Isifo se-reflux se-gastroesophageal (GERD) sibangelwa ukuhlushwa kwe-asidi yesisu ngaphakathi kwesifo uma isifo sakho sokungena esincane sise-FS (ifomu) singabuthakathaka noma sivuselela uma kungadingeki. Ezinye izimbangela ezikhona zingabandakanya ukukhuluphala, ukubhema, ukudla nokukhulelwa, phakathi kwabanye. I-GERD ingabuye ibe ngenxa yezimo ezihlukahlukene, kufaka phakathi izici ezingavamile zezici noma zesakhiwo.
Uma ubhekene nesifo senhliziyo, kubalulekile ukuthi uxoxe nodokotela wakho ukuthola imbangela ye-reflux yakho ye-asidi futhi uvumelane ohlelweni lwezokwelapha.
Izimbangela ezivamile
Kunezinto eziningi ezingabangela i-GERD. Ngezinye izikhathi imbangela ye-GERD yakho ingaba yinkimbinkimbi futhi ihilele izici eziningi.
Ukungasebenzi kahle kwe-Esophageal Sphincter (LES)
Kulabo abanesifo esiningi, i-reflux ye-asidi ingenxa yokuphumula kwe-LES, okuphethwe ukuvala nokuvula ukuphela okuphansi kwalesi sigameko futhi yenza njengendlela yokucindezela ngokumelene nokuqukethwe kwesisu. Uma ibuthakathaka noma ilahlekelwa ithoni, i-LES ngeke ivalwe ngokuphelele emva kokudla kudlula esiswini sakho. I-asidi yesisu ingahle ibuye isiphakamiso sakho.
I-lophagus lining ayifani neyesisu futhi ayikwazi ukubhekana ne-asidi futhi, ngakho-ke kulimala kalula. Kuyi-reflux ye-asidi engxenyeni eveza izimpawu kanye nokulimala okungenzeka kuyo.
Ngezinye izikhathi lokhu kungasebenzi kahle, kodwa ukudla okunye nokuphuza, izidakamizwa nezinye izici kungenza buthaka i-LES futhi kusebenze umsebenzi wayo.
Ukukhuluphala
Ukweqa ngokweqile kwandisa ukucindezeleka kwesisu sakho, okwenza izimpawu ze-GERD zibi nakakhulu. Ukuxhumana okuqondile phakathi kwe-GERD nokukhuluphala akuqondakali ngokugcwele, kepha ukugqithisa kubhekwa njengokubili okubangela imbangela kanye nenkinga engozini yokuthuthukisa i-GERD.
Imithi
Kukhona izidakamizwa ezihlukahlukene ezingathinta ingozi yomuntu we-GERD nokwehlisa izimpawu.
Izidakamizwa eziphikisana nezidakamizwa (ama-NSAID) afaka i- aspirin , i-Motrin noma i-Advil (ibuprofen), ne-Aleve (naproxen), nemiphumela emibi yemithanga iyabonakala uma ibathatha. Lezi imithi ngokuvamile zihlobene nokubangela izilonda ze-peptic , futhi zingase zenze ukucasula nokucasula okubuhlungu ngokudambisa noma ukuphumula i-LES.
Kulabo asebevele benayo i-GERD, le mithi ingathuthukisa ubunzima bezimpawu; kubantu abangasebenzanga, ukusetshenziswa kwesikhathi eside kwama-NSAID kungabamba iqhaza ekwakheni i-GERD.
Imithi ethile yegciwane ingase ibangele noma ibuhlungu izimpawu ze-GERD. Kubalulekile ukubonana nodokotela wakho uma uqala ukuthola noma yiziphi izimpawu ngenkathi uthola imithi. Nazi ezinye izigebengu ezivamile:
- Ama-blockers wesiteshi se-calcium, asetshenziselwa ukuphatha ukucindezeleka kwegazi nesifo senhliziyo
- I-Anticholinergics, esetshenziselwa izidakamizwa eziphatha ukuphazamiseka kwamagciwane, i-allergies, ne-glaucoma
- Ama-agonists e-Beta-adrenergic, asetshenziselwa izifo ze-asthma kanye nezifo zamaphaphu ezivimbelayo
- Ama-anti-depressants e-Tricyclic afana ne-amitriptyline, i-Tofranil (i-imipramine), ne-Pamelor (i-nortriptyline)
- Ama-antihistamine, asetshenziselwa ukuphika umzimba
- Amaphilisi asemthethweni afana ne-codeine nemithi equkethe i-acetaminophen ne-hydrocodone
- I-Progesterone
- I-quinidine, isilonda semithi yama-anti-malaria esetshenziselwa ukuphatha ama-arrhythmias yenhliziyo kanye ne-malaria
- I-Sedatives ne-benzodiazepines, njenge-Valium (diazepam)
- I-Theophylline, esetshenziselwa i-bronchodilators ye-asthma, i-bronchitis engapheli nezinye izifo zamaphaphu
- Diazepam, esetshenziselwa ukwelashwa
- I-dopamine, esetshenziselwa isifo sikaParkinson
- Ama-bisphosphonates asetshenziselwa ukwelapha i-osteoporosis
- Ama-antibiotics, afana ne-tetracycline
- Izithako zePotassium
- Izithako ze-Iron
Ukubhema
Ukubhema noma ukuphefumula komusi womuntu obhekene nayo kubhekwa njengesizathu kanye nengozi yokuthuthukisa i-GERD. Kunezindlela eziningi lapho ukubhema kungaholela khona ekugubheni , njengokunciphisa inani lemali oyikhiqizayo, okwenza isisu sakho singabi nalutho kancane, futhi kudala isisu esiswini esiningi.
Ukuyeka ukubhema cishe kungenye yezinto ezinhle kakhulu ongayenza ukuze unciphise izimpawu zakho noma unciphise ingozi yokuthuthukisa i-reflux endaweni yokuqala.
I-Hernia yamaHiatal
I- hernia yokubeletha kwenzeka lapho ingxenye engenhla yesisu sakho ingaphezu kwe-diaphragm, udonga lwe-muscle oluhlukanisa isisu kusuka esifubeni. Lokhu kunciphise ukucindezelwa ku-LES, okubangela ukuhlushwa kwe-reflux. I-hernia yokuzala ingenzeka kubantu banobuphi ubudala; abaningi abantu abanempilo engaphezu kuka-50 banempilo encane.
Umsebenzi wesisu ongasebenzi kahle
Labo abane-GERD bangase babe nesisindo esingavamile noma se-muscle esiswini esiswini, esibangela ukuba ukudla nesisu esiswini kuhlungwe kancane kancane. Lokhu kubangela ukulibaziseka esiswini ukuthulisa okuqukethwe kwalo, ukuphakamisa ingcindezi ngaphakathi kulo nokwandisa ingozi ye-acid reflux.
Ukungahleleki kwe-Motility
Ngokugaya okujwayelekile, ukudla kudluliselwa emgqabeni wokugaya ngokwezinqamulelo zesigqi okuthiwa i-peristalsis. Uma unesifo sokungahambi kahle kwe-motility yokugaya, lezi zingqinamba azivamile. Lokhu kungavamile kungaba ngenxa yeyodwa yezimbangela ezimbili: Inkinga ngaphakathi kwemisipha ngokwayo, noma inkinga enezinzwa noma amahomoni alawula ukuphazamiseka kwemisipha. Izinkinga ku-peristalsis kule ndawo zivame ku-GERD, nakuba kungacacile ukuthi ukuvela okunjalo kuyimbangela noma umphumela wemiphumela yesikhathi eside ye-GERD.
Ukukhulelwa
Ukwanda kwamahomoni e-estrogen kanye ne- progesterone ngesikhathi sokukhulelwa kuvusa i-LES, kanye nesisu sakho esikhulayo sibeka ingcindezi enkulu esiswini sakho. Ngenxa yalokhu, kuhle ukuba abesifazane abakhulelwe bazwe ukuqubuka, okungaholela ku-GERD.
I-asthma
Amaphesenti angaba ngu-75 abantu abane-asthma akholelwa ukuthi nawo aneGERD. Akekho owaziyo ngempela ukuthi i-asthma ibangela i-GERD, noma ngabe enye indlela. Kunezizathu ezimbalwa zokuthi kungani lezi zimo ezimbili zihambisana nomunye. Okokuqala ukuthi ukukhwehlela okuhambisana nokuhlaselwa kwesifo se-asthma kungabangela ushintsho esifubeni somfutho, okungabangela i-reflux. Khona-ke kukhona iqiniso lokuthi imishanguzo ethile ye-asthma ihamba emoyeni, iphumule i-LES futhi iholela ku-reflux. Zombili lezi zifo zimbiza izimpawu zomunye, kepha ukuphatha i-GERD kuvame ukusiza izimpawu ze-asthma.
Ukudla
Kukhona ingxabano eqhubekayo mayelana nokuthi ukudla okunye kungabangela ukuphuza umoya. Uma ungavamile ukushaya isisu, ukudla ngokuvamile akuhlobene nokuhlaselwa. Kodwa uma unayo ngezikhathi eziphindaphindiwe, ungase ubone ukuthi ukudla okunye kubonakala kubangela wena. Ezinye izinhlobo zokudla zivuselela ukukhiqizwa kwe-acid futhi ezinye ziphumule i-LES.
Ukudla Okutholisa I-Sopincter Engaphansi Kakhulu
Ngokujwayelekile, i-LES ivala ngokuqinile ukugcina ukudla nesisu esiswini sakho. Uma kukhululeka uma kungadingeki, ukudla nesisu se-asidi siphindele emuva ku-oophagus yakho futhi ungase uzwe ukushisa inhliziyo.
Okulandelayo yizibonelo zokudla ezingahle ziphumule i-LES:
- Ukudla okuthosiwe (amafutha)
- Amafutha aphezulu kakhulu
- I-Butter ne-margarine
- Imayonnaise
- Ama-sauces amancane
- Isaladi ukugqoka
- Imikhiqizo yobisi yobisi wonke
- Chocolate
- I-Peppermint
- Iziphuzo ze-caffeinated njengeziphuzo ezithambile, ikhofi, itiye, ne-cocoa
Ukudla Okugqugquzela Ukukhiqizwa Kwe-acid
Ukuphuza isisu kungase kwenzeke lapho isisu sakho senza i-asidi eningi kakhulu, ebuyela emuva endaweni yakho. Ukudla okungashukumisa ukukhiqizwa kwe-asidi nokwandisa ukukhwabanisa yilokhu:
- Iziphuzo ze-caffeinated
- Iziphuzo ezidakayo
- Utshwala
- Ukudla okumnandi
- I-pepper emnyama
- Izithelo zikaCitrus namajusi afana ne-orange noma i-grapefruit
- Utamatisi ijusi
Usawoti
Ucwaningo luye lwabonisa ukuthi ukudla okuphezulu kwi-sodium kungabangela i-reflux ye-acid engabangela i-GERD. Kodwa-ke, kubantu abanempilo, ukudla okunomsoco ngokweqile akubonakali ukwandisa i-acid reflux. Ucwaningo oluningi luzodingeka lwenziwe, kodwa okungenani, usawoti ungabangela abantu abathile ukushaya inhliziyo. Indlela kuphela yokwazi ngokuqinisekile ukuzama ukunciphisa uketshezi lwakho usawoti ukuze ubone uma kwenza umehluko.
I-Genetics
Ucwaningo oluningi luye lwabonisa ukuthi kukhona izakhi zofuzo ezimweni eziningi ze-GERD, okungenzeka ngezinye izikhathi ngenxa yezinkinga ze-muscular noma zezinkinga ezizuzwe njengezifo ezisesigabeni esiswini noma esiswini. Ucwaningo olulodwa luthole ukuthi ukuhlukahluka kwe-DNA okuthiwa i-GNB3 C825T kwakukhona kuzo zonke izifundo ezibandakanyekayo ne-GERD, kodwa kwakungekho eqenjini lokulawula elingenalo iGERD.
Izakhi zofuzo nazo zibonakala zidlala indima enkulu ekuthinteni kwesiguli kumbono kaBarrett, isimo esinqandekile esibangelwa ukuhlushwa kwe-gastroesophageal kakhulu . Ucwaningo olulodwa lwathola ukuthi i-GERD, isifo se-Barrett, nomdlavuza we-esophageal bonke banezinkinga ezibalulekile zofuzo.
Ososayensi bakholelwa ukuthi i-GERD ethuthukayo ithatha inhlanganisela yezici zezakhi zofuzo kanye nemvelo, kanye nokukhetha kokuphila. Kungenxa yokuthi umzali wakho noma umntakwethu unayo i-GERD ayisho ukuthi uzokwenza, nakuba ingozi yakho yanda. Ucwaningo olwengeziwe luzodingeka lwenziwe ekwenzeni izakhi zofuzo ukuze ukuxilongwa nokuphathwa kwe-GERD kungasebenza futhi kuhloswe nakakhulu.
Izingozi zeMpilo
Abantu abaningi abadala bathola ukuqubuka kwenhliziyo futhi noma ubani kunoma yimuphi ubudala bangakha i-GERD. Nazi ezinye izici ezingase zande ingozi yakho.
Scleroderma
Lesi sifo esizimele, lapho amasosha omzimba ahlasela amangqamuzana anempilo emzimbeni, engeza ingozi yakho yeGERD. Abantu abaningi abanalokhu kukhathazeka nabo banayo i-GERD ngoba i-oophagus isici esithinteka kakhulu ku-scleroderma.
I-asthma ne-COPD
Futhi, ochwepheshe abaqiniseki ukuthi iyiphi inkukhu noma iqanda uma kuziwa nge-asthma ne-GERD, kodwa iningi liyavuma ukuthi kukhona uxhumano olubalulekile. Ngaphezu kokukhathazeka okushiwo ngenhla, i-GERD ihlotshaniswe nezinye izinkinga zokuphefumula ezingaphezulu futhi ingaba yimbangela ye-asthma eqala lapho umuntu esemdala, kunokuba kube nomphumela.
Isifo se-Chronic obstructive pulmonary (COPD) futhi sikubeka engozini enkulu yokuthuthukisa i-GERD, futhi ukuba ne-GERD ingenza izimpawu zakho ze-COPD zibi nakakhulu.
Isifo sikashukela
Abantu abanesifo sikashukela, ikakhulukazi uhlobo lwesifo sikashukela , ngokuvamile bahlakulele isimo esibizwa ngokuthi i- gastroparesis . Lesi simo sibonakala ngokukhipha isisu okubambezelekile. Ukucindezeleka ngaphakathi kwesisu kungakhula, okungaholela ekutheni kufakwe i-reflux, okwenza ube lula ukuthuthukisa i-GERD.
Izifo zeCeliac
Abantu abanesifo se-celiac kubonakala sengathi banesilinganiso esiphezulu se-GERD kunabantu abaningi, ikakhulukazi uma besanda kutholakala. Izifundo zibonise ukuthi ukudla okungenalutho kwe-gluten kunciphisa kakhulu izimpawu ze-GERD. Ochwepheshe abaqiniseki ukuthi i-gluten edlayo idala i-GERD noma uma i-GERD isimo esihambisana nesifo se-celiac. Ngezinye izikhathi i-GERD ayitholakali kuze kube yilapho umuntu ethola ukuthi unesifo se-celiac, esibonisa ukuthi kungase kube khona okunye okubangela.
Izindlela Zengozi Yokuphila
Kunezici ezithile zokuphila eziyingozi ezihlobene nokuthuthukisa i-GERD. Lokhu kungaba yizinto ongashintsha noma ukuzilawula.
Ukukhuluphala / ukukhuluphala ngokweqile
Khumbula, ukukhuluphala kokubili kuyimbangela kanye nesici esiyingozi ekuthuthukiseni i-GERD. Isisindo esiningi esiseduze nesisu sakho, ikakhulukazi, sikubeka engozini enkulu yokuthuthukisa i-GERD kanye nezinkinga ezinjenge-Barrett kanye nomdlavuza we-esophageal. Ukwenza konke okusemandleni akho ukugcina isisindo esinempilo kungahamba ngendlela ende ekutheni u-GERD uqubude.
Ukubhema
Njengokukhuluphala, ukubhema kubangele imbangela kanye nengozini yokuthuthukisa i-GERD. Uma ubhema, ingozi yeGERD ingenye esinye isizathu esihle sokuyeka.
Ukudla Amaphethini
Ukudla ukudla okukhulu ngesikhathi esisodwa, ikakhulukazi uma ulala phansi emva kwalokho, futhi udle ngaphambi kokulala wonke ukwandisa ingozi yokuthuthukisa i-reflux ye-asidi, engaholela ku-GERD. Zama ukudla okuncane, okudla njalo futhi ungadli amahora ambalwa ngaphambi kokulala.
I-Hormone Alternative Therapy
Abesifazane abasebenza kwi-hormone therapy esikhundleni sokuthi bayakwazi ukuthuthukisa i-GERD. Uma usuwedlule futhi ukwandisa umthamo we-estrogen, kuphakama ingozi.
> Imithombo:
> Kahrilas PJ. I-Pathophysiology ye-Reflux Esophagitis. Kusesikhathini. Kubuyekezwe ngomhla ka-6 Mashi, 2018.
> Isikhungo Sikazwelonke Sesifo Sikashukela kanye Nezifo Zokugula Nezinso Zokugaya. Ukudla, Ukudla, nokudla kweGER & GERD. Kushicilelwe ngoNovemba 2014.
> Isikhungo Sikazwelonke Sesifo Sikashukela kanye Nezifo Zokugula Nezinso Zokugaya. Izimpawu Nezizathu ze-GER & GERD. Kushicilelwe ngoNovemba 2014.
> Abasebenzi beMayo Clinic. Izifo ze-Reflux ze-Gastroesophageal (GERD). I-Mayo Clinic. Kubuyekezwe ngomhla ka-9 Mashi, 2018.
> Ping W, Xiao-Hu Z, Zi-Sheng A, et al. I-Intake Yokudla Neengozi Ye-Reflux Esophagitis: Isifundo Sokulawula I-Case-Gastroenterology Research and Practice. 2013; 2013: 691026. i-doi: 10.1155 / 2013/691026.