Ulcer peptic

ʻO kahi ulcer peptic kahi ʻeha ākea a maka maka paha i ka pale o ka ʻōpū a i ʻole ka ʻōpū.

ʻElua ʻano o ka peptic ulcer:

• Gastric ulcer - hiki i ka ʻōpū
• Ula Duodenal - hiki i ka ʻāpana mua o ka ʻōpū liʻiliʻi

ʻO ka maʻamau, hiki i ka pale o ka ʻōpū a me nā ʻōpū liʻiliʻi ke pale iā ia iho i nā waikawa ʻōpū ikaika. Akā inā ua haki ka uhi, ʻo ka hopena paha:

• Pehu a me ka inflamedʻaʻaʻa (gastritis)
• He ulcer

ʻO ka hapa nui o nā ulcer i ka papa mua o ka uhi o loko. Kapa ʻia kahi puka ma ka ʻōpū a i ʻole duodenum kahi perforation. He pilikia olakino kēia.

ʻO ke kumu maʻamau o ka ulcer ka maʻi o ka ʻōpū e nā bacteria i kāhea ʻia Helicobacter pylori (H pylori). ʻO ka hapa nui o ka poʻe me nā maʻi peptic loaʻa kēia mau koʻohune e noho nei i kā lākou wahi digestive. Eia nō naʻe, ʻaʻole nui ka poʻe i loaʻa kēia mau koʻohune i loko o ko lākou ʻōpū e hoʻomohala i kahi maʻi maʻi.

ʻO nā kumuhana aʻe e hāpai i kou makaʻi no nā ulcer peptic:

• Ke inu nui nei i ka waiʻona
• Hoʻohana mau o ka aspirin, ibuprofen, naproxen, a i ʻole nā ​​lāʻau anti-inflammatory nonsteroidal (NSAIDs)
• Puhi paka a me ka nau ʻana i ka paka
• Ke maʻi nui nei, e like me ka mea ma ka mīkini hanu
• Nā mālama uila
• Kaumaha

ʻO kahi ʻano laha ʻole, i kapa ʻia ʻo Zollinger-Ellison Syndrome, ke kumu o ka ʻōpū a me nā maʻi maʻi duodenal.

ʻAʻole hiki i nā ulcer liʻiliʻi ke hana i kekahi ʻōuli. Hiki i kekahi mau ulcer ke kumu i ke kahe nui.

ʻO ka ʻeha o ka ʻōpū (pinepine i ka waena waena-ʻōpū) kahi hōʻailona maʻamau. Hiki ke ʻokoʻa ka ʻeha mai kekahi kanaka a i kekahi. ʻAʻohe ʻeha o kekahi poʻe.

Hana ʻia ka ʻeha:

• I ka ʻōpū luna
• I ka pō a hoʻāla iā ʻoe
• Ke ʻike ʻoe i kahi ʻōpū nele, pinepine ka 1 a i ka 3 mau hola ma hope o ka pāʻina ʻana

ʻO nā ʻōuli ʻē aʻe e like me:

• ʻO ka manaʻo o ka piha a me nā pilikia e inu ana i ka nui o ka wai e like me ka maʻamau
• Nusea
• ʻO ka luaʻi
• Koko a ʻeleʻele paha, noho aliʻi
• ʻEha ʻeha
• Ka luhi
• Komo, koko paha
• Kaumaha emi
• ʻBurnpuʻu puʻuwai e mau nei

No ke kuhikuhi ʻana i kahi ulcer, pono ʻoe i kahi hoʻokolohua i kapa ʻia he endoscopy luna (EGD).

• He hoʻāʻo kēia e nānā i ka uhi o ka paipu meaʻai, ʻōpū, a me ka ʻāpana mua o ka ʻōpū liʻiliʻi.
• Hana ʻia me kahi kāmela liʻiliʻi (endoscope maʻalahi) i hoʻokomo ʻia i lalo i ka ʻāʻī.
• Pono kēia ho'āʻo pinepine i ka sedation i hāʻawi ʻia ma o ke aa.
• I kekahi mau hihia, hoʻohana ʻia paha kahi endoscope liʻiliʻi i lilo i loko o ka ʻōpū ma o ka ihu. ʻAʻole koi kēia i ka sedation.

Hana ʻia ʻo EGD ma ka hapanui o ka poʻe ke manaʻo ʻia nā maʻi maʻi peptic a i ʻole iā ʻoe.

• Helu koko haʻahaʻa (anemia)
• Pilikia i ka ale ʻana
• Luai kōkō
• ʻO nā noho noho koko a ʻeleʻele a lohi hoʻi
• Ua lilo kaupaona me ka hoʻāʻo ʻole
• ʻO nā mea i ʻike ʻia e hāpai i ka hopohopo no ka maʻi ʻaʻai i loko o ka ʻōpū

Pono pū ka hoʻāʻo ʻana no H pylori. Hiki i kēia ke hana ʻia e ka biopsy o ka ʻōpū i ka manawa o endoscopy, me kahi hōʻike stool, a i ʻole me kahi hōʻike hanu urea.

Nā hoʻokolohua ʻē aʻe āu i loaʻa:

• Hōʻike koko Hemoglobin e nānā no ka anemia
• ʻO ka hoʻāʻo ʻana i ke koko hoʻokalakupua e hoʻāʻo no ke koko i kāu pahu

I kekahi manawa, pono ʻoe i kahi hoʻokolohua i kapa ʻia ʻo ka papa GI kiʻekiʻe. Lawe ʻia kahi moʻo o nā x-ray ma hope o kou inu ʻana i kahi mea mānoanoa i kapa ʻia ʻo barium. ʻAʻole koi kēia i ka sedation.

E paipai kāu mea mālama ola i nā lāʻau e hoʻōla i kou maʻi maʻi a pale i ka hoʻi hou ʻana. ʻO nā lāʻau:

• Pepehi i ka H pylori koʻohune, inā aia.
• E hoʻemi i nā kiʻekiʻe o ka acid i loko o ka ʻōpū. Hoʻopili kēia i nā mea pale H2 e like me ranitidine (Zantac), a i ʻole kahi mea hoʻopihapiha proton pump (PPI) e like me pantoprozole.

E lawe i kāu mau lāʻau āpau e like me ka mea i haʻi ʻia iā ʻoe. Hiki ke kōkua i nā hoʻololi ʻē aʻe i kou nohona.

Inā loaʻa iā ʻoe kahi peptic ulcer me kahi H pylori maʻi, ka hoʻohana maʻamau maʻamau i nā hui like ʻole o nā lāʻau aʻe no 7 a 14 mau lā:

• ʻElua mau antibiotic ʻokoʻa e pepehi H pylori.
• ʻO nā PPI e like me omeprazole (Prilosec), lansoprazole (Prevacid), a i ʻole esomeprazole (Nexium).
• Hiki ke hoʻohui ʻia ʻo Bismuth (ka mea nui i Pepto-Bismol) e kōkua ai i ka luku ʻana i ka maʻi bacteria.

E lawe paha ʻoe i kahi PPI no 8 mau pule inā:

• Loaʻa iā ʻoe kahi maʻi ulcer me ka ʻole o H pylori maʻi maʻi.
• Hoʻokumu ʻia kāu ulcer e ka lawe ʻana i ka aspirin a i ʻole nā ​​NSAID.

Kauoha paha kāu mea hāʻawi i kēia ʻano lāʻau inā hoʻomau ʻoe i ka lawe ʻana i ka aspirin a i ʻole nā ​​NSAID no nā kūlana olakino ʻē aʻe.

ʻO nā lāʻau ʻē aʻe i hoʻohana ʻia no nā maʻi puʻupuʻu:

• ʻO Misoprostol, kahi lāʻau i hiki ke kōkua i ka pale ʻana i nā maʻi puʻupuʻu i ka poʻe e lawe i nā NSAID i kēlā me kēia manawa
• Nā lāʻau lapaʻau e pale ai i ka uhi o kaʻiʻo, e like me sucralfate

Inā he nui ke kahe o ka peptic ulcer e pono ai, pono paha kahi EGD e hōʻoki i ke kahe. Nā hana i hoʻohana ʻia e hōʻoki i ke kahe ʻana o ke koko:

• Hoʻokomo i ka lāʻau i ka ulcer
• Ke noi ʻana i nā kaha metala a i ʻole hoʻomehana wela i ka ulcer

Pono paha ke ʻoki kino inā:

• ʻAʻole hiki ke hoʻokau ʻia ka hele ʻana me ka EGD
• Ua hana ka ulcer i kahi waimaka

Peptic ulcer mālama i ka hoʻi inā untreated. Aia kahi manawa kūpono i ka H pylori e hoʻōla ʻia ka maʻi inā lawe ʻoe i kāu lāʻau a hahai i ka ʻōlelo aʻoaʻo a kāu mea hāʻawi. E emi iki ana paha kāu loaʻa ʻana i kahi ulcer hou.

Komo pū nā pilikia:

• Kahe nui o ke koko
• ʻO ka scarring mai kahi ulcer ka mea e paʻakikī ai ka hakahaka o ka ʻōpū
• Perforation a i ʻole puka o ka ʻōpū a me nā ʻōpū

E kiʻi koke i ke kōkua lapaʻau inā ʻoe:

• Hoʻoulu i ka ʻeha o ka ʻōpū hōʻeha
• E loaʻa i kahi ʻōpū ʻoʻoleʻa, paʻakikī e palupalu e hoʻopā
• Loaʻa nā ʻōuli o ka pīhoihoi, e like me ka maʻule ʻana, ka sweating nui, a huikau paha
• Lipi ke koko a i ʻole he koko i loko o kāu pahu (ʻoiaʻiʻo inā he poni a ʻeleʻele, ʻeleʻele lōʻihi)

Kāhea i kāu mea hāʻawi inā:

• Pīhoihoi ʻoe a uila ʻole paha.
• Loaʻa iā ʻoe nā hōʻailona ulcer.

Hōʻalo i ka aspirin, ibuprofen, naproxen, a me nā NSAID ʻē aʻe. E hoʻāʻo i ka acetaminophen ma kahi. Inā pono ʻoe e lawe i nā lāʻau, e kamaʻilio mua i kāu mea hāʻawi. Hiki i kāu mea hāʻawi ke:

• E hoʻāʻo iā ʻoe no H pylori ma mua o kou lawe ʻana i kēia mau lāʻau
• E noi iā ʻoe e lawe i nā PPI a i ʻole kahi blocker acid H2
• Kauoha i ka lāʻau i kapa ʻia misoprostol

ʻO nā loli nohona e hiki ke kōkua i ka pale ʻana i nā maʻi maʻi peptic:

• MAI Puhi paka, ʻaʻole nau i ka paka.
• Hōʻalo i ka ʻalekohola.

Ulcer - peptic; Ulcer - duodenal; Ulcer - ʻōpū; Ulia Duodenal; Gastric ulcer; Dyspepsia - ulcer; Ulcer hehe; Kahe koko - Gastrointestinal kahe - peptic ulcer; Gastrointestinal hemorrhage - peptic ulcer; ʻO G.I. kahe - peptic ulcer; H. pylori - peptic ulcer; Helicobacter pylori - peptic ulcer

• Lawe i nā antacids

• Nā ulia pōpilikia ulcer
• Nā hana Gastroscopy
• Kahi o nā peptic ulcer
• Kumu o ka peptic ulcer
• ʻO ka maʻi ʻōpū a i ʻole trauma

ʻO Chan FKL, Lau JYW. Maʻi maʻi peptic I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 53.

Uhi TL, Blaser MJ. Helicobacter pylori a me nā ʻōpū ʻōpū Helicobacter ʻano laha. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 217.

Lanas A, Chan FKL. Maʻi maʻi peptic Lancet. 2017; 390 (10094): 613-624. PMID: 28242110 www.pubmed.ncbi.nlm.nih.gov/28242110/.