Cov tsos mob thiab kev kho mob ntawm biliary reflux gastritis

pathologies ntawm lub digestive system ntau ntawm cov pejxeem. Common kab mob txuam nrog reflux. Yuav ua li cas yog lawv cov yam ntxwv?

reflux esophagitis

Tus kab mob yog ib tus mob o ntawm cov hlab pas, uas yog tshwm sim los ntawm kev sib cuag nrog nws acidic plab txheem. Lub pathology txuam nrog rau ua hauj lwm ntawm lub sab esophageal sphincter, uas feem ntau yuav tiv thaiv cov hlab pas ntawm lub allergic ntawm lub pais plab kua txiv.

Mob biliary reflux gastritis

Qhov no daim ntawv yog tsiag ntawv los ntawm txoj kev loj hlob ntawm mob o nyob rau hauv lub qog ua kua membrane raws li ib tug tshwm sim ntawm kis tau tus kua tsib nyob rau hauv nyob tus yeees ntawm cov khoom noj khoom haus bolus. Ob peb cov variants ntawm mob gastritis:

1. Esogastritis ntsiab manifestation yog me ntsis hyperemia thiab o ntawm lub plab phab ntsa. Nws thickens thiab them nrog ib tug txheej ntawm tuab hnoos qeev. Cov txheej membrane muaj ib tug me me petechial hemorrhages thiab yaig.
2. Fibrinous gastritis, nyob rau ib lub phab ntsa tsim epithelial necrosis aav infiltrated fibrinopurulent purulent exudate. Lub manifestation ntawm no phenomenon - fibrin nyias zaj duab xis nyob rau qhov chaw ntawm lub cuam tshuam qhov chaw ntawm lub mucosa. Ces dag gastritis yus looseness ntawm cov zaj duab xis, thiab thaum twg nws yog sib sib zog nqus o fused nrog epithelium.
3. Necrotizing gastritis, nyob rau hauv tas li ntawd mus rau lwm yam muaj feem xyuam rau epithelial mucosa khaubncaws sab nraud povtseg. Nyob rau hauv necrosis to taub cell tuag nyob rau hauv tus ntawm txhoj puab heev yam.
4. Purulent gastritis - lub loj tshaj plaws hauv daim ntawv ntawm o. Cov txheej txheem yuav koom nrog tag nrho cov khaubncaws sab nraud povtseg ntawm lub plab, uas poses ib tug kev hem thawj rau lub perforation. Lub manifestation ntawm no embodiment - lub xub ntiag ntawm exudate, tab sis kuj khaus infiltration mucosal leukocytes.

Mob biliary reflux gastritis

Qhov no hom yog yus muaj los ntawm ib tug ua ke ntawm inflammatory thiab degenerative phenomena. Tsis tu ncua uas nkag mus rau cov kua tsib thiab pancreatic enzymes rau hauv lub plab ua rau txoj kev loj hlob ntawm tus kab mob mob. Tsis tas li ntawd, daim ntawv no tej zaum yuav tshwm sim ntawm mob gastritis. Raws li ib tug tshwm sim ntawm alkalinity nyob rau hauv lub mucosa nce nqi ntawm histamine, uas ua rau nws edematous thiab erythematous.

pathogenesis

Nruab nrab ntawm lub plab, nws antrum thiab lub duodenum muaj ib tug sphincter, uas hu ua "gatekeeper". Lub chaw ua hauj lwm ntawm no nqaij qhia Move chyme (bolus) los ntawm lub plab rau hauv cov hnyuv rau ntxiv zom cov zaub mov thiab tom ntej haum cov as-ham. Cuam tshuam cov sphincter yuav ua tau kom dab tsi yuav tsim biliary reflux, gastritis, kev kho mob ntawm cov uas yuav tsum tau ib tug ua ke ntawm cov tshuaj thiab kev noj haus. Yuav kom qhov no tus kab mob tau nyob rau hauv untimely qhib ntawm lub sphincter, uas ib tug pob ntawm cov khoom noj uas koom cov kua tsib ua los ntawm lub siab rov qab mus rau hauv lub plab. Muaj pes tsawg leeg cov kua tsib muaj ib tug nyhuv dejnum nyob rau lub xeev ntawm nws mucosa. Nws muaj ntsev, kua qaub thiab enzymes raug xa mus rau aggression yam.

etiology

Cov ua rau biliary reflux gastritis txuam nrog ib tug malfunction ntawm lub sphincter - lub gatekeeper. Yuav kom qhov no yuav ua kom muaj kev phais kev pab uas muaj feem xyuam rau cov kom ntawm tus mob huam. Tsis tas li ntawd ntawm cov etiologic yam yuav qhia tau cov kab mob xws li kab mob siab, mob cholecystitis thiab duodenitis. Tsis muaj zog rau cov nqaij ntshiv ntawm lub sphincter thiab ua rau kom lub siab nyob rau hauv cov hnyuv yog feem ntau qhov ua rau ntawm gastritis, thiab qhov no yuav ua rau ib tug xov tooj ntawm pathologies ntawm tus mob huam. Qhov tseem ceeb luag hauj lwm ntawm predisposing yam. Piv txwv li, ib qhov kev nyuaj siab yog txo mucosal tiv thaiv zog, thiab nws resists weaker txiav txim irritants. Tib yam siv rau tsis yog-tshuaj anti-inflammatory siv tshuaj uas ua rau kom txoj kev pheej hmoo ntawm gastritis ob peb lub sij hawm. Cov tshuaj cuam tshuam prostaglandin synthesis, thiab lawv ua ib qho tseem ceeb muaj nuj nqi - mus tsim kho lub tsim ntawm hnoos qeev los ntawm Goblet hlwb, uas tsub kom lub barrier thaj chaw ntawm lub mucosa. Anti-inflammatory tshuaj inhibit qhov kev enzyme cyclooxygenase, thiab yog li thiaj li tus nqi ntawm cov prostaglandin, thiab chaw pib lub nqi ntawm hnoos qeev.

Los ntawm tsim ntawm reflux esophagitis ua ascites, uas ua rau muaj zog siab nyob rau hauv lub plab constriction pyloroduodenal qhov. Ntxiv yam tej zaum yuav ua rau cov neeg pluag noj cov zaub mov, kaw ntom nti ua khaub ncaws, noj tshuaj, kev nyuaj siab thiab kev haus luam yeeb. Qhov no tshwm sim tej zaum yuav tshwm sim thaum lub sij hawm cev xeeb tub, ces nws yog tsis txuam nrog pathology.

Biliary reflux gastritis thiab reflux esophagitis: Cov tsos mob

Lub ntsiab ntawm cov tsos mob reflux esophagitis yog kub siab thiab acid eructation, uas feem ntau tshwm sim tom qab noj mov, thiab thaum twg qaij de rau pem hauv ntej. Complementing qhov no yog ib tug tsis xis nyob rau hauv lub epigastric cheeb tsam.

Richer lub tsev kho mob txawv biliary reflux gastritis. Cov tsos mob ntawm tus kab mob no muaj xws li mob thiab lwm yam mob. Feem ntau cov neeg mob kev txhawj xeeb zoo nkaus li fullness thiab tsam plab, raws li zoo raws li lub heev ntawm epigastric. Mob feem ntau tshwm sim tas plab, thiab lawv siv tej zaum yuav txawv - los ntawm sab kev mob rau mob tej. Feem ntau muaj yog ntuav.

diagnostics

Mob ntawm biliary reflux gastritis yog nqa tawm tom qab nqa tawm tshwj xeeb kev tshawb fawb thiab anamnesis. Ib txhia tsis txaus siab yog tsis txaus, lawv pab xwb xav tias txoj kev loj hlob ntawm tus kab mob. Ua ntej ntawm tag nrho cov, tus neeg mob yog raws kev coj kom tus me nyuam ntawm cov quav, qhov twg cov kws txawj ntes Occult ntshav. Tsis tas li ntawd ib tug yuav tsum yog rau kev EGD uas yuav pab tau visually ntsuam xyuas hauv lub xeev ntawm lub qog ua kua membrane, mus ntes mob foci. Ua lub siab nyob rau hauv lub duodenum yuav txiav txim los ntawm manometry.

Reflux esophagitis thiaj paub hais tias advantageously radiographic txoj kev siv tus zoo neeg sawv cev. Qhov no txoj kev tso cai rau koj mus taug qab lub sij hawm ntawm casting ntawm lub plab txheem rau hauv cov hlab pas. Nws kuj pom zoo mus nqa tawm endoscopy, uas yuav ntsuam xyuas qhov mob ntawm lub mucosa thiab coj lom cov khoom siv rau kawm ntxiv.

kev kho mob

Biliary reflux gastritis thiab reflux esophagitis yuav tsum tau tam sim ntawd kev kho mob. Qhov no yuav pab txhim kho tus neeg mob tus mob thiab tsis txhob tau yam mob. Thaum nrhiav kom tau ntawm esophagitis yuav tsum tso tseg tsis tau phem, raws li zoo raws li khaus ib ce muaj zog nyob rau hauv lub plab cheeb tsam.

Tshuaj kho yog raws li nyob rau hauv lub sij hawm ntawm antacids uas txo lub txhoj puab heev tus ntawm pais plab kua txiv nyob rau hauv lub esophageal mucosa. Ntawm lawv yog cov lub "Almagel", "Maalox" thov tus nqi. Lawv envelop cov phab ntsa hauv lub plab thiab sab acidity.

Nyob rau hauv tas li ntawd, nws yog pom zoo kom siv cov tshuaj uas kom tsis txhob tso pa tawm ntawm pais plab kua txiv ( "omeprazole"). Prokinetics yuav ua tau kom lub suab nrov ntawm lub sphincter, uas yog lub tiv thaiv ntawm lub casting ntawm acid. "Motilium" yuav paub qhov txawv ntawm cov xws tshuaj thiab "Motilak". Yog hais tias conservative kev kho mob tsis, phais tej zaum yuav tsum tau, uas yog nqa tawm nrog kev pab los ntawm endoscopic khoom.

Yuav ua li cas yog cov kev kho mob ntawm cov kab mob xws li biliary reflux gastritis? Cov tsos mob thiab kev kho mob ntawm tus kab mob no yog inextricably txuas. Cov neeg mob yuav tsum tau complex pharmacological thiab uas tsis yog-tshuaj ntsuas, uas yuav ua kom tus mob, tau tshem ntawm kev soj ntsuam ces. Ua ntej ntawm tag nrho cov nws yog tsim nyog los normalize lub neej - muab tsis tau phem, khoom noj kom zoo. Cov medicinal npaj no feem ntau yog muab histamine receptor blockers uas txo lub tso pa tawm. Gastroprotectives tsis ua li cas tsis - lawv kom lub zoo rau cov qog ua kua membrane txhab. Tsis tas li ntawd, nws yog tsim nyog losis tswvyim dabtsi kua tsib acids, uas ua rau siv ursodeoxycholic acid. Tiv thaiv tiv thaiv tshaj chyme nyob rau hauv lub plab los pab tshuaj xws li "Domperidone" thiab "metoclopramide".

kev tiv thaiv

Tiv thaiv kom txhob tsim ntawm biliary reflux gastritis thiab esophagitis pab khoom noj kom zoo thiab raws sij hawm mob ntawm pathological dab. Nws yog pom zoo kom tiv thaiv kev coj cwj pwm tsis tu ncua endoscopic xeem, uas yuav pab tau kom paub tias tus kab mob nyob rau ntawm ib thaum ntxov rau theem. Qhov no yuav ua rau kom cov hauj lwm zoo ntawm conservative kev kho mob kom tsis txhob muaj kev phais thiab qhov tshwm sim ntawm mob.

Tsis tas li ntawd, nws yuav tsum txhim kho lub barrier thaj chaw ntawm lub mucosa. Nws yog pom zoo kom muab tsis tau phem (los yog txo lawv mus rau ib tug tsawg kawg nkaus), sim noj noj qab nyob zoo cov khoom noj thiab tsis txhob ntxhov siab ntau zaus.

Tsis tas li ntawd predisposing tshaj yuav yog tus nquag siv ntawm nonsteroidal anti-inflammatory siv tshuaj uas txo hnoos qeev ntau lawm nyob rau hauv lub plab, ua mucosa yuav lam tau lam ua. Qhov tseem ceeb luag hauj lwm ua si los ntawm cov kev tiv thaiv thiab kho thaum ntxov ntawm concomitant kab mob.

Qhov teeb meem ntawm qhov tshwm sim ntawm biliary reflux gastritis thiab esophagitis yog cov, raws li cov no tej yam kev mob tej zaum yuav tsis tau tsuas yog paug tus mob ntawm tus neeg mob, tab sis kuj ua rau mob. Raws sij hawm mob tso cai kho mob yuav pib nyob rau hauv lub sij hawm.