Kwa anthu ambiri, nthendayi zowonongeka zimayambitsa kupweteketsa mtima kochepa, komwe kumatha kuchiritsidwa mosavuta ndi antiacids ndi acid-blockers. Pokhapokha ngati phokoso liri lalikulu kwambiri, mankhwala opitirira muyeso (OTC), kulemera kwake, ndi kusintha kwa zakudya nthawi zambiri zimakhala zokwanira kuti zitsimikizire mpumulo. Komabe, pa milandu yovuta kwambiri, opaleshoni ingakhale yofunikira ngati mimba ikulepheretsa kapena kudula magazi.
Malinga ndi kukula kwake kwa vutoli, opaleshoni yotseguka kapena laparoscopic ("keyhole") ingagwiritsidwe ntchito kukonza zowonongeka.
Zothetsera Pakhomo ndi Moyo Wamoyo
Zizindikiro za nthendayi zowoneka bwino zimakhala zofanana ndi zovuta za m'mimba zotsika kwambiri zapopugeal (LES), zomwe zimasiyanitsa m'mimba kuchokera ku tizilombo toyambitsa matenda. Chifukwa nthenda imatha kusintha malo a LES, mimba ya asidi ndipo chakudya nthawi zina chimatha kutsuka m'mimba ndipo chimapangitsa kutupa komanso kusokonezeka.
Izi zimachitika makamaka mwa anthu omwe ali olemera kwambiri kapena olemera kwambiri. Kuwonjezera pa kupanikizika kwambiri m'mimba ndi kumtunda kwa mimba, kunenepa kwambiri kumalimbikitsa reflux mwa kulepheretsa kusamba kwa chimbudzi. Kuwonjezera apo, zakudya zomwe zimadya zakudya zamtundu wambiri, zimakhala zovuta kwambiri kuti zikhale ndi asidi kuti zithetse mafuta owonjezera komanso zakudya zosavuta .
Kuti mugonjetse izi, muyenera kuthana ndi zifukwa zomwe zimayambitsa reflux.
Pali zinthu zingapo zofunika kusintha pamoyo zomwe zingathandize:
- Kutaya thupi kumachepetsa mphamvu ya m'mimba yomwe imalimbikitsa herniation. Ngakhale kuti sizingasinthire nthendayi, zingateteze nthenda yochepa kuti ikhale phokoso lalikulu kwambiri la pharaesophageal . Ichi ndi choyimira chokhudzana ndi chiopsezo chowonjezereka cha matenda a reflux a gastroesophageal (GERD) .
- Zakudya zochepa kwambiri zamtundu wambiri , zimangowonjezera kulemera kwa thupi, zimathandiza kuchepetsa ubongo ndi kuthetsa chidziwitso chomwe chimapangitsa kuti mimba ikhale yochepa. Zakudya zapamwamba zimakhala njira zothandiza.
- Mankhwala oyenera , omwe amamwa mowa osachepera asanu ndi atatu magalasi a madzi patsiku, amachepetsetsa chiopsezo cha kudzimbidwa pamene akuchepetsetsa asidi m'mimba.
- Kupewa kuyambitsa zakudya kungakupatseni mpumulo kaya ndinu wamkulu kapena wolemera. Zowonongeka kaŵirikaŵiri zimaphatikizapo nyama zofiira, zakudya zokazinga, zakudya zonunkhira, mkaka wa mafuta, tomato-based sauces, machungwa, zakumwa za carbonate, caffeine, mowa, ndi mchere wambiri . Mosiyana ndi izi, zakudya zotetezeka monga nkhuku, nsomba, mkaka wa mafuta, mafuta, ndi masamba zimathandiza kuchepetsa zizindikiro za reflux.
- Kusiya ndudu ndikoyenera ngati mukulimbana ndi kupweteka. Pamene kusuta sikupangitsa kuti phokoso likhale losavuta, limatha kumasula a LES omwe akufooka kale ndipo amalola chakudya ndi asidi kuti zisakanike mosavuta. Ichi ndi chifukwa chake anthu osuta fodya amawotchera nthawi yomweyo atatha kuyatsa kapena chifukwa chake amakhala okalamba kuposa osasuta.
Mankhwala
Mankhwala OTC ndiwo njira yoyamba yothetsera vuto la kupweteka kwa mtima ndi reflux ya asidi. Izi zingakhale zothandiza kuchepetsa zizindikiro pamene mukugwira ntchito yothetsera vuto lawo, reflux yokha, ndi kusintha komwe tawasintha pamwambapa.
Mankhwalawa amawoneka otetezeka kuti agwiritsidwe ntchito moyenera koma angayambitse mavuto ngati agwiritsidwa ntchito mopitirira malire.
Mwa zina mwa mankhwala omwe amagwiritsidwa ntchito kwambiri:
- Antacids , monga Tums, Rolaids, ndi Gaviscon, amagwira ntchito polepheretsa asidi m'mimba ndi zowonjezera monga aluminium hydroxide ndi magnesium hydroxide. Kugwiritsa ntchito mowa mwauchidakwa kungapangitse kudzimbidwa (antiacidum-based antacids) ndi kutsekula m'mimba (antacids).
- Mankhwalawa a H2 , omwe amachepetsa kutulutsa mimba, amachititsa kuti ma OTC azidziwika monga Pepcid (famotidine), Tagamet (cimetidine), ndi Zantac (ranitidine). Zotsatirapo zimaphatikizapo kudzimbidwa, kutsegula m'mimba, kamwa, khungu, ndi kumvetsera m'makutu ( tinnitus ).
- Proton pump inhibitors (PPIs) amapereka chithandizo chomwecho kwa H2 blockers koma ali amphamvu komanso mofulumira. Amaphatikizapo Nexium (esomeprazole), Prevacid (lansoprazole), ndi Prilosec (omeprazole). Ma PPI amagwiritsidwa ntchito ngati H2 blocker sapereka chithandizo. Mutu, kudzimbidwa, kutsegula m'mimba, ndi kugwiritsira ntchito ulemu ndizo zotsatira zofala.
Matembenuzidwe amphamvu a H2 blockers ndi PPIs amapezeka mwa mankhwala.
Opaleshoni
Kuchita opaleshoni ya chithokomiro chokhalirapo kumangotchulidwa ngati nthenda ya pharaeophageal imayambitsa zizindikiro zomwe sizingakhoze kuchiritsidwa ndi mankhwala kapena kusintha kwa moyo. Izi zikutanthauza kuti maonekedwe a zizindikiro amasonyeza kuti mimba yakula kwambiri mu chifuwa ndipo tsopano ikusintha malo a LES. Monga chithandizo cha pharaopophage chimayamba kukhala chopita patsogolo, ndibwino kuti muzitha kuchipatala kale kuposa kale.
Zina mwa zovuta kwambiri, monga volvulus (vuto limene mimba limapotoza madigiri oposa 180) ndi kumveka (komwe magazi akuchotsedwa), amaonedwa kuti ndi oopsa mchipatala.
Ngati muli ndi nthenda yaikulu, kusankha kwa opaleshoni kudzadziwika kwambiri ndi chikhalidwe ndi kuuma kwa vutoli.
Kutsegula kosavuta kapena laparoscopic
Mwina opaleshoni ("lotseguka") kapena transabdominal (laparoscopic, kapena "keyhole") ingagwiritsidwe ntchito kukonzanso chithandizo cha pharaeophageal.
- Opaleshoni yotseguka imatanthawuza kuloŵa mu thupi kudzera mu kutengeka, makamaka kumbali ya kumanzere kwa thupi. Amagwiritsidwa ntchito mobwerezabwereza pakakhala vuto lakupha magazi kapena ziwalo. Ikhoza kugwiritsidwanso ntchito pazifukwa zosautsa, monga pamene mimba yonse yalowa mu chifuwa (yomwe imadziwika kuti intraathoraic).
- Kuchita opaleshoni ya laparoscopic kumaphatikizapo kuika zipangizo zamakono opangira opaleshoni m'zinthu zitatu zomwe zimapangidwira pamimba. Chifukwa cha zinthu zomwe sizidzidzimutsa, zimaonedwa ngati zogwira mtima monga opaleshoni ya transthoracic koma ndi zovuta zochepa komanso nthawi yowonongeka mwamsanga.
Nissen Fundoplication
Nissen fundoplication ndi njira yatsopano anachita laparoscopically. Cholinga cha opaleshoni ndichokulumikiza mwamphamvu kumtunda kwa m'mimba (wotchedwa fundus) pafupi ndi malo otetezeka ndipo chitetezeni mmalo ndi zikhomo kapena zofunikira kuti zikhale zolimba ndi zothandizidwa. Ngati achita bwino, ndalama zothandizira ndalama zikhoza kuwonetsa LES kuti azigwira ntchito bwinobwino.
Nissen fundoplication akuonedwa kuti ndi yotetezeka kwambiri komanso yothandiza, ndipo peresenti yochepa ya anthu akufa ndi yotsika mtengo komanso 89.5 peresenti yoposa 10. Kuchetsa, kusanza, ndi matenda osakwiya (IBS) ndizo zotsatira zofala zomwe zimachitika pakatha milungu iwiri kapena inayi.
Mankhwala Ophatikiza (CAM)
Kuwonjezera pa antacids ndi asidi-blockers, pali mankhwala angapo othandizira omwe angapereke chithandizo chachikulu cha zizindikiro zovuta.
Licorice
Licorice, yochokera muzu wa licorice , yakhala ikugwiritsidwa ntchito pochizira kupweteka kwa thupi ndi zizindikiro zina za m'mimba. Ngakhale kuti kafukufuku akusowabe, kafukufuku wina wasonyeza kuti ili ndi malo ake pamodzi ndi mankhwala a chikhalidwe cha acid acid.
Phunziro la 2013 lomwe linafalitsidwa mu Clinical and Experimental Gastroenterology linanena kuti kugwiritsidwa ntchito pamodzi kwa chotsitsa cha rootorice ndi mphamvu-mankhwala PPI (pantoprazole) kunabweretsa zizindikiro zochepa za kupweteka kwa mtima, kupweteka pachifuwa, ndi kutupa m'mimba poyerekezera ndi kugwiritsa ntchito PPI wokha.
Tiyi ya licorice ndi imodzi mwa mitundu yofala kwambiri. Wina, wotchedwa deglycyrrhizinated licorice (DGL) , amapezeka ngati zakudya zowonjezera zakudya ndipo angakhale olekerera chifukwa chochotsa glycyrrhizin (chinthu chodziwika ndi kuchepa kwa potaziyamu).
Ginger
Ginger ndi njira ina yotchuka yomwe ingathandize kuchepetsa zizindikiro za kupweteka kwa mtima. Mizu ya ginger imakhala ndi antioxidants ndipo imakhala ndi mankhwala a phenolic omwe amakhulupirira kuti kuchepetsa kutsekemera kwa m'mimba ndikumachepetsera mwayi wa asidi reflux.
Komabe, ngati agwiritsidwa ntchito mopitirira muyeso, ginger angakhale ndi zotsatira zosiyana. Phunziro la 2014 kuchokera ku yunivesite ya Stanford linanena kuti, pamene mawonekedwe a ginger kapena mawonekedwe a ufa angathandize kuchepa kwa m'mimba komanso kuchepetsa m'mimba motility , mlingo wa tsiku ndi tsiku wa mlingo wapamwamba kuposa magalamu asanu ukhoza kuwonjezera chiopsezo cha kupweteka kwa mtima ndi kumimba kwa m'mimba.
Ginger ingagulidwe monga tiyi kapena ufa, capsule, kapena madzi.
Monga momwe ziliri ndi CAM zosankha, ndi bwino kukambirana licorice ndi ginger ndi dokotala musanayese kuziyesa.
> Zotsatira:
> Di Pierro, F .; Gatti, M .; ndi Rapacioli, G. "Zotsatira mwa odwala omwe alibe matenda a reflux omwe sagwiritsidwa ntchito ndi proton pump inhibitor ndi alginic acid ± glycyrrhetinic acid ndi anthocyanosides." Clin Exp Gastroenterol. 2013; 6: 27-33. DOI: 10.2147 / CEG.S42512.
> Bungwe la Amayi Am'mimba a American and Endoscopic Opaleshoni (SAGES). "Malangizo Othandizira Kulamulira kwa Hernia ya Hiatal." Los Angeles, California; yakutuluka mu April 2013.
> Eya, A. ndi Golianu, B. "Chithandizo Chogwirizanitsa cha Reflux ndi Dyspepsia Yogwira Ntchito mwa Ana." Ana (Basel). 2014; 1 (2): 119-33. DOI: 10.3390 / ana1020119.