Mtundu wa GERD umene Sukuwonetsa Kuwonongeka Kowoneka kwa Esophagus
Matenda a reflux a gastroesophageal (GERD) amapezeka pamene mchere wotsika (s) wotsekemera sungatseke bwino, kotero kuti m'mimba muli zotsekemera m'mbuyo, kapena kuti reflux, m'kati mwake.
Kwa odwala ena, GERD ingayambitse matenda oopsa kwambiri , omwe amachititsa kuti kutupa, ziphuphu, ndi zilonda zipangidwe. Mankhwala oopsa kwambiri amatha kuoneka ndi mapulogalamu otchedwa endoscope-chida chokhala ndi kuwala ndi kamera komwe kumathandiza dokotala kuganizira mmene thupi limagwirira ntchito.
Koma anthu ambiri ali ndi matenda otchedwa refrox nonerosive, kapena NERD. Ndi NERD, anthu amawona zizindikiro za GERD zomwe zimayambitsa asidi reflux, koma alibe kuwonongeka koyang'ana kwa osophageal.
Chithandizo cha NERD n'chofanana ndi cha GERD yochuluka. Malingana ndi kuopsa kwa zizindikiro, mankhwala angaphatikizepo chimodzi kapena zingapo zotsatirazi: kusintha kwa moyo, mankhwala, kapena opaleshoni.
Zosintha Zamoyo kuti Zichitikire NERD
Malingana ndi American College of Gastroenterology, zizoloŵezi zamoyo zimakhala zofunikira pakuyang'anira acid acid reflux.
- Kuperewera kwa Thupi: Ngati muli olemera kwambiri kapena ochepa kwambiri (zomwe zikutanthauza chiwerengero cha thupi lalikulu kuposa 25), kapena ngati mwangopeza kulemera, kulemera kwake kumalimbikitsidwa kwambiri. Sayansi yambuyoyi ndi yakuti kulemera kwina kumbali yanu kumatha kuwonjezera mphamvu ya m'mimba, yomwe imatha kukankhira mmimba mkati mwake.
- Kukwezera mutu wa bedi lanu , makamaka ngati zizindikiro zanu za reflux zimakhala zovuta usiku ndi / kapena kudzudzutsani usiku, zimaperekedwa.
- Kusiya kusuta ndi kumwa mowa kungakhale kothandiza, ngakhale kusintha kumeneku sikungotsimikizidwe mosatsimikiziridwa mu maphunziro a sayansi kuthandiza ndi zizindikiro za GERD. Komabe, madokotala ambiri amalimbikitsa izo payekha.
- Kuchotsa zakudya zina kungathandizenso kuchepetsa zizindikiro za acid reflux, makamaka chokoleti, caffeine, zakudya zokometsera zokometsera, zamchere, ndi zakumwa zamchere. Kusintha kumeneku kungakhale kopindulitsa makamaka kwa anthu omwe amawona kugwirizana pakati pa zizindikiro zawo ndi chakudya chimodzi kapena zingapo.
- Kudya zakudya zing'onozing'ono (monga chakudya chachikulu chingapangitse kuti anthu asamapanikizidwe ndi sophgeal sphincter) komanso kupewa kudya osachepera maola awiri kapena atatu asanakagone kapena kukhala pansi kungathandizenso.
Mankhwala Oyenera Kuchitira NERD
Dokotala wanu angalimbikitse mankhwala osokoneza bongo, omwe amagwira ntchito pochepetsa ma asidi m'mimba, kapena mankhwala omwe amaletsa kupanga acid.
- Antacids , monga Maalox , Mylanta , Tums , ndi Rolaids ndizo mankhwala oyambirira omwe amalimbikitsa kuchepetsa kupweteka kwa mtima ndi zizindikiro zina zofatsa za GERD. Mankhwala ambiri pamsika amagwiritsira ntchito mitundu itatu ya salti-magnesium, calcium, ndi aluminium-ndi hydroxide kapena iicicbonbon ion kuti asamalire asidi m'mimba mwako. Chokhumudwitsa ndi chakuti antacids ali ndi zotsatira zina. Mchere wa Magnesium ukhoza kuyambitsa kutsekula m'mimba, ndipo mchere wa aluminium ukhoza kuyambitsa kudzimbidwa. Aluminium ndi salesi ya magnesium nthawi zambiri zimagwirizanitsidwa mu chinthu chimodzi chokhazikitsa zotsatirazi.
- Okhazikitsa H2 , monga Tagamet , Pepcid , Axid, ndi Zantac , kupanga acid acid. Iwo alipo mu mphamvu ya mankhwala ndi pa-counter-counter. Mankhwalawa amapereka mpumulo wa nthawi yayitali, koma pa-counter-counter-counter-H2 blockers sayenera kugwiritsidwa ntchito kwa milungu yambiri pa nthawi popanda malangizo oyenera a dokotala.
- Proton pump inhibitors ndi Prilosec , Prevacid, Protonix , Aciphex, ndi Nexium , zomwe zimapezeka ndi mankhwala. Prilosec ikupezeka pa fomu yapamwamba (Prilosec OTC). Proton pump inhibitors (PPIs) ndi gulu la mankhwala omwe amaletsa kutulutsa asidi mmimba ndi m'matumbo. Proton pump inhibitors nayenso sayenera kugwiritsidwa ntchito kwa milungu yambiri panthawi popanda malangizo kuchokera kwa dokotala.
Opaleshoni Yopereka NERD
Malingana ndi American College of Gastroenterology, kusankha kwa opaleshoni kwa anthu omwe ali ndi GERD kumaphatikizapo laparoscopic fundoplication kapena opaleshoni yachipatala mwa munthu amene ali ochepa kwambiri.
Mu laparoscopic fundoplication, chigawo chapamwamba cha m'mimba chikulumikizidwa kuzungulira pansi.
Chisankho chochita opaleshoni ndi chovuta ndipo chimafuna kukambirana moganizira pakati pa munthu ndi madokotala ake.
> Zotsatira:
> Hershcovici T, ndi R. Osalimbikitsa Matenda a Reflux (NERD) - Chotsitsimutsa. J Neurogastroenterol Motil. 2010 Jan; 16 (1): 8-21.
Katz PO, Gerson LB, Vela MF. Malangizo othandizira kupeza matenda ndi matenda a reflux matenda a gastroesophageal. Am J Gastroenterol 2013; 108: 308-28.
> Kahrilas PJ. (March 2016). Kusamalira zamankhwala za matenda a reflux opatsirana pogonana kwa anthu akuluakulu. Mu: UpToDate, Talley NJ (Ed), UpToDate, Waltham, MA.
> Sigterman KE, van Pinxteren B, Bonis PA, Lau J, Numans ME. Kuchiza kwa nthawi yayitali ndi proton pump inhibitors, amatsutso a H2-receptor ndi prokinetics kwa matenda a reflux odwala matenda odwala matenda a gastro-oesophageal symptoms ndi matenda a reflux osapitirira. Msonkhano wa Cochrane Wolemba Rev. 2013 May 31; (5): CD002095.