Kudziwa zinthu zomwe zingapangitse asidi reflux
Pafupifupi anthu 25 akuluakulu a ku America ali ndi asidi reflux , kapena kupweteka kwa mtima, tsiku ndi tsiku, ndipo oposa 60 miliyoni a ku America akuvutika ndi kuphulika kamodzi pa mwezi. Aliyense angathe kuvutika ndi kupwetekedwa mtima mofatsa komanso nthawi zina ngati amadya zakudya zamakono kapena zokometsera. Ngati iwo amatha kupwetekedwa mtima kosalekeza kamene kamapezeka kawiri kapena kawiri pa sabata, akhoza kukhala ndi matenda a reflux a gastroesophageal (GERD).
GERD ikhoza kukhala chifukwa cha zochitika zosiyanasiyana, kuphatikizapo zachilengedwe zosadziwika bwino kapena zofunikira. Ndikofunika kuti anthu omwe amavutika ndi kupweteka kwa mtima amvetsetse ndi madokotala awo kuti adziwe chifukwa cha asidi reflux, ndipo avomereze pa dongosolo la mankhwala.
Kulephera kwa zochepa za Lower Esophageal Sphincter (LES)
Gulu la minofu yomwe ili pamphambano pakati pa mimba ndi m'mimba imatchedwa low esophageal sphincter (LES). Minofuyi ndi yothetsa ndi kutsegula kumapeto kwa chiwindi ndipo zimakhala ngati chotchinga chotsutsana ndi zomwe zili mmimba. Ngati ili yofooka kapena kutaya volo, LES sayenera kutseka kwathunthu chakudya chitapita m'mimba. Matenda a m'mimba amatha kubwerera m'mimba. Zakudya zina ndi zakumwa, mankhwala osokoneza bongo, ndi zinthu zamanjenje zikhoza kufooketsa LES ndi kuwononga ntchito yake.
Zovuta ku Esophagus
Pali maphunziro ena omwe amasonyeza kuti anthu ambiri omwe ali ndi zizindikiro za GERD zosamveka (monga mantha, kumverera ngati kuti pali pakhosi pamutu, chifuwa chachikulu) ali ndi vuto linalake limene odwala ena a GERD samatero.
Ntchito Yopanda Imimba
Kafukufuku wina wasonyeza kuti oposa theka la odwala GERD amasonyeza mitsempha yambiri kapena minofu m'mimba mwawo. Zosokonekera izi zimayambitsa motility. Izi zimachitika pamene minofu m'mimba simungathe kuchita pokhapokha. Minofu siimagwira ntchito nthawi zonse, yomwe imayambitsa kuchepa kwa mphamvu m'mimba.
Izi zikhoza kuwonjezera kupanikizika mmimba zomwe zingathe kuonjezera chiwopsezo cha mimba ya mimba kuti ifike kumbuyo.
Kusokonezeka kwa Motility .
Mwachizolowezi chimbudzi, chakudya chimachotsedwa kudzera m'magulu opatsirana pogwiritsa ntchito zizindikiro zomveka zomwe zimatchedwa peristalsis. Pamene wina akudwala motility wosalimba, izi zimakhala zosavomerezeka. Izi sizingatheke chifukwa cha chimodzi mwa zifukwa ziwiri: vuto mkati mwa minofu yokha, kapena vuto la mitsempha kapena mahomoni omwe amachititsa kuti mitsempha iwonongeke. Mavuto omwe amapezeka m'magawo amodzi ndi omwe amapezeka mu GERD, ngakhale izi sizikuwonekera ngati zochitika zoterozo ndizo chifukwa kapena zotsatira za nthawi yaitali za GERD.
Hatalia ya Hiatal
Nthenda yotaya pathupi imapezeka pamene gawo lakumtunda kwa mmimba limapyola kutseguka mu chifuwa, mpaka mpaka mu chifuwa. Kutsegula kotereku kumatchedwa hiatus kapena ophrase hiatus. Zimakhulupirira kuti chotupa chotheka chikhoza kufooketsa (LES) ndikuyambitsa reflux. Komabe, kafukufuku alephera kusonyeza kuti ndizovuta zomwe zimayambitsa GERD. Komabe, nthenda yotsegula, ingawonjezere zizindikiro za GERD kwa odwala omwe ali ndi zikhalidwe zonsezi.
Phumu
Madokotala sangamvetsetse bwino mgwirizano pakati pa mphumu ndi GERD, koma akatswiri ambiri amavomereza kuti pali kugwirizana kofunikira.
Akatswiri ena amakhulupirira kuti kutsokomola komwe kumaphatikizapo masewero a asthmatic kungachititse kusintha kusintha mu chifuwa, chomwe chimatha kuyambitsa reflux. Mankhwala ena a mphumu yomwe imayendetsa mlengalenga angathenso kumasuka a LES ndi kuthandiza ku GERD. Mofananamo, GERD yakhala ikugwirizanitsidwa ndi mavuto ena apumtima apamwamba ndipo ikhoza kukhala chifukwa cha mphumu, osati zotsatira.
Genetic Factors
Kafukufuku asonyeza kuti pali zovuta zomwe timalandira mwazochitika zambiri za GERD. Izi zikhoza kukhala chifukwa cha mavuto obadwa mwathumodzi kapena okhwima omwe ali nawo m'mimba kapena m'mimba. Zinthu zamtunduwu zingakhale zofunikira kwambiri m'maganizo a wodwala kwa bongo la Barrett, vuto lodziwika bwino lomwe limayambitsa matenda aakulu a gastroesophageal reflux .
Mankhwala Owonjezera Mavuto a GERD
NSAIDs.
Mankhwala otsutsana ndi kutupa ( NSAIDs ) ndi omwe amachititsa kuti zilonda zam'mimba zikhale zachilendo . Zikhozanso kuyambitsa GERD ndikuwonjezera zizindikiro ndi kuuma kwa GERD kwa anthu omwe ali kale kale. Mu kafukufuku wina wa zaka zitatu za anthu 25,000, ogwiritsira ntchito NSAID anali ndi mwayi wambiri kuti akhale ndi zizindikiro za GERD monga osasintha. Zizindikiro sizinawoneke mpaka patapita pafupifupi miyezi isanu ndi umodzi yogwiritsiridwa ntchito nthawi zonse. NSAID zikuphatikizapo:
- Aspirin
- Ibuprofen (Motrin, Advil, Nuprin, Rufen)
- Naproxen (Aleve)
Mfundo yochititsa chidwi ndi yakuti NSAID zili ndi zinthu zomwe zingathandize kuteteza kusintha kwapadera kuchokera ku mbali ya Barrett. NSAID zatsopano zomwe zimatchedwa COX-2 inhibitors zingakhale ndi khansa yotetezera mwa odwalawa popanda kupanga GERD. COX-2 inhibitors ndi: Celecoxib (Celebrex) Valdecoxib (Bextra).
Mankhwala Ena.
Mankhwala ena ambiri angayambitse GERD, kapena kuwonjezera kuopsa kwa zizindikiro kwa omwe ali kale ndi vutoli. Izi zikuphatikizapo:
- Mankhwala oletsa anticholinergic (matenda osokoneza ubongo, antihistamines)
- Zimaphatikizapo zachilengedwe za belladonna alkaloids (atropine, belladonna, hyoscyamine, ndi scopolamine) ndi mankhwala ogwirizana.
- Beta-2 agonists (bronchodilator [Inhalation] - mphumu)
- Zimaphatikizapo Mapulopa, Bronkaid Mist, Primatene Mist, Proventil, Ventolin, Ventolin Rotacaps.
- Magetsi a calcium ( kuthamanga kwa magazi )
- Zimaphatikizapo Cardizem, Dilacor-XR, Norvasc, Procardia, Vascor.
- Diazepam (matenda osokonezeka, kugunda)
- Zimaphatikizapo Librium, Paxipam, Valium, Xanax.
- Nitrates (angina)
- Zimaphatikizapo Nitrogard, Nitrostat, Nitroglyn ER, Sorbitrate.
- Mankhwala otchedwa opioid analgesics (opha ululu)
- Zimaphatikizapo morphine, oxycodone, mankhwala osokoneza bongo opioid.
- Theophylline (bronchodilator [m'kamwa] - mphumu)
- Zojambulajambula. Zimaphatikizapo Aerolate Sr, Choledyl, Respbid, Slo-Bid Gyrocaps, Theobid Duracaps, Theo-Dur.
- Tricyclic (psychotherapeutic agents, anti-pressure)
- Zimaphatikizapo Anafranil, Elavil, Norpramin, Pamelor.