Als je fibromyalgie hebt, heb je misschien gemerkt dat de symptomen waar iedereen aan denkt, chronische vermoeidheid, pijn en mentale mist, niet de helft zijn van alles waarmee je worstelt. Fibromyalgie lijkt u kwetsbaarder te maken voor tal van andere aandoeningen. En het zijn vaak dingen die je niet associeert met de ziekte, zoals chronische jeuk, frequent urineren en auto-immuunziekten. Maar er is ook een andere complicatie waar mensen niet vaak aan denken: GERD of gastro-oesofageale refluxziekte.
Deze aandoening, die ervoor zorgt dat maagzuur terug in de slokdarm wordt gewassen, is pijnlijk en frustrerend om mee te leven. Maar het kan ook leiden tot een ernstige complicatie die darmmetaplasie wordt genoemd. In het geval van darmmetaplasie transformeren de cellen die de slokdarm bekleden zich in het type cellen dat u gewoonlijk in de darm ziet. Dus wat is precies deze aandoening en hoe is het gerelateerd aan fibromyalgie? Wat zijn de symptomen en risico’s? En wat kunt u doen om het te behandelen?
Intestinale metaplasie en fibromyalgie
Metaplasie is een term die betekent dat één type cel muteert in een andere cel. Als het gaat om darmmetaplasie veranderen de cellen in de slokdarm in darmcellen, wat resulteert in een aandoening die de slokdarm van Barrett wordt genoemd.
Kortom, de cellen van je lichaam passen zich aan hun omgeving aan. En wanneer de cellen in de slokdarm constant voelen dat ze worden blootgesteld aan maagzuur als gevolg van GERD, verplaatsen ze zich naar darmcellen omdat darmcellen zijn aangepast om met dat zuur om te gaan.
En als u fibromyalgie heeft, loopt u een veel hoger risico om GERD te ontwikkelen. Bijna zestig procent van de mensen met fibromyalgie heeft zelfs last van een vorm van maagzuur of gastro-oesofageale reflux. We weten niet waarom fibromyalgie uw risico lijkt te verhogen. En het kan zijn dat de chronische pijn en vermoeidheid van fibromyalgie ertoe leiden dat mensen met fibromyalgie niet kunnen trainen en dus een hoger risico op obesitas hebben, wat een belangrijke risicofactor is voor brandend maagzuur.
GERD veroorzaakt een chronische zuurstoom in de slokdarm, waardoor GERD de belangrijkste risicofactor is voor het ontwikkelen van de slokdarm van Barrett. En dat kan veel complicaties veroorzaken.
Wat zijn de symptomen en risico’s?
De meeste mensen met de slokdarm van Barrett merken aanvankelijk geen symptomen. Ze zullen natuurlijk nog steeds worstelen met de symptomen van GORZ, maar het is moeilijk te zeggen of de cellen in je slokdarm zijn verschoven naar de darmcellen. Deze verschuiving in de samenstelling van uw cellen heeft niet echt invloed op het vermogen van uw slokdarm om zijn werk te doen, vooral wanneer slechts een klein deel van de cellen wordt beïnvloed.
Het echte gevaar zijn niet de symptomen die de slokdarm van Barrett veroorzaakt, maar eerder het feit dat het uw risico op kanker aanzienlijk verhoogt. Met de slokdarm van Barrett krijg je vijftig keer meer kans op slokdarmkanker. Dat komt omdat de muterende cellen in de slokdarm waarschijnlijker kanker worden. En slokdarmkanker is erg gevaarlijk. Tweeëntachtig procent van de gevallen van slokdarmkanker is uiteindelijk terminaal. Het is daarom van vitaal belang om zo snel mogelijk een behandeling te krijgen.
Hoe wordt het behandeld?
De eerste stap in de behandeling is het krijgen van een diagnose. Omdat de slokdarm van Barrett niet tot merkbare symptomen leidt, is het waarschijnlijker dat de arts de aandoening opmerkt tijdens het controleren op een gerelateerde zure reflux. Om de aandoening te diagnosticeren, doen artsen iets dat een endoscopie wordt genoemd. Dit is in wezen een procedure waarbij de arts een kleine, flexibele camera door de slokdarm duwt om een visuele inspectie van de schade uit te voeren.
De arts zal dan een kleine biopsie van weefsel uit de slokdarm nemen en het weefsel onder een microscoop onderzoeken om te zien of metaplasie is opgetreden. Als je eenmaal een diagnose hebt, zijn er een paar manieren om de aandoening te behandelen.
De eerste stap is om het risico op kanker te minimaliseren. Dit omvat meestal basisbehandelingen voor zure reflux en veranderingen in levensstijl om het risico te verminderen. Dingen zoals roken en alcoholgebruik zijn niet alleen een belangrijke factor bij zure reflux, maar kunnen ook het risico op kanker verhogen. Door veranderingen aan te brengen in deze gewoonten en uw dieet, kunt u helpen de hoeveelheid zure reflux die u ervaart te verminderen en uw risico op kanker te verminderen.
Er is geen goede optie om de verandering in cellen in de slokdarm om te keren, maar ze kunnen operatief worden verwijderd. De meeste artsen zijn echter van mening dat de risico’s van deze operatie de voordelen niet waard zijn. In plaats daarvan raden artsen aan preventieve inspanningen te combineren met regelmatige kankerscreening. In dit geval is dat echt de beste optie.
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