Lapho Bobabili Abakwa-Esophageal Sphincters Abasebenzi Ngokufanele
Kunemisipha emibili e-sphincter esesithombeni: I-sphincter esezansi ephansi (LES) kanye ne-sphincter esophageal esiphezulu (UES). Lapho i- sphincter engaphansi kwe-esophageal ingasebenzi kahle, kune-backflow ye-asidi yesisu ngaphakathi kwesigcawu. Uma lokhu kwenzeka izikhathi ezimbili noma ngaphezulu ngesonto, kungaba uphawu lwe- reflux yesifo se-gastroesophageal noma i-GERD .
Kodwa kwenzekani lapho i-sphincter engaphezulu ephezulu ingasebenzi kahle? Njenge-sphincter esezansi ephansi, uma i- sphincter engaphezulu kakhulu engasebenzi kahle, i-asidi ebuyele emuva egijima ivumelekile emgqonyeni nasebhokisini lezwi. Uma lokhu kwenzeka, kubizwa ngokuthi i-reflux yama-laryngopharyngeal, noma i-LPR.
Ungakwazi yini ukuthola i-LPR ngaphandle kwenhliziyo noma ezinye izimpawu ze-GERD ? Yebo! Abantu abaningi abane-LPR abanalo izimpawu zokuphuza . Kungani? Ukuze i-refluxed acid ibangele ukushisa, kufanele ihlale isisindo eside ngokwanele ukudala ukucasuka. Futhi, i-osopha ayinandaba nokucasula njengoba umphimbo ukhona. Ngakho-ke, uma i-asidi idlula masinyane ngokusebenzisa i-esophagus kodwa amachibi emqaleni, izimpawu zokushaya inhliziyo ngeke zenzeke kodwa izimpawu ze-LPR zizokwenza.
Izimpawu ze-Reflux Laryngopharyngeal yizi:
- Umphimbo oqhubekayo wokuhlanza
- Ukucasuka komphimbo ongapheli
- Ukukhwehlela okungapheliyo
- Ukuthuthumela
- I-phlegm eyiphutha emqaleni
- I-Dysphagia ( ubunzima bokugwinya )
- Ukuzwa okuqhubekayo kokuthile emqaleni
- Ukudla okugcobile kubuyela emuva
- Umsele wamanzi othunyelwe
- Izwi eliphansi
- Izwi elihlabayo
- Ukuvinjelwa kwendima yokuphefumula
- I-spasm ye-larynx (ibhokisi lezwi)
- Ukushisa
- Ukuguquka kwenhliziyo
Ukuxilongwa kwe-LPR
Udokotela wakho angenza olunye lwezivivinyo ezilandelayo ukuthola ukuthi une-LPR:
- I-Laryngoscopy: Le nqubo isetshenziselwa ukubona izinguquko emgqeni webhola kanye nezwi.
- Ukuhlolwa kwe-pH yamahora angu-24: Le nqubo isetshenziselwa ukubona ukuthi isisu esiswini esikhulu sihamba yini endaweni ephezulu noma emqaleni. Kusetshenziswe izinzwa ezimbili ze- pH . Enye itholakala phansi phansi futhi enye phezulu. Lokhu kuzovumela udokotela ukuthi abone ukuthi i-asidi engena ngaphansi kwesigxila ishukumisela phezulu kwesigcawu.
- I-Endoscopy ephezulu ye-GI : Le nqubo ivame ukuhlala njalo uma isiguli sikhala ngokubunzima ukugwinya. Kwenziwe ukubona ukuthi zikhona yini izibazi noma ukukhula okungavamile kulesisindo, futhi ukucacisa noma yikuphi ukungafani okutholakala. Lokhu kuhlola kuzokhombisa nokuthi kukhona ukuvuvukala kwesifo esibangelwa i-refluxed acid.
Ukwelapha
Ukwelashwa kwe-LPR ngokuvamile kufana nalokhu kweGERD. Kunezinhlobo ezine zokwelapha ezine-LPR
- Izinguquko zokuphila. Kukhona izinguquko eziningana zokuphila ongazenza ezinganciphisa, futhi ngezinye izikhathi zivimbele, i-acid reflux engenzeki.
- Ukudla kokuguqulwa. Kukhona ukudla okunye okungajwayelekile ukuthi kubangele ukuqubuka kwenhliziyo nokudla okumelwe kugwenywe. Thola ukuthi yikuphi ukudla okuhle nokuthi yikuphi ukudla okungalungile.
- Imithi yokwehlisa isisu esiswini noma ukugqugquzela ukuziphatha okuvamile. Lezi zingabandakanya iProton Pump Inhibitors , i- Histamine Receptor Antagonists , kanye nezixazululo ezingaphezu kwe-counter .
- Ukuhlinzwa ukuvimbela reflux. Ukuhlinzwa ukuqinisa ukuhlangana phakathi kwesisu nesisu. Ukuhlinzwa okuvame ukwenziwa kuthiwa yi-Nissen fundoplication. Iqinisa umxhwele phakathi kwesisu nesisu ngokumboza ingxenye ephezulu yesisu ezungeze ukuhlangana phakathi kwesisu nesisu nokuthunga endaweni.
Imithombo:
> Priston J, Thoen R, Medeiros T, Assunção A, Campagnolo A. Laryngopharyngeal Reflux: Ukuxilongwa, Ukwelashwa, kanye Nokusesha Kwamuva. I-Archives Yomhlaba Wonke Ye-Otorhinolaryngology . 2013; 18 (02): 184-191. i-doi: 10.1055 / s-0033-1352504.