Kutsekemera kumatha kuchitika m'njira zosiyanasiyana. Pozindikira zomwe zimayambitsa kuyambitsa kupweteka kwa mtima, mukhoza kusintha kusintha kwa moyo wanu ndi zakudya zomwe zimayambitsanso matenda a gluroesophageal reflux (GERD). Zina mwa njira zomwe zingayambitse kupweteketsa mtima zimaphatikizapo kukhumudwa mwachindunji kwa mimba, kufooketsa kwapansipophageal sphincter (LES), kusokonezeka kwa motility kwa kapangidwe ka zakudya komwe kumabweretsa kuchepetsa kupweteka kwa mimba, ndi chilakolako chokhalitsa.
Nthaŵi zambiri, zoposa chimodzi mwazifukwazi zimapangitsa kuti ziwonongeke.
Kupweteka kwa Mphungu ndi Chidodomaso
Kumvetsa kupweteka kwa mtima kumayamba ndi kudziwa momwe dongosolo labwino lakumagwirira ntchito limagwirira ntchito. Chigawo chanu cha m'mimba chimayamba ndi pakamwa panu, komwe chakudya chimafunidwa ndi kusakanizidwa ndi mpeni , kuyamba kuyambira. Kuchokera pano, chakudya chimapita kumalo osungira kapena kumayambira chubu. Thupi la minofuyi limapanga tizilombo toyambitsa matenda, kutchedwa peristalsis , kusuntha chakudya kumimba.
Mimba ndi mimba zimagwirizanitsidwa ndi gulu la minofu yotchedwa lowering esophageal sphincter (LES). Kawirikawiri, a LES amagwira ntchito ngati valve, kutsegula kuti alole chakudya kupita m'mimba ndi kutseka kusunga zakudya ndi timadzi timene timadya timene timachokera kumtunda. Koma ngati sphincter imabwereranso pamene siyeneranso, kapena imakhala yofooka, m'mimba ya asidi ikhoza kubwerera mmbuyo kupita ku chiwonongeko chomwe chimayambitsa kutentha komwe kumatchedwa kutentha kwa mtima.
Zomwe Zimayambitsa
Njira zowonjezera zomwe zingayambitse kupweteketsa mtima zingathenso kumabweretsa chitukuko cha GERD ngati kupweteka kwa mtima kwanu kumakhala kobwerezabwereza.
Kutentha kwa Esophageal
Mitundu ina ya chakudya, zakumwa, kusuta fodya, ndi mankhwala amatha kukhumudwitsa mwachindunji chidebe cha mitsempha ndi kuyambitsa kutentha. Pankhani ya mankhwala, zingakhale zosiyana kuti mukhale oyenera kwa mphindi 20 kapena 30 mutatha kumwa mankhwala, komanso kumwa mapiritsi ndi madzi onse.
Kusokonezeka kwa Lower Esophageal Sphincter (LES)
Ngati mchere wotsika thupi umakhala wofooka kapena utaya mphamvu, LES sayenera kutseka kwathunthu chakudya chitapita m'mimba. Matenda a m'mimba amatha kubwerera m'mimba. Zakudya zina ndi zakumwa zoledzeretsa, mowa, mankhwala osokoneza bongo, ndi zinthu zamanjenje zikhoza kufooketsa LES ndi kuwononga ntchito yake.
Kusokonezeka kwa Motility (Kutsika Kwambiri Kumimba)
Mwachizolowezi chimbudzi, chakudya chimachotsedwa kudzera m'magulu opatsirana pogwiritsa ntchito zizindikiro zomveka zomwe zimatchedwa peristalsis. Pamene wina ali ndi vuto la kuchepa kwa motility , maselowa ndi achilendo. Izi sizingatheke chifukwa cha chimodzi mwa zifukwa ziwiri-vuto mkati mwa minofu yokha, kapena vuto ndi mitsempha kapena mahomoni omwe amachititsa kuti mitsempha isamveke. Pa theka la anthu omwe ali ndi matenda a m'mimba a reflux (GERD) ali ndi mitsempha yambiri kapena minofu m'mimba mwawo yomwe ingawononge motility.
Pamene minofu m'mimba siimagwira ntchito bwino, mimba sichitha kulowa m'mimba mwachangu mofulumira. Kuphatikiza kwa zakudya zambiri zomwe zimasiyidwa m'mimba komanso kuwonjezeka kwa m'mimba chifukwa cha kuchepetsa kuchepetsa kutaya kumawonjezera chiopsezo cha mimba ya mimba kuti ifike m'mimba.
Hatalia ya Hiatal
Nthenda yotaya pathupi imapezeka pamene gawo lakumtunda la mmimba limakankhira mmwamba mu chifuwa kudzera mu kutsegula kwa chifuwa. Izi zikhoza kuchitika chifukwa cha kufooka kwa diagrragm kapena chifukwa cha kuwonjezeka kwa m'mimba (monga kunenepa kwambiri.) Kutsegula kotereku kumatchedwa hiatus kapena ophraseal hiatus. Amakhulupirira kuti chotupa chokhacho chikhoza kuchepa kuchepa kwa sophageal sphincter ndikupangitsa reflux, komabe maphunziro salephera kutsimikizira kuti ndizowunikira wamba wa GERD.
Kupsinjika Pamimba
Kupsyinjika kwambiri pamimba kungapangitse kuti thupi likhale lochepa kwambiri, limalola kuti asidi am'mimba alowe m'mimba kapena pakamwa.
Azimayi ndi olemera kwambiri amatha kupweteka chifukwa chaichi.
Zochitika Zochiritsira Zina
Zochitika zina zamankhwala zomwe zingapangitse WABWINO zikuphatikizapo mphumu ndi shuga .
Genetic Factors
Kafukufuku wasonyeza kuti pali chiopsezo chobadwa nacho kwa GERD. Izi zikhoza kukhala chifukwa cha mavuto obadwa mwathumodzi kapena omangika omwe ali nawo m'mimba kapena m'mimba. Zinthu zamtunduwu zingakhale zofunikira kwambiri m'maganizo a wodwala kwa bongo la Barrett , vuto lodziwika bwino lomwe limayambitsidwa ndi GERD.
Zochitika Zowopsa Kwamoyo
Anthu ena ali ndi kachibadwa kofooka omwe sangathe kulimbana ndi mavuto omwe amapezeka m'mimba. Koma zifukwa zina zingathandizenso kuti izi zifooke ndikupweteketsa zigawo.
Mowa
Mowa umatsitsimutsa la LES , zomwe zimapangitsa kuti thupi likhale lopweteka. Zimapangitsanso kukula kwa m'mimba ya asidi ndipo zimapangitsa kuti mimba yanu isamve bwino m'mimba mwa asidi. Kumwa mowa kumathandizanso kuti musamakhale ndi thanzi labwino komanso kudya zakudya zomwe mukudziwa zomwe zingayambitse kupweteka kwanu.
Kusuta fodya
Mankhwala omwe ali mu utsi wa ndudu amafooketsa LES pamene akuchoka m'mapapu kupita m'magazi. Kusuta fodya kumalepheretsa kupanga mpeni, womwe ndi umodzi mwa chitetezo cha thupi lanu kuti musamawonongeke. Osuta fodya amachititsanso mankhwala ochepa omwe amachititsa kuti asidi azikhala osakanizika m'matumbo, otchedwa bicarbonates. Komanso, kusuta kumayambitsa kupanga mimba ya asidi ndikusintha ziwalo za m'mimba mwa kulimbikitsa kuyendetsa kwa salt salt kuchokera m'mimba m'mimba. Kuwombera kumachepa pamene mukusuta ndipo mimba imatenga nthawi yaitali kuti ikhale yopanda kanthu.
Zakudya Zomwe Zimayambitsa Kutentha kwa Mtima
Anthu amasiyana chifukwa cha zakudya zomwe zimayambitsa kupsa mtima. Izi ndizofala kwambiri:
- Kafi, tiyi, ndi zakumwa zina zam'nyinayi: Caffeine ikhoza kutulutsa mpweya wotsika kwambiri wam'mimba (LES) , zomwe zimapangitsa kuti m'mimba mukhale m'mimba . Chakumwa cha khofi amatha kupangitsa kuti asidi azipanga.
- Chokokoleti: Chokoleti chiri ndi malo ochepa kwambiri a theobromine, kamodzi kamene kamapezeka mwachilengedwe mu zomera zambiri monga kakale, tiyi, ndi khofi. Izi zimatsitsimutsa mitsempha yotchedwa sophgeal sphincter muscle , yomwe imalola kuti asidi am'mimba agwire m'mimba.
- Zakudya zokazinga, zonunkhira, kapena mafuta: Zakudya izi zimachepetsa kuchepa kwa chakudya ndikusunga chakudya m'mimba mwathu. Izi zingabweretse mavuto ambiri m'mimba, zomwe zimapangitsa kuti afooka azivutika kwambiri. Zonsezi zimalola reflux ya zomwe ziri m'mimba mwako.
- Peppermint kawirikawiri imayambitsa kupweteka kwa mtima.
- Matenda a tomato ndi tomato: Zakudya zilizonse zomwe zimakhala ndi tomato zimapangitsa kuti thupi likhale ndi mimba.
- Zakudya zonunkhira ndi tsabola wakuda zimapangitsa kuti azikhala m'mimba mwa asidi.
- Zipatso zam'madzi ndi mandimu: Manyowa, mandimu, mandimu, ndi zipatso zina zimayambitsa mimba ya asidi.
Zotsatira Zakudya
Momwe inu mumadyera zingayambitsenso kuyambitsa ziwombankhanga:
- Zakudya zazikulu: Mimba yonse imatha kukanikiza kwambiri pa LES, yomwe idzawonjezera mwayi kuti zakudya zina zidzasokonekera.
- Kudya maola awiri kapena atatu asanayambe kugona: Kugona ndi mimba mokwanira kungayambitse mimba kuti imveke molimba motsutsana ndi LES. Izi zimapangitsa kuti anthu azikhala ndi zakudya zambiri.
Kupweteka kwa m'mimba
Kukhala pamalo olemera kwambiri kapena obisala kumapangitsa kuti mimba ingayambe kupweteketsa mtima, ndipo kulemera kwake kumalimbikitsidwa. Ngakhale kuvala zovala zolimba zingayambitse kupweteka m'mimba. Izi zimalimbikitsa chakudya motsutsana ndi LES ndipo zimayambitsa kuti ayambe kugwiritsidwa ntchito. Mabotolo ogwiritsira ntchito ndi zovala zopanda zovala ndi awiri omwe amachimwa. Mutha kumvanso zizindikiro zowonjezereka pamene mugona kapena muli ndi mimba.
Anthu ena amapeza mitundu ina ya masewera olimbitsa thupi. Zochita zapamwamba zomwe zimaphatikizapo kudumphira, komanso machitidwe monga kugwedeza komwe kumapangitsa kuti mimba ikhale yovuta kwambiri.
Mankhwala
Pafupifupi mankhwala aliwonse angayambitse kupweteka, koma pali mankhwala ena omwe ndi achikulire kuposa ena. Pali njira zambiri zomwe mankhwala amatha kuyambitsa kupweteka kwa thupi ndipo nthawi zina kupwetekedwa mtima kumakhala chifukwa cha zosiyana siyana. Mungathe kugwira ntchito ndi dokotala wanu kuti mupeze njira zothandizira mankhwala omwe amachepetsa zizindikiro zanu zowonongeka, kapena kusintha kwa mankhwala ena omwe sungayambe kupweteka.
Mankhwala omwe adziwika kuti amachititsa kupweteka ndi awa:
- Mankhwala osokoneza bongo, monga Valium (diazepam), sangathe kungosangalala maganizo anu, koma kuchepa kwanu kwapansi kumapanganso.
- Maantibayotiki ena, monga tetracycline, amatha kukhumudwitsa mwachindunji.
- Anticholinergics monga Compazine (prochlorperazine) ndi Phenergan (promethazine) amachititsa kuti thupi likhale lochepa kwambiri.
- Aspirin. Kwa anthu ena omwe satha kulekerera aspirin chifukwa cha kupweteka kwa mtima, aspirin yokhala ndi enteric ikhoza kusankha. Musayime aspirin musanalankhule ndi dokotala wanu.
- Mabisphosphonates monga Fosomax (alendronate), Actonel (resendronate), ndi Boniva (ibandronate) zingayambitse kupweteka mwachindunji kukhumudwitsa mimba. Ngati mankhwala anu akuyambitsa kupweteketsa mtima, pali njira zomwe mungakonzekere zomwe zimaperekedwa monga jekeseni omwe sungapangitse chizindikiro ichi.
- Njira ya calcium yomwe imayambitsa kuthamanga kwa magazi, monga Procardia (nifedipine), ndi Cardizem (diltiazem) ingachepetse kuchepa kwapopugeal sphincter komanso kuchepetsa kutaya kwa m'mimba. Mwamwayi, pali magulu osiyanasiyana omwe amapanga mankhwala, ndipo kusintha kwa gulu lina kungakhale kothandiza ngati zizindikiro zikupitirira.
- Mankhwala a mphumu monga Proventil (albuterol) ndi theophylline
- Chemotherapy mankhwala
- Corticosteroids (steroids) monga Deltasone (prednisone) ndi Medrol (methylprednisolone) ingayambitse kupweteketsa mtima komanso zinthu zina zofunika kwambiri m'mimba.
- Hormone replacement therapy (HRT), yomwe ikuphatikizapo estrogen ndi progesterone
- Mankhwala osokoneza bongo angayambitse kupweteka pochedwa kuchepetsa kutaya kwapamimba.
- NSAIDs (antisteroidal anti-inflammatory drugs) monga Advil (ibuprofen) ndi Aleve (naproxen) amatha kuwonjezera asidi m'mimba mwa kuletsa prostaglandin. Zosankha zothandizira kupweteka monga Tylenol (acetominophen) kapena mankhwala osokoneza bongo angafunikire pamene NSAIDS imayambitsa kupweteka kwa mtima kapena kupweteketsa mtima kwa matenda. Nthawi zina, kutsimikiza kuti kutenga NSAIDS kumakhala kwathunthu kungakhale kothandiza.
- Tizilombo toyambitsa matenda a Tricyclic, monga Tofranil (imipramine), Sinequan (doxepin), Norpramin (desipramine), ndi Pamelor (nortriptyline) yochepetsetsa m'mimba. Ambiri mwa atsopano odana ndi depressants sangawononge chizindikiro ichi.
- Potaziyamu ingayambitse kupweteka kwachangu mwachindunji kukhumudwitsa mimba.
- Iron imathandizira imatha kukwiyitsa m'mimba mwachindunji. Anthu ena amapeza mpumulo mwa kutenga zakudya zowonjezereka ndi chakudya kapena kuzigwiritsa ntchito kumayambiriro kwa tsiku.
- Vitamini C
> Zotsatira:
> Kutsekemera. Chipatala cha Mayo. http://www.mayoclinic.org/diseases-conditions/heartburn-gerd/basics/definition/CON-20019545?p=1.
> GERD Moyo wamakono ndi Zothetsera Pakhomo. Chipatala cha Mayo. http://www.mayoclinic.org/diseases-conditions/gerd/basics/lifestyle-home-remedies/con-20025201.
> Kodi Kukhumudwa Kwambiri Kokha Kapena Chofunika Kwambiri? Kumvetsa GERD . American College of Gastroenterology. http://s3.gi.org/patients/pdfs/UnderstandGERD.pdf.
> Zizindikiro ndi Zifukwa za GER & GERD. National Institute of Diabetes Digestive and Kidney Diseases. Chiwongola dzanja