Yini i-Upper Endoscopy? Inhloso, Inqubo & Imiphumela

I-Upper endoscopy iyinqubo yezokwelapha evumela udokotela wakho ukuthi abone ngaphakathi kwengxenye yakho engenhla yokugaya ukudla esebenzisa ithumbu elincanyana, eliguquguqukayo elinekhamera. Lolu vivinyo oluphephile futhi oluvame ukwenziwa lusiza ukuxilonga izinkinga e-esophagus yakho, esiswini, kanye nengxenye yokuqala yamathumbu akho amancane ebizwa nge-duodenum.

Le nqubo ibizwa nangokuthi i-EGD, okusho ukuthi i-esophagogastroduodenoscopy. Ngenkathi igama lizwakala liyinkimbinkimbi, ukuhlolwa ngokwako kuqondile futhi kuvame ukuthatha imizuzu eyi-15 kuya kwengama-30 ukuqedela.

Yini i-upper endoscopy?

I-Upper endoscopy iyinqubo yokuxilonga lapho i-gastroenterologist isebenzisa ithuluzi elikhethekile elibizwa nge-endoscope ukuhlola uhlelo lwakho olungaphezulu lokugaya ukudla. I-endoscope iyithumbu elincanyana, eliguquguqukayo elingaba nobubanzi bomunwe wakho omncane oqukethe ikhamera encane nokukhanya ekugcineni kwayo.

Ngesikhathi senqubo, udokotela wakho uqondisa ngobumnene leli thumbu ngomlomo wakho, phansi emqaleni wakho, nangaphakathi kwe-esophagus yakho, isisu, kanye ne-duodenum. Ikhamera enencazelo ephezulu ithumela izithombe zesikhathi sangempela ku-monitor, okuvumela udokotela wakho ukuthi abone ngokusobala ukuthi lezi zitho zihamba kanjani futhi abone noma yiziphi izinto ezingavamile.

Lokhu kubona okuqondile kusiza odokotela ukuthi baxilongwe izimo ezingase zingabonakali kahle kuma-X-ray noma ezinye izivivinyo zokucabanga. I-endoscope ingahlonyiswa futhi ngamathuluzi amancane ukuthatha amasampula ezicubu noma ukwenza ukwelashwa okuncane uma kudingeka.

Kungani kwenziwa i-upper endoscopy?

I-Upper endoscopy yenziwa ukuze kuphenywe izimpawu ezithinta ingxenye yakho engenhla yokugaya ukudla futhi ukuxilonga izimo ezihlukahlukene. Udokotela wakho angase ancome lolu vivinyo uma uhlangabezana nezimpawu zokugaya ukudla eziqhubekayo noma ezikhathazayo ezidinga ukuhlolwa okuseduze.

Le nqubo ingasiza ukukhomba imbangela yezimpawu ongase uzithole. Nazi ezinye izizathu ezivamile odokotela abancoma ngazo i-upper endoscopy:

• Ukuvuvukala kwesifuba okuqhubekayo noma i-acid reflux engathuthuki ngemithi
• Ukunqika ukugwinya noma ukuzwa sengathi ukudla kuyabambeka
• Ubuhlungu besisu obuqhubekayo noma ukungakhululeki esiswini
• Isicanucanu nokuhlanza okungachazeki
• Ubufakazi bokopha emathunjini akho, njengokuhlanza igazi noma izitulo ezimnyama
• Ukuncipha kwesisindo okungachazeki
• I-anemia engapheli engase ibangelwe ukuphuma kwegazi ngaphakathi

I-Upper endoscopy ingathola futhi ixilongwe izimo ezihlukahlukene, kusukela ezinkingeni ezivamile kuya ezingxenyeni ezingathi sína. Udokotela wakho angakwazi ukuhlonza ukuvuvukala, izilonda, izimila, noma ukungajwayeleki kwesakhiwo okungase kubangele izimpawu zakho.

Ngezinye izikhathi odokotela basebenzisa i-upper endoscopy ngenjongo yokuhlola, ikakhulukazi uma unezici eziyingozi zezinye izimo ezinjenge-Barrett's esophagus noma uma unomlando womndeni womdlavuza wesisu. Le nqubo ingase futhi iqaphe izimo ezaziwayo noma ihlole ukuthi ukwelashwa kusebenza kahle kangakanani.

Yini inqubo ye-upper endoscopy?

Inqubo ye-upper endoscopy ngokuvamile yenzeka endaweni yeziguli eziphuthumayo, njenge-hospital endoscopy suite noma umtholampilo okhethekile. Uzofika cishe ihora ngaphambi kwesikhathi sakho esihleliwe senqubo ukuze uqedele imibhalo futhi ulungiselele ukuhlolwa.

Ngaphambi kokuthi inqubo iqale, ithimba lakho lezokwelapha lizobuyekeza umlando wakho wezokwelapha nemithi yamanje. Uzoshintsha ufake ingubo yasesibhedlela futhi ufake umugqa we-IV engalweni yakho ukuze uthole imithi. Izimpawu zakho ezibalulekile zizoqashwa kuyo yonke inqubo.

Iziguli eziningi zithola i-conscious sedation, okusho ukuthi uzobe ukhululekile futhi ukozela kodwa usaphefumula ngokwakho. Umuthi wokuthulisa ukukusiza ukuthi uzizwe ukhululekile futhi unciphise noma yikuphi ukukhathazeka noma ukungakhululeki. Ezinye iziguli zingase zikhethe ukwenza inqubo ngomshini wokufutha umphimbo ukuze ube ndikindiki indawo, nakuba lokhu kuvamile.

Ngesikhathi somsebenzi wangempela, uzoqala ukulala ngohlangothi lwakho lwesobunxele etafuleni lokuhlolwa. Udokotela wakho uzofaka ngobumnene i-endoscope ngomlomo wakho bese eyihola phansi emqaleni wakho. I-endoscope ayiphazamisi ukuphefumula kwakho, njengoba yehla esofagus yakho, hhayi umoya wakho.

Udokotela wakho uzohlola ngokucophelela indawo ngayinye, ebheka ukugqama kwe-esophagus yakho, isisu, kanye ne-duodenum. Bangase bathathe izithombe noma amarekhodi evidiyo yanoma yini engajwayelekile. Uma kudingeka, bangathatha amasampula amancane ezicubu abizwa ngokuthi ama-biopsies besebenzisa amathuluzi amancane adluliswa nge-endoscope.

Yonke inqubo ngokuvamile ithatha imizuzu eyi-15 kuya kwengama-30, kuye ngokuthi udokotela wakho utholani nokuthi ngabe kudingeka yini ezinye izinqubo. Ngemuva kokuthi ukuhlolwa kuqediwe, i-endoscope ikhishwa ngobumnene, futhi uzothathwa endaweni yokululama.

Ungalungiselela kanjani i-upper endoscopy yakho?

Ukulungiselela okufanele kubalulekile ukuze i-upper endoscopy iphumelele nokuphepha kwakho ngesikhathi senqubo. Ihhovisi likadokotela wakho lizokunikeza imiyalelo ethile, kodwa nazi izinyathelo zokulungiselela ezijwayelekile okuzodingeka uzilandele.

Isidingo esibaluleke kakhulu sokulungiselela ukuzila ukudla ngaphambi kwenqubo yakho. Kuzodingeka uyeke ukudla nokuphuza okungenani amahora ayi-8 kuya kwayi-12 ngaphambi kwesikhathi sakho sokuqokwa esihleliwe. Lokhu kuqinisekisa ukuthi isisu sakho singenalutho, sinikeza udokotela wakho umbono ongcono kakhulu futhi kunciphisa ubungozi bezinkinga.

Kufanele futhi ubuyekeze imithi yakho nodokotela wakho ngaphambi kwesikhathi. Eminye imithi ingase idinge ukulungiswa noma imiswe okwesikhashana ngaphambi kwenqubo:

• Izinciphisi zegazi ezinjenge-warfarin noma i-clopidogrel zingase zidingeke ukuthi ziyekiswe ezinsukwini ezimbalwa ngaphambi
• Imithi yesifo sikashukela ingase idinge ukulungiswa ngenxa yezidingo zokuzila ukudla
• Ama-proton pump inhibitors e-acid reflux angase adinge ukuyekiswa ukuze kuvunyelwe ukubonakala okungcono
• Izithasiselo zensimbi zingayekiswa okwesikhashana njengoba zingase zithinte ukubonakala

Qiniseka ukuthi uhlela ukuthi othile akuqhubele ekhaya ngemva kwale nqubo, njengoba imithi yokuthulisa izothinta ikhono lakho lokushayela ngokuphepha. Kufanele futhi uhlele ukuthatha lonke usuku olusele ungayi emsebenzini noma kwezinye izinto ukuze uvumele imiphumela yokuthulisa ukuthi iphele ngokuphelele.

Ngosuku lwenqubo yakho, gqoka izingubo ezikhululekile, ezikhululekile futhi ushiye ubucwebe nezinto eziyigugu ekhaya. Susa amalensi okuxhumana, amazinyo okwenziwa, noma yimuphi umsebenzi wamazinyo osuswayo ngaphambi kokuthi inqubo iqale.

Ungazifunda kanjani imiphumela yakho ye-endoscopy engenhla?

Imiphumela yakho ye-endoscopy engenhla ngokuvamile izotholakala ngokushesha ngemva kwenqubo, nakuba imiphumela ye-biopsy ingase ithathe izinsuku eziningana kuya evikini. Udokotela wakho ngokuvamile uzoxoxa ngemiphumela yokuqala nawe nelungu lomndeni wakho endaweni yokululama uma usulungile ngokwanele ukuqonda.

Umbiko ojwayelekile we-endoscopy engenhla uzokhombisa ukuthi i-esophagus yakho, isisu, kanye ne-duodenum kubonakala kunempilo ngaphandle kwezimpawu zokuvuvukala, izilonda, amathumba, noma ezinye izinto ezingavamile. Ukugqama kufanele kubonakale bushelelezi futhi kupinki, ngaphandle kwanoma yikuphi ukukhula okungavamile noma izindawo zokukhathazeka.

Uma kutholakala izinto ezingavamile, udokotela wakho uzochaza ukuthi babone ini nokuthi kusho ukuthini empilweni yakho. Okutholakele okuvamile kungabandakanya:

• Isifo se-Gastroesophageal reflux (GERD) ngobufakazi bokulimala kwe-asidi ku-esophagus
• Izilonda ze-Peptic esiswini noma ku-duodenum
• Ukuvuvukala kokugqama kwesisu okubizwa ngokuthi i-gastritis
• I-Hiatal hernia lapho ingxenye yesisu iphushwa phezulu ngaphakathi kwe-diaphragm
• I-Barrett's esophagus, isimo lapho i-asidi reflux ishintsha ukugqama kwe-esophageal
• Ama-polyps noma ukukhula okuncane okungase kudingeke ukuqapha noma ukususwa

Uma amasampula ezicubu athathwa ngesikhathi senqubo yakho, lawo azothunyelwa kuchwepheshe wezifo ukuze ahlolwe ngemicroscopic. Imiphumela ye-biopsy isiza ukuqinisekisa ukuxilongwa futhi ikhiphe izimo ezingathi sína njengomdlavuza. Udokotela wakho uzokuxhumana nawe ngale miphumela futhi axoxe nganoma yikuphi ukunakekelwa okulandelayo okudingekayo.

Udokotela wakho uzokunikeza umbiko obhaliwe ohlanganisa izithombe ezivela enqubweni yakho kanye nemiphumela enemininingwane. Lo mbiko kubalulekile ukuwugcina emarekhodini akho ezokwelapha futhi wabelane nabanye abahlinzeki bezempilo uma kudingeka.

Ziyini izici eziyingozi zokudinga i-endoscopy ephezulu?

Ezinye izici zingakhuphula amathuba akho okuthuthukisa izinkinga eziphezulu zokugaya ukudla ezingase zidinge ukuhlolwa nge-endoscopy ephezulu. Ukuqonda lezi zici eziyingozi kungakusiza ukuthi ubone ukuthi yiziphi izimpawu ezingase zidinge ukunakekelwa kwezokwelapha.

Iminyaka ingenye yezici eziyingozi ezibaluleke kakhulu, njengoba izinkinga zokugaya ukudla ziba njalo njengoba sikhula. Abantu abaneminyaka engaphezu kwengu-50 maningi amathuba okuthi bathuthukise izimo ezinjenge-peptic ulcers, gastritis, kanye ne-Barrett's esophagus. Kodwa-ke, izinkinga eziphezulu zokugaya ukudla zingenzeka kunoma iyiphi iminyaka.

Izici eziningana zokuphila zingakhuphula ingozi yakho yokuthuthukisa izimo ezingase zidinge i-endoscopy ephezulu:

• Ukusetshenziswa njalo kwemithi engavuvukali engewona ama-steroidal (NSAIDs) njenge-ibuprofen noma i-aspirin
• Ukusetshenziswa kakhulu kotshwala, okungathukuthelisa umugqa wesisu
• Ukubhema, okwandisa ukukhiqizwa kwe-asidi futhi kubambezele ukwelashwa
• Ukucindezeleka okungapheli, okungenza i-acid reflux nezinkinga zesisu zibe zimbi
• Imikhuba emibi yokudla, okuhlanganisa ukudla okuningi okunezinongo, okune-asidi, noma okunamafutha

Ezinye izimo zezokwelapha nazo zikhuphula ingozi yakho yezinkinga eziphezulu zokugaya ukudla. Abantu abanesifo sikashukela, izifo ze-autoimmune, noma isifo sezinso esingapheli bangase bathambekele kakhulu ku-gastritis kanye nezilonda. Umlando womndeni womdlavuza wesisu noma i-Barrett's esophagus nayo ingase idinge i-screening endoscopy.

Ukutheleleka ngamabhaktheriya e-Helicobacter pylori kungenye yezinto ezibalulekile eziyingozi ezibangela izilonda emathunjini nokuvuvukala kwesisu. Lokhu kutheleleka kwamabhaktheriya okuvamile kungatholakala ngezivivinyo zegazi, izivivinyo zomoya, noma amasampula endle, futhi ukwelashwa okuphumelelayo kuvame ukuxazulula izimpawu ezihambisanayo.

Ziyini izinkinga ezingaba khona ze-endoscopy ephezulu?

I-endoscopy ephezulu ngokuvamile iyinqubo ephephile kakhulu enengozi ephansi yezinkinga. Izinkinga ezinzima azivamile, zenzeka ngaphansi kuka-1% wamacala. Kodwa-ke, njenganoma iyiphi inqubo yezokwelapha, kunezinye izingozi ezingaba khona okufanele uzazi.

Imiphumela emibi evame kakhulu imnene futhi yesikhashana. Ungase uzwe umphimbo obuhlungu usuku noma ezimbili ngemuva kwenqubo, okufana nalokho ongase ukuzwe ngemuva kwenqubo yamazinyo. Abanye abantu bazizwa beqhubukile noma benomuzwa omncane wokungakhululeki esiswini ngenxa yomoya osetshenziselwa ukukhukhumeza isisu ngesikhathi sokuhlolwa.

Izinkinga ezingathi sína azivamile kodwa zingabandakanya:

• Ukuphuma kwegazi, ikakhulukazi uma kuthathwa ama-biopsies noma kususwa ama-polyps
• Ukugqobhoza noma ukudabuka okuncane odongeni lomgudu wokugaya ukudla
• Ukutheleleka, nakuba lokhu kungavamile kakhulu ngamasu anamuhla okubulala amagciwane
• Ukuphendula okungalungile emithini yokuthulisa
• Ukuhogela uma okuqukethwe esiswini kungena emaphashini

Ingozi yezinkinga iphakeme kancane uma unezimo ezithile zezokwelapha, njengesifo senhliziyo esibi noma isifo samaphaphu, noma uma usebenzisa imithi yokunciphisa igazi. Udokotela wakho uzohlola ngokucophelela izici zakho eziyingozi ngaphambi kokuncoma inqubo.

Izinkinga eziningi, uma zenzeka, zincane futhi zingelashwa ngempumelelo. Ithimba lakho lezokwelapha liqeqeshwe ukubona nokuphatha noma yiziphi izinkinga ezingase zivele ngesikhathi noma ngemuva kwenqubo. Izinzuzo zokuthola ukuxilongwa okunembile ngokuvamile zidlula kakhulu izingozi ezincane ezihilelekile.

Kufanele ngibone nini udokotela nge-endoscopy ephezulu?

Kufanele ucabange ukuxoxa nge-upper endoscopy nodokotela wakho uma uhlangabezana nezimpawu eziqhubekayo noma ezikhathazayo ezihlobene nengxenye yakho engenhla yokugaya ukudla. Okubalulekile ukubona ukuthi izimpawu ziba nini ngaphezu nje kokungakhululeki ngezikhathi ezithile futhi zingase zibonise isimo esidinga ukuhlolwa kwezokwelapha.

Funana nosizo lwezokwelapha ngokushesha uma uhlangabezana nanoma yiziphi zalezi zimpawu ezingathi sína, njengoba zingase zibonise izimo ezidinga ukuhlolwa ngokushesha:

• Ukuphalaza igazi noma izinto ezibukeka njengomhlabathi wekhofi
• Izihlalo ezimnyama, ezinamathelayo ezingase zibonise ukopha kwangaphakathi
• Ubuhlungu obukhulu besisu obungathuthuki ngemithi etholakala ngaphandle kwekhawunta
• Ubunzima bokugwinya obuya ngokuya bubi noma obukuvimbela ukuthi ungadli ngokujwayelekile
• Ukuncipha kwesisindo okungachazeki okungaphezu kwamaphawundi ayi-10
• Ukuphalaza okuqhubekayo okukuvimbela ukuthi ungagcini ukudla noma uketshezi

Kufanele futhi ukhulume nodokotela wakho nge-upper endoscopy uma unezimpawu ezingapheli ezithinta kakhulu izinga lempilo yakho. Ukusha kwenhliziyo okwenzeka ngaphezu kwamasonto amabili ngesonto, ubuhlungu besisu obuqhubekayo, noma isicanucanu esiqhubekayo nokuhlanza kuqinisekisa ukuhlolwa kwezokwelapha.

Uma uneminyaka engaphezu kwengama-50 futhi unezici eziyingozi njomlando womndeni womdlavuza wesisu, udokotela wakho angase ancome i-screening endoscopy ngisho noma ungenazo izimpawu. Ngokufanayo, uma une-Barrett's esophagus noma ezinye izimo ezikhuphula ingozi yomdlavuza, i-surveillance endoscopy ejwayelekile ingase inconywe.

Unganqikazi ukuxoxa ngezimpawu zakho nodokotela wakho oyinhloko, ongamsiza ukuthi anqume ukuthi i-upper endoscopy ilungele yini isimo sakho. Ukuhlolwa kwasekuqaleni nokwelashwa kwezinkinga zokugaya ukudla kuvame ukuholela emiphumeleni engcono futhi kungavimbela izinkinga ezingathi sína.

Imibuzo evame ukubuzwa mayelana ne-upper endoscopy

Q.1 Ingabe ukuhlolwa kwe-upper endoscopy kulungile ekutholeni umdlavuza wesisu?

Yebo, i-endoscopy ephezulu ilungele ukuthola umdlavuza wesisu futhi ithathwa njengezinga eliphezulu lokuxilonga lesi simo. Le nqubo ivumela udokotela wakho ukuthi abone ngqo umugqa wesisu futhi ahlonze noma yikuphi ukukhula okungajwayelekile, izilonda, noma izinguquko ezithweni ezingase zibonise umdlavuza.

Ngesikhathi senqubo, udokotela wakho angathatha amasampula ezicubu ezindaweni ezisolisayo ukuze ahlaziywe nge-biopsy. Lokhu kuhlanganiswa kokubona ngqo nokuthatha amasampula ezicubu kwenza i-endoscopy ephezulu inembe kakhulu ekutholeni umdlavuza wesisu, ngisho nasezigabeni zawo zokuqala lapho ukwelashwa kuphumelela kakhulu.

Umbuzo 2. Ingabe i-endoscopy ephezulu iyabuhlungu?

I-endoscopy ephezulu ngokuvamile ayibuhlungu, ikakhulukazi uma yenziwa ngemithi yokudambisa ubuhlungu. Iningi leziguli lithola imithi yokudambisa ubuhlungu, okwenza zikhululeke futhi zizwe ukozela ngesikhathi senqubo. Ungase uzwe ukucindezela okuthile noma ukungakhululeki okuncane njengoba i-endoscope idlula emqaleni wakho, kodwa lokhu kuvamile ukuthi kube mfushane futhi kulawuleke.

Ngemuva kwenqubo, ungase ube nomphimbo obuhlungu kancane usuku olulodwa noma ezimbili, okufana nalokho ongase ukuzwe ngemva kwenqubo yamazinyo. Abanye abantu bazizwa beqhubukile kancane ngenxa yomoya osetshenziswe ngesikhathi sokuhlolwa, kodwa lokhu ngokuvamile kuyanyamalala ngokushesha.

Umbuzo 3. Kuthatha isikhathi esingakanani ukululama ku-endoscopy ephezulu?

Ukwelulama ku-endoscopy ephezulu kuvamile ukuthi kube ngokushesha futhi kuqonde. Iningi labantu lingaqala kabusha imisebenzi ejwayelekile kungakapheli amahora angu-24 ngemva kwenqubo. Imiphumela yemithi yokudambisa ubuhlungu ngokuvamile iyaphela kungakapheli amahora angu-2 kuya kwangu-4, nakuba ungafanele ushayele noma wenze izinqumo ezibalulekile ngosuku olusele.

Ngokuvamile ungadla futhi uphuze ngokujwayelekile uma imithi yokudambisa ubuhlungu isiphelile, uqala ngokudla okulula futhi ubuyele kancane kancane ekudleni kwakho okuvamile. Noma yikuphi ukuba buhlungu komphimbo noma ukuqhubuka kufanele kunyamalale kungakapheli usuku olulodwa noma ezimbili ngaphandle kokwelashwa okukhethekile.

Umbuzo 4. Ingabe i-endoscopy ephezulu ingathola i-acid reflux?

Yebo, i-endoscopy engenhla ingathola i-acid reflux kanye nezinkinga zayo. Le nqubo ivumela udokotela wakho ukuthi abone ukuvuvukala, ukuguguleka, noma izilonda e-esophagus ezibangelwa yi-asidi yesisu. Ubufakazi obubonakalayo busiza ukuqinisekisa ukuxilongwa kwesifo se-gastroesophageal reflux (GERD) futhi kuhlole ubunzima baso.

I-endoscopy engenhla ingakwazi futhi ukuhlonza izinkinga ze-acid reflux yesikhathi eside, njenge-Barrett's esophagus, lapho umugqa ojwayelekile we-esophagus ushintsha ngenxa yokuchayeka kwe-asidi okungapheli. Lolu lwazi lusiza udokotela wakho ukuthi akhe uhlelo lokwelapha olufanele kakhulu isimo sakho esithile.

Q.5 Kufanele ngibe ne-endoscopy engenhla kaningi kangakanani?

Ukuvama kwe-endoscopy engenhla kuncike ezimweni zakho ngazinye, izimpawu, nanoma yiziphi izimo ezitholwe ngesikhathi sezinqubo zangaphambilini. Abantu abaningi abadingi i-endoscopy ejwayelekile ngaphandle uma benesimo sezempilo esithile esidinga ukuqapha.

Uma une-Barrett's esophagus, udokotela wakho angase ancome i-surveillance endoscopy njalo eminyakeni engu-1 kuya kwengu-3 kuye ngobunzima. Abantu abanomlando wama-polyps esiswini noma ezinye izimo ezingaphambi komdlavuza bangase futhi badinge ukuqapha ngezikhathi ezithile. Udokotela wakho uzohlinzeka ngezincomo ezithile ezisekelwe esimweni sakho sempilo kanye nezici eziyingozi.