Umehluko Phakathi kwama-PPI kanye ne-H2 Blockers for Heartburn

by USharon Gillson; Ibukezwe ngu-Emmy Ludwig, MD

Ukuqhathanisa Imithi Emibili Eyinhloko Yemithi ye-GERD

Uma une-heartburn, cishe uyazibuza ukuthi umehluko phakathi kwemithi eyinhloko yokwelapha: i- proton pump inhibitors (i-PPIs) ne-H2 blockers. Zomi zombili zivimbela ukuvinjelwa kwe-gastric acid. Bahlukile, noma kunjalo, ukuthi benzani lokhu.

Ngesikhathi ama-PPI evala amaphampu e-proton esiswini, ama-block block H2 asebenza ngokuvimbela i-histamine receptors kuma-cell producing-acid producing.

Funda kabanzi mayelana nokwahlukana, ukuthi bangakusiza kanjani ukushaya kwenhliziyo yakho, nokuthi kungani udokotela wakho angancoma omunye komunye.

Yini Ebangelwa Ukugubha Inhliziyo Nokuthi Yini Edingekayo Ukuyiphatha?

Ukuguquka komlilo kungabangelwa isimo esiqhubekayo esibizwa ngokuthi i- reflux isifo se-gastroesophageal (GERD) . I-GERD ivela lapho i-asidi isuka esiswini ibuyela emuva. Ngokuvamile isisu esiswini kanye nezinye izinto zigcinwa esiswini (futhi ngaphandle kwendawo) nge-valve okuthiwa i- sphincter esezansi ephansi (LES). Kodwa izici eziningana zingenza buthaka leyo valve kufaka:

Ukudla ukudla okuvame ukubangela ukuguquka kwenhliziyo , njengokudla okunomsoco (isibonelo, utamatisi nezithelo ze-citrus), ukudla okwesipuni, noma ushokolethi
Ukuphuza utshwala noma i-caffeine
Ugwayi ugwayi
Ukuba nezimo ezithile zezokwelapha, ezifana nesifo sikashukela nesifuba somoya
Ukuba nengcindezi eyengeziwe esiswini sakho (isibonelo, ukukhuluphala ngokweqile, ukukhulelwa, noma amabhande aqinile)

Ukuguqula indlela yokuphila - ukuyeka ukubhema, ukuphuza utshwala nokudla okubangelwa ukuphuza, nokulahlekelwa isisindo - ngokuvamile kuyindlela yokuqala yokwelapha ukuphuza.

Kodwa ngezinye izikhathi imithi iyadingeka, futhi yilapho i-PPIs ne-H2 blockers ingasiza khona.

I-Proton Pump Inhibitors (i-PPIs)

Ipompo ye-proton iyi-molecule ngamaseli athile esiswini. It "amaphampu" i-asidi esiswini. Kuthatha ion potassium ion non-acidic esiswini bese uyifaka esikhundleni se-acidic hydrogen ion.

Le i-hydrogen ion yenza izinto zenzeke. Ngokubeka i-i-hydrogen ions ngaphezulu esiswini sakho, ipompo yenza okuqukethwe kwesisu sakho kube nzima. Kodwa ngokumisa isenzo sepom (ukuvimbela), ukuvimba kwe-asidi esiswini kusamisiwe.

Ama-proton pump inhibitors asetshenziselwa ukwelapha i-GERD, isisu kanye nezilonda zamadayimoni , isifo se-esophagitis nesifo se-Zollinger-Ellison . I-PPIs ingasetshenziswa yedwa noma ithathwe ngokuhambisana nama-antacids. Wonke ama-PPI afana nendlela asebenza ngayo, futhi abukho ubufakazi obubonisa ukuthi kusebenza kakhulu kunomunye. Kodwa-ke, ahluke endleleni ahlukunyezwa ngayo isibindi nokuthi asebenzelana kanjani neminye imithi. Ukwengeza, imiphumela yamanye ama-PPI angahlala isikhathi eside kunabanye futhi angathathwa kaningi.

Ama-PPI afaka:

I-Aciphex (i-rabeprazole)
I-Nexium (esomeprazole)
I-Prevacid (i-lansoprazole)
I-Prilosec (i-omeprazole) : iyatholakala futhi ngaphezu kwe-counter njenge-Prilosec OTC
I-Protonix (i-pantoprazole)
I-Dexilant (Dexlansoprazole)

Ama-PPI aqala ukusebenza ngokushesha ngesikhathi abakwa-H2 beqala ukusebenza phakathi nehora. I-PPI isebenza isikhathi eside: amahora amaningi kuya kwangu-24, futhi imiphumela ingahlala ezinsukwini ezi-3. I-H2 blockers, noma kunjalo, ngokuvamile isebenza kuze kube ngu-12 amahora.

H2 Blockers

Amaseli e-parietal esiswini sakho sokugaya avuselelwe ngezindlela eziningi zokukhiqiza i-asidi.

Enye yalezi zivuselelo ze-asidi i-histamine, ebophezela ku-histamine 2 receptors kwiseli ye-parietal. Abakhi be-H2, ngokuvumelana negama labo, vimba lezi zindawo ze-receptor ngakho-ke banciphise ukukhiqizwa kwe-asidi.

Ama-block block a-H2 ahlanganisa:

I-H2 Blockers ihluke kanjani ku-Proton Pump Inhibitors (i-PPIs)?

Nakuba bobabili abakhi be-H2 ne-proton pump inhibitors kokubili bevimbela ukuvinjelwa kwe-gastric acid, kunezindlela eziningana lapho le mithi ihluke khona:

Indlela abasebenza ngayo: Basebenza ngezigaba ezahlukene ekukhiqizeni isisu se-asim. Abavukuzi be-H2 (i-histamine blockers) bavimbela enye yezinto zokuqala zokukhiqiza i-acid. I-Proton pump inhibitors ivimbela isinyathelo sokugcina endleleni yokuvimba kwe-asidi esiswini. Ngamanye amazwi, i-asidi ekhiqizwa (okungancishiswa ngenxa yokuvimba i-H2) ivinjelwe ekufikeni esiswini.

Lapho basebenza khona: Womabili lawa mithi asebenza emangqamuzaneni e-parietal, ama-cell-productive cells at the bining of the stomach. Ama-block block H2 asebenza ngokuvimbela i-histamine receptors kuma-parietal cells ukuze anciphise inani le-asidi elikhiqizwayo (nakuba kunezinye izinkinga ukuze i-asidi ethile isakhiwe). I-proton pump inhibitors isebenza ngokuvala amaphampu aseproton kulezi zinqamuzana nokuvimbela i-asidi ukuba ingene ngaphakathi esiswini.
Zisebenza kanjani kahle: I- Proton pump inhibitors inomphumela wokunciphisa okukhulu kwe-asidi kune-block block H2. Lokhu kungenxa yokuthi kunezinye izinkinga, ngaphezu kwe-histamine 2, okukhuthaza ukukhiqizwa kwe-acid ne-H2 blockers kuphela ukuvimbela i-histamine 2.
Bazosebenza ngokushesha: Abavukuzi be-H2 baqala ukusebenza ngokushesha, bavame ukusebenza phakathi nehora lokuthatha imithi. I-Proton pump inhibitors, ngokuphambene, inokuqala kokusebenza okubambezelekile.
Bazohlala isikhathi esingakanani: Abavukuzi be-H2 bangase basebenze amahora angama-12 ngemuva kokuthatha imithi. I-proton pump inhibitors idla ukuhlala isikhathi eside. Amanye ama-PPI ahlala emahoreni angu-24, kanti amanye angase abe nemiphumela egcina izinsuku ezintathu.
Imiphumela emibi: Ngenxa yezici ezahlukene zezenzo, imiphumela emibi yalezi zigaba ezimbili zemithi ihlukile, nakuba zombili izinhlobo zemithi ngokuvamile zibekezeleleke kahle. Imiphumela emibi engase ibe khona ibuye ihluke phakathi kwemithi ethize kwisigaba ngasinye. Ngama-block block, i-headache ivame kakhulu. Ama-proton pump inhibitors ajwayelekile kakhulu ephephile kodwa ahlotshaniswa (kwezinye izifundo kodwa hhayi konke) ngenengozi eyengeziwe yokwehlukana kwe-hip . Kuneminye imiphumela emibi, futhi kubalulekile ukuxoxa nabo nodokotela wakho ngaphambi kokusebenzisa noma iyiphi yale mithi.

Yiziphi ezinye i-H2 Blockers kanye nama-PPIs okumele zenziwe?

Kuhle ukwazi ukuthi ngaphezu kokuphuza (futhi ikakhulukazi, i-GERD), le mithi isetshenziselwa ukwelapha isifo sofuba nokunciphisa izimpawu zesifo se- peptic ulcer . Kungase futhi zisetshenziselwe ukwelapha ezinye izifo zokugaya ezingabangela isidumbu esiningi ngokweqile.

Ukukhetha phakathi kwe-H2 Blockers ne-Proton Pump Inhibitors

Ungase uzibuze ukuthi kungani udokotela wakho angakhetha enye yale mithi phezu komunye. Njengoba i-proton pump inhibitors inikeza ukucindezelwa okukhulu kwe-acid, lokhu kuvame ukudingwa ukuze kube nezimpawu ezinzima kakhulu.

Isikhathi sokuqala kwesenzo singase sinqume ukuthi yimiphi imithi udokotela wakho azokutusa. Njengoba abavukuzi be-H2 basebenza ngokushesha, bavame ukusetshenziselwa lapho umuntu ephethe izimpawu zabo. Ngenxa yalesi senzo esiphuthumayo, le mithi ingasetshenziselwa labo abayeke ukukhwabanisa kwesinye isikhathi.

Njengoba i-proton pump inhibitors ithatha isikhathi eside ukuze iqale ukusebenza kodwa ibe nomthelela omkhulu, ijwayele ukusetshenziselwa labo abanezimpawu ezingapheli zokugubha kwenhliziyo ukuze bathole ukulawula izimpawu.

Uma usanda kutholakala ukuthi uneGERD, khuluma nodokotela wakho mayelana nohlelo lwezokwelapha. Uma ungatholi impumuzo ngezinguquko zokuphila, isilingo sesonto eli-8 se-PPI therapy sizocelwa.

Uma uqhubeka nokuthola izimpawu ngemuva kokuba ukwelashwa kwe-PPI kuphelelwe noma uma unenkinga evela ku-GERD yakho (njenge-esophagitis eyingozi), ukugcinwa (isikhathi eside isikhathi eside) ukwelashwa kwe-PPI cishe kuzobekwa. Ngezinye izikhathi i-H2-blocker, esikhundleni se-PPI, inconywa ukuthi ithole ukwelashwa.

Imithi yokulwa nemithi ephezulu ye-Pres-the-Counter Heartburn

Imithi eminingi esetshenziselwa ukuphuza inhliziyo iyatholakala njengoba kokubili imithi futhi njengemithi ephezulu. Yize izidakamizwa zifana, imithi ehamba phambili iyatholakala kumthamo onciphise (ngokuvamile uhhafu wenani lomuthi).

Khuluma nodokotela wakho noma ummithi ngaphambi kokufaka enye yalezi omunye. Futhi, qaphela imiphumela engase ibe khona ye-antacids. Zinganciphisa ukumunwa kweminye imithi, kuhlanganise nezinye izidakamizwa zokukhwabanisa.

Ezinye zokwelapha zokuphelelwa yisisu

Ngaphezu kwabalandeli be-H2 ne-proton pump inhibitors, abantu abaningi basebenzisa izintuthwane ukuze basize ukulawula ukuphuza kwabo. Khumbula ukuthi kukhona umehluko phakathi kwe-antacids ngayinye futhi ukhulume nodokotela wakho ukuthi yiyiphi yale mithi ezoba ngcono kuwe. Ngaphandle kwemithi nokuguquka kwendlela yokuphila, abanye abantu badinga ukwelashwa okunye, njengokuhlinzekwa kwe-hernias ye-hiatal .

Ngaphandle Kwemithi Yokuphuza Inhliziyo

Ngayo yonke imithi etholakalayo yokwelapha i-heartburn, sivame ukukhohlwa mayelana nezinguquko zendlela yokuphila ezingasiza ukushona kwenhliziyo . Uma udinga imithi ukulawula ukushaya kwenhliziyo yakho, qiniseka ukuthi ubona ukuthi noma iyiphi yalezi zinyathelo ingathuthukisa izimpawu zakho:

Yeka ukubhema. Ukubhema ugwayi kuholela ekugqumeni ngezindlela eziningana.
Bheka indlela odla ngayo. Yazi kahle ukudla okwenza ukushaya kwenhliziyo kube nzima, kanye nokudla okubekezeleleke kahle kubantu abanezinhliziyo .
Ncishisa ukuphuza utshwala. Ukuphuza kungabangela ukuphuza abanye abantu.

Izwi elivela

Uma unemibuzo mayelana nemithi yakho yokushaya inhliziyo, sicela ukhulume nodokotela wakho. Kubalulekile futhi ukuthatha imithi yakho njengoba kunqunywe, kubandakanya ukunamathela kumthamo oqondile kanye nesikhathi sokudla. Kanye nemithi, bheka izindlela ongenza ngazo izinguquko zokuphila ngendlela enempilo ezokwenza futhi ukunciphisa ukushaya kwenhliziyo yakho.

> Imithombo:

> Katz PO, Gerson LB, Vela MF. Ukuxilongwa Nokuphathwa Kwezifo Ze-Reflux Ye-Gastroesophageal. Am J Gastroenterol 2013; 108: 308-28.

> I-Scarpignato C, i-Gatta L, i-Zullo A, i-Blandizzi C. I-Proton Pump Therapy Inhibitor Therapy ku-Acid-Related Diabetes-Iphepha Lokumelana Nezinzuzo Nezikhwama Ezenzekayo Zokunciphisa I-Acid. BMC Medicine . Ishicilelwe ku-Online 2016 Nov 9.

> Shin JM, Kim N. > Pharmacokinetics > nama Pharmacodynamics we-Proton Pump Inhibitors. I-Journal ye-Neurogastroenterology ne-Motility . 2013; 19 (1): 25-35. doi: 10.5056 / jnm.2013.19.1.25.

> Zhang Y, Qing L, B B, Liu R, Zuo-Jing L. Proton Pump Inhibitors Ukwelapha vs H2 Receptor Antagonists Ukwelapha Ukunyuka Okuphezulu Kwesisu emva kwe-Endoscopy: A Meta-Analysis. I-World Journal ye-Gastroenterology . 2015. 21 (20): 6341-6351.