Ingabe uvame ukuba nesilungulela? Njenge-gastritis? Ingabe uzizwa sengathi ukudla kuyabuya emphinjeni wakho ngemva kokudla? Iningi lethu liyakhohlwa ngalezi zinto, licabanga ukuthi "zivamile." Kodwa ngemuva kwalezi zimpawu ezibonakala zincane, kungase kube nento esingacabangi ngayo futhi okufanele sikhathazeke ngayo kancane. Leso yisimo esikhuluma ngaso kulesi sihloko namuhla. Leso yi-"Barrett's Esophagus."
Kalula nje, iyini i-Barrett's Esophagus?
Kulungile, ake sikuchaze kalula lokhu. Uyazi ukuthi uma sigwinya ukudla, kusuka emlonyeni kuya esiswini ngepayipi elibizwa ngokuthi i-esophagus . Njengendlela yethu yonke yokugaya ukudla (i-GI tract), ingaphakathi lale-esophagus ligcwele ungqimba oluncane noluvikelayo lwamaseli.
Kodwa ake sithi ngokuhamba kwesikhathi eside, kukhona okuqhubeka nokulimaza noma ukucasula lolu lwelwesi olubucayi. Isibonelo, ungase uhlale une-acid esiswini ebuyela emphinjeni wakho. Njengoba lokhu kuqhubeka, amangqamuzana asemphinjeni wakho awasakwazi ukusingatha umonakalo. Bese, lawo maseli aqala ukushintsha ukuze azivikele.
Lolu shintsho lwenzeka lapho amangqamuzana avamile emhubheni eqala ukukhula abe uhlobo oluhlukile lweseli, olufana namangqamuzana asemathunjini ethu. Kwezokwelapha, lokhu sikubiza ngokuthi (i-Intestinal Metaplasia) .
Kalula nje, lapho umphimbo uzama ukuzivikela, ushintsha uhlobo lwamaseli angaphakathi kwawo. Lokhu kufana nokubeka ungqimba lwekhaphethi phezu komgwaqo ojwayelekile lapho ungcola ngenxa yezimoto eziqhubekayo. Kodwa lawa maseli amasha akuwona amaseli angaphansi komphimbo.
Ingabe lesi yisimo esiyingozi? Ingabe sizobangela umdlavuza?
Lo mbuzo ungase ube ngowokuqala ofika engqondweni yakho. Nansi impendulo: I-Barrett's esophagus ayiwona umdlavuza. Kodwa-ke, yisimo esikhuphula kancane ingozi yokuba nomdlavuza we-esophagus.
Kodwa ungakhathazeki. Le ngozi ayinkulu njengoba ungase ucabange. Ucwaningo luthole ukuthi amathuba okuba umuntu onalesi simo abe nomdlavuza ngonyaka mancane kakhulu, cishe angu-0.5%.
Into ebalulekile ukuthi lezi zinguquko zamaseli ziyenzeka kancane kancane. Ngaphambi kokuba amaseli abe nomdlavuza, adlula kwesinye isigaba esiphakathi. Sikubiza ngokuthi (i-Dysplasia) . Okusho ukuthi, izinguquko zamaseli angaphambi komdlavuza. Odokotela bangakwazi ukubona lesi sigaba (i-Dysplasia) kusenesikhathi, basuse lawo maseli futhi bavimbele umdlavuza ukuthi ungakhuli. Yingakho kubalulekile ukuqaphela lesi simo.
Ziyini izimpawu zalokhu?
Nansi into emangazayo. Umphimbo kaBarrett awunazo izimpawu ezithile. Lokho kusho ukuthi, noma ngabe unalesi simo, ngeke uzizwe ubuhlungu noma ukungakhululeki.
Ngakho-ke uthola kanjani lokhu?
Sithola izimpawu ngenxa yembangela eyinhloko yalesi simo. Njengoba sixoxile ngaphambili, lokhu kungenxa yomonakalo wesikhathi eside emhubheni. Imbangela eyinhloko yalomonakalo yi -gastritis (GERD - Gastroesophageal Reflux Disease) . Okusho ukuthi, i-asidi esiswini ivame ukukhuphukela emhubheni.
Ngakho-ke, uma unezimpawu ezilandelayo isikhathi eside, kufanele ukhathazeke:
- Ubuhlungu besifuba obuvamile: Ukuzwa sengathi kukhona umlilo phakathi kwesifuba.
- Ubunzima bokugwinya: Ukuzwa sengathi kukhona okubambeke emphinjeni.
- Okuqukethwe esiswini (i-asidi, ukudla) okukhuphukela emphinjeni: Ukunambitheka okumuncu emlonyeni, ikakhulukazi uma ulele phansi ebusuku noma ugobile phambili.
- Umphimbo obuhlungu noma ukukhwehlela okuqhubekayo.
- Ubuhlungu besifuba.
Into ebalulekile yile: Abanye abantu baba nalezi zimpawu iminyaka eminingi, kodwa abayithathi imithi yazo. Kuphela uma umphimbo wonakele isikhathi eside lapho umphimbo kaBarrett ungakhula khona. Ngakho-ke, uma unalezi zimpawu, ungazinaki. Qiniseka ukuthi ubona udokotela futhi uthole iseluleko.
Ubani osengozini enkulu yokuthuthukisa lokhu?
Nakuba noma ubani angaba nomphimbo kaBarrett, abanye abantu basengozini enkulu kancane. Ake sibheke ukuthi bangobani.
| Isici sengozi | Incazelo |
|---|---|
| I-gastritis engapheli (GERD) | Lesi yisona sici esiyinhloko esiyingozi. Abantu asebene-gastritis iminyaka engaphezu kweyi-10 basengozini enkulu. Cishe abantu abayi-10% - 15% abane-GERD bangase babe nalesi simo. |
| Ubudala | Ngokuvamile kubonakala kakhulu kubantu abaneminyaka engaphezu kwengu-55. Lokhu kungenxa yokuthi kuthatha isikhathi ukuthi la maseli ashintshe. |
| Ubulili | Amadoda anamathuba amabili noma amathathu okuthola lesi simo kunabesifazane. |
| Ukubhema | Ukubhema kungase kube esinye isici esiyinhloko esibangela lokhu. |
Udokotela ukuthola kanjani lokhu?
Ngemva kokulalela izimpawu zakho, uma udokotela ekusola lokhu, uzokudlulisela kuchwepheshe, udokotela wezifo zamathumbu. Uzokwenza isivivinyo esibalulekile ukuqinisekisa lesi simo. Leso yi -endoscopy .
Kuyini i-endoscopy?
Lokhu kuhilela ukufaka ipayipi elincane neliguquguqukayo elinekhamera ekugcineni ngomlomo wakho bese uhlola umphimbo wakho, isisu, kanye nengxenye yokuqala yamathumbu akho amancane. Ngeke uzizwe ubuhlungu phakathi nalolu vivinyo, ngoba uzodanjiswa umuthi.
Ebheka ngekhamera, udokotela ubona ushintsho embala kanye nokuthungwa kolwelwesi lwesitho sangasese sowesifazane.
- Nakuba ulwelwesi lwesitho sangasese sowesifazane olujwayelekile lupinki futhi lubushelelezi,
- Izindawo ezine-Barrett's zingase zibonakale zinombala we-salmon futhi ziqinile kancane.
Uma udokotela ebona lolu shintsho, uthatha izingcezu ezimbalwa ezincane kakhulu zezicubu ezindaweni ezishintshile. Lokhu sikubiza ngokuthi i-biopsy . Ngemuva kwalokho, lezi zingcezu zezicubu zihlolwa ngaphansi kwe-microscope ukuqinisekisa ukuthi amaseli ashintshile ngempela yini, okungukuthi, ukuthi ngabe kukhona yini isimo esibizwa ngokuthi i-Intestinal Metaplasia.
Uhlukanisa kanjani lesi simo ngemva kokuhlolwa?
Uma umbiko we-biopsy usufikile, udokotela uzohlela isimo sakho. Lokhu kusekelwe kakhulu ezintweni ezimbili.
1. Ubungakanani ubude bomhubhe obuthintekile yilolu shintsho.
2. Kungakhathaliseki ukuthi kukhona yini izinguquko zamaseli ezingaphambi komdlavuza (i-dysplasia).
| Ukuhlukaniswa | Incazelo |
|---|---|
| Ngokusho kwezinguquko zamaseli angaphambi komdlavuza (i-Dysplasia) | |
| (Ukubola kwezicubu okungeyona i-dysplastic) | Amaseli ashintshile, kodwa awakaqali ukuthuthukisa izinguquko zangaphambi komdlavuza. Ingozi yomdlavuza iphansi kakhulu. |
| I-dysplasia yezinga eliphansi | Izinguquko zamaseli angaphambi komdlavuza seziqalile ukuvela. Kukhona ingozi encane yomdlavuza. |
| I-dysplasia yezinga eliphezulu | Izinguquko zamaseli angaphambi komdlavuza zibonakala ngokucacile. Ingozi yomdlavuza iyanda kakhulu. |
| Umdlavuza (i-Carcinoma) | Lesi simo (i-dysplasia) siye saba sibi kakhulu futhi saphenduka umdlavuza. |
Lokhu kuhlukaniswa kubaluleke kakhulu, ngoba kunquma ukuthi yikuphi ukwelashwa okufanele ukuthole nokuthi kufanele uphinde uhlolwe kangaki.
Yiziphi izindlela zokwelapha lokhu?
Kunezinhloso ezintathu eziyinhloko zokwelapha umphimbo kaBarrett.
1. Misa isimo ukuba singabi sibi ngokwelapha imbangela eyinhloko.
2. Ukuqapha njalo ukuthuthukiswa kwezinguquko zangaphambi komdlavuza (i-dysplasia).
3. Uma kwenzeka isimo (i-dysplasia), susa amaseli athintekile.
1. Ukwelapha imbangela eyisisekelo
Njengoba abantu abaningi beba nalesi simo ngenxa yesifo sohudo esingamahlalakhona (i-GERD), into yokuqala okufanele uyenze ukuselapha ngendlela efanele. Udokotela wakho uzokweluleka ngalokhu:
- Ukushintsha indlela yokuphila: Ukunciphisa ukudla okunongwe ngamafutha, ikhofi, njll., nokungalali phansi ngokushesha ngemva kokudla kwakusihlwa.
- Imithi: Imithi enciphisa ukukhiqizwa kwe-asidi esiswini, ikakhulukazi i-Proton Pump Inhibitors (PPIs) (isib. i-Omeprazole, i-Esomeprazole, i-Pantoprazole), iyasebenza kakhulu. Iyamisa umonakalo emgudwini womchamo futhi isize izicubu ukuba ziphilise.Le mithi kufanele ithathwe kuphela ngokwelulekwa udokotela.
2. Ukuqapha njalo (Ukuqapha)
Kuye ngesimo sakho, udokotela wakho uzokutshela ukuthi udinga kangaki ukwenziwa i-endoscopy.
- Ngaphandle kwalokho, ukuhlola njalo eminyakeni emi-3-5 kwanele.
- Uma kukhona i-dysplasia yezinga eliphansi, batusa ukuthi ihlolwe cishe kanye ngonyaka.
3. Ukwelapha lesi simo (i-Dysplasia)
Uma i-biopsy iqinisekisa ukuthi kukhona izinguquko zamaseli ngaphambi komdlavuza (i-dysplasia), odokotela bazoncoma ukususa lawo maseli. Kunezindlela eziningana zokwenza lokhu.
- Ukwelashwa Kokukhipha Izicubu Ezifile: Lokhu kuhilela ukusebenzisa idivayisi ekhethekile ngesikhathi se-endoscopy ukubhubhisa ungqimba lweseli olungavamile. Lokhu kungenziwa ngokusebenzisa ukushisa okuphezulu (i-radiofrequency) noma umkhuhlane ophezulu (i-cryotherapy).
- Ukususwa Kwama-Mucosal Endoscopic (EMR): Lokhu futhi kuyindlela encane yokuhlinzwa eyenziwa nge-endoscopy. Lapha, kunqunywa izicubu ezingavamile kuphela bese zisuswa.
- Ukuhlinzwa (Ukususwa Kwesisu): Uma i-dysplasia inzima kakhulu noma isiye yaba umdlavuza, kungase kudingeke ukuhlinzwa ukuze kususwe ngokuphelele ingxenye ethintekile yesisu.
Ingabe lesi simo singalapheka ngokuphelele?
I-Metaplasia, noma ushintsho kumaseli, ayithuthuki ngokwayo. Kodwa-ke, ukwelashwa esixoxe ngakho ngaphambilini (i-Ablation, i-EMR) kungasusa amaseli ashintshiwe. Futhi, uma imbangela eyisisekelo (njenge-GERD) iphathwa kahle futhi umonakalo womhubhe umiswa, lesi simo singalawulwa.
Kodwa ngisho nangemva kokwelashwa, kunethuba elincane lokuthi lesi simo sizophinde sibuye. Ngakho-ke, kubaluleke kakhulu ukuqhubeka nokuya kokuhlolwa okulandelayo njengoba udokotela esho.
Umuntu one-Barrett's emophagus angaphila impilo ejwayelekile. Into ebaluleke kakhulu ukuvimbela lesi simo ukuthi singabi sibi kakhulu. Uma izinguquko ezingaphambi komdlavuza zitholakala futhi zelashwa kusenesikhathi, akudingeki ukhathazeke ngekusasa lakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Barrett's Esophagus ayiyona umdlavuza, kodwa yisimo esikhuphula kancane ingozi yomdlavuza womphimbo.
- Imbangela eyinhloko yalokhu yisifo sofuba esihlala isikhathi eside (i-GERD).
- Uma ubhekene nezimpawu ezifana nobuhlungu besifuba obuvamile noma ukudla okubhajwa emphinjeni, ungakuzibi. Qiniseka ukuthi ubona udokotela futhi uthole iseluleko.
- Lesi simo sitholakala nge-endoscopy kanye ne-biopsy.
- Uma kungekho zinguquko ezingaphambi komdlavuza (i-dysplasia), asikho isizathu sokwesaba. Kodwa-ke, kubaluleke kakhulu ukuhlolwa njalo ngokwesheduli enconywe udokotela wakho.
- Lesi simo singaphathwa ngempumelelo enkulu ngokwelapha imbangela eyisisekelo ngendlela efanele, futhi uma kudingeka, ukususa amaseli athintekile.
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