Ukopha Emathunjini 

Ukopha emathunjini kuphakathi kwezimo zezempilo ezimbi kakhulu ezibonwa kubantu bayo yonke iminyaka. Kwenzeka lapho ukulahleka kwegazi kwenzeka noma yikuphi eduze komgudu wokugaya ukudla. Kungaba mnene kuye kokuqina, futhi kubalulekile ukuqonda izimpawu nezimpawu zayo ukuze uthole usizo lwezokwelapha olufika ngesikhathi. 

Lesi sihloko sihlola izindlela ezisebenzayo zokuphatha ukopha kwamathumbu, okuhlanganisa izici ezihlukahlukene zalesi simo. Sizophenya ngezinhlobo zokopha kwe-GI emathunjini, okuhlanganisa ukopha kwamathumbu aphezulu naphansi, futhi sixoxe ngezimbangela zakho nezici zobungozi. 

Kuyini ukopha kweGastrointestinal? 

Ukopha emathunjini (GI) kuwuphawu olwenzeka lapho ukulahleka kwegazi kwenzeka noma yikuphi eduze komgudu wokugaya ukudla, kusukela emgudwini (okuvame ukubizwa ngokuthi ipayipi lokudla) kuya ku-rectum. Akusona isimo ngokwaso kodwa kuwuphawu lwesifo esiwumsuka noma udaba. Izimpawu zokopha emathunjini zingahluka kuye endaweni kanye nobukhulu bokopha, okwenza kube semqoka ukuqaphela ukubonakaliswa okuhlukene kokopha emgudwini wamathumbu. 

Izinhlobo Zokopha Emathunjini 

Ukuphuma kwegazi emathunjini kungahlukaniswa ngezinhlobo eziningana ngokusekelwe ezicini ezihlukahlukene. Isigaba esisodwa esiyinhloko sihlukanisa ukopha kwe-GI kube izinhlobo ezingaphezulu neziphansi, futhi uphawu lwe-anatomical luwumsipha we-Treitz. 

• Ukopha kwe-GI ephezulu kuvela ngaphezu komsipha we-Treitz, umsipha omisiwe we-duodenum. Ivame ukuvela njenge-hematemesis (ukuhlanza igazi noma okokusebenza okunjengekhofi) noma i-melena (indle emnyama, ephuzile). 
• Ukopha kwe-GI ephansi, okuvela ngaphansi komsipha, kuvame ukuvela njenge-hematochezia (ukudlula kwegazi elibomvu ngokugqamile nge-rectum). 

Olunye uhlelo lokuhlukanisa luhlukanisa ukopha kwe-GI ngokusekelwe ubude besikhathi nokubonakala kwayo:

• Ukopha okukhulu kwe-GI kungazelelwe futhi kwesinye isikhathi kungaba kubi kakhulu, kudinga ukunakekelwa ngokushesha. 
• Ngakolunye uhlangothi, okungamahlalakhona GI ukopha kuhlanganisa ukopha okuncane okungahlala isikhathi eside noma kungase kubuye kudlule. 
• Ukopha ngokusebenzelana nemimoya kuncane kakhulu futhi akubonakali ngeso lenyama. Ingatholwa kuphela ngokuhlolwa kwaselabhorethri. 

Izimpawu Zokopha Emathunjini 

Izimpawu zokopha emathunjini zincike endaweni kanye nobukhulu bokopha. Izimpawu ezijwayelekile zihlanganisa: 

• Indle emnyama noma ephuzile (melaena) 
• Igazi elibomvu elikhanyayo emhlanzweni noma ezindle 
• Izikhwama zomzimba 
• isiyezi 
• Ukungabi namandla 
• Ukukhathala 
• Ngezinye izikhathi, ukuhlanza kungase kufane nesisekelo sekhofi, okubonisa igazi eligaywe kancane. 
• Ukopha okungamahlalakhona emathunjini kuvame ukuphumela i-anemia, okubangela ukukhathala nokuphefumula okuthuthuka kancane kancane ngokuhamba kwesikhathi. 
• Okunye ukopha kwezimpawu zepheshana lamathumbu zihlanganisa ukuphaphatheka, ubuthakathaka, kanye ukuphelelwa umoya. 

Izimbangela Nezingozi Zokopha Emathunjini 

Ukopha emathunjini kungathinta izingxenye ezihlukene zesistimu yokugaya ukudla, ngokuvamile zihlukaniswe ukopha kwe-GI ephezulu nephansi. 

Nazi ezinye izimbangela zokopha kwe-GI ephezulu: 

• Izilonda ze-Peptic 
• Ukutheleleka kwe-Helicobacter pylori 
• ukusetshenziswa ngokweqile kwezidakamizwa ezingezona ukuvuvukala (ama-NSAID) 
• I-Esophagitis 
• Isifo se-reflux ye-gastroesophageal (GERD) 
• kolwelwesi 
• Imithambo ye-Oesophageal 
• Isimila se-Gastrointestinal stromal (GIST) 
• Isimila se-pancreatic 
• Isimila sesisu 
• Umdlavuza wesibindi 

Nazi ezinye izimbangela zokopha kwe-GI ephansi: 

• I-Diverticulosis 
• Izifo zamathumbu okuvuvukala (isifo sikaCrohn kanye ne-ulcerative colitis) 
• Ama-polyps amakholomu 
• Ama-hemorrhoids kanye nemifantu yendunu 
• Izilonda ze-rectal 
• umdlavuza Colorectal 
• Isimila sangemuva 

Izinto eziyingozi zokuphuma kwegazi emathunjini zihlanganisa: 

• Ukuphuza utshwala okungapheli 
• Imithi ethile (ikakhulukazi ama-NSAID nama-anticoagulants) 
• Umlando wokuhlinzwa kwamathumbu 
• Ukuhlanza okungapheli 
• Ukulimala kwesibindi 

Izinkinga Zokopha Emathunjini 

Ukuphuma kwegazi emathunjini, uma kungalawulwa ngokushesha nangempumelelo, kungaholela ezinkingeni ezinzima, ezihlanganisa: 

• Omunye wemiphumela emibi kakhulu yokopha emathunjini ukushaqeka, okwenzeka lapho ukugeleza kwegazi okwanele ezithweni ezibalulekile. Lesi simo singabangela isiyezi, ukuquleka, kanye nobunzima bokuchama. 
• Ukucindezeleka kokuphefumula kungenye inkinga engase ibe khona, njengoba ukulahlekelwa kakhulu kwegazi kungase kuthinte ukulethwa komoyampilo emaphashini. 
• Kwezinye izimo, ukopha kwamathumbu kungase kuholele ku-myocardial infarction, ikakhulukazi ezigulini ezinezimo zenhliziyo ezivele zikhona. Ukutheleleka nakho kuyakhathaza, ikakhulukazi ezimeni zokopha isikhathi eside noma lapho izinqubo ezihlaselayo zidingeka ekwelashweni. 
• Ukopha okungamahlalakhona emathunjini kungabangela i-anemia, okubangela ukukhathala kanye nokuphefumula okuthuthuka kancane kancane ngokuhamba kwesikhathi. 

Sifo 

Odokotela benza ukuhlola okuphelele ukuze bathole ukopha emathunjini, baqale ngomlando wezokwelapha ophelele kanye nokuhlolwa komzimba. 

• Umlando Wezokwelapha Nokuhlolwa Komzimba: 

Odokotela babuza ngezimpawu zakho, njengendle emnyama noma ephuzile (melena), igazi elibomvu elikhanyayo esitulweni (i-hematochezia), noma igazi lokuhlanza (i-haematemesis). Bazobuza ngomlando wakamuva wezokwelapha, imithi, kanye nemikhuba yokudla. Odokotela bazohlola umzimba ukuze bahlole izimpawu zokopha, njengokumhlophe noma ukuthamba kwesisu. 

• Ukuhlolwa Kwelebhu: 
  • Ukuhlolwa kwegazi kuvame ukwenziwa ukuze kuhlolwe izimpawu ze-anemia nokuhlola ubucayi bokulahleka kwegazi. 
  • Ukuhlolwa kwendle, okufana nokuhlola igazi le-faecal occult blood (FOBT), kuthola igazi elincane endle. 
• Izinqubo ze-Endoscopic: 

I-endoscopy engenhla ivumela ukuhlolwa komminzo, isisu, ne-duodenum, kuyilapho i-colonoscopy isiza ukuhlola amathumbu amakhulu kanye ne-rectum. Ezindaweni okunzima ukufinyelela kuzo emathunjini amancane, ibhaluni i-enteroscopy noma i-capsule endoscopy ingase isetshenziswe. 

• Ukuhlolwa Kwezithombe: 
  • Ama-CT scan anikeza ukubukwa okuningiliziwe kwe-3D kwamathumbu 
  • I-GI X-ray ekhethekile esebenzisa ukungafani kwe-barium ukuhlola izimpawu zokopha noma ezinye izimo. 
  • Kwezinye izimo, odokotela bangenza i-angiography ukuze babone ngeso lengqondo imithambo yegazi epheshaneni le-GI. 
  • Ezimweni lapho umthombo wokopha uhlala unzima, izinqubo ezihlaselayo ezifana ne-laparoscopy noma i-laparotomy zingase zicatshangelwe ukuze zihlole i-cavity yesisu ngokuqondile. 

Ukwelashwa Kokopha Emathunjini 

Ukwelapha ukopha kwamathumbu kuncike ebubini bakho, indawo, kanye nembangela ewumsuka. 

• Ukuphatha Kwasekuqaleni: 
  • I-Fluid Resuscitation: Uketshezi lwe-IV ukugcina umthamo wegazi nomfutho 
  • Ukumpontshelwa Igazi: Ukumpontshelwa kwamangqamuzana abomvu egazi ngokuvamile kuqala lapho amazinga e-hemoglobin ehla ngaphansi kwe-g/dL eyisikhombisa. Ukumpontshelwa kwe-platelet kungase kudingeke ezigulini ezinezibalo eziphansi ze-platelet. 
• Imithi: 
  • I-Proton Pump Inhibitors: Lezi zisetshenziselwa ukukhiqiza i-asidi yesisu futhi kusize ukuphulukisa izilonda. 
  • Imithi ye-Vasoactive: Ezimweni zokopha kwe-variceal 
  • Nemithi Elwa Namagciwane: Uma kungenxa yokopha okubangelwa ukutheleleka (isb, izilonda noma izinhlobo ezithile ze-gastritis) 
  • Izinqubo ze-Endoscopic: Phakathi nalezi zinqubo, abahlinzeki bezokunakekelwa kwempilo bangasusa ukukhula okungavamile, bajove imithi yokumisa ukopha, noma bavale imithambo yegazi engavamile besebenzisa iziqeshana noma amabhande. 

Uzoyibona Nini Udokotela 

Ukuqaphela ukuthi kufanele ufune nini usizo lwezokwelapha ukuze uthole ukopha emathunjini kubalulekile ukuze uvimbele izinkinga ezinzima. Kubalulekile ukufuna usizo lwezokwelapha ngokushesha uma kuvela izimpawu nezimpawu ezithile, njenge: 

• Isiyezi noma ukuquleka (syncope) 
• Kunzima ukuchama 
• Ukushaya kwenhliziyo okusheshayo 
• Shock 

Prevention 

Ukuvimbela ukopha kwamathumbu kuhilela ukubhekana nezimbangela eziyisisekelo kanye nokuthatha imikhuba yokuphila enempilo. 

• Nciphisa ukuphuza izidakamizwa ezingezona ukuvuvukala (ama-NSAID) kanye ne-aspirin 
• Ukulungiswa kwendlela yokuphila njengokunciphisa utshwala nokuyeka ugwayi kungasiza ukuvikela ulwelwesi lwamathumbu ekulimaleni. 
• Kubantu abanezimo ezikhona zesisu, ukulandela izincomo zikadokotela zokwelashwa kubalulekile. 
• Ukuhlolwa njalo nokuhlolwa kubalulekile, ikakhulukazi kulabo abasengozini enkulu. 

Isiphetho 

Ukopha emathunjini kuyisimo esibucayi esihlobene ne-gastro esingathinta abantu bayo yonke iminyaka. Ukunakekelwa ngokushesha kwezokwelapha kubalulekile lapho ubhekana nokopha emathunjini. Ngokuqaphela izinkomba nezici eziyingozi, abantu ngabanye bangathatha izinyathelo zokuvimbela izinkinga futhi bafune ukwelashwa okufika ngesikhathi. Khumbula, ngenkathi ezinye izimo zokopha kwe-GI zingaphathwa kahle ekhaya, ezinye zingadinga ukunakekelwa okuphuthumayo. Ukuhlala unolwazi futhi umatasa ngempilo yomuntu kubalulekile ukuze ubhekane ngempumelelo nalokhu kukhathazeka kwezempilo okubucayi. 

FAQs 

1. Ingabe izimpawu zokopha kakhulu zihlukile? 

Izimpawu zokopha okukhulu emathunjini zivame ukuza ngokuzumayo futhi zingaba nzima kakhulu. Umuntu ngamunye angase abe nesiyezi, aquleke, noma abe nobunzima bokuchama. Ukushaya kwenhliziyo okusheshayo, okungabangela ukukhathazeka noma ukuzwa okuphaphazelayo enhliziyweni, kungenye inkomba engase ibe khona. 

2. Yiziphi izinhlobo zokuhlola engingazidinga? 

Ukuze bahlole ukopha emathunjini, odokotela bangase bacele uphenyo oluhlukahlukene. Lokhu kungabandakanya ukuhlaziywa kwesampula yegazi ukuze kuhlolwe i-anemia nokuhlola ubucayi bokulahlekelwa kwegazi. Ukuhlola indle, njengokuhlola igazi lendle, kungase kusetshenziselwe ukuthola igazi elincanyana endle. Ukuhlolwa kwesithombe njengama-CT scan noma ama-X-ray akhethekile kusetshenziswa umehluko we-barium kunganikeza imibono enemininingwane yamathumbu. 

3. Wazi kanjani ukuthi unokopha emathunjini? 

Izimpawu zokopha emathunjini zingahluka futhi zincike endaweni kanye nobukhulu bokopha. Izimpawu ezijwayelekile zihlanganisa indle emnyama noma ephuzile, igazi elibomvu ngokugqamile emhlanzweni noma ezindle, kanye ubuhlungu besisu. Ezinye izimpawu zingase zihlanganisa ukukhathala, isikhumba esiphaphathekile, ubuthakathaka kanye nokuphelelwa umoya. 

4. Indlela yokwelapha ukopha kwamathumbu ekhaya? 

Kubalulekile ukuqonda ukuthi akukho ukunakekelwa kwasekhaya okuphephile ngokopha kakhulu emathunjini. Noma yikuphi ukopha okuphawulekayo emgudwini wamathumbu kudinga ukubonisana ngokushesha nochwepheshe. 

5. Iyiphi imbangela evame kakhulu yokopha kwe-GI? 

Ukopha emathunjini kungase kube nezimbangela ezihlukahlukene, kuye ngokuthi kwenzeka epheshaneni le-GI eliphezulu noma eliphansi. Izimbangela ezivamile zokopha kwe-GI ephezulu zihlanganisa izilonda ze-peptic, esophagitis, ne-gastritis. Ukuze uthole ukopha kwe-GI ephansi, izimbangela ezivamile zihlanganisa ama-hemorrhoids, imifantu yendunu, i-diverticulosis, nezifo zamathumbu ezivuvukalayo, njengesifo sikaCrohn nesifo sokuqaqamba kwamathumbu. 

6. Yikuphi ukudla okufanele ukugweme ngemva kokopha kwe-GI? 

Ngemuva kokuphuma kwegazi emathunjini, ukulandela ukudla okukhuthaza ukuphulukiswa nokunciphisa ingozi yokucasuka okwengeziwe kubalulekile. Ngokuvamile, kuhle ukugwema ukudla okubabayo nokune-asidi kanye nokudla okunzima ukukugaya. 

7. Ingabe ukopha kwe-GI kubuhlungu? 

Ukuphuma kwegazi emathunjini kungahlotshaniswa nobuhlungu, nakuba izinga lokungakhululeki lingahluka. Abanye abantu bangase babe namajaqamba noma ubuhlungu besisu, kanti abanye bangase bangabi nazinhlungu nhlobo. Ukuba khona kanye nobukhulu bobuhlungu kuvame ukuncika emsuka wembangela yokopha. Kubalulekile ukukhumbula ukuthi ukungabikho kobuhlungu akusho ukuthi ukopha akubi kakhulu.

UDkt. Rajesh Singhri

CARE Medical Team

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