Isilonda Peptic

I-peptic ulcer sisifo esivulekileyo okanye indawo ekrwada kulusu lwesisu okanye emathunjini.

Zimbini iintlobo zezilonda ezisemzimbeni:

• Isisu esiswini - senzeka esiswini
• Isilonda esiswini - sivela kwinxalenye yokuqala yamathumbu amancinci

Ngokwesiqhelo, ulwelo lwesisu kunye namathumbu amancinci lunokuzikhusela ngokuchasene nesisu esomeleleyo. Kodwa ukuba ulwelwesi luyaphuka, umphumo unokuba:

• Ukudumba kunye nezicwili (gastritis)
• Isilonda

Uninzi lwezilonda zenzeka kwinqanaba lokuqala langaphakathi. Umngxuma esiswini okanye i-duodenum ibizwa ngokuba yi-perforation. Le yimeko yongxamiseko kwezonyango.

Unobangela oqhelekileyo wezilonda kukosulelwa sisisu ziintsholongwane ezibizwa ngokuba Helicobacter pylori (H pylori). Uninzi lwabantu abanezilonda zepeptic baneebhaktheriya ezihlala kwindawo yabo yokugaya. Nangona kunjalo, abantu abaninzi abaneebhaktheriya esiswini sabo abanasilonda.

Ezi zinto zilandelayo ziphakamisa umngcipheko wezilonda zesilonda:

• Ukusela kakhulu utywala
• Ukusetyenziswa rhoqo kwe-aspirin, ibuprofen, naproxen, okanye ezinye iziyobisi ezichasayo (i-NSAID)
• Ukutshaya icuba okanye ukutshaya icuba
• Ukugula kakhulu, njengokuhlala kumatshini wokuphefumla
• Unyango ngemitha
• Uxinzelelo

Imeko enqabileyo, ebizwa ngokuba yi-Zollinger-Ellison syndrome, ibangela izilonda zesisu kunye nezomzimba.

Izilonda ezincinci azinakubangela zimpawu. Ezinye izilonda zinokubangela ukopha kakhulu.

Intlungu yesisu (ihlala iphakathi esiswini) luphawu oluqhelekileyo. Intlungu ingahluka kumntu kumntu. Abanye abantu abanazintlungu.

Ubuhlungu buvela:

• Kumazantsi esisu
• Ebusuku ndikuvuse
• Xa uziva ungenanto isisu, uhlala u-1 ukuya kwiiyure ezi-3 emva kwesidlo

Ezinye iimpawu zibandakanya:

• Ukuziva ugcwele kwaye uneengxaki zokusela ulwelo oluninzi njengesiqhelo
• Isicaphucaphu
• Ukuhlanza
• Igazi okanye mnyama, izitulo zokulinda
• Iintlungu zesifuba
• Ukudinwa
• Ukuhlanza, mhlawumbi kunegazi
• Ukuhla ukusinda
• Isitshisa esiqhubayo

Ukufumanisa isilonda, unokufuna uvavanyo olubizwa ngokuba yi-endoscopy ephezulu (EGD).

• Olu luvavanyo lokujonga ulungelelwaniso lombhobho wokutya, isisu, kunye nenxalenye yokuqala yamathumbu amancinci.
• Yenziwe ngekhamera encinci (i-endoscope eguqukayo) efakwa ezantsi emqaleni.
• Olu vavanyo luhlala ludinga ukuthomalalisa okunikezwe ngomthambo.
• Ngamanye amaxesha, i-endoscope encinci inokusetyenziswa edluliselwe esiswini ngeempumlo. Oku akufuneki ukuba kuhlaliswe.

I-EGD yenziwa kubantu abaninzi xa kukrokrelwa izilonda zep peptic okanye xa une:

• Inani eliphantsi legazi (i-anemia)
• Ingxaki yokuginya
• Ukugabha kwegazi
• Igazi okanye ubumnyama kunye nokujonga okujongeka
• Ukuphulukana nobunzima ngaphandle kokuzama
• Ezinye iziphumo eziphakamisa inkxalabo yomhlaza esiswini

Ukuvavanywa kuka-H pylori nako kuyafuneka. Oku kunokwenziwa nge-biopsy yesisu ngexesha le-endoscopy, ngovavanyo lwe-stool, okanye ngovavanyo lokuphefumla lwe-urea.

Olunye uvavanyo olunokuthi lubandakanye:

• Uvavanyo lwegazi lweHemoglobin ukukhangela i-anemia
• Uvavanyo lwegazi lokuhlola ukujonga igazi kwisitulo sakho

Ngamanye amaxesha, unokufuna uvavanyo olubizwa ngokuba luluhlu oluphezulu lwe-GI. Uthotho lwee-x-reyi zithathwa emva kokuba usele into eshinyeneyo ebizwa ngokuba yi-barium. Oku akufuneki ukuba kuhlaliswe.

Umboneleli wakho wezempilo uya kukucebisa amayeza okuphilisa isilonda sakho kunye nokuthintela ukubuyela umva. Amayeza aya:

• Yibulale H pylori Iibhaktheriya, ukuba zikhona.
• Nciphisa amanqanaba e-asidi esiswini. Oku kubandakanya i-H2 blocker ezinje nge-ranitidine (iZantac), okanye iproton pump inhibitor (PPI) enjenge-pantoprozole.

Thatha onke amayeza akho njengoko uxelelwe. Olunye utshintsho kwindlela yakho yokuphila lunokunceda.

Ukuba unesilonda esine peptic H pylori usulelo, unyango oluqhelekileyo lusebenzisa indibaniselwano eyahlukeneyo yamayeza alandelayo kwiintsuku ezisi-7 ukuya kwezi-14:

• Amayeza amabini okubulala H pylori.
• Ii-PPI ezinje nge-omeprazole (Prilosec), lansoprazole (Prevacid), okanye esomeprazole (Nexium).
• I-Bismuth (eyona nto iphambili kwi-Pepto-Bismol) inokongezwa ukunceda ukubulala ibacteria.

Kuya kufuneka uthathe iPPI iiveki ezisibhozo ukuba:

• Unesilonda ngaphandle H pylori usulelo.
• Isilonda sakho sibangelwa kukuthatha iiasprini okanye iiNSAID.

Umboneleli wakho unokumisela olu hlobo lwamayeza rhoqo ukuba uqhubeka nokuthatha iiasprini okanye ii-NSAID zezinye iimeko zempilo.

Amanye amayeza asetyenziselwa izilonda ngala:

• I-Misoprostol, iyeza elinokukunceda ukukhusela izilonda kubantu abathatha ii-NSAID rhoqo
• Amayeza akhusela ulwelwesi lwethishu, njenge-sucralfate

Ukuba isilonda sep peptic sopha kakhulu, i-EGD inokufuneka ukunqanda ukopha. Iindlela ezisetyenziselwa ukunqanda ukopha zibandakanya:

• Ukutofa iyeza kwisilonda
• Ukufaka umboniso wesinyithi okanye unyango lobushushu kwisilonda

Utyando lunokufuneka ukuba:

• Ukopha akunakunqandwa nge-EGD
• Isilonda sibangele iinyembezi

Izilonda ze-Peptic zihlala zibuya ukuba azinyangwa. Kukho ithuba lokuba i H pylori Usulelo luyanyangeka ukuba uthatha amayeza akho kwaye ulandele iingcebiso zomboneleli wakho. Uya kuba mancinci amathuba okuba ufumane esinye isilonda.

Iingxaki zinokubandakanya:

• Ukopha kakhulu
• Ukuqhekeka kwesilonda kunokwenza kube nzima ukuba isisu sikhuphe
• Ukugqobhoza okanye umngxunya wesisu kunye namathumbu

Fumana uncedo lwezonyango ngokukhawuleza ukuba:

• Ukuphuhlisa ngequbuliso, iintlungu ezibukhali zesisu
• Yiba nesisu esiqinileyo, esinzima nesithambileyo ukuchukumisa
• Yiba neempawu zokothuka, njengokuphelelwa ngamandla, ukubila kakhulu, okanye ukudideka
• Hlanza igazi okanye unegazi kwisitulo sakho (ngakumbi ukuba imaroon okanye imnyama, hlala umnyama)

Fowunela umnikezeli wakho ukuba:

• Uziva unesiyezi okanye unentloko elula.
• Unempawu zesilonda.

Gwema i-aspirin, ibuprofen, naproxen, kunye nezinye ii-NSAID. Zama i-acetaminophen endaweni yoko. Ukuba kufuneka uthathe amayeza anjalo, thetha nomboneleli wakho kuqala. Umboneleli wakho anga:

• Vavanya i- H pylori ngaphambi kokuba uthathe la mayeza
• Cela ukuba uthathe ii-PPIs okanye i-H2 acid blocker
• Misela iyeza elibizwa ngokuba yi-misoprostol

Olu tshintsho lulandelayo kwindlela yokuphila lunokunceda ukuthintela izilonda ezisemzimbeni:

• Musa ukutshaya okanye ukuhlafuna icuba.
• Gwema utywala.

Isilonda - isilonda; Isilonda - duodenal; Isilonda - esiswini; Isilonda esiswini; Isilonda esiswini; Dyspepsia - izilonda; Isilonda sokopha; Ukopha emathunjini - isilonda esisesiswini; Ukopha emathunjini - isilonda sephepha; IGI Ukopha - isilonda esinesibindi; H. pylori - isilonda esisesiswini; Helicobacter pylori - isilonda peptic

• Ukuthatha ii-antacids

• Isilonda esingxamisekileyo
• Inkqubo yeGastroscopy
• Indawo yezilonda ezisemzimbeni
• Unobangela wezilonda ezisemzimbeni
• Isifo esiswini okanye umothuko

UChan FKL, uLau JYW. Isifo sesilonda Peptic. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 53.

Isimbozo se-TL, iBlaser MJ. Helicobacter pylori kunye nezinye isisu Helicobacter iintlobo. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahluko 217.

ILanas A, uKhan FKL. Isifo sesilonda Peptic. ILancet. Ngo-2017; 390 (10094): 613-624. IINKCUKACHA: 28242110 www.pubmed.ncbi.nlm.nih.gov/28242110/.