye kuderedza zviratidzo. |
Ramangwana rangu richave rakaita sei nemamiriro ezvinhu aya?
Uyu mubvunzo unobvunzwa nevanhu vazhinji. Remangwana rako rinoenderana nerudzi rwegomarara raunaro.
- Matumbu asiri ekenza: Aya haasi njodzi kuhupenyu, asi uchafanira kuramba uchitora mishonga yekuderedza acid yemudumbu.
- Matumbu egomarara: Mamiriro acho akasiyana zvishoma pano. Kana masero ese egomarara mumuviri akabviswa kuburikidza nekuvhiyiwa, chirwere chacho chinogona kurapwa zvachose. Kunyangwe zvakadaro, uchafanirwa kuramba uchiongororwa nachiremba kuti uone kana chirwere chacho chichidzoka.
Zvichienderana nehuwandu hwenyanzvi, varwere vanopfuura 90% vakabviswa mabundu avo ese vanorarama kwemakore mashanu kusvika gumi. Kana kuvhiyiwa kukasakwanisa kubvisa mabundu ese, mwero wekurarama kwemakore mashanu ungangoita 43%.
Asi yeuka izvi: Nhamba idzi ingori avhareji chete zvichibva padata kubva kuzviuru zvevarwere. Mamiriro ako ega ega anogona kunge akasiyana zvikuru. Saka, munhu akanakisa kuziva chaizvo mamiriro ako ndichiremba wako ari kurapa.
Ndinofanira kuzvitarisira sei?
Kana ukaonekwa uine ZES, uchafanira kuchinja zvimwe zvinhu muhupenyu hwako.
- Nwa mushonga wako nemazvo: Zvakakosha kutora mishonga inoderedza acid (PPIs) panguva yakakodzera, sezvakarairwa nachiremba wako.
- Kuongororwa nachiremba nguva dzose: Kunyanya kana wakambova negomarara, unofanira kuenda kunoongororwa nguva nenguva sezvakarairwa nachiremba wako kuti uone kana chirwere chacho chadzokazve.
- Ziva zviratidzo: Kana zviratidzo zvakaita sekurwadziwa mudumbu nemanyoka zvikadzoka mushure mekurapwa, zivisa chiremba wako nekukasika .
Zvakajairika kuti unzwe kunetseka uye kutya kana ukaziva kuti une chirwere chisingawanzoitiki chakadai. Une mibvunzo yakawanda. Taura nachiremba wako pachena nezvezvose. Teerera zvakanaka mhinduro dzebvunzo dzako uye zvirongwa zvekurapa. Vakagadzirira uye vanoda kukubatsira.
Mharidzo Yekuenda Nayo Kumba
- Zollinger-Ellison Syndrome (ZES) chirwere chisingawanzoitiki chinokonzerwa nemabundu anonzi gastrinomas anokonzera acid yakawanda mudumbu.
- Zviratidzo zvikuru maronda emudumbu anogara achiitika asingapindure kana apihwa mushonga uye manyoka anotora nguva yakareba.
- Mabundu aya anogona kunge ari ekenza kana kuti kwete, saka kuongororwa nekukurumidza kwakakosha zvikuru.
- Chirwere ichi chinogona kudzorwa zvinobudirira nemishonga yakakodzera, kuvhiyiwa, uye, kana zvichidikanwa, kurapwa nekenza.
- Kana uine zviratidzo izvi, usavhunduka uye kurumidza kubvunza chiremba ane hunyanzvi kuti akupe mazano.
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