Ukwazi izimo ezingabangela i-acid reflux
Cishe abantu abayizigidi ezingama-25 baseMelika abanama-aclux ase-Aids , noma ukukhwabanisa, nsuku zonke, futhi abangaphezu kwezigidi ezingama-60 baseMelika bahlushwa ukushona okungenani kanye ngenyanga. Noma ubani angabhekana nokuphefumula okuncane nangesikhathi esifanayo uma bedla ukudla okunomsoco noma okubabayo. Kodwa-ke, uma bebhekene nokuphefumula okungapheli okwenzeka izikhathi ezimbili noma ngaphezulu ngesonto, bangase babe nesifo se-reflux se-gastroesophageal (GERD).
I-GERD ingaba ngenxa yezimo ezihlukahlukene, kufaka phakathi izici ezingavamile zezici noma izici. Kubalulekile ukuthi abantu abahlukunyezwayo njalo baxoxe nodokotela babo ukuthola imbangela ye-reflux yabo ye-asidi, futhi bavumelane ngezinhlelo zokwelapha.
Ukungasebenzi kwe-Lower Esophageal Sphincter (LES) Imisipha
I-band of muscle etholakala ehlangothini phakathi kwesisu nesisu kuthiwa yi- sphincter esezansi ephansi (LES). Le muscle inesibopho sokuvala nokuvula ukuphela okuphansi kwalesi sigameko futhi senze njengengqinamba yokucindezela ngokumelene nokuqukethwe kwesisu. Uma ibuthakathaka noma ilahlekelwa ithoni, i-LES ngeke ivalwe ngokuphelele emva kokudla kudlula esiswini. I-asidi yesisu ingahle ibuye isiphakamiso. Ukudla okunye kanye neziphuzo, izidakamizwa, kanye nezici zesisindo zingaphazamisa i-LES futhi zinciphise umsebenzi wayo.
Okungajwayelekile ku-Esophagus
Kunezifundo ezithile eziphakamisa ukuthi abantu abaningi abanezimpawu zeGERD ezingavamile kungenzeka (njengokwesaba, ukuzwa sengathi kunomunwe emqaleni, ukukhwehlela okungapheli) kunokungajwayelekile kwezinye izigameko ezinye iziguli ze-GERD ezingenalo.
Umsebenzi wesisu ongasebenzi kahle
Ucwaningo olulodwa lubonise ukuthi ngaphezu kwengxenye yeziguli ze-GERD babonise umsebenzi ongavamile noma wesisu emithanjeni yabo. Lezi zimo ezingavamile zidala umonakalo onobungozi. Lokhu kwenzeka lapho imisipha esiswini ingakwazi ukwenza ngokuzenzekelayo. Imisipha ayivumelani ngokujwayelekile, okubangela ukubambezeleka kwekhono lomzimba ukuba lingenalutho.
Lokhu kungakwandisa ingcindezi esiswini, okuyokwandisa ingozi ye-asidi esiswini ukuze ibuyele emuva emgodleni.
Ukungahleleki kwe-Motility .
Ngokugaya okujwayelekile, ukudla kudluliselwa emgqabeni wokugaya ngokwezinqamulelo zesigqi okuthiwa i-peristalsis. Uma othile ehlushwa ukungasebenzi okungavamile, 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 lokhu akucaci ukuthi ukuvela okunjalo kuyimbangela noma imiphumela yemiphumela yesikhathi eside ye-GERD.
I-Hernia yamaHiatal
I- hernia yokubeletha kwenzeka lapho ingxenye engenhla yesisu iqhubekela phambili ekuvulekeni kwesibindi, futhi kufinyelele esifubeni. Lokhu kuvulwa kubizwa ngokuthi i-hiatus esophageal noma i-hiatus ye-diaphragmatic. Kukholelwa ukuthi i- hernia yokubeletha ingenza buthaka (LES) futhi ibangele i-reflux. Noma kunjalo, izifundo zihlulekile ukufakazela ukuthi kuyimbangela evamile yeGERD. Nokho, i-hernia yokubeletha ingathuthukisa izimpawu ze-GERD kwiziguli ezinezimo zombili.
I-asthma
Odokotela bangase bangaqondi ngokuphelele ubudlelwane phakathi kwe-asthma ne-GERD, kodwa ochwepheshe abaningi bavumelana kukhona uxhumano olubalulekile.
Abanye ochwepheshe bacabanga ukuthi ukukhwehlela okuhambisana nokuhlaselwa kwe-asthmatic kungabangela ushintsho ekucindezelweni esifubeni, okungabe kungabangela i-reflux. Izidakamizwa ezithile ze-asthma ezithuthukisa imimoya yomoya zingase ziphumule i-LES futhi zihlanganyele ku-GERD. Ngokufanayo, i-GERD ihlotshaniswe nezinye izinkinga ezingaphezulu zokuphefumula futhi ingaba yisisusa se-asthma, kunokuba kube nomphumela.
Izakhi zofuzo
Ucwaningo luye lwasikisela ukuthi inengozi ezuzwe njengefa kumazombe amaningi weGERD. Lokhu kungaba ngenxa yezinkinga ze-muscular noma zesakhiwo esithathwe njengezinkinga ezisezindlini noma esiswini. Izakhi zofuzo zingase zibe isici esibalulekile ekukhusweni kwesiguli ku-Brett's eye, isimo esibucayi esibangwa yi- reflux eyingozi kakhulu ye- gastroesophageal .
Izidakamizwa ezandisa Ingozi yeGERD
Ama-NSAID.
Izidakamizwa eziphikisana nezidakamizwa ( ama-NSAID ) yizimbangela ezivamile zezilonda ze- peptic . Kungase futhi kubangele i-GERD futhi kwandise izimpawu nobuqili be-GERD kubantu abakhona kakade. Kwesinye isifundo seminyaka emithathu yabantu abangu-25,000, abasebenzisi be-NSAID babenamathuba amabili okuba nezimpawu ze-GERD njengezingabonisi. Izimpawu azizange zibonakale kuze kube ngemva kwezinyanga eziyisithupha zokusetshenziswa njalo. Ama-NSAID afaka:
- Aspirin
- Ibuprofen (Motrin, Advil, Nuprin, Rufen)
- I-Naproxen (i-Aleve)
Iphuzu lokuthakazelisa ukuthi ama-NSAID anempahla engasiza ekuvimbeleni izinguquko ezingenakuqhathaniswa kusuka kulesi sigameko sikaBarrett. Ama-NSAID amasha abizwa ngokuthi i-COX-2 inhibitors angase abe nomdlavuza wokuvikela kulezi ziguli ngaphandle kokukhiqiza i-GERD. I-COX-2 inhibitors ihlanganisa: iCelecoxib (Celebrex) iValdecoxib (Bextra).
Ezinye izidakamizwa.
Ezinye izidakamizwa eziningi zingabangela i-GERD, noma ukwandise ubukhulu bezimpawu kulabo abasenaso lesi simo. Lokhu kufaka:
- Izidakamizwa ze-Anticholinergic (ukuphazamiseka komgogodla, ama-antihistamines)
- Kuhlanganisa i-alkaloids yemvelo ye-belladonna (i-atropine, i-belladonna, i-hyoscyamine, ne-scopolamine) nemikhiqizo ehlobene.
- Ama-agonists e-Beta-2 (i-bronchodilators [i-Inhalation] - isifuba se-asthma)
- Kuhlanganisa i-Apentage, i-Bronkaid Mist, i-Primatene Mist, i-Proventil, i-Ventolin, i-Ventolin Rotacaps.
- Ama-blockers wesiteshi se-calcium ( umfutho wegazi ophezulu )
- Kufaka phakathi i-Cardizem, iDilacor-XR, i-Norvasc, i-Procardia, i-Vascor.
- I-Diazepam (ukukhathazeka kokukhathazeka, ukuhlukunyezwa)
- Kufaka i-Librium, i-Paxipam, i-Valium, i-Xanax.
- Ama-nitit (angina)
- Kuhlanganisa i-Nitrogard, i-Nitrostat, i-Nitroglyn ER, i-Sorbitrate.
- Ama-analgesics e-opioid (ababulala ubuhlungu bezilonda)
- Kuhlanganisa i-morphine, i-oxycodone, izidakamizwa zokwenza ama-opioid.
- I-Theophylline (i-bronchodilators [ngomlomo] - isifuba somoya)
- Bronchodilators. Kufaka i-Aerolate Sr, i-Choledyl, i-Respbid, i-Slo-Bid Gyrocaps, i-Theobid Duracaps, i-Theo-Dur.
- I-Tricyclic (ama-psychotherapeutic agents, ama-antidepressants)
- Kuhlanganisa u-Anafranil, u-Elavil, u-Norpramin, u-Pamelor.