Odokotela abaningi bakholelwa ukuthi ukusetshenziswa kwesikhathi eside kweproton-pump inhibitors (PPIs) njenge-Prevacid (lansoprazole) ne-Prilosec (omeprazole) ye- reflux isifo somzimba ( isifo senhliziyo ) singasusa isisu somzimba esiswini (okungukuthi, corpus) esiswini-ikakhulukazi kubantu abane- H. pylori ukutheleleka. Inothi, ukutheleleka ngeHypylori kungaholela ezilonda zesisu ngisho nomdlavuza wesisu.
Ngaphandle kokuphazamisa ukumuncwa, i-atrophic gastritis engapheli kungenzeka isebenza njengesilonda esiphezulu noma esingenqandekile esenza umuntu abe nomdlavuza wesisu (okungukuthi, i-adenocarcinoma).
Ucabanga ukuthi ukusebenzisa isikhathi eside imithi efana ne-Prevacid no-Prilosec, empeleni, kuholela ekuguleni kwe-atrophic kubantu abane- Hplori ukutheleleka, futhi ngaleyo ndlela kwandisa ingozi yomdlavuza wesisu kungabe kuyindlela yokwenza lokho kunzima?
I-Atrophic Gastritis engapheli
I-gastritis engapheli i-atrophic gastritis ivuvukala isikhathi eside sokugqoka isisu. Kwenzeka kaningi kakhulu kubantu asebekhulile kepha kungenzeka kubantu abasha, futhi. Kubantu abaningi, H. pylori , amabhaktheriya aphinde abangele izilonda, abangela i-atrophic gastritis, futhi. Ezinye izimbangela ze-gastritis ye-atrophic zifaka isifo se-autoimmune njenge-anemia esesimweni esibi, ukukhulelwa ngokweqile (ukwanda kwesisu se-gastric acid) kanye nemvelo.
I-atrophic gastritis engapheli iholela ekubhujisweni okukhulu kwama-parietal kanye namangqamuzana asemqoka akhiqiza i-asidi esiswini kanye ne-enzymes esiswini, ngokulandelana.
I-gastric acid ne-enzyme esiswini kuyadingeka ukugaya. Lapho okwanele kulawa maseli elahlekile, izinkinga ezihlobene nokugaya zivela kuhlanganise nokuntuleka kwe-cobalamin (i-vitamin B12), ukutholakala kwe-iron anesia kanye nokutheleleka okubangelwa ukudla esikudlayo.
Ukuntuleka kwe-Vitamin B12 yinkinga enkulu kunazo zonke kulezi zinkinga futhi kungabangela izinkinga zezinzwa kulabo abane-anemia ephazamisayo noma isifo se-autoimmune.
Kubantu abathatha ama-PPIs isikhathi eside kakhulu, ukuntuleka kwe-cobalamin akuvamile; Kodwa-ke, ukutheleleka kokutheleleka kwebhaktheriya kwanda. Inothi, i-asidi esiswini ibulala amabhaktheriya ekudleni kwethu, futhi uma kune-asidi esiswini encane ngenxa ye-PPIs, ama-bacteria ahlala enamandla futhi angakwazi ukuthelela kalula.
I-atrophic gastritis engapheli iyinkimbinkimbi kakhulu ngoba ibeka umuntu emdlalweni wesifo somdlavuza obulala isisu esibulalayo futhi unomsoco omnyama.
Imiklamo ehlongozwayo ye-Atrophic Gastritis eyenziwe yi-PPI e-People With H. Pylori
Ama-PPI afana nomsebenzi we-Prevacid no-Prilosec ngokuvimbela ukukhiqizwa kwe-asidi esiswini. Isifo se-reflux se-gastroesophageal (i-GERD noma "i-reflux acid") senzeke uma i-sphincter ephansi engaphansi kwe-esophageal ihluleka ukuvalelwa kahle, futhi i-asidi esiswini esisuka esiswini ifike emgodleni obangela ukuzwa kwenhliziyo. Nge-acid encane encane, le nzwa yokuphuza isisu iyancipha.
Uma amazinga we-gastric acid ehla, ama-bile acids ayenamathele kakhulu. Ama-acide e-bile ayimvelo , futhi engxenyeni ye-distal noma ephansi yesisu (eduze kwe-intestine encane), ukuhlushwa kwe-bile e-bile acids kwenza imvelo ingabonakali ekukhuleni kwe-atrophic-gastritis-eyabangela i- H . pylori . Kodwa-ke, cishe noma ngaphezulu kakhulu emzimbeni wesisu, ama-PPI enza izimo ezihle ekukhuleni kukaHl pylori .
Ngokuqondile, amafomu ama-gradient aphezulu phakathi kwe-bile enama-plasma amangqamuzana e-plasma, awakwazi ukuhlaziya ; Ngakho-ke, uHl pylori ukushintshaniswa kwamakoloni ku-epithelial cell layer.
Ngamanye amazwi, ngokuvumelana nale ndlela ehlongozwayo, ukusetshenziswa kwesikhathi eside kwama-PPI kuphazamisa isimo semikhemikhali yesisu esisenza isidumbu sesisu sibe yindawo ekahle ye- H. pylori bacteria. Lokhu i- H. H. pylori amabhaktheriya bese kubangela i-atrophic gastritis ebeka phambili umuntu ekuthuthukiseni umdlavuza wesisu.
Imithi efana ne-Prevacid ne-Prilosec itholakale kalula phezu kwe-counter, kanti abantu abaningi bathambekele ekuziphatheni ngemithi.Nakuba ama-PPI ngokuvamile ephephile futhi ephumelela kakhulu ekunakekeleni i-GERD, uma lokhu kuhlongozwa uH. pylori- kusetshenziselwa indlela ye-atrophic gastritis kuyiqiniso, khona-ke kungaba umqondo omuhle ukuba uxoxe nodokotela ngaphambi kokuthatha ama-PPIs isikhathi eside.
Ngokuqondile, udokotela wakho uzokufuna ukukuhlola ukutheleleka kwe-H. pylori futhi akuphathe ngokutheleleka okunjalo (okungukuthi, ukwelapha kathathu) ngaphambi kokukubeka ekwelapheni kwe-PPI yesikhathi eside.
Manje, ake siphonse isikhala semonkey kule ncazelo. Ngomhlahlandlela we-Cochrane ka-2014, abacwaningi baqoqa idatha kusuka kuzilingo eziyisikhombisa zokulawula (ngezibalo eziyi-1789 abahlanganyeli) futhi bacabanga ukuthi ama-PPIs awazange akhulise ingozi ye-gastritis ye-atrophic ngisho nalabo abane-H. pylori ukutheleleka . Uma ama-PPIs engakhulisi ingozi ye-gastritis ye-atrophic, khona-ke bekungeke kube ne-lesion eqondile eqondile engabeka kamuva isiteleka somdlavuza wesisu.
Izwi elivela
Ekugcineni, uma wena noma omunye umuntu omthandayo enesifo esibi kakhulu esiqhubekayo, naphezu kwakho konke esikuthumele kuze kube manje, kuyinto enhle ukubona umbono odokotela. Vumela udokotela wakho anqume ukuthi angakubeka yini ukwelashwa kwe-PPI yesikhathi eside. (Kodwa-ke, yizwa ukhululekile ukubuza mayelana nokuhlolwa kwe-H. pylori nokwelashwa.) Kungenxa yokuthi imithi itholakale kalula phezu kwe-counter akusho ukuthi kufanele uyithathe ngaphandle kokubonisana nodokotela ikakhulukazi isikhathi eside.
> Imithombo:
> Barrett KE. Isahluko 3. Isivinini se-Gastric Secretion. Ku: Barrett KE. ama-eds. I-Physiology yamathumbu, 2e. ENew York, NY: McGraw-Hill; 2014.
> Kitagawa Y, Dempsey DT. Isisu. Ku: Brunicardi F, Andersen DK, B Billiar, Dunn DL, Hunter JG, Matthews JB, Pollock RE. ama-eds. Izimiso Zokuhlinza Schwartz, 10e . ENew York, NY: McGraw-Hill; 2014.
> Mukaisho, K, et al. Inqubo engase ibe ne-corpus-predominant gastritis ngemuva kokwelashwa kwe-PPI ku- Helicobacter Pylori- iziguli eziphazamisayo ezine-GERD. I-World Journal ye-Gastroenterology . 2014; 20 (34): 11962-5
> Ingoma, H, Zhu, J, Lu, D. Ukusetshenziswa kwe-proton pump inhibitor (PPI) yesikhathi eside kanye nokuthuthukiswa kwezilonda ezingaphambi kokulimala. I-Database Cochrane Yokubuyekeza Okuhlelekile. 2014.