Chilonda chachikulu

Zilonda zam'mimba ndi zilonda zotseguka kapena zobiriwira mkatikati mwa m'mimba kapena m'matumbo.

Pali mitundu iwiri ya zilonda zam'mimba:

• Zilonda zam'mimba - zimapezeka m'mimba
• Zilonda zam'matumbo - zimapezeka koyambirira kwamatumbo ang'onoang'ono

Nthawi zambiri, kulowa kwa m'mimba ndi matumbo ang'onoang'ono kumatha kudzitchinjiriza ku zidulo zam'mimba zolimba. Koma ngati akalowa awonongeka, zotsatira zake zitha kukhala:

• Matenda otupa komanso otupa (gastritis)
• Chilonda

Zilonda zambiri zimapezeka m'mbali yoyamba yamkati. Bowo m'mimba kapena duodenum limatchedwa perforation. Izi ndizadzidzidzi zachipatala.

Zomwe zimayambitsa zilonda zam'mimba ndimatenda m'mimba ndi mabakiteriya otchedwa Helicobacter pylori (H pylori). Anthu ambiri omwe ali ndi zilonda zam'mimba amakhala ndi mabakiteriyawa omwe amakhala m'matumbo awo. Komabe, anthu ambiri omwe ali ndi mabakiteriya m'mimba samadwala zilonda.

Zinthu zotsatirazi zimapangitsa kuti mukhale ndi zilonda zam'mimba:

• Kumwa mowa kwambiri
• Kugwiritsa ntchito aspirin pafupipafupi, ibuprofen, naproxen, kapena mankhwala ena osagwiritsa ntchito kutupa (NSAIDs)
• Kusuta ndudu kapena fodya wotafuna
• Kukhala wodwala kwambiri, monga kukhala pamakina opumira
• Mankhwala a radiation
• Kupsinjika

Matenda osowa, otchedwa Zollinger-Ellison syndrome, amayambitsa zilonda zam'mimba ndi zam'mimba.

Zilonda zazing'ono sizingayambitse zizindikiro zilizonse. Zilonda zina zimatha kutulutsa magazi kwambiri.

Kupweteka m'mimba (nthawi zambiri kumtunda kwapakati pamimba) ndichizindikiro chofala. Kupweteka kumatha kusiyanasiyana pakati pa munthu ndi munthu. Anthu ena alibe zopweteka.

Ululu umachitika:

• Pamimba chapamwamba
• Usiku ndikukudzutsani
• Mukamva kuti mulibe kanthu m'mimba, nthawi zambiri 1 mpaka 3 maola mutadya

Zizindikiro zina ndizo:

• Kumva kukhuta ndi mavuto akumamwa madzi ambiri monga mwachizolowezi
• Nseru
• Kusanza
• Magazi kapena mdima, malo odikira
• Kupweteka pachifuwa
• Kutopa
• Kusanza, mwina wamagazi
• Kuchepetsa thupi
• Kutentha pa chifuwa kosalekeza

Kuti mupeze chilonda, mungafunike kuyesa kotchedwa endoscopy chapamwamba (EGD).

• Uku ndiyeso kuti muwone kulumikizidwa kwa chitoliro cha chakudya, m'mimba, ndi gawo loyamba la m'mimba.
• Zimachitika ndi kamera yaying'ono (endoscope yosinthasintha) yomwe imayikidwa pakhosi.
• Kuyesaku nthawi zambiri kumafunikira sedation yoperekedwa kudzera mumtsempha.
• Nthawi zina, titha kugwiritsa ntchito endoscope yaying'ono yomwe imadutsa m'mimba kudzera mphuno. Izi sizitengera kukhazikika.

EGD imachitika kwa anthu ambiri pomwe zilonda zam'mimba zimakayikira kapena mukakhala ndi:

• Kuchuluka kwa magazi (kuchepa magazi m'thupi)
• Vuto kumeza
• Masanzi amagazi
• Zojambula zamagazi kapena zakuda komanso zochedwa
• Kuchepetsa thupi osayesa
• Zotsatira zina zomwe zimadzetsa nkhawa khansa m'mimba

Kuyesedwa kwa H pylori kumafunikanso. Izi zitha kuchitika ndikutsata m'mimba nthawi ya endoscopy, poyesa chopondapo, kapena poyesa mpweya wa urea.

Mayesero ena omwe mungakhale nawo ndi awa:

• Kuyezetsa magazi kwa hemoglobin kuti muwone kuchepa kwa magazi
• Kuyesa magazi mwamatsenga kuti muyese magazi mu mpando wanu

Nthawi zina, mungafunike mayeso otchedwa chapamwamba cha GI. Ma x-ray angapo amatengedwa mukamamwa chinthu chakuda chotchedwa barium. Izi sizitengera kukhazikika.

Wothandizira zaumoyo wanu amalangiza mankhwala ochizira zilonda zanu ndikupewa kuyambiranso. Mankhwala awa:

• Iphani H pylori mabakiteriya, ngati alipo.
• Kuchepetsa asidi m'mimba. Izi zikuphatikiza ma H2 blockers monga ranitidine (Zantac), kapena proton pump inhibitor (PPI) monga pantoprozole.

Tengani mankhwala anu onse monga anauzidwira. Zosintha zina m'moyo wanu zitha kuthandizanso.

Ngati muli ndi zilonda zam'mimba zomwe zili ndi H pylori Matendawa, mankhwalawa amagwiritsa ntchito mankhwala osiyanasiyana kwa masiku 7 mpaka 14:

• Mankhwala awiri opha tizilombo H pylori.
• Ma PPI monga omeprazole (Prilosec), lansoprazole (Prevacid), kapena esomeprazole (Nexium).
• Bismuth (chinthu chachikulu mu Pepto-Bismol) chitha kuwonjezedwa kuti chithandizire kupha mabakiteriya.

Muyenera kutenga PPI kwa masabata 8 ngati:

• Muli ndi chilonda chopanda H pylori matenda.
• Zilonda zanu zimayamba chifukwa chotenga ma aspirin kapena ma NSAID.

Wothandizira anu amathanso kukupatsani mankhwala amtunduwu pafupipafupi ngati mupitiliza kumwa ma aspirin kapena ma NSAID pazinthu zina zathanzi.

Mankhwala ena omwe amagwiritsidwa ntchito pa zilonda ndi awa:

• Misoprostol, mankhwala omwe angathandize kupewa zilonda mwa anthu omwe amatenga ma NSAID pafupipafupi
• Mankhwala omwe amateteza kulumikizana kwa minofu, monga sucralfate

Ngati chilonda chachikulu chimatuluka magazi ambiri, EGD ingafunike kuti magazi asiye kutuluka. Njira zomwe zimagwiritsidwa ntchito poletsa kutaya magazi ndi monga:

• Kubaya jekeseni wa mankhwala mu chilondacho
• Kugwiritsa ntchito zotengera zazitsulo kapena mankhwala othandizira kutentha pachilonda

Kuchita opaleshoni kungafunike ngati:

• Kutuluka magazi sikungayimitsidwe ndi EGD
• Chilondacho chayambitsa misozi

Zilonda zam'mimba zimakonda kubwerera ngati sizinalandire chithandizo. Pali mwayi wabwino kuti H pylori Matendawa adzachiritsidwa ngati mutamwa mankhwala anu ndikutsatira malangizo a omwe amakupatsani. Simudzakhala ndi chilonda china.

Zovuta zingaphatikizepo:

• Kutaya magazi kwambiri
• Kupunduka kwa zilonda zam'mimba kungapangitse kuti zikhale zovuta m'mimba kukhuthula
• Kuwonongeka kapena dzenje la m'mimba ndi matumbo

Pezani chithandizo chamankhwala nthawi yomweyo ngati:

• Khalani ululu wam'mimba mwadzidzidzi
• Khalani ndi mimba yolimba, yolimba yomwe imakonda kugwira
• Khalani ndi zizindikiro zakukhumudwa, monga kukomoka, kuchita thukuta kwambiri, kapena kusokonezeka
• Sulani magazi kapena mukhale ndi magazi mu mpando wanu (makamaka ngati kuli maroon kapena mdima, khalani akuda)

Itanani omwe akukuthandizani ngati:

• Mumamva chizungulire kapena mutu wopepuka.
• Muli ndi zilonda zam'mimba.

Pewani aspirin, ibuprofen, naproxen, ndi ma NSAID ena. Yesani acetaminophen m'malo mwake. Ngati mukuyenera kumwa mankhwalawa, kambiranani ndi omwe amakupatsani chithandizo choyamba. Wopereka wanu atha:

• Yesani inu H pylori musanamwe mankhwalawa
• Funsani kuti mutenge ma PPIs kapena H2 acid blocker
• Perekani mankhwala otchedwa misoprostol

Kusintha kwa moyo potsatira kungathandize kupewa zilonda zam'mimba:

• Osasuta kapena kutafuna fodya.
• Pewani mowa.

Zilonda - peptic; Chilonda - mmatumbo; Zilonda - chapamimba; Chilonda cha mmatumbo; Zilonda zam'mimba; Dyspepsia - zilonda; Kupha magazi; Kutuluka m'mimba - zilonda zam'mimba; Kutaya magazi m'mimba - zilonda zam'mimba; GI kutuluka magazi - zilonda zam'mimba; H. pylori - zilonda zam'mimba; Helicobacter pylori - zilonda zam'mimba

• Kutenga ma antiacids

• Zilonda zadzidzidzi
• Ndondomeko ya gastroscopy
• Malo azilonda zam'mimba
• Zomwe zimayambitsa zilonda zam'mimba
• Matenda am'mimba kapena zoopsa

(Adasankhidwa) Chan FKL, Lau JYW. Matenda a zilonda zam'mimba. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Matenda a Mimba ndi a Fordtran Amatenda a Chiwindi. 11th ed. Philadelphia, PA: Elsevier; 2021: mutu 53.

Phimbani TL, Blaser MJ. Helicobacter pylori ndi zina zam'mimba Helicobacter zamoyo. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: chap 217.

Zoyambira A, Chan FKL. Matenda a zilonda zam'mimba. Lancet. 2017; 390 (10094): 613-624. (Adasankhidwa) PMID: 28242110 www.pubmed.ncbi.nlm.nih.gov/28242110/.