Ngimaphi Uhlobo Lwe-Esophagitis Enginayo?

by UKristin Hayes, uRN; Ibuyekezwe udokotela oqinisekisiwe webhodi

Izinhlobo Eziyinhloko Zokusakaza I-Esophagitis

I-esophagitis ukuvuvukala kwesifo sakho esingase sibangelwe izizathu ezithathelwanayo noma ezingezona ezithathelwanayo. Isisu sakho sishubhu se-muscular esithwele ukuphatha ukudla kusuka emqaleni wakho kuya esiswini sakho. Ngoba itholakala esifubeni sakho esiphezulu, i-esophagitis ivame ukuzwa sengathi i-heartburn futhi ivame ukuhambisana nobuhlungu uma igwinya. Ukwehla kwesifo esibi kakhulu kwenzeka lapho isifo sakho sesiqala ukulimala noma siphume.

Izinhlobo eziyisikhombisa eziyinhloko ze-esophagitis zihlanganisa:

i-reflux ye-asidi
ukutheleleka
ukungenisa kwe-caustic
imithi-yenziwe
i-eosinophilic
i-chemotherapy kanye nokwelashwa kwemisebe
ukugula okuhlelekile

Ngenkathi lezi zinhlobo eziyisikhombisa ze-esophagitis zihlanganisa izimbangela eziyinhloko ze-esophagitis, kunezinye izimbangela eziningi ezingavamile ze-esophagitis.

Izimpawu ze-Esophagitis

Izimpawu eziningi ezihlobene ne-esophagitis nazo zingatholakala kwezinye izifo futhi zibandakanya:

ukuguquka kwenhliziyo-kungase kufane nobuhlungu besifuba esifweni se-coronary artery
ubuhlungu ngokugwinya (odynophagia)
ubunzima bokugwinya (dysphagia)
isicanucanu kanye / noma ukuhlanza
ubuhlungu besisu
ukukhwehlela
i-anorexia nokulahlekelwa kwesisindo

Ngokusekelwe ezimpawu zakho nomlando wezokwelapha, cishe uzodinga inqubo eyodwa noma ezimbili njengoba igazi lidonsa ngeke likwazi ukuhlukanisa ukuthi yini ebangela izimpawu zakho. Ngokuya kokuhlolwa kwakho, udokotela wakho angase aqale ngesifundo sokugwinya i-barium , esaziwa nangokuthi u-esophagography.

Ukuze ucwaningo lwama-barium, uzoya e-radiology, lapho umtholampilo uzothatha i-x-ray ye-esophagus ngenkathi ugxilisa i-barium nokudla okuthile. Ama-barium agqoke isisu sakho, esivela sibe mhlophe ku-x ray. Lokhu kuzovumela udokotela wakho ukuba abone ukuthi kukhona yini ukuvimbela noma ukunciphisa endaweni yakho.

Ukuhlolwa kokugwinya kwe-barium kuyasiza ekusizeni ukuthi udokotela wakho udinga yini ukubhekisisa umdlavuza njengesibangele sezibonakaliso zakho. Uma umdlavuza ucatshangelwa, i-CT scan ingalawulwa njengendlela yokuphanga okuqhubekayo.

Enye indlela, eyovela ngezinye izikhathi emva kokuhlolwa kwesimiso se-barium, i- endoscopy , esetshenziselwa ukubona ngeso lengqondo umphimbo wakho nge-fiber optic scope. I-endoscopy, eyaziwa nangokuthi i-esophagogroduodenoscopy (EGD), yenziwa njengendlela yokwelashwa, okusho ukuthi awudingi ukufakwa ezibhedlela ebusuku. Kodwa-ke, uzonikezwa ukunakwa, ngakho-ke uzodinga ukuba othile akushayele ekhaya ngemuva kwenqubo. Phakathi ne-endoscopy, i-gastroenterologist izobukeka isifo sakho, isisu nesisu sangaphezulu. Bayofuna izibonakaliso zokuvuvukala noma isilonda futhi babheke ukukhomba noma yiziphi izimbangela zezimpawu zakho. I-Biopsies ivame ukuthathwa ukuze ibheke noma yiziphi izimbangela ezithathelwanayo zezimpawu zakho.

I-Reflux Esophagitis

I-esophagitis ivame ukubangelwa yisifo se-reflux ye-gastroesophageal (GERD) . Iningi labantu lizobhekana nokuqukethwe kwe-reflux yesisu. Kodwa-ke, uzoba nengozi eyengeziwe yokuthuthukisa isifo somzimba uma uthola ukuvama kwesisu esiswini, i-pepsin (i-enzyme esiswini), ne-bile, njengoba kungabangela ukuvuvukala nezilonda endaweni yakho.

Uma une-esophagitis ngenxa yesifo se-reflux, kufanele uphathwe nge-proton pump inhibitor (PPI), njenge- Prilosec noma i- Dexilant , amasonto amane kuya kwangu-8. Ngemuva kwamasonto amane okungenani, udokotela wakho uzohlola kabusha izimpawu zakho. Uma ngemuva kokuba unezinkinga eziphindaphindiwe ne-esophagitis ehlobene ne-GERD noma ube nesifo se-Barrett, cishe uzodinga ukwelashwa okuqhubekayo kwe-PPI.

Isifo Esophagitis Esithathelwanayo

I-esophagitis ingenzeka njengomphumela wesifo. Uma unamasosha omzimba obuthakathaka, uzobe usengozini yokuthola isifo esenza ukuba isifo se-esophagitis. Lokhu kuvame ukubonwa kubantu abaye bathola imishanguzo ye-immunodeficiency syndromed (i-AIDS), ukufakelwa komzimba, noma kubantu abaye babe ne-chemotherapy yokwelashwa komdlavuza.

Ngenkathi usengozini enkulu yokwelapha isifo esivela esibangelwa yizimbangela ezithathelwanayo uma unamasosha omzimba obuthakathaka, usengathola isifo sokuzivikela esithathelwanayo nesistimu yomzimba omzimba efanele. Ukutheleleka okuvame ukubangela ukuqubuka kwamagciwane kuhlanganisa:

candida (imvubelo) -zizathu ezivamile
i-herpes simplex virus (HSV)
i-cytomegalovirus (i-CMV)
i-apthous ulceration-eyaziwa nangokuthi idiopathic (engaziwa) isilonda esiswini

Isifo esithathelwanayo ngokutheleleka ngokuvamile asikwazi ukuhlukaniswa yizimpawu noma ngokubukwa kwezilonda ngesikhathi se-endoscopy. Izilonda ezitholakala ngesikhathi se-endoscopy ngokuvamile zimhlophe zibe ziphuzi ezimibalabala. I-Candida ivame ukutholakala njenge-plaque-like, kuyilapho i-HSV noma i-CMV kungenzeka ibe nezilonda. Ukuze uhlolisise kahle ukutheleleka okubangela ukuba isifo se-esophagitis, udokotela wakho uzothatha "ukushayela" noma ama-biopsies we-oophagus yakho.

Uma uthola ukuthi une-candida ukutheleleka, uzobe unqunywe imithi elwa ne-fungal ukuze uphathe isifo sakho somzimba. Uma uthola ukuthi unesifo sengculaza, njenge-HSV noma i-CMV, udokotela wakho uzokunika i-antiviral. I-Prednisone yindlela yokwelashwa uma ukhethwe ukuthi une-apthous esophagitis. Ukwelashwa ngemithi yomlomo kuzohlala phakathi kwezinsuku ezingu-14 no-21.

I-Caustic Esophagitis

I-Caustic esophagitis ivela lapho udla ikhemikhali elivutha isifo sakho. Imikhiqizo enomkhiqizo equkethe i-lye, noma amanye amakhemikhali acidic, uma ukungenwa kungabangela ukucasuka, izilonda, noma i-perforation (izimbobo noma izinyembezi) zesimo sakho. Ezinganeni lokhu kuvame ukubangelwa ukungenisa ngengozi ye- caustic . Uma usola ukuthi ingane yakho ifake ikhemikhali ekhaya, ungahlala ubiza ikholi ye-Poison ku (800) 222-1222. Uma ingane yakho inenkinga yokuphefumula ucingo 911 ngokushesha.

Ukulimaza isisindo sakho kuyoba ngokulingana nesilinganiso sesikhathi sakho esivela kuso emakhemikhali. uma kwenzeka ukuxhumana okuncane nje, ungase ube nokucasuka nje. Ukwehliswa okuqhubekayo kwandisa ingozi yakho yokwakhiwa kwezilonda noma umonakalo obi kakhulu. Ngokuvamile, kuzodingeka ube ne-endoscopy ukuhlola umonakalo we-esophagus yakho kungakapheli amahora angu-24.

Uma ungenayo izimpawu ezimbi emva kokufaka imithi engumphumela, ungabhekwa kuphela amahora ambalwa. Kodwa-ke, uma unezimpawu zokulimala kokuqeda, uzodinga ukuthi ungeniswe esibhedlela sabaphathi.

I-Esophagitis Yokwelashwa-Ebonakalayo

Ukuxoshwa kwamagciwane okubangelwa imithi akuvamile. Kuvele kuphela kubantu abangaba ngu-4 kwabangu-100,000. Ukuxilongwa kwe-medication kungenziwa ngokuxhumana ngokuqondile, okufana ne-caustic esophagitis, noma ngokuthinta izithiyo zokuzivikela esiswini nasesimweni sokuqhafaza. Imithi ene-pH ephansi (i-acidic) futhi ingabangela ukuxilongwa kwe-medication-induced isophagitis kuhlanganisa:

ama-antibiotics-tetracycline, i-doxycycline, ne-clindmycin
i-ascorbic acid (i-vitamin C) ne-sulfate enezinsimbi (iron)

Izidakamizwa ze-Aspirin nezidakamizwa ezingekho ukuvuvukala (ama-NSAID), njenge-Ibuprofen, zingaphazamisa ukuvinjelwa kwesivinini nesisu. Lokhu kungandisa ingozi yakho yokuthuthukisa isifo sengculaza. Ukwelashwa kwanoma yiluphi uhlobo lwe-esophagitis olwenziwe ngemithi luhlanganisa ukuyeka imithi. Uma ungeke ukwazi ukuyeka imithi, udokotela wakho uzama ukuyala inguqulo ye-liquide yemithi.

Ngokuvamile izidakamizwa ezithinteka ngemithi zizoxazulula ngokushesha ngaphandle kwemiphumela yesikhathi eside uma umonakalo uvaliwe kusenesikhathi. Ngokuvamile uzobona ukuthuthukiswa ngokushesha ngemva kwezinsuku ezine.

I-Eosinophilic Esophagitis

I-eosinophilic esophagitis (EoE), iyisiphetho se-allergen / immune. Ngokuvamile isifo sakho asinayo i-eosinophils, engamaseli amhlophe egazi ayingxenye yesistimu yakho yomzimba. Uma u-EoE ecatshangwa udokotela wakho, i-endoscopy izokwenziwa yi-gastroenterologist. Ngesikhathi se-endoscopy, ama-biopsies azosuswa ukuze afune ama-eosinophils. Uma kutholakala ama-eosinophil, uzothunyelwa ku-allergen ukuze uthole olunye ulwazi lokuvivinya umzimba. Ukuze izimpawu zixazulule uzodinga ukuqeda ukuvezwa kokudla okubangela impendulo yokugula endaweni yakho. Lokhu kungenziwa ngu:

hlola ukuhlolwa kwesikhumba -method ukuhlola izilonda ezahlukene esikhumbeni sakho
ukuhlolwa kwegazi
indlela yokudla-yokudla lapho kutholakala khona ukudla ekamelweni elincane elincane (i-Finn chamber) futhi lishiye othintana namahora angu-48

Kwezinye izimo, ungase ukwazi ukubona ukudla okugqugquzela ukugwema kusuka ekuhlolweni ngenhla. Kodwa lokhu kungase kungabonakali ngaso sonke isikhathi ukudla okufanele ukugweme. Kulesi simo, udokotela wakho angancoma ukudla kokuqeda ukudla , okususa ukudla okuvamile okuvela ekudleni kwakho. Uma izimpawu zixazulula, ungabe usuqala ukuvuselela ukudla okuhleliwe ekudleni kwakho kuze kube yilapho unzima kakhulu; okuyinto ekhomba ukudla okufanele ugweme.

I-esophagitis ehlobene ne-Chemotherapy & Therapy Radiation

I-esophagitis ingenzeka ngenxa ye-chemotherapy noma ukwelashwa kwe-radiation yokwelapha umdlavuza. Kungase kudingeke izinyanga eziningana ukuphulukiswa, uma kukhona, kungenzeka. Ukwelashwa kwaloluhlobo lwe-esophagitis kuzokwenziwa usebenzisa i-lidocaine e-viscous ukuze unqamule umlomo wakho futhi ulandele, okuyi-antiacid ukusiza ukuphatha noma yiziphi izilonda. Uma i-chemotherapy noma i-radiation therapy iveza izigxobo ezingapheli, noma ukunciphisa umzimba wakho, kungase kudingeke ukuba usebenzise izikhathi zokugcina isikhathi ukuze uhlise isifo sakho .

Isifo Esophagitis Esihlobene Nokugula Okuyisimiso

Ngenkathi udokotela wakho ehlola umlando wakho ngenxa yezimbangela ze-esophagitis yakho, bazocabangela ukuthi unayo yini izifo ezihleliwe ezivame ukwakhiwa kwe-esophagitis. Kunezinhlobo eziningi zezifo ezingase zande ingozi yokuba ne-esophagitis futhi ngamunye unendlela ehlukile yokwelapha. Nakuba i-corticosteroids, njenge-Prednisone, isetshenziswa kakhulu ekwelapheni, kufanele uxoxe ngaso sonke isikhathi ngendlela engcono yokwelashwa nodokotela wakho. Izifo ezehlukene ezingase zidale i-esophagitis zihlanganisa:

> Imithombo:

> Ukufinyelela ekuhloleni kwe-dysphagia kubantu abadala. Iwebhusayithi ye-UpToDate. http://www.uptodate.com. Kubuyekezwe ngo-Okthoba 26, 2017.

> Ukulimala okubangelwa ukukhubazeka kwabantwana. Iwebhusayithi ye-UpToDate. http://www.uptodate.com. Kubuyekezwe ngomhla ka-1 Mashi, 2017.

> I-Eosinophilic Esophagitis (EoE). I-American Academy Yezokwelapha, i-Asthma, ne-Immunology iwebhusayithi. http://www.aaaai.org/conditions-and-treatments/related-conditions/eosinophilic-esophagitis.

> Esophagitis. Iwebhusayithi yeMedscape. https://emedicine.medscape.com/article/174223-ukubukwa kokubukwa. Kubuyekezwe i-Apreli 27, 2017.

> Graman, PS. (2015). Mandell, Douglas, kanye nemigomo ye-Bennett kanye nokuzijwayeza kwezifo ezithathelwanayo, Edition Edition, 99, 1248-1252.e2

> Ukuxilongwa kwezidakamizwa. Iwebhusayithi ye-UpToDate. http://www.uptodate.com. Kubuyekezwe ngoNovemba 8, 2016.