Uhlobo lweGERD olungabonakali ukulimala okubonakalayo ku-Esophagus
Isifo se-reflux se-gastroesophageal (GERD) senzeke uma isisindo esincane esingaphansi kwe-sphincter (LES) singasondeli kahle, ngakho okuqukethwe kwesisu kuvuza emuva, noma ku-reflux, ku-esophagus.
Kwezinye iziguli, i-GERD ingabangela isifo sokuphefumula , isifo esibangela ukuvuvukala, izidakamizwa, nezilonda ukwenza ifomu. Ukwehla kwesifo somzimba kungabonakala nge-endoscope-ithuluzi elinokukhanya nekhamera kulo okuvumela udokotela ukuba abone ngeso lengqondo isimiso somuntu sokugaya.
Kodwa abantu abaningi banezinto ezibizwa ngokuthi isifo se-reflux esingenayo, noma i-NERD. Nge-NERD, abantu bahlangabezana nezibonakaliso ezivamile ze- GERD ezibangelwa i-acid reflux, kodwa abanalo ukulimala okubonakalayo kokuqapha.
Ukwelashwa kwe-NERD kufana nalokhu kwe-GERD ekhulayo. Ngokuya ngobukhulu bezimpawu, ukwelashwa kungabandakanya okukodwa noma okungaphezulu kwalokhu okulandelayo: izinguquko zokuphila, imithi noma ukuhlinzwa.
Izinguquko zokuphila zokuphatha iNERD
Ngokusho kwe-American College of Gastroenterology, imikhuba yokuphila iyingxenye yokulawula isifo se-acid reflux.
- Ukulahlekelwa Isisindo: Uma ukhuluphele ngokweqile noma ukhuluphele (okusho ukuthi inani lomzimba elikhulu kunama-25), noma uma usanda kunesisindo, ukunciphisa umzimba kunconywa kakhulu. Isayensi ngemuva kwalokhu ukuthi isisindo esingeziwe esiqongweni sakho singakhuphula ukucindezeleka kwesisu, okungase kuqhubekele okuqukethwe kwesisu kuze kube seqenjini.
- Ukuphakamisa ikhanda lombhede wakho , ikakhulukazi uma izimpawu zakho ze-reflux zibi kakhulu ebusuku kanye / noma ukuvusa ebusuku, kuphakanyisiwe.
- Ukuyeka ukubhema nokuphuza utshwala kungase kube usizo, nakuba lolu shintsho aluzange luboniswe ngokucacile ngezifundo zesayensi ukusiza ngezimpawu ze-GERD. Noma kunjalo, odokotela abaningi bayasikhuthaza ngesisodwa.
- Ukuqeda ukudla okunye kungasiza futhi ekulawuleni izimpawu ze-acid reflux, ikakhulukazi ushokoledi, i-caffeine, ukudla okunezinongo, ama-citrus kanye neziphuzo ze-carbonated. Lolu shintsho lungasiza kakhulu kubantu abaqaphela ukuxhumana phakathi kwezimpawu zabo kanye nokudla okukodwa noma okunye okuqondile.
- Ukudla ukudla okuncane (njengokudla okukhulu kungakwandisa ukucindezela okuphezulu ngokumelene ne-sphincter ye-esophageal) futhi ukugwema ukudla okungenani amahora amabili kuya kwethathu ngaphambi kokulala noma ukuhlala kungase kube usizo.
Imithi yokwelapha i-NERD
Udokotela wakho angase ancoma ama-antacids angaphezu kwe-counter, asebenza ngokunciphisa i-asidi esiswini, noma imithi eyeka ukukhiqizwa kwe-asidi.
- Ama-Antacids , afana neMaalox , i- Mylanta , i- Tums , ne- Rolaids ngokuvamile yilapho izidakamizwa zokuqala zinconywa ukunciphisa ukushaya kwenhliziyo nezinye izimpawu ze-GERD ezincane. Imikhiqizo eminingi emakethe isebenzisa inhlanganisela ehlukene yama-salts amathathu ayisisekelo-i-magnesium, i-calcium, ne-aluminium-ne-hydroxide noma i-bicarbonate ions ukuze i-asidi isiswini esiswini. Ukuphazamiseka ukuthi ama-antacids anemiphumela emibi. I-Magnesium usawoti ungabangela ukuhuda, kanti i-aluminium usawoti ingabangela ukuqothulwa. I-aluminium ne-magnesium usawoti ngokuvamile ihlangene nomkhiqizo owodwa ukulinganisa lemiphumela.
- Abakhi be-H2 , njenge- Tagamet , i- Pepcid , i-Axid, ne- Zantac , i- impede acid production. Zitholakala emagunyeni omuthi we-odokotela futhi ngaphezulu kwe-counter. Lezi zidakamizwa zinikeza usizo olusenesikhathi esifushane, kepha abakwa-block H2 abangaphezu kwe-alliance akufanele basebenzise isikhathi esingaphezu kwamasonto ambalwa ngesikhathi ngaphandle kwesiqondiso esifanele sikadokotela.
- Ama-proton pump inhibitors afaka i- Prilosec , i- Prevacid , i-Protonix, i- Aciphex ne- Nexium , konke okutholakala ngemithi. I-Prilosec itholakale kwifomu engaphezulu kwe-counter (Prilosec OTC). I-Proton pump inhibitors (i-PPIs) yiqembu lemithi evimbela ukukhululwa kwe-asidi esiswini nasemathunjini. Ama-proton pump inhibitors nawo akufanele asetshenziswe isikhathi esingaphezu kwamasonto ambalwa ngesikhathi ngaphandle kokuqondiswa udokotela.
Ukuhlinza Ukwelapha I-NERD
Ngokusho kwe-American College of Gastroenterology, izinketho zokukhetha abantu abane-GERD zihlanganisa i-laparoscopic fundoplication noma ukuhlinzeka nge-bariatric kumuntu onamandla kakhulu.
Ku-fundoplication ye-laparoscopic, isifunda esingenhla sesisu sisongwe engxenyeni engezansi ye-esophagus.
Isinqumo sokuhlinzwa siyinkimbinkimbi futhi sidinga izingxoxo ezicabangayo phakathi komuntu nodokotela bakhe.
> Imithombo:
> I-Hershcovici T, i-Fass R. Izifo ezingenayo i-Reflux (NERD) - Isibuyekezo. J Neurogastroenterol Motil. 2010 Jan; 16 (1): 8-21.
> Katz PO, Gerson LB, Vela MF. Imihlahlandlela yokuxilongwa nokuphathwa kwesifo se-reflux se-gastroesophageal. Am J Gastroenterol 2013; 108: 308-28.
> Kahrilas PJ. (Mashi 2016). Ukuphathwa kwezokwelapha kwe-reflux ye-gastroesophageal kubantu abadala. Ku: UpToDate, Talley NJ (Ed), UpToDate, Waltham, MA.
> Sigterman KE, van Pinxteren B, Bonis PA, Lau J, Numans ME. Ukwelapha okwesikhashana ngeproton pump inhibitors, abaphikisana ne-H2-receptor kanye ne-prokinetics yezibonakaliso ezifana nezifo ezifana ne-reflux nesifo se-refosx. I-Cochrane Database Syst Rev. 2013 Meyi 31; (5): CD002095.