Isisu sikaBarrett

-Delile

• Yini ebangela isisu sikaBarrett
• Yiziphi izinto eziyingozi?
• Ukuqaphela izimpawu zesifo sikaBarrett
• Ukuhlonza nokuhlukanisa isigaba sikaBarrett
• Izinketho zokwelashwa kwesifo sikaBarrett
• Cha noma i-dysplasia esezingeni eliphansi
• Ukusetshenziswa kwemali kweNissen
• I-LINX
• Inqubo ye-Stretta
• I-dysplasia ebangeni eliphakeme
• Ukukhishwa kwe-Radiofrequency
• I-Cryotherapy
• Ukwelashwa kwe-Photodynamic
• Izinkinga
• Uyini umbono wesifo sikaBarrett?

Yini isisu sikaBarrett

Isigaxa sikaBarrett yisimo lapho amangqamuzana akha i-esophagus yakho aqala ukubukeka njengamaseli akha amathumbu akho. Lokhu kuvame ukwenzeka lapho amaseli elinyazwa ukuvezwa i-asidi esiswini.

Lesi simo sivame ukukhula ngemuva kweminyaka yokuthola i-reflux ye-gastroesophageal (GERD). Kwezinye izimo, umqala kaBarrett ungakhula ube ngumdlavuza wokuqopha.

Yini ebangela isisu sikaBarrett

Imbangela ngqo yesibhaxu sikaBarrett ayikaziwa. Kodwa-ke, isimo sivame ukubonakala kubantu abane-GERD.

I-GERD yenzeka lapho imisipha engezansi kwe-esophagus ingasebenzi kahle. Imisipha ebuthakathaka ngeke ivimbele ukudla ne-asidi ekubuyeleni emuva ku-esophagus.

Kukholakala ukuthi amangqamuzana asemgodini angaba ngokungajwayelekile ngokuvezwa kwesikhathi eside kwi-asidi yesisu. Isigaxa sikaBarrett singakhula ngaphandle kwe-GERD, kepha iziguli ezine-GERD zinamathuba ama-3 kuye kwayi-5 okuba nesifo sikaBarrett.

Cishe amaphesenti ama-5 kuya kwayi-10 abantu abane-GERD bathuthukisa umphimbo kaBarrett. Ithinta abesilisa cishe kaningi ngokuphindwe kabili kunabesifazane futhi ivame ukutholakala ngemuva kweminyaka yobudala engama-55.

Ngokuhamba kwesikhathi, amangqamuzana endwangu yesophageal angakhula abe ngamaseli acashile. Lawa maseli angashintsha abe amaseli anomdlavuza. Kodwa-ke, ukuba nomphimbo kaBarrett akusho ukuthi uzothola umdlavuza.

Kulinganiselwa ukuthi cishe amaphesenti angu-0.5 kuphela abantu abanesifo somzimba sikaBarrett aba nomdlavuza.

Yiziphi izinto eziyingozi?

Uma unezimpawu ze-GERD isikhathi esingaphezu kweminyaka eyi-10, unengozi eyengeziwe yokukhula kwesibindi sikaBarrett.

Ezinye izinto eziyingozi ekuthuthukiseni i-esophagus kaBarrett zifaka:

• ukuba ngowesilisa
• ukuba seCaucasian
• ukuba ngaphezu kweminyaka engama-50
• ukuba no-H pylori gastritis
• ukubhema
• ukukhuluphala

Izici ezithuthukisa i-GERD zingabhebhethekisa i-esophagus kaBarrett. Lokhu kufaka phakathi:

• ukubhema
• utshwala
• ukusetshenziswa kaningi kwe-NSAIDS noma i-Aspirin
• ukudla izingxenye ezinkulu ekudleni
• ukudla okunamafutha amaningi
• ukudla okubabayo
• ukulala noma ukulala kungakapheli amahora amane udlile

Ukuqaphela izimpawu zesifo sikaBarrett

Isigaxa sikaBarrett asinazo izimpawu. Kodwa-ke, ngoba abantu abaningi abanalesi simo banayo ne-GERD, imvamisa bazobhekana nokushiswa yinhliziyo njalo.

Shayela udokotela wakho khona manjalo uma kukhona kulezi zimpawu ezilandelayo:

• ukuba nobuhlungu besifuba
• ukuhlanza igazi, noma ukuhlanza okufana nezindawo zekhofi
• ukuthola ubunzima bokugwinya
• ukudlula okumnyama, okulindile, noma okokuchitha okunegazi

Ukuhlonza nokuhlukanisa isigaba sikaBarrett

Uma udokotela wakho esola ukuthi une-Barrett's esophagus bangahle ba-oda i-endoscopy. I-endoscopy inqubo esebenzisa i-endoscope, noma ithubhu enekhamera encane nokukhanya kuyo. I-endoscope ivumela udokotela wakho ukuthi abone ingaphakathi lesisu sakho.

Udokotela wakho uzobe ehlola ukwenza isiqiniseko sokuthi umphimbo wakho ubukeka ubomvana futhi ucwebezela. Abantu abane-Barrett's esophagus bavame ukuba ne-esophagus ebukeka ibomvu futhi i-velvety.

Udokotela wakho futhi angathatha isampula lezicubu elizovumela ukuthi baqonde ukuthi yiziphi izinguquko ezenzekayo esophagus yakho.Udokotela wakho uzohlola isampula lezicubu ze-dysplasia, noma ukukhula kwamaseli angajwayelekile. Isampula lezicubu libalwa ngokuya ngamadigri woshintsho alandelayo:

• akukho i-dysplasia: akukho okungajwayelekile kweseli okubonakalayo
• ibanga eliphansi le-dysplasia: inani elincane lokungajwayelekile kwamaseli
• i-high grade dysplasia: inani elikhulu lokungajwayelekile kwamaseli namaseli angahle abe ngumdlavuza

Izinketho zokwelashwa kwesifo sikaBarrett

Ukwelashwa kwesifo somzimba sikaBarrett kuncike kunoma yiliphi izinga le-dysplasia udokotela wakho anquma ukuthi unalo. Izinketho zingafaka:

Cha noma i-dysplasia esezingeni eliphansi

Uma ungenayo noma une-dysplasia esezingeni eliphansi, udokotela wakho cishe angancoma ukwelashwa okuzokusiza ukuphatha izimpawu zakho ze-GERD. Imithi yokwelapha i-GERD ifaka abaphikisi be-H2-receptor kanye ne-proton pump inhibitors.

Ungase futhi ube ukhetho lokuhlinzwa olungakusiza ukuphatha izimpawu zakho ze-GERD. Kunokuhlinzwa okubili okuvame ukwenziwa kubantu abane-GERD, okubandakanya:

Ukusetshenziswa kwemali kweNissen

Lokhu kuhlinzwa kuzama ukuqinisa i-esophageal sphincter (LES) ephansi ngokugoqa ingaphezulu lesisu sakho ngaphandle kwe-LES.

I-LINX

Kule nqubo, udokotela wakho uzofaka idivayisi ye-LINX ezungeze umphimbo ophansi. Idivayisi ye-LINX yakhiwe ngobuhlalu bensimbi obuncane obusebenzisa ukukhanga kazibuthe ukugcina okuqukethwe yisisu sakho kungangeni ku-esophagus yakho.

Inqubo ye-Stretta

Udokotela wenza inqubo ye-Stretta nge-endoscope. Amagagasi omsakazo asetshenziselwa ukudala ushintsho emisipheni yomphimbo eduze nalapho ejoyina khona isisu. Le ndlela iqinisa imisipha futhi yehlise ukukhishwa kwesisu.

I-dysplasia ebangeni eliphakeme

Udokotela wakho angancoma izinqubo ezengeziwe zokuhlasela uma une-dysplasia esezingeni eliphakeme. Isibonelo, ukususa izindawo ezilimele ze-esophagus ngokusebenzisa i-endoscopy. Kwezinye izimo, kususwa izingxenye zonke zomphimbo. Ezinye izindlela zokwelapha zifaka:

Ukukhishwa kwe-Radiofrequency

Le nqubo isebenzisa i-endoscope ene-attachment ekhethekile ekhipha ukushisa. Ukushisa kubulala amaseli angajwayelekile.

I-Cryotherapy

Kule nqubo, i-endoscope ikhipha igesi ebandayo noma uketshezi olufriza amangqamuzana angajwayelekile. Amaseli avunyelwe ukuncibilika, bese ebanda futhi. Le nqubo iyaphindwa kuze kube yilapho amangqamuzana efa.

Ukwelashwa kwe-Photodynamic

Udokotela wakho uzokujova ngekhemikhali ezwela ukukhanya ebizwa nge-porfimer (Photofrin). I-endoscopy izohlelwa amahora angama-24 kuye kwangama-72 ngemuva komjovo. Ngesikhathi se-endoscopy, i-laser izovula ikhemikhali futhi ibulale amaseli angajwayelekile.

Izinkinga

Izinkinga ezingaba khona zazo zonke lezi zinqubo zingabandakanya ubuhlungu besifuba, ukuncipha komphimbo, ukusikeka ekucineni kwakho, noma ukuqhekeka kwesisu sakho.

Uyini umbono wesifo sikaBarrett?

Isigaxa sikaBarrett siphakamisa ingozi yokuba nomdlavuza wokuqunjelwa. Kodwa-ke, abantu abaningi abanalesi simo abakaze babe nomdlavuza. Uma une-GERD, khuluma nodokotela wakho ukuthola uhlelo lokwelashwa oluzokusiza ukuphatha izimpawu zakho.

Uhlelo lwakho lungabandakanya ukwenza ushintsho endleleni yokuphila njengokuyeka ukubhema, ukunciphisa ukusetshenziswa kotshwala, nokugwema ukudla okubabayo. Ungaqala nokudla ukudla okuncane okuphansi kumafutha agcwele, ulinde okungenani amahora ama-4 ngemuva kokudla ukuze ulale, futhi uphakamise ikhanda lombhede wakho.

Zonke lezi zinyathelo zizonciphisa i-reflux ye-gastroesophageal. Nawe ungabekwa abaphikisi be-H2-receptor noma ama-proton pump inhibitors.

Kubalulekile futhi ukuhlela izikhathi zokuqokwa okulandelwa njalo nodokotela wakho ukuze bakwazi ukuqapha ulwelwesi lwe-esophagus yakho. Lokhu kuzokwenza ukuthi kube lula kakhulu ukuthi udokotela wakho athole amaseli anomdlavuza kusaqalwa.