Uma sizwa ubuhlungu besisu noma ukuvuvukala, sivame ukucabanga nge-gastritis. Kodwa ngezinye izikhathi imbangela yalobo buhlungu ingaba isilonda sesisu noma isilonda sesisu (Isisu / Isisu). Njengesilonda esikhumbeni sethu, lesi isilonda esakheka odongeni lwangaphakathi lwesisu. Lesi yisimo esivame kakhulu futhi singelashwa futhi selapheke. Kodwa-ke, uma singelashwa kahle, singaholela ezimweni ezimbi kakhulu. Ngakho-ke, siyini isilonda sesisu? Kungani senzeka? Yiziphi izimpawu? Yiziphi izindlela zokwelapha nezokuvimbela? Sizoxoxa ngakho konke lokhu kulesi sihloko.

Iyini lesi silonda esiswini? (Isifinyezo)

Izilonda zesisu zikhula kanjani?

Isisu sethu siqukethe i-hydrochloric acid nama -enzyme asiza ekugayeni ukudla. Lokhu kunamandla kakhulu. Ngakho-ke, ukuze kuvikelwe izindonga zesisu kula ma-asidi, kukhona ulwelwesi lwesisu oluvikelayo olwenziwe nge-mucus ejiyile. Kodwa uma ngesizathu esithile lolu lwelwelwesi oluvikelayo lonakele, leyo asidi enamandla ingadla ulwelwesi lwesisu. 'Isilonda esivulekile' esakhiwa ngokusidla sibizwa ngokuthi isilonda sesisu.

Kuvamile kangakanani?

Empeleni lesi yisimo esivame kakhulu. Sivame naseSri Lanka. Isizathu esiyinhloko salokhu ukuthi izimbangela ezimbili eziyinhloko zezilonda zesisu zivame kakhulu emphakathini wethu. Lezi yizi:

1. Ukusetshenziswa kabanzi kwemithi yobuhlungu ethengiswa ngaphandle kwemithi kadokotela ( ama-NSAID ) .
2. Ukusabalala kokutheleleka kwe -H. pylori .

Izilonda Zesisu vs Izilonda Zesisu

La magama amabili angadida. " Isifo Sezilonda Zesisu" yisimo lapho i-asidi yesisu ibangela isilonda olwelwesini lwesisu noma engxenyeni yokuqala yamathumbu amancane ( i-duodenum).) igama elivamile lezilonda. Ngakho-ke, izilonda ezenzeka esiswini (Gastric Ulcer / Stomach Ulcer) ziwuhlobo lwesilonda se-peptic. Izilonda ezenzeka engxenyeni yokuqala yamathumbu zibizwa ngokuthi "i-Duodenal Ulcers". Izimbangela kanye nokwelashwa kwazo zombili kufana kakhulu.

Izimpawu Nezimbangela

Ziyini izimpawu zesilonda esiswini?

• Uphawu oluyinhloko: Ubuhlungu bokushisa : Uphawu oluyinhloko abantu abaningi abaluzwayo ubuhlungu obuvuthayo noma obuhlabayo esiswini esingaphezulu (ngaphansi nje kwesifuba, ngaphezu kwenkaba, futhi obunzima ngakwesobunxele). Lokhu kungazwakala njengokusha ngenxa ye-asidi, noma sengathi kukhona okudliwayo ngaphakathi (ikhwalithi yokuluma). Lo muzwa awusiwo nje umuzwa, kodwa okwenzekayo empeleni ukuthi i-asidi nama-enzyme kuyadla inxeba. Lobuhlungu bungaba bubi kakhulu esiswini esingenalutho, ikakhulukazi ebusuku. Abanye abantu bathola ukuthi ubuhlungu buyaqedwa ngokudla, kodwa kwabanye (ikakhulukazi ngezilonda zesisu), ubuhlungu bungaba bubi kakhulu lapho bedla.
• Ukungagayi kahle ukudla kanye nokugcwala: Abantu abaningi abanezilonda esiswini bathola izimpawu zokungagayi kahle ukudla. Lokhu kuwumuzwa oshisayo esiswini kanye nomuzwa wokugcwala. Ungase uzizwe usuthi ngokushesha nje lapho uqala ukudla, noma ungase uzizwe usuthi isikhathi eside ngemva kokudla.
• Ezinye izimpawu ezivamile: Ngaphezu kwalezi, izimpawu ezihlobene nezimo ezibangele ukulimala zingafaka:
  • I-acid reflux kanye nokushisa kwenhliziyo
  • Isicanucanu nokuhlanza
  • Ukuqunjelwa, ukubhoboza, kanye nobuhlungu begesi
• Izilonda Ezithule Nezimpawu Zezinkinga: Ngokumangalisayo, abanye abantu banezilonda zesisu kodwa abazizwa ubuhlungu noma izimpawu. Lezi zibizwa ngokuthi "izilonda ezithule." Bangase bangaqapheli ukuthi banesilonda kuze kube yilapho kuvela inkinga enkulu, njengokuphuma kwegazi noma ukubhoboka. Funa usizo lwezokwelapha ngokushesha uma unanoma yiziphi zalezi zimpawu:
  • Ukuphaphatheka kwesikhumba (Umbala okhanyayo)
  • Isiyezi, ubuthakathaka noma ukuphelelwa yithemba - kungase kube ngenxa yokulahlekelwa yigazi.
  • Indle emnyama, ephuzi - ngenxa yegazi eligayiwe.
  • Ukuhlanza okufana nekhofi eligayiwe - ngenxa yokuqhekeka kwegazi esiswini.
  • Ubuhlungu besisu obungazelelwe, obukhulu obungapheli - kungaba uphawu lokubhoboka.

Zingakanani izinkinga?

Uma ingelashwa, izilonda zesisu zingadala izinkinga ezinkulu:

• Izilonda Zokopha: Inxeba lingase liphume igazi njalo, kungaba kancane noma ngokuzumayo. Uma liphuma igazi kancane, ngokuhamba kwesikhathi, ukutholakala kwegazi emzimbeni kungancipha, okuholela ekulahlekelweni kwegazi. Uma liphuma igazi kakhulu, umzimba ungashaqeka futhi uze ufe.
• Izilonda Ezibhobozekile: Isimo esiphuthumayo esingavamile kodwa esibucayi lapho isilonda siphula khona ngokuphelele udonga lwesisu bese sakha imbobo. Lo mbobo ungavumela i-asidi yesisu namabhaktheriya ukuthi angene emgodini wesisu, okubangela ukutheleleka okukhulu (i-peritonitis). Lokhu kutheleleka kungasakazeka nasegazini, kubangele isimo esisongela ukuphila esibizwa ngokuthi i-sepsis.

Yiziphi izimbangela eziyinhloko zezilonda zesisu?

Izimbangela ezimbili eziyinhloko zezilonda zesisu eSri Lanka nasemhlabeni jikelele yilezi:

• Ukutheleleka kwebhaktheriya i-H. pylori (Helicobacter pylori): Lokhu ukutheleleka kwebhaktheriya okuvamile kakhulu. Kulinganiselwa ukuthi cishe ingxenye yabantu emhlabeni inaleli bhaktheriya elihlala esiswini salo. Kwabaningi abantu, leli bhaktheriya alibangeli zinkinga. Kodwa-ke, kwabanye abantu, leli bhaktheriya likhula kakhulu esiswini futhi liqala ukudla ulwelwesi oluvikelayo lwesisu. Lokhu kubangela ukuvuvukala okungapheli, okungabangela izilonda zesisu ngokuhamba kwesikhathi.
• Ukusetshenziswa kwemithi yokubulala izinhlungu ye-NSAID: I-NSAID (Imithi Engavimbi Ukuvuvukala Engeyona I-steroidal) uhlobo lomuthi wokuqeda izinhlungu esivame ukuwuthenga ekhemisi. Izibonelo zifaka phakathi i-Ibuprofen, i-Naproxen, i-Diclofenac, ne-Aspirin.Imithi efana nalena ingeyaleli qembu. (I-Paracetamol akuyona imithi kuleli qembu). Uma la ma-NSAID engena esiswini, abangela ukucasuka okuncane odongeni lwesisu, futhi avimbela nokukhiqizwa kwamakhemikhali athile avikela futhi alungise udonga lwesisu. Ngokuvamile, udonga lwethu lwesisu lungalulama emonakalweni omncane onjengalona. Kodwa uma sithatha la ma-NSAID kaningi, udonga lwesisu alunaso isikhathi esanele sokuzilungisa. Kancane kancane, ungqimba oluvikelayo luyaphela futhi kwakheke izilonda.

Ezinye izimbangela ezingavamile

Ngaphezu kwalezi zimbangela ezimbili eziyinhloko, izilonda zesisu nazo zingabangelwa yilokhu okulandelayo, okungajwayelekile kakhulu:

• Ezinye izifo: Akuvamile ukuthi ezinye izifo ezibangelwa amagciwane, amagciwane, noma isikhunta zingathinta isisu futhi zibangele izilonda.
• I-Zollinger-Ellison syndrome: Lesi yisimo esingavamile kakhulu lapho isisu sikhiqiza i-asidi eningi kakhulu esiswini, okubangela umonakalo elangeni lesisu.
• Ukucindezeleka okukhulu ngokomzimba: Izinguquko zama-hormone kanye namakhemikhali ezenzeka njengoba umzimba uzama ukululama esifweni esisongela ukuphila (isib. ukusha okukhulu, ukuhlinzwa okukhulu) noma ingozi zingabangela ukwanda kwe-asidi yesisu, okuholela ekukhuleni kwalokho okwaziwa ngokuthi "isilonda sokucindezeleka." Lokhu akusikho ukucindezeleka kwengqondo esikutholayo ekuphileni kwansuku zonke.

Ingabe indlela yokuphila iyayithinta?

Abantu abaningi bacabanga ukuthi ukudla ukudla okunongwe kanye nokucindezeleka kubangela izilonda esiswini. Iqiniso liwukuthi, izici zokuphila kwansuku zonke (njengokudla nokuphuzayo, ukucindezeleka okuvamile) azibangeli ngqo izilonda esiswini. Kodwa-ke, uma usuvele unesilonda esiswini, lezi zinto zingenza izimpawu zakho zibe zimbi kakhulu . Lokhu kungenxa yokuthi zandisa i-asidi esiswini sakho, zenze isilonda sibe sibi kakhulu.

• Ukubhema
• Ukusetshenziswa kotshwala
• Ukudla okunongwe
• Ukudla okune-asidi njengotamatisi nezithelo ze-citrus
• Iziphuzo ezine-caffeine njengekhofi netiye

Ukuxilongwa Nokuhlolwa

Uyibona kanjani isilonda esiswini?

Uma uya kudokotela, bazoqala bakubuze ngezimpawu zakho, ukuthi uthatha ama-NSAID njalo yini, nokuthi uke waba nokutheleleka kwe-H. pylori ngaphambilini. Uma izimpawu zakho zibonisa isilonda esiswini, kungadingeka bahlole ingaphakathi lesisu sakho ukuze baqinisekise.

Hlobo luni lokuhlolwa olwenzayo?

Kunezinto ezimbili eziyinhloko udokotela okudingeka azazi:

1. Ingabe unesifo se-H. pylori?
2. Unesilonda esiswini? Sibukeka kanjani?

Indlela engcono kakhulu yokwenza kokubili lokhu ngesikhathi esisodwa iwukusebenzisa i-endoscopy .

• Ukuhlolwa kwe-Upper Endoscopy / EGD: Lokhu kuhilela ukufaka ithubhu ende, encane, eguquguqukayo (i-endoscope) enekhamera kanye nokukhanya ekugcineni ngomlomo wakho nangaphansi komphimbo wakho ukuhlola ingaphakathi lesisu sakho kanye namathumbu amancane. Uzonikezwa umuthi wokudambisa ukuze uzizwe ukhululekile. Udokotela angasebenzisa ikhamera ukuze abone ukuthi kukhona yini izilonda noma ukopha odongeni lwesisu sakho. Angasebenzisa futhi ithuluzi elincane ngethubhu ukuze athathe ucezu oluncane lwezicubu (i-biopsy) endaweni esolisayo noma isilonda ukuze ahlole igciwane le-H. pylori. Uma kukhona ukopha okuvela esilondeni, ukwelashwa kunganikezwa ukuze kumiswe ukopha ngokushesha (isibonelo, ukubulala umthambo wegazi) phakathi nale endoscopy.
• Ezinye Izivivinyo: Nakuba i-endoscopy iyindlela engcono kakhulu, ezinye izindlela zingasetshenziswa ngezinye izikhathi:
  • Uchungechunge lwe-Upper GI X-ray (i-Barium Swallow): Kulokhu, kugwinywa uketshezi olubizwa ngokuthi i-barium bese kuthathwa izithombe ze-X-ray. Ngenxa yokuthi i-barium imboza ulwelwesi lwesisu, noma yiziphi izilonda zingabonakala ku-X-ray. Kodwa-ke, lokhu akunembile njenge-endoscopy, futhi izilonda ezincane zingase zingatholakali.
  • Ukuhlolwa kwe-H. pylori: Kunezivivinyo ezihlukene zokuhlola ukuba khona kwamagciwane:
    • Ukuhlolwa Kokuphefumula Kwe-Urea: Unikwa uketshezi olukhethekile ukuze uluphuze, bese kuhlolwa umoya wakho owukhiphayo.
    • Ukuhlolwa Kwegazi: Lokhu kuhlola ama-antibodies ngokumelene ne-H. pylori. Kodwa-ke, akukwazi ukusho ngokuqinisekile ukuthi unesifo okwamanje noma uke watheleleka yini ngaphambilini.
    • Ukuhlolwa Kwe-Antigen Yendle: Isampula yendle ihlolwa ukuthi ikhona yini i-antigen yamagciwane.

Ezinye izimo ezingaphambaniswa nesilonda esiswini

Uma ukuhlolwa kuqinisekisa ukuthi awunaso isilonda esiswini, imbangela yezimpawu zakho ingaba yinto ehlukile, njengale:

• I-GERD (Isifo Sokuphindezela Kwesisu): Uma i-asidi evela esiswini iqhubeka nokubuyela emphinjeni (i-asidi reflux), ingabangela nezimpawu ezifana nesilungulela, ukungagayi kahle kokudla, kanye nesicanucanu.
• I-Functional Dyspepsia: Lesi yisimo lapho kuba khona izimpawu eziqhubekayo zokungagayi kahle ukudla (ubuhlungu besisu, isilungulela, ukugcwala) ngaphandle kwembangela esobala yomzimba. Nakuba izimpawu zifana nezesilonda sesisu, akukho silonda esibonakalayo odongeni lwesisu.
• Umdlavuza Wesisu: Lokhu akuvamile kakhulu, kodwa kungabangela izimpawu ezifana nesilonda esiswini (ubuhlungu besisu, ukwehla kwesisindo, ukulahlekelwa yisifiso sokudla). Yingakho kubalulekile ukwenza i-biopsy ngesikhathi sokuhlolwa kwe-endoscopy.

Ukuphathwa Nokwelashwa

Ungasiphulukisa kanjani isilonda esiswini ngokushesha?

Uma imbangela yesilonda isisusiwe, ulwelwesi lwesisu luzoqala ukuphola kancane kancane. Isibonelo, uma isilonda sakho sibangelwa yi-NSAID, uma uyeka ukuthatha umuthi, isilonda singaphola ngaphandle kokwelashwa okunye. Kodwa-ke, uma unegciwane le-H. pylori, kuzodingeka uthathe ama-antibiotic ukuze ubulale amagciwane. Ngaphezu kwalokho, udokotela angase akunikeze eminye imithi enciphisa i-asidi yesisu futhi ivikele ulwelwesi lwesisu kuze kube yilapho isilonda siphola. Ukuthatha le mithi ngendlela efanele kungasiza isilonda siphole ngokushesha.

Yiziphi izindlela zokwelapha ezitholakalayo?

Ngokuvamile, izilonda zesisu zelashwa ngenhlanganisela yemithi. Le mithi ihlanganisa:

1. Kunciphisa inani le-asidi esiswini.
2. Kumboza, kuvikela, futhi kusiza inxeba ukuba liphiliswe.
3. Uma kukhona ukutheleleka (H. pylori), kuzosuswa.

Akuvamile ukuthi kudingeke inqubo yezokwelapha ukuze kumiswe ukopha noma kuvalwe imbobo.

• Imithi:
  • Ama-antibiotic : Uma une-H. pylori noma olunye ukutheleleka ngamagciwane, udokotela wakho cishe uzokunikeza ama-antibiotic amabili noma amathathu ngesikhathi esisodwa izinsuku ezingu-7-14 ukuze abulale ngokuphelele amagciwane. Ama-antibiotic asetshenziswa kakhulu yilawa: i-Tetracycline, i-Metronidazole, i-Clarithromycin, kanye ne-Amoxicillin. Kubalulekile ukuthatha yonke imithi oyinikezwe udokotela wakho isikhathi sonke senkambo, kungenjalo ukutheleleka kungase kubuye.
  • Ama-cytoprotective agents: Le mithi isebenza ngokwakha ungqimba oluvikelayo (ijazi) phezu kodonga lwesisu, iluvikele kuze kube yilapho isilonda siphola. Ivame ukusetshenziswa ukwelapha nokuvimbela izilonda ezibangelwa ama-NSAID. Izibonelo: i-Sucralfate, i-Misoprostol, i-Bismuth subsalicylate.
  • Ama-H2 blockers (ama-Histamine receptor blockers / ama-H2 blockers): Avimba ikhemikhali ebizwa ngokuthi i-histamine, ekhombisa umzimba ukuthi ukhiqize i-asidi esiswini, futhi inciphise ukukhiqizwa kwe-asidi. Izibonelo: i-Famotidine, i-Cimetidine, i-Nizatidine.
  • Ama-Proton Pump Inhibitors (PPI): Lawa futhi yimithi enamandla enciphisa ukukhiqizwa kwe-asidi esiswini. Avikela futhi ulwelwesi lwesisu futhi asheshise ukuphulukiswa kwezilonda. Okwamanje lena yimithi esetshenziswa kakhulu yezilonda zesisu. Izibonelo: I-Omeprazole, i-Esomeprazole, i-Lansoprazole, i-Pantoprazole, i-Rabeprazole.
• Izinqubo Zokwelapha: Isilonda esiyinkimbinkimbi (ukopha, ukubhoboka) kuzodingeka selashwe ngqo ngudokotela . Lokhu kungenziwa ngesikhathi esifanayo ne-endoscopy. Isilonda esophayo singamiswa ngokujova umuthi noma ngokuwushisa ngokushisa. Uma kukhona ukubhoboka, kuzodingeka sivalwe ngokuhlinzwa.
• Ukuhlinzwa kwezilonda ezingapheli:Akuvamile kakhulu, izilonda zesisu zabanye abantu zingaqhubeka ngaphandle kokwelashwa, noma zingaphola futhi ziphinde zibuye. Lokhu kungabangela ubuhlungu besikhathi eside kanye nezibazi zesisu. Ngezinye izikhathi lesi silonda singavimba indlela yokungena esiswini iye emathunjini. Ezimweni ezinjalo, kungadingeka ukuhlinzwa, njengokuthi:
  • Ukususa izicubu zesilonda noma ukuvula indlela evalekile (i-Pyloroplasty).
  • Ukususwa kwe-vagotomy ukunqunywa kwe-vagus nerve, okukhuthaza ukukhiqizwa kwe-asidi yesisu.

Ungakuvimbela kanjani? (Ukuvimbela)

Izilonda zesisu zingavinjelwa kanjani ukuthi zakheke noma zibuye?

Nazi ezinye izinto ongazenza ukuvimbela ukwakheka kwesilonda esiswini, noma ukusivimba ukuthi singabuyi ngemva kokuba sesipholile:

• Ukususwa kokutheleleka kwe-H. pylori: Abantu abaningi banesifo se-H. pylori kodwa abazi ukuthi sinaso. Ungathola ukuthi unaso yini ngokuhlolwa kokuphefumula okulula noma ukuhlolwa kwendle. Uma unaso, ungasiqeda ngama -antibiotic ngaphambi kokuba sibangele izinkinga.
• Ukusetshenziswa okufanele kwama-NSAID: Uma uphuza njalo ama-NSAID ekhemisi ngenxa yobuhlungu bomzimba kanye nekhanda, qiniseka ukuthi awuphuzi ngaphezu komthamo onconywayo. Uma uqhubeka nokuthatha ama-NSAID ngeseluleko sikadokotela ngesinye isimo (isb. isifo samathambo), uma kungenzeka, yehlisa umthamo, ushintshele komunye umuthi, noma ukhulume nodokotela wakho mayelana nokuthatha omunye umuthi ovikela isisu (njenge-PPI) ngesikhathi esifanayo.
• Nciphisa eminye imikhuba eyingozi: Uma unegciwane le-H. pylori noma uthatha ama-NSAID, ukubhema nokuphuza utshwala kwandisa ingozi yakho yokuthola izilonda zesisu. Ngakho-ke kubalulekile ukuyeka le mikhuba.

Kuzothatha isikhathi esingakanani ukululama? (I-Outlook / Ukubikezela)

Kuthatha isikhathi esingakanani ukuthi isilonda esiswini siphole?

Uma uphuza imithi yakho njengoba nje uyalelwe futhi ugwema izinto ezenza isilonda sibe sibi kakhulu (ama-NSAID, ukubhema, utshwala), isilonda kufanele siphole ngokuphelele phakathi namasonto ambalwa . Udokotela wakho angaphinda i-endoscopy noma olunye uvivinyo ukuqinisekisa ukuthi isilonda siphole ngokuphelele nokuthi ukutheleleka kwe-H. pylori sekuphelile ngokuphelele.

Izimo ezingapheli

Iningi labantu lidinga ukwelashwa kwesikhashana kuphela. Kodwa-ke, abanye abantu bangase babe nezimo ezingamahlalakhona ezibangela izilonda zesisu. Isibonelo, umuntu one-Zollinger-Ellison syndrome, okukhulunywe ngaye ekuqaleni, unesifo lapho isisu sikhiqiza khona i-asidi eningi kakhulu. Laba bantu kungadingeka bathathe imithi (njenge-PPI) isikhathi eside.

Yini okufanele uyenze uma usola ukuthi unesilonda esiswini? (Ukuphila Naso)

Ukubaluleka kokufuna iseluleko sezokwelapha

Uma usola ukuthi unesilonda esiswini, qiniseka ukuthi ufuna iseluleko sezokwelapha. Imithi etholakala ngaphandle kwemithi kadokotela efana nemithi yokwelapha i-asidi noma i-bismuth subsalicylate ingase inciphise izimpawu okwesikhashana, kodwa ngeke iphulukise isilonda. Ukuze isilonda siphole , imbangela eyinhloko (i-H. pylori noma i-NSAID) kumele yelashwe.

Izingozi uma zingelashwa

Ngisho noma ungenazo izimpawu ezibucayi, isilonda esiswini esingalashwanga singaholela ezinkingeni ezinkulu, njengokuphuma kwegazi noma ukubhoboka. Kukhona futhi ingozi yomdlavuza wesisu uma ukutheleleka kwe-H. pylori, imbangela eyinhloko yezilonda zesisu, kushiywa kungelashwa isikhathi eside.

Kufanele ufune nini ukwelashwa okuphuthumayo?

Uma unalezi zimpawu, hamba esibhedlela ngokushesha (ETU) :

• Ubuhlungu besisu obungabekezeleleki, obungabekezeleleki.
• Uma unegazi elimnyama esitulweni sakho noma uhlanza igazi (njengezitsha zekhofi).
• Izimpawu zokopha ngokweqile (isikhumba esikhanyayo, isiyezi esikhulu, ukuquleka).

Ekugcineni

Izilonda zesisu ziyisimo esivamile futhi esingelapheka. Izimbangela eziyinhloko ukutheleleka kwe-H. pylori kanye nokusetshenziswa kwemithi yokubulala ubuhlungu ye-NSAID. Uma unezimpawu ezifana nokuvuvukala kwesisu, ubuhlungu, kanye nokungagayeki kahle kokudla, kubaluleke kakhulu ukufuna iseluleko sezokwelapha kunokumane ucabange ukuthi yi-gastritis. Ngemuva kwalokho, imbangela ingatholakala, ukwelashwa okufanele kungaqalwa, futhi izinkinga ezinkulu zingavinjelwa. Futhi, ukunciphisa ukubhema nokuphuza utshwala, nokusebenzisa imithi ye-NSAID kuphela uma kudingeka, ngomthamo ophansi kakhulu, isikhathi esifushane kakhulu, kungasiza ekuvikeleni izilonda zesisu. Hlala uphilile!