Vanachiremba vazhinji vanodavira kuti kushandiswa kwenguva refu kweproton-pump inhibitors (PPIs) sePrevacid (lansoprazole) uye Prilosec (omeprazole) yegastroesophageal reflux chirwere (heartburn) inogona kuwedzera inrophic gastritis mumuviri (kureva, corpus) yedumbu-kunyanya mune vanhu vane hutachiona hutachiona. Kutaura, hutachiona neH H. pylori kunogona kutungamirira kumaronda emudumbu uye kunyange nekenza yepamu.
Mukuwedzera pakupindira nekunyanya kudya, chirwere chisingaperi chine atrophic gastritis chinogona kushanda sechirongwa chekare kana chepincerous lesion iyo inokonzera munhu kuti ave nekenza yemuviri (kureva, adenocarcinoma).
Achifunga kuti kushandiswa kwemishonga kwenguva yakareba sePreccid uye Prilosec, ikoizvo, kunotungamirira kune inrophic gastritis kune vanhu vane hutachiona hweH. Pylori , uye zvino inowedzera dambudziko rekenza yemudumbu chii chaizova nzira yekuwedzera kwakanyanya?
Chronic Atrophic Gastritis
Chronic atrophic gastritis inogara kwenguva refu kuputika kwemuviri wechipfu. Zvinowanzoitika kune vakwegura asi zvinogona kuitika kuvanhu vaduku, zvakare. Muvanhu vakawanda, H. pylori , bhakitiriya inokonzera ulcers, inokonzera atrophic gastritis, zvakare. Zvimwe zvinokonzera chirwere chinonzi atrophic gastritis chinosanganisira chirwere chemoto chinosangana nehutachiona anemia, hypersecretion (yakawedzera gastric acid secretion), uye nzvimbo.
Chronic atrophic gastritis inotungamirira pakuparadzwa kwakanyanya kweparietal uye masero masero anobudisa gastric acid uye gastric enzymes, maererano.
Gastric acid uye gastric enzyme inodiwa kuti igone. Kana zvakakwana zvemasero aya zvakarasikirwa, zvinetso zvinokonzerwa nekudya zvinokonzera kusanganisira kushayikwa kwechibaramin (vitamin B12), iron-inoshaya anemia uye zvirwere zvinokonzerwa nechikafu chatinodya.
Vitamini B12 kushayikwa ndiyo inonyanya kukosha yezvinetso izvi uye inogona kukonzera matambudziko emagetsi kune avo vane chirwere chinokonzera chirwere chinokonzera chirwere cheperesi kana chirwere chemoto.
Muvanhu vanotora PPIs kwenguva yakareba, kushayikwa kweklabalamin ishoma; zvisinei, kubatwa neutachiona hunowedzera. Izvozvi, gastric acid inouraya mabhakitiriya mune zvokudya zvedu, uye kana pane zvishoma gastric acid nokuda kwePPIs, mabhakitiriya anoramba ari asina simba uye anogona nyore nyore kuuraya.
Chronic atrophic gastritis inonyanya kurwadza nokuti inogadzirira munhu kuti ave nechirwere chepachirwere chinokonzera uye chinotakura kusagadzikana kwakashata.
Proposed Mechanism for PPI-induced Atrophic Gastritis muvanhu neH. H. Pylori
PPIs seSevhisi yePreccid uye Prilosec kuburikidza nekudzivisa kugadzirwa kwegastric acid. Gastroesophageal reflux chirwere (GERD kana "asidi reflux") inoitika apo pasi reesophageal sphincter inokundikana kuvhara zvakanaka, uye gastric acid kubva mudumbu dzomukati kusvika mudumbu rinokonzera kushungurudzika kwepfungwa. Nechingwa shoma asidi, uku kunzwa kwekurwadziwa kunopera.
Kana maitiro echingamu echine kuderera, bile acid inogadziriswa. Bile acids inokonzerwa nemakemikari , uye mumharaunda yakadzika kana kuti yakadzika yedumbu (pedyo pedumbu duku), kuwedzera kwemajeri e-soluble bile acids kunoita kuti zvisikwa zvirege kugadzirisa kukura kweatrophic-gastritis-zvichiita H. pylori . Zvisinei, iri pedyo kana kuti yakakwirira mumuviri wemudumbu, PPIs inoita mamiriro ezvinhu akanaka pakukura kwaHh pylori .
Kunyanya, iyo yakakosha yemadidient pakati pemhepo yakasanganiswa nemasero ema plasma, ayo ari chemoattractive ; saka, H. pylori colonization shifts kuenda kune epithelial cell layer kumusoro.
Mune mamwe mazwi, maererano nekugadziriswa uku, kushandiswa kwenguva refu kwePPIs kunovhiringidza nemakemikari mukati memudumbu ichiita kuti muviri wemudumbu ive imba yakanaka yeH. pylori bhakteriya. Iyi H. pylori mabhakitiriya zvino inokonzera atrophic gastritis iyo inotungamirira munhu kumusana wekenza yemuviri.
Mishonga yakadai sePreccid uye Prilosec inowanikwa nyore nyore pane-the-counter, uye vanhu vazhinji vanowanzozvidavirira. Kunyange zvazvo maPPIs ari akachengeteka uye anoshanda zvakanyanya mukurapa GERD, kana izvi zvinoratidzwa H. pylori- zvakagadziriswa atrophic gastritis maitiro zvaiva zvechokwadi, ipapo iyo ingangodaro pfungwa yakanaka yokuti iwe uone nechiremba usati watora PPIs kwenguva yakareba.
Kunyanya kunyanya, chiremba wako angada kukuedza kuti uwane hutachiona hweH H. pylori uye anokubata iwe nehutachiona hwakadai (kureva, katachirapa hutatu) usati wakuisa pane chirwere chemaPI kwenguva refu.
Zvino, ngatikandire mutsara monkey muchirevo ichi. Muchiitiko chegore ra2013 Cochrane, vatsvakurudzi vakaburitsa mashoko kubva kumanomwe ekuongorora-maitiro (1789 tsvakurudzo dzevadzidzi) uye vakafunga kuti maPPIs haana kuwedzera dambudziko rekushaya gastritis kunyange kune avo vane hutachiona hunonzi H. pylori . Kana maPPIs asingawedzeri njodzi ye-atrophic gastritis, ipapo hapangavi nechirwere chakakosha chechigoni chinogona kuisa danho rekenza yemudumbu.
Shoko Rinobva
Pakupedzisira, kana iwe kana mumwe munhu waunoda ane kuora mwoyo kwakanyanya kunopfuurira, pasinei nezvose zvatakanyora kusvika ikozvino, zviri pachena pfungwa yakanaka kuona chiremba. Rega chiremba wako asarudze kuti angakuisa pane chirwere chekare chePPI. (Ita wakasununguka, zvisinei, kubvunza pamusoro peH. Pylori kuongororwa uye kurapwa.) Nemhaka yokuti mishonga inowanikwa nyore nyore pane-the-counter haina kureva kuti iwe unofanira kuitora usingabvunzi chiremba kunyanya kwenguva refu.
> Sources:
> Barrett KE. Chitsauko 3. Gastric Secretion. Mu: Barrett KE. eds. Gestrointestinal Physiology, 2e. New York, NY: McGraw-Hill; 2014.
> Kitagawa Y, Dempsey DT. Dumbu. Mu: Brunicardi F, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, Pollock RE. eds. Schwartz's Principles of Surgery, 10e . New York, NY: McGraw-Hill; 2014.
> Mukaisho, K, et al. Nzira inogona kuita gastritis yakakurumbira pashure pePII remishonga muHelicobacter Pylori- vane zvirwere vane GERD. World Journal of Gastroenterology . 2014; 20 (34): 11962-5
> Rwiyo, H, Zhu, J, Lu, D. Penguva refu proton pump inhibitor (PPI) inoshandiswa uye kukura kwezvipembenene zvezvipembenene zvinotyisa. Nhamba yeChrane yeChrane yeUkuongorora kwakarongeka. 2014.