Siyakwamukela kule ndawo ekhethekile kakhulu yokuhlinzwa okuvamile, i-gastroenterology, ukuxilongwa kwe-endoscopic, kanye nempilo yokuvimbela.
Ukuqonda ukuthi amatshe esiswini ayini ngempela kudinga ukuhlukanisa phakathi kolimi oludumile kanye nokwakheka kwangempela kwesistimu yokugaya ukudla.
Njengodokotela ohlinzayo onguchwepheshe kanye noprofesa oqeqeshiwe eNyuvesi yaseCuenca, into engiyibeka phambili ukukunikeza ukucaca okuphelele kwezokwelapha, ngifundisa ukuthi lapho abantu bezwa ubuhlungu ngemva kokudla amafutha, imbangela cishe njalo iwukuba khona kwamatshe enyongo hhayi amatshe emgodini wesisu.
Kodwa-ke, ukunqwabelana okuqinile okubizwa ngokuthi ama-bezoars (e-fiber noma izinwele ezingagayiwe) kungakheka esiswini, noma amatshe amakhulu avela enyongweni angahlala nge-fistula (i-Bouveret's syndrome).
Ngaphambi kokuhlaziya indlela ama-phytobezoar akheka ngayo ezigulini ezine-gastroparesis, ukuhlaziya ukuthi kungani izindlela zokwelapha zasekhaya 'zokuncibilikisa amatshe' ziyingozi, noma ukuchaza ukuthi inqubo yethu yesimanje ibhekana kanjani nokukhishwa kwe-endoscopic kanye nokuhlinzwa okungangenisi kakhulu, ngiyanimema ukuba nifune isiqiniseko ebufakazini besayensi.
Ngaphansi kwesiqondiso sezemfundo sikaDkt. Jorge Delgado, sihlola impilo yakho yokugaya ukudla ngokuzimisela okukhulu kwezokwelapha. Kulokhu, isihloko socwaningo ngamatshe esisu , aziwa nangokuthi i-gastric calculi noma i-gastroliths: ama-hard deposits akha esiswini sabantu nezilwane.
Nakuba kungavamile kubantu, la matshe angaba yingozi futhi angaba yingozi uma engaphathwa kahle.
Manje siqhubekela esigabeni esinemibuzo evela kozakwethu bezokwelapha, amalungu omndeni, kanye neziguli kuya kodokotela abahlinzayo noma odokotela bezifo zamathumbu mayelana namatshe esiswini. Izimpendulo zizoba lula futhi zibe ngolimi lwansuku zonke. Ake siqale!
Imibuzo evamile
Ingabe “amatshe” akheka ngaphakathi esiswini akhona ngempela?
Yebo, kodwa azenziwanga nge-calcium noma i-cholesterol njengalezo ezisezinso noma enyongweni. Esiswini, kwakheka ama-bezoar, ayizinqwaba ezincane ezingagayeki.
Ezivame kakhulu yi-phytobezoars (ukuqongelela kwe-fibre yezitshalo, amakhasi ezithelo njenge-persimmon noma i-fig) kanye ne-trichobezoars (amabhola ezinwele noma izinwele ezigciniwe).
Kungani abantu bedidanisa amatshe enyongo “namatshe esisu”?
Ngoba ubuhlungu benyongo (i-biliary colic) buzwakala engxenyeni ephezulu nephakathi yesisu (epigastrium noma "umgodi wesisu"), ngaphansi nje kwe-sternum.
Ngenxa yokuthi zihlotshaniswa nesicanucanu, ukusinda, kanye nokungagayi kahle ukudla ngemva kokudla ukudla okunamafutha, iziguli zicabanga ngephutha ukuthi amatshe asesiswini kanti empeleni atholakala enyongweni.
Iyini i-Bouveret's Syndrome futhi itshe lingena kanjani esiswini?
Kuyinkinga enkulu ye-cholelithiasis engapheli. Kwenzeka lapho itshe elikhulu lenyongo (> 2.5 cm) ligugula udonga lwenyongo kanye ne-duodenum/isisu, okudala i-cholecystoduodenal fistula.
Itshe liyahamba bese libhajwa ku-pylorus noma ku-duodenal bulb, okudala ukuvinjelwa okuphelele kokukhipha isisu ngokuhlanza okufana nephalishi.
Lezi zinhlayiya zesisu zihlolwa futhi zelashwa kanjani?
Zitholakala nge-Upper Digestive Endoscopy (EDA) noma i-Computed Axial Tomography (CAT).
Ama-phytobezoar amancane angancibilikiswa ngezinqubo zokuwasha ze-endoscopic kanye nama-mucolytic/enzyme agents (njenge-cellulase noma iziphuzo ze-cola carbonated); izinqwaba ezinkulu noma eziqinile zidinga ukuqhekeka kwe-endoscopic nge-loop noma ukususwa ngokuhlinzwa nge-laparoscopy.
Kulesi sihloko, "esibhalwe ngabantu, ngenxa yabantu", sizoxoxa ngokuthi kungani amatshe esiswini eyingozi nokuthi singawavimbela kanjani.
Kuyathakazelisa, okwamanje, ukuphuza inkomishi yetiye eliluhlaza; liqukethe i-amino acid ebizwa ngokuthi i-L-theanine esivumela ukuthi sigxile kangcono, futhi ngesikhathi esifanayo, sithole kangcono ulwazi olusha ukuze sithuthuke.
Ngakho-ke, kukhona ukuthuthuka kokujikeleza kwegazi, okuvumela ukugeleza okukhulu kwegazi elinomoya-mpilo ukunikeza ubuchopho umthombo wamandla ongcono kakhulu, okungumoya-mpilo, ngaleyo ndlela kunqunywe isimo sengqondo sokuthatha isinyathelo.
Ngakho-ke, intuthuko yakho yomuntu siqu iqinisekiswa ngokugcina isimo sengqondo sokuqapha nokubhekana nokuzethemba kanye nokwelapha ngokwakho , okubambezela ukuvakashela izibhedlela noma imitholampilo yezempilo ngohlelo lwezempilo lomphakathi noma oluzimele, ngaleyo ndlela kunciphisa izinkinga ezinkulu zokugaya ukudla.
Amatshe esiswini
Amatshe esiswini, aziwa nangokuthi i-gastric calculi, ayisifo esingavamile kodwa esingaba yingozi. Ngokwezibalo zokubhaliswa kuzwelonke, le nkinga eyingqayizivele yenzeka kubantu abayi-1 kuya kwabayi-2 ngesigidi ngonyaka.
Amatshe ayizinsalela eziqinile zezinto ezakhayo endleleni yokugaya ukudla, ikakhulukazi ngenxa yokuhlanganiswa kwezici zendlela yokuphila, njengokudla okunganele kanye nokuphelelwa amanzi emzimbeni.
Izimpawu aziqondile futhi zifaka phakathi ubuhlungu besisu noma ukungakhululeki, isicanucanu nokuhlanza, ukuqunjelwa okubolayo noma isifo sohudo, ukulahlekelwa yisifiso sokudla, kanye nokwehla kwesisindo. Uma kungelashwa, amatshe esiswini angaholela ezinkingeni ezinkulu, njengokuvaleka kwamathumbu noma ukubhoboka kodonga lwesisu.
Ngenhlanhla, ukuvimbela kungenzeka ngokwamukela imikhuba yokudla enempilo, njengokulandela ukudla okulinganiselayo okucebile nge-fiber nokuphuza amalitha ama-2 amanzi anuka kamnandi ngosuku ukuqinisekisa ukuthi amanzi anele.
Ukuvivinya umzimba njalo ukuze ugcine isisindo esinempilo nakho kusiza ekugcineni ukusebenza kahle kwamathumbu kanye nokunyakaza kwamathumbu okulula. Ngalezi zinyathelo zokuvimbela, abantu abaningi ngeke bakhathazeke ngamatshe esiswini.
⚠️ INOTHI EBALELEKILE:
Sicela uqaphele ukuthi lesi sihloko senzelwe ulwazi kuphela futhi akufanele sibhekwe njengeseluleko sezokwelapha. Kubalulekile njalo ukubonisana nochwepheshe wezempilo endaweni yakini ukuze uthole ukuxilongwa okufanele kanye nohlelo lokwelashwa olufika ngesikhathi.
Itshe esiswini
Amatshe esiswini ayisifo sezokwelapha esibonakala ngokuba khona kwezinsalela zezinto eziqinile. Angakheka ngenxa yenyongo eningi ephumayo, ukudla okungagaywanga , noma ezinye izinto , futhi ubukhulu bawo bungasukela ezinhlayiyeni ezincane kuya ezinqwabeni ezinkulu.
Nakuba la matshe ngokuvamile engenangozi, angaba yingozi kakhulu uma engelashwa. Inkinga enkulu kakhulu ukuvaleka kwendlela yamathumbu , okungabangela ubuhlungu besisu , ukuhlanza, ngisho nokuqhekeka kwamathumbu.
Ukuvimbela kubalulekile uma kukhulunywa ngamatshe esiswini. Ukulandela ukudla okunempilo, okunamafutha amancane noshukela, kuzosiza ekunciphiseni ingozi yokuba nawo.
Kubalulekile futhi ukuphuza amanzi anele usuku lonke (okungenani amalitha ama-2 amanzi e-chamomile noma e-mint) ukuze umzimba wakho ugcine amazinga oketshezi anele okugaya ukudla.
Uma usengozini yokuthola amatshe enyongo ngenxa yesimo esivele sikhona, njengesifo sikashukela noma isifo senyongo (i-Bouveret's syndrome: i-gallstone enkulu ( > 2.5 cm ) igugula udonga lwenyongo kanye ne-duodenum/isisu, idale i- cholecystoduodenal fistula . Itshe liyahamba bese lihlala ku-pylorus noma i-duodenal bulb, okwenza kube nokuvinjelwa komshini kokuphuma kwesisu ngokuhlanza okufana nephalishi), khuluma nodokotela wakho ngezinyathelo zokuvimbela ongazithatha.
Ukuhlolwa njalo nodokotela wakho kuzosiza futhi ukuqinisekisa ukuthi noma yiziphi izinkinga ezingaba khona zitholakala kusenesikhathi ngaphambi kokuba zibe zimbi kakhulu.
Yile ndlela amatshe esiswini akheka ngayo.
Amatshe esisu ( amatshe esiswini ngendlela evamile yaseLatin America) akheka lapho izinto ezithile emgudwini wokugaya ukudla ziqoqana futhi ziqina, okuholela ekumisweni okuqinile.
Lezi zinto zifaka amaminerali, ama-bile acid, i-mucus, namaseli afile. Amatshe esiswini ayahlukahluka ngobukhulu, ukuma, nombala, kusukela kokuncane nokuyindilinga kuya kokukhulu nokubukhali.
Izimbangela eziqondile zokwakheka kwamatshe esiswini azicaci, kodwa kusobala ukuthi ukudla kudlala indima ebalulekile.
Okunye ukudla, njengalokho okucebile ngamafutha namaprotheni ezilwane, kuvame ukwandisa ukukhiqizwa kwe-hydrochloric acid esiswini futhi kwandise ingozi yokwakheka kwamatshe.
Ukuphelelwa amanzi emzimbeni njalo , okungukuthi, ukuphelelwa amanzi emzimbeni nsuku zonke, kanye nokuqina kwesisu (lapho ukudla kuhlala khona esiswini isikhathi eside, ikakhulukazi kubantu abanesifo sikashukela) nakho kungandisa ingozi yokwakheka kwamatshe noma i-calculi okungenzeka ukuthi kuvimbe amathumbu.
Ukuvimbela amatshe esiswini
Amatshe enyongo esiswini angaba yingozi ngenxa yezizathu ezilandelayo.
- Okokuqala, kungabangela Ubuhlungu besisu izimpawu ezibukhali nezinye, njengesicanucanu nokuhlanza. Ezimweni ezimbi kakhulu, amatshe esiswini angabangela Ukuvinjwa kwamathumbuokungaba yingozi.
- Endaweni yesibiliAmatshe esiswini angaba uphawu lwezinye izinkinga zempilo eziyisisekelo. Isibonelo, ukwakheka kwe ama-gastroliths o amatshe esiswini Kungaba uphawu lwesifo samathumbu esivuvukalayo noma ukutheleleka kwesisu. Kungaba futhi uphawu uphawu lwezifo ze-metabolic ezifana ne-hyperparathyroidism.
Ukuvimbela ama-gastrolith
Amatshe esiswini ayingozi. Ngenhlanhla, kunezinyathelo ongazithatha ukuze uwavimbele ukuthi akheke . Nazi ezinye izindlela ezibalulekile ongazisebenzisa:
- Landela ukudla okunempilo, ucebile nge-fiber yokudla Ukudla okunamafutha amancane kunganciphisa ingozi yamatshe esiswini. Kunconywa futhi ukunciphisa ukudla okune-asidi nokunongwe kakhulu.
- Phuza amanzi anele: Ukuthola amanzi anele kungavimbela ukuphelelwa amanzi emzimbeni kanye nokuqina kwesisu, okuyizinto ezimbili ezibangela ukwakheka kwamatshe esiswini.
- Thatha imithi ebhalwe ngudokotela: Uma unikezwe imithi yezinkinga zokugaya ukudla eziyisisekelo (njengesifo samathumbu esivuvukalayo), qiniseka ukuthi uyithatha njengoba kuyalelwe ukuze unciphise ingozi yokwakheka kwamatshe enyongo.
- Gwema ukukhuluphala ngokweqile: Ukukhuluphala ngokweqile kuyimbangela yezifo eziningi futhi kungandisa ingozi yokwakheka kwamatshe esiswini kanye nokungasebenzi kahle kokunyakaza kwesisu, ngakho-ke kubalulekile ukugcina isisindo esinempilo ngokuzivocavoca umzimba kanye nokudla okulinganiselayo.
- Gwema utshwala nogwayi: Ukuphuza utshwala ngokweqile nokubhema kungandisa ingozi yokwakheka kwe-gastrolith, ngakho-ke kubalulekile ukunciphisa ukudla kwakho.
Susa amatshe esiswini
Amatshe esisu, noma ama-gastrolith, ayisimo esiyingozi esibangelwa ukunqwabelana kwezinto eziqinile esiswini. Angaholela ezinkingeni ezinkulu, okuhlanganisa ukuvaleka, ukubhoboka, ukuvuvukala, kanye nokutheleleka kwesisu.
Ukuze kuvinjelwe lokhu, kubalulekile ukuhlonza izici eziyingozi bese wenza ngokufanele. Ama-gastrolith avame kakhulu kubantu abadla ukudla okunzima isikhathi eside, kubantu abanesifo sikashukela ngenxa yokugaya ukudla kancane, noma kulabo abangatholi ukunakekelwa kwamazinyo okwanele, okuholela ekuhlafuneni izinsini ngokweqile noma kwezinye izinhlobo zokugaya.
Ungasusa kanjani amatshe esiswini? Ukuze kususwe ama-gastrolith, ukwelashwa kuzoncika ngobukhulu bawo nendawo yawo endleleni yokugaya ukudla. Ukwelashwa okungangenisi uketshezi, njenge-endoscopy , kungasiza ekususeni amatshe amancane esiswini, kanti amacala anzima kakhulu angadinga ukuhlinzwa.
Kodwa-ke, ukuvimbela kufanele kube yinto ebaluleke kakhulu ngaso sonke isikhathi: ukuhlonza izici eziyingozi, ukudala uhlelo lokudla olufanele, kanye nokukhuthaza inhlanzeko yomlomo efanele kuyizindlela ezisebenzayo zokugwema ukwakheka kwamatshe esiswini.
ukuxilongwa okuhlukile
Ukuxilongwa okuhlukile kwamatshe esiswini kufaka phakathi izimo ezahlukahlukene ezingabonisa izimpawu ezifanayo.
Lokhu kufaka phakathi i-gastritis, engabangela ubuhlungu besisu kanye nokungakhululeki kokugaya ukudla; izilonda zesisu, ezingabonakala njengobuhlungu obukhulu esiswini esingaphezulu; kanye ne-cholelithiasis, evame ukuhlotshaniswa ne-biliary colic futhi engaphambaniswa nokungakhululeki kwesisu.
Ngaphezu kwalokho, izifo ezifana nesifo se-gastroesophageal reflux (GERD) kanye ne-pancreatitis kufanele zicatshangelwe, njengoba zingaveza nezimpawu ezifanayo, okwenza ukuhlaziywa okuphelele kwezokwelapha kanye nokuhlolwa kokuxilonga kudingeke ukuqinisekisa imbangela yokungakhululeki.
Ukuhlaziywa kwenani
Iphrothokholi Ye-Chemical-Endoscopic eneziphuzo ze-Carbonated (Ukwelashwa nge-Coca-Cola):
UDkt. Delgado uletha inani eliphakeme lomehluko ocwaningweni lwezokwelapha ngokuchaza ukuncibilika kwe-phytobezoar ngaphandle kokuhlinzwa.
Ukufundisa ukuthi ukuphathwa okuqondiwe noma ukufakwa kwe-endoscopic kwesisombululo se-Coca-Cola esine-carbonated (ngenxa ye-pH yaso ene-acid, ukuba khona kwe-phosphoric acid kanye nokukhishwa kwama-bubble e-CO2) kuyathambisa futhi kuphule imicu ye-pectic ye-phytobezoar ezimweni ezingaphezu kuka-90% ezingezinhle, kugwema i-laparotomy engadingekile futhi kumele isibuyekezo sezokwelapha esisezingeni eliphezulu.
Umbono Wezemfundo Nobuprofesa (UMnyango Wezokuhlinzwa - IYunivesithi yaseCuenca):
Ukuxilongwa okuhlukile kusekelwe ku- Pathophysiological Triangle ye-Gastric Bezoar . Njengoprofesa baseyunivesithi, sifundisa izakhamuzi ukuthi ukwakheka kwe-bezoar akuvamile ukwenzeka esiswini esinempilo; kudinga izici ezintathu ezihambisanayo:
1) Ukudla ngokweqile i-fiber engagayeki.
2) Ukushintsha kokuphuma kwesisu ngenxa ye-diabetic gastroparesis noma i-vagotomy yangaphambilini; kanye,
3) I-Hypochlorhydria noma ukwehla kwe-pepsin esiswini.
Isiphetho
Ngamafuphi, nakuba amatshe esiswini engavamile kubantu, ama-gastrolith emifino, akhiwe yizinsalela zezitshalo ezingagaywanga, avame ukuba yingozi futhi angaba yingozi uma engelashwa kahle.
Ukuvimbela kuyisihluthulelo sokugwema ingozi yamatshe esiswini; ngokulandela ukudla okunempilo, ukuphuza amanzi anele nokugwema ukukhuluphala ngokweqile, utshwala nogwayi, kungathathwa izinyathelo zokuvimbela ukwakheka kwamatshe esiswini.
Uma usola ukuthi unamatshe esiswini noma uzwa ubuhlungu besisu obuhlala isikhathi eside, kubalulekile ukufuna usizo lwezokwelapha edolobheni ngokushesha, kungaba ngohlelo lokunakekelwa kwempilo lukahulumeni noma oluzimele, ukuze kuncishiswe ingozi yezinkinga zokugaya ukudla, njengokuvaleka kwamathumbu.
Usufike esikhathini esikhethekile sokubonisa ubumbano ngokwabelana ngolwazi lwezempilo lokuvimbela ngamatshe esiswini ezinkundleni zokuxhumana, ngaleyo ndlela, ndawonye, sisiza abantu abaningi ukuba bazuze ekudleni okufanele kanye nokumanzisa amanzi ukuze bagweme izinkinga eziningi.
Ngiyabonga ngokushiya imibono neziphakamiso zakho kubhulogi. Sizobonana kokuthunyelwe okulandelayo…
UDkt. Jorge Delgado, Udokotela Ohlinzayo. Amatshe esisu.
📌 Ukufundwa okunconyiwe:
👉 Umhlahlandlela nge -cholestasis, i-acholia kanye nokugaya amafutha.
👉 Ukuhlaziywa kwe -ultrasound yenyongo kanye nokuxilongwa okuhlukile.
👉 Iphrothokholi yokuhlola ukuvinjelwa kwe-pyloric kanye ne-peritonitis.