He aha kāu e ʻike ai e pili ana i ka maʻi ʻaʻai koko

Anter

• He aha nā hōʻailona o ka ulcer?
• He aha ke kumu o ka ulcer?
• Helicobacter pylori (H. pylori)
• Nā lāʻau anti-inflammatory nonsteroidal (NSAIDs)
• Nā kumu pilikia hou aʻe
• He aha ka lapaʻau no ka maʻi puʻupuʻu?
• Loaʻa hou mai kahi ulcer
• He aha nā pilikia kūpono?
• Outlook
• ʻO nā kaʻao puʻupuʻu puʻupuʻu

Ulcer hehe

ʻO nā maʻi maʻi peptic he maʻi ʻeha i loko o kāu wahi digestive. Ke loaʻa lākou i loko o kou ʻōpū, ua kapa ʻia lākou he gastric ulcer. Ke loaʻa lākou i ka ʻaoʻao i luna o kou ʻōpū liʻiliʻi, ua kapa ʻia lākou he duodenal ulcer.

ʻAʻole nō i ʻike kekahi poʻe he ulcer lākou. Loaʻa i kekahi poʻe nā ʻōuli e like me ka ʻeha o ka puʻuwai a me ka ʻeha o ka ʻōpū. Hiki i nā ulcer ke lilo i mea weliweli inā perforate lākou i ka ʻōpū a kahe nui paha (i ʻike ʻia he hemorrhage).

E hoʻomau i ka heluhelu ʻana e aʻo hou aʻe e pili ana i nā ʻōuli a me ka mālama ʻana no ka maʻi ulcer, a me ka wehe ʻana i kekahi mau kaʻao ulcer.

He aha nā hōʻailona o ka ulcer?

ʻAʻole pinepine nā ulcer i nā hōʻailona. ʻO ka ʻoiaʻiʻo, ma kahi o hoʻokahi hapahā wale nō o ka poʻe me ka maʻi ulcer e ʻike i nā ʻōuli. ʻO kekahi o kēia mau ʻōuli me:

• abdominal eha
• bloating a i ʻole ka manaʻo o ka piha
• kāʻei
• puʻuwai puʻuwai
• nausea
• ka luaʻi

He ʻokoʻa iki paha nā ʻōuli no kēlā me kēia kanaka. I kekahi mau hihia, hiki i ka ʻai ʻana i ka meaʻai ke hōʻoluʻolu i ka ʻeha. I nā poʻe ʻē aʻe, ʻo ka ʻai ʻana ka mea e ʻino ai nā mea.

Hiki i kahi ulcer ke kahe mālie a ʻike ʻole ʻoe. ʻO nā hōʻailona mua o ka ulcer lohi-kōkō he ʻōuli o ka anemia, e pili pū ana me:

• ʻulaʻula ʻulaʻula
• pōkole o ka hanu me ka hoʻoikaika kino
• nele i ka ikaika
• luhi
• ʻālohilohi

ʻO kahi ulcer e kahe nui ana i ke kahe e kumu:

• ʻōpala i ʻeleʻele a palu hoʻi
• ʻulaʻula ʻulaʻula a ʻulaʻula paha i ke koko i kāu pahu
• ka luaʻi koko me ke kū mau o ka papa kope

ʻO ke kahe wikiwiki mai kahi ulcer kahi hanana hoʻoweliweli. Inā loaʻa kēia mau ʻōuli iā ʻoe, e ʻimi koke i ka lāʻau.

He aha ke kumu o ka ulcer?

Aia kekahi papa o ka mucus i kāu wahi digestive e kōkua ai i ka pale ʻana i ka uhi ʻōpū. Ke nui a nui ʻole ka waikawa a i ʻole lawa ʻole ka mucus, holoi ka waikawa i ka papa o kou ʻōpū a i ʻole kou ʻōpū liʻiliʻi. ʻO ka hopena he ʻeha hāmama i hiki ke kahe.

No ke aha e hiki ʻole ai ke hoʻoholo i kēia. ʻO nā kumu maʻamau ʻelua Helicobacter pylori a me nā lāʻau anti-inflammatory nonsteroidal.

Helicobacter pylori (H. pylori)

H. pylori he koʻohune e noho ana ma loko o ka ʻūhū i loko o ka ʻaoʻao digestive. Hiki iā ia i kekahi manawa ke hoʻonā i ka pale o ka ʻōpū, a hiki i kahi maʻi maʻi. E ʻoi aku paha ka nui o ka makaʻi inā maʻi ʻoe H. pylori a puhi pū kekahi ʻoe.

Nā lāʻau anti-inflammatory nonsteroidal (NSAIDs)

Hana paʻakikī kēia mau lāʻau i kou ʻōpū a me kou ʻōpū liʻiliʻi e pale iā lākou iho mai nā waikawa ʻōpū. Hoʻoemi ka NSAID i ka hiki i kou koko ke kāpili, kahi e hiki ai ke lilo i ka maʻi maʻi hehe ʻoi aku ka weliweli.

Nā lāʻau i loko o kēia hui pū:

• aspirin (Bayer Aspirin, Bufferin)
• ibuprofen (Advil, Motrin)
• ketorolac (Acular, Loaʻa)
• naproxen (Aleve)
• oxaprozin (Daypro)

ʻO Acetaminophen (Tylenol) ʻaʻole he NSAID.

Hoʻokomo pū ʻia ka NSAID i kekahi mau lāʻau hoʻohui e hoʻohana ʻia e mālama ai i ka huhū o ka ʻōpū a i ʻole ke anu. Inā ʻoe e hoʻohana nei i nā lāʻau he nui, aia ka manawa kūpono e lawe ʻoe i nā NSAID he nui aʻe ma mua o kou manaʻo.

ʻOi aku ka makaʻu o ka hoʻomohala ʻia ʻana o kahi ulcer e NSAID inā ʻoe:

• e lawe i kahi kiʻekiʻe ma mua o ka mahele lāʻau maʻamau
• lawe pinepine iā lākou
• inu rama
• he ʻelemakule
• hoʻohana i nā corticosteroids
• ua loaʻa nā ulcer i ka wā i hala

Nā kumu pilikia hou aʻe

ʻO Zollinger-Ellison Syndrome kahi kūlana ʻē aʻe e hiki ai ke alakaʻi i nā maʻi puʻupuʻu. Hoʻokumu ia i nā gastrinomas, a i ʻole nā ​​tumors o nā hunaola hana ʻawa i loko o kou ʻōpū, kahi e hoʻonui ai i ka waikawa.

ʻO kekahi ʻano ulcer ʻano ʻē kāhea ʻia ʻo Cameron's ulcer. Kūpono kēia mau ulcer ke loaʻa i kahi kanaka kahi hinia hernia nui a hana pinepine i ke kahe GI.

He aha ka lapaʻau no ka maʻi puʻupuʻu?

Inā loaʻa iā ʻoe nā hōʻailona maʻi ulcer, e ʻike i kāu kauka. Hiki i ka mālama koke ʻana ke pale i ke kahe nui ʻana a me nā pilikia ʻē aʻe.

Hoʻomaopopo pinepine ʻia nā ulcer ma hope o ka endoscopy GI kiʻekiʻe (EGD a i ʻole esophagogastroduodenoscopy). ʻO kahi endoscope kahi paipu hikiwawe lōʻihi me ke kukui a me ka pahu paʻi kiʻi ma ka hopena. Hoʻokomo ʻia ka paipu i loko o kou ʻāʻī, a laila i ka esophagus, ʻōpū, a me ka hapa luna o ka ʻōpū liʻiliʻi. E aʻo pehea e hoʻomākaukau ai no kahi endoscopy ma aneʻi.

Hana maʻamau ma ke ʻano he hana outpatient, ʻae ia i ke kauka e huli a ʻike i nā pilikia i loko o ka ʻōpū a me ka ʻōpū o luna.

Pono e kamaʻilio wikiwiki ʻia nā ulcer toto, a hiki ke hoʻomaka i ka mālama ʻana i ka endoscopy mua. Inā loaʻa ke kahe ʻana o ka maʻi maʻi mai ka maʻi ulcer i ka manawa o ka endoscopy, hiki i ke kauka ke:

• e hoʻopili pono i ka lāʻau
• cauterize i ka ulcer e hoʻokū i ke kahe
• ʻūmiʻi i ka moku kahe

Inā loaʻa iā ʻoe kahi ulcer, e hoʻāʻo ʻia ʻoe H. pylori. Hiki i kēia ke hana me ka hoʻohana ʻana i kahi kiko kiko i lawe ʻia i ka endoscopy. Hiki ke hoʻokō ʻia me nā hoʻokolohua noninvasive e like me kahi laulau a hoʻāʻo hanu paha.

Inā loaʻa ʻoe i ka maʻi, antibiotics a me nā lāʻau ʻē aʻe hiki ke kōkua i ke kaua ʻana i nā bacteria a hōʻoluʻolu hoʻi i nā ʻōuli. I mea e hemo ai ʻoe, pono ʻoe e hoʻopau i ka lawe ʻana i ka lāʻau e like me ke kuhikuhi ʻana, ʻoiai inā kū kou mau ʻōuli.

Mālama ʻia nā ulcer me nā lāʻau kalaiwa-acid i kapa ʻia nā proton pump inhibitors (PPI) a i ʻole H2 blockers. Hiki iā lākou ke lawe waha ʻia, akā inā loaʻa iā ʻoe kahi maʻi maʻi koko, hiki ke lawe pū ʻia me lākou me ke kino. Hoʻomaʻamaʻa pinepine ʻia nā maʻi maʻi ʻo Cameron me nā PPI, akā e hoʻoponopono hou i ka hernia hiatal.

Inā ʻo kāu ulcer ka hopena o ka lawe ʻana i nā NSAID he nui loa, e hana pū me kāu kauka e loaʻa i kahi lāʻau hou e mālama ai i ka ʻeha.

ʻO nā antacid over-the-counter i kekahi manawa e hōʻoluʻolu i nā ʻōuli. E noi i kāu kauka inā maikaʻi ke lawe i nā antacids.

Loaʻa hou mai kahi ulcer

Pono ʻoe e inu i ka lāʻau no kekahi mau pule. Pono ʻoe e hōʻalo i ka lawe ʻana i nā NSAID i mua.

Inā loaʻa iā ʻoe nā maʻi maʻi kōkō nui, makemake paha kāu kauka e hana i kahi endoscopy i kekahi lā ma hope e ʻike pono ua hoʻōla piha ʻoe a ʻaʻohe ou mau maʻi ʻeha hou aʻe.

He aha nā pilikia kūpono?

Hiki i kahi ulcer untreated ke pehu a i ʻole nā ​​scars ke ālai i kāu wahi digestive. Hiki iā ia ke perforate i kou ʻōpū a i ʻole kou ʻōpū liʻiliʻi, e hoʻopili ana i kou kōpū ʻōpū. ʻO ia ke kumu o kahi kūlana i ʻike ʻia ma ke ʻano he peritonitis.

Hiki i kahi ulcer kahe ke alakaʻi i ka anemia, ka luaʻi koko, a i ʻole nā ​​noho koko. ʻO ka maʻi ulcer kahe ka hopena ma kahi noho haukapila. Hoʻoweliweli ke ola i nā kahe kūloko. Perforation a i ʻole ke kahe ʻana i ke kahe e koi paha i ke komo ʻana o ka lāʻau.

Outlook

Hiki ke mālama kūleʻa i nā ulcer, a hoʻōla maikaʻi ka hapa nui o ka poʻe. Ke mālama ʻia me nā lāʻau ʻalopika a me nā lāʻau ʻē aʻe, ʻo ka helu kūleʻa 80 a 90 pakeneka.

E maikaʻi wale nō ka hoʻomaʻamaʻa inā lawe ʻoe i kāu lāʻau āpau e like me ke kauoha. ʻO ka puhihihi ʻana a me ka hoʻomau ʻana o ka hoʻohana ʻana i nā NSAID e hoʻopilikia i ka hoʻōla. Eia kekahi, kekahi mau kānana o H. pylori kūpaʻa antibiotic, hoʻopilikia i kāu kuana wā lōʻihi.

Inā hoʻokau ʻia ʻoe ma ka haukapila ma muli o ke kahe kahe o ke kahe, e pili ana ka helu make ma 30 mau lā. ʻO ka makahiki, ke kahe hou ʻana, a me ka comorbidity nā kumu i kēia hopena. ʻO nā wānana nui no ka make make lōʻihi lōʻihi me:

• ʻelemakule
• comorbidity
• anemia koʻikoʻi
• hoʻohana paka
• he kāne

ʻO nā kaʻao puʻupuʻu puʻupuʻu

Nui a hewahewa nā ʻike e pili ana i ka ulcer, me ke kumu o lākou. No kekahi manawa lōʻihi, ua manaʻo ʻia nā maʻi puʻupuʻu ma muli o:

• hoʻoluhi
• hopohopo
• hopohopo
• he papaʻai momona
• mea ʻai ʻona a ʻakika paha

Ua aʻo ʻia ka poʻe me ka maʻi puʻupuʻu e hana i nā loli nohona e like me ka hōʻemi ʻana i ke koʻikoʻi a me ka lawe ʻana i ka papa ʻai bland.

Ua loli kēlā i ka manawa H. Pylori ua ʻike ʻia ma 1982. Hoʻomaopopo nā kauka i kēia manawa ʻoiai ʻo ka papaʻai a me ka nohona e hiki ai ke hoʻonāukiuki i nā maʻi ʻeha e kū nei i kekahi poʻe, ʻo ka mea maʻamau ʻaʻole lākou i kumu i ka maʻi maʻi. ʻOiai ke koʻikoʻi hiki ke hoʻonui i ka waikawa ʻōpū i mea e hoʻonāukiuki ai i ka mucosa gastric, ʻaʻole paʻakikī ke koʻikoʻi ke kumu nui o kahi ulcer. ʻO kahi ʻokoʻa i loko o kēlā me kēia kanaka i maʻi nui, e like me nā mea ma kahi haukapila mālama maʻi koʻikoʻi.

ʻO kekahi kaʻao lōʻihi ʻē aʻe he maikaʻi ka inu ʻana i ka waiū no nā ulcer. ʻO ia paha no ka pale ʻana o ka waiū i ka uhi ʻana o kou ʻōpū a hoʻomaha i ka maʻi ulcer, ma ka liʻiliʻi no kahi manawa pōkole. Minamina, paipai ka waiū i ka hana ʻana i nā wai ʻakika a me nā meaʻai digestive, ka mea e ʻoi aku ka maikaʻi o ka ulcer.