Kutsitsimula kwa khanda ndi vuto lalikulu, makamaka kwa makanda omwe anabadwa msinkhu. Mu reflux, minofu pamwamba pa mimba (yotchedwa lower infopugeal sphincter, kapena LES) imalola kuti m'mimba muli m'mimba ndi m'mimba. Kwa ana ambiri, reflux ndi yofatsa. Ana amatha kulavulira mobwerezabwereza, koma amakhala osangalala komanso wathanzi.
Izi ndi zachilendo ndipo safuna chithandizo.
Kwa ana ena, reflux ingakhale yovuta. Reflux yomwe imakhala yochuluka kwambiri yofunikira chithandizo imatchedwa matenda a reflux a gastroesophageal, kapena GERD. GERD kwa ana amafunikira chithandizo ngati mwanayo:
- Ali ndi kukula kosauka
- Ndikumva ululu waukulu
- Akukana kudya chifukwa cha ululu
- Ali ndi vuto lopuma chifukwa chotseketsa mkaka wosakaniza
Kugwira Ntchito ndi Mwana Wanu Wamankhwala
Kusamalira ana a ana ang'onoang'ono kungakhale kokhumudwitsa. Mabanja ambiri amayesa mankhwala angapo asanayambe kupeza omwe amawagwirira iwo, kokha kuti mankhwalawa asayambe kugwira ntchito patapita miyezi ingapo.
Ngati mwana wanu ali ndi GERD, ndiye kuti mukulitsa ubale wapamtima ndi mwana wa ana omwe mumamukhulupirira ndi wofunika kwambiri. Kugwira ntchito limodzi ndi dokotala wa ana amene amadziwa mwana wanu, zizindikiro zake, ndi zomwe zisanachitikepo komanso zomwe sizinachitikepo zingakuthandizeni kugwira ntchito limodzi ngati gulu kuti mupeze njira zabwino zothandizira kuti mwana wanu asamangidwe.
Zothetsera Pakhomo
Kaya reflux mwana wanu ndi wofewa kapena wovuta, pali mankhwala ena omwe angathandize kuchepetsa zizindikiro zake:
- Kudyetsa kochepa , kobwerezabwereza: Ana sangathe kulavulira ngati matumbo awo sali odzaza. Kupatsa mwana wanu chakudya chochepa kangapo kumamuthandiza kuti azilavulira pang'ono kapena akhale ndi zizindikiro zochepa za reflux.
- Udindo wokwanira pambuyo pa kudyetsa: Kuyika mwana wanu wolunjika kwa pafupi mphindi 30 mutatha kudya kungathandize kuchepetsa zizindikiro za kukomoka kwambiri. Kuyika mwana wanu mu malo omwe ali oongoka pakubwerera kapena kubwezera pambuyo pa kudyetsa kungathandizenso.
- Kusintha zakudya zanu: Ngati mukuyamwitsa, ndiye kuti mwana wanu angayankhire zakudya zomwe mumadya. Puloteni wa mkaka wa khola ndi amene amachititsa kuti awonongeke, ndipo ana omwe ali ndi m'mawere ndi mavitamini a mkaka wa mkaka akhoza kukhala ndi zizindikiro za GERD. Kuchotsa mkaka wonse kuchokera ku zakudya zanu kungathandize mwana wanu, koma khalani oleza - zimatenga masabata awiri kuti athetse mkaka kuti athandizidwe.
- Kusintha fomu ya mwana wanu: Ngati zizindikiro za mwana wanu zimayamba chifukwa cha zakudya zowonjezera, ndiye kuti kusintha kwasakaniza kamwana kake kamene kamakhala ndi mapuloteni osiyanasiyana (monga soy kapena hypoallergenic formula) angathandize. Lankhulani ndi dokotala musanasinthe fomu lanu kuti muonetsetse kuti mwana wanu akupeza chakudya chokwanira.
Mankhwala
Ngati mwana wanu adakali ndi zizindikiro za GERD ngakhale atayesa mankhwala omwe aperekedwa pamwambapa, kambiranani ndi ana anu kuti mudziwe ngati mankhwala angathandize. Zingatenge nthawi kupeza mankhwala ndi zotsatira zochepa zomwe zingakhale zothandiza kwa mwana wanu, popeza pali mitundu yambiri ya mankhwala ochizira matenda.
Ngakhale mutagwiritsa ntchito mankhwala osokoneza bongo kwa mwana wanu, onetsetsani kuti mufunsane ndi ana anu musanagwiritse ntchito mankhwala aliwonse otsutsa-reflux. Mankhwala amakhudza ana mosiyana ndi momwe amakhudzira akulu ndi akuluakulu, ndipo nthawi zina sangakhale otetezeka kwa mwana wanu.
- Othandiza: Ngakhale kuti si mankhwala, kugwiritsa ntchito mpunga umene ukudya kuti mwana wanu adye zakudya zingathandize kusunga mkaka m'mimba. Gwiritsirani ntchito 1 mpaka 2 tsp ya mpunga patsiku, kapena gwiritsani ntchito fomu imene kale mpunga yowonjezera. M'mayiko a ku Ulaya, Gaviscon kwa makanda (osiyana ndi Gaviscon wamkulu yemwe amagulitsidwa ku US) nthawi zina amagwiritsidwa ntchito kuti apange mkaka wambiri m'mimba, kuteteza reflux.
- Antacids: Zomwe zimayambitsa matendawa zingathandize ana omwe ali ndi zizindikiro zochepa za GERD. Mylanta, Maalox, ndi Tums ndizo zotsutsana ndi antacids zomwe zingathandize ndi asidi reflux kwa makanda.
- H-2 Oteteza: H-2 blockers (Tagamet, Zantac, Pepcid, ndi Axid) amachepetsa kuchuluka kwa asidi opangidwa ndi m'mimba ndipo akhala akugwiritsidwa ntchito kwambiri pofuna kuchepetsa kutaya kwa ana ndi ana. Zotsatirapo zingaphatikizepo kutsegula m'mimba, kudzimbidwa, ndi ululu m'mimba.
- Proton-pump inhibitors: Proton-pump inhibitors, kapena PPIs, ndi mankhwala atsopano omwe ali othandiza kwambiri kuposa H-2 blockers pochepetsa mimba ya asidi. Ma PPI ndi Nexium, Prilosec, Prevacid, Aciphex, ndi Protonix. Kuti mupeze mawonekedwe ena a PPI, muyenera kugwiritsa ntchito mankhwala omwe amagwiritsidwa ntchito, kapena kusakaniza, mankhwala ake omwe. Mankhwalawa angayambitse mavuto ena a nthawi yaitali, kuphatikizapo mavuto a chiwindi ndi mapuloteni m'mimba, kuposa H-2 blockers.
- Ogwira ntchito a Motility: M'mbuyomu, oimira motility ( Reglan ndi Propulsid) amagwiritsidwa ntchito kuthandiza thupi kukumba mofulumira, kuteteza reflux potulutsa mimba mofulumira. Chifukwa cha zotsatira zoyipa, mankhwalawa salinso olembedwa kwa makanda.
Opaleshoni ya Reflux Wamwana
Nthawi zambiri, GERD imatha kuposa chaka choyamba cha moyo, imayambitsa zizindikiro zoopsa, ndipo sichimayankha mankhwala. Panthawiyi, njira yopaleshoni yotchedwa fundoplication ingagwiritsidwe ntchito. Pothandizira ndalama, pamwamba pa mimba yadzaza pafupi ndi mimba, kuimitsa la LES ndikupangitsa kuti zikhale zovuta kuti chakudya chichoke m'mimba.
Ngakhale angakhale njira yabwino kwa ana omwe ali ndi reflux kwambiri omwe samayankhidwa ndi mankhwala, opaleshoni yopereka ndalama ndi njira yaikulu yopaleshoni yomwe ili ndi zotsatira zochepa. Opaleshoniyi ili ndi chiwerengero cholephera kwambiri kwa ana ena; Lankhulani ndi dokotala wanu kuti muone ngati chithandizo cha ndalama chingakhale choyenera kwa mwana wanu.
Zotsatira:
Horvath, A., Dzlechclarz, P., ndi Szajewska, H. "Zotsatira za Zowonjezera Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chapafupi Matenda a Dokotala Dec. 2008: 122, e1268-e1278.
Kellymom. "Zakudya Zamakaka ndi Zakudya Zina mwa Ana Amnyamwitsa."
Los Altos Kudyetsa Kliniki. "Fundoplication."
Nerko, S. "Kutenga Reflux ya Acid Katika Makanda." Masewera a Pambuyo August 2007.
Woo, J., Yang, H., Min, T., Jeon, Y., Lee, H., Lee, J., Pyun, B. "Njira Yabwino Kwambiri pa Gastro-Esophageal Reflux ndi Reflux-Related Zizindikiro za Kutupa Kumatenda Omwe Amakhala ndi Zizindikiro Zopanda Kuthamanga. " Kupuma kwa Kachilombo Kafukufuku wa Immunology Jan. 2012; 4, 17-23.