Isilonda se-Peptic

I-peptic ulcer yisifo esivulekile noma indawo eluhlaza kulwelwesi lwesisu noma lwamathumbu.

Kunezinhlobo ezimbili zezilonda ezine-peptic ulcers:

• I-gastric ulcer - ivela esiswini
• Isilonda se-duodenal - senzeka engxenyeni yokuqala yamathumbu amancane

Imvamisa, ulwelwesi lwesisu namathumbu amancane lungazivikela kuma-acids esisu aqinile. Kepha uma ulwelwesi lwehla, umphumela ungahle ube:

• Izicubu ezivuvukile nezivuvukele (i-gastritis)
• Isilonda

Izilonda eziningi zenzeka kusendlalelo sokuqala sendwangu yangaphakathi. Imbobo esiswini noma i-duodenum ibizwa ngokuthi i-perforation. Lesi yisimo esiphuthumayo sezokwelapha.

Isizathu esivame kakhulu sezilonda ukutheleleka kwesisu ngamagciwane abizwa I-Helicobacter pylori (H pylori). Iningi labantu abanezilonda ezine-peptic banezi bhaktheriya ezihlala endaweni yazo yokugaya ukudla. Kodwa-ke, abantu abaningi abanaleli bhaktheriya esiswini sabo ababi nesilonda.

Izici ezilandelayo ziphakamisa ingozi yakho yezilonda ezinama-peptic:

• Ukuphuza kakhulu utshwala
• Ukusetshenziswa njalo kwe-aspirin, ibuprofen, naproxen, noma ezinye izidakamizwa ezingezona ukuvuvukala (ama-NSAID)
• Ukubhema ugwayi noma ugwayi ohlafunwayo
• Ukugula kakhulu, njengokuhlala emshinini wokuphefumula
• Ukwelashwa ngemisebe
• Ukucindezeleka

Isimo esingajwayelekile, esibizwa ngokuthi yi-Zollinger-Ellison syndrome, sidala izilonda zesisu nezesikhumba.

Izilonda ezincane kungenzeka zingabangeli zimpawu. Ezinye izilonda zingadala ukopha okungathi sína.

Ubuhlungu besisu (imvamisa esiswini esingaphezulu esiswini) kuyimpawu ejwayelekile. Ubuhlungu bungahluka kuye ngomuntu nomuntu. Abanye abantu abanabo ubuhlungu.

Ubuhlungu benzeka:

• Esiswini esingenhla
• Ebusuku futhi ikuvusa
• Uma uzizwa unganalutho esiswini, imvamisa ihora elilodwa kuya kwele-3 ngemuva kokudla

Ezinye izimpawu zifaka:

• Ukuzizwa ugcwele futhi unezinkinga zokuphuza uketshezi oluningi njengokujwayelekile
• Isicanucanu
• Ukuhlanza
• Izihlalo ezinegazi noma ezimnyama
• Ubuhlungu besifuba
• Ukukhathala
• Ukuhlanza, mhlawumbe okunegazi
• Ukwehla kwesisindo
• Isilungulela esiqhubekayo

Ukuze uthole isilonda, ungadinga ukuhlolwa okubizwa nge-endoscopy ephezulu (i-EGD).

• Lokhu ukuhlolwa ukuhlola ulwelwesi lwepayipi lokudla, isisu, nengxenye yokuqala yamathumbu amancane.
• Kwenziwa ngekhamera encane (i-endoscope eguquguqukayo) efakwa ngomphimbo.
• Lokhu kuhlolwa kuvame ukudinga ukuthambisa okunikezwa ngomthambo.
• Kwezinye izimo, kungasetshenziswa i-endoscope encane edluliselwa esiswini ngekhala. Lokhu akudingi ukuthambisa umzimba.

I-EGD yenziwa kubantu abaningi lapho kusolwa izilonda zep peptic noma uma une:

• Ukubalwa kwegazi okuphansi (i-anemia)
• Inkinga yokugwinya
• Ukuhlanza okunegazi
• Izitulo ezibukeka zinegazi noma ezimnyama nezilindile
• Kwehliswe isisindo ngaphandle kokuzama
• Okunye okutholakele okuphakamisa ukukhathazeka ngomdlavuza esiswini

Ukuhlolwa kuka-H pylori nakho kuyadingeka. Lokhu kungenziwa nge-biopsy yesisu ngesikhathi se-endoscopy, ngokuhlolwa kwendle, noma ngokuhlolwa komoya we-urea.

Olunye uvivinyo ongahle ube nalo lubandakanya:

• Ukuhlolwa kwegazi le-Hemoglobin ukuhlola i-anemia
• Ukuhlolwa kwegazi lokulingwa kwe-Stool ukuhlola igazi esitokisini sakho

Kwesinye isikhathi, ungadinga isivivinyo esibizwa ngochungechunge oluphezulu lwe-GI. Uchungechunge lwama-x-ray luthathwa ngemuva kokuphuza into ebanzi ebizwa nge-barium. Lokhu akudingi ukuthambisa umzimba.

Umhlinzeki wakho wokunakekelwa kwezempilo uzoncoma imithi yokwelapha isilonda sakho nokuvikela ukubuyela emuva. Imithi izo:

• Bulala i- H pylori amabhaktheriya, uma ekhona.
• Yehlisa amazinga e-acid esiswini. Lokhu kufaka phakathi ama-H2 blocker njenge-ranitidine (i-Zantac), noma i-proton pump inhibitor (PPI) efana ne-pantoprozole.

Thatha yonke imithi yakho njengoba utsheliwe. Olunye ushintsho endleleni yakho yokuphila lungasiza.

Uma une-peptic ulcer ene- H pylori ukutheleleka, ukwelashwa okujwayelekile kusebenzisa inhlanganisela ehlukile yemithi elandelayo izinsuku eziyi-7 kuya kweziyi-14:

• Ama-antibiotic amabili okubulala H pylori.
• Ama-PPI afana ne-omeprazole (Prilosec), i-lansoprazole (i-Prevacid), noma i-esomeprazole (i-Nexium).
• I-Bismuth (isithako esiyinhloko ku-Pepto-Bismol) ingangezwa ukusiza ukubulala amagciwane.

Kuzodingeka uthathe i-PPI amasonto ayi-8 uma:

• Unesilonda ngaphandle kwe- H pylori ukutheleleka.
• Isilonda sakho sibangelwa ukuthatha ama-aspirin noma ama-NSAID.

Umhlinzeki wakho angaphinde anikeze lolu hlobo lomuthi njalo uma uqhubeka nokusebenzisa ama-aspirin noma ama-NSAID ezinye izimo zezempilo.

Eminye imithi esetshenziselwa izilonda yilena:

• I-Misoprostol, umuthi ongasiza ekuvimbeleni izilonda kubantu abathatha ama-NSAID njalo
• Imithi evikela ulwelwesi lwezicubu, njenge-sucralfate

Uma i-peptic ulcer yopha kakhulu, kungadingeka i-EGD ukumisa ukopha. Izindlela ezisetshenziselwa ukumisa ukuphuma kwegazi zifaka:

• Ukujova umuthi esilondeni
• Ukufaka iziqeshana zensimbi noma ukwelashwa kokushisa kulonda

Ukuhlinzwa kungadingeka uma:

• Ukopha ngeke kumiswe nge-EGD
• Isilonda sibangele ukudabuka

Izilonda ze-Peptic zivame ukubuya uma zingelashwa. Kukhona ithuba elihle lokuthi i- H pylori ukutheleleka kuzolapheka uma uthatha imithi yakho futhi ulandela izeluleko zomhlinzeki wakho. Ngeke ube mancane amathuba okuthi uthole esinye isilonda.

Izinkinga zingafaka:

• Ukwehla kwegazi okukhulu
• Ukuqubuka kwesilonda kungenza kube nzima ukuthi isisu sikhiphe
• Ukugcwala noma imbobo yesisu namathumbu

Thola usizo lwezokwelapha ngokushesha uma:

• Thuthukisa ubuhlungu obungazelelwe, obubukhali besisu
• Yiba nesisu esiqinile, esiqinile esithambile ukusithinta
• Yiba nezimpawu zokwethuka, njengokuquleka, ukujuluka okweqile, noma ukudideka
• Hlanza igazi noma unegazi esitokisini sakho (ikakhulukazi uma kuyi-maroon noma kumnyama, hlala umnyama)

Shayela umhlinzeki wakho uma:

• Uzizwa unesiyezi noma unekhanda elincane.
• Unezimpawu zezilonda.

Gwema i-aspirin, ibuprofen, naproxen, namanye ama-NSAID. Zama i-acetaminophen esikhundleni salokho. Uma kufanele uthathe le mithi, khuluma nomhlinzeki wakho kuqala. Umhlinzeki wakho anga:

• Kukuvivinye H pylori ngaphambi kokuba uthathe le mithi
• Cela ukuthi uthathe ama-PPIs noma i-H2 acid blocker
• Nikeza umuthi obizwa nge-misoprostol

Lezi zinguquko ezilandelayo zendlela yokuphila zingasiza ekuvikeleni izilonda ezisemathunjini:

• UNGABHALI noma uhlafune ugwayi.
• Gwema utshwala.

Isilonda - i-peptic; Isilonda - duodenal; Isilonda - isisu; Isilonda se-duodenal; Isilonda esiswini; I-Dyspepsia - izilonda; Ukopha isilonda; Ukopha emathunjini - isilonda peptic; Ukopha emathunjini - isilonda peptic; I-GI wopha - isilonda peptic; H. pylori - isilonda peptic; Helicobacter pylori - isilonda peptic

• Ukuthatha ama-antacids

• Izimo eziphuthumayo ze-Ulcer
• Inqubo ye-Gastroscopy
• Indawo yezilonda ezisemabeleni
• Imbangela yezilonda ezinamaphaphu
• Isifo sesisu noma ukuhlukumezeka

UChan FKL, uLau JYW. Isifo sesilonda se-Peptic. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 53.

Ikhava ye-TL, iBlaser MJ. I-Helicobacter pylori kanye nezinye isisu I-Helicobacter izinhlobo. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 217.

ILanas A, uKhan FKL. Isifo sesilonda se-Peptic. I-Lancet. 2017; 390 (10094): 613-624. PMID: 28242110 www.pubmed.ncbi.nlm.nih.gov/28242110/.