Yamkuro

Yamkuro yɛ nsisiiɛ a ɛsi yafunu nwoma no mu,ɔfa a ɛdi kan wɔ yafunu no mu a nnuanenuro kɔgu no, anaa sɛ drobɛn a ɛwɔ fam no.Yamkuro a ɛsi wɔ yafunu mu no, wɔfrɛ no"**gastric ulcer**", na deɛ ɛsi wɔ yafunu no nwoma a ɛdi kan no, wɔfrɛ no "**duodenal ulce**r".Yamkuro a ɛsi wɔ yafunu nwoma no mu a ɛnyɛ na koraa ne sɔre a wobɛsɔre anadwo ne w’ayase soro a ɛbɛyɛ wo ya na ɛrentumi mma wo nnidi  no.Wɔ kuro a ɛsi wɔ yafunu no mu no,yaw no ano bɛyɛ den na adidie nso bɛyɛ den.Mpɛn pii no, wɔfrɛ saa yaw no sɛ ɔhyeɛ.Mpopoeɛ binom ne mmusoɔ,feɛ,wo so bɛte,anaa sɛ worentumi nnidi.Ɛbɛyɛ sɛ mpaninfoɔ nkyekyɛmu mmiɛnsa na sɛ wɔnya yamkuro a worenhunu ɛho mpopoeɛ.Nsunsuansoɔ no bi bɛtumi ayɛ mogyatuo,tokuro a ɛbɛsi wo yam anaa sɛ wo yam kwan bɛsi.Mogyatuo no si bɛyɛ ɔha mu nkyekyɛmu dunnum(15%)wɔ akwan beberee so.
## Deɛ Ɛde Ba
Adeɛ a ɛde yamkuro ba pa ara ne sɛ wobɛnya yareɛ a wɔfrɛ no *[[:en:Helicobacter_pylori|Helicobacter pylori]]* ne non-steroidal anti-inflammatory drugs(NSAIDS).Nneɛma binom a ɛsan de yamkuro ba ne nnubɔnenom,sɛ wobɛha nipadua no beberee berɛ a nipadua no wɔ yareɛ bi a ano yɛ den no,nyarewa a ɛtumi bɔ nipadua akwaa beberee, yareɛ a ɛyɛ nipadua no mu deɛ ɛyam aduane a yɛdi kɔ yɛn mu no ne brɛboɔ ho yareɛ.Wɔn a wɔanyini no wɔ atinka pa ara ma yamkuro a NSAIDS de ba no.Wɔtumi hunu saa yamkuro yi ɛsiane mpopoeɛ a ɛda ne ho adi no a endoscopy anaa sɛ barium swallow de ba no.Yɛbɛtumi ahunu yareɛ a wɔfrɛ no *H. Pylori* sɛ yɛde mogya no fa mfidie mu hwehwɛ mmoawa a wɔbɔ nipadua no ho ban a,afei sɛ yɛbɛyɛ nhwehwɛmu afa dwonsɔtwaa ho,nhwehwɛmu a wode bɛhunu mmoawa binom,anaa sɛ yafunu no mu nhwehwɛmu. Nyarewa binom a ɛwɔ saa mpopoeɛ no bi ne yafunu yareɛ mu koankorɔ,akoma yareɛ, ne yafunu no nwoma a ɛno ara bɔ ne ho mmɔden tia nyarewa binom.

## Akwansideɛ
Adidie nnyɛ ade titire a ɛde yamkuro ba anaa sɛ ɛtumi si ayamtuo ano.Ɛho ayaresa no bi ne sɛ wobɛgyae nnubɔnenom,wobɛgyae NSAIDS nom, wobɛgyae nsaden nom,na afei woanom nnuro a ɛbɛte nsuden a ɛwɔ yafunu no mu ahoɔden so.Mpɛn pii no nnuro a wɔde te saa nsuden yi ahoɔden so ne proton pump inhibitor(PPI) anaa sɛ H2 blocker, a ɛwɔ sɛ ɛho ayaresa no di nnawɔtwe nnan(4weeks).Wɔde nnuro ahodoɔ bi te sɛ amoxicillin, clarithromycin, ne PPI na ɛhwɛ yamkuro a *H. Pylori* de ba no.Nnuro ahodoɔ a ɛsi nyarewa ano kwan no kɔ soro deɛ nanso ɛnyɛ berɛ biara na ɛtumi di dwuma.Yɛbɛtumi de endoscopy asa yamkuro a ɛtu mogya,na yɛbɛtumi nso apae ne yam asa no yareɛ berɛ a endoscopy no antumi anyɛ adwuma no.

## Mpopoeɛ

Yamkuro ho mpopoeɛ na ɛdidisoɔ yi:

* Ayase yaw (abdominal pains) a wɔhyehyɛ no berɛ a wɔde didi.Sɛ ɛba no yamkuro a ɛsi wɔ yafunu nwoma no mu nso a, yaw no tumi di bɛyɛ dɔnhwere mmiɛnsa berɛ a nipa no adidi awie na wanyane no no.
* Ayase hono(bloating)ne ayase yaw ankasa;
* waterbrush(ntasuo a ɛfra nsuden wɔ drobɛn mu, ɛwɔ mu ɛne yareɛ a wɔfrɛ no gastroesophageal reflux disease na ɛnam);
* Abofono ne feɛ ntɛntɛm
* loss of appetite na afei wo so bɛte, wɔ yamkuro mu;
* Wo mu bɛyɛ duru, wɔ yamkuro a ɛsi yafunu nwoma mu, a yaw no tumi gyae berɛ a woredidi no;
* hematemesis(mogyafeɛ);deɛ ɛde ba ne moguatuo a ɛfiri yafunu no mu ba anaa sɛ, sɛ drobɛn no ho to kyema a, ɛsiane feɛ beberebe no nti.
* melena(tarry, foul-smelling feces due to presence of oxidized iron from hemoglobin);
* yamkuro tumi de tokuro to yafunu mu anaa yafunu nwoma mu, a ɛde honam mu kuro ba, yaw, a ɛhia sɛ yɛpae nipa no na yɛsa no yareɛ..

## Nsɔano
Yamkuro nsɔano ma wɔn a wɔfa NSAIDS bɛtumi ayɛ yie sɛ wɔde nneɛma binom te sɛ proton pump inhibitor(PPI), H2 antagonist anaa sɛ misoprostol.NSAIDS a ɛyɛ COX-2 inhibitors tumi te mpɛn dodoɔ a yamkuro de ba no so, sɛ wode toto non- selective NSAIDS no ho a.PPI yɛ adeɛ a ɛtumi boa sɔ ayamkuro ano.Ɛkwan bi so no, yɛnni adanseɛ biara a ɛkyerɛ sɛ H2 antagonist tumi sɔ yafunu mu mogyatuo ano ma wɔn a wɔfa NSAIDS no.Ɛwɔ mu misoprostol tumi boa si yamkuro ano,Wɔn a wɔwɔ cardiovascular risk a ɛwɔ soro no, naproxen a ɛwɔ PPI no hia pa ara. Ɛnte saa nso a, wobɛtumi de nnuro bi te sɛ aspirin, celecoxib, ne PPI kakra adi dwuma.

## Abakɔsɛm
John Lykoudis, a ɔyɛ nhwehwɛmu fa nnwuma titire ho wɔ Greeceman mu no, de nnuro binom saa nnipa  a ɔwɔ yamkuro yareɛ wɔ afe apem ahankron aduonum nwɔtwe(1958) mu, na ɛkyɛreeɛ pa ara ansa na wɔrehunu sɛ ɛyɛ mmoawa yi na ɛde ba.

Ɛyɛ Robin Warren ne Barry J. Marshall a wɔyɛ abɔdeɛ mu nyansapɛfoɔ a wɔfiri Astraliaman mu hunu *[[:en:Helicobacter_pylori|Helicobacter pylori]]* sɛ ɛno ne adeɛ titire a ɛde ayamkuro ba, wɔ afe apem ahankron aduonwɔtwe mmienu(1982)mu. Wɔ wɔn krataa ankasa a wɔtwerɛeɛ no, Warren ne Marshall sii so dua sɛ yamkuro dodoɔ no ara no, ɛyɛ mmoawa yi na ɛde ba, na mmom no ɛnyɛ ɔbrɛ anaa sɛ nnuane binom a mfemfem nneɛma wɔ mu pii no na ɛde yamkuro ba, sɛdeɛ yɛsusu sɛ ɛteɛ no.

## Hyɛ No Nso
Ɛyɛ Sonnenberg, wɔ n'adesua mu no, ka sii no pi sɛ,ɛyɛ akwan ahodoɔ a wɔfa so de si yamkuro ano no, "sɛ wonom nsaden kakra a, ɛno nso tumi boa kum yamkuro".

## Beaeɛ A Menyaa Mmoa Firiiɛ