{"id":2838,"date":"2021-09-12T14:45:02","date_gmt":"2021-09-12T14:45:02","guid":{"rendered":"https:\/\/www.q-bital.com\/?p=2838"},"modified":"2021-09-12T14:45:02","modified_gmt":"2021-09-12T14:45:02","slug":"endoscopy-demand-is-up-and-not-just-for-detecting-cancer","status":"publish","type":"post","link":"https:\/\/www.q-bital.com\/da_dk\/endoscopy-demand-is-up-and-not-just-for-detecting-cancer\/","title":{"rendered":"Eftersp\u00f8rgslen efter endoskopi er stigende - og ikke kun for at opdage kr\u00e6ft"},"content":{"rendered":"

Gastroskopi er for eksempel 'guldstandarden' til diagnosticering af c\u00f8liaki, en tilstand som bliver mere og mere almindelig p\u00e5 verdensplan. Selvom symptomer er mindre bekymrende end formodede kr\u00e6ftformer, er medicinsk diagnose stadig vigtig, og patienterne st\u00e5r over for l\u00e6ngere ventetid end nogensinde.\n\n En stadig mere almindelig tilstand\n<\/strong>\nC\u00f8liaki er en tilstand, hvor en persons immunsystem reagerer unormalt p\u00e5 gluten, et protein, der findes i hvede og andre korn, og for\u00e5rsager skade p\u00e5 tyndtarmen. Hvis tilstanden ikke diagnosticeres eller behandles korrekt, kan dette f\u00f8re til alvorlige helbredsm\u00e6ssige konsekvenser.<\/p>\n

Det ansl\u00e5s, at c\u00f8liaki rammer i gennemsnit ca\n\n 1 ud af 100 personer\n<\/a>\np\u00e5 verdensplan, selvom priserne varierer fra land til land. De fleste mennesker med tilstanden har dog ikke en medicinsk diagnose - s\u00e5 mange som 80% af dem, der lever med c\u00f8liaki, menes at forblive udiagnosticerede.<\/p>\n

Forbedringer i testteknologi for c\u00f8liaki i l\u00f8bet af det sidste \u00e5rti har afsl\u00f8ret, at c\u00f8liaki er mere udbredt end tidligere antaget. Oprindeligt anset for at p\u00e5virke prim\u00e6rt hvide kaukasiske befolkninger, har forskning afsl\u00f8ret, at tilstanden er til stede globalt, og at\n\n h\u00f8jeste pr\u00e6valens\n<\/a>\naf c\u00f8liaki overalt i verden er faktisk blevet fundet i det nordlige Afrika.<\/p>\n

Flere mennesker f\u00e5r ogs\u00e5 diagnosen nu sammenlignet med for 10 \u00e5r siden. En nylig\n\n global unders\u00f8gelse\n<\/a>\nfandt, at ny diagnose af c\u00f8liaki steg med mere end 7,5% hvert \u00e5r, og fandt, at m\u00f8nsteret med stigende forekomst over tid var konsistent p\u00e5 tv\u00e6rs af geografi, k\u00f8n og alder, selvom stigningen var lidt h\u00f8jere hos kvinder og b\u00f8rn.<\/p>\n

Selvom stigningen i antallet af diagnosticerede personer i de senere \u00e5r delvist kan tilskrives forbedret bevidsthed om tilstanden og st\u00f8rre adgang til testning, er en reel stigning i forekomsten af c\u00f8liaki globalt anerkendt. Dette bidrager til en stigende byrde p\u00e5 sundhedssystemerne, herunder st\u00f8rre eftersp\u00f8rgsel efter endoskopi.\n\n Diagnose via gastroskopi\n<\/strong>\nEn grund til, at kun 20% af dem med tilstanden er medicinsk diagnosticeret, er, at op til 50% af patienter med c\u00f8liaki menes at v\u00e6re asymptomatiske. Tilstanden screenes ikke rutinem\u00e6ssigt for; det opfanges kun, n\u00e5r symptomer er rapporteret og unders\u00f8gt. Og selv da kan en diagnose tage flere \u00e5r, da symptomerne er s\u00e5 forskellige.<\/p>\n

Hele 99% af patienter, der f\u00e5r sygdommen, har en genetisk disposition, men s\u00e5 mange som halvdelen af befolkningen kan b\u00e6re generne, s\u00e5 dette er ikke en mark\u00f8r for c\u00f8liaki alene. Genotypetestning kan dog bruges til at udelukke c\u00f8liaki, n\u00e5r diagnosen er i tvivl.<\/p>\n

Immunresponset p\u00e5 c\u00f8liaki producerer antistoffer, der kan m\u00e5les. Men selvom antistoftestning har en h\u00f8j sensitivitet og specificitet, forekommer falsk negative og falsk positive tests i\n\n cirka 5% af tests\n<\/a>\n. Den eneste m\u00e5de at opn\u00e5 en endelig diagnose p\u00e5 kr\u00e6ver derfor gastroskopi og en duodenal biopsi, hvor potentiel skade p\u00e5 slimhinden i tyndtarmen unders\u00f8ges.<\/p>\n

Fig. - Diagnose af c\u00f8liaki\n\"\"\n\n Kilde:\n<\/em>\n\n \n Test for c\u00f8liaki\n <\/em>\n<\/a>\nHistorisk set blev mange patienter med mistanke om c\u00f8liaki aldrig henvist eller medicinsk diagnosticeret, men de blev r\u00e5det til i stedet at tage en glutenfri di\u00e6t for at se, om symptomerne blev bedre. Selvom det stadig er tilf\u00e6ldet i dag, g\u00e5r et stigende antal patienter nu videre til en endelig diagnose via en gastroskopi.\n\n Medicinsk diagnose er vigtig\n<\/strong>\nSymptomerne p\u00e5 sygdommen er hovedsageligt gastrointestinale, s\u00e5som kvalme, mavesmerter og munds\u00e5r, men omfatter ogs\u00e5 v\u00e6gttab, tr\u00e6thed, unormale leverfunktionspr\u00f8ver og vitamin- og mineralmangel.<\/p>\n

De langsigtede konsekvenser af ubehandlet c\u00f8liaki omfatter generelt d\u00e5rligt helbred, systemisk bet\u00e6ndelse, d\u00e5rlig ern\u00e6ring eller malabsorption af n\u00e6ringsstoffer, og det er blevet forbundet med tidligt inds\u00e6ttende osteoporose, infertilitet, abort, depression og tandemaljefejl. Rettidig diagnose og en livslang, streng glutenfri di\u00e6t kan forhindre eller vende mange af de tilknyttede sundhedstilstande.<\/p>\n

Ved at fjerne \u00e5rsagen til sygdommen f\u00e5r tyndtarmen lov til at hele og symptomerne f\u00e5r lov til at forsvinde, selvom der vil opst\u00e5 et tilbagefald, hvis gluten genindf\u00f8res i kosten. Men at p\u00e5begynde en streng livslang glutenfri di\u00e6t uden en sikker diagnose af c\u00f8liaki kan have sine egne konsekvenser, og da blodpr\u00f8ver har en h\u00f8j falsk positiv rate, er en biopsi i stigende grad\n\n anbefales til alle patienter\n<\/a>\nfor at bekr\u00e6fte diagnosen.\n\n Andre kilder til endoskopi eftersp\u00f8rgsel\n<\/strong>\nDet er ikke kun c\u00f8liaki, der er stigende. Selvom gastro\u00f8sofageal reflukssygdom generelt ikke er en farlig tilstand, er dens\n\n udbredelsen er stigende\n<\/a>\nefterh\u00e5nden som befolkningen \u00e6ldes, og fedmeniveauet stiger, og der kan udf\u00f8res en gastroskopi for at udelukke en mere alvorlig tilstand.<\/p>\n

Helicobacter (pylori), som kan for\u00e5rsage smerter og maves\u00e5r og kan \u00f8ge risikoen for at f\u00e5 mavekr\u00e6ft, p\u00e5vises ogs\u00e5 ved hj\u00e6lp af en\n\n gastroskop\n<\/a>\n. Selvom mavekr\u00e6ft og kr\u00e6ft i spiser\u00f8ret er mere ualmindeligt, kan personer med symptomer have brug for en gastroskopi for at udelukke dem.<\/p>\n

P\u00e5 lignende m\u00e5de kan \u00e6ndringer for\u00e5rsaget af Barretts spiser\u00f8r, en tilstand, hvor slimhinden i den nederste del af spiser\u00f8ret \u00e6ndres, og tegn p\u00e5 leversygdom ses under en gastroskopi. Colitis ulcerosa og Crohns sygdom er nogle af de tilstande, der kan opdages gennem en koloskopi.<\/p>\n

Tidlig opdagelse, forebyggelse og behandling af tarmkr\u00e6ft er en af hoved\u00e5rsagerne til, at der udf\u00f8res koloskopier, og screening for tidlige tegn bliver mere almindeligt.\n\n Eftersp\u00f8rgslen efter endoskopi er stigende\n<\/strong>\nAntallet af udf\u00f8rte endoskopier forts\u00e6tter med at stige \u00e5r-til-\u00e5r. Officielle data fra\n\n Australian Institute of Health and Welfare\n<\/a>\nviser, at mellem 2016\/17 og 2018\/19 alene steg antallet af endoskopiprocedurer med hele 12%, mens data fra\n\n NHS England\n<\/a>\nom diagnostiske ventetider og aktivitet viser, at i England er antallet af udf\u00f8rte endoskopier steget med 47% over de sidste 10 \u00e5r. Og eftersp\u00f8rgslen ser ud til at stige endnu hurtigere.<\/p>\n

P\u00e5virkningen af Covid-19 har v\u00e6ret betydelig i lande, der stod over for lange perioder med aflysninger. I England faldt endoskopiaktiviteten med mere end 80% i de tidlige stadier af den indledende b\u00f8lge af Covid-19, og p\u00e5 trods af, at niveauerne er kommet sig noget siden da, er der nationalt stadig over 40% flere mennesker, der venter p\u00e5 en endoskopi end f\u00f8r pandemien.<\/p>\n

I Australien, som var mindre h\u00e5rdt ramt af det f\u00f8rste udbrud, blev screeningkoloskopi stort set fortsat som en del af det nationale screeningprogram for tarmkr\u00e6ft. Men alligevel skete der ogs\u00e5 der en v\u00e6sentlig reduktion i endoskopiaktivitet. EN\n\n ny unders\u00f8gelse\n<\/a>\nhar afsl\u00f8ret, at 66% f\u00e6rre procedurer blev udf\u00f8rt under Covid-19, med koloskopi reduceret til 46% af pr\u00e6-Covid niveauer og gastroskopi til 25%.<\/p>\n

Selvom kr\u00e6ftrelaterede aftaler er fortsat gennem pandemien, og mange stater er begyndt at indhente eftersl\u00e6bet, er der stadig sp\u00f8rgsm\u00e5l om den sande indvirkning p\u00e5 endoskopitjenester. Antallet af bes\u00f8g i den prim\u00e6re sygepleje for gastrointestinale symptomer skal evalueres, men er faldet i l\u00f8bet af det seneste \u00e5r, is\u00e6r for mindre alvorlige tilstande, og det er sandsynligt, at dette skjuler et mere betydeligt eftersl\u00e6b, end det er klart synligt i \u00f8jeblikket.\n\n Der er behov for betydelig kapacitet p\u00e5 lang sigt\n<\/strong>\nUd over at komme sig efter Covid-19 betyder den ekstra byrde med hyppigere henvisninger til gastroenterologer for c\u00f8liaki og andre mindre alvorlige tilstande, drevet af forbedringer af blodpr\u00f8ver, st\u00f8rre opm\u00e6rksomhed og \u00f8get screening af disse tilstande, fortsat at udf\u00f8re diagnostiske endoskopiske procedurer ovenfor. en minimumst\u00e6rskel kan v\u00e6re kritisk for at forhindre, at en venteliste eskalerer ud over acceptable niveauer i den n\u00e6rmeste fremtid.<\/p>\n

For at g\u00f8re det vil der v\u00e6re behov for yderligere kapacitet. Dette kan komme i form af st\u00f8rre diagnostiske hubs eller supercentre, som kan g\u00f8re en st\u00f8rre forskel for flere mennesker, eller som mere lokaliseret ydelse, afh\u00e6ngigt af hvert lands behov. Det, der dog er klart, er, at der er behov for betydelige investeringer og tid til at etablere denne infrastruktur. Men med den ekstra kapacitet, der er akut behov for nu, hvilke andre muligheder er der?<\/p>\n

En m\u00e5de at opskalere kapaciteten v\u00e6sentligt p\u00e5 inden for meget kort tid er at idrifts\u00e6tte en mobil eller modul\u00e6r\n\n endoskopi suite\n<\/a>\n. Et s\u00e5dant anl\u00e6g kan v\u00e6re oppe at k\u00f8re i l\u00f8bet af f\u00e5 uger og kan komme med indbyggede dekontamineringsfaciliteter for at underst\u00f8tte opjusteringen af aktiviteten.<\/p>","protected":false},"excerpt":{"rendered":"

Endoskopi er ofte forbundet med kr\u00e6ftdiagnostik, men andre tilstande diagnosticeres ogs\u00e5 ved hj\u00e6lp af forskellige typer endoskopi \u2013 og mange af disse sygdomme opdages i stigende grad.<\/p>","protected":false},"author":1,"featured_media":1301,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2,123],"tags":[134,130],"class_list":["post-2838","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-procedures","tag-endoscope-decontamination","tag-endoscopy-suite"],"acf":[],"yoast_head":"\nEndoscopy demand is up - and not just for detecting cancer - Q-bital Healthcare Solutions<\/title>\n<meta name=\"description\" content=\"Endoscopy demand is up and not just for detecting cancer, other conditions are also diagnosed using different types of endoscopy\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.q-bital.com\/da_dk\/endoscopy-demand-is-up-and-not-just-for-detecting-cancer\/\" \/>\n<meta property=\"og:locale\" content=\"da_DK\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Endoscopy demand is up - 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