Umgudu oqhelekileyo kunye ne-over-counter-counter-counter-counter-counter-cancellers zikhokelela kwizilonda.
Isilonda sesigxina sisigama esisetyenziselwa isifo esiyingozi kwi-mucosal bining of the stomach, intestine encinci, okanye isifo. Xa isilonda sisisu, kunokuthiwa isilonda esiswini. Izilonda kwinxalenye yokuqala yesisu esincinci (duodenum) sinokuthiwa isilonda se-duodenal. Isizathu esona siqhelo sesilonda sesilonda sihlobo lwebhakteria ebizwa ngokuba nguHelicobacter pylori (H pylori) .
Okwesibini, engaqhelekanga, kodwa ukwanda ngokunyanisekileyo kubangele, imbangela yezilonda zamathambo ziyindlela yokusebenzisa imithi engeyi-steroidal anti-inflammatory (NSAIDs) .
Ukusebenzisa ii-NSAID ezingaphezu kwe-counter-counter, ezifana ne- aspirin okanye i- ibuprofen kwintloko yesifo okanye i-backy yesikhewu ayiyi kubangela isilonda se-peptic. Kunoko, isifo sesilonda sezilonda sisifo esinokuthi senzeke ngamaqondo angaphezulu kwama-NSAID asetyenziswa ixesha elide, njengentlungu engapheliyo enxulumene ne- arthritis okanye ezinye izimo ezivuthayo. Abantu abaneenkxalabo malunga nokusetyenziswa kwe-NSAID kunye nendlela indlela yokutya yokugaya ichatshazelwa ngayo kufuneka ithethe nodokotela.
Kutheni i-NSAID idala i-Ulcers
I-NSAID ezifana ne-aspirin, ibuprofen, kunye ne- naproxen , inokubangela izilonda ngokuphazamisa amandla esisu sokuzikhusela kwi-acid acast. Nangona isisu se-acids zibaluleke kakhulu kwinkqubo yokugaya inyama, kunokudala umonakalo ukuba izithintelo zokukhusela zesisu ziyahlaselwa.
Ngokuqhelekileyo, isisu sinezikhuselo ezintathu kwi-acid esiswini:
- I-Mucus eveliswa ngamaseli e-foveolar ejikeleza isisu
- I-bicarbonate eveliswa ngamaseli e-foveolar anceda ukuphucula isisu esiswini
- Ukujikelezwa kwegazi okwenza ukulungiswa nokuhlaziywa kweeseli kwisisu se-mucosal
Ii-NSAID zinciphisa umveliso we-mucus ukhuselo kwaye zitshintshe isakhiwo sayo.
Iklasi ye lipids eyenziwa ngumzimba obizwa ngokuba yi- prostaglandines inefuthe lokufumana ubuhlungu beentlungu. Ii-NSAID zisebenza ukunciphisa intlungu ngokuthintela i-enzyme ezibandakanyeka kwimveliso ye-prostaglandines ethile. I-Prostaglandins nayo ikhuselekileyo kwisalathisi se-mucosal yesisu, kwaye xa iphelile, kukho ukuphuka kweso sigaba. Ukukhutshwa komzimba wokhuselo lwezemvelo kwi-acast gastric acid kungakhokelela ekuvukeni kwesisu. Ngokuhamba kwexesha, oku kungabangela ukugqithwa kwesitya segazi se-capillary, kubangele ukuphuma kwamanzi kunye nokuphuhliswa kwesibindi esilula, esilonda kwi-mucosal.
Iimpawu ze-ulcer Peptic
Isilonda sesigulane sinokubangela iimpawu kwi-digestive tract kodwa abanye abantu abanalo iimpawu. Uphawu oluqhelekileyo luyintlungu ephezulu esiswini (apho isisu sitholakala khona) esinokuvakalelwa okanye sitshisa. Intlungu ihamba ngokukhawuleza, kunye nabanye bafumana ubunzima obubuhlungu kunye nabanye abaneentlungu ezinzima. Uninzi lwangethuba intlungu iya kwenzeka emva kokutya kodwa kwabanye abantu kungenzeka nakusihlwa. Iyakwazi ukuqhubeka kuyo yonke imizuzu embalwa ukuya kwiiyure ezimbalwa.
Ezinye iimpawu zingaphantsi kodwa zingabandakanya i-gas, i-nausea, ukuhlanza, ukulahleka kwesidlo, ukulahleka kwesisindo, kunye nokuziva kupheleleyo emva kokutya okuncinci.
Kwiimeko ezinqabileyo, abantu abanezilonda zamathambo bangabona igazi kwi-stool yabo okanye babe nezitishi ezimnyama kuba ziqulethe igazi. Igazi elivela kwelinye okanye ngaphezulu kwezilonda zezilonda ziyakwazi ukubonakala kumhlanzi.
Ukuchonga i-Peptic Ulcers
Xa iimpawu zesilonda se-peptic zikhoyo, ugqirha angalawula iimvavanyo eziliqela ukuqonda isizathu kunye nokuqinisekisa ukuxilongwa. Kubantu abafumana ii-NSAID zentlungu engapheliyo, ugqirha usenokuba nekrokrelo ephakamileyo ukuba le nto ibangela, okanye igalelo, isifo sesilonda sezilonda. Ngenxa yokuba iyona nto ibangela kakhulu izilonda zamapulpers, ukusulelwa nguHl pylori ngokuqhelekileyo kulawulwa ngaphandle kokusetyenziswa kovavanyo lokuphefumula okanye ukuvavanywa kwesigxina.
Uchungechunge oluphezulu lweGI okanye i- endoscopy ephezulu ingasetyenziswa ukujonga ngaphakathi kwiphepha eliphezulu lokutya kunye nokujonga izilonda. Kwi-GI ephezulu, izigulisi zisela into ebizwa ngokuba yi- barium kunye nohlu lwe-x-ray. I-barium inceda izitho zangaphakathi zibonise kwi-x ray. Ngexesha lokugcina i-endoscopy ityhubhu eguquguqukayo enekhamera isetyenziselwa ukujonga ngaphakathi kwesisu, isisu kunye ne-duodenum. Izigulane zidityaniswe ngeli xesha kunye neengcezu ezincinci (i- biopsy ) zingathathwa kwimbombo yesigxina sokutya ukuze kuqhutywe uvavanyo.
Izinto zobungozi
Zonke i-NSAID zinokubangela ukunyanzeliswa, ukuphuma kwegastric, kunye nezilonda. Nangona kunjalo, abanye abantu banomdla wokuhlakulela isifo sesilonda esiswini kunabanye. Ngokomzekelo, ngelixa uphando lubonisa ukuba abantu abangama-25 ekhulwini kwipesenti zabantu abafumana ii-NSAID eziphezulu ziza kuhlakulela isilonda, kuphela ipesenti zezo zinto ziya kuqhubeka nokuhlakulela iingxaki ezinzulu.
Iingxaki ezinzulu ezivela kwizilonda zezilonda ezibangelwa yi-NSAID zinokwenzeka ukuba zenzeke kubantu aba:
- Bakhulu kunama-65
- Kwakhona uthathe i-corticosteroids
- Usebenzise i-NSAID ngaphantsi kweenyanga
- Yiba nembali yezilonda
- Thatha i-NSAID ye dose ephezulu
- Unentsholongwane kaHl pylori
- Sebenzisa i-aspirin imihla ngemihla (kubandakanywa ne-aspirin ephantsi- ntsholongwane ngenjongo yenhliziyo)
- Kwakhona bathathe i- blood thinners
Ukunyanga ii-Ulcers zePeptic
Ngoku kuyaziwa ukuba ukutya okunesonka kunye noxinzelelo azibanga izilonda. Nangona kunjalo, kukho ezinye iinguqulelo zokuphila ezinokucetyiswa ukwenzela ukukunceda ukuphulukisa izilonda . Ugqirha unokuncoma ukuba isigulane esinezifo zesilonda se-peptic siyeka ukutshaya, siphephe utywala, siphephe i-caffeine, uyeke ii-NSAID, kwaye ugweme nayiphi na enye intlobo yokutya ephazamisayo.
Kwezinye iziganeko unyango lunokumiselwa kwizigulane ezithatha ii-NSAID ukwenzela ukukhusela izilonda ze-peptic ukuba zenzeke kwindawo yokuqala. Izilonda zonyango ze-NSAID zivame ukuphuluza kanye kanye unyango kunye ne-NSAID imisiwe. Ukukhawuleza inkqubo yokuphilisa, ugqirha unokuncoma ukuthatha i-anti-counter-counter-medication. I-antacid, engayifumana ngaphandle kwemithi, inokumiselwa ngenxa yokuba inceda ukuphucula isisu esiswini. Kwezinye iziganeko ze-bismuth subsalicylate (ezifana ne- Pepto-Bismol okanye i-Kaopectate ) ingasetyenziswa kwakhona.
Imishanguzo yesigqirha enokuthi iphakanyiswe iquka i-H2-blocker (i-histamine receptor blocker), ekhusela ukuveliswa kwesisu esiswini ngokukhusela i-histamine, kunye / okanye iproton pump inhibitor (PPI) , eyanciphisa inani le-asidi esiswini. Iimpawu zokukhusela i-Mucosal (i-MPAs) enye iklasi yezilwanyana zonyango ezingasetyenziselwa ukusetyenziswa, kwaye la mayeza asebenza ukugcina umzimba uvelise uhla lwe-mucosal inzuzo esiswini.
Ingxaki enkulu kubantu abafumana isifo sesilonda se-peptic ngenxa yonyango kunye ne-NSAID yindlela yokulawula intlungu xa loo miyeza inqanyulwa. Kwimeko yokubuhlungu okungapheliyo, oku kungadinga uncedo lweqela leengcali, kubandakanywa nogqirha lolawulo lweentlungu. Iklasi lemithi ebizwa ngokuthi i- COX-inhibitors (i-cyclooxygenase inhibitors) ingasetyenziswa ukulawula intlungu kwabanye abantu. I-COX-inhibitors ziye zaboniswa ukuba zisebenzele ukukhululeka kwentlungu kwaye zidibaniswa nemiphumo emibini yecala yokugaya kunezinye iintlobo ze-NSAID. Ezi zi yobisi ziboniswe ukuba zineempembelelo zengqondo, nangona kunjalo, ngoko kudla ngokucetyiswa ukuba zisetyenziswe kwiqondo eliphantsi kakhulu.
Uninzi lwezilonda ziphilisa xa ii-NSAID zivaliwe kodwa kwezinye iimeko zingaphi ukuhlinzwa. Oku kudla njalo xa kukho iingxaki ezinjenge-ulcer, ezifana nokuphuma kwegazi, ukugodla (umngxuma esiswini okanye intlungu encinci), okanye ukuphazamiseka (ukukhutshwa kwamathumbu).
ILizwi
Uninzi lwabantu abathatha ii-NSAID abayi kuba nesifo sesifo sesilonda. Nangona kunjalo, abantu abaneentlungu ezingapheliyo kunye nabafumana amayeza aphezulu ala mayeza kufuneka baqonde ukuba kwenzeka izilonda. Kwezinye iimeko, kunokuba kulungile ukucela ugqirha ukuba kukho iindlela zokuthintela izilonda kwaye ukuba ezo nyathelo kufuneka zenzeke ngelixa zifumana amanqanaba aphezulu e-NSAID. Ngenxa yokuba izilonda ezingaphendulwanga zingakhokelela kwiimeko ezinzima, kubalulekile ukufumanisa unyango kwaye ufumane unyango ngokukhawuleza ukuba isilonda sikhankanywe. Kwiimeko ezininzi izilonda ziya kuphilisa ngokumisa ii-NSAID kunye neempawu zingaphathwa ngeenguqu zendlela yokuphila, kodwa ukusetyenziswa kweeyeza kunye neyeza zokugaya imithi kungasetyenziselwa ukukhawuleza inkqubo. Ukuba ubuhlungu obungapheliyo buyaqhubeka buba ngumngcipheko kwaye kukho umngcipheko wokuphucula izilonda ezinxulumene ne-NSAID, ukujongana nomthombo wentlungu kunye nokusebenza ngophando lweengxaki ukufumana ezinye iindlela zokuphucula iintlungu zibe yinto ekhethekileyo.
> Umthombo:
> Lanza, F, Chan F, Quigley E, et al. "Izikhokelo zokuthintela iingxaki zezilonda ezinxulumene ne-NSAID." Amer J Gastroenterol. 2009; 104: 728-38. INGXELO: 10.1038 / ajg.2009.115.
> Larkai EN, Smith JL, uLidsky MD et al. I-Gastroduodenal mucosa kunye neempawu ze-dyspeptic kwizigulane ze-arthritic ngexesha lokusebenzisa iziyobisi ezingapheliyo. Am J Gastroenterol .1987; 82: 1153-1158.
> Isizwe seSizwe seSifo seswekile kunye neeNtsholongwane zeNtsholongwane kunye neNtsholongwane (iNIDDK). "Iimpawu kunye neengxaki zezilonda zePeptic Ulcers." Amaziko eZiko lezeMpilo ngoNovemba 2014.