Usulelo lwe-Helicobacter pylori

Helicobacter pylori (H pylori) luhlobo lweebhaktheriya ezichaphazela isisu. Kuqheleke kakhulu, kuchaphazela malunga nesibini kwisithathu sabemi behlabathi. H pylori Usulelo ngoyena nobangela uqhelekileyo wezilonda ezisemzimbeni. Nangona kunjalo, usulelo alubangeli ngxaki kubantu abaninzi.

H pylori Iibhaktheriya zinokudlula ngokuthe ngqo zisuka kumntu ziye emntwini. Oku kudla ngokwenzeka ngexesha lobuntwana. Usulelo luhlala ubomi bonke ukuba alunyangwa.

Akucaci ukuba ibhaktheriya idluliselwa njani komnye umntu. Iibhaktheriya zingasasazeka ukusuka:

• Ukunxibelelana ngomlomo nomlomo
• Ukugula kwe-GI tract (ngakumbi xa ukugabha kwenzeka)
• Ukunxibelelana nesitulo (izinto zelindle)
• Ukutya okungcolileyo namanzi

Iibhaktheriya zingabangela izilonda ngale ndlela ilandelayo:

• H pylori ingena kwi-mucus yomaleko wesisu kwaye incamathele kwisisu esiswini.
• H pylori kubangela ukuba isisu sivelise iasidi engaphezulu yesisu. Oku konakalisa ulusu esiswini, kukhokelela kwizilonda kwabanye abantu.

Ngaphandle kwezilonda, H pylori Iibhaktheriya zinokubangela ukudumba okungapheliyo esiswini (gastritis) okanye kwinxalenye ephezulu yamathumbu amancinci (duodenitis).

H pylori ngamanye amaxesha kunokukhokelela kumhlaza wesisu okanye kuhlobo olunqabileyo lwesisu se-lymphoma.

Malunga ne-10% ukuya kwi-15% yabantu abosuleleke H pylori phuhlisa isifo sesilonda. Izilonda ezincinci azinakubangela zimpawu. Ezinye izilonda zinokubangela ukopha kakhulu.

Intlungu ebuhlungu okanye evuthayo esiswini sakho luphawu oluqhelekileyo. Intlungu inokuba mbi ngakumbi ngaphandle kwesisu esingenanto. Intlungu inokwahluka kumntu ngomntu, kwaye abanye abantu abanantlungu.

Ezinye iimpawu zibandakanya:

• Ukuziva ugcwele okanye uqunjelwe kunye neengxaki zokusela ulwelo oluninzi njengesiqhelo
• Indlala kunye nokuziva ungenanto esiswini, rhoqo emva kweeyure ezi-1 ukuya kwezi-3 emva kwesidlo
• Isicaphucaphu esithambileyo esinokuhamba nokugabha
• Ukuphelelwa ngumdla wokutya
• Ukwehla kobunzima ngaphandle kokuzama
• Ukuqhuma
• Igazi okanye mnyama, ilindle okanye ukugabha okunegazi

Umboneleli wakho wezempilo uya kukuvavanya H pylori ukuba u:

• Yiba nezilonda ezisemzimbeni okanye imbali yezilonda
• Unobunzima kunye neentlungu esiswini ezihlala ngaphezulu kwenyanga

Xelela umboneleli wakho ngamayeza owasebenzisayo. Amachiza e-nonsteroidal anti-inflammatory (NSAIDs) nawo anokubangela izilonda. Ukuba ubonakalisa iimpawu zosulelo, umboneleli unokwenza uvavanyo olulandelayo lwe H pylori. Oku kubandakanya:

• Uvavanyo lokuphefumla Uvavanyo lokuphefumla urea (Uvavanyo lweBreath Isotope-urea, okanye i-UBT). Umboneleli wakho uya kukwenza ukuba uginye into ekhethekileyo ene-urea. Ukuba H pylori Zikhona, ibacteria iguqula i-urea ibe yi-carbon dioxide. Oku kufunyenwe kwaye kurekhodwe ekuphefumlweni kwakho okuphefumlayo emva kwemizuzu eli-10.
• Uvavanyo lwegazi - amanyathelo antibodies ukuya H pylori egazini lakho.
• Uvavanyo lwelindle - ibhaqa ubukho beentsholongwane kwisitulo.
• Uqhaqho -ivavanya isampulu yethishu ethathwe kwisisu esiswini usebenzisa i-endoscopy. Isampuli ihlolwe usulelo lwebacteria.

Ukuze isilonda sakho sinyange kwaye sinciphise amathuba okuba sibuye, uya kunikwa amayeza:

• Yibulale H pylori ibhaktheriya (ukuba ikho)
• Nciphisa amanqanaba e-asidi esiswini

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

Ukuba unesilonda peptic kunye ne H pylori usulelo, unyango luyacetyiswa. Unyango oluqhelekileyo lubandakanya indibaniselwano eyahlukeneyo yamayeza alandelayo kwiintsuku ezili-10 ukuya kwezi-14:

• Amayeza okubulala H pylori
• Iiproton pump inhibitors zinceda ukunciphisa amanqanaba e-asidi esiswini
• I-Bismuth (eyona nto iphambili kwi-Pepto-Bismol) inokongezwa ukunceda ukubulala ibacteria

Ukuthatha onke la mayeza ukuya kwiintsuku ezili-14 akukho lula. Kodwa ukwenza njalo kukunika elona thuba lilungileyo lokususa iifayile ze H pylori iintsholongwane kunye nokuthintela izilonda kwixa elizayo.

Ukuba uthatha amayeza akho, kukho ithuba elihle lokuba H pylori usulelo luyanyangeka. Uya kuba mancinci amathuba okuba ufumane esinye isilonda.

Ngamaxesha athile, H pylori kunokuba nzima ukunyanga ngokupheleleyo. Izifundo eziphindaphindwayo zonyango ezahlukeneyo zinokufuneka. Ngamanye amaxesha i-biopsy yesisu iya kwenziwa ukuvavanya intsholongwane ukuze ibone ukuba yeyiphi na i-antibiotic enokusebenza ngcono. Oku kunokukunceda ukukhokela unyango lwexesha elizayo. Ngamanye amaxesha, H pylori ayinakunyangeka nangaluphi na unyango, nangona iimpawu zinako ukunciphisa.

Ukuba uyanyangeka, ukosuleleka kwakhona kunokubakho kwiindawo apho imeko yezempilo inempilo.

Usulelo lwexesha elide (olungapheliyo) H pylori ingakhokelela ku:

• Isifo sesilonda Peptic
• Ukudumba okungapheliyo
• Izilonda emathunjini nangaphezulu emathunjini
• Umhlaza wesisu
• Isisu esine-lymphoid tishu (MALT) ye-lymphoma

Ezinye iingxaki zinokubandakanya:

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

Iimpawu ezinzima eziqala ngesiquphe zingabonisa ukuvaleka emathunjini, ukugqobhoza, okanye ukopha, zonke ezo zingxamisekileyo. Iimpawu zingabandakanya:

• Zilibele, zimnyama, okanye izitulo ezinegazi
• Ukugabha okumandundu, okunokubandakanya igazi okanye into eneenkangeleko zekofu (uphawu lokopha kakhulu) okanye isisu sonke (uphawu lokuthintelwa kwamathumbu)
• Intlungu ebuhlungu esiswini, kunye okanye ngaphandle kokugabha okanye ubungqina begazi

Nabani na onalezi mpawu kufuneka aye kwigumbi likaxakeka kwangoko.

H pylori usulelo

• Isisu
• I-Esophagogastroduodenoscopy (i-EGD)
• Iintsholongwane
• Indawo yezilonda ezisemzimbeni

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

Ku GY, Ilson DH. Umhlaza wesisu. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, ii-eds. I-Oncology yeklinikhi yase-Abeloff. Umhla wesi-6. IPhiladelphia, PA: Elsevier; 2020: isahluko 72.

UMorgan DR, uCrowe SE. Usulelo lwe-Helicobacter pylori. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahl 51.