Ingabe uvame ukuba nezilonda zesisu noma i-gastritis? Ingabe uhlushwa izilonda zesisu ezingapheli ezingathuthuki naphezu kokwelashwa? Ingabe unesifo sohudo? Ngezinye izikhathi sibheka lezi njengezinto ezivamile, kodwa namuhla sizokhuluma ngesimo esingavamile esifihliwe ngemuva kwalezi, kodwa esingaba sibi kakhulu. Lokhu kubizwa ngokuthi i-Zollinger-Ellison Syndrome.
Kalula nje, iyini i-Zollinger-Ellison Syndrome (ZES)?
Ake sithi kukhona ushintsho esiswini sethu olulawula ukukhiqizwa kwe-asidi. I-hormone ebizwa ngokuthi i-gastrin isebenza njengalolo shintsho. Ngokuvamile, lapho sidla, le hormone iyakhishwa, okubangela ukuthi isisu sikhiqize i-asidi ukuze sisize ekugayeni ukudla. Uma umsebenzi usuqediwe, ukukhiqizwa kwe-asidi kuyalawulwa.
Kodwa-ke, kubantu abane-Zollinger-Ellison Syndrome (ZES), uhlobo lwesimila olubizwa ngokuthi i-gastrinoma luvela emzimbeni. Lawa mathumba avame ukuvela ku-pancreas noma engxenyeni engenhla yamathumbu amancane (i-duodenum). Lawa mathumba akhiqiza inani elikhulu kakhulu le-hormone gastrin ngaphandle kokulawulwa. Kunjengokungathi ukushintsha kuhlala 'kuvuliwe'.
Uma sine-gastrin eningi kakhulu, isisu sethu siqala ukukhiqiza i-asidi eningi kakhulu. Le-asidi eningi kakhulu yiyo ebangela izilonda zesisu ezinzima (izilonda zesisu) kanye nesifo sohudo esingamahlalakhona.
Cishe ama-60% ala ma-gastrinoma angaba nomdlavuza , ngakho-ke kubaluleke kakhulu ukuwathola nokuwelapha kusenesikhathi.
Ziyini izimpawu zalesi sifo? Sazi kanjani?
Ngezinye izikhathi, i-ZES ingase ingakhombisi zimpawu ezigabeni zokuqala. Kodwa uma izimpawu zivela, zingaba zimbi kakhulu kune-gastritis evamile. Ubunzima bezimpawu buyahlukahluka kuye ngobukhulu kanye nenani lezimila emzimbeni wakho.
Ake sichaze lokhu kabanzi kuthebula elingezansi.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ubuhlungu obukhulu besisu noma ukuqunjelwa | Lobuhlungu buvela lapho izindonga zesisu namathumbu zonakaliswa yi-asidi eningi esiswini. |
| Uhudo olungapheli | Uma i-asidi eningi ingena emathunjini, iphazamisa ukusebenza kwama-enzyme lapho, okubangela uhudo kanye nokudla okungagaywa kahle. |
| Ukuhlanza noma ukukhipha igazi esitulweni | Yilokhu okungenzeka uma kuphuma igazi ngenxa yezilonda esiswini. Ukuhlanza kungaba mnyama njengekhofi noma indle ingaba mnyama njengethayela. |
| Izihlalo ezintantayo nezinamafutha | Uma ukugaya kwamafutha kuphazamiseka ngenxa ye-asidi eningi, amafutha angagaywanga akhishwa esitulweni. |
| Ukushisa kwenhliziyo okuvamile | Lesi simo senzeka ngenxa ye-asidi eningi esiswini ekhuphukela e-esophagus (i-acid reflux). |
| I-Anorexia kanye nokwehlisa isisindo | Ubuhlungu obungapheli kanye nezinkinga zokugaya ukudla kungaholela ekunciphiseni isifiso sokudla kanye nokwehla kwesisindo. |
| Ukukhathala nobuthakathaka | Njengoba amanxeba esiswini ephuma kancane kancane, ungase uzizwe ukhathele ngenxa yokuntuleka kwegazi emzimbeni. |
Kwezinye izimo, uma la mathumba esakazekela esibindini (i-metastasis) , angabonisa nezimpawu zomdlavuza wesibindi. Isibonelo, kungase kube nokulunywa, ukuphuzi kwamehlo nesikhumba (i-jaundice).
Kungani kwenzeka into efana nale?
Esikhathini esiningi, i-ZES yenzeka ngezikhathi ezithile , okusho ukuthi iyenzeka nje.
Kodwa cishe ama-25% eziguli athola lesi simo esibizwa ngokuthi i-MEN Type 1 (Multiple Endocrine Neoplasia Type 1).Ngesimo sofuzo esibizwa ngokuthi i-ZES. Kalula nje, lesi yisimo sofuzo esingavamile. Kulokhu, kunengozi yokuthi kuvele izimila ezinhlayiyeni eziningana ezikhiqiza ama-hormone emzimbeni wethu ngesikhathi esisodwa. I-ZES iyingxenye eyodwa nje yayo.
Yiziphi izivivinyo ezenziwayo ukuze kutholakale lokhu?
Uma unezimpawu ezishiwo ngenhla, udokotela wakho cishe uzoyala ukuhlolwa okuningana uma esola ukuthi une-ZES.
Ukuhlolwa kokuqala
- Ukuhlolwa Kwegazi: Lokhu kuhlola izinga le-gastrin ye-hormone egazini lakho. Uma une-ZES, leli zinga lizoba phezulu ngendlela engavamile . Lokhu kubizwa ngokuthi i-hypergastrinemia.
- Ukuhlola amazinga e-asidi esiswini: Kufakwa ipayipi ngekhala esiswini bese kuthathwa isampula ye-asidi bese ihlolwa. Ku-ZES, leli zinga le-asidi liphezulu kakhulu.
- Ukuhlolwa Kwezithombe: Kwenziwa i-CT scan noma i-MRI scan ukuze kuhlolwe izimila ku-pancreas noma emathunjini.
Ukuhlolwa okwengeziwe uma kuqinisekisiwe ukuthi kunezimila
Kuqhutshwa ukuhlolwa okwengeziwe ukuze kutholakale ukuthi la mathumba akuphi, ubukhulu bawo, nokuthi angomdlavuza noma cha.
- I-Endoscopy: Kufakwa ithubhu elincane elinekhamera ngomlomo ukuhlola isisu kanye nengxenye engenhla yamathumbu amancane. Lokhu kungasiza ukubona ukuthi kukhona yini izilonda zesisu.
- I-Endoscopic Ultrasound: Lokhu kuyinhlanganisela ye-endoscopy kanye ne-ultrasound scan. Ingabona ngisho nezimila ezincane kakhulu ku-pancreas.
- I-ERCP: Lokhu futhi kuyiskeni ekhethekile.
- I-Biopsy (Ukufuthwa kwenaliti encane): Kuthathwa ingxenye encane kakhulu yezicubu esigaxeni bese ihlolwa ngaphansi kwe-microscope ukuze kubonakale ukuthi inamangqamuzana omdlavuza yini.
Yiziphi izindlela zokwelapha lokhu?
Izindlela zokwelapha zincike ebunzimeni bezimpawu zakho nokuthi iqhubu linomdlavuza noma cha. Kunezindlela ezintathu zokwelapha eziyinhloko.
| Indlela yokwelapha | Incazelo |
|---|---|
| Imithi | Ezisetshenziswa kakhulu yi -proton pump inhibitors (PPIs).Lena imithi elawula ukukhiqizwa kwe-asidi esiswini. Kungase kudingeke ukuthi uphuze le mithi impilo yakho yonke. |
| Ukuhlinzwa | Uma isimila singasuswa, kunconywa ukuhlinzwa. Uhlobo lokuhlinzwa luyahlukahluka kuye ngokuthi isimila sikuphi (isib., i-Pancreatectomy - ukususwa kwengxenye ye-pancreas, i-Duodenectomy - ukususwa kwengxenye yamathumbu amancane). |
| Ukwelashwa Komdlavuza | Uma izimila zinomdlavuza futhi zisakazekele kwezinye izingxenye zomzimba, kunikezwa ukwelashwa okufana nokwelashwa ngamakhemikhali . Lokhu kusebenza ukulawula ukukhula kwamangqamuzana omdlavuza nokunciphisa izimpawu. |
Lizoba njani ikusasa lami ngalesi simo?
Lona umbuzo abantu abaningi abanawo. Ikusasa lakho lincike ohlotsheni lomdlavuza onawo.
- Izimila ezingezona umdlavuza: Lezi azisongeli impilo, kodwa kuzodingeka uqhubeke uthatha imithi yokulawula i-asidi yesisu.
- Izimila zomdlavuza: Isimo sihlukile kancane lapha. Uma wonke amangqamuzana omdlavuza emzimbeni engasuswa ngokuhlinzwa, lesi sifo singalapheka ngokuphelele. Ngisho nalapho, kuzodingeka uqhubeke nokuhlolwa kwezokwelapha ukuze ubone ukuthi lesi sifo siyabuya yini.
Ngokwezibalo zochwepheshe, iziguli ezingaphezu kuka-90% ezisuswe zonke izimila zazo ngokuhlinzwa ziphila iminyaka emi-5-10. Uma ukuhlinzwa kungakwazi ukususa zonke izimila, izinga lokusinda kweminyaka emi-5 lingaba ngu-43%.
Kodwa khumbula lokhu: Lezi zibalo ziyisilinganiso nje esisekelwe kudatha evela ezinkulungwaneni zeziguli. Isimo sakho singase sihluke kakhulu. Ngakho-ke, umuntu ongcono kakhulu ukwazi kahle ukuthi isimo sakho siyini udokotela wakho okwelaphayo.
Kufanele ngizinakekele kanjani?
Uma kutholakale ukuthi une-ZES, kuzodingeka wenze izinguquko ezithile empilweni yakho.
- Phuza imithi yakho ngendlela efanele: Kubalulekile ukuthatha imithi yokwehlisa i-asidi (ama-PPI) ngesikhathi esifanele, njengoba kunqunywe udokotela wakho.
- Ukuhlolwa njalo kwezokwelapha: Ikakhulukazi uma uke waba nezimila ezinomdlavuza, kufanele uye kokuhlolwa okulandelayo ngezikhathi ezithile njengoba kuqondiswe udokotela wakho ukuze kubonakale ukuthi lesi sifo sesiphinde sabuya yini.
- Qaphela izimpawu: Uma izimpawu ezifana nobuhlungu besisu kanye nesifo sohudo ziphinde zivele ngemva kokwelashwa, yazisa udokotela wakho ngokushesha .
Kuvamile ukuzizwa ukhathazekile futhi wesaba uma uthola ukuthi unesifo esingavamile njengalesi. Unemibuzo eminingi. Khuluma nodokotela wakho ngokukhululekile ngayo yonke. Lalela ngokucophelela imiphumela yakho yokuhlolwa kanye nezinhlelo zokwelashwa. Bakulungele futhi bazimisele ukukusiza.
Umlayezo Wokuya Nawe Ekhaya
- I-Zollinger-Ellison Syndrome (ZES) yisifo esingavamile esibangelwa izimila ezibizwa ngokuthi ama-gastrinoma akhiqiza i-asidi eningi esiswini.
- Izimpawu eziyinhloko izilonda zesisu ezivame ukungasabeli ekwelashweni kanye nesifo sohudo esithatha isikhathi eside.
- Lezi zimila zingase zibe umdlavuza noma zingabi umdlavuza, ngakho-ke ukutholakala kusenesikhathi kubaluleke kakhulu.
- Lesi sifo singalawulwa ngempumelelo ngemithi efanele, ukuhlinzwa, kanye, uma kudingeka, nokwelashwa komdlavuza.
- Uma unalezi zimpawu, ungesabi futhi ngokushesha uxhumane nodokotela ofanelekayo ukuze akunike iseluleko.
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