Ukutheleleka kwe-Helicobacter pylori

I-Helicobacter pylori (H pyloriuhlobo lwebhaktheriya elithelela isisu. Kuvamile kakhulu, kuthinta cishe izingxenye ezimbili kwezintathu zabantu emhlabeni. H pylori ukutheleleka kuyimbangela evame kakhulu yezilonda ezibelethayo. Kodwa-ke, ukutheleleka akubangeli izinkinga kubantu abaningi.

H pylori amabhaktheriya kungenzeka adluliselwe ngqo kusuka kumuntu kuye komunye. Lokhu kuvame ukwenzeka ngesikhathi sobuntwana. Ukutheleleka kuhlala impilo yonke uma kungenakwelashwa.

Akucaci ukuthi amagciwane adluliselwa kanjani esuka komunye umuntu aye komunye. Ama-bacteria angasakazeka kusuka ku:

• Ukuxhumana ngomlomo nomlomo
• Ukugula kwepheshana le-GI (ikakhulukazi lapho kwenzeka ukuhlanza)
• Ukuthintana nesitulo (impahla yendle)
• Ukudla namanzi okungcolisiwe

Amagciwane angadala izilonda ngale ndlela elandelayo:

• H pylori ingena kungqimba lwesisu bese inamathela ulwelwesi lwesisu.
• H pylori kubangele ukuthi isisu sikhiqize i-acid eningi esiswini. Lokhu kulimaza ulwelwesi lwesisu, okuholela ezilondeni kwabanye abantu.

Ngaphandle kwezilonda, H pylori amabhaktheriya angadala nokuvuvukala okungapheli esiswini (i-gastritis) noma engxenyeni engenhla yamathumbu amancane (i-duodenitis).

H pylori futhi kwesinye isikhathi kungaholela kumdlavuza wesisu noma kuhlobo olungajwayelekile lwesisu i-lymphoma.

Cishe i-10% kuya ku-15% yabantu abatheleleke nge-HIV H pylori ukuthuthukisa isifo peptic ulcer. Izilonda ezincane kungenzeka zingabangeli zimpawu. Ezinye izilonda zingadala ukopha okungathi sína.

Ubuhlungu obuhlungu noma obushisayo esiswini sakho kuyisifo esivamile. Ubuhlungu bungaba bukhulu kakhulu ngesisu esingenalutho. Ubuhlungu bungahluka kumuntu nomuntu, futhi abanye abantu abanabo ubuhlungu.

Ezinye izimpawu zifaka:

• Ukuzwa ukugcwala noma ukuqunjelwa nezinkinga zokuphuza uketshezi oluningi njengokujwayelekile
• Indlala nokuzizwa kungenalutho esiswini, imvamisa ihora eli-1 ukuya kwele-3 ngemuva kokudla
• Isicanucanu esimnene esingahle sihambe nokuhlanza
• Ukuphelelwa isifiso sokudla
• Ukwehla kwesisindo ngaphandle kokuzama
• Ukuqhuma
• Igazi noma mnyama, izitulo zokulinda noma ukuhlanza okunegazi

Umhlinzeki wakho wokunakekelwa kwezempilo uzokuhlolela H pylori uma u:

• Yiba nezilonda ezinamaphaphu noma umlando wezilonda
• Yiba nokungahambi kahle nobuhlungu esiswini obuhlala isikhathi esingaphezu kwenyanga

Tshela umhlinzeki wakho ngemithi oyiphuzayo. Izidakamizwa ezingezona ukuvuvukala (ama-NSAID) nazo zingadala izilonda. Uma ukhombisa izimpawu zokutheleleka, umhlinzeki angenza izivivinyo ezilandelayo ze- H pylori. Lokhu kufaka phakathi:

• Ukuhlolwa komoya - Urea ukuphefumula test (Carbon Isotope-urea Breath Test, noma UBT). Umhlinzeki wakho uzokugwinya into ekhethekile ene-urea. Uma H pylori akhona, amabhaktheriya aguqula i-urea ibe yisikhutha. Lokhu kutholakala futhi kwarekhodwa ekuphefumuleni kwakho okuphefumulayo ngemuva kwemizuzu eyi-10.
• Ukuhlolwa kwegazi - ulinganisa amasosha omzimba ukuze H pylori egazini lakho.
• Ukuhlolwa kwendle - kuthola ukuba khona kwamagciwane esitulweni.
• Isidumbu - ihlola isampula lezicubu ezithathwe kulolwelwesi lwesisu kusetshenziswa i-endoscopy. Isampula lihlolwe ukutheleleka kwamagciwane.

Ukuze isilonda sakho silaphe futhi sinciphise ithuba lokuthi sizobuya, uzonikezwa imithi:

• Bulala i- H pylori amabhaktheriya (uma akhona)
• Yehlisa amazinga e-acid esiswini

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

Uma une-peptic ulcer ne- H pylori ukutheleleka, ukwelashwa kunconywa. Ukwelashwa okujwayelekile kubandakanya izinhlanganisela ezahlukahlukene zemithi elandelayo izinsuku eziyi-10 kuya kweziyi-14:

• Ama-antibiotic ukubulala H pylori
• Proton pump inhibitors ukusiza ukwehlisa amazinga e-asidi esiswini
• I-Bismuth (isithako esiyinhloko ku-Pepto-Bismol) ingangezwa ukusiza ukubulala amagciwane

Ukuphuza yonke le mithi kuze kube yizinsuku eziyi-14 akulula. Kepha ukwenza kanjalo kukunikeza ithuba elihle lokususa ifayela le- H pylori amabhaktheriya nokuvimbela izilonda esikhathini esizayo.

Uma uthatha imithi yakho, kunethuba elihle lokuthi i- H pylori ukutheleleka kuzolashwa. Ngeke ube mancane amathuba okuthi uthole esinye isilonda.

Kwesinye isikhathi, H pylori kungaba nzima ukwelapha ngokuphelele. Izifundo eziphindaphindwayo zokwelashwa okuhlukile zingadingeka. Ngesinye isikhathi kwenziwa i-biopsy yesisu ukuhlola igciwane ukuze libone ukuthi imuphi umuthi olwa namagciwane ongasebenza kahle. Lokhu kungasiza ekuqondiseni ukwelashwa kwesikhathi esizayo. Kwezinye izimo, H pylori ayikwazi ukwelashwa nganoma yikuphi ukwelashwa, nakuba izimpawu zingase zikwazi ukunciphisa.

Uma selaphekile, ukutheleleka kabusha kungenzeka ezindaweni lapho izimo zenhlanzeko zimbi.

Ukutheleleka kwesikhathi eside (okungamahlalakhona) nge H pylori kungaholela ku:

• Isifo sesilonda se-Peptic
• Ukuvuvukala okungapheli
• Izilonda zamathumbu emathunjini nangaphezulu
• Umdlavuza wesisu
• Izicubu ze-lymphoid ezihambisana ne-mucosa (MALT) lymphoma

Ezinye izinkinga zingafaka:

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

Izimpawu ezinzima eziqala ngokuzumayo zingakhombisa ukuvinjelwa emathunjini, ukugcotshwa, noma ukopha, konke okuyizimo eziphuthumayo. Izimpawu zingafaka:

• Izitulo zokulinda, ezimnyama, noma ezinegazi
• Ukuhlanza okukhulu, okungafaka igazi noma into enezindawo zekhofi (uphawu lokopha okungathi sína) noma konke okuqukethwe yisisu (uphawu lokuvinjelwa kwamathumbu)
• Ubuhlungu obukhulu besisu, ngokuhlanza noma ngaphandle noma ubufakazi begazi

Noma ngubani onalezi zimpawu kufanele aye egumbini lezimo eziphuthumayo ngokushesha.

H pylori ukutheleleka

• Isisu
• I-Esophagogastroduodenoscopy (EGD)
• Amasosha omzimba
• Indawo yezilonda ezisemabeleni

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

Ku GY, Ilson DH. Umdlavuza wesisu. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 72.

UMorgan DR, uCrowe SE. Ukutheleleka kwe-Helicobacter pylori. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 51.