Xa sifumana iintlungu zesisu okanye ukudumba, sihlala sicinga nge-gastritis. Kodwa ngamanye amaxesha unobangela waloo ntlungu unokuba sisilonda sesisu okanye isilonda sesisu (Isisu / Isilonda Sesisu). Njengesilonda eluswini lwethu, esi sisilonda esakheka eludongeni lwangaphakathi lwesisu. Esi sisifo esixhaphakileyo kwaye sinokunyangwa kwaye sinyangeke. Nangona kunjalo, ukuba asinyangwa ngokufanelekileyo, sinokukhokelela kwiimeko ezinzulu. Ngoko ke, yintoni isilonda sesisu? Kutheni sisenzeka? Zithini iimpawu? Ziziphi iindlela zonyango kunye nokuthintela? Siza kuthetha ngazo zonke ezi zinto kweli nqaku.

Yintoni le isilonda esiswini? (Isishwankathelo)

Zikhula njani izilonda zesisu?

Isisu sethu sine-hydrochloric acid kunye nee-enzymes ezinceda ekugayeni ukutya. Ezi zinamandla kakhulu. Ngoko ke, ukukhusela udonga lwesisu kwezi asidi, kukho ulwelo olukhuselayo lwesisu olwenziwe nge-mucus etyebileyo. Kodwa ukuba ngesizathu esithile olu lwelo lukhuselayo lonakele, loo asidi inamandla inokutyibiliza udonga lwesisu. 'Intlungu evulekileyo' eyenziwa kukutya ibizwa ngokuba sisilonda sesisu.

Ixhaphake kangakanani?

Esi sisifo esixhaphakileyo ngokwenene. Sixhaphakile naseSri Lanka. Isizathu esiphambili soku kukuba izizathu ezibini eziphambili zezilonda zesisu zixhaphakile kakhulu kuluntu lwethu. Nazi:

1. Ukusetyenziswa ngokubanzi kwe - NSAIDs ezithengiswa ngaphandle kwemvume kagqirha.
2. Ukuxhaphaka kosulelo lwe -H. pylori .

Izilonda Zesisu vs Izilonda ZePeptic

La magama mabini anokubhida. " Isifo sePeptic Ulcer" yimeko apho i-asidi yesisu ibangela isilonda kulwelo lwesisu okanye inxalenye yokuqala yamathumbu amancinci ( i-duodenum).) ligama eliqhelekileyo lezilonda. Ngoko ke, izilonda ezenzeka esiswini (Gastric Ulcer / Stomach Ulcer) luhlobo lwesilonda sesisu. Izilonda ezenzeka kwinxalenye yokuqala yamathumbu zibizwa ngokuba yi "Duodenal Ulcers". Izizathu kunye nonyango lwazo zombini ziyafana kakhulu.

Iimpawu kunye nezizathu

Zithini iimpawu zesilonda esiswini?

• Uphawu oluphambili: Intlungu yokutsha : Uphawu oluphambili abantu abaninzi abaluvayo kukutshisa okanye ukuhlaba esiswini esingaphezulu (ngaphantsi nje embindini wesifuba, ngaphezulu kwenkaba, kwaye kunzima ngasekhohlo). Oku kunokuvakala ngathi kukutsha ngenxa ye-asidi, okanye ngathi kukho into etyiwa ngaphakathi (umgangatho wokukrwela). Olu luvo aluyomvakalelo nje kuphela, kodwa okwenzekayo kukuba i-asidi kunye nee-enzymes ziyayitya inxeba. Olu buhlungu lunokuba mandundu esiswini esingenanto, ingakumbi ebusuku. Abanye abantu bafumanisa ukuba intlungu iyancitshiswa ngokutya, kodwa kwabanye (ingakumbi ngezilonda zesisu), intlungu inokuba mandundu xa besitya.
• Ukungagayi kakuhle ukutya kunye nokugcwala: Abantu abaninzi abanezilonda esiswini bafumana iimpawu zokungagayi kakuhle ukutya. Oku kukutshisa esiswini kunye nokuziva ugcwele. Ungaziva ugcwele kwangoko xa uqala ukutya, okanye ungaziva ugcwele ixesha elide emva kokutya.
• Ezinye iimpawu eziqhelekileyo: Ukongeza kwezi, iimpawu ezinxulumene neemeko ezibangele ukwenzakala zingabandakanya:
  • I-acid reflux kunye ne-heartburn
  • Isicaphucaphu nokuhlanza
  • Ukudumba, ukubhoboza, kunye nentlungu yegesi
• Izilonda Ezithuleyo Neempawu Zeengxaki: Okumangalisayo kukuba, abanye abantu banezilonda zesisu kodwa abaziva ntlungu okanye iimpawu. Ezi zibizwa ngokuba "zii-ulcers ezithuleyo." Basenokungazi ukuba banezilonda de kubekho ingxaki enkulu, efana nokopha okanye ukugqobhoka. Funa uncedo lwezonyango ngokukhawuleza ukuba unezinye zezi mpawu:
  • Ubumhlophe besikhumba (Ubumhlophe)
  • Ukudinwa, ubuthathaka okanye ukuphelelwa lithemba - kusenokuba kubangelwa kukulahlekelwa ligazi.
  • Indle emnyama, ehlala ixesha elide - ngenxa yegazi eligayiweyo.
  • Ukuhlanza okufana nekofu egayiweyo - ngenxa yokuqhekeka kwegazi esiswini.
  • Intlungu yesisu ebuhlungu ngequbuliso engapheziyo - isenokuba luphawu lokugqobhoka.

Zinzima kangakanani ezi ngxaki?

Ukuba ayinyangwa, izilonda zesisu zinokubangela iingxaki ezinkulu:

• Izilonda Eziphuma Egazini: Inxeba linokuqhubeka liphuma igazi, nokuba liphuma kancinci okanye ngequbuliso. Ukuba liphuma kancinci, ngokuhamba kwexesha, igazi lomzimba lisenokuncipha, nto leyo ekhokelela kwi-anemia. Ukuba liphuma kakhulu igazi, umzimba unokuba nengxaki yokungonwabi kwaye ude ufe.
• Izilonda Ezigqobhokileyo: Yimeko engxamisekileyo engaqhelekanga kodwa enzima apho isilonda siqhekeza ngokupheleleyo udonga lwesisu size senze umngxuma. Lo mngxuma unokuvumela i-asidi yesisu kunye neebhaktheriya ukuba zivuzele ngaphakathi esiswini, nto leyo ebangela usulelo olunzima (i-peritonitis). Olu sulelo lunokusasazeka luye egazini, nto leyo ebangela imeko esongela ubomi ebizwa ngokuba yi-sepsis.

Zithini izizathu eziphambili zezilonda zesisu?

Izizathu ezimbini eziphambili zezilonda zesisu eSri Lanka nakwihlabathi liphela zezi:

• Usulelo lwebhaktiriya i-H. pylori (Helicobacter pylori): Olu sulelo lwebhaktiriya luxhaphakileyo. Kuqikelelwa ukuba malunga nesiqingatha sabemi behlabathi sinale bhaktiriya ehlala esiswini sabo. Kubantu abaninzi, le bhaktiriya ayibangeli ngxaki. Nangona kunjalo, kwabanye abantu, le bhaktiriya ikhula kakhulu esiswini ize iqale ukutya ulwelo olukhuselayo lwesisu. Oku kubangela ukudumba okungapheliyo, okuthi ngokuhamba kwexesha kubangele izilonda zesisu.
• Ukusetyenziswa kwee-NSAID painkillers: I-NSAID (Nonsteroidal Anti-inflammatory Drugs) luhlobo lwe-painkiller esihlala siyithenga kwikhemesti. Imizekelo ibandakanya i-Ibuprofen, i-Naproxen, i-Diclofenac, i-Aspirin.Amayeza anje ngala akweli qela. (I-Paracetamol ayiloyeza kweli qela). Xa la ma-NSAID engena esiswini, abangela ukurhawuzelelwa okuncinci eludongeni lwesisu, kwaye athintela nokuveliswa kweekhemikhali ezithile ezikhusela kwaye zilungise udonga lwesisu. Ngokwesiqhelo, udonga lwethu lwesisu lunokubuyela kwimeko entle emva komonakalo omncinci onje. Kodwa ukuba sithatha la ma-NSAID rhoqo, udonga lwesisu alunaxesha laneleyo lokuzilungisa. Kancinci kancinci, umaleko okhuselayo uyaphela kwaye kuvele izilonda.

Ezinye izizathu ezingaqhelekanga

Ukongeza kwezi zizathu zimbini ziphambili, izilonda zesisu zinokubangelwa zezi zilandelayo, ngokungaqhelekanga:

• Ezinye izifo: Kunqabile kakhulu ukuba ezinye izifo zebhaktiriya, iintsholongwane, okanye iifungus zichaphazele isisu kwaye zibangele izilonda.
• Isifo sikaZollinger-Ellison: Esi sisifo esingaqhelekanga apho isisu sivelisa i-asidi eninzi esiswini, nto leyo ebangela umonakalo kwi-inside yesisu.
• Uxinzelelo olukhulu lomzimba: Utshintsho lwehomoni kunye neekhemikhali ezenzekayo njengoko umzimba uzama ukuphola kwisifo esisongela ubomi (umz., ukutsha kakhulu, utyando olukhulu) okanye ingozi zinokubangela ukuba i-asidi yesisu inyuke, nto leyo ekhokelela ekuphuhlisweni kwento eyaziwa ngokuba yi-"stress ulcer." Olu asiloxinzelelo lwengqondo esilufumanayo kubomi bemihla ngemihla.

Ngaba indlela yokuphila iyayichaphazela?

Abantu abaninzi bacinga ukuba ukutya ukutya okuneziqholo kunye noxinzelelo kubangela izilonda zesisu. Inyaniso kukuba, izinto zemihla ngemihla (ezifana noko ukutyayo nokuselayo, uxinzelelo oluqhelekileyo) azibangeli ngqo izilonda zesisu. Nangona kunjalo, ukuba sele unesilonda sesisu, ezi zinto zingenza iimpawu zakho zibe zimbi ngakumbi . Oku kungenxa yokuba zonyusa i-asidi yesisu sakho, zenze isilonda sibe sibi ngakumbi.

• Ukutshaya
• Ukusetyenziswa kotywala
• Ukutya okunongwe
• Ukutya okune-asidi njengeetumato kunye neziqhamo ze-citrus
• Iziselo ezine-caffeine ezifana nekofu neti

Uxilongo kunye noVavanyo

Uyibona njani isilonda esiswini?

Xa usiya kugqirha, baya kuqala bakubuze ngeempawu zakho, nokuba uthatha ii-NSAID rhoqo na, nokuba ukhe wanosulelo lwe-H. pylori ngaphambili. Ukuba iimpawu zakho zibonisa isilonda esiswini, banokufuna ukuhlola ingaphakathi lesisu sakho ukuqinisekisa.

Luhlobo luni lovavanyo olwenzayo?

Kukho izinto ezimbini eziphambili ekufuneka ugqirha azi:

1. Ngaba unosulelo lwe-H. pylori?
2. Ingaba unesilonda esiswini? Sinjani?

Eyona ndlela ilungileyo yokwenza zombini ezi zinto ngaxeshanye kukusebenzisa i-endoscopy .

• Uvavanyo lwe-Upper Endoscopy / EGD: Oku kuquka ukufaka ityhubhu ende, ebhityileyo, eguquguqukayo (i-endoscope) enekhamera kunye nokukhanya ekupheleni ngomlomo wakho nasemqaleni wakho ukuze uhlole ingaphakathi lesisu sakho kunye namathumbu amancinci. Uya kunikwa i-sedation ukukunceda uzive ukhululekile. Ugqirha angasebenzisa ikhamera ukuze abone ukuba kukho naziphi na izilonda okanye ukopha eludongeni lwesisu sakho. Angasebenzisa nesixhobo esincinci ngaphakathi kwityhubhu ukuze athathe iqhekeza elincinci lesicwili (i-biopsy) kwindawo erhanelekayo okanye isilonda ukuze avavanye intsholongwane ye-H. pylori. Ukuba kukho ukopha kwesilonda, unyango lunokunikwa ukuze kumiswe ukopha ngoko nangoko (umzekelo, ukutshisa umthambo wegazi) ngexesha le-endoscopy.
• Ezinye Iimvavanyo: Nangona i-endoscopy iyeyona ndlela ilungileyo, ezinye iindlela ngamanye amaxesha zingasetyenziswa:
  • Uthotho lwe-Upper GI X-ray (Barium Swallow): Kule nto, kuginywa ulwelo olubizwa ngokuba yi-barium kwaye kuthathwe imifanekiso ye-X-ray. Ngenxa yokuba i-barium igquma ulwelo lwesisu, naziphi na izilonda zinokubonwa kwi-X-ray. Nangona kunjalo, oku akuchanekanga njenge-endoscopy, kwaye izilonda ezincinci zinokungabonwa.
  • Uvavanyo lwe-H. pylori: Kukho uvavanyo olwahlukileyo lokujonga ubukho bebhaktheriya:
    • Uvavanyo lokuphefumla lwe-Urea: Unikwa ulwelo olukhethekileyo ukuba ulusele, uze emva koko uvavanye umoya wakho ophumayo.
    • Uvavanyo lweGazi: Olu vavanyo luvavanya ii-antibodies ezichasene ne-H. pylori. Nangona kunjalo, alunakukwazi ukuqiniseka ukuba usulelekile okanye ukhe wasuleleka.
    • Uvavanyo lwe-Antigen yeSitulo: Isampuli yestulo iyavavanywa ukuze kubonwe ukuba kukho ii-antigens zebhaktiriya.

Ezinye iimeko ezinokubhidaniswa nesilonda esiswini

Ukuba uvavanyo luqinisekisa ukuba awunaso isilonda esiswini, unobangela weempawu zakho unokuba yinto eyahlukileyo, efana nale:

• I-GERD (Isifo se-Gastroesophageal Reflux): Ukuba i-asidi evela esiswini iqhubeka ibuyela emqaleni (i-asidi reflux), inokubangela neempawu ezifana ne-heartburn, i-indigestion, kunye ne-nausea.
• I-Functional Dyspepsia: Le yimeko apho kukho iimpawu ezingapheliyo zokungagayi kakuhle ukutya (iintlungu zesisu, isitshiso sentliziyo, ukugcwala) ngaphandle kwesizathu esicacileyo somzimba. Nangona iimpawu zifana nezo zesilonda sesisu, akukho silonda sibonakalayo eludongeni lwesisu.
• Umhlaza Wesisu: Oku kunqabile kakhulu, kodwa kunokubangela iimpawu ezifana nesilonda esiswini (intlungu yesisu, ukwehla kobunzima, ukuphelelwa ngumdla wokutya). Yiyo loo nto kubalulekile ukwenza i-biopsy ngexesha le-endoscopy.

Ulawulo kunye noNyango

Ungasinyanga njani isilonda esiswini ngokukhawuleza?

Nje ukuba unobangela wesilonda upheliswe, ulwelo lwesisu luya kuqala ukuphola kancinci kancinci. Umzekelo, ukuba isilonda sakho sibangelwa yi-NSAID, ukuba uyeka ukuthatha amayeza, isilonda sinokuphola ngaphandle kolunye unyango. Nangona kunjalo, ukuba une-H. pylori, kuya kufuneka uthathe amayeza okubulala iintsholongwane. Ukongeza, ugqirha unokukunika amanye amayeza anciphisa i-asidi yesisu kwaye akhusele ulwelo lwesisu de isilonda siphole. Ukusela la mayeza ngokuchanekileyo kunokunceda isilonda siphole ngokukhawuleza.

Zeziphi iindlela zonyango ezikhoyo?

Amaxesha amaninzi, izilonda zesisu zinyangwa ngokudibanisa amayeza. La mayeza aquka:

1. Inciphisa ubungakanani be-asidi esiswini.
2. Iyagquma, ikhusela, kwaye inceda ukuba inxeba liphole.
3. Ukuba kukho usulelo (H. pylori), luya kupheliswa.

Kunqabile ukuba kubekho inkqubo yezonyango efunekayo ukuze kumiswe ukopha okanye kuvalwe umngxuma.

• Amayeza:
  • Iiantibiotics : Ukuba une-H. pylori okanye olunye usulelo lwebhaktiriya, ugqirha wakho uya kukunika ii-antibiotics ezimbini okanye ezintathu ngexesha kangangeentsuku ezisi-7-14 ukuze abulale ngokupheleleyo intsholongwane. Ii-antibiotics ezisetyenziswa kakhulu zezi: iTetracycline, iMetronidazole, iClarithromycin, kunye ne-Amoxicillin. Kubalulekile ukuthatha amayeza apheleleyo achazwe ngugqirha wakho ngalo lonke ixesha lekhosi, kungenjalo usulelo lunokubuya.
  • Ii-cytoprotective agents: La mayeza asebenza ngokwenza umaleko okhuselayo (ingubo) phezu kodonga lwesisu, esikhusela de isilonda siphole. Ahlala esetyenziselwa ukunyanga nokuthintela izilonda ezibangelwa zii-NSAIDs. Imizekelo: iSucralfate, iMisoprostol, iBismuth subsalicylate.
  • Ii-H2 blockers (ii-Histamine receptor blockers / ii-H2 blockers): Zithintela ikhemikhali ebizwa ngokuba yi-histamine, enika umzimba umqondiso wokuvelisa i-asidi esiswini, kwaye inciphise ukuveliswa kwe-asidi. Imizekelo: iFamotidine, iCimetidine, iNizatidine.
  • IiProton Pump Inhibitors (PPIs): Ezi zikwangamayeza anamandla anciphisa ukuveliswa kwe-asidi esiswini. Zikwakhusela ulwelo lwesisu kwaye zikhawulezise ukuphiliswa kwezilonda. La ngamayeza asetyenziswa kakhulu ngoku kwizilonda zesisu. Imizekelo: I-Omeprazole, i-Esomeprazole, i-Lansoprazole, i-Pantoprazole, i-Rabeprazole.
• Iinkqubo Zonyango: Inxeba elinzima (ukopha, ukugqobhoka) kuya kufuneka linyangwe ngqo ngugqirha . Oku kunokwenziwa ngaxeshanye ne-endoscopy. Inxeba elophayo linokumiswa ngokufaka amayeza okanye ngokulitshisa ngomlilo. Ukuba kukho ukugqobhoka, kuya kufuneka livalwe ngotyando.
• Utyando lwezilonda ezingapheliyo:Amaxesha amaninzi, izilonda zesisu zabanye abantu zisenokuqhubeka ngaphandle konyango, okanye zinokuphiliswa ziphinde zibuye. Oku kunokubangela iintlungu ezinde kunye namanxeba esiswini. Ngamanye amaxesha esi silonda sinokuvala indlela yokungena esiswini iye emathunjini. Kwimeko ezinjalo, kunokufuneka utyando, olufana:
  • Ukususa izicubu ezibomvu okanye ukuvula indlela evalekileyo (iPyloroplasty).
  • Ukususwa kwe-vagotomy kukunqunyulwa kwe-vagus nerve, ekhuthaza ukuveliswa kwe-asidi yesisu.

Ungayithintela njani? (Ukuthintela)

Izilonda zesisu zingathintelwa njani ukuba zingabikho okanye zingabuyi?

Nazi ezinye izinto onokuzenza ukuthintela ukuba isilonda esiswini singabikho, okanye ukusithintela ukuba singabuyi emva kokuba sipholile:

• Ukupheliswa kosulelo lwe-H. pylori: Abantu abaninzi bane-H. pylori kodwa abazi ukuba banayo. Ungafumanisa ukuba unayo ngovavanyo olulula lokuphefumla okanye uvavanyo lwesitulo. Ukuba unayo, ungayisusa ngee -antibiotics ngaphambi kokuba ibangele naziphi na iingxaki.
• Ukusetyenziswa ngokufanelekileyo kwee-NSAID: Ukuba uthatha ii-NSAID rhoqo kwikhemesti ngenxa yeentlungu zomzimba kunye nentloko ebuhlungu, qiniseka ukuba awuthathi ngaphezu kwedosi ecetyiswayo. Ukuba uqhubeka nokuthatha ii-NSAID ngengcebiso kagqirha ngenxa yesinye isifo (umz. isifo samathambo), ukuba kunokwenzeka, yehlisa idosi, utshintshele kwelinye iyeza, okanye uthethe nogqirha wakho malunga nokuthatha elinye iyeza elikhusela isisu (njenge-PPI) ngaxeshanye.
• Nciphisa eminye imikhwa eyingozi: Ukuba une-H. pylori okanye uthatha ii-NSAID, ukutshaya nokusela utywala kwandisa umngcipheko wakho wokuba nezilonda zesisu. Ngoko ke kubalulekile ukuyeka le mikhwa.

Kuza kuthatha ixesha elingakanani ukuba umntu aphile? (Imbono/Ingqikelelo)

Kuthatha ixesha elingakanani ukuba isilonda esiswini siphole?

Ukuba uthatha amayeza akho njengoko kuyalelwe kwaye uphepha izinto ezenza isilonda sibe sibi ngakumbi (ii-NSAID, ukutshaya, utywala), isilonda kufuneka siphiliswe ngokupheleleyo kwiiveki ezimbalwa . Ugqirha wakho unokuphinda uvavanyo lwe-endoscopy okanye olunye uvavanyo ukuqinisekisa ukuba isilonda siphilisiwe ngokupheleleyo kwaye usulelo lwe-H. pylori luphelile ngokupheleleyo.

Iimeko ezingapheliyo

Uninzi lwabantu lufuna unyango lwexesha elifutshane kuphela. Nangona kunjalo, abanye abantu banokuba neemeko ezingapheliyo ezibangela ukuba kuvele izilonda zesisu. Umzekelo, umntu one-Zollinger-Ellison syndrome, ekuthethwe ngaye ngaphambili, unemeko apho isisu sivelisa i-asidi eninzi kakhulu. Aba bantu banokufuna ukuthatha amayeza (afana ne-PPI) ixesha elide.

Yintoni omawuyenze ukuba ukrokrela ukuba kukho isilonda esiswini? (Ukuphila Naso)

Ukubaluleka kokufuna iingcebiso zonyango

Ukuba ukrokrela ukuba unesilonda esiswini, qiniseka ukuba ufuna ingcebiso kagqirha. Amayeza athengiswa ngaphandle kwemvume kagqirha anjenge-antacids okanye i-bismuth subsalicylate anokunceda okwethutyana iimpawu, kodwa aziyi kuphilisa isilonda. Ukuze isilonda siphilise , unobangela oyintloko (i-H. pylori okanye i-NSAIDs) kufuneka unyangwe.

Iingozi ukuba azinyangwa

Nokuba awunazo iimpawu eziqatha, isilonda esiswini esinganyangwanga sinokukhokelela kwiingxaki ezinkulu, ezinje ngokopha okanye ukugqobhoka. Kukwakho nomngcipheko womhlaza wesisu ukuba usulelo lwe-H. pylori, oluyimbangela ephambili yezilonda zesisu, lushiywa lunganyangwa ixesha elide.

Ufanele ufune nini unyango olungxamisekileyo?

Ukuba unezi mpawu, yiya esibhedlele ngoko nangoko (ETU) :

• Intlungu yesisu enganyamezelekiyo nenganyamezelekiyo.
• Ukuba unegazi elimnyama kwindle yakho okanye uhlanza igazi (njengekofu egayiweyo).
• Iimpawu zokopha kakhulu (ulusu olukhanyayo, isiyezi esigqithisileyo, ukuquleka).

Ekugqibeleni

Izilonda zesisu zizinto eziqhelekileyo nezinganyangekiyo. Izizathu eziphambili lusulelo lwe-H. pylori kunye nokusetyenziswa kwee-NSAID painkillers. Ukuba uneempawu ezifana nokudumba kwesisu, iintlungu, kunye nokungagaywa kakuhle kokutya, kubaluleke kakhulu ukufuna ingcebiso kagqirha endaweni yokucinga nje ukuba yi-gastritis. Emva koko, unobangela unokufunyanwa, unyango olufanelekileyo lunokuqaliswa, kwaye iingxaki ezinkulu zinokuthintelwa. Kwakhona, ukunciphisa ukutshaya nokusetyenziswa kotywala, kunye nokusebenzisa amayeza e-NSAID kuphela xa kuyimfuneko, kwidosi ephantsi, ixesha elifutshane kangangoko, kunokunceda ukukhusela kwizilonda zesisu. Hlala usempilweni!