\u0130\u00e7 Hastal\u0131klar\u0131, Gastroenteroloji ve Hepatoloji Uzman\u0131 Prof. Dr. Y\u00fcksel G\u00fcm\u00fcrd\u00fcl\u00fc, makat b\u00f6lgesinde \u015fiddetli a\u011fr\u0131, kanama, \u00e7atlak, ve ka\u015f\u0131nt\u0131 ile kendini g\u00f6steren anal fiss\u00fcr (makatta \u00e7atlak) hastal\u0131\u011f\u0131n\u0131n te\u015fhisinin de tedavisinin de kolay oldu\u011funu ancak, ge\u00e7 kal\u0131nd\u0131\u011f\u0131nda ise hayat\u0131 zehir edebilece\u011fi konusunda uyar\u0131da bulundu.<\/p>\n
Prof. Dr. G\u00fcm\u00fcrd\u00fcl\u00fc, \u201cAnal fiss\u00fcr, makat\u0131n \u00e7\u0131k\u0131\u015f\u0131nda, \u00e7atlak \u015feklinde olu\u015fanince bir yara sonucu d\u0131\u015fk\u0131lama s\u0131ras\u0131nda ve sonras\u0131nda \u015fiddetli a\u011fr\u0131ya ve s\u0131kl\u0131kla kanamaya neden olan hastal\u0131kt\u0131r. K\u00fc\u00e7\u00fck bir \u00e7atlak da olsa verdi\u011fi rahats\u0131zl\u0131k b\u00fcy\u00fck olan bu hastal\u0131k, erken d\u00f6nemde tedavi edilmedi\u011finde kronik hale gelir ve tedavi daha g\u00fc\u00e7 olur\u201d dedi.<\/p>\n
An\u00fcs derisinin yo\u011fun sinir ucu i\u00e7eri\u011fi nedeniyle \u00e7ok hassas bir b\u00f6lge oldu\u011funu ayr\u0131ca, iki farkl\u0131 ve i\u00e7 i\u00e7e yerle\u015fik kas tabakas\u0131 taraf\u0131ndan sar\u0131l\u0131p s\u0131k\u0131ld\u0131\u011f\u0131n\u0131 ifade eden G\u00fcm\u00fcrd\u00fcl\u00fc, \u015f\u00f6yle konu\u015ftu:<\/p>\n
\u201c\u00d6zellikle v\u00fccut d\u0131\u015fk\u0131lamaya haz\u0131r de\u011filken yap\u0131lan zorlu d\u0131\u015fk\u0131lamalar veya makat\u0131n \u00e7ok tahri\u015f oldu\u011fu ishal ve kab\u0131zl\u0131k durumlar\u0131nda bu b\u00f6lgede y\u0131rt\u0131klar olu\u015fabilir. Hastalar sanki k\u00fc\u00e7\u00fck cam par\u00e7alar\u0131 \u00e7\u0131kar\u0131yormu\u015f gibi hissederler. As\u0131l a\u011fr\u0131 ise d\u0131\u015fk\u0131lama bitiminde ortaya \u00e7\u0131kar ve bazen saatlerce s\u00fcrebilir. Son derece a\u011fr\u0131l\u0131 olan bu y\u0131rt\u0131klar kaslarda spazma yol a\u00e7arak daha fazla bas\u0131nca maruz kal\u0131rlar ve kan dola\u015f\u0131mlar\u0131 yetersiz kald\u0131\u011f\u0131 i\u00e7in y\u0131rt\u0131k iyile\u015femez.\u201d<\/p>\n
Kad\u0131n ve erkekte ayn\u0131 oranlarda ve \u00e7ok sa\u011fl\u0131kl\u0131 bireylerde de g\u00f6r\u00fclen bu hastal\u0131\u011f\u0131n belirtilerine dikkati \u00e7eken G\u00fcm\u00fcrd\u00fcl\u00fc, hastalar\u0131n en s\u0131k \u015fikayetlerinin makatta a\u011fr\u0131, d\u0131\u015fk\u0131lama s\u0131ras\u0131nda meydana gelen yanma, kanama ya da y\u0131rt\u0131lma hissi ile ka\u015f\u0131nt\u0131 oldu\u011funu belirterek, \u015f\u00f6yle devam etti:<\/p>\n
\u201cHastalar\u0131n b\u00fcy\u00fck b\u00f6l\u00fcm\u00fc makat \u00e7atla\u011f\u0131n\u0131n derideki uzant\u0131s\u0131n\u0131 basur (hemoroid) memesi zannederler. Fiss\u00fcrler akut ve kronik olarak ikiye ayr\u0131l\u0131r. Bu ayr\u0131m\u0131 sa\u011flayan fiss\u00fcr\u00fcn g\u00f6r\u00fcn\u00fcm\u00fcd\u00fcr, ayr\u0131ca birka\u00e7 hafta dan uzun zamand\u0131r semptomlar\u0131 olan fiss\u00fcrler kronikle\u015fmi\u015f kabul edilir. Anal fiss\u00fcr, kad\u0131n ve erkekte e\u015fit oranda g\u00f6zlenir. Her ya\u015fda g\u00f6r\u00fcl\u00fcr ancak en s\u0131k 30 ve 40 ya\u015flar\u0131nda ortaya \u00e7\u0131kar. Erkeklerde y\u00fczde 99, kad\u0131nlarda y\u00fczde 90 oranda makat\u0131n arka k\u0131sm\u0131nda g\u00f6zlenir. Yan duvarda yer alan bir fiss\u00fcr i\u00e7in Crohn\u2019s hastal\u0131\u011f\u0131, t\u00fcberk\u00fcloz, sifiliz, HIV\/AIDS, dermatolojik hastal\u0131klar, (ps\u00f6riazis) veya anal karsinom gibi di\u011fer klinik durumlar d\u00fc\u015f\u00fcn\u00fclmelidir.\u201d<\/p>\n
Bol s\u0131v\u0131, bol lifli g\u0131dalar t\u00fcketin<\/p>\n
Y\u00fczeysel bir \u00e7atlak olarak ba\u015flayan anal fiss\u00fcr hastal\u0131\u011f\u0131n\u0131n bazen ba\u015flang\u0131\u00e7 d\u00f6neminde kendili\u011finden de iyile\u015febildi\u011fini ancak, sert d\u0131\u015fk\u0131lama ataklar\u0131 tekrarlad\u0131k\u00e7a y\u0131rt\u0131klar\u0131n daha da derinle\u015fmeye ba\u015flad\u0131\u011f\u0131n\u0131 ifade eden Prof. Dr. G\u00fcm\u00fcrd\u00fcl\u00fc, \u201cAkut fiss\u00fcrlerin bir\u00e7o\u011fu baz\u0131 kolay \u00f6nlemlerle de tedavi edilebilir. Tedavinin temeli t\u0131ka\u00e7 gibi olan d\u0131\u015fk\u0131n\u0131n yumu\u015fat\u0131lmas\u0131 ve anal kanal\u0131n tekrarlayan y\u0131rt\u0131lmalar\u0131n\u0131n \u00f6nlenmesidir. Bol lifli g\u0131dalar ve bol s\u0131v\u0131 d\u0131\u015fk\u0131n\u0131n yumu\u015famas\u0131n\u0131 sa\u011flayarak tedaviyi destekler. Bu basit tedavi ilkelerine uyularak bir y\u0131l sonra akut fiss\u00fcrlerin y\u00fczde 80\u2019nde iyile\u015fme sa\u011flanabilir. D\u0131\u015fk\u0131lama sonras\u0131nda \u0131l\u0131k suya oturma i\u00e7 kas\u0131n gev\u015femesini sa\u011flad\u0131\u011f\u0131 i\u00e7in basit tedaviye destek sa\u011flar. Bu \u00f6nlemlerle sert d\u0131\u015fk\u0131lama sorunu \u00e7\u00f6z\u00fclemiyorsa laksatiflerden (d\u0131\u015fk\u0131 yumu\u015fat\u0131c\u0131lardan) yararlan\u0131labilir\u201d diye konu\u015ftu.<\/p>\n
Tedavi<\/p>\n
Di\u011fer tedavi se\u00e7eneklerine de dikkati \u00e7eken G\u00fcm\u00fcrd\u00fcl\u00fc, \u015f\u00f6yle devam etti:<\/p>\n
\u201cHastalar\u0131n hemen yar\u0131s\u0131, oturma banyolar\u0131, posal\u0131 beslenmenin arttr\u0131lmas\u0131, ve gaita hacmini art\u0131r\u0131c\u0131 ila\u00e7 tedavisi ile topikal anestetik ve antiinflamatuarlar eklenerek veya eklenmeden tedavi olmaktad\u0131r. Bununla birlikte fiss\u00fcr iyile\u015fmesi, kanama ve a\u011fr\u0131n\u0131n semptomatik iyili\u011fi, ve yan etki olmadan g\u00f6r\u00fclmektedir. Topikal nitrik oksit olanlar aras\u0131nda kronik fiss\u00fcr\u00fc olan hastalar\u0131n y\u00fczde 50\u2019sinde iyile\u015fme olur. Tedavi s\u0131ras\u0131nda kullan\u0131lan topikal nitrogliserin a\u011fr\u0131y\u0131 b\u00fcy\u00fck oranda giderir. Anal fiss\u00fcr tedavisinde bir sonraki a\u015fama makata halk aras\u0131nda “botox” olarak bilinen botulin zehirinin enjekte edilmesidir. Yakla\u015f\u0131k y\u00fczde 70 oran\u0131nda ba\u015far\u0131l\u0131 olan bu y\u00f6ntem ge\u00e7ici olarak makat kaslar\u0131n\u0131n k\u0131smi felci ile etki etmektedir.\u201d<\/p>\n
Cerrahi se\u00e7enek<\/p>\n
Prof. Dr. Y\u00fcksel G\u00fcm\u00fcrd\u00fcl\u00fc, uzun s\u00fcre devam ederek kronikle\u015fen anal fiss\u00fcr hastal\u0131\u011f\u0131nda gaz tutamama, nadiren de d\u0131\u015fk\u0131 tutamama gibi sorunlara neden olabilece\u011fini belirterek, \u201cAnal fiss\u00fcrde son \u00e7are ameliyatt\u0131r. Ameliyatta makat\u0131 kasan kaslardan i\u00e7teki kesilerek yaran\u0131n kan dola\u015f\u0131m\u0131n\u0131n artmas\u0131 ve iyile\u015fmesi sa\u011flan\u0131r. Do\u011fru yap\u0131ld\u0131\u011f\u0131nda ba\u015far\u0131 oran\u0131 y\u00fczde 98-99 civar\u0131ndad\u0131r\u201d dedi.<\/p>\n","protected":false},"excerpt":{"rendered":"
\u0130\u00c7 HASTALIKLARI, GASTROENTEROLOJ\u0130 VE HEPATOLOJ\u0130 UZMANI PROF. DR. Y\u00dcKSEL G\u00dcM\u00dcRD\u00dcL\u00dc, MAKAT B\u00d6LGES\u0130NDE \u015e\u0130DDETL\u0130 A\u011eRI, KANAMA, \u00c7ATLAK, VE KA\u015eINTI \u0130LE KEND\u0130N\u0130 G\u00d6STEREN ANAL F\u0130SS\u00dcR (MAKATTA \u00c7ATLAK) HASTALI\u011eININ TE\u015eH\u0130S\u0130N\u0130N DE TEDAV\u0130S\u0130N\u0130N DE KOLAY OLDU\u011eUNU ANCAK, GE\u00c7 KALINDI\u011eINDA \u0130SE HAYATI ZEH\u0130R EDEB\u0130LECE\u011e\u0130 KONUSUNDA UYARIDA BULUNDU.<\/p>\n","protected":false},"author":1,"featured_media":184336,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_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},"jetpack_post_was_ever_published":false},"categories":[1],"tags":[45626,43122,45627,14388,5256],"class_list":["post-184335","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-anal","tag-edebilir","tag-fissur","tag-hayatinizi","tag-zehir"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.tvturk.com\/wp-content\/uploads\/2019\/07\/anal-fissur-hayatinizi-zehir-edebilir_a03b685.jpg?fit=1000%2C666","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/paKIfm-LX9","_links":{"self":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/184335","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=184335"}],"version-history":[{"count":0,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/184335\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media\/184336"}],"wp:attachment":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media?parent=184335"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/categories?post=184335"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/tags?post=184335"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}