Iingxaki eziqhelekileyo kunye namaqhinga okwelashwa kwangoku
Inkunkuma yokubeleka ivela xa inxalenye esezantsi yesisu sakho ixhamla kwisithsaba-isisundu esahlula isifuba nesisu. Kwi-diaphragm ukuvula encinci, okubizwa ngokuba yi-hiatus, apho i-tube yakho yokutya (i-esophagus) idlulayo. Ukuba isisu sinezela ngolu hlobo, kungabangela ukutya kunye nama-acids ukuba abuyele kwi-esophagus, ebangela ukuguquka kwenhliziyo, ukunyanzelisa, kunye nentlungu.
Ngoxa i-over-the-counter (i-OTC) kunye neyeza zonyango, kuquka i-antacids kunye ne-acid-blockers, ingaphatha iimpawu ezinxulumene nesisu, ukulahlekelwa kwesisindo kunye nokutshintsha kwimizimba kuyadingeka ukunciphisa i-reflux bonke ndawonye. Ukuhlinzwa kungadinga kwiimeko ezinzima.
Iimpawu
Ingaphezulu kwesiqingatha sabantu abaxilongwa ngendlala yokubeletha abayi kuba neempawu. Kwabo benzayo, i- reflux ye-acast acid okanye i-air kwisigxina iya kuba zezizathu ezibalulekileyo. Iimpawu ziyakwazi ukuhluka ngokuphawulekayo ngohlobo lwe-hernia onalo.
I- hernia ye-hira ehambayo yindlela apho umxube we-esophagus nesisu (obizwa ngokuba yi-gastroesophageal junction) kunye nenxalenye yesisu iqhubela kwisigxobo sesifuba. I-Hernias njengaleyo ibizwa ngokuba "ukulahla" ngenxa yokuba inxalenye yesisu isenokungena kwi-cavity njengoko uginya.
Uninzi oluncinci lwe-hernias aluyi kubangela nayiphi na impawu. Ukuba kubonakala iimpawu, ziquka:
- Ukuguquka
- Ukunyanzelisa
- Ukuphindaphinda
- Ukuxhamla
- Ukucima
- Isihlunu kunye nokuhlanza
Uhlobo lwe- paraesophageal hernia luhlobo oluthile kodwa olubi kakhulu apho kuphela isisu siphumelela kwisibilini sesifuba. I-Hernias njengaleyo inokubangela ukuba ukutya kubambelele kwi-esophagus okanye kuphazamiseke, ukusika igazi.
Xa kuthethwa oko, ininzi ye-paresophageal hernias ayiyi kubangela iimpawu ukuba zincinci. Ukuba ziba zikhudlwana kwaye ziqala ukunyanzelisa i-esophagus, zingenza ukuba ukutya kubambelele phakathi kwesifuba njengoko uzama ukugwinya. Ukuba i-herniation iqhubela phambili kwi-chest cavity, inokubangela ukuba iboshwe (iboshwe) kwi-hiatus kwaye iholele ku:
- Intlungu yesifuba emva kokutya
- Ubuhlungu besisu esiswini kunye nokuhamba
- Iintlungu zesifuba ezingenakunyangwa ngama-antacids
- Unzima ukugwinya ( dysphagia )
- Ukuphefumula ( dyspnea )
- Ukungakwazi ukubetha
- Ukuqhubela phambili ukuqhubela phambili kwi-retching retreat
- Izibonda eziMnyama okanye zithela
- Ukuvuthwa kwegazi
Zonke ezi zibonakaliso zengxowankulu yokulala , imeko engakhokelela ekuphawuleni kwegazi kunye nokugulisa isisu. I-hernia eboshiweyo kufuneka ihlale ithathwa njengongxamiseko lwezonyango oludinga unyango olukhawulezileyo.
Izizathu
Isizathu somfuyo we-hiatal asihlali ngaso sonke isikhathi. Kungenzeka ukuba uzalwe nge-hiatus enkulu okanye ngokudala, ukuhlinzwa, okanye ukulimala okwenyama kuye kwancipha ubuqhetseba besisu sakho seengqungquthela.
Iimeko ezifana nalezi zinokukubeka phambili kwi-hernia yokuzala, ingakumbi ukuba unxinzelelo okanye unxinzelelo olunzulu kwiimisipha ezungeze esiswini.
Imizekelo yale nto ingabandakanya ukukhwehlela okungapheliyo, ukuphakamisa izinto ezinzima, ukuhlanza ubudlova, okanye ukuxhatshazwa ngexesha lokunyakaza.
Ukunyanyiswa kukubaluleke kakhulu. Abantu abangaphezu kwamandla amaninzi okanye abagqithiseleyo banesicinci esikhulu se-intra-esiswini, xa kuthelekiswa nezobunzima obuphilileyo. Olu xinzelelo luthintela izihlunu zengqungquthela xa zandisa indawo yokuhlala. Njengemiphumo, abantu babecingisisa ngokugqithisileyo njengengqamaniso yesigxina somzimba (BMI) enkulu kunama-30-banokuphindwa kabili ukuba babe ne-hija ye-hiatal kunezo ezine-BMI ezingaphantsi kwama-25.
Kuyafana okufanayo ngexesha lokukhulelwa, ngokuqhelekileyo kwizigaba ezilandelayo njengoko ukwandiswa kwesibeletho kunomxinzelelo kwindonga yesisu.
I-hiatal hernias inokuchaphazela abantu abangaphezu kwama-50. Nangona ukutshaya kungabangeli i-hernia, ingakwazi ukwandisa iimpawu ngokuphucula i-sphincter esezantsi (i-LES) efuna ukugcina ukutya kunye ne-asidi ngaphandle kwe-esophagus.
Ukuxilongwa
Kukho inani leemvavanyo eziqhelekileyo ezisetyenziselwa ukuxilonga i-hernia yokuzalwa . Ukhetho olulungele wena luxhomeke kakhulu kulolu hlobo kunye nobukhulu beempawu ozifumanayo.
Phakathi kwezixhobo eziqhelekileyo zokuxilonga:
- I-Barium X-rays yizona mvavanyo ezisetyenziswa rhoqo ukuxilonga i-hernia. Kwakhona kubhekiswe njengengxube ye-barium, kufuna ukuba uphuze umthamo oqhekezayo owembethe iindonga zesisu kunye nesisu. Oku kunceda ngokucacileyo ukwahlula izitho kwi-X-ray.
- I-endoscopy ephezulu isoloko igcinelwe abantu abaneempawu ezinzima, eziphindaphindiweyo okanye i-para-esophageal hernias eziye zaba zizibonakaliso. Kuquka ukungeniswa kwendawo elula, eguquguqukayo emqaleni wakho ukujonga isisu, isisu, kunye ne-duodenum.
- I-manometer (High-resolution manometer) (HRM) yindlela yobuchwepheshe obutsha esetyenziselwa ukulinganisa izithintelo zesigqirha sesigxina njengoko ugwinya. Oku kunokunika ugqirha wakho ingcaciso malunga nendlela ukugwinya kwakho kunye ne-LES ziye zaphazamiseka.
Iimvavanyo zegazi zenziwa kwakhona ukuze zihlolwe i-anemia kunye nezinye izinto ezingekho phantsi kwegazi. Uvavanyo lwe-pH lungasetyenziselwa ukulinganisa i-asidi kwisigxu.
Unyango
Uninzi lweempawu ze-hernia yokubeleka zingaphathwa ngokuzenzekelayo ngemichiza ye-OTC, ukulungiswa kwendlela yokuphila, kunye neendlela zokuzinakekela. Ukuvuthwa akunakudliwa kwaye kuyaqwalaselwa kuphela kwiimeko ezinzima kakhulu.
Mayeza
Iimvavanyo ze-OTC eziqhelekileyo ezisetyenziselwa ukunyanga iimpawu ze-reflux ziquka:
- Ii-Antacids zokunciphisa i-acid acids, njenge-Tums, i-Rolaids kunye ne-Gaviscon
- I-H2 ye-receptor blockers eyanciphisa i-acid esiswini, njengeTagamet (cimetidine) kunye ne-Zantac (ranitidine)
- Iproton pump inhibitors (PPIs) , ezinamandla kune-H-blockers kwaye zibandakanya i-Prevacid (lansoprazole) ne-Prilosec (omeprazole)
Iinguqulelo ezinamandla ze-H2 blockers kunye ne-PPIs zifumaneka ngomyalelo.
Indlela yokuphila
Iinguqulelo zendlela yokuphila zizo ezo ziphatha ezinokuguguza ezinokunciphisa ubukhulu kunye nobukhulu beempawu, eziquka:
- Ukuqala ukulahleka kwesisindo esifanelekileyo kunye nesicwangciso sokuzilolonga
- Ukutya ukutya okunamafutha aphantsi, okutya okuphezulu, okona kulula ukugaya kodwa kungakunceda ukunciphisa ukungagqirha okungapheliyo
- Ukusela okungekho ngaphantsi kweziglasi ezisibhozo zamanzi ngosuku, ezinokuthintela ukungcoliswa kwamanzi kunye nokunciphisa isisu se-acids
- Ukuphepha utywala kunye ne-caffeine, ekhuthaza ukuhlaziya
- Ukuyeka ugwayi; ukutshaya kugxotha i-LES
Ukuhlinzwa
Ukugqithwa kunokuqwalaselwa xa i-heresophageal hernia iqala ukwenza iimpawu zesisu. Ukunyanga i-hernia kusasa, ngelixa indawo yokuhlala isancinci, inokunciphisa kakhulu ingozi yokuxhatshazwa kwe-post-optic. Iimpawu ze-paraesophageal hernias zihlala ziqhubeka zihamba phambili.
Utyando lwe-hiatal ukuhlinzwa ngokuqhelekileyo lwenziwa phantsi kwe-anesthesia jikelele malunga nesifo sengqondo okanye isiguli. Uninzi lwabonyango luqhutyelwa i- laparoscopically (eyaziwa nangokuthi "utyando").
Enye indlela yokuhlinzwa, eyaziwa ngokuthi yi-Nissen fundoplication, yenziwa ngokufaka isiqwenga esisentla sesisu (esibizwa ngokuba yi-fundus) ngeenxa zonke kwisigxina esisezantsi kwaye mhlawumbi ukuyibeka okanye ukuyibeka. Oku kuyomeleza i-sphincter esezantsi kwaye, ngokwenza njalo, kunciphisa umngcipheko wokuhlaziya.
Ukujamelana
Njengoko kunzima njengoko iimpawu zengxowankulu yokubeleka ingaba, kukho iindlela zokulawula ukuguquka kwenhliziyo kunye nokunyanzeliswa ukuze ungahlali ufikelele kwi-antacids. Ngaphandle kokuba ungadli kakuhle kwaye uyeke u-cigarettes, kukho nezinye iindlela ezinokukunceda ukuba uphumelele xa ufumana iimpawu ezingenasiphelo ze-reflux:
- Ukuhlala ngokuqondile esihlalweni sakho xa udla kukuvumela ukutya kudlule kakuhle phakathi kwesisu kunye nesisu.
- Ukuthatha amancinci amancinci nokutshiza ixesha elide kunokukwenza ukuba ukugaya kukulula ngokunciphisa isidingo se-asidi esiswini.
- Ukuphepha ukutya ukutya kweeyure ezintathu ngaphambi kokuba ulele ixesha lokulala kuqinisekisa ukuba ukutya kuye kwagcoba kwaye ayikwazi ukuhlaziya.
- Ukuphakamisa intloko yebhedi yakho ngamasentimitha amane ukuya kwisibhozo kunokunciphisa amathuba okuhlaziya xa ulala.
- Ukuphepha iibhande kunye neengubo zokunciphisa ukunyanzeliswa kwengcambu kwindonga engenasiswini esiswini, okwenza ukugwinya kube lula xa kunciphisa umngcipheko we-acid reflux.
ILizwi
Uninzi lwama-hernias alandelayo aludingi ulawulo lwezokwelapha okanye ukujonga. Ukuba uhlakulela iimpawu, kufuneka ufumane izicwangciso, ngaphaya kweemithi zonyango, ukukunceda ukuhlangabezana nayo. Akunamacala amabini afanayo, kwaye oko kusebenza komnye umntu akunakukusebenzela.
Gxininisa kwiinguqu zokuphila owaziyo ukuba ufanele wenze, kuquka ukutya okungcono, ukuqhuba rhoqo, nokunciphisa umzimba. Ukuba unenkathazo yokufikelela iinjongo zakho, thetha nomxhasi wezondlo okanye umqeqeshi ozifumanayo kwi- syndrome yezilwanyana kunye nezinye iingxaki zesisindo.
Nangona kunjalo, ukuba iimpawu zakho ziba zibi okanye zingaphumeleli ukuphendula unyango olulondolozayo, cela udokotela wakho ukuba ahanjiswe kwi- gastroenterologist .
> Imithombo:
> UmRoma, S. Ukuxilongwa kunye nokulawulwa kwe-hiatus hernia. BMJ. 2014; 349: g6154. INGXELO: 10.1136 / bmj.g6154.
> I-Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Izikhokelo zoLawulo lweHernia yeHatalatal. ELos Angeles, eCalifornia; ukukhupha ngo-Ephreli 2013.