Ukuguquka komlilo kungahle kubangelwe ngezindlela ezihlukahlukene. Ngokuqonda izimbangela ezivame kakhulu zokuphefumula, ungenza izinguquko endleleni yakho yokuphila nokudla okuyingxenye yokwelashwa kwesifo se-reflux ye-gastroesophageal (GERD). Ezinye zezinqubo ezingabangela ukushisa kwegazi zihlanganisa ukucasuka okuqondile kwesifo, ukukhubazeka kwe-sphincter esezansi engezansi (LES), ukuphazamiseka kwe-motility kwegciwane lokugaya okuholela ekubambezelweni kwe-gastric gastric, kanye ne-hernia yokubeletha.
Ngokuvamile, okungaphezu kweyodwa yalezi zici kunomthelela ekuvuthweni kwenhliziyo.
Ukuguquka kwesisu kanye nesistimu yokugaya
Ukuqonda ukuphuza kuqala ngokukwazi ukuthi uhlelo lokusebenza lokugaya kahle lusebenza kanjani. Ipheshana lakho lokugaya liqala ngomlomo wakho, lapho ukudla kuhlafunwa khona futhi kuhlanganiswe nomathela , kuqale inqubo yokugaya. Kusuka lapha, ukudla kuhambela ku-tube noma ukugwinya ithubhu. Le tube ye-muscular yenza izinhlangothi ezincane, okuthiwa i- peristalsis , ukuhambisa ukudla esiswini.
I-esophagus nesisu zixhunywe yi-band of fibrous fibers okuthiwa i-sphincter esezansi ephansi (LES). Ngokuvamile, i-LES isebenza njenge-valve, evulekile ukuvumela ukudla kudlule esiswini futhi kuvaliwe ukugcina ukudla nokugaya amaju kusukela ekuhleleni emuva kuya endaweni. Kodwa uma i-sphincter igxila lapho ingafaneleki, noma iba buthakathaka, isisu se-asidi singaphambuka emuva emuva ku-esophagus ebangela ukuzwa okuvuthayo okubizwa ngokuthi ukuguquka kwenhliziyo.
Izimbangela ezivamile
Izindlela ezisemqoka ezingabangela ukuqubuka kwenhliziyo zingase ziholele ekuthuthukiseni i-GERD uma ukushaya kwenhliziyo yakho kuvamile.
Irritation Esophageal
Ezinye izinhlobo zokudla, ukuphuza, ukubhema, kanye nemithi zingacasula ngokuqondile umgodi wesifo bese kudala ukuphuza. Endabeni yemithi, kungenza umehluko ukuhlala ulungele okungenani amaminithi angu-20 kuya kwangu-30 emva kokuthatha imithi, futhi uthathe iphilisi ngeklasi eligcwele lamanzi.
Ukungasebenzi Kwe-Esophageal Sphincter (LES)
Uma i- sphincter esezansi ephansi ingenamandla noma ilahlekelwa ithoni, i-LES ngeke ivalwe ngokuphelele ngemva kokudla kudlula esiswini. I-asidi yesisu ingahle ibuye isiphakamiso. Ukudla okunye kanye neziphuzo, utshwala, izidakamizwa kanye nezimo zesisindo kungenza buthaka i-LES futhi kusebenze umsebenzi wayo.
Ukuphazamiseka kwe-Motility (Ukuphuma Kwesisu Esiphansi)
Ngokugaya okujwayelekile, ukudla kudluliselwa emgqabeni wokugaya ngokwezinqamulelo zesigqi okuthiwa i-peristalsis. Uma othile enesifo sokugula se-motility , lezi zingqinamba azivamile. Lokhu kungavamile kungaba ngenxa yeyodwa yezimbangela ezimbili-inkinga ngaphakathi kwemisipha uqobo, noma inkinga enezinzwa noma amahomoni alawula ukuphazamiseka kwemisipha. Abantu abangaphezu kwesigamu abane-dislude reflux disorder (GERD) banezinzwa ezingavamile noma ze-muscle eziswini zabo ezingabangela ukungabi nhlobo komzimba.
Uma izidumbu esiswini zingenzi isivumelwano ngokujwayelekile, isisu asinalutho emathunjini amancane ngokusheshisa njengokujwayelekile. Ukuhlanganiswa kokudla okuningi okusele esiswini kanye nokucindezelwa okwenyuka esiswini ngenxa yokuthungatha ukulibazisa kwandisa ingozi yesisu esiswini ukuvuza emuva.
I-Hernia yamaHiatal
I- hernia yokubeletha kwenzeka lapho ingxenye engenhla yesisu iphoqelelwa phezulu ukuya esifubeni ngokusebenzisa ukuvulwa kwesikhala. Lokhu kungase kwenzeke ngenxa yokwehluleka kwe-diagphragm noma ngenxa yokucindezela kwesisu (njengokunene nokukhuluphala.) Lokhu kuvulwa kubizwa ngokuthi i-hiatus esophageal noma i-hiatus ye-diaphragmatic. Kukholelwa ukuthi i-hernia yokubeletha inganciphisa i-sphincter esezansi ephansi futhi ibangele i-reflux, noma kunjalo, izifundo zihlulekile ukufakazela ukuthi kuyimbangela evamile ye-GERD.
Ukucindezelwa Kwisisu
Ukucindezela ngokweqile ngesisu kungafaka ingcindezi ku-sphincter esezansi ephansi, okuvumela isisu esiswini ukuba singene emgodini noma ngisho nasemlonyeni.
Abesifazane abakhulelwe kanye nabantu abakhuluphele ngokweqile bajwayele ukugubha ngenxa yalesi sizathu.
Ezinye izimo zezokwelapha
Ezinye izimo zezokwelapha ezingase zibe nomthelela kwi-GERD zibandakanya i- asthma nesifo sikashukela .
Izakhi zofuzo
Ucwaningo luphakamisa ukuthi kukhona ingozi ezuze njengefa le-GERD. Lokhu kungaba ngenxa yezinkinga ze-muscular noma ze-structural in aophagus noma esiswini. Izakhi zofuzo zingase zibe yisici esibalulekile ekuthinteni kwesiguli kumbono kaBarrett , isimo esinqunyiwe esibangelwa i-GERD enamandla.
Izindlela Zengozi Yokuphila
Abanye abantu banesifo se-LES esingakwazi ukubhekana nokucindezela okujwayelekile okuvela kwisisu. Kodwa ezinye izici nazo zingaba nomthelela kulokhu kubuthakathaka futhi ziholele ekuqothuleni iziqephu.
Utshwala
Utshwala luxosha i-LES , okuvumela ukuba isimo se-reflux sesisu sibe sesiswini. Futhi kwandisa ukukhiqizwa kwesisu se-asidi futhi kwenza isifo sakho sizwele kakhulu kwisisu se-asidi. Ukuphuza utshwala kungaholela ekukhethweni kokudla okuncane okunempilo nokudla ukudla owaziyo kungabangela ukushaya kwenhliziyo yakho.
Ukubhema Ugwayi
Amakhemikhali enduku kagwayi ayaphazamisa i-LES njengoba edlula emaphashini angene egazini. Ukubhema ugwayi kunciphisa ukukhiqizwa kwamathe, okuyisinye sezivikelo zomzimba wakho ngokumelene nomonakalo kulesisindo. Ababhemayo baphinde bakhiqize amakhemikhali ambalwa-acid-neutralizing ngamathe, okuthiwa ama-bicarbonates. Futhi, ukubhema kuvuselela ukukhiqizwa kwesisu esiswini futhi kushintshe izifo zesisu ngokukhuthaza ukuhamba kwe-bile usawoti kusuka emathunjini kuya esiswini. Ukugaya kunciphisa ngenkathi ubhema futhi isisu sithatha isikhathi eside singenalutho.
Ukudla Okuvame Ukuqeda Ukushisa Kwesifo
Abantu bahluke ngokuqondene nokuthi yikuphi ukudla okubangelwa ukuguquka kwenhliziyo. Lezi zivame kakhulu:
- Ikhofi, itiye kanye nezinye iziphuzo ze-caffeinated: I-caffeine ingakwazi ukukhulula i- sphincter esezansi ephansi (LES) , okuvumela ukuthi okuqukethwe kwesisu kuqhubekele ngaphakathi. Iziphuzo ze-caffeinated nazo zingabangela ukukhiqizwa kwe-asidi.
- Umshokolethi: Ushokoledi uqukethe ukugxila kwe-theobromine, isakhi esenza ngokwemvelo izitshalo eziningi ezifana ne-cocoa, itiye, nezitshalo zekhofi. Lokhu kuhoxisa ubuhlungu obunzima bokuzibulala , ukuvumela isisu esiswini sikhuphukele phezulu.
- Ukudla okuthosiwe, okune-greasy, noma amafutha: Lokhu kudla kuvame ukunciphisa ukugaya nokugcina ukudla esiswini sakho isikhathi eside. Lokhu kungabangela ukucindezeleka okweqile esiswini, okube nakho kubeka ingcindezi engaphezulu ku-LES ebuthakathaka. Konke lokhu kuvumela i-reflux yezinto ezisesiswini sakho.
- I-Peppermint ivame ukuqala ukushaya inhliziyo.
- Imikhiqizo yamatamatisi nemithamo: Noma yikuphi ukudla okuqukethe utamatisi kukhuthaza ukukhiqizwa kwe-acid esiswini.
- Ukudla okwemakhayo kanye nomsundu omnyama kukhuthaza ukukhiqizwa kwe-asidi yesisu.
- Izithelo ze-Citrus nama-juice: Ama-oranges, ama-lemons, ama-lime, nezinye izithelo ze-citrus zikhuthaza ukukhiqizwa kwesisu esiswini.
Izindlela zokudla
Indlela oyidla ngayo nayo ingabangela iziqephu ze-heartburn episodes:
- Ukudla okukhulu: Isisu esiphelele singafaka ingcindezi eyengeziwe kwi-LES, okuyokwandisa ithuba lokuthi ezinye zezinto ezikudla zizobe zixhumane.
- Ukudla amahora amabili kuya kwamathathu ngaphambi kokulala: Ukulala phansi ngesisu esigcwele kungabangela okuqukethwe kwesisu ukuba ucindezele kanzima ngokumelene ne-LES. Lokhu kwandisa amathuba okudla okuyi-refluxed.
Ukucindezeleka Kwesisu
Ukuba nomzimba ngokweqile noma ukugqwala kakhulu ukucindezela esiswini okungabangela ukuguquka kwesisu, futhi ukuncipha kwesisindo kunconywa. Ngisho nokugqoka izingubo ezinamathele kungabangela ukucindezeleka esiswini. Lokhu kubangela ukudla ngokumelene ne-LES futhi kubangele ukuthi ibuyele emgqeni. Amabhande afanelekayo nokugqoka izingubo zangaphansi kukhona amacala amabili avamile. Ungase uzizwe unyukile izimpawu uma ulala phansi noma ugcwele isisu.
Abanye abantu bathola izinhlobo ezithile zokuzivocavoca okubangelwa ukuqhuma. Izivivinyo ezinomthelela ophezulu ezibandakanya ukugxuma, kanye nokuzivocavoca ezifana ne-crunches ezifaka ukucindezeleka esiswini kungenzeka ukuthi zibangele.
Imithi
Cishe noma yimiphi imithi ingabangela ukuphuza, kodwa ngokusobala kukhona ezinye izidakamizwa ezimbi kakhulu kunabanye. Kunezindlela ezingaphezu kweyodwa lapho izidakamizwa zingabangela ukuphuza ukuphuza futhi ngezinye izikhathi ukushaya kwenhliziyo kungenxa yokuhlanganiswa kwezimbangela ezihlukahlukene. Ungasebenza nodokotela wakho noma uthole izindlela zokuthatha imithi yakho ezokwehlisa izimpawu zakho zokushaya inhliziyo, noma ukushintshela kwesinye isidakamizwa esingenakubangela ukuphuza.
Imithi eyaziwa ngokubangela ukukhwabanisa ihlanganisa:
- Imithi ephikisana nokukhathazeka, efana neValium (diazepam), ingase ingagcini nje ukukhulula isimo sakho, kepha isifo sakho se-esophageal sphincter.
- Amanye ama-antibiotics, afana ne-tetracycline, angamcasula ngokuqondile.
- I-Anticholinergics efana neCompazine (prochlorperazine) ne-Phenergan (promethazine) ingabangela ukuphumula okwehla kwesiphincter esingaphansi.
- Aspirin. Kwabanye abantu abangakwazi ukubekezelela i-aspirin ngenxa yokuphuza, i-aspirin ene-enteric ingaba inketho. Ungalokothi umise i-aspirin ngaphambi kokukhuluma nodokotela wakho.
- Ama-bisphosphonates afana ne-Fosomax (alendronate), i-Actonel (i-resendronate), ne-Boniva (i-ibandronate) ingabangela ukuguqulwa ngokushayisana ngokuqondile ngqo nomswakama. Uma imithi yakho ibangela ukukhwabanisa, kunezinketho zamalungiselelo anikezwa njengomjovo okungenakwenzeka ukudala lesi sibonakaliso.
- Abavimbela isiteshi se-calcium ye-high blood pressure, njenge-Procardia (nifedipine), ne-Cardizem (diltiazem) kungaholela ekutheni amandla e-sphincter esezansi aphelise futhi abuye aphuze ukuthutha kwesisu. Ngokujabulisayo, kunezigaba eziningi zemithi yokucindezelwa kwegazi ezitholakalayo, futhi ukushintshela kwesinye isigaba kungasiza uma izimpawu zakho ziqhubeka.
- Imithi ye-asthma njenge-Proventil (albuterol) ne-theophylline
- Imithi ye-Chemotherapy
- I-Corticosteroids (i-steroids) efana no-Deltasone (prednisone) ne-Medrol (methylprednisolone) ingabangela ukuqubuka kwamanye amazwe kanye nezinye izinto ezibalulekile zokugaya ukudla.
- I-hormone therapy esikhundleni (HRT), okuyinto inhlanganisela ye-estrogen ne-progesterone
- Ama-Narcotics angabangela ukugubha kwenhliziyo ngokubambezela ukukhipha isisu.
- Ama-NSAID (izidakamizwa ezingavimba ukuvuvukala) ezifana ne-Advil (ibuprofen) ne-Aleve (naproxen) zingandisa ubusika esiswini ngokuvimbela i-prostaglandins. Izinketho zokulawulwa kobuhlungu ezifana ne-Tylenol (acetominophen) noma ngisho nemithi yezinambuzane kungadingeka lapho i-NSAIDS ibangela ukugubha kwenhliziyo noma ukuphazamiseka kwamagciwane. Kwezinye izimo, ukuqinisekisa ukuthi ukuthatha i-NSAIDS ngesisu esisodwa kungasiza.
- Ama-anti-depressants e-Tricyclic, afana ne-Tofranil (imipramine), i-Sinequan (doxepin), i-Norpramin (desipramine), ne-Pamelor (nortriptyline) yokunciphisa isisu esiswini. Abaningi balabo abasha abacindezelayo bancane amathuba okubangela lesi sibonakaliso.
- I-potassium ingabangela ukuqubuka kwenhliziyo ngokucasula ngokuqondile isifo.
- Izithako ze-Iron zingabacasula ngokuqondile isisu. Abanye abantu bathola impumuzo ngokuthatha lezi zithako ngokudla noma ngokuzisebenzisa ekuseni kakhulu.
- I-Vitamin C
> Imithombo:
> Ukuphuza amanzi. I-Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/heartburn-gerd/basics/definition/CON-20019545?p=1.
> GERD Izindlela Zokuphila NeziKhambi Zasekhaya. I-Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/gerd/basics/lifestyle-home-remedies/con-20025201.
> Ingabe Kuwukuphela Kokuphefumula Okuncane noma Okuthile Okubaluleke Kakhulu? Ukuqonda i-GERD . I-American College of Gastroenterology. http://s3.gi.org/patients/pdfs/UnderstandGERD.pdf.
> Izimpawu Nezizathu ze-GER & GERD. Isikhungo Sikazwelonke Sesifo Sikashukela Ukugaya Nokugula Kwezinso. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes.