Uluhlobo lweGERD olungabonakali bungozi obungabonakaliyo kwi-Esophagus
Isifo se-reflux se-Gastroesophageal (GERD) senzeke xa i-sphincter esezantsi engezantsi (LES) ingasondeli kakuhle, ngoko isisu sesisu siphumelele, okanye siphumelele, kwisigxina.
Kwezinye izigulane, i-GERD ingabangela isophagitis eerosi , imeko edala ukuvuvukala, i-erosions, kunye nezilonda ukwenza ifom. I-esophagitis ebonakalayo ingabonwa nge-endoscope-isitya esinokukhanya kunye nekhamera evumela ukuba ugqirha abone ngeso lengqondo inkqubo yomntu yokugaya.
Kodwa abantu abaninzi banayo into ebizwa ngokuba yi-reflux disease, okanye i-NERD. Nge-NERD, abantu bafumana iimpawu ze-GERD ezibangelwa yi-acid reflux, kodwa abanalo ukulimala okubonakalayo kokuzibulala.
Unyango lwe-NERD ufana neleyo ye-GERD. Ngokuxhomekeka kobunzima beempawu, unyango lunokubandakanya enye okanye ngaphezulu kwezi zilandelayo: utshintsho lwezinto zokuphila, imichiza, okanye utyando.
Indlela yokuphila iinguqu zokuphatha iNERD
Ngokutsho kwe-American College ye-Gastroenterology, imikhuba yokuphila iyingxenye yokulawula i-acid reflux.
- Ukulahlekelwa kwesisindo: Ukuba ukhuluphele okanye ukhuluphele (oko kuthetha ukuba isalathisi somzimba esiphezulu kunama-25), okanye ukuba usandul 'ukuva, ukulahleka kwesisindo kunconywa kakhulu. Inzululwazi emva kwalokhu ukuba isisindo esongezelelekileyo esinqeni sakho sinokunyusa uxinzelelo lwesisu, esinokuyichukumisa isisu esiswini.
- Ukuphakamisa intloko yebhedi yakho , ingakumbi ukuba iimpawu zakho ze reflux zibi kakhulu ebusuku kunye / okanye ukuvusa ebusuku, kuphakanyisiwe.
- Ukuyeka ukutshaya nokusela utywala kunokuba luncedo, nangona lo tshintsho aluzange luqinisekiswe ngokuqinisekileyo kwizifundo zesayensi ukuze luncede ngeempawu ze-GERD. Sekunjalo, oogqirha abaninzi baya kuncomela ngomntu ngamnye.
- Ukuphelisa ukutya ezithile kunokunceda ekulawuleni iimpawu ze-aclu reflux, ngakumbi i-tsholatshi, i-caffeine, ukutya okunesonka, i-citrus kunye ne-carbonated drinks. Olu tshintsho lunokubaluleka ngakumbi kubantu abaqaphela ukuxhuma phakathi kweempawu zabo kunye nokutya okanye okunye okuthe ngqo.
- Ukutya ukutya okuncinci (njengokuba ukutya okukhulu kunokunyusa uxinzelelo oluphezulu malunga ne-sphincter esophageal) kwaye ukuphepha ukutya ukutya okungenani ezimbini ukuya kwiiyure ezintathu ngaphambi kokuba ulale okanye uhlale unokuba luncedo.
Amachiza okuphatha i-NERD
Ugqirha wakho unokuncoma amaninzi angama-antacids, asebenzayo ngokunciphisa i-asidi esiswini, okanye amayeza ayeka ukuveliswa kwe-asidi.
- I-Antacids , njenge- Maalox , i- Mylanta , i- Tums , kunye ne- Rolaids ziqhelekileyo izidakamizwa zokuqala ezicetyiswayo ekunciphiseni ukuguquka kwenhliziyo kunye nezinye iimpawu ze-GERD ezintle. Iimveliso ezininzi kwiimarike zisebenzisa iintlobo ezahlukeneyo zetyuti-i-magnesium, i-calcium, kunye ne-aluminium-ne-hydroxide okanye i-bicarbonate ions ukuze ungagcini i-asidi esiswini sakho. Ukuphazamiseka kukuba i-antacids ineempembelelo ezithile. Ityuwa ye-Magnesium ingakhokelela kwisifo sohudo, kwaye i-aluminium isaliti inokubangela ukutyunjwa. I-aluminium kunye ne-salesi ye-magnesium zihlala zidibaniswa kwimveliso enye ukulinganisa le miphumo.
- I-H2 blockers , njengeTagamet , i- Pepcid , i-Axid, ne- Zantac , i-impede acid production. Zifumaneka kumagunya omyalelo kunye ne-counter-counter-counter. Ezi zonyango zibonelela ngoncedo lwexesha elifutshane, kodwa i-block block H2 ayifanele isetyenziswe ngaphezu kweeveki ezimbalwa ngexesha ngaphandle kokukhokelwa ngokufanelekileyo kogqirha.
- Iproton pump inhibitors ziquka iProlosec , Prevacid, Protonix , Aciphex, kunye neNexium , ezifumaneka ngokusemthethweni. I-Prilosec ifumaneka kwifom ye-over-the-counter (Prilosec OTC). Iproton pump inhibitors (PPIs) yiqela lemithi ekhusela ukukhutshwa kwe-asidi esiswini nasemathumbu. Iproton pump inhibitors ayifanele isetyenziselwe ngaphezu kweeveki ezimbalwa ngexesha ngaphandle kokukhokelwa kugqirha.
Ugqirha wokuphatha i-NERD
Ngokutsho kwe-American College of Gastroenterology, ukhetho lokuzikhethela abantu abane-GERD lubandakanya i-laparoscopic fundoplication okanye utyando lwe-bariatric kumntu ogqithiseleyo.
Kwi-laparoscopic fundoplication, ummandla ophezulu wesisu uhlanganiswe ngaphantsi kwengxenyana engaphantsi kwesigxina.
Isigqibo sokuqhutyelwa kokuhlinzwa siyinkimbinkimbi kwaye sidinga iingxoxo ezicingayo phakathi komntu kunye noogqirha bakhe.
> Imithombo:
> Hershcovici T, Fass R. Izifo ezingenayo i-Reflux Disease (NERD) - Isibuyekezo. J Neurogastroenterol Motil. NgoJan 2010; 16 (1): 8-21.
> Katz PO, Gerson LB, Vela MF. Izikhokelo zokuxilongwa kunye nokulawulwa kwesifo se-reflux yesifo se-gastroesophageal. U-J Gastroenterol 2013; 108: 308-28.
> Kahrilas PJ. (Matshi 2016). Ulawulo lwezokwelapha lwe-reflux ye-gastroesophageal kubantu abadala. Ku: UpToDate, Talley NJ (Ed), UpToDate, Waltham, MA.
> Sigterman KE, van Pinxteren B, Bonis PA, Lau J, Numans ME. Ukunyangwa kwexesha elifutshane kunye neproton pump inhibitors, abaphili be-H2-receptor kunye neprokinetics kwiimpawu ze-reflux ezifana ne-gastro-oesophageal-disease kunye ne-endoscopy-negative negative reflux. I-Cochrane Database Syst Rev. 2013 Meyi 31; (5): CD002095.