Ukuqonda i-Esophageal Varices: Izimpawu, Izimbangela, Nokwelashwa

I-Esophageal varices yizicubu zezinzwa ezinkulu, eziqandayo esibindini sakho ezingaba yingozi uma ziqhekeka. Cabanga ngazo njengezinzwa ze-varicose, kodwa esikhundleni sokuba ezinyaweni zakho, zikhula empompini ethwala ukudla emlonyeni wakho kuya esiswini sakho.

Lezi zinzwa eziqandayo zivame ukuvela uma ukugeleza kwegazi elichibini lakho kuvinjelwe, kukhuthaza igazi ukuba lifune izindlela ezihlukile. Nakuba lesi simo sizwakala sisabisa, ukuqonda ukuthi kwenzekani emzimbeni wakho kungakusiza ukusebenzisana neqembu lakho lokunakekelwa kwezempilo ukuze uliphathe kahle.

Ziyini izimpawu ze-esophageal varices?

I-Esophageal varices ivame ukungabi nazimpawu kuze kube yilapho igazi liqhekeka, kungakho ngezinye izikhathi kubizwa ngokuthi “isimo esithule.” Awukwazi ukuthi unazo kuze kube yilapho kwenzeka inkinga enzima.

Uma igazi liqhekeka, kwenza isimo esiphuthumayo esidinga ukunakekelwa kwezokwelapha ngokushesha. Nazi izimpawu ezixwayisayo ezisho ukuthi udinga ukubiza u-911 ngokushesha:

• Ukugabha igazi noma into ebukeka njengezicucu zekhofi
• Izisu ezimnyama, ezinamathelayo, noma ezigcwele igazi
• Ukukhathala okukhulu noma ukuphelelwa amandla
• Ukubetha kwenhliziyo okusheshayo noma ukuzizwa sengathi inhliziyo yakho iyagijima
• Ubuthakathaka obuzuma noma ukudideka

• Ubuhlungu esifubeni noma ubunzima bokuqeda umoya

Abanye abantu bangase babe nezimpawu ezingathandeki kakhulu ngaphambi kokuba kube khona ukopha okukhulu. Lokhu kungafaka ukugula okuncane, ukuzizwa ukhathele kakhulu, noma ukuba nezisu ezimnyama ezingalona oluhlaza okumnyama.

Uma unayo i-liver disease noma i-cirrhosis, udokotela wakho cishe uzokulandelela njalo nge-esophageal varices, ngisho noma ungenazo izimpawu. Le ndlela yokwenza ngaphambi kwesikhathi ikusiza ukubamba lesi simo ngaphambi kokuba kuqale ukopha.

Yini ebangela i-esophageal varices?

I-Esophageal varices ivela uma igazi lingakwazi ukugeleza kahle nge-liver yakho, idala ukugcwala okukhuthaza igazi ukuba lifune ezinye izindlela. Lokhu kugcwala kwegazi esimisweni sakho se-portal vein kukhuthaza igazi ukuba liye ezicubeni zezinzwa ezincane esibindini sakho, kubangela ukuba ziqande.

Izimbangela eziyinhloko zihlanganisa izimo ze-liver ezidala le nkinga yokugeleza kwegazi:

• I-Cirrhosis evela ekusetshenzisweni kotshwala, okuyimbangela yazo zonke izimo
• Ukutheleleka kwe-Hepatitis B noma C okonakalisa inyama ye-liver ngokuhamba kwesikhathi
• I-Non-alcoholic fatty liver disease, evame kakhulu namuhla
• I-Primary biliary cholangitis, isimo se-liver se-autoimmune
• I-Hemochromatosis, lapho umzimba wakho ugcina khona insimbi eningi kakhulu

Ngokungavamile, ama-blood clots e-portal vein noma isimo esibizwa nge-Budd-Chiari syndrome singadala umphumela ofanayo wokugcwala. Abanye abantu bazalwa nezimo eziqeda ukugeleza kwegazi elichibini, nakuba lokhu kuyinto engavamile.

Imithi ethile nezinye izinto eziyingozi zingalimaza i-liver yakho ngokuhamba kwesikhathi, okungenzeka kubeka i-varices. Udokotela wakho uzofuna ukuqonda ukuthi yini engase ibe nomthelela e-liver yakho ukuze aphathe imbangela yangempela kanye nokuphatha i-varices ngokwayo.

Nini okufanele ubone udokotela nge-esophageal varices?

Kufanele ufuna ukunakekelwa okusheshayo kwesimo esiphuthumayo uma uhlangabezana nanoma yiziphi izimpawu zokopha, kufaka phakathi ukugabha igazi, izisu ezimnyama, noma ubuthakathaka obuzuma. Lezi zimpawu zibonisa isimo esiphuthumayo sezempilo esidinga ukwelashwa ngokushesha.

Uma unayo i-liver disease noma i-cirrhosis, uzodinga ukuqapha njalo ngisho noma ungenazo izimpawu. Udokotela wakho cishe uzokuncoma ukwenza i-screening endoscopies ukuze ahlole i-varices ngaphambi kokuba zibe yingozi.

Hlela i-appointment nodokotela wakho uma uqaphela ukukhathala okuqhubekayo, ukwehla kwesisindo okungachazeki, noma ukushintsha kwesifiso sakho sokudla. Nakuba lezi zimpawu zingaba nezimbangela eziningi, kufanele zixoxwe, ikakhulukazi uma unazo izimbangela zengozi ze-liver disease.

Ungalindi ukuthola usizo uma ukhathazekile ngokusetshenziswa kwakho utshwala noma uma ukhombiswe i-hepatitis. Ukungenelela kwangaphambi kwesikhathi kwezimo ze-liver kungavimbela izinkinga ezinjenge-esophageal varices ezingavela.

Ziyini izimbangela zengozi ze-esophageal varices?

Ubungozi bakho bokuthola i-esophageal varices kuncike kakhulu ezintweni ezingalimaza i-liver yakho noma eziqeda ukugeleza kwegazi kuyo. Ukuqonda lezi zimbangela zengozi kungakusiza ukuba uthathe izinyathelo zokuvikela impilo ye-liver yakho.

Izimbangela zengozi ezibaluleke kakhulu zihlanganisa:

• Ukusetshenziswa okukhulu kotshwala eminyakeni eminingi, okuyimbangela ehamba phambili
• Ukutheleleka kwe-Hepatitis B noma C okuqhubekayo
• Ukukhuluphala ne-metabolic syndrome, okungadala i-fatty liver disease
• I-Diabetes, ikakhulukazi uma ingalawulwa kahle
• Umlando womndeni we-liver disease noma izimo ezithile ze-genetic
• Ukukhombiswa ezinye izinto eziyingozi noma imithi engalimaza i-liver

Abanye abantu babhekene nobungozi obukhulu ngenxa yezinto abangazilawuli, njengezimo eziwusifa njenge-Wilson’s disease noma i-alpha-1 antitrypsin deficiency. Iminyaka nayo idlala indima, njengoba ukwephulwa kwe-liver kuvame ukuqoqwa ngokuhamba kwesikhathi.

Imithi ethile, kufaka phakathi ezinye izilwela ubuhlungu kanye nezinye izithasiselo, ingacindezela i-liver yakho uma isebenziswa isikhathi eside. Udokotela wakho angakusiza ukuqonda ukuthi yimiphi imithi engase ibe yingozi futhi anikeze ezinye izindlela eziphephile uma kungenzeka.

Ziyini izinkinga ezingase zenzeke nge-esophageal varices?

Inkinga ebuhlungu kakhulu ye-esophageal varices ukopha, okungaba yingozi futhi kudinga ukunakekelwa kwezokwelapha ngokushesha. Uma lezi zinzwa eziqandayo ziqhekeka, zingadala ukulahlekelwa igazi okukhulu ngokushesha.

Izinkinga zokopha zingafaka:

• I-Hemorrhagic shock evela ekulahlekelweni kwegazi okusheshayo
• I-Aspiration pneumonia uma igazi liphefumlelwa emaphashini
• Izinkinga zezinso ezivela ekulahlekelweni kwegazi nasekuguquleni kwamanzi
• Izinkinga zenhliziyo ezivela e-anemia enzima
• I-Hepatic encephalopathy, lapho izinto eziyingozi zithinta khona umsebenzi wobuchopho

Ngisho noma ukwelashwa okuphumelelayo kwe-bleeding varices, kunengozi yokuba kuphinde kuqale ukopha. Kungakho ukuqapha okuqhubekayo nokuphathwa kokuvimbela kubaluleke kakhulu kubantu abanesimo.

Ezimweni ezingavamile, ukwelashwa okusetshenziswayo ukuyeka ukopha kungadala izinkinga ezinjengokuqina kwesibindini noma ukutheleleka. Iqembu lakho lezokwelapha lizoqondanisa ngokucophelela izinzuzo nezingozi zezindlela ezahlukene zokwelapha.

I-esophageal varices ihlonishwa kanjani?

Ukuhlola i-esophageal varices kuvame ukudinga i-endoscopy, inqubo lapho udokotela wakho esebenzisa khona i-tube encane, egubekayo enenkhamera ukubuka ngaphakathi kwesibindini sakho. Lokhu kubanika umbono ocacile wanoma iyiphi izinzwa eziqandayo futhi kusiza ukuqonda ubungozi bokopha.

Udokotela wakho kuqala uzohlola umlando wakho wezokwelapha futhi enze ukuhlolwa komzimba, efuna izimpawu ze-liver disease njenge-jaundice noma ukugcwala kwamanzi. Izivivinyo zegazi zingaveza izinkinga zomsebenzi we-liver futhi zisize ukubona izimbangela eziyinhloko.

Inqubo ye-endoscopy ngokwayo ithatha cishe imizuzu engu-15-30 futhi ivame ukwenziwa ngokulala ukuze uhlale ukhululekile. Udokotela wakho uzokwazi ukubona i-varices ngokuqondile futhi azilinganise ngokusekelwe ebukhoneni nasesimo sazo.

Ezinye izivivinyo zingafaka i-CT scans noma i-ultrasounds ukuhlola i-liver yakho nezinzwa zegazi. Lezi zifundo zokuthwebula izithombe zisiza udokotela wakho ukuqonda isithombe esiphelele sokuthi kwenzekani emzimbeni wakho.

Yini ukwelashwa kwe-esophageal varices?

Ukwelashwa kwe-esophageal varices kugxila ekuvimbeleni ukopha nasekuphatheni isimo se-liver esiyinhloko. Udokotela wakho uzokwenza uhlelo lokwelapha olusekelwe ebukhoneni be-varices yakho nasempilweni yakho yonke.

Uma awukophi njengamanje, ukwelashwa kokuvimbela kungafaka:

• Imithi ye-Beta-blocker ukuze unciphise ukucindezela ezicubeni zakho ze-portal veins
• I-Endoscopic band ligation ukuvala i-varices
• Ukuqapha njalo nge-repeat endoscopies
• Ukwelashwa kwesimo se-liver esiyinhloko

Ngokupha okusebenzayo, ukwelashwa okuphuthumayo kugxila ekuyekekeni kokulahlekelwa igazi ngokushesha. Lokhu kungafaka izinqubo ze-endoscopic ukuvala izinzwa zegazi ezikopha, imithi yokunciphisa ukugeleza kwegazi, noma amadivayisi e-balloon okubekwa isikhashana ukufaka ukucindezela.

Ezimweni ezinzima, ungase udinga izinqubo ezinzima njenge-TIPS (transjugular intrahepatic portosystemic shunt), edala indlela entsha yokugeleza kwegazi. Abanye abantu bangase ekugcineni badinge ukwelashwa kwe-liver transplant uma i-liver disease yabo iphezulu.

Indlela yokuphatha i-esophageal varices ekhaya?

Ukuphatha i-esophageal varices ekhaya kuhilela ukuvikela impilo ye-liver yakho nokulandela iziphakamiso zikadokotela wakho ngokucophelela. Isinyathelo esibaluleke kakhulu ukugwema utshwala ngokuphelele, njengoba kungalimaza i-liver futhi kukhulise ubungozi bokopha.

Thatha imithi yakho eyalwe ngokunembile njengoba kuyalwe, ikakhulukazi i-beta-blockers esiza ukunciphisa ukucindezela ezicubeni zakho. Ungaphuthi izilinganiso noma uyeke imithi ngaphandle kokukhuluma nodokotela wakho kuqala.

Qaphela ukudla kwakho ngokulinganisela i-sodium ukuze unciphise ukugcwala kwamanzi futhi udle ukudla okujwayelekile, okujwayelekile ukuze usekele umsebenzi we-liver. Gwema i-aspirin ne-non-steroidal anti-inflammatory drugs (NSAIDs) njenge-ibuprofen, njengoba lezi zingakhuphula ubungozi bokopha.

Hlala uxwayile ngezimpawu zoxwayiso zokopha futhi wazi ukuthi nini kufanele ufuna ukunakekelwa okuphuthumayo. Gcina uhlu lwemithi yakho nezimimo zezokwelapha nawe ngaso sonke isikhathi uma kwenzeka isimo esiphuthumayo.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Lungiselela i-appointment yakho ngokuqoqa ulwazi mayelana nezimpawu zakho, imithi, nomlando wezokwelapha. Bhala phansi noma yimiphi imibuzo ofuna ukuyibuza futhi ulethe uhlu lwemithi yonke nezithasiselo ozithathayo.

Gcina irekhodi lazo zonke izimpawu ozibonile, kufaka phakathi ukuthi zenzeke nini nokuthi zazinzima kangakanani. Qaphela noma yikuphi ukushintsha ezingeni lakho lamandla, isisindo sakho sokudla, noma izisu zakho.

Letha ilungu lomndeni noma umngani uma kungenzeka, ikakhulukazi uma uzizwa ukhathazekile nge-appointment. Bangakusiza ukuba ukhumbule ulwazi olubalulekile futhi banikeze ukwesekwa.

Yiba eqotho ngokusetshenziswa kwakho utshwala nanoma yiziphi ezinye izinto ezingase zithinte impilo ye-liver yakho. Udokotela wakho udinga ulwazi oluphelele ukuze anikeze ukunakekelwa okuhle kakhulu okungenzeka.

Yini okuyisifundo esiyinhloko mayelana ne-esophageal varices?

I-Esophageal varices yisimo esinzima esidinga ukunakekelwa kwezokwelapha okuqhubekayo, kodwa ingaphathwa kahle ngokwelashwa okufanele. Okubalulekile ukusebenzisana eduze neqembu lakho lokunakekelwa kwezempilo ukuze uqaphe isimo sakho futhi uvikele izinkinga.

Ukuhlolwa kwangaphambi kwesikhathi nokuphathwa kwesimo se-liver esiyinhloko kungavimbela i-varices ekuveleni noma ekubeni zimbi. Uma usuvele unayo i-varices, ukulandela uhlelo lwakho lokwelapha nokuhlala uxwayile ngezimpawu zoxwayiso kungasiza ukuvimbela izigameko zokopha ezingaba yingozi.

Khumbula ukuthi ukuba ne-esophageal varices akusho ukuthi awukwazi ukuphila impilo ezele. Abantu abaningi baphatha lesi simo ngempumelelo ngokunakekelwa kwezokwelapha okufanele nokushintsha indlela yokuphila.

Imibuzo evamile ebuzwa mayelana ne-esophageal varices

Ingabe i-esophageal varices ingaphela yodwa?

I-Esophageal varices ivame ukungapheli ngaphandle kokwelashwa, ikakhulukazi uma isimo se-liver esiyinhloko siqhubeka nokubangela ukucindezela okukhulu. Noma kunjalo, ukwelashwa okufanele kunganciphisa kakhulu ubukhulu bazo nobungozi bokopha. Ezimweni ezithile, ukwelashwa okuphumelelayo kwesimo se-liver esiyinhloko kungadala ukuthuthuka kwe-varices ngokuhamba kwesikhathi.

Ubude kangakanani ongabuphila nge-esophageal varices?

Abantu abaningi abane-esophageal varices baphila iminyaka eminingi ngokuphathwa kwezokwelapha okufanele nokushintsha indlela yokuphila. Ukubuka kwakho kuncike ezintweni eziningi, kufaka phakathi ubukhulu besimo se-liver esiyinhloko, indlela ophendula ngayo ekwelapheni, nokuthi izinkinga zokopha zenzeka yini. Ukusebenzisana eduze neqembu lakho lokunakekelwa kwezempilo kukunika ithuba elihle kakhulu lokuphila impilo enhle.

Ingabe kukhona ukudla okufanele ngikugweme nge-esophageal varices?

Kufanele ugweme ukudla okuqine, okuhlaba, noma okukhulu okungase kuqinisise isibindini sakho, njenge-chips, i-crust bread, noma i-nuts. Ukudla okunoshukela kanye neziphuzo ezishisayo kakhulu kungase futhi kuqinisise. Gxila ekudleni okulula, okulula ukuqeda, futhi ugweme utshwala ngokuphelele. Udokotela wakho noma umchwepheshe wokudla angakunikeza isiqondiso esithile sokudla esisekelwe esimweni sakho.

Uyini umehluko phakathi kwe-esophageal varices nezinzwa ze-varicose ezijwayelekile?

Nakuba kokubili kuhilela izinzwa ezinkulu, i-esophageal varices inzima kakhulu kunama-varicose veins ongawaqaphela ezinyaweni zakho. I-Esophageal varices itholakala endaweni ebalulekile lapho ukopha kungaba yingozi, futhi kubangelwa izinkinga ezinzima ze-liver. Ama-varicose veins ajwayelekile ngokuyinhloko kuyinkinga yokuhlobisa futhi awenzi izinkinga ezinzima.

Ingabe ukucindezeleka kungenza i-esophageal varices ibe zimbi?

Nakuba ukucindezeleka kungabangeli i-esophageal varices ukuba ibe zimbi, kungathinta impilo yakho yonke futhi kungenzeka ukuthi kuthinte umsebenzi we-liver yakho. Ukucindezeleka kungase futhi kuholele ezenzweni ezingalimaza i-liver yakho, njengokusetshenziswa okukhulu kotshwala. Ukuphatha ukucindezeleka ngezindlela zokuxazulula izinkinga ezempilo, ukuzivocavoca njalo, nokulala okwanele kungasekele uhlelo lwakho lokwelapha lonke.