PUMPUI ULCER

 *Pumpui nâ, nerve nâ, tha zâwi, hnung nâ zawhna a tam si a, inentir a harsa si a. Mithiam te thu leh hla ka lo share ang che u.*

*PUMPUI ULCER :*

Kan ka (mouth), chaw  kawng, pumpui  leh ril te hi  gastrointestinal  tract an ti a. Gastrointestinal tract hi  tisa mur (gastrointestinal mucosa)-in a tuam chhuak leh vek a ni. 

Kan hriat angin  kan thil ei te pai tawih awlsamtir turin pumpui hian  acid a tichhuak ve a *(ie.pepsin, hydrochloric acid).* 

Acid hi a siam chhuah tam lutuk chuan  gastrointestinal mucosa te hi acid hian a lo ei ral emaw a lo ei hlum  ta thin a, hei hi  ‘ Peptic Ulcer’  kan tih chu a ni. Peptic  ulcer hi  gastrointestinal tract khawiah pawh  hian  awm thei mahse rilfang (Duodenum)–ah leh pumpui-ah a awm hnem ber a ni. Mi tam tak hian peptic ulcer leh gastritis hi kan hriat pawlh fo niin a lang. Pum nuam lo leh pumpai nuam lo riauva awm si; mahse taksa chhung enna khawl hmang pawha  a dik lohna hmuh tur awm si lo leh clinical signs  fel fai tak awm  bawk si lo hi  Gastritis chu an ti.

*Peptic ulcer  hi chi hnihah a then theih a, chungte  chu:*

*A. Acute  Peptic (stress)  Ulcer:*

*B. Chronic Peptic Ulcers ( Gastric and Duodenal).*

Tunah chuan a mal te tein i lo  bih thuak thuak chauh teh ang u.

*A. ACUTE  PEPTIC* (stress)  *ULCERS:* He  ulcer-ah hi chuan  zim te te-ah  mucosa te  ei rala awmin hmun tam takah a inzarpharh a. Pumpui-ah a hluar ber a; 

Duodenum-ah pawh a awm  ve zauh zauh thin.

*A thlentu:*

*(1) Psychological stress:* 

Rilru hah nei nasa te tan Acute peptic ulcer neih a awlsam em em.

  

*(2) Physiological stress:*

* Shock

* Taksa hliam nasat vangin.

* Septicaemia

* Kang (burns) vangin

* Damdawi- aspirin, steroids, butazolidine,   

Indomethacin etc. pawngpaw ei nasat lutuk vangin.

*Zu leh zuk leh hmuam vangin.

*B. CHRONIC PEPTIC ULCERS* (Gastric and Duodenal ulcers)                      

Chronic peptic ulcer han tih ringawt hi chuan  gastric ulcer leh duodenal ulcer te a huam ve ve a ni.

*A thlentu:*

(1) Natna hrik chi khat  Helicobacter pylori  infection vangin a lo awm thei.

(2) Gastritis nei nasa te tan chronic peptic ulcer neihna chance hi a sang hle.

(3) Pumpuiin Acid-pepsin a siam hnem lutukin.

(4) Nonsteroidal Antiinflammatory Drugs (NSAIDs) an tih heng Aspirin, Ibuprofen, Paracetamole, Nimesulide, etc. te hian chronic ulcer thlenna kawngah direct effect an nei.

(5) Hmuihmer tamna  leh um tawih ei leh in te, zuk leh hmuam leh zu te hian an thlen ve bawk.

*Gastric ulcer leh Duodenal  ulcer danglamna i lo thlir teh ang:*

(1) Duodenal ulcer hi gastric ulcer aiin a let 4 in a hluar zawk.

(2) Duodenal ulcer hi kum 25-50 inkar zingah a hluar a;  Gastric ulcer erawh kum 50 chunglam zingah a hluar thung.

(3) Duodenal ulcer leh gastric ulcer  te hi  mipa-ah a hluar zawk ve ve.    

(4) Duodenal ulcer hi H-pylori Infection vang te, acid-pepsin tam lutuk vang te,  mei zial zuk leh zu in nasat vangte in a lo awm thin. Tin, blood group 0 nei zingah a awm duh bik.

                                    Gastric ulcer erawh H-pylori vangin a lo awm thei a, mucus-barrier tihchhiat vang te, gastritis, bile reflux, drugs, zu leh meizial zuk vang te in a lo awm thin.                                     

(5) Duodenal ulcer-ah chuan  thisen hloh nasat te, gastrointestinal tract pawp (perforation) te, chaw kawng hnawh phui te leh cancer te hial a lo thleng thei thin a ni.

Gastric ulcer-ah erawh  cancer thlenna chance a sang lem lo.

(6) Duodenal ulcer-ah chuan  chaw ei apiangin a na/ a thip a dam thin; Gastric ulcer-ah erawh chaw ei apiangin a thip em em thung.

(7) Duodenal ulcer-ah chuan zan mutnaah a na/thip em em thin; Gastric ulcer-ah erawh a na lem lo.

(8)Duodenal ulcer-ah chuan luak (vomitting) a awm ve lem lo; Gastric ulcer-ah erawh a awm.

(9) Duodenal ulcer-ah chuan thi-a luak ( haematemesis) a hluar lutuk lova; Gastric ulcer-ah erawh a hluar hle thung.

(10) Duodenal ulcer-ah chuan rihna a tlahniam  ngai lem lo; Gastric ulcer-ah erawh a tlahniam thin thung.

(11) Duodenal  ulcer nei tan ei tur chung changah fimkhur a tul ve lem lo; Gastric ulcer nei tan erawh fimkhur tur a ni.

(12) Duodenal ulcer-ah chuan pum dinglam hi khawih/hmeh hian a na veng veng thin a; Gastritis ulcer-ah erawh  pumpui chung lam zawn ( epigastric area)  hmeh hian a na thung.

(13) Duodenal ulcer hi sik leh sa danglam zelah a nihphung a danglam ve zel thin a; Gastric ulcer erawh  a danglam ve ngai lo.

(14) Duodenal ulcer hi rilru hah nei te zingah a hluar zawk a; Gastric ulcer erawh kut hnathawk nasa te zingah a hluar zawk thung.

*TREATMENT:* Pumpui ulcer nei te tan chuan damdawi uluk taka ei hi a enkawl dan tha a ni mai. 

*Damdawi  hnathawh dan tlem a zawng  i lo tarlang ang:*

1. Pumpui-in acid a siam hnem lutuk tur thunun turin. 

Eg. Cimetidine, Misoprostol, omeprazole , pirenzepine, etc.

2. Acid thur chiah dal turin.

Eg. Sodium bicarbonate, Magnesium hydroxide, Calcium carbonate, Magnesium trisilate, etc.

3.Ulcer protective. Eg. Sucralfate, CBS.

4.Anti-H.pylori drugs. 

Eg. Amoxicillin, Tetracycline, Metronidazole, Tinidazole, etc.

Bonus: Ulcer  damdawi  chi hnih Sucralfate leh Antacid te hi an hnathawh an inthai chhiat tawn avangin a kawpa ei hian an chakna an hloh thin a; chuvang chuan  a mala ei  hi a tha zawk a ni.

*- Joel Lairemsanga*