ʻO ka maʻi Helicobacter pylori

Helicobacter pylori (H pylori) he ʻano bacteria i hoʻopili i ka ʻōpū. He mea maʻamau ia, e pili ana i ʻelua hapakolu o ko ka honua heluna. H pylori ʻo ka maʻi ke kumu pinepine o nā ulcer peptic. Eia naʻe, ʻaʻole pilikia ka maʻi i ka hapanui o ka poʻe.

H pylori Hoʻoholo pololei ʻia nā bacteria mai kekahi kanaka a kanaka. Kūpono kēia i ka wā kamaliʻi. Noho ka maʻi i loko o ke ola inā ʻaʻole mālama ʻia.

ʻAʻole maopopo pehea ka hāʻawi ʻia ʻana o nā bacteria mai kekahi kanaka a i kekahi. Pāhola paha nā bacteria mai:

• Hoʻopaʻa waha-waha
• Maʻi maʻi GI (ʻoiai ke lūlū ʻia)
• Kāhea aku me ka pahu (fecal material)
• Mea ʻai hoʻohaumia a me ka wai

Hiki i nā bacteria ke hoʻoulu i nā ulcer i ke ala aʻe:

• H pylori komo i ka papa mucus o ka ʻōpū a hoʻopili i ka uhi o ka ʻōpū.
• H pylori hana i ka ʻōpū e hoʻohua i ka waikawa ʻōpū. Hoʻopilikia kēia i ka uhi ʻana o ka ʻōpū, hiki i ka maʻi ulcer i kekahi poʻe.

Ma waho aʻe o ka ulcer, H pylori Hiki i nā bacteria ke hoʻoulu i ka mumū mau i loko o ka ʻōpū (gastritis) a i ʻole ka ʻaoʻao kiʻekiʻe o ka ʻōpū liʻiliʻi (duodenitis).

H pylori hiki i kekahi manawa ke alakaʻi i ka maʻi ʻaʻai ʻōpū a i ʻole kekahi ʻano ʻano o ka ʻōpū lymphoma.

Ma kahi o 10% a 15% o ka poʻe i loaʻa i nā maʻi H pylori ulu i ka maʻi ulcer peptic. 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 a ʻeha paha i loko o kou ʻōpū kahi hōʻailona maʻamau. ʻOi aku paha ka ʻeha me ka ʻōpū hakahaka. Hiki ke ʻokoʻa ka ʻeha mai kekahi kanaka a i kekahi, a ʻaʻohe ʻeha o kekahi poʻe.

ʻO nā ʻōuli ʻē aʻe e like me:

• ʻIke o ka piha a bloating paha a me nā pilikia e inu ana i ka nui o ka wai e like me ka maʻamau
• Pōloli a me ka manaʻo hakahaka i loko o ka ʻōpū, 1 mau a 3 mau hola ma hope o ka pāʻina ʻana
• Mānā huhū e hele pū paha me ka luaʻi
• Loaʻa ka ʻai ʻole
• Ka hoʻemi kaumaha me ka hoʻāʻo ʻole
• ʻŌhumu
• Koko a ʻeleʻele paha, noho humu a me nā luaʻi koko

E hoʻāʻo kāu kauka olakino iā ʻoe no H pylori inā 'oe:

• Loaʻa i nā peptic peptic a i ʻole ka moʻaukala
• Loaʻa ka hōʻoluʻolu a me ka ʻeha i loko o ka ʻōpū e ʻoi aku ana ma mua o hoʻokahi mahina

E haʻi i kāu mea hoʻolako e pili ana i nā lāʻau āu e lawe ai. Hiki i nā lāʻau anti-inflammatory nonsteroidal (NSAIDs) ke hana pū i nā ulcer. Inā ʻoe e hōʻike i nā ʻōuli o ka maʻi, e hana paha ka mea hāʻawi ma hope o nā hoʻokolohua no H pylori. Pākuʻi ʻia kēia mau mea:

• Hōʻike hanu - Hōʻike hanu urea (Carbon Isotope-urea Breath Test, a i ʻole UBT). E hoʻolilo kāu mea hāʻawi iā ʻoe e ale i kahi mea kūikawā i loaʻa ka urea. Inā H pylori aia i kēia manawa, hoʻolilo ka bacteria i ka urea i carbon dioxide. Kuhi ʻia kēia a hoʻopaʻa ʻia i kou hanu i hoʻokuʻu ʻia ma hope o 10 mau minuke.
• Hōʻaʻo koko - ana i nā meaʻaeʻa i H pylori i kou koko.
• Hōʻike moʻo noho - huai ae i ke alo o nā koʻohune i loko o ka pahu.
• ʻO Biopsy - ho'āʻo i kahi kiko kiko i lawe ʻia mai ka pale o ka ʻōpū e hoʻohana ana i ka endoscopy. Nānā ʻia ka laʻana no ka maʻi bacteria.

I mea e hōʻola ai kou maʻi maʻi a hoʻoliʻiliʻi i ka manawa e hoʻi ai ia, hāʻawi ʻia nā lāʻau iā ʻoe:

• Pepehi i ka H pylori koʻohune (inā loaʻa)
• E hoʻemi i nā kiʻekiʻe o ka acid i loko o ka ʻōpū

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

Inā loaʻa iā ʻoe kahi peptic ulcer a me kahi H pylori maʻi maʻi, paipai ʻia ka lapaʻau. Hoʻopili ka mālama maʻamau i nā hui like ʻole o nā lāʻau aʻe no 10 a 14 mau lā:

• Nā Antibiotics e pepehi H pylori
• ʻO nā mea pale lāʻau Proton e kōkua i ka hoʻohaʻahaʻa i nā pae ma ka ʻōpū
• Hiki ke hoʻohui ʻia ʻo Bismuth (ka mea nui i Pepto-Bismol) e kōkua ai i ka luku ʻana i ka bacteria

ʻAʻole maʻalahi ka lawe ʻana i kēia mau lāʻau āpau a 14 mau lā. Akā ke hāʻawi nei iā ʻoe i ka manawa kūpono loa no ka hemo ʻana o ka H pylori koʻohune a me ka pale ʻana i nā ulcer i ka wā e hiki mai ana.

Inā ʻoe e lawe i kāu lāʻau, loaʻa ka manawa kūpono i ka H pylori e hoʻōla ʻia ka maʻi. E emi iki ana paha kāu loaʻa ʻana i kahi ulcer hou.

I kekahi manawa, H pylori hiki ke paʻakikī e hoʻōla piha. Pono paha i mau papa hana hou o nā ʻano lāʻau like ʻole. E hana ʻia kahi biopsy ʻōpū i kekahi manawa e hoʻāʻo i ka germ e ʻike i kahi antibiotic e holo pono paha. Hiki i kēia ke kōkua i ke alakaʻi ʻana i ka lapaʻau e hiki mai ana. I kekahi mau hihia, H pylori ʻaʻole hiki ke hoʻōla ʻia me kekahi therapy, ʻoiai e hiki ke hoʻoliʻiliʻi ʻia nā ʻōuli.

Inā hoʻōla ʻia, hiki i ka reinfection i nā wahi kahi e maikaʻi ʻole ai nā kūlana hoʻomaʻemaʻe.

ʻO kahi maʻi wā lōʻihi (mau) me H pylori hiki ke alakaʻi iā:

• Maʻi maʻi peptic
• Pāhū mau
• Gastric a me luna ulcer ʻōpū
• Maʻi ʻaʻai ʻōpū
• Gastric mucosa-pili lymphoidʻaʻaʻa (MALT) lymphoma

Hiki i nā pilikia ʻē aʻe ke:

• 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

ʻO nā ʻōuli koʻikoʻi e hoʻomaka koke e hōʻike i kahi blockage i loko o ka ʻōpū, perforation, a i ʻole hemorrhage, nā mea āpau āpau. Pākuʻi ʻia paha nā ʻōuli:

• Pākuʻi, ʻeleʻele, a i ʻole nā ​​noho koko
• Ka luaʻi nui, i hiki ke hoʻopili ʻia i ke koko a i ʻole kahi mea me ke ʻano o nā papa kope (kahi hōʻailona o ka hemorrhage koʻikoʻi) a i ʻole nā ​​ʻōpū āpau (kahi hōʻailona o ke kahakaha ʻana o ka ʻōpū)
• ʻEha nui o ka ʻōpū, me ka luaʻi ʻole a i ʻole ka hōʻike o ke koko

ʻO ka mea loaʻa kekahi o kēia mau hōʻailona pono e hele koke i ka lumi pilikia.

Maʻi H pylori

• ʻŌpū
• ʻO Esophagogastroduodenoscopy (EGD)
• Nā Antibodies
• Kahi o nā peptic ulcer

Uhi TL, Blaser MJ. Helicobacter pylori a me nā ʻano ʻōpū Helicobacter gastric In: Bennett JE, Dolin R, Blaser MJ, eds. 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.

Ku GY, Ilson DH. Kanesa o ka ʻōpū. I: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. ʻO Oncology Clinical ʻo Abboff. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2020: chap 72.

Morgan DR, Crowe SE. ʻO ka maʻi Helicobacter pylori. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 51.