Ingabe uvame ukuzwa umuzwa oshisayo esiswini sakho, ukungakhululeki esiswini sakho? Iningi lethu liyakhohlwa ukuthi lokhu kuyinto evamile, mhlawumbe licabanga ukuthi "yi-gastritis". Kodwa-ke, ngezinye izikhathi lokhu kungakhululeki kungaba yinto engathi sína kakhulu. Leso yisimo sezilonda zesisu, noma njengoba odokotela bekubiza kanjalo, 'Isifo Sezilonda Zesisu (i-PUD). Ngakho-ke, namuhla sizoxoxa ngalokhu ngemininingwane ethe xaxa, njengokungathi sitshela umngane. Ngoba ukuqaphela lokhu kungaba kubaluleke kakhulu kuwe.
Siyini isifo sesilonda se-Peptic? Kalula nje...
Kalula nje, isifo sesilonda se-peptic siyisilonda esivulekile esakheka olwelwesini lwesimiso sethu sokugaya ukudla, ingxenye yomgudu wokugaya ukudla lapho sigaya khona ukudla neziphuzo. Igama elithi "peptic" lisho ukuthi "okuhlobene nokugaya ukudla." Livela egameni elithi "pepsin," okuyi-enzyme enkulu yokugaya ukudla ekhiqizwa esiswini sethu.
Cabanga nje, esiswini sethu sine-asidi yesisu kanye nale enzyme ebizwa ngokuthi i-pepsin. Lokhu okubili yikho okusisiza ukuthi sihlukanise ukudla esikudlayo futhi sikugaye ngamakhemikhali. Lo jusi une-asidi kakhulu, uma sikhuluma iqiniso, uyagqwala. Lo jusi ngezinye izikhathi uya engxenyeni yokuqala yamathumbu ethu amancane (i-duodenum).
Manje bheka, yonke indlela yethu yokugaya ukudla igcwele ulwelwesi lwamafinyila oluvikelayo, njengesivikelo esivikela izindonga ezintweni ezinzima ngaphakathi. Lolu lwelwesi oluvikelayo luqinile kakhulu esiswini nasengxenyeni yokuqala yamathumbu amancane. Kodwa-ke, kumuntu onesifo sesilonda se-peptic, lolu hlelo lokuvikela luba buthaka . Khona-ke lawo majusi okugaya ukudla aqinile angadla izindonga.
Isilonda siwukuguguleka okujulile ngokwanele ukungena kuzo zonke izingqimba ezintathu zolwelwesi lwesisu. Ngokuvamile, lezi zilonda zenzeka esiswini noma engxenyeni yokuqala yamathumbu amancane (i-duodenum), ngoba yilapho ujusi wokugaya ukudla usebenza khona kakhulu. Kodwa akuvamile, zingavela kwezinye izindawo.
La manxeba angavela kuphi? Ingabe zikhona izinhlobo?
Yebo, lezi zilonda zenzeka kakhulu esiswini sethu kanye nasengxenyeni yokuqala yamathumbu amancane (i-duodenum).
- Izilonda ze-Duodenal: Lezi yizona ezivame kakhulu, ezibalelwa cishe ku-80%.
- Izilonda zesisu: Lokhu kubonakala cishe kuma-20% ezimo.
Kodwa-ke, ezimweni ezingavamile kakhulu, i-asidi yesisu ingavuza kwezinye izindawo, ibangele izilonda. Isibonelo:
- Isilonda somqala: Abanye abantu bane-acid reflux engapheli, okuyilapho i-acid yesisu ikhuphukela emphinjeni. Uma lokhu kuqhubeka, ulwelwesi lomqala lungaphela kancane kancane, okubangela isilonda. Lokhu kungenxa yokuthi ulwelwesi lomqala alumelani ne-acid njengolwelwesi lwesisu.
- Isilonda se-Jejunal:I-jejunum iyingxenye ephakathi yamathumbu ethu amancane. Ezinye izinhlinzeko (isib. i-gastrojejunostomy - ukuhlinzwa okuxhumanisa isisu ngqo ne-jejunum) kungabangela ukulimala kule ngxenye.
Sivame kangakanani lesi simo?
Emhlabeni wonke, abantu abaphakathi kuka-5% no-10% bazoba nesifo sesilonda se-peptic (PUD) ngesikhathi esithile empilweni yabo. Nakuba kungenzeka kunoma yimuphi ubudala, kuvame kakhulu kubantu abaseminyakeni ephakathi kanye nabesilisa.
Ziyini izimpawu zalokhu? Ukubona kanjani?
Ngokumangalisayo, cishe abantu abangu-70% abanalesi simo ababonisi zimpawu . Kodwa-ke, izinto ezivame kakhulu abantu abanezimpawu abazishoyo yilezi:
- Ubuhlungu be-epigastric: Uma sikhuluma iqiniso, ubuhlungu obuvela phakathi kwesisu , ngaphansi kwesifuba.
- I-Dyspepsia: Iqoqo lokungakhululeki kokugaya ukudla okwenzeka ngemva kokudla. Lokhu kufaka phakathi ubuhlungu esiswini esingaphezulu, umuzwa wokushisa , umuzwa wokugcwala ngemva kokudla, kanye nomuzwa oqhubekayo wokugcwala.
Lo muzwa wokushisa ufana nomuzwa we-asidi yesisu nama-enzyme edla ulwelwesi lwesisu. Abanye abantu bawuchaza ngokuthi "njengokungathi kukhona okumba ngaphakathi kwesisu." Ungase ukwazi ngisho nokukhomba indawo eqondile yobuhlungu.
Nakuba kunzima ukusho ngqo ukuthi isilonda sisesiswini noma emathunjini amancane, kunezinkomba ezithile:
- Uma unesilonda esiswini , ubuhlungu bungase bube bubi kakhulu ngemva kokudla (kungakapheli nemizuzu engama-30), ngoba yilapho kuphuma khona ujusi wesisu omningi.
- Uma kwenzeka isilonda se-duodenal , ubuhlungu bungase buphele ngemva kokudla. Kodwa-ke, ngemva kwamahora amabili kuya kwamathathu, ubuhlungu bungase bukhule futhi njengoba ukudla kanye nojusi wokugaya ukudla kudlulela emathunjini amancane. Abanye abantu bacabanga ukuthi lokhu yindlala, njengoba ukudla kunikeza impumuzo. Ukuvuka ebusuku ngenxa yobuhlungu kuvamile nakubantu abanalezi zilonda zamathumbu amancane.
Ngaphezu kwalokhu, ungabona nezinye izici ezifana nalezi:
- Isisu esivuvukele
- Ukubhoboza noma ukubhoboza njalo
- Ukulahlekelwa yisifiso sokudla
- Isicanucanu nokuhlanza
Kwenzekani uma ingelashwa? Yiziphi izinkinga?
Abanye abantu baba nezimpawu ngemva kokuba lesi simo sesibe nezinye izinkinga. Lokhu kwenzeka uma singelashwa isikhathi eside. Ngaphandle kwalokho, amanxeba angaqala ukuphuma igazi , noma udonga lungajula kakhulu futhi lwakhe imbobo .
Uma unesifo sokuphuma kwegazi esiswini, ungase ube nezimpawu ezifana nalezi:
- Igazi esitulweni ( indlu emnyama, indle ephuzile )
- Ukuhlanza kwekhofi okugayiwe
- Isiyezi noma ukuphelelwa yithemba
- Ukuphaphatheka kwesikhumba (Umbala okhanyayo)
- Isilinganiso senhliziyo esisheshayo
Uma kuvela imbobo endleleni yokugaya ukudla (ukubhoboka kwesisu), izimpawu ezifana nalezi:
- Ubuhlungu besisu obungazelelwe, obukhulu, obubukhali
- Ukuvuvukala kwesisu kanye nobuhlungu obungabekezeleleki
- Umkhuhlane kanye nokubanda
Uma zingelashwa isikhathi eside, izilonda zingaphola bese ziphinde zibuye. Kwabanye abantu, izibazi nokuvuvukala kwendlela yokugaya ukudla kunganda, okuholela ekuvinjweni kwesisu . Lokhu kungaholela ezimpawini ezifana nalezi:
- Ukuqunjelwa, ukuvuvukala, kanye nobuhlungu
- Isicanucanu nokuhlanza
- Ukulahlekelwa yisifiso sokudla kanye nokwehla kwesisindo
- Ukungakwazi ukuzibamba kanye nokuqunjelwa
Kungani sithola lezi zilonda zesisu? Yiziphi izimbangela eziyinhloko?
Ulwelwesi oluvikelayo lomgudu wethu wokugaya ukudla luklanyelwe ukumelana nama-asidi nama-enzyme aqinile futhi luzilungise uma lonakele. Lokhu kuyiqiniso ikakhulukazi esiswini nasengxenyeni yokuqala yamathumbu amancane. Kodwa-ke, izilonda zenzeka lapho okuthile kuphazamisa lezi zivikelo zemvelo.
Ukuze lokhu kuvikelwa kuncishiswe futhi isilonda sijule ngokwanele ukungena ngaphakathi kwe-mucosa, kufanele kube nesimo sesikhathi eside noma esiqhubekayo . Ososayensi bathole izimbangela ezimbili eziyinhloko ezibangela iningi lala ma-PUD:
1. Ukutheleleka Kwamagciwane kwe-H. pylori (Helicobacter pylori): Leli gciwane lihlala esiswini kanye/noma emathunjini amancane cishe ingxenye yabantu bomhlaba. Kubantu abaningi, alibangeli izinkinga. Kodwa-ke, uma amabhaktheriya eba makhulu kakhulu, angaphazamisa ibhalansi yamanye ama-microorganism lapho futhi abangele impendulo yokuvuvukala . Lokhu kuvuvukala kwesikhathi eside kwenza udonga lube buthaka futhi kunciphisa ikhono lalo lokuzilungisa. Ngezinye izikhathi, amabhaktheriya angahlasela ngisho nodonga ngqo.
2. Ukusetshenziswa ngokweqile kwemithi engeyona eye-steroidal yokulwa nokuvuvukala (ama-NSAID): Lawa ama-painkiller esiwathenga ekhemisi ngaphandle kwencwadi kadokotela, njenge-aspirin ne-ibuprofen. Ngenxa yokuthi athathwa ngaphandle kweseluleko sezokwelapha, abantu abaningi bawathatha kaningi kunalokho abakudingayo. Lokhu kuthinta ibhalansi yamakhemikhali esiswini sethu nasemathunjini amancane. Ama-NSAID asebenza ngokunciphisa ukukhiqizwa kwamakhemikhali abizwa ngokuthi ama-prostaglandins, alungisa umonakalo olwelwesini lomgudu wokugaya ukudla.
Ngaphezu kwalezi zizathu ezimbili eziyinhloko, kunezinye izizathu ezingavamile kakhulu:
- Ezinye izifo
- Ukuncipha kokunikezwa kwegazi (`Ischemia`)
- Ukucindezeleka okukhulu ngokomzimba (ngokuvamile okubangelwa ukugula okusongela impilo noma ingozi)
- Ukwelashwa ngamakhemikhali noma ngemisebe
- I-Zollinger-Ellison syndrome - isimo lapho isisu sikhiqiza khona i-asidi eningi kakhulu
- Isifo sikaCrohn - isimo sokuvuvukala kwendlela yokugaya ukudla
- Umdlavuza wesisu
Ubani osengozini enkulu yokuthola lesi simo?
Uma unegciwane le-H. pylori noma usebenzisa njalo ama-NSAID, kungenzeka kakhulu ukuthi ube nalezi zilonda zesisu. Ingozi iphezulu kakhulu uma unazo zombili lezi zici eziyingozi.
Ngaphezu kwalokho, ukubhema, ukuphuza utshwala, kanye neminye imithi oyithathayo nakho kungaba nomthelela kulokhu. Nakuba lezi zinto zodwa zinganamandla ngokwanele okubangela izilonda, uma zihlanganiswa nokutheleleka kwe-H. pylori noma ukusetshenziswa kwe-NSAID, zandisa amathuba okuba nezilonda zesisu.
Odokotela bakuthola kanjani lokhu?
Uma udokotela wakho esola isilonda esiswini ngokusekelwe ezimpawini zakho kanye nezici eziyingozi, uzoqala ahlole umphimbo wakho ukuze abone izilonda. Bazohlola nokutheleleka kwe-H. pylori.
Kwabaningi, i-endoscopy ephezulu yomphimbo (ukuhlolwa kwe-EGD) iwukuxilongwa kokugcina. Lokhu kuhilela ukufaka ithubhu elincane elinekhamera encane ekugcineni ngomlomo bese kuhlolwa umphimbo, isisu, kanye nengxenye yokuqala yamathumbu amancane. Ngalesi sikhathi, ucezu oluncane lwezicubu (i-biopsy) lungathathwa esiswini ukuze kuhlolwe ukuthi kukhona yini i-H. pylori.
I-Endoscopy iwusizo kakhulu ngoba ayikuvumeli nje kuphela ukubona izithombe, kodwa futhi ikuvumela ukuthi udlulise amathuluzi ngepayipi uma kudingeka futhi wenze ukwelashwa. Isibonelo, uma inxeba liphuma igazi, ungalelapha ngokushesha ukuze ulimise.
Ezinye izivivinyo:
- Ukuhlolwa kwe-'CT scan (Computed Tomography scan)' noma 'GI series X-ray' kungenziwa ukuze kutholakale izilonda ezinkulu.
- Ukuhlolwa kokuphefumula kwe-"Urea" noma "ukuhlolwa kwendle" kungenziwa ukuthola ukutheleleka kwe-"H. pylori".
Yiziphi izindlela zokwelapha?
Ukwelashwa okuyinhloko kwezilonda zesisu inhlanganisela yemithi enciphisa i-asidi yesisu, ivikele ulwelwesi, futhi isize ukuba siphole . Uma unesifo, ungase udinge nama-antibiotic . Into ebaluleke kakhulu ukuthola nokwelapha imbangela yesilonda.
Esikhathini esiningi, amanxeba angaphulukiswa ngemithi yodwa. Kodwa-ke, uma kunezinkinga, njengesilonda esophayo noma isilonda esibhobokile, kungadingeka ukwelashwa okwengeziwe. Eziningi zalezi zinkinga zingaphathwa ngezinqubo zezokwelapha ezilula, njenge-endoscopy.
Imithi
- Ama-antibiotic: Uma unegciwane le-H. pylori noma elinye igciwane, udokotela wakho uzokunikeza inhlanganisela yama-antibiotic ukubulala amagciwane. (Isibonelo: i-Amoxicillin, i-Clarithromycin, i-Metronidazole)
- Ama-cytoprotective agents: Le mithi isebenza ngokugqoka nokuvikela ulwelwesi lwesisu kuze kube yilapho luphola. (Isibonelo: `Sucralfate`, `Misoprostol`, `Bismuth subsalicylate`)
- Ama-histamine receptor blockers (ama-H2 blockers): Le mithi inciphisa i-asidi ngokuvimbela ikhemikhali ekhombisa isisu ukuthi sikhiqize i-asidi. (Isibonelo: `Famotidine`, `Cimetidine`)
- Ama-proton pump inhibitors (PPIs): Le mithi inciphisa i-asidi yesisu futhi isiza ulwelwesi lwesisu ukuba luphole ngokuluvikela. (Isibonelo: i-Omeprazole, i-Pantoprazole, i-Esomeprazole)
- Ama-painkiller ahlukile esikhundleni sama-NSAID: Uma uvame ukuthatha ama-NSAID, ungase ufune ukukhuluma nodokotela wakho nge-alternative. I-Acetaminophen (i-paracetamol) ayiyona i-NSAID futhi ayinawo umphumela ofanayo elangeni lesisu.
Izinqubo zezokwelapha
Uma unesilonda esiyinkimbinkimbi, esopha igazi, udokotela wakho kuzodingeka aselaphe ngqo. Lokhu kungenziwa njalo ngesikhathi se-endoscopy. Ukopha kuyamiswa ngokufaka isilonda esinobuthi noma ngokufaka umuthi wokujova. Uma kukhona imbobo, iyathungwa ivalwe.
Akuvamile, uma isilonda sivale umphimbo, kungadingeka ukungenelela ukuze siphinde sivulwe. Lokhu kungahilela ukumunca okungaphakathi esiswini noma, okungavamile kakhulu, ukuhlinzwa.
Yini okufanele siyenze ukuze sizivikele kulesi simo? (Ukuvimbela)
Izinto ezibaluleke kakhulu ongazenza ukuze uzivikele esifweni sesilonda se-peptic yilezi:
1. Hlola ukutheleleka kwe-H. pylori bese welashwa: Abantu abaningi banesifo se-H. pylori kodwa abazi. Ungathola ukuthi unaso yini ngokwenza ukuhlolwa okulula kokuphefumula kwe-urea. Uma unaso, thola ukwelashwa ngaphambi kokuba kuvele izinkinga. Ngisho noma uke welashwa ngaphambilini, kuwumqondo omuhle ukuhlolwa futhi, ngoba ngezinye izikhathi kungabuya.
2. Sebenzisa ama-NSAID kuphela njengoba kuyalelwe: Uma ujwayele ukuthatha ama-NSAID ngenxa yobuhlungu obuncane nsuku zonke, qaphela ukuthi ungaphuzi ngaphezu komthamo onconywayo. Uma unomlando wezilonda zesisu, kungcono ukugwema ukuzisebenzisa. Uma kudingeka, zithathe nomunye umuthi ovikela ulwelwesi lwesisu.
Ingabe la manxeba azophola ngaphandle kwemithi?
Uma imbangela yesilonda isusiwe, isilonda singaphola. Kodwa-ke, ukuhlolwa kwezokwelapha kuvame ukudingeka ukuze kutholakale imbangela. Uma imbangela kuyisifo se-H. pylori noma esinye isimo sezokwelapha, kuzodingeka ukwelashwa ukuze kuqedwe.
Uma imbangela kungama-NSAID nje, isilonda singaphola sodwa uma uyeka ukuwathatha. Kodwa-ke, kufanele ubone udokotela ukuqinisekisa lokhu. Ungase ube nokutheleleka kwe-H. pylori, futhi ama-NSAID angenza kube kubi kakhulu ukutheleleka obekungeyona ingozi ngaphambili.
Kwenzekani ngemva kokwelashwa? Kuthatha isikhathi esingakanani ukululama?
Izilonda eziningi zesisu ziyaphola zingakapheli amasonto ambalwa . Iningi labantu kudingeka lithathe umuthi cishe izinyanga ezimbili. Lo muthi usebenza kahle kakhulu. Kodwa-ke, abantu abanezimo zesikhathi eside njenge-Zollinger-Ellison syndrome kungadingeka bathathe umuthi impilo yabo yonke.
Ngemva kokwelashwa, udokotela uzokwenza izivivinyo zokulandelela ukuqinisekisa ukuthi isilonda selulaphekile ngokuphelele nokuthi ukutheleleka sekuphelile. I-H. pylori iyibhaktheriya eliyinkimbinkimbi futhi ngezinye izikhathi lingabuya. Futhi, uma izimo ezibangele isilonda ziqhubeka, isilonda singabuya.
Akuvamile kakhulu, abanye abantu bangase babe nezilonda zesisu ezingapheli ezingapholi ngokwelashwa. Lokhu kungabangela izinkinga ezifana nobuhlungu besikhathi eside kanye nezibazi ezinkulu. Ezimweni ezinjalo, kungase kudingeke ukuhlinzwa (isib., ukususa izicubu zesibazi (i-pyloroplasty), noma ukusika umthambo olawula ukukhiqizwa kwe-asidi yesisu (i-vagotomy)).
Ingabe udinga ukwenza izinguquko ekudleni kwakho nasendleleni yakho yokuphila?
Ukudla nokuphuza akuzibangeli izilonda esiswini, kodwa uma unezilonda, ukudla okuthile neziphuzo (ikakhulukazi ukudla okubabayo, okumuncu) kungenza zibe zimbi kakhulu . Uma unezimpawu noma uke waba nezilonda esiswini ngaphambilini, kufanele ugweme ngokuphelele utshwala nokubhema .
Khuluma nodokotela wakho ngayo yonke imithi oyithathayo (ikakhulukazi ama-NSAID). Eminye imithi ingabangela izinkinga uma ithathwa kanye.
Ingabe lokhu akukwazi ukwelashwa ngokusebenzisa imithi yokunciphisa i-asidi ekhaya?
Ama-antacid asebenza ngokunciphisa i-asidi nokunciphisa izimpawu ezifana nesilungulela, isilungulela, kanye nokungagayeki kahle kokudla. Angenza isilonda sizizwe singcono okwesikhashana, kodwa awasiphulukisi isilonda . Uma uke waba nezilonda esiswini ngaphambili, ama-antacid angasiza ekuvimbeleni ukuthi zingabuyi.
Yiziphi izikhathi ezinhle kakhulu zokuya kudokotela?
Uma usola ukuthi unesilonda esiswini, qiniseka ukuthi ubona udokotela . Nakuba imithi etholakala ngaphandle kwemithi kadokotela ingalawula izimpawu zakho okwesikhashana, ngeke yelaphe isilonda. Imbangela eyinhloko kumele itholakale futhi yelashwe.
Isilonda esingalashwanga, noma ngabe awunazo izimpawu ezibucayi, singaholela ezinkingeni ezinkulu. Ukutheleleka nge-H. pylori, okuyimbangela eyinhloko yezilonda zesisu, kungaholela nakwezinye izinkinga (njengengozi yokuba nomdlavuza wesisu).
Uma ubona izimpawu zezinkinga ezinkulu ezifana nalezi, hamba uye ekamelweni eliphuthumayo ngokushesha:
- Ubuhlungu obungapheli nobunzima.
- Izimpawu zegazi esitulweni (indle emnyama) noma ukuhlanza igazi.
- Izimpawu zokulahlekelwa igazi okukhulu (ukufiphala, ukuquleka).
Izinto ezibaluleke kakhulu okudingeka sizikhumbule (Umyalezo Wokuya Ekhaya)
Isifo Sezilonda Zesisu yisifo esibi kakhulu esithinta uhlelo lwakho lokugaya ukudla. Sivela lapho uhlelo lwakho lokuzivikela lwemvelo lubuthakathaka. Lesi simo sithatha isikhathi ukuba sikhule futhi ngokuvamile sidinga ukwelashwa ukuze siphole.
Izilonda zesisu ziyisimo esivamile futhi esingelapheka. Kodwa-ke, kubalulekile ukufuna ukwelashwa ngisho noma ungenazo izimpawu ezibucayi.Uma ingelashwa, amanxeba angaba maningi futhi abe makhulu. Ngakho-ke, ungalibali ukukhuluma nodokotela ngezimpawu zakho. Impilo yakho iyakufanelekela!
Izilonda zesisu, izilonda zesisu, ukuvuvukala kwesisu, i-H. pylori, i-NSAID, i-gastritis, ukungagayi kahle kokudla
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