Kwabaninzi abantu, i-hiara hernias iya kubangela kuphela ukucheka kwentlungu ephakathi, ekwazi ukuphathwa ngokulula kunye ne-antacids kunye ne-acid-blockers. Ngaphandle kokuba i-hernia inkulu kakhulu, iyeza-anti-counter (i-OTC), ukulahleka kwesisindo, kunye nokutshintsha kwezinto zokutya kudla ngokwaneleyo ukuqinisekisa ukufumana uncedo. Kwiimeko ezinzima, nangona kunjalo, utyando lungafuneka ukuba ukuba i-herniation ibangela ukuphazamiseka okanye ukunciphisa igazi.
Ngokuxhomekeke kubukhulu beenkcenkceshe, ukuvula okanye i-laparoscopic ("isihluthulelo") ingasetyenziswa ukulungisa umonakalo.
IziPhulo zaseKhaya kunye nokuPhila
Iimpawu ze-hernia yokubeletha zixhomekeke ekungasebenzi kwe-sphincter esezantsi (LES), eyahlula isisu ukusuka kwiphubhu yokutya (isophagus). Ngenxa yokuba i-hernia ingakwazi ukuguqula isikhundla se-LES, isisu se-acid kunye nokutya ngezinye izihlandlo kunokuthi kungabonakali kwi-esophagus kwaye kubangele ukuvuvukala nokungahambi kakuhle.
Oku kwenzeka ngokuqhelekileyo kubantu abagqithiseleyo okanye baninzi. Ukongezelela ukubeka uxinzelelo oludlulileyo kwisisu nangasodongeni esiswini esiswini, ukukhuluphala kwamandla kukukhuthaza ukutshatyalaliswa ngokuphazamiseka kokuhamba komzimba. Ngaphezu koko, ukutya okudliwe ngokuqhelekileyo, ukutya okuninzi okunamafutha kunokwenzeka ukuba kushukumise i-asidi ukwenzela ukuba uphule amafutha angaphezulu kunye nama- carbohydrate alula .
Ukuze unqobe oku, kufuneka udibanise izizathu eziphambili ze-reflux.
Kukho utshintsho oluthile lwezinto zokuphila ezinokukunceda:
- Ukulahlekelwa kwesisindo kunciphisa uxinzelelo lwesisu olukhuthaza ukunyusa. Nangona akuyi kuba yinto yokuguqula i-hernia, inokuthi ithintele ukhula olunzima ukuba lube yindawo ephezulu kakhulu yeperesophageal hernia . Olu luhlobo olunxulumene nobungozi obuninzi bokugula kwe-reflux ye-gastroesophageal (GERD) .
- Ukutya okuncinci, ukuphakama kwe-fiber kungekhona nje ekuncedeni ekulahlekeni kwesisindo, kunokunceda ukulungelelanisa umsebenzi wezilwanyana kunye nokunciphisa ukutyunjwa okubangela ukuba uhlambuluke. Ukutya okuphezulu kusetyenziswa iindlela zokuphucula.
- I-hydration efanelekileyo, okubandakanya ukusela okungaphantsi kweesibhozo ezisibhozo zamanzi ngosuku, kunokunciphisa umngcipheko wokuqhawulwa xa kuhlanjululwa i-acid kwisisu.
- Ukugwema ukutya kunokubangela ukuphucula nantoni na ubudala okanye ubunzima bakho. Iziphumo eziqhelekileyo ziquka inyama ebomvu, ukutya okuthosiweyo, ukutya okunesonka, i-fat oil-fat based, i-citrus-based based sauces, i-citrus, iziphuzo ze-carbonate, i-caffeine, utywala kunye netyuwa . Ngokwahlukileyo, ukutya "okukhuselekileyo" okunjengokukhumba inkukhu, intlanzi, i-fat fat fat, i-grains, kunye nemifuno kunokunceda ukunyanga iimpawu ze-reflux.
- Ukuyeka u-cigarettes kuyimfuneko ukuba unzima ukukhwaza. Nangona ukutshaya kungabangeli i-hernia, kukhulula i-LES esele ibuthathaka kwaye ivumela ukutya kunye ne-asidi ukuba ihlaziye ngokulula. Yingakho ababhemayo badla ngokukhawuleza ngokukhawuleza emva kokukhanyisa okanye ukuba kutheni banako ukuhlakulela i-GERD kunokuba bangabhemi.
Mayeza
I-OTC imithi yindlela yokukhusela yokuqala yokuphatha ukuhlaselwa ngokukrakra kokutshiza kwegazi kunye ne-acid reflux. Ezi zinokukunceda ekunciphiseni iimpawu njengoko usebenza ekujonganeni nezizathu zawo, i-reflux ngokwayo, kunye nokuguqulwa oku ngasentla.
Ezi zi yobisi zibhekwa zikhuselekile ukusetyenziswa ngokukhawuleza kodwa zingabangela iingxaki ukuba zisetyenziswe ngokugqithiseleyo.
Phakathi kwamanye amayeza asetyenziswa ngokuqhelekileyo:
- I-Antacids , njenge-Tums, i-Rolaids, kunye ne-Gaviscon, isebenza ngokunciphisa i-asidi yesisu kunye nezithako ezifana ne-aluminium hydroxide kunye ne-magnesium hydroxide. Ukusetyenziswa ngokugqithiseleyo kunokukhokelela ekuqotheni (i-anti-magnesium-based antacids) kunye nehudo (i-aluminium-based antiacids).
- I-H2 receptor blockers , eyanciphisa ukuveliswa kwe-acid acids, iquka ii-OTC ezifana neePepcid (famotidine), iTagamet (cimetidine) kunye ne-Zantac (ranitidine). Imiphumo emibi ibandakanya ukugcoba, isifo sohudo, umlomo owomileyo, intloko, kunye nokukhala kwiindlebe ( tinnitus ).
- Iproton pump inhibitors (PPIs) inikezela isenzo esifanayo kwi-block block ye-H2 kodwa inamandla kwaye ishesha. Ziquka Nexium (esomeprazole), Prevacid (lansoprazole), kunye ne-Prilosec (omeprazole). Ii-PPI zisetyenziswa ngokuqhelekileyo ukuba i-block blocks ye-H2 ihluleka ukubonelela. Intloko, ukunqandwa, isifo sohudo, kunye nokunyaniseka kuyingozi.
Iinguqulelo ezinamandla ze-H2 blockers kunye ne-PPIs zifumaneka ngomyalelo.
Utyando
Utyando lwe-hernia ye-hialia luboniswa kuphela ukuba i-heresophageal hernia ibangela iimpawu ezingenakuphathwa ngamachiza okanye utshintsho lwendlela yokuphila. Oku kungenxa yokuba ukubonakala kweempawu kubonisa ukuba isisu siphumelele kwisigxina sesifuba kwaye ngoku sitshintsha indawo ye-LES. Njengoko iplasyaophageal hernia ithambekele ekuqhubekeni, kubhetele kakhulu ukuyiphatha ngaphambi kwangoko.
Ezinye zeengxaki ezinzima kakhulu, ezifana ne-volvulus (imeko apho isisu sitshintsha ngaphezu kwama-degrees angama-180) kunye nokuqhawulwa (apho ukujikeleza kwegazi kupheliswe), kuthathwa njengongxamiseko lwezonyango.
Ukuba unayo i-hernia enkulu, ukhetho lokuhlinzwa luya kuba lubekwe ngokuthe ngqo kwimeko kunye nobunzima beengxaki.
Ukuvula okanye iLaparoscopic Repair
Ingaba i-transthoracic ("evulekile") okanye i-transabdominal (laparoscopic, okanye "isihluthulelo") ingasetyenziswa ukulungisa i-hernia ephageal hernia.
- Kuvulwa ukuhlinzwa kukubandakanya ukungena emzimbeni ngokubakho, ngokuqhelekileyo kwicala lasekhohlo lomzimba. Ngokuqhelekileyo kusetyenziswa kwiimeko ezixakeka apho kukho ukuphaphazeka okukhulu okanye ukubhuka komzimba. Ingasetyenziselwa kwiimeko ezingezoxakeka, njengokuba xa isisu siswele kwisigxina sesifuba (esaziwa njengesisu sangaphakathi).
- Uphando lwe-Laparoscopic lubandakanya ukufakwa kwezixhobo zokupakisha ezininzi kwizinto ezintathu eziphambili ezibalulekileyo kwiisisu. Ngeemeko ezingezoxakeka, kuthathwa njengento esebenzayo njengophando olusisigxina kodwa ngeengxaki ezimbalwa kunye nexesha lokuphucula ngokukhawuleza.
Nissen Fundoplication
I-Nissen fundoplication yindlela yokutsha eyenziwa i-laparoscopically. Injongo yocandelo lokulungisa ukumbomboza ingxenyeni engenasiswini yesisu (ebizwa ngokuba yi-fundus) ecaleni kwendawo yesondlo kwaye ikhuselekile kwindawo kunye nezicathulo okanye izicwangciso zokuba zigcinwe ngokuthe tye kwaye zixhaswe. Ukuba kwenziwe ngokuchanekileyo, i-fundoplication ingayifumana i-LES ibe yindawo apho isebenza ngokuqhelekileyo.
I-Nissen fundoplication ithathwa njengekhuselekile kakhulu kwaye isebenzayo, kunye nengozi engaphantsi kwe-1 yemingcipheko yokufa kunye nenani eliphumelelayo lama-89.5% ngaphezu kweminyaka eyi-10. Ukukhupha, ukuhlanza, kunye nesifo esilumkileyo esiswini (IBS) ziqhelekileyo iziphumo zecala lokusebenza emva kokuba zenze isisombululo ngokwazo kwiiveki ezimbini ukuya kwezine.
I-Medicine Complementary (CAM)
Ukongeza kwii-antacids kunye ne-acid-blockers, kukho inqanaba leempawu zonyango ezinokubangela ukukhululeka okukhulu kwempawu ezinzima.
Licorice
I-Licorice, etholakala kwiingcambu zeengcorice , sele isetyenziselwa ukuphatha ukutshabalalisa kunye nezinye iimpawu zesisu. Nangona uphando luhlala luswele, ezinye izifundo zicebise ukuba zineendawo zayo kunye nemithi yemveli yokhuselo.
Uphando lwe-2013 olupapashwe kwi- Clinical and Experimental Gastroenterology luchaze ukuba ukusetyenziswa okudibeneyo kweengcambu ze-licorice kunye ne-anti-prescription-PPI (pantoprazole) kubangele iimpawu ezimbalwa zokuphunga, ukuhlunguzeka kwesifuba kunye nokuvuvuka kwesisu xa kuthelekiswa nokusebenzisa i-PPI yedwa.
I-Licorice itiye yenye yeefom eziqhelekileyo ezisetyenziswayo. Enye, eyaziwa ngokuba yi- deglycyrrhizinated licorice (DGL) , ifumaneka njengesongezelelo sesondlo kwaye inokunyamezeleka ngenxa yokususwa kwe-glycyrrhizin (into eyaziwa ngamanqanaba e-potassium aphantsi).
Ginger
I-Ginger enye into ekhethiweyo enokuncedisa ukunciphisa iimpawu zokuguquka. Ingcambu ye-Ginger icebile kuma-antioxidants kwaye iqukethe ama-phenolic compounds akholelwa ukunciphisa izithintelo zesisu kwaye, ngoko, unciphise amathuba okuhlaziya i-asidi.
Nangona kunjalo, ukuba isetyenziswe ngokweqile, i-ginger ingaba nempembelelo echaseneyo. Ucwaningo olwenziwa ngo-2014 oluvela kwiYunivesithi yaseStanford lubhengeze ukuba, ngelixa i-ginger ekhutshiwe okanye ifom powder iyakunciphisa i-spasms kunye nokuphucula umlingo wesisu, izilwanyana zansuku zonke eziphezulu ngaphezu kweesigremu ezinhlanu zingenako ukwandisa umngcipheko wokugubha intlungu kunye nesisu esiswini.
I-Ginger ingathengwa njengeeyi okanye nge powder, capsule, okanye i-formulations yamanzi.
Njengokuba kukho naziphi na iindlela ze-CAM, kukulungele ukuxoxa ngelayisensi kunye ne-ginger kunye nodokotela wakho ngaphambi kokuba uzame.
> Imithombo:
> Di Pierro, F .; Gatti, M .; kunye neRapacioli, G. "Iziphumo kwizigulane ezinezifo ezingenanjenge-reflux eziphathwe ngeproton pump inhibitor kunye ne-alginic acid ± glycyrrhetinic acid kunye ne-anthocyanosides." I- Clin Exp Exp Gastroenterol. 2013; 6: 27-33. INGXELO: 10.2147 / CEG.S42512.
> I-Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). "Izikhokelo zoLawulo lweHernia yamaHatalia." Los Angeles, eCalifornia; ukukhupha ngo-Ephreli 2013.
> Ewe, A. kunye neGolianu, B. "Ukwelashwa okuhlangeneyo kweReflux kunye neDyspepsia esebenzayo kubantwana." Abantwana (Basel). 2014; 1 (2): 119-33. INGXELO: 10.3390 / abantwana1020119.