Xa iNgxaki ibuyisela
Ixesha elichasayo le- reflux disease (refractory GERD) lichaza izi gulane eziqhubeka zibonisa iimpawu ze-reflux ye-gastroesophageal nangona unyango oluqhelekileyo kunye neproton pump inhibitors (PPIs).
Izigulane ezinamava e-GERD zivame ukuwela kwelinye lamaqela amabini:
- Abo bafuna unyango olungaphezulu
- Abo banezinye izimbangela zeempawu zabo zokuzikhumbuza
Unyango olungakumbi lwe-GERD ye-Refractory
Ukunyamekela unyango olongezelelweyo alubhekiseli kwindlela yokwenza kwezi zi gulane. Enyanisweni, abo baneziphumo eziphambili kwi-anti-reflux operesheni yilabo baye baphendule kwimithi. Izigulane ezingabonakaliyo aziphenduli ngokufanayo kunye nokuchithwa kwe-reflux. Oku, kodwa, akuthethi ukuba utyando, njengengxowa-mali, ayiyi kuba lukhetho. Ugqirha uya kuhlola ingozi kunye neengxaki zokuhlinzwa ngokuchasene nezibonelelo ezinokwenzeka kwaye uxoxe ngesigulane nokuba utyando luyinto efanelekileyo.
Ezinye izigulane aziphendulanga kunye neendleko zendabuko ze-PPIs, kwaye ugqirha unokucinga ukuba ukwandisa umthamo, kunye nokuba nezigulane zihamba kabini kwimizuzu yesibini kunokuba zenzeke kanye ngosuku ngosuku.
Kubalulekile ukulawula ukuhlaziywa kwama-acids ebusuku. Ukuthatha i- block ye-H2 ngaphambi kokulala ixesha kuboniswe ukunceda ngeempawu.
Ezinye iindlela zokulawula i-reflux yasebusuku ziquka:
- Ukulala nentloko kunye namagxa aphakamileyo
- Ukulala kwicala lasekhohlo
- Ukulinda iiyure ezimbini okanye ezintathu emva kokutya ukulala
- Ukugqoka iimpahla zokulala ezihlambulukileyo
Oogqirha banokuthi banikeze nokusetyenziswa kwe-agent agent, njenge-Reglan, ngaphambi kokutya nangaphambi kokulala ngexesha lokulala ukuze kunciphise umngcipheko we-acid reflux.
Ezinye izizathu zeMpawu zeReflux
Xa isigulane singaphenduli kwiinkqubo zonyango ezichasayo, ingakumbi emva kokunyangwa kobugwenxa obuninzi, ezinye iingxaki ngaphandle kweGERD zingasondela.
Nangona i-GERD yimbangela eqhelekileyo yezimpawu ze-reflux, akusona nje isizathu. Ezinye iingxaki zokugaya ezinokubangela ukuhlaziywa zibandakanya i- hernia ne- distilers .
Iimvavanyo ugqirha angayisebenzisa ukuqinisekisa ukuxilongwa:
- Uvavanyo lwe-PH
- Endoscopy ephezulu
- I-Manophyge yase-Esophageal
Iziphumo zezi mvavanyo ziza kunceda ugqirha ukuba anqume kwisicwangciso sonyango esifanelekileyo.
I-Refractory GERD ayinqabile. Ukuba iziganeko zesigulane ziqhubeka zibonakalisa iimpawu zokuzikhumbuza nangona unyango, ugqirha kufuneka uqhagamshelane. Ukuxubusha uhlobo lweempawu eziye zenzeka, ukuvama kwazo, kunye nokugcinwa kwendlela yokuhlaziya i-reflux ekhoyo kunokuncedisa ekufumaneni isicwangciso socwangciso olufanelekileyo.
Imithombo:
> Kenneth R. DeVault MD, FACG, uDonald O. Castell MD, i-MACG > "Izikhokelo ezihlaziyiweyo zokuHlola kunye nokuPhathwa kweSifo se-Reflux ye-Gastroesophageal." i-doi: 10.1111 / j.1572-0241.2005.41247.x. Ikholeji yaseMerika yaseGastroenterology. 5 Disemba 2007.
> Ikuo Hirano, MD, 1 uJoel E. Richter, MD, "Izikhokelo zeCacG Practice Guidelines: Ukuhlolwa kwe-Reflux ye-Esophageal Reflux." i-doi: 10.1111 / j.1572-0241.2006.00936.x. Ikholeji yaseMerika yaseGastroenterology. 5 Disemba 2007.