Pamene Kukhumudwa Kubwerera
Mawu akuti reflux gastroesophageal reflux matenda (refractory GERD) akulongosola odwala omwe akupitiriza kukhala ndi zizindikiro za reflux ya gastroesophageal ngakhale kuti mankhwalawa ndi proton pump inhibitors (PPIs).
Odwala omwe ali ndi GERD osakayikira nthawi zambiri amagwera m'magulu awiri:
- Anthu amene amafunikira chithandizo chamankhwala
- Amene ali ndi zifukwa zina za zizindikiro zawo za reflux
Chithandizo Chamankhwala Chowonjezereka cha GERD Yotsutsa
Kusamalira chithandizo chokwanira sichikutanthauza kuti njira yokhayo ya odwalawa ndi opaleshoni. Ndipotu, omwe ali ndi zotsatira zabwino kuchokera ku opaleshoni yotsutsana ndi reflux ndi omwe adayankha kale mankhwala. Omwe akutsutsa odwala sagwirizana ndi opaleshoni ya anti-reflux. Izi, sizitanthawuza opaleshoni, monga kuperekera ndalama, sizingatheke. Dokotala adzayesa zovuta zomwe zingatheke komanso zovuta za opaleshoniyo potsutsa phindu lomwe lingatheke ndikukambirana ndi wodwalayo ngati opaleshoni ndi njira yabwino.
Odwala ena samayankha mwambo wa mapiritsi a PPI, ndipo dokotala angalingalire kuchulukitsa mlingo, komanso kuti odwala apite kuwirikiza tsiku ndi tsiku m'malo mwa odwala kamodzi pa tsiku.
Nkofunika kuteteza reflux ya asidi usiku. Kutenga chophimba H2 asanayambe kugona kwawonetsedwa kuti kuthandizidwe ndi zizindikiro.
Njira zina zogwiritsira ntchito reflux wa usiku ndi awa:
- Kugona ndi mutu ndi mapewa kukwera
- Kugona kumanzere
- Kudikira maola awiri kapena atatu mutatha kudya kuti mugone
- Kuvala zovala zogonera
Madokotala angaperekenso kugwiritsa ntchito kampani yogulitsira chithandizo, monga Reglan, musanadye komanso musanagona kuti muthe kuchepetsa chiopsezo cha reflux ya asidi.
Zifukwa Zina za Zizindikiro za Reflux
Pamene wodwalayo samayankha mankhwala osokoneza bongo, makamaka ngati mankhwala akuyesedwa akuyesedwa, mavuto ena kupatula GERD angakhale pafupi.
Ngakhale kuti GERD ndilo vuto lalikulu la zizindikiro za reflux, sizomwe zimayambitsa. Matenda ena osokoneza ubongo omwe angayambitse reflux ndi odwala matenda opatsirana pogonana komanso mavuto a motility .
Mayeso omwe dokotala angagwiritse ntchito kuti atsimikizidwe kuti ali ndi matendawa ndi awa:
- PH
- Kutsekemera kochepa kwambiri
- Esophageal Manometry
Zotsatira za mayesowa zidzathandiza dokotala kusankha chisankho choyenera cha mankhwala.
GERD yotsutsa ndi yosawerengeka. Ngati zochitika za wodwalayo zikupitirizabe kuyerekezera zizindikiro ngakhale atachiritsidwa, dokotala ayenera kufunsidwa. Kukambilana za zizindikiro zomwe zimakhalapo, nthawi zambiri, ndikuzindikila zotheka kuti zikhale zotsekemera zimathandiza kupeza njira yoyenera ya mankhwala.
Zotsatira:
> Kenneth R. DeVault MD, FACG, MD Donald O. Castell, MACG > "Zotsatiridwa Zotsatira za Kuzindikira ndi Chithandizo cha Matenda a Reflux Operekera Matenda." lembani: 10.1111 / j.1572-0241.2005.41247.x. American College of Gastroenterology. 5 Dec 2007.
> Ikuo Hirano, MD, 1 Joel E. Richter, MD, "ACG Practice Guidelines: Kuyesedwa kwa Reflux Testing." lembani: 10.1111 / j.1572-0241.2006.00936.x. American College of Gastroenterology. 5 Dec 2007.