Amagqirha amaninzi akholelwa ukuba ukusetyenziswa kwexesha elide leproton-pump inhibitors (PPIs) njenge-Prevacid (lansoprazole) kunye ne-Prilosec (omeprazole) yesifo se-reflux se-gastroesophageal (i-heartburn) inokunyusa i-groritis i-atrophic body (ie, corpus) yesisu-ngokukodwa kubantu abaneHIV pylori . Ingqalelo, ukusuleleka nguHl pylori kunokukhokelela kwizilonda zesisu nangomdlavuza wesisu.
Ukongeza kokuphazamisa ukuxhamla, i-gastritis engapheliyo inokuthi isebenza njengesiqhwala esilungelelaniso okanye esilungelelaniso esichaza umntu kumdlavuza wesisu (oko kukuthi, i-adenocarcinoma).
Ukucinga ukuba ukusetyenziswa kwexesha elide njengamachiza afana ne-Prevacid ne-Prilosec, ngokwenene, kukhokelela kwi-atrophic gastritis kubantu abaneHIV pylori , kwaye ngoko kwandisa ingozi yomhlaza wesibeleko yintoni eya kuba yindlela yokuxhatshazwa?
I-Atrophic Gastritis
I-gastritis engapheliyo i-gastritis i-Chronicly is a long-term inflammation of the stomach lining. Kwenzeka ngokuphindaphindiweyo kubantu asebekhulile kodwa kunokwenzeka nakubantu abancinci, nabo. Kwabantu abaninzi, H. pylori , ibhaktheriya ebangela ukuba izilonda, zibangele i-groritis i-atrophic, nayo. Ezinye izimbangela ze-gastritis ye-atrophic zibandakanya izifo ezizimelayo njenge-anemia ephazamisayo, i-hypersecretion (ukwanda kwe-acid gastric acid secretion), kunye nokusingqongileyo.
I-groritis engapheliyo i-Chronicle iholele ekutshatyalalisweni okukhulu kwee-parietal kunye neeseli eziyinhloko ezivelisa i-acid esiswini kunye ne-enzyme ye-gastric, ngokulandelanayo.
I-asidi ye-gastric kunye ne-enzyme zesisu ziswelekile ukugaya. Xa ezaneleyo zeetyeli zilahlekile, iingxaki ezinxulumene nokugcoba zivela kubandakanya ukungabikho kwe-cobalamin (i-vitamin B12), i-iron-deficiency anemia kunye nezifo ezibangelwa kukutya esikudlayo.
Ubunqongophala be-Vitamin B12 bubona bunzima kakhulu kulezi ngxaki kwaye kunokubangela iingxaki ze-neurological kulabo abane-anemia okanye i-autoimmune.
Kubantu abathatha ii-PPIs ixesha elide, ukulahleka kwe-cobalamin ayinqabile; Noko ke, ukukhutshwa kweentsholongwane kubangele. Ingqalelo, i-acid isisu ibulala amabhaktheriya ekudleni kwethu, kwaye xa kuncinci i-acid esiswini ngenxa ye-PPIs, iibhaktheriya zihlala zintsholongwane kwaye ziyakwazi ukutheleleka kalula.
I-gastritis engapheliyo i-gastritis engapheliyo iyingozi kakhulu kuba ibangela umntu ukuba abe nomhlaza wesantya esichengeni kwaye uyathintela.
Inkqubo ephakanyisiweyo ye-PPI-eyenziwe i-Atrophic Gastritis e-People With H. Pylori
Ii-PPIs ezifana nomsebenzi we-Prevacid kunye ne-Prilosec ngokuvimbela ukuveliswa kwe-acid esiswini. Isifo se-reflux se-Gastroesophageal (GERD okanye "acid reflux") senzeke xa i-sphincter engaphantsi kwe-esophageal ihluleka ukuvaliwe kakuhle, kwaye isisu esiswini esisuka kwisisu siphumela kwisigxu esibangela ukuvalelwa kwintlungu. Nge-asidi encinci ye-acast, le ntliziyo yokuphuza isithintelo.
Xa amanqanaba e-gastric acid eyancipha, i-bile acids iyancibilika. I-bile acids i- chemorepellant , kwaye kwi-distal okanye inxalenye engezantsi yesisu (kufuphi nomathumbu omncinci), ukunyuswa kwengxube ye-bile e-acid acids kwenza ukuba indawo engabonakaliyo ikwazi ukukhula kwe-atrophic-gastritis-eyabangela uHylylori . Nangona kunjalo, ngokukhawuleza okanye phezulu kumzimba wesisu, ii-PPI zenza iimeko ezifanelekileyo zokukhula kukaHl pylori .
Ngokukodwa, iifom ze-gradient ezifanelekileyo phakathi kwe-soluble bile kunye neeseli ze-plasma zee-cell, ezichithwa ngokutsha ; Ngaloo ndlela, iHl pylori i- colonization shifts ukuya kwi-epithelial cell layer.
Ngamanye amazwi, ngokwemiqathango ecetywayo, ukusetyenziswa kwexesha elide lwePPIs kukuphazamisa imeko yechemati yesisu esenza isidumbu sesisu sibe yindawo efanelekileyo ye- HP pylori . I- H. pylori ibterteria yenze ukuba i-atrophic gastritis ebeka phambili kumntu ekuphuhliseni umdlavuza wesisu.
Amachiza afana ne-Prevacid kunye ne-Prilosec atholakala ngokukhawuleza ngaphezu kwe-counter-counter, kwaye abaninzi abantu banamathele ekuziphatheleni ngamachiza. Nangona ii-PPIs zikhuselekileyo kwaye zichanekileyo ekuphatheni i-GERD, ukuba oko kuphakanyiswa nguHl pylori -kusetyenziswe i-atrophic gastritis indlela mhlawumbi ingcinga efanelekileyo ukuba uxoxe nodokotela ngaphambi kokuthatha iiPPIs ixesha elide.
Ngokugqithiseleyo, ugqirha wakho uya kufuna ukuvavanya u- H. pylori ukusuleleka kwaye akuphathise intsholongwane enjalo (oko kukuthi, unyango oluthathu) ngaphambi kokukubeka kwi-PPI yexesha elide.
Ngoku, masiphonse isikhankqalazi samatye kule ngcaciso. Ngomhla wokuhlaziywa kwe-Cochrane ka-2014, abaphandi baqoqa idatha evela kwizilingo ezi-7 zokulawulwa kweengxaki (abachaphazelekayo bezophando-1789) kwaye baqikelela ukuba ii-PPIs azikhulanga umngcipheko we-gastritis kwi-atrophic even among those with H. pylori . Ukuba i-PPIs ayinyuli umngcipheko we-gastritis ye-atrophic, ngoko bekungekho nantoni eqhelekileyo yesikhuhlane esingaza kubeka isigaba somdlavuza wesisu.
ILizwi
Ekugqibeleni, ukuba wena okanye umntu omthandayo unesifo esibuhlungu esiqhubekayo, naphezu kwayo yonke into esiyifumene ngayo ngoku, ingumzekelo omuhle ukubona ugqirha. Vumela ugqirha wakho agqibe isigqibo sokuba unokubeka kwixesha elide le-PPI unyango. (Zivalekile, nangona kunjalo, ukubuza malunga nokuhlolwa kwe- H. pylori kunye nonyango.) Kungenxa yokuba isilwanyana sifumaneka ngokukhawuleza ngaphezu kwe-counter-does not mean that you should take it without consulting a doctor in particular for long periods of time.
> Imithombo:
> Barrett KE. Isahluko 3. IsiGulana sokuSondeza. Ku: Barrett KE. eds. I-Psychostestinal Physiology, 2e. New York, NY: McGraw-Hill; 2014.
> Kitagawa Y, uDempsey DT. Isisu. Ku: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. I-Schwartz Iimigaqo zoPhando, 10e . New York, NY: McGraw-Hill; 2014.
> Mukaisho, K, et al. Indlela yokwenza i-corpus-predominant gastritis emva kwonyango lwe-PPI kwi- Helicobacter Pylori-izigulane ezinokuthi zi-GERD. I-World Journal yeGastroenterology . 2014; 20 (34): 11962-5
> Ingoma, H, Zhu, J, Lu, D. Ixesha elide lokusetyenziswa kweproton pump inhibitor (PPI) kunye nokuphuhliswa kwesilonda esiswini esilungileyo. I-Cochrane Database yeeNkqubo eziPhononongo. 2014.