Peptic ulcer

Chironda chembabvu chironda chakavhurika kana nzvimbo yakasvibirira mukati memukati medumbu kana ura.

Kune maviri marudzi eeptic ulcers:

• Gastric ulcer - inoitika mudumbu
• Duodenal ulcer - inoitika muchikamu chekutanga chemukati mudumbu

Kazhinji, iro dumbu remudumbu uye ura hudiki hunogona kuzvidzivirira kubva kune yakasimba dumbu acids. Asi kana iyo lining ikaputsika, mhedzisiro inogona kuve:

• Kuzvimba uye kuputira nyama (gastritis)
• Chironda

Maronda mazhinji anoitika mune yekutanga dura remukati mekunze. Buri mudumbu kana duodenum inonzi perforation. Ichi chiitiko chekurapa.

Chikonzero chakajairika chemaronda hutachiona hwemudumbu nemabhakitiriya anonzi Helicobacter pylori (H pylori). Vazhinji vanhu vane peptic ulcers vane aya mabhakitiriya anogara mune yavo yekugaya nzira. Asi, vanhu vazhinji vane mabhakitiriya aya mudumbu mavo havaite chironda.

Izvi zvinotevera zvinhu zvinomutsa njodzi yako yezvironda zvemaronda.

• Kunwa doro rakawandisa
• Kugara uchishandisa aspirin, ibuprofen, naproxen, kana mamwe asiri -steroidal anti-anogumbura zvinodhaka (NSAIDs)
• Kusvuta fodya kana kutsenga fodya
• Kunyanya kurwara, sekuve pamushini wekufema
• Radiation kurapwa
• Kushungurudzika

Chinhu chisingawanzoitika, chinonzi Zollinger-Ellison syndrome, chinokonzera maronda emudumbu uye e duodenal.

Zvironda zvidiki zvinogona kusakonzera chero zviratidzo. Zvimwe zvironda zvinogona kukonzera kubuda ropa kwakakomba.

Kutambudzika kwepamuviri (kazhinji mumusoro wepakati-mudumbu) chiratidzo chakajairika. Marwadzo anogona kusiyana kubva kumunhu kumunhu. Vamwe vanhu havana kurwadziwa.

Kurwadziwa kunoitika:

• Mudumbu repamusoro
• Husiku uye anomutsa iwe
• Paunenge uchinzwa chisina chinhu mudumbu, kazhinji 1 kusvika maawa matatu mushure mekudya

Zvimwe zviratidzo zvinosanganisira:

• Kunzwa kuzara uye matambudziko kunwa zvakawandisa mvura semazuva ese
• Nausea
• Kusvipa
• Ropa kana rima, zvigaro zvekugara
• Kurwadziwa pachifuva
• Kuneta
• Kurutsa, pamwe neropa
• Kuonda
• Kuenderera mberi kwekurwadziwa kwepfungwa

Kuti uone ulcer, ungangoda bvunzo inonzi yepamusoro endoscopy (EGD).

• Uku ndiko kuyedza kutarisa kumadziro kwepombi yekudya, mudumbu, uye chikamu chekutanga chemukati mudumbu.
• Inoitwa nekadiki kamera (inoshanduka endoscope) inoiswa pasi nehuro.
• Muedzo uyu unowanzo kuda kutonhodzwa kunopihwa kuburikidza netsinga.
• Mune zvimwe zviitiko, endoscope diki inogona kushandiswa inopfuudzwa mudumbu kuburikidza nemhino. Izvi hazvidi sedation.

EGD inoitwa pane vanhu vazhinji apo maronda eronda anofungidzirwa kana kana iwe uine:

• Yakaderera ropa kuverenga (kupererwa neropa)
• Dambudziko kumedza
• Rutsa ropa
• Ropa kana rima uye anononoka-kutarisa zvituru
• Kurasikirwa uremu pasina kuyedza
• Zvimwe zvakawanikwa zvinomutsa kunetsekana nekenza mudumbu

Kuedzwa kwaH pylori kunodiwa zvakare. Izvi zvinogona kuitwa ne biopsy yemudumbu panguva yeendoscopy, neye stool bvunzo, kana neye urea mweya bvunzo.

Mimwe bvunzo iwe yaungave unayo inosanganisira:

• Hemoglobin ropa bvunzo kuongorora kushomeka
• Stool yemashiripiti eropa bvunzo kuyedza ropa mune chako chestool

Dzimwe nguva, iwe ungangoda muyedzo unonzi wepamusoro GI akateedzana. Akateedzana eX-ray anotorwa mushure mekunwa chinhu chakakora chinonzi barium. Izvi hazvidi sedation.

Anokuchengetedza hutano achakurudzira mishonga yekupodza ulcer yako uye kudzivirira kudzokazve. Iyo mishonga icha:

• Uraya iyo H pylori mabhakitiriya, kana aripo.
• Deredza acid mumazinga. Izvi zvinosanganisira H2 blockers senge ranitidine (Zantac), kana proton pump inhibitor (PPI) senge pantoprozole.

Tora mishonga yako yese sezvawakaudzwa. Dzimwe shanduko muhupenyu hwako dzinogona zvakare kubatsira.

Kana uine peptic ulcer ine H pylori hutachiona, kurapwa kwakazara kunoshandisa musanganiswa wakasiyana wemishonga inotevera kwemazuva manomwe kusvika gumi nemana:

• Mishonga miviri inorwisa mabhakitiriya kuuraya H pylori.
• PPI dzakadai se omeprazole (Prilosec), lansoprazole (Prevacid), kana esomeprazole (Nexium).
• Bismuth (chinhu chikuru muPepto-Bismol) inogona kuwedzerwa kubatsira kuuraya hutachiona.

Iwe ungangoda kutora PPI kwemavhiki masere kana:

• Une chironda chisina H pylori hutachiona.
• Ronda rako rinokonzerwa nekutora maaspirin kana maNSAID.

Wako mupi anogona zvakare kupa iyi mhando yemishonga nguva dzose kana iwe uchiramba uchitora maaspirin kana maNSAID kune mamwe mamiriro ehutano.

Mimwe mishonga inoshandiswa yezvironda ndeiyi:

• Misoprostol, mushonga unogona kubatsira kudzivirira maronda muvanhu vanotora maNSAID nguva dzose
• Mishonga inodzivirira iyo lining lining, senge sucralfate

Kana peptic ulcer ichibuda ropa zvakanyanya, EGD inogona kudiwa kumisa kubuda kweropa. Nzira dzinoshandiswa kumisa kubuda kweropa dzinosanganisira:

• Kubaya jekiseni mushonga mune ulcer
• Kuisa clip dzesimbi kana kurapwa kwekupisa kune iyo ulcer

Kuvhiya kunogona kudikanwa kana:

• Kubuda ropa hakugone kumiswa neEGD
• Ronda racho rakonzera kuchema

Peptic ulcers inowanzo kudzoka kana isina kurapwa. Pane mukana wakanaka wekuti iyo H pylori hutachiona hunorapwa kana iwe ukatora mishonga yako uye ukatevera rairo yemupi wako. Iwe unenge usingaite zvakanyanya kuwana imwe chironda.

Zvinetso zvinogona kusanganisira:

• Kurasikirwa kukuru kweropa
• Kupenga kubva pachironda kunogona kuita kuti zviome kuti dumbu ribude
• Kukanganiswa kana gomba redumbu uye ura

Wana rubatsiro rwechiremba ipapo kana iwe:

• Kukura kamwe kamwe, kwakapinza kurwadziwa mudumbu
• Iva nedumbu rakaoma, rakaoma iro rakapfava kubata
• Iva nezviratidzo zvekuvhunduka, sekufenda, kudikitira zvakanyanya, kana kuvhiringidzika
• Rutsa ropa kana uine ropa muchigaro chako (kunyanya kana iri maroon kana rima, tarisa nhema)

Fonera mupiki wako kana:

• Unonzwa dzungu kana musoro usina musoro.
• Une maronda zviratidzo.

Dzivisa aspirin, ibuprofen, naproxen, uye dzimwe NSAID. Edza acetaminophen panzvimbo. Kana iwe uchifanira kutora mishonga yakadaro, taura nemupi wako kutanga. Wako mupi anogona:

• Kukuedza iwe H pylori usati watora mishonga iyi
• Kumbira iwe kuti utore PPIs kana H2 acid blocker
• Ipa mushonga unonzi misoprostol

Shanduko dzinotevera dzemararamiro dzinogona kubatsira kudzivirira maronda eronda:

• Usasvuta kana kutsenga fodya.
• Dzivisa doro.

Chironda - peptic; Urikanwi - duodenal; Urikanwi - gastric; Duodenal ulcer; Gastric urikanwi; Dyspepsia - maronda; Kubuda ropa ulcer; Kubuda kwepamuviri - peptic ulcer; Urombo hwepamuviri - peptic ulcer; GI kubuda ropa - peptic ulcer; H. pylori - peptic ulcer; Helicobacter pylori - peptic ulcer

• Kutora antacids

• Chironda chimbi
• Maitiro eGastroscopy
• Nzvimbo yezvironda zvemaronda
• Chikonzero chemaronda eronda
• Chirwere chedumbu kana kushungurudzika

Chan FKL, Lau JYW. Peptic ulcer chirwere. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chiropa. 11th ed. Philadelphia, PA: Elsevier; 2021: chits. 53.

Vhara TL, Blaser MJ. Helicobacter pylori uye chimwe gastric Helicobacter mhando. Mune: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, uye Bennett's Maitiro uye Maitiro Ezvirwere zvinotapukira. 9th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 217.

Lanas A, Chan FKL. Peptic ulcer chirwere. Lancet. 2017; 390 (10094): 613-624. PMID: 28242110 www.pubmed.ncbi.nlm.nih.gov/28242110/.