Izimbangela ezivamile kanye namasu okulashwa kwamanje
I-hernia yokubeletha kwenzeka lapho ingxenye engenhla yesisu yakho iqhuma ngesibindi-umsipha ohlukanisa isifuba nesisu. Esikhathini somdwebo kukhona ukuvula okuncane, okubizwa ngokuthi i-hiatus, lapho i-tube yakho yokudla ihamba ngayo. Uma isisu siphumelela ngalesi sivule, singabangela ukudla kanye nama-acids ukuba abuyele emuva emgodleni, okubangela ukuguquka kwenhliziyo, ukuguqulwa kwesibindi, nobuhlungu.
Ngenkathi i-over-the-counter (i-OTC) nemithi yokwelashwa, okubandakanya i-antacids kanye ne-acid-blockers, ingaphatha izimpawu eziphathelene namathumbu, ukulahlekelwa kwesisindo kanye nokushintsha kokudla kuyadingeka ukunciphisa reflux bonke ndawonye. Ukuhlinzwa kungadingeka ezimweni ezinzima.
Izimpawu
Abantu abangaphezu kwengxenye yabantu abatholwe ukuthi bane-hernia yokuzalwa ngeke babone izimpawu nhlobo. Kulabo abenzayo , i- reflux ye-esiswini ye-gastric noma i-air ibe sesiswini kuyoba yizizathu eziyinhloko zokuthi kungani. Izimpawu zingahluka kakhulu ngohlobo lwe-hernia onalo.
I- hernia yokubeletha ehambayo yindlela uhlobo lokuhlangana nesisu (okubhekwa ngokuthi ukuhlanganiswa kwe-gastroesophageal) futhi ingxenye yesisu iqhubekela emgodini wesifuba. Ama-Hernias afana nalawa abizwa ngokuthi "ukuhambisa" ngoba ingxenye ye-herniated ingakwazi ukujikijela emuva nangaphandle emgodleni njengoba ugwinya.
Iningi lamancane elincane elihambayo ngeke lidale izimpawu. Uma kuvela izimpawu, ngokuvamile zihlanganisa:
- Ukuguquka kwenhliziyo
- Ukuzithoba
- Ukuphindaphinda
- Ukubheka
- Ukubamba
- I-nausea nokuhlanza
Uhlobo lwe- paraesophageal uhlobo oluthile kodwa olubi kakhulu lapho isisu esisodwa singena emgodini wesifuba. Ama-Hernias afana nalawa angabangela ukuthi ukudla kukhonjiswe ku-oophagus noma kuphuthelwe, ukusika igazi.
Uma sekushiwo lokho, ama-hernias amaningi epulasophageal angeke abangele izimpawu uma ezincane. Uma zikhula futhi ziqala ukucindezela lesi sifo, zingabangela ukudla ukuthi kubambeke phakathi kwesifuba njengoba uzama ukugwinya. Uma i-herniation iqhubekela phambili emgodini wesifuba, ingabangela ukuboshwa (ukuboshwa) kule hiatus bese kuholela ku:
- Ubuhlungu besifuba ngemuva kokudla
- Ubuhlungu bomzimba obuphezulu nokuthungelwa
- Khipha ubuhlungu besifuba esingenakuphathwa nge-antacids
- Kunzima ukugwinya ( dysphagia )
- Ukuphefumula ( dyspnea )
- Ukungakwazi ukugoba
- Ukunciphisa ukuqhubekela phambili ekufinyeleleni okungenakukhiqiza
- Izitshalo ezimnyama noma zokuhlala
- Ukuvuthwa kwegazi
Zonke lezi zibonakaliso zendlala yokulala eboshiwe , isimo esingaholela ekuqotheni kwegazi kanye nokukhishwa kwesisu. I-hernia eboshiwe kufanele ihlale ibhekwa njengesimo esiphuthumayo sezokwelapha esidinga ukwelashwa ngokushesha.
Izimbangela
Isizathu se-hernia yokuzalwa asihlali ngaso sonke isikhathi ngokuphelele. Kungenzeka ukuthi wazalwa ene-hiatus enkulu ngokungavamile noma leyo minyaka, ukuhlinzwa, noma ukulimala ngokomzimba kuye kwenza buthakathaka ubuqotho bemisipha yakho ye-diaphragm.
Izimo ezinjengalezi zingakunqanda emthonjeni we-hiatal, ikakhulukazi uma ucindezela ngokuzumayo noma ngokweqile emisipha ezungeze isisu.
Izibonelo zalokhu zingabandakanya ukukhwehlela okungapheli, ukuphakamisa izinto ezinzima, ukuhlanza okunonya, noma ukuhlunga ngesikhathi sokunyakaza kwamathumba.
Ukwanda ngokweqile nakho kuyimbangela enkulu. Abantu abakhuluphele ngokweqile noma abakhuluphele banesisindo esikhulu segciwane lesisu nangokwesisu uma kuqhathaniswa nalabo abanesisindo esinempilo. Lokhu kucindezela kunciphisa imisipha ye-diaphragm ngenkathi ukwandisa isikhala sokuhlala. Njengomphumela, abantu babhekwa njengama-obese-okuchazwe njenge-mass mass index (BMI) abangaphezu kuka-30-banamathuba amabili okuba nenkosikazi yokubeletha kunelabo abane-BMI engaphansi kuka-25.
Okufanayo kungenzeka ngesikhathi sokukhulelwa, ngokuvamile ngezigaba kamuva njengoba ukwandiswa kwesibeletho kunomcindezelo odongeni lwesisu.
Ama-hernias ama-Hiatal athambekele ekuthinteni abantu abangaphezu kuka-50. Nakuba ukubhema kungabangeli imithi yokuzala, kungabangela izimpawu ngokuphumula i-sphincter esezansi engezansi (LES) okuhloswe ukugcina ukudla ne-asidi ngaphandle kwesimo.
Ukuxilongwa
Kukhona izivivinyo eziningi ezivame ukusetshenziselwa ukuhlonza i-hernia yokuzalwa . Ukuzikhethela okukufanele kuwe kuncike ekutheni uhlobo nobukhulu bezimpawu ozizwayo.
Phakathi kwamathuluzi okuxilonga avamile kakhulu:
- I-Barium X-rays yizivivinyo ezivame ukusetshenziselwa ukuxilongwa ngendlala yokuzalwa. Okunye okubizwa ngokuthi i-barium swallow, kudinga ukuba uphuze umkhuhlane omanzi ogqoka izindonga zesisu sakho nesisu. Lokhu kusiza okungcono ukuhlukanisa izitho kwi-X ray.
- I-endoscopy ephezulu kakhulu igcinelwe abantu abanezimpawu ezinzima, ezivame ukuphindaphindiwe noma ama-hernias epay-esophageal asebe yizibonakaliso. Kuhilela ukungena kwendawo ekhanyayo, eguquguqukayo emqaleni wakho ukubuka isifo sakho, isisu, ne-duodenum.
- I-manometry ephezulu yokuxazululwa (HRM) ubuchwepheshe obusha esetshenziselwa ukulinganisa ukuphazamiseka kwesigqi kwesigxila njengoba ugwinya. Lokhu kungabonisa ukuthi udokotela wakho uqonde ukuthi ukugwinya kwakho futhi i-LES kakhudlwana kanjani.
Ukuhlolwa kwegazi kuyenziwa ukuze kuhlolwe i-anemia kanye nezinye izinto ezingavamile zegazi. Ukuhlolwa kwe-pH kungasetshenziswa futhi ukukala ubuhle be-asidi endaweni.
Ukwelapha
Izimpawu eziningi ze-hernia yokubeletha zingaphathwa ngendlela efanele ngemithi ye-OTC, ukulungiswa kwendlela yokuphila, namasu okuzinakekela. Ukuhlinzwa akudingeki kakhulu futhi kubhekwe kuphela amacala obukhulu kakhulu.
Imithi
Imithi ye-OTC ejwayele ukusetshenziselwa ukuphatha izimpawu ze-reflux ihlanganisa:
- Ama-Antacids awanciphise ama-acids esiswini, njenge-Tums, Rolaids, ne-Gaviscon
- Ama-block block H2 anciphisa ukukhiqizwa kwe-acid acids, njenge-Tagamet (cimetidine) ne-Zantac (ranitidine)
- I-Proton pump inhibitors (i-PPIs) , enamandla kune-H-blockers futhi ihlanganisa i-Prevacid (i-lansoprazole) no-Prilosec (i-omeprazole)
Izinguqulo ezinamandla ze-H2 blockers nama-PPI zitholakala ngomuthi.
Izinguquko zokuphila
Izinguquko zokuphila ziyizimo zokuziphatha ezingaguquguqukayo ezinganciphisa ukuvama nokuqina kwempawu, kubandakanya:
- Ukuqala uhlelo olufanele lokulahlekelwa nokuzivocavoca
- Ukudla ukudla okunamafutha aphansi, okuphezulu okuphefumula, okungukuthi kulula ukugaya kuphela kodwa kungasiza ekunciphiseni ukuqothulwa okungapheli
- Ukuphuza ama-glass angaphansi kuka-8 ngosuku, okungavimbela ukuphelelwa amandla kwamanzi nokunciphisa isisu se-acids
- Gwema utshwala ne-caffeine, okukhuthaza i-reflux
- Ukuyeka ugwayi; ukubhema kudambisa i-LES
Ukuhlinzwa
Ukuhlinzwa kungacatshangwa lapho i-hernia paraesophageal iqala ukubangela izimpawu zamathumbu. Ukwelapha i-hernia ekuqaleni, kanti isikhala sokuhlala esiyingcosana siseyingcosana, singanciphisa kakhulu ingozi yokucindezeleka ngemuva kokuhlinzwa. Amakhemikhali e-paraesophageal symptomatic cishe ahlale eqhubekayo.
Ukuhlinzwa okubelethwe yi-Hiatal kuvame ukuqhutshwa ngaphansi kwe-anesthesia ejwayelekile noma isifo sesisu noma isiguli. Ukuhlinzwa okuningi kwenziwa nge- laparoscopically (eyaziwa nangokuthi "ukuhlinzwa kwesihluthulelo").
Inqubo eyodwa yokuhlinzeka, eyaziwa ngokuthi i-Nissen fundoplication, yenziwa ngokufaka ingxenyeni engenhla yesisu (ebizwa ngokuthi i-fundus) ejikeleze umgudu ophansi noma ukuyibeka noma ukuyibeka endaweni. Lokhu kuqinisa i-sphincter esezansi ephansi futhi, ngokwenza kanjalo, kunciphisa ingozi ye-reflux.
Ukubhekana
Njengoba zikhukhumeza njengoba izimpawu zensimbi ye-hiatal zingaba khona, kunezindlela zokuphatha ukugubha kwenhliziyo nokuzikhukhumeza ukuze ungahlali ngaso sonke isikhathi ukuthi ufinyelele ama-antacids. Ngaphandle kokuba udle kangcono futhi ulahle ugwayi, kunezinye izindlela ezingakusiza ukubhekana kangcono uma uhlushwa izimpawu ze-reflux ezingapheli:
- Ukuhlala uhlezi esihlalweni sakho ngenkathi udla uvumela ukudla kudlule kahle phakathi kwesisu sakho nesisu.
- Ukubamba amancane nokuhlafuna isikhathi eside kungenza ukugaya kungelula ngokunciphisa isidingo se-asidi esiswini.
- Ukugwema ukudla amahora amathathu ngaphambi kokulala kuqinisekisa ukuthi ukudla kuye kwagonywa futhi ayikwazi ukucubungula.
- Ukuphakamisa ikhanda lombhede wakho ngamasentimitha amane kuya kwangu-8 kunganciphisa amathuba okuba reflux ngenkathi ulele.
- Ukugwema amabhande anamanzi nokugqoka kugqoke ukucindezela emgqeni ongaphezulu kwesisu, okwenza ukugwinya kube lula ngenkathi kunciphisa ingozi ye-acid reflux.
Izwi elivela
Iziningi ze-hernias ezibelethayo azidingi ukuphathwa kwezokwelapha noma ukubhekwa. Uma uthuthukisa izimpawu, udinga ukuthola amasu, ngaphandle kwemithi nje, ukukusiza ukuba ubhekane nakho. Awekho amacala amabili afanayo, futhi yini engase isebenze komunye umuntu angeke isebenzele wena.
Gxila ekushintsheni kwendlela yokuphila owazi ukuthi kufanele uyenze, kuhlanganise nokudla okungcono, ukuzivocavoca njalo nokulahlekelwa isisindo. Uma unenkinga yokufeza imigomo yakho, khuluma nomqeqeshi wokudla okunomsoco noma umqeqeshi womuntu siqu ohlangenwe nakho kwe- syndrome ye-metabolic nezinye izinkinga zesisindo.
Kodwa-ke, uma izimpawu zakho ziba zimbi noma zingaphenduli ukwelashwa okuzenzekelayo, cela udokotela wakho ukuba adluliselwe ku- gastroenterologist .
> Imithombo:
> Roman, S. Ukuxilongwa nokuphathwa kwe-hiatus hernia. BMJ. 2014; 349: g6154. I-DOI: 10.1136 / bmj.g6154.
> Society of American Gastrointestinal and Endoscopic Doctors (SAGES). Izikhombandlela zokuphathwa kweHernia yamaHiatal. I-Los Angeles, eCalifornia; ukukhipha ngo-Ephreli 2013.