Gastroenteroloji Uzman\u0131 Do\u00e7. Dr. \u0130brahim Koral \u00d6nal, \u00fclkemizde ortalama her be\u015f ki\u015fiden birinde g\u00f6r\u00fclen ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131n\u0131n (NASH) alkol ve alkol d\u0131\u015f\u0131 nedenlere ba\u011fl\u0131 olabilece\u011fini s\u00f6yledi.<\/p>\n
VM Medical Park Kocaeli Hastanesi Gastroenteroloji Uzman\u0131 Do\u00e7. Dr. \u0130brahim Koral \u00d6nal, ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131 \u00e7ok s\u0131k g\u00f6r\u00fclen bir rahats\u0131zl\u0131k oldu\u011funu belirterek, \u201cYa\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131 alkol ve alkol d\u0131\u015f\u0131 nedenlere ba\u011fl\u0131 olabilmektedir. S\u00f6z konusu olan karaci\u011ferde fazla ya\u011f birikimidir. En s\u0131k g\u00f6r\u00fclen formu olan \u2018ya\u011fl\u0131 karaci\u011ferde\u2019 karaci\u011fer h\u00fccrelerinde ya\u011f birikimi mevcuttur. Karaci\u011ferde ya\u011f birikimi normal olmamakla birlikte tek ba\u015f\u0131na karaci\u011fere zarar vermez ve tek ba\u015f\u0131na ya\u011fl\u0131 karaci\u011fer \u00e7ok ciddi bir sa\u011fl\u0131k sorunu de\u011fildir. Baz\u0131 ki\u015filerde ise karaci\u011fer ya\u011flanmas\u0131na de\u011fi\u015fik derecelerde karaci\u011fer iltihaplanmas\u0131 ve karaci\u011ferde skar (nedbe) dokusu olu\u015fmas\u0131 e\u015flik eder; bu durum alkol d\u0131\u015f\u0131 steatohepatit (NASH) olarak adland\u0131r\u0131l\u0131r. NASH potansiyel olarak ciddi bir durumdur ve zamanla ciddi karaci\u011fer hasar\u0131 ve siroz geli\u015fimi ile sonu\u00e7lanabilir. \u0130leri d\u00fczeyde yap\u0131sal hasar yani siroz geli\u015fimi zamanla karaci\u011ferin g\u00f6revlerini yeterince yerine getirememesi yani karaci\u011fer yetmezli\u011fi ile sonu\u00e7lanabilir ve karaci\u011fer nakil ihtiyac\u0131 g\u00fcndeme gelebilir\u2019\u2019 dedi.<\/p>\n
\u00c7o\u011fu hastada belirti vermeyebiliyor<\/p>\n
Dr. \u00d6nal, ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131n\u0131n belirtilerinin \u015funlar oldu\u011funu s\u00f6yledi:<\/p>\n
“\u00c7o\u011fu hastada herhangi bir belirti vermez ve muayene bulgular\u0131 genellikle normaldir. Fizik muayenede bazen karaci\u011ferde b\u00fcy\u00fcme tespit edilebilir. \u00c7ocuklarda daha fazla olmak \u00fczere boyunda ve kollarda yama tarz\u0131, koyu renk de\u011fi\u015fiklikleri olabilir.\u201d<\/p>\n
Obezitenin en yayg\u0131n risk fakt\u00f6r\u00fc oldu\u011funu belirten Dr. \u00d6nal \u015f\u00f6yle konu\u015ftu:<\/p>\n
“Ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131 \u00e7o\u011fu zaman zemininde ins\u00fclin direncinin yatt\u0131\u011f\u0131 ve metabolik sendrom denilen; abdominal obezite, hipertansiyon, bozulmu\u015f kan ya\u011flar\u0131 (trigliserid y\u00fcksekli\u011fi, HDL d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc), bozulmu\u015f a\u00e7l\u0131k \u015fekeri veya a\u015fikar diyabetes mellitus hatal\u0131\u011f\u0131 ile karakterize tablonun bir par\u00e7as\u0131d\u0131r. Daha ciddi bir tablo olan NASH\u2019in geli\u015fiminde rol oynayan fakt\u00f6rlerle ili\u015fkin bilgiler ise s\u0131n\u0131rl\u0131d\u0131r. Bu konuda devam eden \u00e7al\u0131\u015fmalar\u0131n odakland\u0131\u011f\u0131 konular aras\u0131nda; oksidatif stres (oksidan ve antioksidan kimyasallar aras\u0131nda dengesizlik sonucu karaci\u011fer h\u00fccre hasar\u0131), karaci\u011fer h\u00fccre nekrozu veya \u00f6l\u00fcm\u00fc (apoptoz), ya\u011f dokunun iltihaplanmas\u0131, ba\u011f\u0131rsak bakteriyel floras\u0131ndaki de\u011fi\u015fiklikler bulunmaktad\u0131r. Ki\u015finin kendi iltihabi h\u00fccrelerinin, karaci\u011fer h\u00fccrelerinin veya ya\u011f h\u00fccrelerinin toksik iltihabi proteinler (sitokinler) \u00fcretmesi ve salg\u0131lamas\u0131 yer almaktad\u0131r.\u2019\u2019<\/p>\n
\u2018T\u00fcrkiye\u2019de her be\u015f ki\u015fiden birinde var\u2019<\/p>\n
Gastroenteroloji Uzman\u0131 Do\u00e7. Dr. \u0130brahim Koral \u00d6nal, ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131n\u0131n \u00e7ok s\u0131k g\u00f6r\u00fclen bir rahats\u0131zl\u0131k olup \u00fclkemizde ortalama her be\u015f ki\u015fiden birinde g\u00f6r\u00fcld\u00fc\u011f\u00fcn\u00fc belirterek, \u201cObezite en yayg\u0131n risk fakt\u00f6r\u00fcd\u00fcr. Obez eri\u015fkinlerin yakla\u015f\u0131k \u00fc\u00e7te ikisinde, obez \u00e7ocuklar\u0131n ise yar\u0131s\u0131nda karaci\u011fer ya\u011flanmas\u0131 oldu\u011fu ve her be\u015f karaci\u011fer ya\u011flanmas\u0131n\u0131n yakla\u015f\u0131k be\u015fte birinin NASH oldu\u011fu tahmin edilmektedir. Tip 2 diyabet ve ins\u00fclin direnci ile ili\u015fkili di\u011fer durumlar, \u00f6rne\u011fin polikistik over sendromu da ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131 i\u00e7in risk fakt\u00f6rleridir\u201d dedi.<\/p>\n
Kan testi ve karaci\u011fer ultrasonuyla NASH tan\u0131s\u0131 konulabilir<\/p>\n
Karaci\u011fer hastal\u0131\u011f\u0131na kan ve g\u00f6r\u00fcnt\u00fcleme testleriyle tan\u0131 konuldu\u011funu ifade eden Dr. \u00d6nal, \u201cKilo fazlas\u0131 veya obezitesi bulunan ve\/veya rutin kan tetkiklerinde hafif d\u00fczeyde karaci\u011fer enzim y\u00fckseklikleri saptanan hastalarda ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fcl\u00fcr. Ancak ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131nda karaci\u011fer enzimlerinin tamamen normal olabilece\u011fi de unutulmamal\u0131d\u0131r. Tan\u0131 g\u00f6r\u00fcnt\u00fcleme tetkikleri s\u0131kl\u0131kla karaci\u011fer ultrasonu ile do\u011frulan\u0131r. Ya\u011fl\u0131 karaci\u011fer ile NASH ay\u0131r\u0131m\u0131 ancak karaci\u011fer biyopsisi (karaci\u011ferden ultrason e\u015fli\u011finde ve lokal anestezi alt\u0131nda i\u011fne ile par\u00e7a al\u0131nmas\u0131 ve patolojide incelenmesi) ile yap\u0131labilir. Karaci\u011fer biyopsisi karaci\u011ferdeki hasar\u0131n varl\u0131\u011f\u0131n\u0131 ve ciddiyetini yans\u0131tmak a\u00e7\u0131s\u0131ndan kan tetkikleri ve ultrason ile elde edilemeyecek bilgileri sa\u011flar\u2019\u2019 diye konu\u015ftu.<\/p>\n
Diyet yaparak hastal\u0131\u011f\u0131 yenebilirsiniz<\/p>\n
Dr. \u00d6nal, \u00e7e\u015fitli \u00e7al\u0131\u015fmalar\u0131n kilo vermenin karaci\u011ferdeki ya\u011f birikimini geriletebilece\u011fini g\u00f6sterdi\u011fini ifade ederek, \u201cBu y\u00fczden kilo fazlas\u0131 olan veya obez bireylerde dengeli bir diyet uygulamas\u0131, fizik aktiviteyi art\u0131rmak, alkolden ve gereksiz ila\u00e7 kullan\u0131m\u0131ndan ka\u00e7\u0131nmak tedavi yakla\u015f\u0131m\u0131n\u0131n temelini olu\u015fturur. Akdeniz tipi beslenmenin d\u00fc\u015f\u00fck ya\u011fl\u0131 diyetlere g\u00f6re daha faydal\u0131 olabilece\u011fine dair veriler mevcuttur. Kahve t\u00fcketiminin karaci\u011fer ya\u011flanmas\u0131 riskini azaltt\u0131\u011f\u0131 g\u00f6zlenmi\u015ftir. Var ise diyabet, kolesterol ve trigliserid y\u00fcksekli\u011finin kontrol alt\u0131nda al\u0131nmas\u0131 gereklidir. Ya\u011fl\u0131 karaci\u011fer hastal\u0131\u011f\u0131 ve NASH tedavisinde kullan\u0131labilecek ve diyet-egzersize ilave katk\u0131 sa\u011flayabilecek ila\u00e7 tedavileri \u00fczerine \u00e7al\u0131\u015fmalar devam etmektedir. Bu anlamda en \u00e7ok \u00e7al\u0131\u015fma konusu olan ila\u00e7lar lipid d\u00fc\u015f\u00fcr\u00fcc\u00fcler, E vitamini, ins\u00fclin duyarl\u0131l\u0131\u011f\u0131n\u0131 art\u0131ran ila\u00e7lar ve antioksidan, antisitokin ve antiapoptotik ajanlard\u0131r\u201d dedi.<\/p>\n","protected":false},"excerpt":{"rendered":"
DO\u00c7. DR. \u0130BRAH\u0130M KORAL \u00d6NAL, \u00dcLKEM\u0130ZDE ORTALAMA HER BE\u015e K\u0130\u015e\u0130DEN B\u0130R\u0130NDE G\u00d6R\u00dcLEN YA\u011eLI KARAC\u0130\u011eER HASTALI\u011eININ (NASH) ALKOL VE ALKOL DI\u015eI NEDENLERE BA\u011eLI OLAB\u0130LECE\u011e\u0130N\u0130 S\u00d6YLED\u0130.<\/p>\n","protected":false},"author":1,"featured_media":168571,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[5509,15632,279,36223,13970,22177,24603,40429,6871,11762],"class_list":["post-168570","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-cikariyor","tag-davetiye","tag-dr","tag-gastroenteroloji","tag-hastaligi","tag-karaciger","tag-onal","tag-siroza","tag-uzmani","tag-yagli"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.tvturk.com\/wp-content\/uploads\/2019\/06\/gastroenteroloji-uzmani-dr-onal-yagli-karaciger-hastaligi-siroza-davetiye-cikariyor_340bcb6.jpg?fit=1000%2C1000","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/paKIfm-HQS","_links":{"self":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/168570","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/comments?post=168570"}],"version-history":[{"count":0,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/168570\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media\/168571"}],"wp:attachment":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media?parent=168570"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/categories?post=168570"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/tags?post=168570"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}