Zomwe Zimayambitsa Ndi Njira Zamakono Zothandizira
Nthenda yotsekemera imachitika pamene gawo lakumtunda kwa m'mimba mwako limapyola mu chifuwa-minofu imene imasiyanitsa chifuwa ndi mimba. Pa diaphragm ndi kutsegula kochepa, komwe kumatchedwa hiatus, kumene kudutsa chubu lanu (esophagus). Ngati mimba ikugwedezeka kudutsa pamtundawu, ikhoza kuyambitsa chakudya ndi zidulo kubwerera m'mimba, zomwe zimayambitsa kupweteka kwa mtima, kudzipweteka, ndi kupweteka.
Ngakhale mankhwala owonjezera (OTC) ndi mankhwala a mankhwala, kuphatikizapo antacids ndi asidi-blockers, akhoza kuthana ndi zizindikiro zowongoka m'mimba, kusintha kwa thupi ndi kusintha kwa zakudya kumafunika kuti kuchepetsa reflux palimodzi. Kuchita opaleshoni kungafunike pa milandu yoopsa.
Zizindikiro
Anthu oposa theka la anthu omwe amapezeka ndi chilakolako cha chiberekero sadzapeza zizindikiro konse. Kwa omwe amachita, reflux ya chapamimba asidi kapena mpweya mu malo otsegulira adzakhala zifukwa zazikulu. Zizindikiro zimasiyana kwambiri ndi mtundu wa nthenda yomwe muli nayo.
Nthendayi yotereyi ndi mtundu umene umagwirizanitsa ndi m'mimba (wotchedwa gastroesophageal junction) ndipo mbali ya m'mimba imalowa m'chifuwa. Hernias monga awa amatchedwa "kutsetsereka" chifukwa chiwalo cha mimba chimatha kugwedezeka m'mbuyo pomwepo.
Zing'onozing'ono zing'onozing'ono zowonongeka zizindikiro sizidzawoneka zizindikiro. Ngati zizindikiro zikuwonekera, zimakhala ndi izi:
- Kuthamangitsani
- Kudzikuza
- Kubwereza
- Kukhadzula
- Kuwombera
- Nsowa ndi kusanza
Mtundu wa peresophageal ndi wamba koma woopsa kwambiri umene mimba yokha imalowerera m'chifuwa. Hernias monga izi nthawi zambiri zimapangitsa kuti chakudya chikhale chokwanira kapena kupotoka, kudula magazi.
Pomwe zikunenedwa, ambiri a peresophageal hernias sangayambitse zizindikiro ngati ali ochepa. Ngati atakula ndikuyamba kupanikizika, akhoza kuchititsa kuti zakudya zizikhala mkati mwa chifuwa pomwe mukuyesera kumeza. Ngati nthendayi imakhala yowonjezera mu chifuwa, ikhoza kumangika (kumangidwa) mu hiatus ndikupititsa ku:
- Chifuwa cha chifuwa mutadya
- Kupweteka kwa m'mimba kwambiri ndi kusweka
- Kupweteka kwapachifuwa kwapachifuwa komwe sikungakhoze kuchiritsidwa ndi antacids
- Kuvuta kumeza ( dysphagia )
- Kupuma pang'ono ( dyspnea )
- Kulephera kubera
- Kulimbitsa patsogolo kupita kuzinthu zopanda kubereka
- Mdima wakuda kapena wamala
- Kuthamanga magazi
Zonsezi ndi zizindikiro za nthendayi yotsekedwa , yomwe imatha kuwonetsa kuti magazi ndi operewera. Nthawi zonse akaidi omwe ali m'ndende ayenera kuonedwa kuti ndi achipatala omwe akufunikira chithandizo chamankhwala.
Zimayambitsa
Chifukwa cha nthendayi sikuti nthawi zonse zimakhala zomveka bwino. N'kutheka kuti munabadwa ndi hiatus zazikulu kapena zaka, opaleshoni, kapena kuvulazidwa mwakuthupi kwafooketsa kukhulupirika kwanu kwa minofu ya diaphragm.
Zinthu monga izi zingakuchititseni kuti mukhale ndi vuto lachiberekero, makamaka ngati muthamanga mimba mwadzidzidzi.
Zitsanzo za izi zingaphatikizepo chifuwa chachikulu, kukweza zinthu zolemetsa, kusanza kwaukali, kapena kusokoneza panthawi yoyenda.
Kunenepa kwambiri ndichinthu chachikulu chothandizira. Anthu omwe ali olemera kwambiri kapena olemera kwambiri amakhala ndi mphamvu yambiri ya m'mimba mofanana ndi ya kulemera kwa thupi. Kupanikizika kumeneku kumachepetsa minofu ya diaphragm pamene ikuwonjezera malo othawirako. Chotsatira chake, anthu amalingalira kuti olemera kwambiri omwe amadziwika ngati thupi lachimake (BMI) oposa 30-ali ndi mwayi wokhala ndi chiopsezo chachikulu kuposa omwe ali ndi BMI ochepera 25.
Zomwezo zikhoza kuchitika pa nthawi ya mimba, kawirikawiri pamayendedwe apambuyo pamene chiberekero cha chiberekero chimapangitsa kuti mimba ikhale yovuta.
Matenda a hiatal amatha kukhudza anthu oposa 50. Pamene kusuta sikuchititsa kuti phokoso likhale lopweteka, likhoza kuwonetsa zizindikiro mwa kuchepetsa kutsika kwa sophageal sphincter (LES) kutanthauza kusunga chakudya ndi asidi kuchokera pachimake.
Kudziwa
Pali mayesero angapo omwe amagwiritsidwa ntchito kuti apeze chithandizo chodziwika bwino . Chosankha chomwe chili choyenera kwa inu makamaka chimadalira mtundu ndi kuuma kwa zizindikiro zomwe mukukumana nazo.
Zina mwa zipangizo zofala zowonetsera:
- Barium X-rays ndi mayesero omwe amagwiritsidwa ntchito kawirikawiri kuti azindikire vuto lachilendo. Amatchedwanso kuti Barium swallow, imafuna kuti mumwe madzi otentha omwe amavala makoma a mimba ndi m'mimba mwanu. Izi zimathandiza bwino kusiyanitsa ziwalo pa X-ray.
- Kumapeto kwapopopi kawirikawiri kumasungidwa kwa anthu omwe ali ndi zizindikiro zoopsa, zomwe zimakhalapo nthawi zonse kapena pena-esophageal hernias zomwe zasanduka chizindikiro. Zimaphatikizapo kulowetsedwa kwa mpweya wokhotakhota, wokhazikika pamtima pako kuti muwone mimba, mimba, ndi duodenum.
- Manometer (High-resolution manometry) (HRM) ndi makina atsopano omwe amagwiritsidwa ntchito poyeza kuyimitsa kwagwiritsidwe kake kamene mumayima. Izi zikhoza kuwonetsa dokotala wanu kuzindikira momwe kumeza kwanu kwakukulu ndi LES zakhala zovuta.
Kuyezetsa magazi kumachitanso kuti muyambe kuchepetsa kuchepa kwa magazi m'thupi komanso matenda ena. Kuyeza kwa pH kungagwiritsidwenso ntchito kupima acidity m'mimba.
Chithandizo
Zizindikiro zambiri za nthendayi zowonongeka zimatha kuchiritsidwa moyenera ndi mankhwala a OTC, kusintha kwa moyo, ndi njira zodzikonda. Kuchita opaleshoni sikofunika kwambiri ndipo kumaganiziridwa ndi milandu yoopsa kwambiri.
Mankhwala
Mankhwala OTC omwe amagwiritsidwa ntchito pochizira zizindikiro za reflux ndi awa:
- Antacids kuti asamalitse mimba, monga Tums, Rolaids, ndi Gaviscon
- H2 zopatsa mavitamini omwe amachepetsa zobala m'mimba, monga Tagamet (cimetidine) ndi Zantac (ranitidine)
- Proton pump inhibitors (PPIs) , omwe ali amphamvu kuposa H-blockers ndipo amaphatikizapo Prevacid (lansoprazole) ndi Prilosec (omeprazole)
Matembenuzidwe amphamvu a H2 blockers ndi PPIs amapezeka mwa mankhwala.
Kusintha kwa Moyo
Kusintha kwa moyo ndizo zizoloŵezi zosintha zomwe zingachepetse kuchuluka kwa zizindikiro, kuphatikizapo:
- Kuyambitsa zofunikira zoyenera kuwonongeka ndi kuchita zolimbitsa thupi
- Kudya zakudya zochepa kwambiri, zomwe zimakhala zochepa kwambiri, zomwe sizingowonjezereka kukumba koma zingathandize kuchepetsa kudzimbidwa kosatha
- Kumwa madzi osachepera asanu ndi atatu pa tsiku, zomwe zingalepheretse kuchepa kwa madzi ndi kuchepetsa zidulo zam'mimba
- Kupewa mowa ndi caffeine, zomwe zimalimbikitsa kukomoka
- Kusiya ndudu; kusuta kumafooketsa LES
Opaleshoni
Kuchita opaleshoni kungaganizidwe pamene chotupa chapasophageal chimayamba kuyambitsa m'mimba zizindikiro. Pochiza matendawa posachedwa, pamene malo otha msinkhu akadakali ang'onoang'ono, akhoza kuchepetsa kwambiri chiopsezo chokumana ndi vutoli pambuyo pa opaleshoni. Zizindikiro zapirinophageal hernias nthawi zambiri zimakhala zowonjezereka.
Kuchita opaleshoni ya feteleza ya chiberekero kumachitika kawirikawiri pamagulu a anesthesia omwe ali odwala kapena odwala matenda opatsirana. Ma opaleshoni ambiri amachitidwa opaleshoni (yotchedwanso "keyhole").
Njira imodzi yopangira opaleshoni, yomwe imatchedwa Nissen fundoplication, imagwira ntchito poika mbali yakumtunda ya m'mimba (yotchedwa fundus) kuzungulira m'munsi mwake komanso kuigwedeza kapena kuigwedeza. Izi zimalimbitsa kachilombo kochepa kwambiri kamene imapangitsa kuti thupi liziyenda bwino.
Kulimbana
Powonjezereka monga zizindikilo za nthenda yotsekemera ikhonza kukhala, pali njira zothetsera kupweteka kwa mtima ndi kudzimbidwa kotero kuti nthawi zonse musamafikire antacids. Kuwonjezera pa kudya bwino ndikusiya ndudu, palinso zina zomwe zingakuthandizeni kuti mupirire ngati mukudwala zizindikiro za reflux:
- Khalani pansi pampando wanu pamene mukudya kumalola kuti zakudya zizipita bwino pakati pa mimba ndi m'mimba.
- Kuwombera pang'ono ndi kusaka nthawi kumapangitsa kuti chimbudzi chikhale chosavuta pochepetsa kuchepa kwa mimba ya asidi.
- Kupewa kudya maola atatu asanayambe kugona kumatsimikizira kuti chakudyacho chafotedwa ndipo sichikhoza kukanika.
- Kukwezera mutu wa bedi lanu ndi mainchesi anai mpaka asanu ndi atatu kungachepetse mwayi wokhala wosakanizika pamene mukugona.
- Kupewa mikanda yolimba ndi zovala kumachepetsa kukakamiza pa khoma la m'mimba, kumapangitsa kumeza mosavuta pochepetsa chiopsezo cha reflux ya asidi.
Mawu Ochokera
Matenda ambiri omwe amatha kubereka samasowa chithandizo chamankhwala kapena kuyang'anira. Ngati mumakhala ndi zizindikiro, muyenera kupeza njira, kupatula mankhwala, kuti muthandizidwe. Palibe milandu iwiri yofanana, ndipo zomwe zingagwire ntchito kwa wina sizingagwire ntchito kwa inu.
Ganizirani za momwe moyo umasinthira womwe ukuyenera kudziwa, kuphatikizapo kudya bwino, kuchita masewera olimbitsa thupi, ndi kulemera. Ngati muli ndi vuto lofikira zolinga zanu, lankhulani ndi katswiri wokhudzana ndi zowonjezera kapena wophunzitsa munthu yemwe ali ndi matenda opatsirana pogonana komanso mavuto ena olemera.
Komabe, ngati zizindikiro zanu zikuwonjezereka kapena sakulephera kuchitapo kanthu, funsani dokotala wanu kuti atumizidwe kwa gastroenterologist .
> Zotsatira:
> Aroma, S. Kuzindikira ndi kusamalira chikhalidwe cha hiatus. BMJ. 2014; 349: g6154. DOI: 10.1136 / bmj.g6154.
> Bungwe la Amayi Am'mimba a American and Endoscopic Opaleshoni (SAGES). Malangizo Otsogolera Olamulira a Hatalia. Los Angeles, California; yakutuluka mu April 2013.