{"id":5684,"date":"2022-12-27T14:42:54","date_gmt":"2022-12-27T11:42:54","guid":{"rendered":"https:\/\/zulfikarpolat.com\/?page_id=5684"},"modified":"2023-02-10T20:02:18","modified_gmt":"2023-02-10T17:02:18","slug":"mide-ulseri","status":"publish","type":"page","link":"https:\/\/zulfikarpolat.com\/en\/mide-ulseri\/","title":{"rendered":"Mide \u00dclseri"},"content":{"rendered":"\t\t
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Mide \u00dclseri Nedir? Belirtisi Ve Tedavisi Nas\u0131ld\u0131r?\n<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Mide \u00fclseri<\/strong>, sindirim sisteminde yemek borusu, mide ve oniki parmak ba\u011f\u0131rsa\u011f\u0131n\u0131n i\u00e7 y\u00fcz\u00fcn\u00fc d\u00f6\u015feyen ve mukoza olarak adland\u0131r\u0131lan tabakan\u0131n,\u00a0mide asidi<\/strong>, sindirim enzimleri (pepsin, safra tuzlar\u0131 ve pankreas enzimleri) veya ila\u00e7larla (Aspirin ve antiromatizmal ila\u00e7lar) hasarlanmas\u0131 sonucunda ortaya \u00e7\u0131kan derin yaralar \u00fclser veya peptik \u00fclser olarak adland\u0131r\u0131l\u0131r.<\/span><\/p>

Mide asidi ve pepsin (midede proteinlerin sindirilmesini sa\u011flayan enzim) g\u0131dalar\u0131n sindirimi i\u00e7in son derece gerekli olan salg\u0131lard\u0131r.<\/span><\/p>

Mide asidi g\u00fc\u00e7l\u00fc bir asit olmas\u0131na ra\u011fmen (pH 1-2) normalde midede ve onikiparmak ba\u011f\u0131rsa\u011f\u0131nda bir hasar olu\u015fturmaz.<\/span><\/p>

Mukoza y\u00fczeyinde mide asidinin mukozaya ula\u015fmas\u0131n\u0131 engelleyen kal\u0131n bir mukus tabakas\u0131 mevcuttur, (mukus= s\u00fcm\u00fcks\u00fc madde). Mide mukozas\u0131nda asit, pepsin ve safra asitleri gibi mukozay\u0131 hasarlayabilecek fakt\u00f6rlerle, mukozay\u0131 koruyucu fakt\u00f6rler aras\u0131nda bir denge s\u00f6z konusudur.<\/span><\/p>

Bu dengenin sald\u0131rgan fakt\u00f6rler lehine de\u011fi\u015fmesi mukoza b\u00fct\u00fcnl\u00fc\u011f\u00fcn\u00fcn bozulmas\u0131na ve \u00fclser olu\u015fmas\u0131na yol a\u00e7ar. Halk aras\u0131nda mide \u00fclseri olarak bilinmesine ra\u011fmen peptik \u00fclserlerin b\u00fcy\u00fck bir k\u0131sm\u0131 onikiparmak ba\u011f\u0131rsa\u011f\u0131nda bulunur.<\/span><\/p>

Mide \u00fclserleri<\/strong>, gastrik \u00fclser, onikiparmak ba\u011f\u0131rsa\u011f\u0131nda olu\u015fan \u00fclserler duoedenum \u00fclseri veya bulber \u00fclser olarak adland\u0131r\u0131l\u0131r. 3-5mm den 5cm e varan geni\u015flikte olabilirler.<\/span><\/p>

Toplumun yakla\u015f\u0131k %10 unun ya\u015famlar\u0131n\u0131n herhangi bir d\u00f6neminde peptik \u00fclser hastal\u0131\u011f\u0131 ge\u00e7irdi\u011fi san\u0131lmaktad\u0131r. Erkeklerde kad\u0131nlara g\u00f6re iki kat daha fazla s\u0131kl\u0131kta g\u00f6r\u00fcl\u00fcr.<\/span><\/p>

Onikiparmak ba\u011f\u0131rsa\u011f\u0131nda \u00fclseri 30-45 ya\u015flar\u0131 aras\u0131nda s\u0131k g\u00f6r\u00fcl\u00fcrken mide \u00fclserleri daha ileri ya\u015flarda (50-65) ortaya \u00e7\u0131kmaktad\u0131r.<\/span><\/p>

\u00dclser Neden Olu\u015fur ?<\/strong><\/span><\/h2>

Mide \u00fclseri<\/strong>\u00a0g\u00fc\u00e7l\u00fc bir sald\u0131rgan fat\u00f6r olmas\u0131na ra\u011fmen tek ba\u015f\u0131na \u00fclser olu\u015fturmas\u0131 imkans\u0131z gibi g\u00f6r\u00fcnmektedir. \u00c7\u00fcnk\u00fc \u00fclserli hastalar\u0131n ancak \u00bc inde mide asit salg\u0131s\u0131 artm\u0131\u015ft\u0131r ve yar\u0131s\u0131nda da normal s\u0131n\u0131rlardad\u0131r.\u00a0Mide asiti sekresyonu<\/strong>nun \u00e7ok a\u015f\u0131r\u0131 miktarda artt\u0131\u011f\u0131 baz\u0131 hastal\u0131klarda hemen her zaman \u00fclser olu\u015fumu s\u00f6z konusu olamakla birlikte bu gibi durumlar \u00e7ok nadir olarak g\u00f6r\u00fcl\u00fcr (Zollinger Ellison sendromu gibi). Bununla birlikte asit olmadan\u00a0\u00fclser<\/strong>\u00a0olamayaca\u011f\u0131 deyimi (No acid No ulcer) g\u00fcn\u00fcm\u00fczde halen ge\u00e7erlili\u011fini s\u00fcrd\u00fcrmektedir, zira mide asit sekresyonunu bask\u0131lamadan mide veya duodenum \u00fclserini iyile\u015ftirmek m\u00fcmk\u00fcn de\u011fildir. G\u00fcn\u00fcm\u00fczde \u00fclserin iki temel sebebi oldu\u011fu kabul edilmektedir. Bir \u00e7ok mide ve oniki parmak ba\u011f\u0131rsa\u011f\u0131,\u00a0mide \u00fclserli hasta<\/strong>\u00a0Helicobacter pylori (HP) ad\u0131 verilen bir bakteri ile enfektedir (%75)<\/span><\/p>

Di\u011fer bir gurup hastada da uzun s\u00fcreli aspirin veya steroid olmayan antiromatizmal ila\u00e7 (NSAE\u0130) kullan\u0131m\u0131 s\u00f6z konusudur. D\u00fcnyada 15 milyon insan\u0131n NSAE\u0130 kulland\u0131\u011f\u0131, bunlar\u0131n %60 n\u0131n mide \u015fikayetleri tan\u0131mlad\u0131\u011f\u0131, %10 unda da mide ve\/veya\u00a0oniki parmak barsak \u00fclseri<\/strong>\u00a0olu\u015ftu\u011fu ve ortalama %3-4 \u00fcnde de hastanede yatmay\u0131 gerektirecek ciddi komplikasyonlar\u0131n ortaya \u00e7\u0131kt\u0131\u011f\u0131 bilinmektedir. Di\u011fer taraftan \u00fclserli hastalar\u0131n yakla\u015f\u0131k 1\/5 inde HP enfeksiyonu veya antiromatizmal ila\u00e7 kullan\u0131m\u0131 saptanamamas\u0131\u00a0\u00fclser<\/strong>\u00a0etyopatogenezinin hen\u00fcz tam olarak anla\u015f\u0131lamad\u0131\u011f\u0131n\u0131n bir g\u00f6stergesidir. \u00d6nceki y\u0131llarda \u00fclser olu\u015fumunda \u00f6nemli bir sebep oldu\u011fu d\u00fc\u015f\u00fcn\u00fclen stres fakt\u00f6r\u00fc g\u00fcn\u00fcm\u00fczde \u00f6nemini yitirmi\u015f olmakla birlikte v\u00fccudun a\u015f\u0131r\u0131 strese maruz kald\u0131\u011f\u0131 durumlarda ( \u00f6rne\u011fin geni\u015f v\u00fccut yan\u0131klar\u0131, kafa travmalar\u0131 ve yo\u011fun bak\u0131mda kalmak gibi) ciddi mide ve\/veya onikiparmak ba\u011f\u0131rsa\u011f\u0131 \u00fclserlerinin olu\u015fabilece\u011fi ve\u00a0\u00fclserli hasta<\/strong>\u00a0strese maruz kald\u0131ktan sonra \u015fikayetlerin artabildi\u011fi bilinmektedir.<\/span><\/p>

\u00dclserin Belirtileri Nelerdir?<\/strong><\/span><\/h3>

\u00dclserin en s\u0131k g\u00f6r\u00fclen bulgusu<\/strong>\u00a0karn\u0131n \u00fcst k\u0131sm\u0131nda, iki kaburga yay\u0131 aras\u0131nda ve g\u00f6\u011f\u00fcs kemi\u011finin alt ucu ile g\u00f6bek aras\u0131nda genellikle avu\u00e7 i\u00e7i ile ifade edilen bir b\u00f6lgede hissedilen k\u00fcnt bir a\u011fr\u0131d\u0131r.<\/span><\/p>

A\u011fr\u0131, ezilme, kaz\u0131nma veya yanma \u015feklinde de olabilir, s\u0131rta iki k\u00fcrek kemi\u011finin aras\u0131na ve karn\u0131n yan taraflar\u0131na yay\u0131labilir. Gece uykudan uyand\u0131rabilir.<\/span><\/p>

A\u011fr\u0131 ile birlikte bazen bulant\u0131 ve kusma olabilir. A\u011fr\u0131 15-20 dk dan birka\u00e7 saate kadar de\u011fi\u015fen bir s\u00fcre devam edebilir. A\u00e7 kalma sonras\u0131nda ba\u015flayabilir.<\/span><\/p>

Genellikle g\u0131da veya antasit al\u0131m\u0131 ile hafifler veya ge\u00e7er. Bu nedenle hastalar s\u0131k yemek yeme ihtiyac\u0131 duyabilirler.\u00a0Mide \u00fclseri<\/strong>\u00a0olan hastalarda a\u011fr\u0131 yemek sonras\u0131nda artma g\u00f6sterebilir ve \u015fi\u015fkinlik ve gaz yak\u0131nmas\u0131 daha belirgin olabilir.<\/span><\/p>

Baz\u0131 hastalarda hi\u00e7bir bulgu yokken kanama veya delinme\u00a0\u00fclserin ilk bulgusu<\/strong>\u00a0olabilir. Kusma \u015fikayeti \u00f6n planda olan hastalarda kilo kayb\u0131 g\u00f6r\u00fclebilir. Baz\u0131 hastalarda \u015fikayetler mevsimsel de\u011fi\u015fimler g\u00f6stererek \u00f6zellikle bahar aylar\u0131nda \u015fiddetlenebilir.<\/span><\/p>

\u00dclser Nas\u0131l Te\u015fhis Edilir?<\/strong><\/span><\/h4>

Mide \u00fclseri \u015fikayetleri<\/strong>\u00a0ile doktora ba\u015fvuran hastalarda ba\u015fvurulacak te\u015fhis y\u00f6ntemi \u00fclserin direkt olarak g\u00f6r\u00fclerek te\u015fhis edilmesine ve gerekti\u011finde doku \u00f6rne\u011fi al\u0131nmas\u0131na imkan veren endoskopidir (Gastroskopi). Nadiren baz\u0131 vakalarda baryumlu mide duodenum grafisi tan\u0131da yard\u0131mc\u0131 olabilir.\u00a0Mide \u00fclseri \u015f\u00fcphesi<\/strong>\u00a0olan hastalara kanser olas\u0131l\u0131\u011f\u0131n\u0131 uzakla\u015ft\u0131rmak i\u00e7in mutlaka endoskopik inceleme yap\u0131lmal\u0131 ve incelenmek \u00fczere doku \u00f6rne\u011fi (biyopsi) al\u0131nmal\u0131d\u0131r.<\/span><\/p>

\u00dclser Nas\u0131l Tedavi Edilir?<\/strong><\/span><\/h5>

Mide \u00fclseri tedavisi<\/strong>nde ilk basamak mide asidinin azalt\u0131lmas\u0131d\u0131r. Asit salg\u0131lanmas\u0131 bask\u0131land\u0131\u011f\u0131nda ancak asit ortamda aktif hale gelebilen bir enzim olan pepsin de inaktive edilmi\u015f olur.<\/span><\/p>

G\u00fcn\u00fcm\u00fczde\u00a0mide asit salg\u0131s\u0131<\/strong>n\u0131 g\u00fc\u00e7l\u00fc bir \u015fekilde bask\u0131layan ila\u00e7lar sayesinde \u00fclser tedavisi olduk\u00e7a ba\u015far\u0131l\u0131 bir \u015fekilde yap\u0131labilmektedir. Aktif ila\u00e7 tedavisinin ne kadar s\u00fcre ile devam edece\u011fine doktorunuz karar verecektir.<\/span><\/p>

Asit salg\u0131s\u0131n\u0131n azalt\u0131lmas\u0131 yan\u0131nda\u00a0\u00fclser tedavisi<\/strong>nde ikinci yap\u0131lmas\u0131 gereken \u015fey midelerinde HP saptanan hastalarda bu bakterinin tedavi edilmesidir.<\/span><\/p>

Bu tedavi genellikle en az iki \u00e7e\u015fit antibiyotik i\u00e7eren 1 veya 2 haftal\u0131k tedavi rejimleri kullan\u0131larak yap\u0131l\u0131r. Hangi tedavi rejiminin se\u00e7ilece\u011fine doktorunuz karar verecektir. HP tedavisi \u00f6zellikle \u00fclser n\u00fcks\u00fcn\u00fcn \u00f6nlenmesi bak\u0131m\u0131ndan \u00f6nemlidir.<\/span><\/p>

Tek ba\u015f\u0131na bakterinin tedavi edilmesi\u00a0\u00fclser tedavisi<\/strong>\u00a0i\u00e7in yetersizdir, \u00fclserin iyile\u015fmesi i\u00e7in mide asidinin yeterli bir s\u00fcre bask\u0131lanmas\u0131 gerekir (genellikle 6-8 hafta).<\/span><\/p>

Mide \u00fclserlerinde genellikle daha uzun s\u00fcreli bir tedaviye ihtiya\u00e7 duyulur.\u00a0Mide \u00fclserleri tedavi sonras\u0131<\/strong>nda mutlaka endoskopik olarak kontrol edilmeli ve tamamen iyile\u015ftikleri g\u00f6r\u00fclmeden hasta takipsiz b\u0131rak\u0131lmamal\u0131d\u0131r.<\/span><\/p>

\u00dclser<\/strong>\u00a0saptanan hastalarda aspirin ve \/veya antiromatizmal ila\u00e7 kullan\u0131m\u0131na ara verilmesi gerekir. Bu ila\u00e7lar \u00e7ok gerekli olduklar\u0131nda ancak doktor kontrol\u00fcnde kullan\u0131labilir.<\/span><\/p>

Mide \u00fclserinde ila\u00e7 tedavisi<\/strong>\u00a0s\u00fcrerken hastalar\u0131n ya\u015fam tarzlar\u0131nda, sigaran\u0131n kullan\u0131m\u0131n\u0131n sonland\u0131r\u0131lmas\u0131 ve alkol t\u00fcketiminin azalt\u0131lmas\u0131 gibi baz\u0131 de\u011fi\u015fiklikler yap\u0131lmas\u0131 uygun olur.<\/span><\/p>

Sigara kullanmaya devam eden hastalarda \u00fclser daha s\u0131k tekrarlamaktad\u0131r.\u00a0 Ac\u0131l\u0131, baharatl\u0131 ,asitli ve kafein i\u00e7eren g\u0131da ve i\u00e7ecekler ve alkol \u00fclserin aktif oldu\u011fu d\u00f6nemlerde \u015fikayetlerin artmas\u0131na sebep olabilece\u011fi i\u00e7in tedavinin erken d\u00f6nemlerinde t\u00fcketilmeleri k\u0131s\u0131tlanabilir.<\/span><\/p>

Bunun d\u0131\u015f\u0131nda\u00a0\u00fclser<\/strong>li hastada \u00f6zel bir diyet uygulamak gerekmez. S\u00fct i\u00e7meyi seven hastalar\u0131n g\u00fcnde 1-2 bardak s\u00fct i\u00e7melerine m\u00fcsade edilebilir. S\u00fct\u00fcn tedavi amac\u0131yla s\u0131k aral\u0131klarla i\u00e7ilmesi sak\u0131ncal\u0131d\u0131r. Stresli bir ya\u015fam s\u00fcren hastalarda stresin azalmas\u0131na y\u00f6nelik yakla\u015f\u0131mlar tedavide yard\u0131mc\u0131 olabilir.<\/span><\/p>

Cerrahi tedavi g\u00fcn\u00fcm\u00fczde ancak t\u0131bbi ve endoskopik tedaviye cevap vermeyen kanama, t\u0131kanma ve delinme gibi komplikasyonlar ortaya \u00e7\u0131kt\u0131\u011f\u0131nda uygulanmaktad\u0131r.<\/span><\/p>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Mide \u00dclseri Nedir? Belirtisi Ve Tedavisi Nas\u0131ld\u0131r? Mide \u00fclseri, sindirim sisteminde yemek borusu, mide ve oniki parmak ba\u011f\u0131rsa\u011f\u0131n\u0131n i\u00e7 y\u00fcz\u00fcn\u00fc d\u00f6\u015feyen ve mukoza olarak adland\u0131r\u0131lan tabakan\u0131n,\u00a0mide asidi, sindirim enzimleri (pepsin, safra tuzlar\u0131 ve pankreas enzimleri) veya ila\u00e7larla (Aspirin ve antiromatizmal ila\u00e7lar) hasarlanmas\u0131 sonucunda ortaya \u00e7\u0131kan derin yaralar \u00fclser veya peptik \u00fclser olarak adland\u0131r\u0131l\u0131r. Mide asidi […]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"yoast_head":"\nMide \u00dclseri - Mide \u00dclseri Tedavisi - Prof Dr Z\u00fclfikar Polat<\/title>\n<meta name=\"description\" content=\"Mide \u00dclseri Nedir ? Belirtileri ve Tedavisi Nas\u0131ld\u0131r ? Mide \u00dclseri Kimlerde Olu\u015fur ? 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