Kodi Ndili Ndi Mtundu Wotani Wopweteka?

by Kristin Hayes, RN; Adayang'aniranso ndi dokotala wodziwika bwino

Mitundu Yambiri Yopatsirana

Kuthamangitsidwa kwa matenda opatsirana ndi kutupa kwa mimba yanu yomwe ikhoza kuyambitsa chifukwa chowopsa kapena chosachiza. Mphuno yanu ndi thumba lamtima loyendetsa chakudya kuchokera kumtima mwako kupita kumimba. Chifukwa chakuti uli pamtunda wanu, matenda otheka m'magazi amamva ngati kupsinjika mtima ndipo nthawi zambiri amawoneka ndi ululu pamene akumeza. Matenda oopsa kwambiri amayamba pamene mimba yanu yayamba kulonda kapena kuchoka kutali.

Mitundu isanu ndi iwiri yayikulu yotsitsimula imaphatikizapo:

acid reflux
matenda
kumayambitsa matenda
mankhwala operekedwa
zosavuta
mankhwala a chemotherapy ndi mankhwala opangira ma radiation
matenda ovuta

Ngakhale mitundu iyi isanu ndi iŵiri ya matenda opatsirana amakhala ndi zifukwa zazikulu zowonjezera, pali zifukwa zina zochepa zomwe zimayambitsa matenda opatsirana.

Zizindikiro za Esophagitis

Zambiri mwazizindikiro zokhudzana ndi matenda a shuga zingapezekanso m'mabvuto ena ndikuphatikizapo:

kukhumudwa-kungakhale kofanana ndi ululu wamtima m'maganizo a mitsempha yamatenda
ululu ndi kumeza (odynophagia)
vuto lomeza (dysphagia)
kunyoza ndi / kapena kusanza
ululu wamimba
chifuwa
anorexia ndi kuchepa kwa thupi

Malingana ndi zizindikiro zanu ndi mbiri ya zamankhwala, mwinamwake mukufunikira njira imodzi kapena ziwiri zomwe magazi amakoka sizidzathandiza kusiyanitsa zomwe zikuyambitsa zizindikiro zanu. Malinga ndi kafukufuku wanu, dokotala wanu angayambe ndi kuphunzira kwa Barium , yomwe imadziwikanso kuti ikuyerekeza.

Kuti muyambe kuphunzira za Barium, mudzapita ku radiology, kumene dokotala adzatenga x-ray ya mimba yanu pamene mukudya bariamu ndi zakudya zina. The barium amavala oophagus, amene kenako amasonyeza woyera pa x-ray. Izi zidzalola dokotala wanu kuti awone ngati muli ndi zolepheretsa kapena zochepetsedwera mu malo anu.

Kugwiritsidwa ntchito kwa Barium kumathandiza kuthandizira kudziwa ngati dokotala wanu akuyenera kuganizira khansa ngati chifukwa chothetsera zizindikiro zanu. Ngati khansa ikuyendetsedwa, kanema wa CT ingathenso kulamulidwa ngati kupitilira.

Njira ina, yomwe nthawi zina imabwera pambuyo poyesa kugwiritsira ntchito barium, ndikumapeto kwake, komwe kumagwiritsidwa ntchito kuwona khosi lako ndi fiber optic. Chombo chotchedwa endoscopy, chomwe chimatchedwanso esophagogastroduodenoscopy (EGD), chimagwiritsidwa ntchito ngati njira yopezeka kuchipatala, kutanthauza kuti simukusowa kupita kuchipatala usiku wonse. Komabe, mutha kupatsidwa chidziwitso, kotero muyenera kukhala ndi wina woti akuyendetseni panyumba mutatha. Panthawi yamapositiki, gastroenterologist ayang'ana mimba, m'mimba, ndi m'mimba mwathu. Iwo adzayang'ana zizindikiro za kutupa kapena zilonda ndi kuyang'ana kuzindikira zomwe zimayambitsa zizindikiro zanu. Zizindikiro zimayendetsedwa pofuna kufufuza zomwe zimayambitsa matenda.

Reflux Esophagitis

Matenda oterewa amayamba chifukwa cha matenda a reflux a gastroesophageal (GERD) . Anthu ambiri adzalandira zizindikiro za m'mimba. Komabe, mudzakhala ndi chiopsezo chowonjezereka kuti mukhale ndi matenda a shuga ngati mukupezeka nthawi zambiri m'mimba mwa asidi, pepsin (mavitamini m'mimba), ndi bile, chifukwa amatha kutupa ndi zilonda m'mimba yanu.

Ngati muli ndi matenda opatsirana chifukwa cha matenda a reflux, muyenera kuchiritsidwa ndi proton pump inhibitor (PPI), monga Prilosec kapena Dexilant , kwa masabata anayi kapena asanu ndi atatu. Pakatha masabata anayi, dokotala wanu adzayambiranso zizindikiro zanu. Ngati mutakhala ndi vuto lachidziwitso chodziwika ndi matenda opatsirana pogonana omwe ali ndi GERD kapena muli ndi vuto la Barrett, mudzafunika chithandizo chamakono cha PPI.

Matenda Opatsirana Opatsirana

Kuthamangitsidwa kwa matenda kungathe kuchitika chifukwa cha matenda. Ngati muli ndi chitetezo champhamvu choteteza mthupi, mumakhala ndi kachilombo koyambitsa matenda a shuga. Izi zimawoneka kawirikawiri mwa anthu omwe ali ndi matenda a Edzi (immunodeficiency syndromed (AIDS), kuika thupi, kapena anthu omwe athandizidwa ndi chemotherapy kuchiza khansa.

Ngakhale kuti muli ndi chiopsezo chowonjezereka chifukwa cha matenda opatsirana pogonana ngati muli ndi mphamvu yoteteza thupi lanu, mungathe kupeza matenda opatsirana pogwiritsa ntchito chitetezo cha m'thupi. Matenda omwe amachititsa kuti matendawa akhale oopsa:

candida (yisiti) -wowonjezera chifukwa
herpes simplex HIV (HSV)
cytomegalovirus (CMV)
apthous ulceration-amadziwika kuti idiopathic (osadziwika) chilonda

Kuchulukanso kwa matendawa sikutha kusiyanitsa ndi zizindikiro kapena kuwonetseredwa kwa zilonda pa nthawi yopuma. Zilonda zomwe zimapezeka panthawi yopuma nthawi zambiri zimakhala zoyera komanso zachikasu. Kawirikawiri Candida imakhala ngati chipika, pamene HSV kapena CMV ndizovuta kukhala ndi zilonda zam'mimba. Pofuna kudziwa bwino matenda omwe akuchititsa kuti matenda a shuga asokonezeke, dokotala wanu adzalandira "brushings" kapena biopsies ya oophagus.

Ngati mutapezeka kuti muli ndi matenda a candida, ndiye kuti mudzatumizidwa mankhwala odana ndi fungaleni kuti muzitha kuchipatala. Ngati mutapezeka kuti muli ndi kachirombo ka HIV, monga HSV kapena CMV, ndiye dokotala wanu akukupatsani mankhwala oletsa tizilombo toyambitsa matenda. Prednisone ndi mankhwala osankha ngati mwapezeka ndi apthous esophagitis. Chithandizo ndi mankhwala am'malamulo amatha kukhala pakati pa masiku 14 ndi 21.

Caustic Esophagitis

Mafupa oopsa amapezeka pamene mumamwa mankhwala omwe amawotcha. Zida zomwe zimakhala ndi lye, kapena mankhwala ena amadzimadzi, pamene ing'ung'onoting'ono ingayambitse kupsa mtima, zilonda zam'mimba, kapena kupweteka (mabowo kapena misonzi) ya mimba yanu. Kwa ana izi kawirikawiri zimayambitsidwa chifukwa chowopsa . Ngati mukuganiza kuti mwana wanu wasambitsa mankhwala m'nyumba, nthawi zonse mungatchule Kuopsa kwa Poizoni ku (800) 222-1222. Ngati mwana wanu akuvutika kupuma 911 mwamsanga.

Kuvulaza kwa chiwalo chanu chidzakhala chofanana ndi kuchuluka kwa nthawi yomwe mimba yanu inkaonekera ku mankhwala. ngati mutangodziwana pang'ono, mungangokhala ndi mkwiyo. Kuwonetsetsa kwowonjezera kumawonjezera chiopsezo chanu popanga zilonda zam'mimba kapena kuwonongeka koopsa. Kawirikawiri, mufunikira kukhala ndi endoscopy kuti muyese kuwonongeka kwa chiwonongeko cha mimba yanu mkati mwa maola 24.

Ngati mulibe zizindikiro zotsutsa mukatha kumwa mankhwala, mukhoza kuyang'anitsitsa maola angapo. Komabe, ngati muli ndi zizindikiro zowonongeka, muyenera kulandiridwa kuchipatala kuti muthandizidwe.

Mankhwala Osokoneza Mankhwala Amakhudza

Kuthamangitsidwa kwa matenda chifukwa cha mankhwala ndizosowa. Zimangokhala pafupifupi pafupifupi anayi pa anthu 100,000. Mankhwala omwe amachititsa mankhwalawa amatha kuchitika mwachindunji, omwe amawoneka ngati oopsa kwambiri, kapena chifukwa chokhala ndi zotetezera m'mimba komanso m'mimba. Mankhwala omwe ali otsika pH (acidic) ndipo angayambitse mankhwala omwe amachititsa mankhwalawa akuphatikizapo:

maantibayotiki-tetracycline, doxycycline, ndi clindmycin
zowonjezera-ascorbic acid (vitamini C) ndi ferrous sulfate (iron)

Mankhwala a aspirin ndi antisteroidal anti-inflamatory (NSAIDs), monga Ibuprofen, akhoza kusokoneza chitetezo cha mimba ndi m'mimba. Izi zikhoza kuonjezera chiwopsezo chanu choyamba kudwala matenda oopsa. Chithandizo cha mtundu uliwonse wa mankhwala omwe amachititsa kuti mankhwalawa asokonezedwe amakhala osiya mankhwala. Ngati simungathe kuimitsa mankhwala, ndiye dokotala wanu ayesa kuitanitsa kumwa mankhwala.

Kawirikawiri mankhwala omwe amachititsa kuti mankhwalawa asokonezedwe adzathetsa mwamsanga popanda zotsatira zanthawi yaitali ngati kuwonongeka kwaimitsidwa msanga. Kawirikawiri mudzawona kusintha patsogolo masiku angapo.

Ososinophilic Esophagitis

Eosinophilic esophagitis (EoE), ndi yankho lachangu / chitetezo cha mthupi. Kawirikawiri mimba yanu ilibe ma eosinophils, omwe ndi maselo oyera omwe ali mbali ya chitetezo chanu cha mthupi. Ngati EoE akudandaula ndi dokotala wanu, malo osungirako zinthu zakale adzachitidwa ndi gastroenterologist. Pa nthawi yopuma, biopsies idzatengedwera kukayang'ana eosinophils. Ngati magulu a eosinophil amapezeka, mudzatumizidwa kwa wotsutsa kuti muthe kuyesedwa. Kuti zizindikiro zithetsedwe muyenera kuthana ndi kuwonetsa zakudya zomwe zikuyambitsa kuyankhidwa kwanu. Izi zikhoza kuchitika ndi:

kuyesa khungu kansalu -momwemo kuti muyesere zosiyana pa khungu lanu
kuyesa magazi
Njira yowonetsera chakudya kumene imayikidwa m'chipinda chaching'ono cha aluminiyumu (chipinda cha Finn) ndipo chatsekedwa kwa maola 48

Nthawi zina, mumatha kuzindikira zakudya zomwe zimayambitsa kuti musapeze mayesero pamwambapa. Komabe izi sizikhoza nthawi zonse kudziwa zakudya zonse zomwe muyenera kuzipewa. Pachifukwa ichi, dokotala wanu angakulimbikitseni kudya zakudya zowononga chakudya , zomwe zimachotsa zakudya zomwe mumadya. Pomwe zizindikiro zithetsa, mungayambe kukhazikitsa zakudya zowonjezereka mu zakudya zanu mpaka mutakhala ovuta; zomwe kenako zimatchula chakudya chimene muyenera kupewa.

Kuthamangitsidwa Kwambiri kwa Chemotherapy & Radiation Therapy

Kuthamanga kwa matendawa kungayambitse chifukwa cha chemotherapy kapena mankhwala othandizira odwala khansa. Miyezi ingapo ikhoza kufunika kuti machiritso, ngati alipo, atha kuchitika. Chithandizo cha mtundu uwu wa eophagitis chidzachitidwa pogwiritsa ntchito lidocaine ya viscous kuti iwononge chitetezo chako ndi sucralfate, yomwe ndi nthendayi yothandizira kuchiza zilonda zilizonse. Ngati mankhwala a chemotherapy kapena mankhwala owonetsetsa mphamvu a dzuwa amachititsa kuti thupi lanu likhale losasunthika, kapena kuti kuchepa kwa thupi lanu, mungafunikire kuti mukhale ndi mapepala osungirako nthawi kuti muchepetse mayendedwe anu .

Kuthamanga Kwambiri Kulimbana ndi Matenda Otchuka

Ngakhale dokotala wanu akufufuza mbiri yanu chifukwa cha zomwe zimayambitsa matenda anu, amayamba kuganizira ngati muli ndi matenda omwe ali ndi kachilombo koyambitsa matendawa. Pali mitundu yambiri ya matenda omwe angapangitse chiopsezo chanu chokhala ndi matenda a shuga ndipo aliyense ali ndi njira zosiyanasiyana zochizira. Ngakhale kuti corticosteroids, monga Prednisone, imagwiritsidwa ntchito mochiritsira, nthawi zonse muyenera kukambirana njira yabwino yothandizira ndi dokotala wanu. Matenda osiyana omwe angayambitse oophagitis ndi awa:

> Zotsatira:

> Kufikira kuunika kwa akuluakulu a dysphagia. Tsambulani webusaitiyi. http://www.uptodate.com. Idasinthidwa pa October 26, 2017.

> Kupweteka koopsa kwa ana. Tsambulani webusaitiyi. http://www.uptodate.com. Kusinthidwa pa March 1, 2017.

> Eosinophilic Esophagitis (EoE). Sukulu ya American Academy of Allergy, Asthma, ndi Immunology. http://www.aaaai.org/conditions-and-treatments/related-conditions/eosinophilic-esophagitis.

> Kuthamangitsidwa. Webusaiti ya Masewera. https://emedicine.medscape.com/article/174223-overview. Idasinthidwa pa April 27, 2017.

> Graman, PS. (2015). Mandell, Douglas, ndi Malamulo a Bennett ndi Machitidwe Opatsirana Opatsirana, Updated Edition, 99, 1248-1252.e2

> Mankhwala omwe amachititsa kuti magazi asokonezeke. Tsambulani webusaitiyi. http://www.uptodate.com. Idasinthidwa November 8, 2016.