Peptic Ulcer

Peptic Ulcer yog dab tsi?

Harvard Health Publishing

Tus kab mob peptic yog ib qho mob los yog qhov uas tsim nyob rau hauv lub plab los yog txoj hnyuv.

Lo lus 'peptic' yog hais txog lub plab zom mov. Ib qho rwj nyob rau hauv lub plab hauv ob sab phlu yog gastric ulcer. Ib qho rwj nyob rau hauv thawj feem ntawm cov hnyuv me yog ib tug duodenal rwj.



Peptic Ulcer

Lub hauv paus ntawm lub plab yog ib txheej ntawm cov cell tshwj xeeb thiab mucous. Mucous tiv thaiv lub plab thiab duodenum los ntawm kev puas tsuaj los ntawm acid thiab digestive enzymes.

Yog tias muaj qhov tawg ntawm lub hauv ob sab phlu (xws li qhov txhab), cov ntaub so ntswg hauv ob sab phlu tuaj yeem raug puas tsuaj los ntawm cov enzymes thiab corrosive acid. Yog tias qhov mob me me, tej zaum yuav muaj qee yam tsos mob. Lub qhov txhab tuaj yeem kho nws tus kheej.

Yog tias qhov txhab tob tob, nws tuaj yeem ua rau mob hnyav lossis los ntshav. Tsis tshua muaj, cov kua qaub hauv cov kua txiv digestive tuaj yeem noj tag nrho ntawm lub plab lossis duodenum phab ntsa.

Peptic ulcers muaj ntau heev. Lawv dhau los ua neeg muaj hnub nyoog.

Cov kab mob Helicobacter pylori tau ntseeg tias ua rau feem ntau cov kab mob peptic. Cov kab mob no ua rau mob plab hauv plab. Qhov no tej zaum yuav ua rau lub hauv ob sab phlu. Tab sis tsuas yog ib feem ntawm cov neeg kis tus kab mob H. pylori tsim rwj.

Lwm qhov ua rau mob plab yog kev siv cov tshuaj uas tsis yog steroidal anti-inflammatory (NSAIDs). Piv txwv ntawm NSAIDs suav nrogtshuaj aspirin,ibuprofen(Advil, Motrin) thiabnaproxen ua(Aleve,Naprosyn).

NSAIDs thaiv kev tsim ntawm qee cov prostaglandins. Prostaglandins yog cov tshuaj uas ib txwm pab tiv thaiv kab mob. Nrog tsawg dua prostaglandins, rwj muaj feem ntau tsim.

Ntau yam tuaj yeem ua rau koj qhov kev pheej hmoo ntawm kev tsim kab mob peptic. Risk yam muaj xws li:

  • Tsev neeg keeb kwm
  • Kev haus luam yeeb (tshwj xeeb yog tias koj kis tus kab mob H. pylori)
  • Kev haus cawv ntau dhau

Txawm li cas los xij, tsis zoo li kev ntseeg nrov, kev ntxhov siab thiab ntsim zaub mov zoo li tsis ua rau muaj kev pheej hmoo ntawm rwj.

Cov tsos mob

Feem ntau cov neeg uas muaj rwj tsis txaus siab ntawm qhov kub hnyiab los yog gnawing mob nyob rau hauv lub plab mog. Qhov no feem ntau tshwm sim thaum lub plab khoob. Cov tsos mob no yuav phem dua thaum hmo ntuj lossis thaum sawv ntxov. Txawm li cas los xij, qee tus neeg mob yuav hnyav dua thaum lawv noj.

Lwm cov tsos mob muaj xws li:

Qee cov tsos mob no yuav daws tau los ntawm kev noj cov tshuaj tiv thaiv kab mob hauv khw lossis tsis txhob noj zaub mov ntsim los yog acidic.

Feem ntau, cov tsos mob phem zuj zus tuaj thaum lub qhov txhab loj tuaj, lossis yog tias muaj ntau tshaj li qhov mob tshwm sim. Qee cov neeg mob me tsis muaj tsos mob.

Nyob rau hauv cov xwm txheej hnyav dua, rwj tuaj yeem los ntshav los yog txuas mus tob rau hauv phab ntsa ntawm lub plab lossis txoj hnyuv. Los ntshav los ntawm cov kab mob loj tuaj yeem ua rau lub neej hem. Ntshav tuaj yeem tshwm hauv ntuav. Nws tuaj yeem tshwm liab lossis dub, lossis zoo li kas fes hauv av. Ntshav kuj tuaj yeem tshwm sim hauv cov quav, uas yuav zoo li tarry-dub lossis maroon.

Peritonitis yog ib qho mob plab heev. Nws tuaj yeem txhim kho yog tias lub plab noj tag nrho los ntawm phab ntsa ntawm lub plab lossis txoj hnyuv

Kev kuaj mob

Yog tias koj tus kws saib xyuas kev noj qab haus huv xav tias koj muaj kab mob peptic, nws tuaj yeem pom zoo ib qho kev kuaj hauv qab no:

  • Kev kuaj ntshav antibody rau pov thawj ntawm H. pylori kab mob. Qhov kev sim no muaj dav thiab yooj yim ua. Yog tias qhov kev kuaj pom zoo, kev kho mob yuav raug muab yam tsis muaj kev kuaj mob ntxiv.

Txawm li cas los xij, lub H. pylori ntshav kuaj tsis yog ib txwm muaj tseeb. Cov txiaj ntsig kev xeem yuav nyob zoo rau xyoo tom qab ib qho H. pylori Cov kab mob tau kho lawm. Tsis tas li ntawd, qhov kev xeem tsis tuaj yeem qhia tau tias yog ib qho H. pylori kev kis tau ua rau mob plab.

  • Kev kuaj quav rau lub xub ntiag ntawm H. pylori antigen. Qhov kev kuaj no yog qhov tshwj xeeb tshaj qhov kev kuaj ntshav antibody.

  • Ib qho esophagogastroduodenoscopy (EGD lossis endoscopy). Ib qho yooj yim, teeb lub raj nrog lub koob yees duab me me ntawm qhov kawg yog dhau los ntawm koj lub caj pas rau hauv koj lub plab thiab cov hnyuv. Qhov no tso cai rau koj tus kws kho mob kuaj cov phab ntsa ntawm lub plab thiab duodenum.

Tus kws kho mob yuav hnia ib qho me me ntawm lub plab hauv ob sab phlu rau kev kuaj ntshav. Biopsy yog ib qho kev soj ntsuam ze ntawm cov ntaub so ntswg hauv chav kuaj. Ib qho biopsy tuaj yeem qhia tau tias puas muaj tus kab mob txuas ntxiv mus H. pylori . Nws tseem tuaj yeem kuaj xyuas kom paub tseeb tias lub plab tsis tsim vim mob qog noj ntshav.

  • Ib qho kev mob plab hnyuv loj (GI) series. Qhov kev ntsuam xyuas no tsis tshua ua tau niaj hnub no vim tias qhov endoscopy feem ntau yog qhov kev sim zoo dua. Nws suav nrog cov X-rays. Lawv tau noj tom qab koj haus cov kua dej chalky uas npog cov hlab pas, lub plab thiab sab sauv ntawm txoj hnyuv.

  • Lwm yam kev xeem rau H. pylori . Lwm qhov kev kuaj xyuas kom pom cov kab mob hu ua urea breath test. Koj nqos ib yam khoom uas muaj cov pa roj carbon (feem ntau, me me ntawm cov xov tooj cua muaj nyob). Yog H. pylori muaj nyob rau hauv koj lub plab, koj yuav tau kuaj ua pa zoo.

    clove tshuaj yej phiv los

Kev kuaj quav tuaj yeem kuaj xyuas cov protein uas cuam tshuam nrog cov kab mob.

Qee zaum, ntau tshaj ib qho kev sim yuav tsum tau kuaj xyuas koj tus mob.

Lub sijhawm xav tau

Cov kab mob uas tshwm sim los ntawm cov tshuaj yuav tsum pib kho sai tom qab koj tsis noj tshuaj. Cov tshuaj tiv thaiv acid tuaj yeem siv li ob mus rau rau lub lis piam los pab kho thiab txo qhov mob.

Cov kab mob tshwm sim los ntawm H. pylori tuaj yeem kho tau tom qab tua kab mob. Feem ntau, koj yuav noj tshuaj tua kab mob nrog rau cov tshuaj tiv thaiv acid rau ob lub lis piam. Tom qab ntawd koj tuaj yeem noj cov tshuaj tiv thaiv acid rau lwm plaub mus rau yim lub lis piam.

Gastric ulcers yuav kho tau qeeb dua li duodenal ulcers. Cov kab mob plab tsis yooj yim yuav siv sij hawm li ob lossis peb lub hlis kom kho tau tag nrho. Duodenal ulcers siv sijhawm li rau lub lis piam los kho.

Cov kab mob tuaj yeem kho tau ib ntus yam tsis muaj tshuaj tua kab mob. Tab sis nws yog ib qho tshwm sim rau tus kab mob kom rov zoo los yog rau lwm qhov txhab los tsim nyob ze, yog tias cov kab mob tsis raug tua.

Kev tiv thaiv

Peptic ulcers feem ntau tsis tuaj yeem tiv thaiv thawj zaug.

Kab mob nrog H. pylori yog qhov ntau heev. Tej zaum nws kis tau los ntawm ib tug neeg mus rau lwm tus. Cov neeg nyob hauv qhov chaw zoo li muaj kev pheej hmoo.

Kev tu cev zoo yuav txwv tsis pub kis tus kab mob H. pylori me ntsis. Qhov no suav nrog kev ntxuav koj txhais tes kom huv si ua ntej noj mov thiab tom qab siv chav dej.

Recurrent ulcers los ntawm H. pylori feem ntau tuaj yeem tiv thaiv yog tias koj tau txais kev kho mob tsim nyog rau koj thawj qhov txhab. Qhov no yuav tsum muaj cov tshuaj tua kab mob uas tua cov kab mob.

Koj tuaj yeem pab tiv thaiv kab mob peptic los ntawm:

  • Zam kev haus luam yeeb
  • Tsis txhob haus cawv ntau dhau
  • Kev txwv kev siv NSAIDs rau qhov mob

Kev kho mob

Rau ulcers tshwm sim los ntawm H. pylori , kev kho mob yuav tsum muaj kev sib xyaw ntawm cov tshuaj. Lub hom phiaj ntawm kev kho mob yog:

  • Tua H. pylori kab mob hauv lub cev
  • Txo cov kua qaub hauv plab
  • Tiv thaiv cov kab mob ntawm lub plab thiab cov hnyuv

Cov neeg mob feem ntau raug kho nrog 'triple therapy.' Qhov no yuav tsum tau noj ob yam tshuaj tua kab mob thiab ib qho tshuaj tiv thaiv acid rau ib mus rau ob lub lis piam. Koj tus kws kho mob yuav sau ib qho kev qhia tshwj xeeb raws li qhov yooj yim, tus nqi thiab txhua yam kev ua xua uas koj muaj.

Yog tias koj qhov mob tshwm sim thaum koj siv cov tshuaj uas tsis yog-steroidal anti-inflammatory (NSAID), koj yuav tsum tsis txhob noj nws. Kev kho yuav pib yuav luag tam sim ntawd. Koj tus kws kho mob tseem yuav pom zoo siv tshuaj los txo cov kua qaub thaum kho. Cov no yuav suav nrog cov tshuaj antacids los ua kom tsis muaj zog hauv plab. Cov tshuaj uas txo cov kua qaub uas ua los ntawm lub plab kuj tseem siv tau. Piv txwv xws li H2 blockers lossis proton twj tso kua mis inhibitors.

Kev kho mob xwm txheej ceev yuav xav tau yog tias mob plab ua rau los ntshav hnyav. Feem ntau, qhov kev kho mob no yog ua los ntawm endoscope. Cov tshuaj tiv thaiv acid tuaj yeem muab tso rau hauv cov hlab ntsha (txhaj rau hauv cov hlab ntsha). Kev txhaj tshuaj ntshav yuav tsim nyog yog tias ntshav hnyav heev.

Qee qhov xwm txheej tsis tshua muaj, kev phais yuav tsum tau kho los kho tus kab mob perforated lossis los ntshav peptic ulcer. Kev phais rau tus kab mob peptic ulcer yuav kaw cov hlab ntsha los ntshav.

Kev phais tsis tshua xav tau rau kev kho mob peptic ulcer hnub no. Qhov ntawd yog vim kev kho mob rau H. pylori kev kis kab mob thiab lwm yam ua rau tus kab mob peptic ulcer tau ua tiav zoo.

Thaum Hu Rau Tus Kws Tshaj Lij

Hu rau cov lus qhia txog kev kho mob yog tias koj muaj mob plab ntxiv lossis plab zom mov. Kuj hu rau yog tias koj xav tau noj cov tshuaj antacid ntau zaus los tiv thaiv cov tsos mob no.

  • Nrhiav kev saib xyuas xwm txheej ceev yog tias koj ntsib:
  • Ib qho mob ntse heev hauv koj lub plab
  • Ntshav los yog ntuav dub
  • Maroon los yog cov quav dub

Kev kwv yees

Nrog kev kho kom raug, qhov kev pom zoo rau peptic ulcers yog qhov zoo heev.

Txhawm rau tiv thaiv lwm tus kab mob, cov neeg uas muaj kab mob peptic yuav tsum zam:

  • Aspirin (tshwj tsis yog xav tau koob tshuaj tsawg los tiv thaiv lub plawv nres lossis mob stroke)
  • NSAIDs
  • Haus cawv ntau dhau
  • Kev haus luam yeeb

Cov peev txheej sab nraud

National Institute of Diabetes & Digestive & Kidney Disorders
http://www.niddk.nih.gov/

American College ntawm Gastroenterology (ACG)
http://www.acg.gi.org/

American Gastroenterological Association
http://www.gastro.org/

Cov ntaub ntawv ntxiv

Nco ntsoov sab laj nrog koj tus kws kho mob kom paub meej tias cov ntaub ntawv uas tshwm sim hauv nplooj ntawv no siv tau rau koj tus kheej.