Umuthi wokuvuvukala kwesisu kanye ne-gastritis! Ake sifunde ngqo ngama-Proton Pump Inhibitors (PPIs)!

Ingabe uvame ukuba nesilungulela noma ubuhlungu besifuba? Noma ingabe udokotela wathi "i-gastritis"? Uhlobo lomuthi odokotela abavame ukuwunikeza ezimweni ezinjalo lubizwa ngokuthi `(Proton Pump Inhibitors)`. Uma singakhuluma ngokungagwegwesi, cishe besizowubiza nangokuthi "umuthi we-gastritis." Ngakho-ke, namuhla sizokhuluma `(Proton Pump Inhibitors)` noma ama-PPI ngamafuphi.

Kungani sidinga la ma-PPI? Kwenzekani nge-asidi yesisu?

Kalula nje, `(Ama-Proton Pump Inhibitors)` uhlobo lomuthi onciphisa inani le-asidi ekhiqizwa esiswini sakho, okungukuthi, inani le-asidi yesisu . Manje ungase ucabange, "O, iyini injongo ye-asidi yesisu? Ayilungile." Lokho akulona iqiniso. I-asidi yesisu ibaluleke kakhulu emizimbeni yethu. Yile-asidi esisiza ukugaya ukudla esikudlayo. Akukhona lokho kuphela, kodwa le-asidi yesisu iyasiza nasekubhubhiseni amagciwane ayingozi esiwadla ngokungazi nokudla.

Kodwa-ke, ngezinye izikhathi izinkinga ziqala lapho inani le-asidi yesisu landa kakhulu, noma lapho i-asidi iya endaweni ehlukile kunaleyo okufanele ibe yiyo. Kufana nesisho esithi "Uma ikhula, ngisho ne-nectar izoba yingozi." Yilapho izilonda zesisu (`izilonda`), noma njengoba sizibiza kanjalo, "izilonda ze-gastritis" zingavela khona. Ezinye izinto ezifana nesilungulela kanye nokunambitheka okumuncu emphinjeni nakho kungavela. Yilapho le mithi ebizwa ngokuthi ama-PPI isisiza khona. Isetshenziswa ikakhulukazi ezinkingeni zesikhathi eside ezihlobene ne-asidi yesisu.

Yiziphi izinhlobo zezifo ezisetshenziswa yilawa ma-PPI?

Odokotela basebenzisa kakhulu lezi zinhlobo zemithi (Proton Pump Inhibitors) ukwelapha izimo ezinjengokulimala nokuvuvukala ezingxenyeni zesimiso sethu sokugaya ukudla, okungukuthi amathumbu kanye nomphimbo, okubangelwa yi-asidi yesisu. Ake sibone ukuthi iyini:

• Isifo i-GERD noma i-Chronic Acid Reflux: Ingabe uvame ukuba nesilungulela? Ingabe unomuzwa omuncu emphinjeni wakho? Yilokho i-GERD eyikho. Kalula nje, yi-asidi esiswini sakho ekhuphukela emhubheni wakho. Lokhu kungalimaza ulwelwesi lomhubhe wakho, olubizwa nangokuthi i-erosive esophagitis. Ama-PPI asebenza ngokunciphisa ukukhiqizwa kwe-asidi esiswini nokunikeza umhubhe wakho isikhathi sokuphulukiswa.
• Izilonda zesisu neze-duodenal: Izilonda zesisu neze-duodenal ziyizilonda ezingabangelwa yi-asidi yesisu, engalimaza ulwelwesi oluvikelayo lwesisu. Zingabangela nezilonda engxenyeni yokuqala yamathumbu amancane (okuthiwa i-duodenum). Ama-PPI angasiza ekwelapheni lezi zilonda. Ngaphezu kwalokho, ezinye izidakamizwa zokuqeda ubuhlungu, ikakhulukazi izidakamizwa ezingezona eze-steroidal anti-inflammatory (NSAIDs), zihlotshaniswa nengozi eyengeziwe yokuthola izilonda. Izifundo zibonisa ukuthi cishe abantu abangu-30% abathatha ama-NSAID bavame ukuba nezilonda. Ama-PPI angasiza ekuvimbeleni nasekuphulukiseni izilonda.
• Ukutheleleka kwe-H. pylori:Lolu uhlobo lwamagciwane angaphila esiswini sethu. La magciwane angabangela nezilonda esiswini. Lapho belapha ukutheleleka kwe-H. pylori, odokotela banikeza ama-PPI kanye nama-antibiotic. Lokhu kungenxa yokuthi ama-PPI ashintsha izinga le-pH yesisu, okwenza kube lula ngama-antibiotic ukubulala amagciwane.
• I-Zollinger-Ellison syndrome: Lesi yisimo esingavamile. Kulesi simo, izinhlobo ezithile zezimila (`izimila`) ziyakhula emzimbeni futhi zibangele ukuthi umzimba ukhiqize i-hormone eningi kakhulu ebangela i-asidi yesisu. Lokhu kuphumela ku-asidi yesisu eningi kakhulu. Ama-PPI nawo asetshenziselwa ukwelapha lesi simo.

Zisebenza kanjani lezi zidakamizwa ezibizwa ngokuthi ama-PPI? Kuyamangalisa, akunjalo?

Cabanga ukuthi kukhona "umshini" omncane esiswini sethu owenza i-asidi. Sibiza lo mshini ngokuthi "i-hydrogen-potassium ATPase pump", noma "i-proton pump" ngamafuphi. Njengoba nje iphampu yamanzi idonsa amanzi phezulu, le phampu ye-proton yiyona eyenza inqubo yamakhemikhali edingekayo ukwenza i-asidi yesisu.

Ngakho-ke, lokho okwenziwa yilaba `(Proton Pump Inhibitors)` noma ama-PPI ukuvimba okwesikhashana ukusebenza kwephampu ye-proton . Okusho ukuthi, "bayayivimbela", okungukuthi, bayayiphazamisa. Bese ukukhiqizwa kwe-asidi yesisu kwehla.

Kodwa lokhu akuvimbeli ngokuphelele ukukhiqizwa kwe-asidi yesisu, akunjalo? Usenayo i-asidi eyanele yokugaya ukudla. Uma uthatha i-PPI cishe izinsuku ezinhlanu zilandelana, ukukhiqizwa kwe-asidi yesisu kuzoncishiswa cishe ngo-65%. Ama-35% asele e-asidi anele ukugaya ukudla.

Ziyini lezi PPI?

Amanye ala ma-PPI angathengwa ngaphandle kwemithi kadokotela (i-OTC) ekhemisi ngaphandle kwemithi kadokotela, kodwa amanye anamandla adinga imithi kadokotela (i-Rx kuphela).

Ama-PPI angathathwa ngomuthi kadokotela noma ngaphandle kwawo (i-OTC kanye ne-Rx):

• I-Esomeprazole (Nexium®)
• I-Lansoprazole (i-Prevacid®)
• I-Omeprazole (i-Prilosec®)
• I-Omeprazole/sodium bicarbonate (Zegerid®)

Ama-PPI atholakala kuphela ngomuthi kadokotela (ama-Rx kuphela):

• I-Dexlansoprazole (i-Dexilant®)
• I-Pantoprazole (Protonix®)
• I-Rabeprazole (i-AcipHex®)

Ngingawuthatha kanjani lo muthi? Kufanele ngiwuthathe malini?

Le mithi iza ngesimo sethebhulethi noma sekhaphu. Uyithatha ngomlomo. Ezinye izinhlobo zamakhaphu ziqukethe impuphu engaxutshwa ekudleni, njenge-applesauce, bese ithathwa. Lokhu kuwusizo olukhulu kubantu abanenkinga yokugwinya amaphilisi.

Ngaphambi kokuthatha umuthi, kufanele ufunde imiyalelo esephaketheni ngokucophelela.Yilapho-ke lapho uzothola khona imiphumela enembile kakhulu. Kunezinhlobo ezithile ze-PPI okufanele uzithathe isigamu sehora noma ihora ngaphambi kokudla, esiswini esingenalutho. Uma uzithatha ngaleso sikhathi, umuthi unesikhathi sokusebenza ngaphambi kokuba isisu sakho siqale ukukhiqiza i-asidi uma udla.

Udokotela wakho kuphela ongakutshela ukuthi udinga umuthi ongakanani (`umthamo`) nokuthi kufanele uwuthathe kangaki ngosuku. Uzokunikeza umthamo ozolawula izimpawu zakho ngamathuba amancane okuba nemiphumela emibi. Kwabanye abantu, ukuphuza iphilisi elilodwa ngaphambi kokudla kwasekuseni kwanele. Kwabanye, ukulithatha kabili ngosuku, ngaphambi kokudla kwasekuseni nangaphambi kokudla kwakusihlwa, kungase kwanele. Ngezinye izikhathi, ukulithatha njalo ngemva kwezinsuku ezimbili kunganele.

Ngokuhamba kwesikhathi, kungadingeka unciphise umthamo wemithi yakho. Udokotela wakho uzokweluleka ngalokhu futhi.

Kuthatha isikhathi esingakanani ukuthi la ma-PPI asebenze?

Ngemva kokuthatha umuthi we-PPI, kungathatha noma yikuphi kusukela emahoreni angu-24 kuya ezinsukwini ezine ukuzwa umphumela wawo ogcwele.

Uma unesishiso senhliziyo noma ubuhlungu besifuba ngokuzumayo futhi udinga impumuzo esheshayo, kungcono ukusebenzisa umuthi oqeda i-acid (njenge-Digene, i-Acidex) noma umuthi ovimba i-histamine (i-H2 blocker) (njenge-Pepcid® noma i-Tagamet®) kune-PPI. Cabanga ukuthi unesishiso senhliziyo ngokuzumayo ngemva kokudla ukudla okunongwe. Ngemuva kwalokho, ukuthatha umuthi onjalo kuzokunikeza impumuzo phakathi nemizuzu embalwa noma amahora ambalwa. Kodwa-ke, umphumela wawo awuhlali isikhathi eside njenge-PPI.

Ama-PPI angcono kakhulu uma unezinkinga ze-asidi yesisu ezihlala isikhathi eside.

Ingabe kukhona imiphumela emibi uma usebenzisa la ma-PPI?

Iningi labantu alinazo izinkinga ezinkulu lapho lithatha ama-PPI. Kodwa-ke, njenganoma yimuphi umuthi, angabangela imiphumela emibi. Lokhu kufaka phakathi:

• Isisu esibuhlungu
• Ukuqunjelwa
• Uhudo
• Isiyezi
• Umlomo owomile
• Ubuhlungu bekhanda
• Imfiva
• Ukuqunjelwa/igesi
• Ukukhanya kwekhanda
• Ukuluma kanye nokuqubuka
• Ukuhlanza

Nakuba ama-PPI ngokuvamile ebhekwa njengaphephile, abacwaningi bathole ukuthi angaba yingozi ethile, ikakhulukazi uma esetshenziswa isikhathi eside . Ake sibheke ukuthi ayini:

• Ukutheleleka kwe-Clostridioides difficile (C. diff): Ama-PPI angashintsha ibhalansi phakathi kwamagciwane amahle namabi emathunjini akho, okwandisa ingozi yakho yokuthola izifo ezifana ne-C. diff.
• Ukuphuka: Ama-PPI anganciphisa ikhono lomzimba wakho lokumunca i-calcium, iminerali esiza ukugcina amathambo ethu eqinile. I-U.S. Food and Drug Administration (FDA) ixwayisa ngokuthi ama-PPI angandisa ingozi yokuphuka kwesinqe, esihlakaleni, noma emgogodleni.
• Isifo sezinso:Lokhu kungandisa ingozi yokuthola isifo sezinso esingamahlalakhona (CKD), noma kwenze izimo ezikhona zibe zimbi kakhulu.
• Ukuntuleka kokudla okunempilo: Ama-PPI anganciphisa ikhono lamathumbu akho amancane lokumunca i-magnesium noma i-vitamin B12. I-magnesium iyiminerali esiza imisipha yethu kanye nemizwa ukuthi isebenze kahle. I-Vitamin B12 ibalulekile ohlelweni lwethu lwezinzwa kanye namaseli abomvu egazi.

Ukuxhumana phakathi kwama-PPI nalezi zici eziyingozi kusacwaningwa. Kodwa-ke, odokotela ngokuvamile batusa ukusebenzisa umthamo ophansi kakhulu futhi isikhathi esifushane ngangokunokwenzeka kuze kube yilapho izimpawu zakho zithuthuka. Lokhu kuzonciphisa ingozi yalezi zici eziyingozi.

Kufanele ngimbone nini udokotela wami?

Uma udokotela ekunike ama-PPI, qiniseka ukuthi ubuza udokotela wakho uma unemibuzo mayelana nokuthatha umuthi, ukuthi uwuyeke nini, noma ukuthi ungawunciphisa kanjani umthamo.

Uma uthatha ama-PPI ngaphandle kwekhawunta ekhemisi futhi uzizwa sengathi uwadinga nsuku zonke ukulawula izimpawu zakho, kufanele usabonane nodokotela. Angakweluleka ngomthamo oqondile kanye nobude besikhathi okufanele uwuthathe ngaso umuthi.

Futhi, uma uhlangabezana nanoma yimiphi yale miphumela emibi eyingozi, bona udokotela ngokushesha:

• Ukusabela kokungezwani komzimba (ukuqubuka kwesikhumba, ukubomvu, ukuvuvukala)
• Izimpawu zokulimala kwezinso (ukuchama kancane kunangaphambili, ukuvuvukala ezandleni nasezinyaweni, emaqakaleni)
• Izimpawu zokuntuleka kwe-magnesium (ukuthuthumela, ukushaya kwenhliziyo okungajwayelekile, ukudikiza kwemisipha)
• Izimpawu zokuntuleka kwevithamini B12 (ubuhlungu ezandleni nasezinyaweni, ukungazweli, ukuqaqamba, isiyezi, ukudideka)
• Uma isikhumba siba bomvu, siqhuma, noma sibukeka sengathi siyaxebuka
• Uma unesifo sohudo esinzima
• Uma unomkhuhlane

Ngakho-ke, uthini umyalezo wokugcina okufanele uwuthathe uye ekhaya?

Ukuba ne-asidi eningi esiswini, noma ukuba nayo endaweni engafanele, kungaba buhlungu kakhulu. Kungalimaza nohlelo lwakho lokugaya ukudla. Ngenhlanhla, kunemithi eminingi engasiza uma unalezi zimpawu.

Ukuze uthole impumuzo yesikhashana, umuthi wokuvimbela i-asidi noma i-H2 blocker ungcono kakhulu. Kodwa uma unesifo sokushisa kwesisu njalo noma unesilonda esiswini, udokotela wakho angase akunike uhlobo lwe-PPI. Le mithi ibilokhu ikhona iminyaka eminingi futhi ibhekwa njengokwelashwa okuphephile nokusebenzayo. Abantu abaningi bathola impumuzo ngale mithi.

Into ebaluleke kakhulu ukuthi lo muthi kufanele usetshenziswe kuphela ngaphansi kweseluleko sikadokotela, ngesilinganiso esinqunyiwe kanye nesikhathi esinqunyiwe.Uma uzama ukuyisebenzisa ngendlela oyifunayo, kungavela izinkinga. Ngakho-ke, kuwukuhlakanipha ukulalela njalo lokho okushiwo udokotela bese uthatha umuthi ngokufanele.

Ama - PPI, i-gastritis, ukuvuvukala kwesisu, i-acid reflux, izilonda zesisu, i-omeprazole, i-pantoprazole