Varices Ya Esophage

Varices yo mu nyuma y’umutwe ni imiyoboro y’amaraso ikomeye iri mu nyuma y’umutwe. Akenshi iterwa no kubangamirwa kw’amaraso anyura mu muhogo, utwara amaraso ava mu mara ajya mu mwijima.

Varices yo mu nyuma y’umutwe ni imiyoboro y’amaraso ikomeye iri mu nyuma y’umutwe, umuyoboro uhuza umuhogo n’igifu. Varices yo mu nyuma y’umutwe ikunda kugaragara mu bantu barwaye indwara zikomeye z’umwijima.

Varices yo mu nyuma y’umutwe itera iyo amaraso asanzwe ajya mu mwijima abangamiwe n’ikibyimba cyangwa umukamba mu mwijima. Kugira ngo amaraso azenguruke ibyo bibangamira, anyura mu mihogo y’amaraso mito itagenewe gutwara amaraso menshi. Iyo mihogo ishobora gukurura amaraso cyangwa ndetse ikanaturika, bigatera kuva amaraso bishobora kwica.

Hari imiti mike n’uburyo bwo kuvura buhari kugira ngo dufashe kwirinda cyangwa guhagarika kuva amaraso biterwa na varices yo mu nyuma y’umutwe.

Varices zo mu nyabitsina zisanzwe nta bimenyetso zigira keretse iyo zivunitse. Ibimenyetso byo kuva amaraso mu myanya y'ubuhumekero birimo: Kuvomera amaraso menshi. Inkari zirakomye, ziracyeye cyangwa zifite amaraso. Kuzana iseseme kubera kubura amaraso. Gutakaza ubwenge mu bihe bikomeye. Muganga wawe ashobora gushidikanya ko ufite varices zo mu nyabitsina niba ufite ibimenyetso by'indwara y'umwijima cyangwa waramaze kuvurwa indwara y'umwijima, birimo: Ibara ry'umuhondo ry'uruhu n'amaso, bizwi nka jaundice. Kuvura amaraso cyangwa kwishimaho byoroshye. Kuvimba mu nda, bizwi nka ascites (uh-SY-teez). Tegura gahunda yo kubonana n'abaganga bawe niba ufite ibimenyetso bikubuza amahoro. Niba umaze kuvurwa indwara y'umwijima, baza umuvuzi wawe ku kibazo cyawe cya varices zo mu nyabitsina n'icyo wakora kugira ngo ugabanye ibyago. Kandi baza niba ukwiye kubona uburyo bwo kugenzura varices zo mu nyabitsina. Niba umaze kuvurwa varices zo mu nyabitsina, umuvuzi wawe azakubwira kwitondera ibimenyetso byo kuva amaraso. Kuva amaraso mu myanya y'ubuhumekero ni ubutabazi bw'ihutirwa. Hamagara 911 cyangwa serivisi z'ubutabazi zaho uba igihe ufite inkari ziracyeye cyangwa zifite amaraso, cyangwa uvomera amaraso.

Suzuguramo umuganga wawe niba ufite ibimenyetso bikubuza amahoro. Niba umaze kubona indwara y'umwijima, baza umuganga wawe ku byerekeye ibyago byo kugira varices zo mu nyabitsina n'icyo wakora kugira ngo ugabanye ibyago. Kandi, baza niba ukwiye gukorerwa isuzuma kugira ngo harebwe niba ufite varices zo mu nyabitsina.

Niba umaze kubona varices zo mu nyabitsina, umuganga wawe arashobora kukubwira ko ukwiye kwitondera ibimenyetso byo kuva amaraso. Varices zo mu nyabitsina zivuze amaraso ari ikibazo cyihutirwa. Hamagara 911 cyangwa serivisi z'ubutabazi zaho hantu ako kanya niba ufite umusega uri umukara cyangwa ufite amaraso, cyangwa niba utuka amaraso.

Ibiheri bya esofaji rimwe na rimwe bibaho iyo amaraso ajya mu mwijima yahagaritswe. Ibi bikunze guterwa n'uduheri mu mwijima kubera indwara y'umwijima, bizwi kandi nka sirozi y'umwijima. Amaraso atangira gusubira inyuma. Ibi byongera umuvuduko mu mutsi munini, uzwi nka portal vein, utwara amaraso ajya mu mwijima. Iyi ndwara yitwa hypertension ya portal. Hypertension ya portal ituma amaraso ashaka inzira zindi zinyura mu mitsi mito, nka biriya biri mu gice cyo hasi cya esofaji. Iyi mitsi ifite inkuta zoroheje iraziba kubera amaraso yiyongereye. Rimwe na rimwe iracika ikavuza. Intandaro z'ibiheri bya esofaji harimo: Uduheri dukomeye mu mwijima, twitwa sirozi. Indwara nyinshi z'umwijima — zirimo kwandura kwa hepatite, indwara y'umwijima iterwa n'inzoga, indwara y'umwijima uterwa na lipide ndetse n'indwara y'umuyoboro w'inzira y'umusemburo yitwa cholangite ya biliaire ya mbere — zishobora gutera sirozi.Igihombo cy'amaraso, cyitwa thrombosis. Igihombo cy'amaraso kiri muri portal vein cyangwa mu mutsi winjira muri portal vein, uzwi nka splenic vein, gishobora gutera ibiheri bya esofaji.Ikigero cy'udukoko. Schistosomiase ni ikigero cy'udukoko tuboneka mu bice bya Afurika, Amerika y'Epfo, Karayibe, Iburasirazuba bwo hagati n'Uburasirazuba bw'Aziya. Udukoko dushobora kwangiza umwijima, ndetse n'ibihaha, umwijima, uruhago n'ibindi bice by'umubiri.

Nubwo abantu benshi barwaye indwara ikomeye y'umwijima bagira varices zo mu nyuma y'umuyoboro w'ibiryo, abenshi ntibazatera amaraso. Varices zo mu nyuma y'umuyoboro w'ibiryo zishobora gutera amaraso cyane iyo ufite: Umuvuduko mwinshi mu mubiri w'umwijima. Icyago cyo gutera amaraso kiyongera uko umuvuduko mu mubiri w'umwijima wiyongera. Varices nini. Uko varices zo mu nyuma y'umuyoboro w'ibiryo ari nini, ni ko zishobora gutera amaraso cyane. Ibirango by'umutuku kuri varices. Zimwe muri varices zo mu nyuma y'umuyoboro w'ibiryo zigaragaza imirongo miremire y'umutuku cyangwa ibice by'umutuku. Umuganga wawe arashobora kubibona akoresheje umuyoboro muto, woroshye, witwa endoscope, ushyirwa mu kanwa kawe. Ibi birango bigaragaza ko hari ibyago byinshi byo gutera amaraso. Cirrhosis ikomeye cyangwa gucika intege kw'umwijima. Akenshi, uko indwara y'umwijima yawe ari ikomeye, ni ko varices zo mu nyuma y'umuyoboro w'ibiryo zishobora gutera amaraso cyane. Gukomeza kunywa inzoga. Icyago cyo gutera amaraso cya varices kiri hejuru cyane niba ukomeje kunywa kurushaho guhagarika, cyane cyane niba indwara yawe iterwa n'inzoga. Niba waraterwemo amaraso na varices zo mu nyuma y'umuyoboro w'ibiryo mbere, ushobora kongera kugira varices zitera amaraso.

Ingaruka ikomeye cyane y'ibibyimba by'umuyoboro w'ibiryo (esophageal varices) ni ukuvuza amaraso. Iyo umaze kuva amaraso, ibyago byo kongera kuva amaraso byiyongera cyane. Niba watakaje amaraso ahagije, ushobora kwinjira mu gihe cy'akaga (shock), ibyo bikaba bishobora gutera urupfu.

Kuri ubu, nta muti uraboneka ushobora gukumira iterambere rya varices zo mu nyabitsina mu bantu barwaye cirrhose. Nubwo imiti ya beta blocker ikora neza mu gukumira kuva amaraso mu bantu benshi bafite varices zo mu nyabitsina, ntiikumira iterambere rya varices zo mu nyabitsina. Niba uherutse kuvurirwa indwara y'umwijima, baza umuvuzi wawe ibijyanye n'ingamba zo kwirinda ingaruka z'indwara y'umwijima. Kugira ngo umwijima wawe ukomeze kugira ubuzima bwiza:

• Ntunywe inzoga. Abantu barwaye indwara y'umwijima bakunze kugirwa inama yo kureka kunywa inzoga, kuko umwijima ari wo utunganya inzoga. Kunywa inzoga bishobora guhangayikisha umwijima usanzwe ufite intege nke.
• Funga indyo yuzuye. Hitamo indyo yuzuye imbuto n'imboga. Hitamo ibinyampeke byuzuye n'ibikomoka ku nyamaswa bike. Kugabanya umubare w'ibiribwa bikozwe mu mafuta menshi n'ibiribwa byagoretswe.
• Komeza ibiro byiza. Umuvuduko mwinshi w'ibinure by'umubiri bishobora kwangiza umwijima wawe. Gutakaza ibiro ni ingenzi niba uri mu kigero cy'uburemere cyangwa urengeje ibiro. Kubyibuha bifitanye isano n'ingaruka nyinshi za cirrhose.
• Koresha ibintu byangiza umubiri bike kandi witonze. Kurikiza amabwiriza ari ku bintu byangiza umubiri, nka ibikoresho byo gusukura n'imiti yo kurwanya udukoko. Niba ukora hafi y'ibintu byangiza umubiri, kurikiza ingamba zose z'umutekano. Umwijima wawe ukuraho uburozi mu mubiri wawe, bityo umuhe akaruhuko no kugabanya umubare w'uburozi butunganya.
• Kugabanya ibyago bya hepatite. Gusangira ibyuma byo guterwa inshinge no gukora imibonano mpuzabitsina idakingiye bishobora kongera ibyago bya hepatite B na C. Wirinde ubwawe utagira imibonano mpuzabitsina cyangwa ukoreshe agakingirizo niba uhisemo gukora imibonano mpuzabitsina. Supima niba waranduye hepatite A, B na C, kuko kwandura bishobora kongera indwara y'umwijima. Kandi baza umuvuzi wawe niba ukwiye gukingirwa hepatite A na hepatite B.

Mu gihe cyo gukora endoscopie y'umutwe, umukozi w'ubuzima ashyiramo umuyoboro muto, woroshye ufite amatara na kamera munsi y'umunwa no mu munwa. Kamera nto itanga ishusho y'umunwa, igifu n'intangiriro z'umwanya muto, witwa duodenum.

Niba ufite cirrhose, umuvuzi wawe akenshi akumenyereza indwara ya esophageal varices iyo ubonye indwara. Ubwinshi bw'ibizamini byo gupima biterwa n'uburwayi bwawe. Ibipimo by'ingenzi bikoresha mu kuvura esophageal varices ni:

• Ibizamini by'amashusho. Scan ya CT y'inda na Doppler ultrasound ya splenic na portal veins bishobora kwerekana ubuhari bw'esophageal varices. Ibizamini bya ultrasound byitwa transient elastography bishobora gukoreshwa mu kupima ibikomere mu mwijima. Ibi bishobora gufasha umuvuzi wawe kumenya niba ufite portal hypertension, ishobora gutera esophageal varices.

Isuzuma rya Endoscopic. Igikorwa cyitwa upper gastrointestinal endoscopy ni uburyo bwiza bwo gupima esophageal varices. Endoscopy irimo gushyiramo umuyoboro woroshye, ufite amatara witwa endoscope munsi y'umunwa no mu munwa. Kamera nto iri ku mpera ya endoscope iha umuganga wawe amahirwe yo gusuzuma umunwa wawe, igifu n'intangiriro z'umwanya muto, witwa duodenum.

Umuvuzi arashaka imiyoboro yagutse. Niba iboneka, imiyoboro yagutse irapimwa kandi irakorwaho kugira ngo harebwe imirongo itukura n'ibice bitukura, bikunze kugaragaza ibyago byinshi byo kuva amaraso. Ubuvuzi bushobora gukorwa mu gihe cy'isuzuma.