Mimba ya Barrett

Zamkati

• Zomwe zimayambitsa kukhweula kwa Barrett
• Kodi chiopsezo ndi chiyani?
• Pozindikira zizindikiro za kholingo la Barrett
• Kuzindikira ndikusanja khola la Barrett
• Njira zochiritsira khola la Barrett
• Ayi kapena otsika dysplasia
• Kuphatikiza ndalama kwa Nissen
• Mzere wa LINX
• Ndondomeko ya Stretta
• Dongosolo lapamwamba la dysplasia
• Kuchotsa ma Radiofrequency
• Cryotherapy
• Thandizo la Photodynamic
• Zovuta
• Kodi malingaliro a chimfine cha Barrett ndi otani?

Kodi khola la Barrett ndi liti?

Chikhodzodzo cha Barrett ndimkhalidwe womwe maselo omwe amapanga khosi lanu amayamba kuwoneka ngati maselo omwe amapanga matumbo anu. Izi zimachitika nthawi zambiri maselo akawonongeka ndikutulutsa asidi m'mimba.

Vutoli limayamba pakatha zaka zambiri akukumana ndi gastroesophageal reflux (GERD). Nthawi zina, kholingo la Barrett limatha kukhala khansa ya m'mimba.

Zomwe zimayambitsa kukhweula kwa Barrett

Zomwe zimayambitsa Barrett's esophagus sizikudziwika. Komabe, vutoli limawoneka nthawi zambiri mwa anthu omwe ali ndi GERD.

GERD imachitika pomwe minofu yomwe ili pansi pamimba sigwira bwino ntchito. Minofu yofooka imalepheretsa chakudya ndi asidi kuti zibwererenso kummero.

Amakhulupirira kuti maselo am'mimbamo amatha kukhala achilendo ndikakhala ndi asidi m'mimba nthawi yayitali. Matenda a Barrett amatha kukula popanda GERD, koma odwala omwe ali ndi GERD ali ndi mwayi 3 mpaka 5 wokhala ndi kholingo la Barrett.

Pafupifupi 5 mpaka 10 peresenti ya anthu omwe ali ndi GERD amakhala ndi khola la Barrett. Amakhudza amuna pafupifupi kawiri kuposa azimayi ndipo amapezeka kuti ali ndi zaka 55.

Popita nthawi, maselo am'mimba amatha kukhazikika m'maselo otsogola. Maselowa amatha kusintha kukhala maselo a khansa. Komabe, kukhala ndi kholingo la Barrett sikutanthauza kuti mudzakhala ndi khansa.

Akuti pafupifupi 0,5 peresenti ya anthu omwe ali ndi kholingo la Barrett amakhala ndi khansa.

Kodi chiopsezo ndi chiyani?

Ngati muli ndi zizindikiro za GERD kwa nthawi yayitali kuposa zaka 10, muli ndi chiopsezo chowonjezeka chokhala ndi khola la Barrett.

Zina mwaziwopsezo zotenga chotupa cha Barrett ndizo:

• kukhala wamwamuna
• kukhala Caucasus
• kukhala wazaka zopitilira 50
• kukhala ndi H pylori gastritis
• kusuta
• kukhala wonenepa kwambiri

Zinthu zomwe zimawonjezera GERD zitha kukulitsa chifuwa cha Barrett. Izi zikuphatikiza:

• kusuta
• mowa
• kugwiritsa ntchito NSAIDS kapena Aspirin pafupipafupi
• kudya magawo akulu pakudya
• zakudya zokhala ndi mafuta ambiri
• zakudya zokometsera
• kugona kapena kugona pasanathe maola anayi mutadya

Pozindikira zizindikiro za kholingo la Barrett

Khola la Barrett lilibe zisonyezo. Komabe, chifukwa anthu ambiri omwe ali ndi vutoli alinso ndi GERD, nthawi zambiri amakumana ndi kutentha pa chifuwa.

Itanani dokotala wanu nthawi yomweyo ngati izi zikuchitika:

• kukhala ndi ululu pachifuwa
• kusanza magazi, kapena kusanza komwe kumafanana ndi malo a khofi
• ovuta kumeza
• kudutsa malo akuda, kudikirira, kapena magazi

Kuzindikira ndikusanja khola la Barrett

Ngati dokotala akukayikira kuti muli ndi vuto la Barrett atha kuyitanitsa endoscopy. Endoscopy ndi njira yomwe imagwiritsa ntchito endoscope, kapena chubu chokhala ndi kamera yaying'ono ndikuwala. Endoscope imalola dokotala wanu kuwona mkati mwanu.

Dokotala wanu akuyang'ana kuti awonetsetse kuti khungu lanu likuwoneka lofiirira komanso lowala. Anthu omwe ali ndi kholingo la Barrett nthawi zambiri amakhala ndi kholingo lomwe limawoneka lofiira komanso losalala.

Dokotala wanu amathanso kutenga zitsanzo zamatenda zomwe zimawathandiza kuti amvetsetse zosintha zomwe zikuchitika m'mimba mwanu.Dokotala wanu adzawona mtundu wa minofu ya dysplasia, kapena kukula kwa maselo achilendo. Zoyeserera za minofu ziwerengedwa kutengera madigiri otsatirawa:

• palibe dysplasia: palibe zovuta zowoneka zama cell
• dysplasia yotsika pang'ono: zovuta zazing'ono zama cell
• high grade dysplasia: kuchuluka kwama cell ndi zovuta zomwe zimatha kukhala khansa

Njira zochiritsira khola la Barrett

Chithandizo cha kum'mero ​​kwa Barrett chimatengera mtundu wa matenda a dysplasia omwe dokotala wanu akutsimikizirani kuti muli nawo. Zosankha zingaphatikizepo:

Ayi kapena otsika dysplasia

Ngati mulibe dysplasia kapena otsika, dokotala wanu angakulimbikitseni chithandizo chomwe chingakuthandizeni kuthana ndi zizindikilo zanu za GERD. Mankhwala ochizira GERD amaphatikizapo omwe amatsutsana ndi H2-receptor ndi ma proton pump inhibitors.

Muthanso kukhala woyenera maopaleshoni omwe angakuthandizeni kuthana ndi zizindikilo za GERD. Pali maopaleshoni awiri omwe amachitidwa kwambiri kwa anthu omwe ali ndi GERD, omwe ndi awa:

Kuphatikiza ndalama kwa Nissen

Kuchita opaleshoniyi kumalimbikitsa kulimbitsa thupi kwa m'munsi mwa esophageal sphincter (LES) ndikukulunga pamwamba pamimba panu kunja kwa LES.

Mzere wa LINX

Pochita izi, dokotala wanu adzaika chida cha LINX mozungulira kum'mero ​​kwenikweni. Chida cha LINX chimapangidwa ndi mikanda yaying'ono yazitsulo yomwe imagwiritsa ntchito maginito okopa kuti zomwe zili m'mimba mwanu zisatuluke mummero.

Ndondomeko ya Stretta

Dokotala amachita njira ya Stretta ndi endoscope. Mafunde a wailesi amagwiritsidwa ntchito kupangitsa kuti minofu ya kumero isinthe pafupi ndi pomwe imalowa m'mimba. Njirayi imalimbitsa minofu ndikuchepetsa kuchepa kwa m'mimba.

Dongosolo lapamwamba la dysplasia

Dokotala wanu angakulimbikitseni njira zowonjezera ngati muli ndi dysplasia yapamwamba. Mwachitsanzo, kuchotsa malo owonongeka pogwiritsa ntchito endoscopy. Nthawi zina, magawo athunthu am'mero ​​amachotsedwa. Mankhwala ena ndi awa:

Kuchotsa ma Radiofrequency

Njirayi imagwiritsa ntchito endoscope yokhala ndi cholumikizira chapadera chomwe chimatulutsa kutentha. Kutentha kumapha maselo osazolowereka.

Cryotherapy

Pochita izi, endoscope imapereka mpweya wozizira kapena madzi omwe amaundana maselo osadziwika bwino. Maselo amaloledwa kusungunuka, kenako amawundana. Izi zimachitika mobwerezabwereza mpaka maselo amwalira.

Thandizo la Photodynamic

Dokotala wanu amakubayani mankhwala opatsa chidwi otchedwa porfimer (Photofrin). Endoscopy idzakonzedwa maola 24 mpaka 72 pambuyo pa jakisoni. Pakati pa endoscopy, laser imayambitsa mankhwala ndikupha maselo osadziwika.

Zovuta

Zovuta zomwe zingachitike panjira zonsezi zitha kuphatikizira kupweteka pachifuwa, kuchepa kwa kholingo, kudula m'mero ​​mwanu, kapena kuphulika kwam'mero.

Kodi malingaliro a chimfine cha Barrett ndi otani?

Chikhodzodzo cha Barrett chimakulitsa chiopsezo chanu chokhala ndi khansa ya m'mimba. Komabe, anthu ambiri omwe ali ndi vutoli samadwala khansa. Ngati muli ndi GERD, lankhulani ndi dokotala wanu kuti mupeze njira yothandizira yomwe ingakuthandizeni kuthana ndi matenda anu.

Dongosolo lanu lingaphatikizepo kusintha moyo wanu monga kusiya kusuta, kuchepetsa kumwa mowa, komanso kupewa zakudya zokometsera. Muthanso kuyamba kudya zakudya zazing'ono zotsika ndi mafuta okhathamira, kudikirira osachepera maola 4 mutadya kuti mugone, ndikukweza mutu wa bedi lanu.

Zonsezi zidzachepetsa Reflux ya gastroesophageal. Inunso mutha kupatsidwa mwayi wodana ndi H2-receptor antagonists kapena proton pump inhibitors.

Ndikofunikanso kukonzekera nthawi ndi nthawi kuti mupite kukaonana ndi dokotala kuti athe kuyang'anira kukhazikika kwa kummero kwanu. Izi zithandizira kuti dokotala wanu apeze maselo a khansa kumayambiriro.