Mukakhala ndi zizindikiro zonena za kupweteka kwa mtima ndi kubwezeretsa, matenda a reflux a gastroesophageal (GERD) amapezeka kawirikawiri ndikuwerenganso mbiri yakale ya zizindikiro zanu. Komabe, ngati mulibe mbendera zofiira zapamwamba, zizindikiro zanu sizikuchiritsidwa ndi chithandizo, kapena dokotala wanu akufuna kuti aone ngati zingakhale zovuta, mungayesedwe ngati aposcopy apamwamba, acid ambulatory (pH) kuyesa kufufuza, kuchepa kwa manometry, kapena kugwiritsidwa ntchito kwa radiyo ya Barium.
Mayesero ndi Ndondomeko
Ngati dokotala akuganiza kuti achite mayeso kuti atsimikizire kuti muli ndi GERD kapena kuti muwone mavuto omwe angapangidwe ndi GERD, izi ndi zina mwa njira zomwe zimagwiritsidwa ntchito nthawi zonse. Malingana ndi zochitika zanu ndi zotsatira za mayeso, mukhoza kukhala oposa oposa.
Kutsika Kwambiri Kwambiri
Kumapeto kwa mapepala apamwamba kumachitika kuchipatala kapena kuchipatala. Pambuyo pake, mudzalandira chilakolako chokhalira pansi kuti muteteze nthawi yonseyi. Dokotala wanu adzakupopera mmero kuti awonongeke ndikugwiritsira ntchito pulogalamu ya pulasitiki yopyapyala yotchedwa endoscope pansi pa mmero.
Kamera kakang'ono ndi kuwala mu endoscope mulole dokotala wanu kuti awone pamwamba pa malo anu ndikufufuza zolakwika. Potsatira ndondomekoyi, dokotala wanu akhoza kuchotsanso kachidutswa kakang'ono ka minofu kuti athe kuyesedwa kwa mavuto ngati Barott.
Ngati mwakhala ndi zizindikiro zolimbitsa thupi ndipo njirayi ikuwonetsa kuvulaza kulikonse, palibe mayesero ena omwe amafunikira kuti atsimikizire GERD.
Acid Ambulatory (pH) Kuwunika Kufufuza
Mu mayesowa, omwe amachitikira kuchipatala kapena kuchipatala, dokotala wanu amaika chubu kakang'ono pamphuno kapena pakamwa panu mu malo omwe angakhalepo kwa maola 24. Mapeto ena a chubu amagwirizanitsa ndi khungu kakang'ono. Pamene mukuchita ntchito zanu zachizolowezi, nthawi ndi kuchuluka kwa asidi yomwe imabwera mumayendedwe anu akuyesoka ndi kulembedwa.
Chowunika choyendetsa pulogalamu yapamwamba ndi chothandiza mukakhala ndi zizindikiro za GERD koma mulibe vuto lowonongeka. Ndondomekoyi imathandizanso kudziwa ngati zizindikiro za kupuma, kuphatikizapo kupuma ndi kukokera, zimayambitsidwa ndi reflux. Mayesowa akuwoneka kuti ndi olondola kwambiri kuti azindikire reflux asidi.
Njira ina ya kuyang'anira pH ikuchitika ndi kapsule yomwe imayikidwa pamalo anu m'malo mwa chubu. Kapsule mosasunthika imatulutsa miyeso ya asidi kwa munthu amene mumamuveka pamphuno. Mumasungiranso zizindikiro zanu mwa kukankhira mabatani ena omwe mumalandira ndikusunga zochitika monga nthawi yomwe mumadya komanso pamene mukugona.
Esophageal Manometry
Mayesowa amachititsa kuti mitsempha yanu iwonongeke pamene mukumeza. Ikhoza kusonyeza ngati zizindikiro zanu za GERD zimachokera ku minofu yanu yofooka ndikuzindikiranso nkhani zina ndi vuto lanu lomwe lingayambitse zizindikiro zanu m'malo mwa GERD.
Zachitidwa ndi kugwedeza mmero mwako ndiyeno ndikuika chubu chochepa kupyola mu mphuno mwako m'mimba mwako. Pambuyo pake chubu imatulutsidwa m'mimba yanu pamene mumadya pamene makompyuta atenga miyeso ndi kulemba zomwe zimachitika m'magulu osiyanasiyana. Izi zikhoza kuchitidwa ku ofesi ya dokotala.
Kujambula
Dokotala wanu angafune kuyang'ana tsamba lanu lakumtunda (GI), makamaka ngati akuganiza kuti muli ndi vuto lachiberekero kapena vuto lanu.
Barium Swallow Radiograph
Mayesowa amachitikira kuchipatala kapena kuchipatala ndipo amagwiritsira ntchito X-ray ya tsamba lanu lapamwamba la GI kuthandiza zowonongeka, ngakhale kuti sizingathe kusonyeza GERD. Pakati pa mayesowa, mudzakhala kapena muyimire kutsogolo kwa x-ray makina ndikumwa yankho lakuda, lalkyamu yomwe imayendetsedwa ndi X-ray kuti dokotala wanu athe kuona momwe barium imayendera pakamwa panu. Mukhozanso kumwa mowa wosakaniza ndi / kapena kumeza mapiritsi a barium pomwe zithunzi zimatengedwa.
Pambuyo pa yeseso, mumatha kumva ngati muli ndi nseru, ndipo mungakhale ndi malo owala kuchokera ku barium. Kuwopsya pang'ono kosalephereka sikudzawonekera pamayesero awa, ngakhale kuti zovuta zowonongeka, za zilonda zam'mimba, ndi chilakolako chokhalira.
Kusanthula Kusiyanasiyana
Pali mavuto ambiri omwe ali ndi zizindikiro zomwe zingagwirizane ndi GERD. Mwamwayi, zonsezi zikhoza kusiyanitsidwa ndi GERD pogwiritsa ntchito mayesero omwewo atchulidwa pamwambapa.
Esophagitis
Zizindikiro zomwe zimakhala zofanana ndi GERD zingawoneke pamene muli ndi kutupa m'mimba yanu (esophagitis) m'malo mwa GERD. Kuthamanga kwa matenda kungayambitse chifukwa chimodzi kapena zingapo izi:
- Kutenga mankhwala ena omwe amakumana ndi vuto lanu kwautali kwambiri, omwe makamaka chifukwa chosawatenga ndi madzi okwanira. Mankhwala omwe amagwiritsidwa ntchito poyambitsa matendawa amatenga antibiotic monga tetracycline ndi doxycycline; kupweteka ngati aspirin, Motrin (ibuprofen), ndi Aleve (naproxen sodium); potaziyamu chloride; biphosphonates ngati Fosamax (alendronate); ndi quinidine.
- Matenda apamwamba kuposa maselo oyera m'magazi anu omwe amayamba chifukwa cha mankhwala osokoneza bongo, acid reflux, kapena onse awiri. Izi zimatchedwa eosinophilic esophagitis.
- Matenda a tizilombo, bakiteriya, kapena fungal m'thupi lanu.
Dokotala wanu amatha kusiyanitsa pakati pa izi ndi GERD pogwiritsira ntchito manometry yochepa kwambiri komanso kumapeto kwapoposcopy ndi biopsy.
Matenda a Esophageal
Ngati mumakumana ndi zovuta kumeza, chizindikiro cha GERD, izi zingatheke chifukwa cha mphete zochepetsetsa kapena webs, matenda osokoneza bongo, odwala matenda osokoneza bongo, kapena khansa yowopsya. Mofanana ndi matenda opatsirana, nkhanizi zingathenso kusiyanitsidwa ndi GERD ndi manometer osungunuka komanso aposcopy apamwamba ndi chidziwitso cha minofu.
Reflux Hypersensitivity ndi Ntchito Yopweteka Kwambiri
Kukhala ndi kupsinjika kwafupipafupi kungakhale chifukwa cha kuthamangitsidwa kwa thupi kapena kupweteka kwa mtima m'malo mopanda mphamvu. Zonsezi ndizofala kwambiri. Kugwilitsika kwa matenda a reflux ali ndi zizindikiro zomwezo monga GERD, koma mapuloteni amatha kutuluka mwachibadwa ndipo mankhwala omwe amagwiritsidwa ntchito kaŵirikaŵiri kawirikawiri sawathandiza.
Kutentha kwa mtima, komwe kumafanana ndi reflux hypersensitivity, imakhalanso ndi zizindikiro zomwezo monga GERD, sizimayankha mankhwala opweteketsa mtima, ndipo zimayambitsa zotsatira zowonongeka za endoscopy, koma zizindikiro sizimayambidwa ndi reflux ngati ali ndi reflux hypersensitivity . Dokotala wanu akhoza kudziwa kusiyana pakati pa awiri ndi kafukufuku wa pH womwe watchulidwa pamwambapa, womwe umasiyanitsa iwo ndi GERD.
> Zotsatira:
> Kahrilas PJ. Zowonetserako zachipatala ndi Kuzindikira kwa Reflux ya Gastroesophageal mu Akuluakulu. Zaposachedwa. Kusinthidwa pa March 6, 2018.
> Chipatala cha Mayo Clinic. Esophagitis. Chipatala cha Mayo. Idasinthidwa pa October 14, 2017.
> Chipatala cha Mayo Clinic. Matenda a Reflux a Gastroesophageal (GERD). Chipatala cha Mayo. Kusinthidwa pa March 9, 2018.
> Chitukuko cha National Diabetes ndi Matenda a Kumimba ndi Impso. Kuzindikira kwa GER ndi GERD. Dipatimenti ya Zaumoyo ya Ukhondo ku United States. Lofalitsidwa November 2014.
> Vandenplas Y, Hauser B. Anakonzedwanso Kudzera pa Gastro-Esophageal Reflux mu Matenda. Kukambirana kwa akatswiri mu Gastroenterology ndi Hepatology . 2015; 9 (12): 1511-21. lembani: 10.1586 / 17474124.2015.1093932.