Nakuba abantu abaningi benomfutho wokuphuza kancane kancane, uma kwenzeka njalo kwenzeka ngaphezu kokuphindwe kabili ngesonto noma kubangela izimpawu ezinzima, ungase ube nesifo se-reflux se-gastroesophageal (GERD). I-GERD iyinkinga engapheli yesistimu yokugaya ukudla okubangelwa yi-sphincter esezansi engezansi (LES) engavali kahle, evumela isisu esiswini ukuba sibe yingxenye yakho.
Cishe amaphesenti angu-20 abantu abahlala e-United States kulinganiselwa ukuthi ayathinteka yi-GERD futhi ingathinta abantu beminyaka yonke. Ngokujabulisayo, abantu abaningi bayakwazi ukulawula izimpawu zabo ngezinguquko zokuphila kanye / noma imithi.
Izimpawu
Isibonakaliso esiyinhloko se-GERD ukugubha , ukuzwa okuvuthayo okuphansi kwesifuba, ngokuvamile kukhanyisa kuya emphinjeni. Akuwona wonke umuntu onesifo se-GERD onenhliziyo. Ukuphindaphinda kuyisimo esibi kakhulu lapho i-asidi esiswini ifika ngemuva komphimbo, ikhiqiza ukunambitheka okumuncu, okunamandla. Lezi zimpawu ngezinye izikhathi zihambisana ne-nausea. Ukuphuza ukuphuza nokuphindaphindiwe kuvame kakhulu nakakhulu emva kokudla futhi kwenziwe kakhulu uma ulele phansi noma uguqa.
Ezinye izimpawu ze-GERD zihlanganisa umphimbo oqhubekayo, umkhuhlane, ukukhwehlela okungapheli, ukuqhuma, umoya omubi, ubuhlungu besifuba, nokuzwa sengathi kunomphunga emqaleni. Lezi zimpawu zivame kakhulu uma ungenayo i-heartburn.
I-GERD ingase ibangele nesisu esiswini ukuvuselela izinzwa endaweni yakho noma kubangele umonakalo ekwakhekeni kwayo okungabangela ukunganaki.
Ngezinye izikhathi, i-GERD ingabangela izinkinga ezingabangela ezinye izinkinga ezinkulu kakhulu. Izinkinga ezivame kakhulu ze-GERD zibandakanya isifo sikaBarrett, isifo sokuphelelwa yisifo sokuphefumula , nokuqina kokulinganisa .
Ngaphandle kokukhathazeka ngokweqile, i-GERD ingaholela kwezinye izinkinga ezibandakanya ikhanda, intamo, kanye nemimoya efana ne-asthma, i-laryngitis engapheli, ukunciphisa imimoya ehamba nge-larynx yakho (ibhokisi lezwi), izigqoko zamazinyo, nezifo ezingapheli zesifo.
Izimbangela
I-GERD ibangelwa i-reflux yokuqukethwe kwesisu esiswini. Ngokuvamile, i-reflux igwetshwe yi-sphincter esezansi engezansi (i-LES), i-ring of muscle etholakala ekuhlanganiseni kwesisu nesisu. Esikhathini esiningi, i-LES inkontileka ukuze kuvalwe ukuvulwa nokwakha umgoqo phakathi kwesisu nesisu. I-LES idlulisa isikhathi eside uma ugwinya ukuvumela ukudla kudlule esiswini. Iphinde ibuyele lapho uvula ukuvumela igesi ukubaleka.
Ezimweni eziningi ze-GERD, i-LES idlulisa isikhathi lapho ingafaneleki, ngaleyo ndlela ivumela isikhathi esifushane lapho okuqukethwe kwesisu kungangena khona. Akucaci ukuthi kungani abantu abaningi kangaka beqala ukuphumula okuqhubekayo kwe-LES.
Ngokuvamile, i-GERD ingakhishwa uma i-LES iba i-flaccid engavamile, ivumela i-reflux ukuba ivele cishe noma nini. Umfutho we-LES ungancishiswa-futhi u-reflux wakhuthazwa-ngokuvinjelwa kwesisu (isisu esigcwele), ukubhema, imithi eminingi, ukuphuza utshwala, i-caffeine, nezinhlobo eziningana zokudla, ikakhulukazi ukudla okunamafutha ne-tshokolethi.
Ezinye izici ezingase zibe nomthelela ku-GERD zibandakanya ukuba nomtholampilo wokubeletha , ukwedlula ngokweqile noma ukugqwala, nokukhulelwa.
Ukuxilongwa
Ezimweni eziningi, i-GERD iyinkimbinkimbi yokwelashwa. Okungukuthi, izimpawu ze-GERD zivame ukuba ziyingqayizivele kangangokuthi odokotela ngokuvamile bangenza ukuxilongwa okuqinisekile okusekelwe kubo kuphela.
Uhlolo lokuhlola luvame ukwenziwa kuphela uma uhluleka ukuphendula ukwelashwa noma uma udokotela wakho esolwa ukuthi enye yezinkinga ezinkulu kakhulu zeGERD kungenzeka ukuthi zenzeke. Izivivinywa ezivame ukusetshenziswa ekuhloleni i-GERD zingabandakanya i- endoscopy , ukuqapha i-pH yamahora angu-24, i-manometry yokulinganisa, nama-X-ray swallow swallow.
Ukwelapha
Uma une-GERD, izindaba ezinhle ukuthi kungenzeka ukuthi uzokwazi ukulawula izimpawu zakho uma uthola izinguquko ezifanele zokuphila.
Lokhu kufaka:
- Ukulahlekelwa kwesisindo
- Ukuphakamisa ikhanda lombhede
- Gwema ukudla okuqala
- Ukugwema ekudleni amahora amathathu noma ngaphezulu ngaphambi kokulala
- Gwema izingubo eziqinile
Ngokuvamile, uma unezimpawu ezincane kuphela, udokotela wakho uzotusa ukulungiswa okunjalo futhi mhlawumbe uphakamise imithi eminingi ye-over-the-counter (OTC). Ama-Antacids awavimbeli i-GERD, kodwa angathathwa ukuze asize ukukhulula izimpawu. Ama-antiacids asetshenziswa ngokuvamile ahlanganisa iGaviscon , Maalox , i- Mylanta , i- Rolaids , ne- Tums .
Uma lezi zingasebenzi, udokotela wakho angakufaka emithi yokwelapha, enamandla kunaleyo ongayithenga eshalofini. Izinketho ezimbili ezivame ukusetshenziselwa, ezibuye zibe nabalingani be-OTC, ziyi:
- Abavimba be-Histamine-2 (abavimbela i-H2): Abavukuzi be-H2 banciphisa ukukhiqizwa kwesisu se-asim, ukuze okuqukethwe kwesisu kubangele izimpawu ezimbalwa uma zibukeka zingena emgodini. Abaqaphi be-H2 baqala ukusebenza phakathi nehora, beba yimpumelelo kakhulu phakathi kwamahora amathathu nantathu ngemuva kokuthatha umthamo, futhi ukusebenza kwabo kuqhubeka kuze kube amahora angu-12, Basebenziseka kakhulu lapho bebanjwa njalo 2 kuya ku- 4- isonto lokwelapha. Ama-H2 blockers ahlanganisa i-Axid (nizatidine), i-Pepcid (i-famotidine), i-Tagamet (i- cimetidine) ne-Zantac (ranitidine).
- I-Proton pump inhibitors (i-PPIs): Ama- PPI asebenza ngokuvimbela i-pump ngaphakathi kwamangqamuzana asiswini abangela isisu esiswini. Ziyi-inhibitors ye-acid enamandla kunazo zonke futhi ziphumelela kakhulu kunabasebenzi be-H2 ekuqedeni izimpawu nokuphulukiswa kwe-esophagitis. Kodwa-ke, bathambekele ekubangela imiphumela emibi kakhulu , ngakho odokotela abaningi bazozama i-block H2 kuqala. Ama-PPI ahlanganisa i-Prevacid (pantoprazole), i-Nexium (esomeprazole) , ne-Prilosec (i-omeprazole) .
Uma izimpawu zakho zingaphuthuki ngezinguquko zokuphila kanye nemithi yokwelashwa, udokotela wakho angase ancome ukuhlinzwa. Uhlobo oluvame kakhulu yi-fundoplication, okuyinto lapho ingxenye engezansi yesisu yakho ihlanganiswe i-LES ukuze iqinise futhi ivimbele ukuhlushwa. Amasu endoscopic kanye nokufakwa kwendandatho yobuhlalu obunamandla obubizwa ngokuthi idivayisi ye-LINX, ingacatshangwa.
Ukunakekelwa
Uma unakekela umuntu ongu-GERD, kungakhathaliseki ukuthi ungumntwana, umzali, noma umlingani, kunezindlela ongasiza ngazo othandekayo wakho ukubhekana nezinkinga zakhe ekhaya. Ungakhuluma futhi umsize ugweme ukudla okungaholela ekuguleni, ukumkhuthaza ukuba agqoke izingubo ezingavamile, asebenzise imithi njengoba kudingeka, amkhuthaze ukuba asebenzise umzimba, futhi agcine ikhanda lakhe liphakanyisiwe ebusuku.
Izwi elivela
I-GERD isifo esijwayelekile somzimba esisodwa esivame ukuba nomnene, kodwa singabangela izinkinga ezinkulu uma kushiywa kungaphathwa kabi. Uma wena noma ingane yakho enezimpawu ze-GERD, kufanele usebenze nodokotela wakho ukuze uqiniseke ukuthi une-diagnostic efanele futhi uqiniseke ukuthi uthola imithi yokwelapha ezosusa inkinga yakho ngaphambi kokuba iqhubeke. Ngenhlanhla, ngokulungiswa ngendlela efanele yokuphila kanye nemithi ekhona namuhla, iningi labantu abaneGERD lingaphathwa ngempumelelo ngaphambi kokuba inkinga ecasulayo iba yingozi.
> Imithombo:
> Kahrilas PJ, Shaheen NJ, Vaezi MF, i-American Gastroenterological Association Institute, iKomidi Yokuzivocavoca kanye NeKomiti Yokuphathwa Kwemfanelo. I-American Gastroenterological Association Institute Review Technical mayelana nokuphathwa kwezifo ze-Reflux ye-Gastroesophageal Reflux. I-Gastroenterology . Okthoba 2008; 135 (4): 1392-1413,1413.e1-5. doi: 10.1053 / j.gastro.2008.08.044.
> Katz PO, Gerson LB, Vela MF. Imihlahlandlela yokuHlola nokuPhathwa kwezifo ze-Reflux ze-Gastroesophageal. I-American Journal of Gastroenterology . Mashi 2013; 108 (3): 308-29. doi: 10.1038 / ajg.2012.444.
> Mikami DJ, Murayama KM. I-Physiology ne-Pathogenesis ye-Gastroesophageal Reflux Izifo. Imitholampilo Yokuhlinzeka eNyakatho Melika . Juni 2015; 95 (3): 515-25. doi: 10.1016 / j.suc.2015.02.006.
> Ness-Jensen E, Lindam A, Lagergren J, Hveem K. Ukulahlekelwa Isisindo Nokunciphisa I-Reflux Ye-Gastroesophageal. Isifundo Sezinkomba Esibambisene Nezibalo Ezihlobene Nabantu: Isifundo se-HUNT. I-American Journal of Gastroenterology . Mashi 2013; 108 (3): 376-82. doi: 10.1038 / ajg.2012.466.