Ingaba usoloko uneentlungu zesisu? Oku kusenokuba sisilonda sesisu (iPeptic Ulcer Disease)! Makhe sithethe ngale nto.

Ngaba uhlala uziva utshile esiswini sakho, ungonwabanga esiswini sakho? Uninzi lwethu luyalibala ukuba le yinto eqhelekileyo, mhlawumbi sicinga ukuba yi "gastritis". Nangona kunjalo, ngamanye amaxesha oku kungakhululeki kunokuba yinto enzulu ngakumbi. Leyo yimeko yezilonda zesisu, okanye njengoko oogqirha beyibiza, 'Isifo sePeptic Ulcer (PUD). Ngoko ke, namhlanje siza kuthetha ngale nto ngokweenkcukacha, ngokungathi sixelela umhlobo. Kuba ukuqaphela oku kunokuba yinto ebalulekileyo kuwe.

Yintoni iPeptic Ulcer Disease? Ngamafutshane...

Ngamafutshane, isifo sesilonda sesisu sisilonda esivulekileyo esikhula phezu kolwelo lwenkqubo yethu yokugaya ukutya, inxalenye yendlela yokugaya ukutya apho sigaya khona ukutya nokusela. Igama elithi "peptic" lithetha "okunxulumene nokugaya ukutya." Livela kwigama elithi "pepsin," eliyi-enzyme enkulu yokugaya ukutya eveliswa esiswini sethu.

Khawucinge nje, esiswini sethu sine-asidi yesisu kunye nale enzyme ibizwa ngokuba yi-pepsin. Ezi zimbini zezona zisinceda siqhekeze ukutya esikutyayo size sikugaye. Le ncindi ine-asidi kakhulu, ukuba sithetha inyaniso, iyabola. Le ncindi ngamanye amaxesha ingena kwinxalenye yokuqala yamathumbu ethu amancinci (duodenum).

Ngoku khangela, yonke indlela yethu yokugaya ukutya igqunywe yi-mucous membrane ekhuselayo, njengekhaka elikhusela iindonga kwizinto ezinzima ngaphakathi. Le membrane ekhuselayo inamandla kakhulu esiswini nakwinxalenye yokuqala yamathumbu amancinci. Nangona kunjalo, kumntu onesifo sesilonda se-peptic, le nkqubo yokukhusela iyabuthathaka . Emva koko loo manzi okugaya ukutya anzima anokutya iindonga.

Isilonda kukukhukuleka okunzulu ngokwaneleyo ukuba kungene kuzo zontathu iileya zesisu. Ngokuqhelekileyo, ezi zilonda zenzeka esiswini okanye kwinxalenye yokuqala yamathumbu amancinci (i-duodenum), kuba kulapho iijusi zokugaya ukutya zisebenza khona kakhulu. Kodwa kunqabile, zinokuvela kwezinye iindawo.

Angaphi la manxeba? Ngaba kukho iintlobo zawo?

Ewe, ezi zilonda zenzeka kakhulu esiswini sethu nakwinxalenye yokuqala yamathumbu amancinci (i-duodenum).

• Izilonda zeDuodenal: Ezi zezona zixhaphakileyo, zimalunga nama-80%.
• Izilonda zesisu: Ezi zibonakala kwi-20% yamatyala.

Nangona kunjalo, kwiimeko ezingaqhelekanga kakhulu, i-asidi yesisu inokuvuza kwezinye iindawo, ibangele izilonda. Umzekelo:

• Isilonda somqala: Abanye abantu bane-acid reflux engapheliyo, apho i-acid yesisu ingena emqaleni. Ukuba oku kuyaqhubeka, ulwelo lomqala lunokonakala kancinci kancinci, nto leyo ebangela isilonda. Oku kungenxa yokuba ulwelo lomqala aluxhathisi i-acid njengolwelo lwesisu.
• Isilonda seJejunal:I-jejunum yinxalenye ephakathi yamathumbu ethu amancinci. Ezinye iindlela zotyando (umz., i-gastrojejunostomy - utyando oludibanisa isisu ngqo ne-jejunum) zinokubangela ukwenzakala kule nxalenye.

Ixhaphake kangakanani le meko?

Ehlabathini lonke, phakathi kwe-5% kunye ne-10% yabantu baya kuba nesifo sesilonda se-peptic (PUD) ngaxa lithile ebomini babo. Nangona sinokwenzeka nakweyiphi na iminyaka, sixhaphake kakhulu kubantu abakwiminyaka ephakathi kunye namadoda.

Zithini iimpawu zoku? Uzibona njani?

Okumangalisayo kukuba, malunga ne-70% yabantu abanale meko ababonisi zimpawu . Nangona kunjalo, izinto ezixhaphakileyo abantu abaneempawu zezi:

• Intlungu ye-epigastric: Ngokuchanekileyo, yintlungu evela embindini wesisu , ngaphantsi kwesifuba.
• I-Dyspepsia: Ingqokelela yezinto ezibangela ukungakhululeki esiswini emva kokutya. Oku kuquka iintlungu esiswini esingaphezulu, ukutsha , ukuziva ugcwele emva kokutya, kunye nokuziva ugcwele rhoqo.

Olu luvo lokutsha lufana noluvo lwe-asidi yesisu kunye nee-enzymes ezitya ulwelo lwesisu. Abanye abantu bayichaza ngokuthi "kungathi kukho into egqobhoza ngaphakathi esiswini." Usenokukwazi nokuchonga indawo echanekileyo yentlungu.

Nangona kunzima ukufumanisa ngqo ukuba isilonda sisesiswini okanye emathunjini amancinci, kukho ezinye iimpawu:

• Ukuba unesilonda esiswini , intlungu inokuba mandundu emva nje kokutya (kwimizuzu engama-30), kuba kulapho kukhutshwa khona uninzi lwejusi yesisu.
• Kwimeko yesilonda se -duodenal , intlungu inokuphela emva kokutya. Nangona kunjalo, emva kweeyure ezimbini ukuya kwezintathu, intlungu inokwanda kwakhona njengoko ukutya kunye nejusi yokugaya ukutya zingena emathunjini amancinci. Abanye abantu bacinga oku njengendlala, njengoko ukutya kunika isiqabu. Ukuvuka ebusuku ngenxa yentlungu kuqhelekile nakubantu abanesi zilonda emathunjini amancinci.

Ukongeza koku, ungabona nezinye iimpawu ezifana nezi:

• Isisu esidumbileyo
• Ukubhoboza okanye ukubhoboza rhoqo
• Ukulahlekelwa ngumdla wokutya
• Isicaphucaphu nokuhlanza

Kuza kwenzeka ntoni ukuba ayinyangwa? Zithini iingxaki ezibangelwa yiyo?

Abanye abantu baba neempawu emva kokuba imeko ibonakalise ezinye iingxaki. Oku kwenzeka ukuba ayinyangwa ixesha elide. Ngaphandle koko, amanxeba angaqala ukopha , okanye udonga lunokuba nzulu ngakumbi kwaye lwenze umngxuma .

Ukuba ukopha okuphezulu kwesisu, unokufumana iimpawu ezifana nezi:

• Igazi elikwisitulo ( isitulo esimnyama, esihlala ixesha elide )
• Ukuhlanza ikofu egayiweyo
• Ukudinwa okanye ukuphelelwa lithemba
• Ubumhlophe besikhumba (Ubumhlophe)
• Isantya sentliziyo esikhawulezayo

Ukuba kuvela umngxuma kwindlela yokugaya ukutya (ukugqobhoka kwesisu), iimpawu ezifana nezi:

• Intlungu yesisu ebukhali, eqatha, nekhawulezileyo
• Ukudumba kwesisu kunye nentlungu enganyamezelekiyo
• Umkhuhlane kunye nokubanda

Ukuba azinyangwa ixesha elide, izilonda zinokuphola zize ziphinde zibuye. Kwabanye abantu, amanxeba kunye nokudumba kwindlela yokugaya ukutya kunokwanda, okukhokelela ekuvalelekeni kwesisu . Oku kunokukhokelela kwiimpawu ezifana nezi:

• Ukudumba, ukudumba, kunye nentlungu
• Isicaphucaphu nokuhlanza
• Ukulahlekelwa ngumdla wokutya kunye nokunciphisa umzimba
• Ukungakwazi ukuzibamba kunye nokuqhina

Kutheni sifumana ezi zilonda zesisu? Zithini izizathu eziphambili?

Ulwelo olukhuselayo lomgudu wethu wokugaya ukutya lwenzelwe ukumelana nee-asidi eziqatha kunye nee-enzymes kwaye luzilungise ukuba lonakele. Oku kuyinyani ngakumbi esiswini nakwinxalenye yokuqala yamathumbu amancinci. Nangona kunjalo, izilonda zenzeka xa kukho into ephazamisana nolu khuselo lwendalo.

Ukuze olu khuselo lunciphe kwaye isilonda sibe nzulu ngokwaneleyo ukuba singene kwi-mucosa, kufuneka kubekho imeko yexesha elide okanye eqhubekayo . Izazinzulu zichonge izizathu ezibini eziphambili ezibangela uninzi lwezi PUD:

1. Usulelo lweBhaktheriya i-H. pylori (i-Helicobacter pylori): Le bhaktheriya ihlala esiswini okanye emathunjini amancinci phantse kwisiqingatha sabemi behlabathi. Kubantu abaninzi, ayibangeli ngxaki. Nangona kunjalo, ukuba ibhaktheriya iba nkulu kakhulu, inokuphazamisa ibhalansi yezinye iintsholongwane apho kwaye ibangele impendulo yokudumba . Oku kudumba kwexesha elide kuyenza buthathaka udonga kwaye kunciphisa amandla ayo okuzilungisa. Ngamanye amaxesha, ibhaktheriya inokuhlasela udonga ngokuthe ngqo.

2. Ukusetyenziswa ngokugqithisileyo kwamayeza angengowe-steroidal anti-inflammatory (NSAIDs): La ngamayeza okuthomalalisa iintlungu esiwathenga kwikhemesti ngaphandle kwemvume kagqirha, njenge-aspirin kunye ne-ibuprofen. Ngenxa yokuba athathwa ngaphandle kwengcebiso kagqirha, abantu abaninzi bawathatha rhoqo kunokuba befuna. Oku kuchaphazela ibhalansi yeekhemikhali esiswini sethu nasemathunjini amancinci. Ii-NSAID zisebenza ngokunciphisa ukuveliswa kweekhemikhali ezibizwa ngokuba yi-prostaglandins, ezilungisa umonakalo kwi-inclusive tract ye-metabolism.

Ukongeza kwezi zizathu zimbini ziphambili, kukho nezinye izizathu ezingaqhelekanga:

• Ezinye izifo
• Ukuncipha kokunikezelwa kwegazi (`Ischemia`)
• Uxinzelelo olukhulu lomzimba (oludla ngokubangelwa sisifo okanye ingozi esongela ubomi)
• Unyango lweKhemotherapy okanye unyango lwemitha
• Isifo sikaZollinger-Ellison - imeko apho isisu sivelisa iasidi eninzi kakhulu
• Isifo sikaCrohn - imeko yokuvuvukala kwendlela yokugaya ukutya
• Umhlaza wesisu

Ngubani osengozini enkulu yokuhlaselwa yile meko?

Ukuba unosulelo lwe-H. pylori okanye usebenzisa rhoqo ii-NSAIDs, unamathuba amaninzi okuba nezi zilonda zesisu. Umngcipheko uphezulu ngakumbi ukuba unazo zombini ezi zinto zinobungozi.

Ukongeza, ukutshaya, ukusela utywala, kunye neminye imithi oyithathayo nayo inokuba negalelo koku. Nangona ezi zinto zodwa zingenawo amandla okwenza izilonda, xa zidityaniswe nosulelo lwe-H. pylori okanye ukusetyenziswa kwe-NSAID, zonyusa amathuba okuba nezilonda zesisu.

Oogqirha bayixilonga njani le nto?

Ukuba ugqirha wakho urhanela ukuba kukho isilonda esiswini ngokusekelwe kwiimpawu zakho kunye nezinto ezikubangela umngcipheko, uza kuqala ajonge umphimbo wakho ukuba awunazo na izilonda. Baza kuvavanya nosulelo lwe-H. pylori.

Kwabaninzi, uvavanyo lokugqibela lwe-endoscopy ye-upper esophageal (uvavanyo lwe-EGD) luvavanyo. Oku kuquka ukufaka ityhubhu encinci enekhamera encinci ekupheleni ngomlomo kwaye kuhlolwe i-esophagus, isisu, kunye nenxalenye yokuqala yamathumbu amancinci. Ngeli xesha, iqhekeza elincinci lesicubu (i-biopsy) linokuthathwa esiswini ukujonga ubukho be-H. pylori.

I-Endoscopy iluncedo kakhulu kuba ayikuvumeli nje kuphela ukuba ubone imifanekiso, kodwa ikwakuvumela ukuba udlulise izixhobo kwityhubhu ukuba kuyimfuneko kwaye wenze unyango. Umzekelo, ukuba inxeba liphuma igazi, ungalinyanga ngoko nangoko ukuze liyeke.

Ezinye iimvavanyo:

• Uvavanyo lwe-`CT scan (Computed Tomography scan)` okanye `GI series X-ray` lunokwenziwa ukuze kufunyanwe izilonda ezinkulu.
• Uvavanyo lokuphefumula lwe-"Urea" okanye uvavanyo lwe-"stool" lunokwenziwa ukuze kufunyanwe usulelo lwe-"H. pylori".

Zithini iindlela zonyango?

Unyango oluphambili lwezilonda zesisu kukudibanisa amayeza anciphisa i-asidi yesisu, akhusele ulwelo, kwaye ancede luphilise . Ukuba unentsholongwane, ungadinga nee-antibiotics . Eyona nto ibalulekileyo kukufumana nokunyanga unobangela wesilonda.

Ixesha elininzi, amanxeba anokuphiliswa ngamayeza kuphela. Nangona kunjalo, ukuba kukho iingxaki, ezifana nenxeba elophayo okanye inxeba eliqhekekileyo, kunokufuneka unyango olongezelelweyo. Uninzi lwezi ngxaki lunokulawulwa ngeenkqubo zonyango ezilula, ezifana ne-endoscopy.

Amayeza

• Ii-antibiotics: Ukuba une-H. pylori okanye enye intsholongwane, ugqirha wakho uya kukunika indibaniselwano yee-antibiotics ukubulala intsholongwane. (Umzekelo: i-Amoxicillin, i-Clarithromycin, i-Metronidazole)
• Iiarhente zokukhusela iiseli: La mayeza asebenza ngokugquma nokukhusela ulwelo lwesisu de luphiliswe. (Umzekelo: `Sucralfate`, `Misoprostol`, `Bismuth subsalicylate`)
• Ii-histamine receptor blockers (ii-H2 blockers): La mayeza anciphisa i-asidi ngokuthintela ikhemikhali enika isilumkiso esiswini ukuba sivelise i-asidi. (Umz: `Famotidine`, `Cimetidine`)
• Izithinteli zeProton pump (PPIs): La mayeza anciphisa i-asidi yesisu kwaye anceda ulwelo lwesisu ukuba luphole ngokusikhusela. (Umzekelo: i-Omeprazole, iPantoprazole, i-Esomeprazole)
• Ezinye iindlela zokubulala iintlungu endaweni ye-NSAID: Ukuba uhlala uthatha ii-NSAID, ungafuna ukuthetha nogqirha wakho ngenye indlela. I-Acetaminophen (i-paracetamol) ayisiyo-NSAID kwaye ayinayo impembelelo efanayo kwi-lap yesisu.

Iinkqubo zonyango

Ukuba unenxeba elinzima nelikhupha igazi, ugqirha wakho kuya kufuneka alinyange ngokuthe ngqo. Oku kunokwenziwa rhoqo ngexesha le-endoscopy. Ukopha kuyamiswa ngokufaka isibulali-zintsholongwane enxebeni okanye ngokufaka amayeza. Ukuba kukho umngxuma, uyathungwa uvalwe.

Amaxesha amaninzi, ukuba isilonda sivale umphimbo, kunokufuneka amanyathelo okungenelela ukuze siphinde sivulwe. Oku kunokubandakanya ukufunxa okungaphakathi esiswini okanye, kunqabile kakhulu, utyando.

Sifanele senze ntoni ukuze sizikhusele kule meko? (Ukuthintela)

Ezona zinto zibalulekileyo onokuzenza ukuze uzikhusele kwisifo sesilonda se-peptic zezi:

1. Vavanywa usulelo lwe-H. pylori uze unyangwe: Abantu abaninzi banosulelo lwe-H. pylori kodwa abazi ukuba lukhona. Ungafumanisa ukuba unalo na ngokwenza uvavanyo olulula lokuphefumula nge-urea. Ukuba unalo, fumana unyango ngaphambi kokuba kubekho iingxaki. Nokuba sele ukhe wanyangwa ngaphambili, licebo elihle ukuphinda uvavanyelwe, kuba ngamanye amaxesha lunokubuya.

2. Sebenzisa ii-NSAID kuphela njengoko kuyalelwe: Ukuba uqhele ukusebenzisa ii-NSAID kwiintlungu ezincinci yonke imihla, lumka ungasebenzisi ngaphezu kwedosi ecetyiswayo. Ukuba unembali yezilonda zesisu, kungcono ukuziphepha. Ukuba kuyimfuneko, zisebenzise nelinye iyeza elikhusela ulwelo lwesisu.

Ngaba la manxeba aya kuphola ngaphandle kweyeza?

Ukuba unobangela wesilonda ususiwe, isilonda sinokuphiliswa. Nangona kunjalo, kufuneka uvavanyo lwezonyango ukuze kufunyanwe unobangela. Ukuba unobangela lusulelo lwe-H. pylori okanye olunye uhlobo lwesifo, kuya kufuneka unyango ukuze lupheliswe.

Ukuba unobangela yi-NSAIDs nje, isilonda sinokuphola ngokwaso ukuba uyeka ukuzisebenzisa. Nangona kunjalo, kufuneka ubone ugqirha ukuqinisekisa oku. Usenokuba nosulelo lwe-H. pylori, kwaye ii-NSAIDs zinokwenza kube mandundu usulelo olwalungenabungozi ngaphambili.

Kwenzeka ntoni emva konyango? Kuthatha ixesha elingakanani ukuchacha?

Uninzi lwezilonda zesisu ziyaphola kwiiveki ezimbalwa . Uninzi lwabantu kufuneka bathathe amayeza kangangeenyanga ezimbini. Eli yeza lisebenza kakhulu. Nangona kunjalo, abantu abaneengxaki zexesha elide ezifana ne-Zollinger-Ellison syndrome banokufuna ukulithatha ubomi babo bonke.

Emva konyango, ugqirha uza kwenza uvavanyo lokulandelela ukuqinisekisa ukuba isilonda siphilisiwe ngokupheleleyo kwaye usulelo alusekho. I-H. pylori yintsholongwane enzima kwaye ngamanye amaxesha inokubuya. Kwakhona, ukuba iimeko ezibangele isilonda ziyaqhubeka, isilonda sinokubuya.

Kunqabile kakhulu, abanye abantu banokuba nezilonda zesisu ezingapheliyo ezingapholiyo ngonyango. Ezi zinokubangela iingxaki ezifana nentlungu ende kunye namanxeba amaninzi. Kwiimeko ezinjalo, utyando lunokufuneka (umz., ukususa izicubu zamanxeba (pyloroplasty), okanye ukusika umthambo olawula ukuveliswa kwe-asidi yesisu (vagotomy)).

Ngaba kufuneka wenze utshintsho kwindlela otya ngayo nendlela ophila ngayo?

Ukutya nokusela akuzibangeli izilonda esiswini, kodwa ukuba unezilonda, ukutya okuthile kunye neziselo (ingakumbi ukutya okuneziqholo, okumuncu) kunokwenza zibe mandundu . Ukuba uneempawu okanye ukhe waba nezilonda esiswini ngaphambili, kufuneka uphephe ngokupheleleyo utywala kunye nokutshaya .

Thetha nogqirha wakho malunga nawo onke amayeza owasebenzisayo (ingakumbi ii-NSAID). Amanye amayeza anokubangela iingxaki xa esetyenziswa kunye.

Ngaba oku akunakunyangwa ngokusebenzisa amayeza okunciphisa i-asidi ekhaya?

Ii-antacids zisebenza ngokunciphisa i-asidi kwaye zinciphise iimpawu ezifana ne-heartburn, i-heartburn, kunye ne-indigestion. Zinokwenza isilonda sivakale ngcono okwethutyana, kodwa azisiphilisi isilonda . Ukuba ukhe waba nezilonda zesisu ngaphambili, ii-antacids zinokunceda ekuthinteleni ukuba zingabuyi.

Ngawaphi amaxesha afanelekileyo okubonana nogqirha?

Ukuba ukrokrela ukuba unesilonda esiswini, qiniseka ukuba ubona ugqirha . Nangona amayeza athengiswa ngaphandle kwemvume kagqirha enokukulawula okwethutyana iimpawu zakho, awayi kunyanga isilonda. Isizathu esiyintloko kufuneka sichongwe kwaye sinyangwe.

Isilonda esinganyangwanga, nokuba awunazo iimpawu eziqatha, sinokukhokelela kwiingxaki ezinkulu. Ukosuleleka yi-H. pylori, eyona nto ibangela izilonda esiswini, kunokukhokelela nakwezinye iingxaki (ezifana nomngcipheko wokuba nomhlaza wesisu).

Ukuba ubona iimpawu zeengxaki ezinkulu ezifana nezi, yiya kwigumbi likaxakeka ngokukhawuleza:

• Intlungu engapheliyo, enzima.
• Iimpawu zegazi kwi-tune (i-black stool) okanye igazi eligabhayo.
• Iimpawu zokulahlekelwa ligazi kakhulu (ukufiphala, ukuquleka).

Izinto ezibalulekileyo ekufuneka sizikhumbule (Umyalezo Wokuya Ekhaya)

Isifo seZilonda zePeptic sisifo esibi kakhulu esichaphazela indlela yakho yokugaya ukutya. Sivela xa indlela yakho yokuzikhusela yendalo ibuthathaka. Esi sifo sithatha ixesha ukuba sikhule kwaye sidla ngokufuna unyango ukuze siphole.

Izilonda zesisu ziyinto eqhelekileyo nenganyangekayo. Nangona kunjalo, kubalulekile ukufuna unyango nokuba awunazo iimpawu eziqatha.Ukuba anganyangwa, amanxeba anokuba nzulu ngakumbi nangakumbi. Ngoko ke, musa ukulibazisa ukuthetha nogqirha malunga neempawu zakho. Impilo yakho ibalulekile!

Izilonda zesisu , izilonda zesisu, ukudumba kwesisu, i-H. pylori, i-NSAID, isifo se-gastritis, ukungagayi kakuhle kokutya