Matenda a reflux a Gastroesophageal (GERD) amayamba chifukwa cha reflux ya m'mimba ya asidi m'mimba pamene mchere wanu wochepa umakhala wofooka kapena umabwereranso pamene suyenera. Zina zomwe zingayambitse zikhoza kuphatikizapo kunenepa kwambiri, kusuta fodya, zakudya, ndi mimba, pakati pa ena. GERD ikhoza kukhazikitsidwa chifukwa cha zochitika zosiyanasiyana, kuphatikizapo zachilengedwe zachilengedwe kapena zochitika zina.
Ngati mukumva kupweteka kwa mtima, nkofunika kuti mufunsane ndi dokotala wanu kuti mupeze chifukwa cha asidi reflux ndi kuvomereza pa dongosolo la mankhwala.
Zomwe Zimayambitsa
Pali zifukwa zingapo zomwe zingayambitse GERD. Nthawi zina zomwe zimayambitsa GERD zanu zingakhale zovuta ndikuphatikizapo zinthu zambiri.
Kusagwiritsiridwa ntchito kochepa kwa Lower Esophageal Sphincter (LES)
Kwa ambiri odwala matendawa, asidi reflux amapezeka chifukwa cha kusungulumwa kwa LES, yomwe imayambitsa kutsegula ndi kutsegula mapeto a m'mimba ndipo imakhala ngati chotchinga chotsutsana ndi zomwe zili m'mimba. Ngati ili yofooka kapena kutaya volo, LES sidzazitseketsa kwathunthu chakudya chitadutsa m'mimba mwako. Matenda a m'mimba amatha kubwerera m'mimba yanu.
Kuphimba kumayambiriro sikuli kofanana ndi kwa m'mimba ndipo sungathe kupirira ndi asidi, kotero ndi kosavulazidwa. Ndiko kusakaniza kwa asidi m'magazi omwe amachititsa zizindikiro komanso kuwonongeka kwa izo.
Nthawi zina izi zimakhala zovuta, koma zakudya zina ndi zakumwa, mankhwala osokoneza bongo, ndi zinthu zina zingafooketse LES ndi kuwononga ntchito yake.
Kunenepa kwambiri
Kukhala wochuluka kumawonjezera kupsinjika pamimba mwako, kupanga zizindikiro za GERD zovuta kwambiri. Mgwirizano weniweni pakati pa GERD ndi kunenepa kwambiri sikumvetsetsedwa bwino, koma kukhala wochuluka kwambiri kumayesedwa kuti ndizomwe zingayambitsire ndi chiwopsezo chokhazikitsa GERD.
Mankhwala
Pali mankhwala osiyanasiyana omwe angakhudze chiopsezo cha munthu wa GERD ndi kuwonjezereka kwa zizindikiro.
Mankhwala otsutsana ndi kutupa (nonsteroidal anti-inflammatory drugs (NSAIDs) amaphatikizapo aspirin , Motrin kapena Advil (ibuprofen), ndi Aleve (naproxen), ndi zotsatira za m'mimba zimakhala zachilendo pozitenga. Mankhwalawa amagwiritsidwa ntchito poyambitsa zilonda zam'mimba , ndipo amatha kupweteketsa mtima komanso kukhumudwitsa kwambiri pofooketsa kapena kupumula la LES.
Kwa anthu omwe ali ndi kachilombo ka HIV, mankhwalawa angawonjezere kuopsa kwa zizindikiro; mwa anthu omwe satero, kugwiritsa ntchito NSAID kwa nthawi yaitali kungathandizire kukulitsa GERD.
Mankhwala ena a mankhwalawa angayambitsenso zizindikiro za GERD kapena kuziipiraipira. Ndikofunika kukaonana ndi dokotala ngati mutayamba kuwona zizindikiro zilizonse panthawi ya mankhwala. Nazi ena omwe amachimwa:
- Mankhwala a calcium, omwe amagwiritsidwa ntchito pochiza magazi ndi matenda a mtima
- Anticholinergics, yogwiritsidwa ntchito mankhwala osokoneza ubongo, matenda oopsa, ndi glaucoma
- Odwala a Beta-adrenergic, omwe amagwiritsidwa ntchito pa matenda a mphumu ndi matenda obwera m'mapapo
- Tricyclic zodzitetezera monga amitriptyline, Tofranil (imipramine), ndi Pamelor (nortriptyline)
- Antihistamines, yogwiritsidwa ntchito kwa chifuwa
- Mankhwala opangira mankhwala monga codeine ndi mankhwala omwe ali ndi acetaminophen ndi hydrocodone
- Progesterone
- Quinidine, mankhwala osokoneza bongo omwe amagwiritsidwa ntchito pochiza mtima wamaganizo ndi malungo
- Zotsalira ndi benzodiazepines, monga Valium (diazepam)
- Theophylline, yomwe imagwiritsidwa ntchito pa bronchodilators ya mphumu, matenda a khate, ndi matenda ena a m'mapapo
- Diazepam, omwe amagwiritsidwa ntchito pochiza matenda
- Dopamine, yogwiritsidwa ntchito mu matenda a Parkinson
- Bisphosphonates ankagwiritsira ntchito matenda odwala matenda a m'mimba
- Maantibayotiki, monga tetracycline
- Potaziyamu zowonjezera
- Iron imathandizira
Kusuta
Kusuta fodya kapena kupuma mu utsi wothandizira kumatchedwanso kuti ndi chifukwa ndi chiwopsezo chokhazikitsa GERD. Pali njira zambiri zomwe kusuta kungayambitsire kukhumudwitsa , monga kuchepetsa kuchuluka kwa mphutsi zomwe mumabereka, kuchititsa kuti mimba yanu ipite pang'onopang'ono, ndikupanga mimba yambiri ya m'mimba.
Kusuta fodya ndi chimodzi mwa zinthu zabwino kwambiri zomwe mungachite kuti muchepetse zizindikiro zanu kapena kuchepetsa chiopsezo chanu choyamba.
Hatalia ya Hiatal
Nthenda yotsekemera imachitika pamene gawo lakumtunda kwa m'mimba mwako liri pamwamba pa chithunzithunzi, khoma la minofu lomwe limasiyanitsa mmimba kuchokera pachifuwa. Izi zimachepetsa vuto la LES, lomwe limayambitsa reflux. Nthenda yowonongeka ikhoza kuchitika mwa anthu a usinkhu uliwonse; Anthu ambiri odwala woposa 50 ali ndi zochepa.
Ntchito Yopanda Imimba
Anthu omwe ali ndi GERD akhoza kukhala ndi mitsempha yambiri m'mimba yomwe imayambitsa chakudya ndi m'mimba ya asidi kuti ichepetse pang'onopang'ono. Izi zimachititsa kuchedwa m'mimba kutulutsa zomwe zili mkati mwake, kukakamiza mkati mwake ndikuwonjezera chiopsezo cha reflux ya asidi.
Kusokonezeka kwa Motility
Mwachizolowezi chimbudzi, chakudya chimachotsedwa kudzera m'magulu opatsirana pogwiritsa ntchito zizindikiro zomveka zomwe zimatchedwa peristalsis. Ngati mukudwala motility wosalongosoka , izi zimakhala zosavomerezeka. Izi sizingatheke chifukwa cha chimodzi mwa zifukwa ziwiri: vuto mkati mwa minofu yokha, kapena vuto la mitsempha kapena mahomoni omwe amachititsa kuti mitsempha iwonongeke. Mavuto omwe amapezeka m'magawo amodzi ndi omwe amapezeka mu GERD, ngakhale kuti sizikuwoneka ngati zochitika zoterozo ndizo chifukwa kapena zotsatira za nthawi yaitali za GERD.
Mimba
Kuwonjezereka kwa mahomoni estrogen ndi progesterone panthawi yomwe mimba imatulutsa, kuphatikizapo mimba yanu ikukula kwambiri. Chifukwa cha izi, ndizokwanira kwa amayi apakati kuti ayambe kupuma, zomwe zingayambitse ku GERD.
Phumu
Anthu oposa 75 peresenti ya anthu omwe ali ndi mphumu amakhulupirira kuti ali ndi GERD. Palibe amene amadziwa ngati mphumu imayambitsa GERD, kapena ngati ili njira yina. Pali zifukwa zingapo zomwe zikhalidwe ziwiri zimagwirizanirana. Choyamba ndikuti kukanganitsa komwe kumayendera matenda a mphumu kungachititse kusintha kwa chifuwa, zomwe zingayambitse reflux. Ndiye palinso kuti mankhwala ena a mphumu amayendetsa mlengalenga, amasangalala ndi LES ndipo amatsogolera ku reflux. Matenda onsewa amaipitsa zizindikirozo, koma kuchiza GERD nthawi zambiri kumathandiza zizindikiro za mphumu.
Zakudya
Pali mtsutso wokhazikika wakuti zakudya zina zingayambitse kupweteka. Ngati simukutha kupsinjika mtima, chakudya nthawi zambiri sichikugwirizana ndi kuukira. Koma ngati muli ndi izi mobwerezabwereza, mungaone kuti zakudya zina zimawoneka ngati zikukuyenderani. Mitundu ina ya zakudya zimayambitsa kupanga acid koma ena amasangalala ndi LES.
Chakudya Chimene Chimasangalatsa Lower Esophageal Sphincter
Kawirikawiri, a LES amatsekera mwamphamvu kuti asunge chakudya ndi m'mimba mwa asidi m'mimba mwako. Ngati izo zibwereranso pamene siziyenera, chakudya ndi m'mimba ya asidi imabwereranso kumalo anu ndipo mukhoza kukhumudwa mtima.
Zotsatirazi ndi zitsanzo za zakudya zomwe zingathetsere LES:
- Zakudya zokazinga (mafuta)
- Zakudya zamtengo wapatali
- Butter ndi margarine
- Mayonesi
- Masizi obiriwira
- Saladi kuvala
- Mkaka wonse wa mkaka
- Chokoleti
- Peppermint
- Zakumwa zofiira monga zakumwa zofewa, khofi, tiyi, ndi kaka
Zakudya Zomwe Zimapangitsa Kujambula Kwake
Kutentha kwapakhosi kungabwerekenso pamene mimba yanu imapanga asidi ochulukirapo, omwe amapita kumalo anu. Zakudya zomwe zingayambitse kupanga acid ndi kuonjezera kupweteka kwa mtima ndi:
- Zakumwa za khofi
- Zakumwa zakumwa
- Mowa
- Zakudya zokometsera
- Tsabola wakuda
- Zipatso za cititrus ndi timadziti ngati lalanje kapena mphesa
- Madzi a phwetekere
Mchere
Kafukufuku wasonyeza kuti zakudya zomwe zili ndi sodium zingapangitse asidi reflux omwe angapangitse GERD. Komabe, kwa anthu abwinobwino, zakudya zamchere zamchere sizikuwoneka kuti zikuwonjezera asidi reflux. Maphunziro ambiri amafunika kuchitidwa, koma osachepera, mchere ukhoza kukhala kupweteka kwa mtima kwa anthu ena. Njira yokhayo yodziwira zenizeni ndiyo kuyesa kuchepetsa kuyamwa kwa mchere kuti muone ngati zimapangitsa kusiyana.
Genetics
Kafukufuku wambiri wasonyeza kuti pali chiwerengero cha majini m'zochitika zambiri za GERD, zomwe nthawi zina zimakhala chifukwa cha mavuto obadwa nawo omwe amatha kukhala nawo m'mimba kapena m'mimba. Kafukufuku wina anapeza kuti kusiyana kwa DNA komwe kunatchedwa GNB3 C825T kunalipo mu phunziro lililonse la OGER, koma silinalipo mu gulu lolamulira lomwe linalibe GERD.
Zinthu zamtunduwu zimawonekeranso kuti zimathandiza kwambiri kuti wodwalayo awonetsere vuto la Barrett, chomwe chimayambitsa matenda a gastroesophageal reflux . Kafukufuku wina anapeza kuti matenda a GERD, a Barrett, ndi khansa yodzimitsa thupi ali ndi chibadwa chofunika kwambiri.
Asayansi amakhulupirira kuti kukula kwa GERD kumatenga mitundu yosiyanasiyana ya maumuna ndi zachilengedwe, komanso kusankha zochita pa moyo. Chifukwa chakuti kholo lanu kapena mbale wanu ali ndi GERD sichikutanthauza kuti mungatero, ngakhale kuti chiopsezo chanu chikuwonjezeka. Kafufuzidwe kafukufuku amafunika kuchitidwa pa chigawo cha jini kuti matenda ndi matenda a GERD athe kukhala ogwira mtima kwambiri.
Zinthu Zowopsa M'moyo
Ambiri achikulire amamva kupweteka ndi wina aliyense pa msinkhu uliwonse akhoza kuyamba GERD. Nazi zina zomwe zingapangitse chiopsezo chanu.
Scleroderma
Matendawa, omwe chitetezo cha mthupi chitetezera maselo wathanzi m'thupi, chimayambitsa chiopsezo cha GERD. Anthu ambiri omwe ali ndi vutoli amakhalanso ndi GERD chifukwa chotheka ndilo gulu lomwe limakhudzidwa kwambiri ndi scleroderma.
Phumu ndi COPD
Apanso, akatswiri sadziwa kuti nkhuku kapena dzira ndi chiyani pa nkhani ya mphumu ndi GERD, koma ambiri amavomereza kuti pali kugwirizana kofunikira. Kuphatikiza pa zodandaula zomwe tatchulazi, GERD yakhala ikukumana ndi mavuto ena amtundu wapamwamba wa kupuma ndipo ikhoza kukhala chifukwa cha mphumu yomwe imayambira mu munthu wamkulu, osati zotsatira.
Matenda owopsa olepheretsa matendawa (COPD) amakuchititsanso kuti mukhale ndi chiopsezo chachikulu chokhala ndi HIV, ndipo kukhala ndi GERD kungapangitse zizindikiro za COPD kukhala zovuta kwambiri.
Matenda a shuga
Anthu omwe ali ndi shuga, makamaka mtundu wa shuga 1 , amakhala ndi matenda otchedwa gastroparesis . Matendawa amadziwika ndi kuchedwa kwa mimba. Kupsyinjika m'mimba kungakulire, komwe kumabweretsa chisokonezo, kukuthandizani kuti mukhale ndi GERD.
Matenda a Celiac
Anthu omwe ali ndi matendawa akuoneka kuti ali ndi chiŵerengero chachikulu cha GERD kusiyana ndi anthu ambiri, makamaka ngati atangophunzira kumene. Kafukufuku wasonyeza kuti zakudya zopanda thanzi zimachepetsa kwambiri zizindikiro za GERD. Akatswiri sadziwa ngati kusuta kwa gluteni kumayambitsa GERD kapena ngati GERD ndi chikhalidwe chogwirizana cha matenda a celiac. Nthawi zina GERD samachitika mpaka munthu atapezeka kuti ali ndi matenda a celiac, omwe amasonyeza kuti pangakhale chinthu china chimene chimayambitsa.
Zochitika Zowopsa Kwamoyo
Pali zinthu zina zomwe zimayambitsa chiopsezo chokhudzana ndi kukula kwa GERD. Izi zikhoza kukhala zomwe mungasinthe kapena kuziletsa.
Kunenepa kwambiri / kunenepa kwambiri
Kumbukirani kuti kunenepa kwambiri ndi chifukwa ndi chiopsezo chokhazikitsa GERD. Kulemera kolemera pamimba mwako, makamaka, kumakuika pangozi yayikulu yowonjezera GERD ndipo imayanjana ndi mavuto monga Barrett's epopus ndi kansa ya m'mimba. Kuchita zomwe mungathe kuti mukhalebe wathanzi wathanzi kungapite patsogolo kuti muyese kuyera.
Kusuta
Monga kunenepa kwambiri, kusuta ndi chinthu choyambitsa ndi chiwopsezo chokhazikitsa GERD. Ngati mumasuta, chiopsezo cha GERD ndi chifukwa china chabwino chosiya.
Kudya Zitsanzo
Kudya zakudya zazikulu nthawi imodzi, makamaka ngati mutagona pansi pambuyo pake, ndikudya musanayambe kugona zonse zimapangitsa kuti mukhale ndi mwayi wokhala ndi asidi reflux, omwe angapangitse GERD. Yesani kudya zakudya zing'onozing'ono, nthawi zambiri komanso musadye maola angapo musanagone.
Mankhwala Othandizira Amadzimadzi Otchedwa Hormone
Azimayi amene ali pa mankhwala othandizira ena amatha kukhala ndi GERD. Ngati mutakhala pafupipafupi komanso kuti mlingo wa estrogen ukhale wapamwamba, umakhala woopsa kwambiri.
> Zotsatira:
> Kahrilas PJ. Pathophysiology ya Reflux Esophagitis. Zaposachedwa. Kusinthidwa pa March 6, 2018.
> Chitukuko cha National Diabetes ndi Matenda a Kumimba ndi Impso. Kudya, Zakudya, & Chakudya kwa GER & GERD. Lofalitsidwa November 2014.
> Chitukuko cha National Diabetes ndi Matenda a Kumimba ndi Impso. Zizindikiro ndi Zifukwa za GER & GERD. Lofalitsidwa November 2014.
> Chipatala cha Mayo Clinic. Matenda a Reflux a Gastroesophageal (GERD). Chipatala cha Mayo. Kusinthidwa pa March 9, 2018.
> Ping W, Xiao-Hu Z, Zi-Sheng A, et al. Kuopsa kwa Zakudya ndi Ngozi ya Reflux Esophagitis: Phunziro la Kugonjetsa Mlandu wa Gastroenterology Research and Practice. 2013; 2013: 691026. onetsani: 10.1155 / 2013/691026.