Kubantu abaningi, ama-hernias we-hiatal azobangela ukuphuza kwenhliziyo okulula, okuphakathi okungaphathwa kalula ngama-antiacids nama-acid-blockers. Ngaphandle kokuba i-hernia ikhulu kakhulu, imishanguzo ye-over-the-counter (OTC), ukulahlekelwa isisindo, kanye nezinguquko zokudla ngokuvamile kuyanele ukuqinisekisa ukukhululeka. Nokho, ezimweni ezimbi kakhulu, kungenzeka ukuthi ukuhlinzwa kungadingeka uma ukugcoba kubangela ukuvinjelwa noma ukusika igazi.
Ngokuya ngobukhulu bezinkinga, ukuvuleka noma i-laparoscopic ("ukhiye") kungase kusetshenziselwe ukulungisa umonakalo.
Amakhambi asekhaya kanye nendlela yokuphila
Izimpawu zensimbi yokubeletha zivame ukuhlobana nokungasebenzi kwe-sphincter esezansi engezansi (LES), ehlukanisa isisu kusuka ku-tube yokudla. Ngenxa yokuthi i-hernia ingashintsha isikhundla se-LES, isisu se-asimu kanye nokudla ngezinye izikhathi kungahle kube khona ukuxubha futhi kubangele ukuvuvukala nokungahambi kahle.
Lokhu kwenzeka kakhulu kubantu abakhuluphele kakhulu noma abakhuluphele kakhulu. Ngaphezu kokubeka ukucindezeleka ngokweqile esiswini nasendongeni elingaphezulu kwesisu, ukukhuluphala kuncoma ukukhuphula i-reflux ngokuphazamisa ukugeleza okujwayelekile kokugaya. Ngaphezu kwalokho, ukudla okudliwe ngendlela ejwayelekile, ukudla okunamafutha amaningi kunamathuba amaningi okugqugquzela i-asidi ukuze aphule amafutha amaningi kanye nama- carbohydrate alula .
Ukuze unqobe lokhu, udinga ukubhekana nezimbangela eziyinhloko ze-reflux.
Kukhona izinguquko eziningana zokuphila zokuphila ezingasiza:
- Ukulahlekelwa kwesisindo kukhulula ukucindezeleka kwesisu okukhuthaza ukugcoba. Ngenkathi ingeke ishintshe imithi yakhe, ingavimbela umtholampilo omncane ukuba ungene waba yindawo yakhe eyingozi kakhulu. Lona uhlobo oluhlobene nengozi ekhulayo yesifo se-reflux ye-gastroesophageal (GERD) .
- Ukudla okunamafutha aphansi, okuphezulu-fiber akugcini nje ngokufaka isisindo sokulahlekelwa isisindo, kungasiza ukugcizelela ukusebenza komzimba kanye nokunciphisa ukudonsa okufaka isandla ekuthandeni. Ukudla okuphezulu-fibre kuyindlela ephumelelayo yokusiza.
- I-hydration efanele , okungukuthi ukuphuza okungenani ngaphansi kwezigesi eziyisishiyagalombili zamanzi ngosuku, kunganciphisa amathuba okuqothulwa ngenkathi ihlanza ama-asidi esiswini esiswini.
- Ukugwema ukudla okuqala kunganikeza ukukhululeka kungakhathaliseki ubudala noma isisindo sakho. Izimbangela ezivamile zihlanganisa inyama ebomvu, ukudla okuthosiwe, ukudla okunomsoco, ubisi olunamafutha wonke, amasoso ase-tomato, iziphuzo ze-citrus, iziphuzo ze-carbonate, i-caffeine, utshwala, nosawoti owedlulele . Ngokuphambene nalokho, ukudla okuphephile okufana nezinkukhu, inhlanzi, ubisi olunamafutha aphansi, okusanhlamvu, nemifino kungasiza ukuphatha izimpawu ze-reflux.
- Ukuyeka ugwayi kuyadingeka uma unenkinga yokushaya inhliziyo. Ngesikhathi ukubhema kungabangeli i-hernia yokuzalwa, ingakwazi ukuphumula i-LES evele ibuthakathaka futhi ivumela ukudla ne-asidi ukuba ivuselele kalula. Yingakho ababhemayo bevame ukuzwa ukuqubuka ngokushesha ngemuva kokukhanyisa noma ukuthi kungani kungenzeka kakhulu ukuthuthukisa i-GERD kunabangabhemi.
Imithi
Imithi ye-OTC yindlela yokuvikela yokuqala yokuphatha ukuhlasela okunamandla kokushaya kwenhliziyo kanye ne-acid reflux. Lokhu kungasiza ekunciphiseni izimpawu njengoba usebenza ekubhekiseni imbangela yazo, reflux ngokwayo, nalezi zinguquko ezingenhla.
Lezi zidakamizwa zibhekwa ziphephile ukusetshenziswa komphakathi kodwa zingabangela izinkinga uma zisetshenziswa ngokweqile.
Phakathi kweminye imithi esetshenziswa kakhulu:
- Ama-Antacids , njenge-Tums, i-Rolaids, ne-Gaviscon, asebenza ngokunciphisa i-asidi esiswini ngezithako ezifana ne-aluminium hydroxide ne-magnesium hydroxide. Ukusebenzisa ngokweqile kungabangela ukuqothulwa (ama-antacids asekelwe-magnesium) kanye nesifo sohudo (antiacids based based antacids).
- H2 receptor blockers , okuyinto ukunciphisa ukukhiqizwa kwesisu esiswini, zihlanganisa ezifana oTC brand njengoba Pepcid (famotidine), Tagamet (cimetidine), kanye Zantac (ranitidine). Imiphumela emibi ihlanganisa ukuqotshwa, isifo sohudo, umlomo omile, ikhanda, nokukhala ezindlebeni ( izinhlamvu ).
- I-Proton pump inhibitors (i-PPIs) inikeza isenzo esifanayo kuma-block block H2 kodwa anamandla futhi asheshe. Zihlanganisa Nexium (esomeprazole), Prevacid (lansoprazole), ne-Prilosec (omeprazole). Ama-PPI asetshenziswe kakhulu uma i-Block H2 ihluleka ukunikeza usizo. Ukukhanda ikhanda, ukuqothulwa, isifo sohudo, kanye ne-flatulence yimiphumela emibi evamile.
Izinguqulo ezinamandla ze-H2 blockers nama-PPI zitholakala ngomuthi.
Ukuhlinzwa
Ukwelashwa kwe-hernia yokubeletha kuboniswa kuphela uma i-hernia paraesophageal ikhipha izimpawu ezingenakulingiswa ngemithi noma izinguquko zokuphila. Lokhu kungenxa yokuthi ukubukeka kwezimpawu kubonisa ukuthi isisu seneqhamuka kakhulu emgodini wesifuba futhi manje sishintsha isikhundla se-LES. Njengoba i-heresophageal hernia ijwayele ukuqhubeka, kungcono kakhulu ukuyiphatha ngaphambi kwesikhathi.
Ezinye zezinkinga ezinkulu, ezifana ne-volvulus (isimo lapho isisu sishintsha khona ama-degrees angaphezu kuka-180) nokuqamba (lapho ukujikeleza kwegazi kuqedwa), kubhekwa njengokuphuthumayo kwezokwelapha.
Uma une-hernia enkulu, ukhetho lokuhlinza luzobe lubekwe ngokuyinhloko ngesimo nokuqina kwesixazululo.
Ukulungiswa okuvuliwe noma kwe-Laparoscopic
Kungenzeka ukuthi ukuhlinzwa okuyisiguli ("evulekile") noma okusetshenziselwa ukuguqula umzimba (laparoscopic, noma "keyhole") kungase kusetshenziselwe ukulungisa i-hernia paraesophageal.
- Ukuhlinzwa okuvulekile kuhilela ukungena emzimbeni ngokusebenzisa ukungcola, ngokuvamile ngakwesokunxele komzimba. Kuvame ukusetshenziselwa izimo eziphuthumayo lapho kukhona ukuphuma okukhulu noma ukubola komzimba. Kungasetshenziswa futhi ezimweni ezingekho eziphuthumayo, njengokuthi sonke isisu sehlile esifubeni esifubeni (esaziwa njengesisu sangaphakathi).
- Ukuhlinzwa kwe-laparoscopic kuhilela ukungena kwezixhobo zokuhlinza eziningi zibe yizicucu ezintathu eziyisihluthulelo esiswini esiswini. Ngezimo ezingekho eziphuthumayo, kubhekwa njengendlela ephumelelayo njengendlela yokuhlinzeka ngokuthula kodwa ngezinkinga ezimbalwa kakhulu nokuphumula okusheshayo.
I-Nissen Fundoplication
I-Nissen fundoplication yizinqubo ezintsha ezenziwe nge-laparoscopically. Inhloso yokuhlinzekwa ukugoqa ngokucophelela ingxenye engezansi yesisu (ebizwa ngokuthi i-fundus) ejikeleze isisu futhi ivikeleke endaweni ngokugxila noma okuyisisekelo ukuze ibambe iqondile futhi isekelwe. Uma kwenziwa kahle, ukuxhaswa ngezimali kungasungula i-LES endaweni lapho isebenza ngokujwayelekile.
I-Nissen fundoplication ibhekwa njengendlela ephephile kakhulu futhi ephumelelayo, ngengozi engaphansi kwezingu-1 yokufa kanye nenani eliphumelelayo lama-89.5% eminyakeni engaphezu kweyishumi. Ukuvimbela, ukuhlanza, nokucasula isifo sofuba (i-IBS) yimiphumela emibi yomsakazo wokuthutha ovame ukuzixazulula ngokwabo phakathi kwamasonto amabili kuya kwamane.
Imithi Ephelele (CAM)
Ngaphandle kwama-antacids nama-acid-blockers, kunezinhlobo zokwelashwa ezihambisanayo ezinganikeza ukukhululeka okuphawulekayo kwezibonakaliso ezinzima.
I-Licorice
I-Licorice, etholakala emthonjeni we- licorice , sekuyisikhathi eside isetshenziselwa ukuphatha ukushaya kwenhliziyo nezinye izimpawu zamathumbu. Ngenkathi ucwaningo luhlala lungekho, ezinye izifundo zishicilele ukuthi zinezindawo zayo kanye nemithi yendabuko yokuvimbela i-asidi.
Ucwaningo lwango-2013 olunyatheliswa ku- Gastroenterology e- Clinical and Experimental libike ukuthi ukusetshenziswa okuhlangene kwezimpande ze-licorice nokukhishwa kwe-prescription-amandla PPI (pantoprazole) kubangele izimpawu ezimbalwa zokuphuza, ukuhlunguzeka kwesifuba nokukhukhumeza kwesisu uma kuqhathaniswa nokusebenzisa i-PPI yedwa.
Itile ye-Licorice ingenye yefomu ezivame ukusetshenziswa. Omunye, owaziwa ngokuthi i- liclycyrrhizinated licorice (DGL) , utholakala njengesengezo sokudla okunomsoco futhi angabekezelela kakhulu ngenxa yokususwa kwe-glycyrrhizin (into eyaziwa ngamazinga aphansi we-potassium).
I-Ginger
I-Ginger enye inketho ethandwayo engasiza ekunciphiseni izimpawu zokushaya inhliziyo. Isimpande se-Ginger sinamakhomikhali e-antioxidants futhi sinezinhlanganisela ze-phenolic ezikholelwa ukunciphisa ukuchithwa kwe-gastric futhi, ngaleyo ndlela, unciphise amathuba okuthi i-acid reflux.
Nokho, uma isetshenziswe ngokweqile, i-ginger ingaba nomphumela ohlukile. Ucwaningo olwenziwa ngo-2014 oluvela eStanford University lwabika ukuthi, ngenkathi i-ginger ixoshiwe noma ifomu ye-powder inganciphisa ama-spasms futhi ithuthukise imimoya yomzimba , ukulinganisa nsuku zonke kwamagremu angaphezu kwamahlanu kungakwandisa ingozi yokuphuza nokuphuza kwesisu.
I-Ginger ingathengwa njengetiyi noma nge-powder, capsule, noma ama-liquidulations.
Njenganoma yiziphi izinketho ze-CAM, kungcono ukuxoxa nge-licorice ne-ginger nodokotela wakho ngaphambi kokuzama.
> Imithombo:
> Di Pierro, F .; I-Gatti, M .; kanye noRajacioli, G. "Imiphumela emagulini ane-reflux isifo esingahlosiwe ephathwa nge-proton pump inhibitor kanye ne-alginic acid ± glycyrrhetinic acid nama-anthocyanosides." I- Exp Exp Gastroenterol. 2013; 6: 27-33. I-DOI: 10.2147 / CEG.S42512.
> Society of American Gastrointestinal and Endoscopic Doctors (SAGES). "Imihlahlandlela yokuphathwa kweHernia yamaHiatal." Los Angeles, California; ukukhipha ngo-Ephreli 2013.
> Yeh, A. noGolianu, B. "Ukwelashwa Okuhlanganisayo kwe-Reflux ne-Dyspepsia esebenzayo kubantwana." Izingane (Basel). 2014; 1 (2): 119-33. I-DOI: 10.3390 / izingane1020119.