Ukwahlukana Phakathi kwama-PPI kunye ne-H2 Blockers ye-Heartburn

by USharon Gillson; Uhlolwe nguEmmy Ludwig, MD

Ukuthelekisa iiMibini eziPhambili zeMida zeGERD

Ukuba unentshukumo, mhlawumbi uyazibuza ngokumahluko phakathi kweyeza eziphambili ezisetyenziselwa ukuyiphatha: iproton pump inhibitors (PPIs) kunye ne-blockers H2. Bobabini banqanda ukukhutshwa kwegastric acid. Bahluke, nangona kunjalo, ngendlela abayenza ngayo.

Nangona ii-PPI zivale iimpompo zeprotton kwisisu, i-H2 blockers isebenza ngokuthintela i-histamine receptors kwiiseli ezivelisa i-asidi esiswini.

Funda kabanzi malunga nokwahlukana, indlela abanokukunceda ngayo ukutshaya, nokuba kutheni ugqirha wakho angancoma omnye kwenye.

Yintoni Ebangelwa Ukugubha Ukutshatyalaliswa Kwento kunye Nento Efunekayo Ukuyiphatha?

Ukuguquka komzimba kungabangelwa imeko eqhubekayo ebizwa ngokuba yi- gastroesophageal reflux (GERD) . I-GERD iyenzeka xa i-acid evela esiswini ibuyela emva. Ngokuqhelekileyo isisu esiswini kunye nezinye izinto eziqulethwe zigcinwe kwisisu (kunye nangaphandle kwesigxina) nge-valve ebizwa ngokuba yi- sphincter esezantsi (LES). Kodwa izinto ezininzi zingenza buthathaka ukuba ivelve iquka:

Ukutya ukutya okuvame ukubangela ukuguquka kwegazi , njengokutya okuyi-acidic (umzekelo, utamatisi kunye neziqhamo zase-citrus), ukutya okunesonka, okanye i-chocolate
Ukusela utywala okanye i-caffeine
Ukubhema ugwayi
Ukuba neemeko ezithile zonyango, ezifana nesifo sikashukela nesifo se-asthma
Ukuba noxinzelelo olongezelelweyo esiswini sakho (umzekelo, ukukhuluphala, ukukhulelwa, okanye izikhwepha ezincinci)

Indlela yokuphila iinguqulelo - ukuyeka ukutshaya, ukunqanda utywala kunye nokutya okubangela ukutshabalalisa, nokulahlekelwa isisindo - ngokuqhelekileyo kuyona mgca wokuqala wokunyangwa kwengqondo.

Kodwa ngamanye amayeza kuyimfuneko, kwaye yiyo apho i-PPIs kunye ne-block block ye-H2 inokunceda.

Proton Pump Inhibitors (PPIs)

Ipompo yeproton yilalulethi kwezinye iiseli zesisu. "Iipompo" i-acid kwisisu. Kuthatha ion i-potassium ion ngaphandle kwesisu kwaye iyifake esikhundleni sayo nge-acidic hydrogen ion.

Le i-hydrogen ion yinto eyenza izinto zenzeke. Ngokubeka ions i-hydrogen ngaphezulu kwisisu sakho, ipompo yenza ukuba isiqulatho sakho sesisu senzeke ngakumbi. Kodwa ngokumisa isenzo sepom (ukuyivimbela), ukuvalwa kwe-asidi kwisisu kumile.

Iproton pump inhibitors isetyenziselwa ukuphatha i-GERD, isisu kunye nezilonda zomzimba , i- esophagitis eyingozi kunye ne- Zollinger-Ellison syndrome . I-PPI ingasetyenziselwa yodwa okanye ithathwe ngokudibanisa ne-antacids. Zonke ii-PPI zifana nendlela abasebenza ngayo, kwaye akukho bungqina obubonisa ukuba omnye usebenza ngakumbi kunomnye. Nangona kunjalo, bahluke ngendlela abaphule ngayo isibindi kunye nendlela abadibana ngayo namanye amayeza. Ukongezelela, imiphumo yee-PPIs ihlala ixesha elide kunezinye kwaye ingathathwa rhoqo.

PPIs ziquka:

Aciphex (rabeprazole)
Nexium (esomeprazole)
Prevacid (lansoprazole)
I-Prilosec (omeprazole) : nayo iyafumaneka kwi-over-counter-counter njenge-Prilosec OTC
IProsioni (pantoprazole)
Umxhasi (Dexlansoprazole)

Ii-PPIs zithe zaqalisa ukulibazisa xa abasebenzi be-H2 beqala ukusebenza ngeyure. Ii-PPIs zisebenza ixesha elide: ezininzi ukuya kwiiyure ezingama-24, kwaye iziphumo zingapheli iintsuku ezi-3. I-H2 blockers, nangona kunjalo, ngokuqhelekileyo isebenza kuphela ukuya kwiiyure eziyi-12.

H2 Blockers

Iiseli zeparietal kwisinya sakho esiswini zikhuthazwa ngeendlela ezininzi zokuvelisa i-asidi.

Enye yezi zivuselelo ze-asidi i-histamine, ebopha kwi-histamine 2 receptors kwiseli yeparietal. I-H2 blockers, ngokuqinisekileyo egameni labo, vala izi ndawo ze-receptor kwaye ngoko ukunciphisa ukuveliswa kwe-acid.

H2 blockers ziquka:

I-H2 Blockers ihluke njani kwi-Proton Pump Inhibitors (PPIs)?

Nangona bobabini be-H2 kunye ne-proton pump inhibitors zombini banqanda ukukhutshwa kwe-acast gastric, kukho iindlela eziliqela apho la mayeza afani:

Indlela abasebenza ngayo: Basebenza kwiinqanaba ezahlukeneyo kwimveliso yesisu esiswini. I-block block ye-H2 (i-histamine blockers) ibhalela enye ye-stimuli yokuqala yokuvelisa i-acid. Iproton pump inhibitors ivimbela isinyathelo sokugqibela kwindlela yokufihla i-asidi esiswini. Ngamanye amazwi, i-asidi eyenziweyo (enokuncitshiswa ngenxa ye-block H2) ithintela ukufika kwisisu.

Apho basebenza khona: Bobabini la mayeza asebenza kumaseli e-parietal, ayenayo iiseli ezivelisa i-asidi kwimbombo yesisu. I-block block ye-H2 isebenza ngokuthintela i-histamine receptors kwiiseli zeparietal ukunciphisa inani le-acid eveliswayo (nangona kukho ezinye i-stimuli ukuze ezinye i-asidi ziveliswe). Iproton pump inhibitors isebenza ngokuvala izipompo zeprotton kule zisele kunye nokukhusela i-asidi ukuba ifihlwe kwisisu.
Zisebenza kakuhle njani: Iproton pump inhibitors kubangela ukunyuswa okukhulu kwe-asidi kune-blockers H2. Oku kungenxa yokuba kukho ezinye i-stimuli, ngaphezu kwe-histamine 2, eyenza umveliso we-asidi kunye ne-H2 blockers kuphela uvimbele i-histamine 2.
Kungekudala basebenza: i- H2 blockers inokuqalisa ngokukhawuleza kwezenzo, ngokuqhelekileyo isebenza ngeyure yokuthatha leyeza. Iproton pump inhibitors, ngokuphambene, inokuqalisa ukunyanzeliswa kwezenzo.
Bahlala ixesha elide kangakanani: ii- block block ze-H2 zingasebenza ngokufikelela kwiiyure ezili-12 emva kokuthatha amayeza. Iproton pump inhibitors idla ukuhlala ixesha elide. Amanye ama-PPI agcina ukufikelela kwiiyure ezingama-24, ngelixa abanye banokuba nemiphumo ehlala kwiintsuku ezintathu.
Imiphumo emibi: Ngenxa yeendlela ezahlukeneyo zokwenza, imiphumo emibi yeeklasi zimbini ziyahlukahluka, nangona zombini iintlobo zonyango zixhomekeke kakuhle. Iziphumo ezichaphazelekayo ziyahlukahluka phakathi kwamachiza athile kwicandelo ngalinye. Ngama-block block ye-H2, intloko yinto eqhelekileyo. Iproton pump inhibitors ziqhelekileyo zikhuselekileyo kodwa zidibaniswe (kwezinye iincwadi kodwa azikho konke) ngonobungozi obuncitshisiweyo bokuqhaqha . Kukho ezinye iziphumo ezichaphazelekayo, kwaye kubalulekile ukuxoxa ngale ngagqirha ngaphambi kokusebenzisa nayiphi na le mayeza.

Ziziphi ezinye ii-Blockers kunye nee-PPI ezisetyenziselwa ukunyanga?

Kukulungele ukwazi ukuba ngaphezu kokubhukuda (kunye nokuthe ngqo, i-GERD), le myeza isetyenziselwa ukuphatha i-esophagitis nokunciphisa iimpawu zesifo sezilonda zesilonda . Zingasetyenziselwa ukuphatha ezinye iingxaki zokugaya ezinokubangela isisu esiswini esiswini.

Ukukhetha Phakathi kwe-H2 Blockers kunye neProton Pump Inhibitors

Unokuzibuza ukuba kutheni ugqirha wakho angakhetha enye yale mithi kunomnye. Ekubeni iproton pump inhibitors inikezela kakhulu ukunyanzelwa kwe-asidi, ezi zifunwa rhoqo kwiimpawu ezinzima.

Isikhathi sokuqalisa isenzo sinokugqiba nokuba yiyiphi imithi ugqirha wakho uya kukuphakamisa. Ekubeni ii-blockers ze-H2 zisebenza ngokukhawuleza, zisoloko zisetyenziselwa xa umntu ephethe iimpawu zabo. Ngenxa yolu nyathelo olukhawulezayo, la mayeza angasetyenziselwa abo banesifo sengqondo esithile.

Ekubeni iproton pump inhibitors ithatha ixesha elide ukuba iqalise ukusebenza kodwa libe nefuthe elikhulu, lisetyenziswa rhoqo kulabo abaneempawu ezingapheliyo zokugubha intlungu ukuze bakwazi ukulawula iimpawu.

Ukuba usandul 'ufumene uvavanyo lweGERD, thetha nogqirha wakho malunga nesicwangciso sonyango. Ukuba awufumani ukhululo ngeenguqu zokuphila, i-week-trial trial of PPI unyango iya kucetyiswa.

Ukuba uqhubeka unempawu emva kokuba unyango lwe-PPI luyeke okanye okanye unenkxalabo evela kwi-GERD yakho (njenge-esophagitis e-serosive), ukugcinwa (ixesha elide) unyango lwe-PPI luya kukhankanywa. Ngamanye amaxesha i-H2-blocker, endaweni yePPI, isinconywa ukulungiselela unyango.

Umrhumo ochasene noMahla wokuPhukisa iMitha

Uninzi lwamachiza asetyenziselwa ukuguquka kwentliziyo lunokufumaneka njengemithi yesibini kunye neyonyango. Nangona iziyobisi zifana, amayeza amaninzi atholakala kwiqondo elinciphile (ngokuphindaphindiweyo isigxina somthamo wegciwane).

Thetha ugqirha okanye wekhemisti ngaphambi kokufaka enye yalezi kwenye. Kwakhona, uqaphele iziphumo ezichaphazelekayo ezichasene nazo. Banokunciphisa ukutyunjwa kwamanye amayeza, kuquka amanye amayeza enkathazo.

Ezinye iiNyango zokwenyuka komlilo

Ukongeza kwi-block block ye-H2 kunye ne-proton pump inhibitors, abantu abaninzi basebenzisa i- antacids ukunceda ukulawula ukutshabalalisa. Gcina ukhumbule ukuba kukho ukungafani phakathi kwamacandacids ngamnye kwaye uthethe ugqirha wakho malunga nalawa mayeza aya kuba ngcono kuwe. Ukongezelela kumachiza kunye nokuguquka kwendlela yokuphila, abanye abantu bafuna unyango olongezelelweyo, olunjengophengululo lwee-hernias zokuhlala .

Ngaphandle kweMithi yokuCoca

Ngayo yonke imishanguzo ekhoyo yokuphatha ukugquma, siyakuthi sikhohlwe ngokutshintsha kwezinto zokuphila ezinokukunceda ukuguquka . Ukuba ufuna imithi yokulawula ukukhwa kwamanzi, qiniseka ukuba ubona ukuba nayiphi na le nyathelo inokuphucula iimpawu zakho:

Yeka ukutshaya. Ukubhema i-cigarette kukukhokelela ekugqibeleni kwiindlela eziliqela.
Jonga ukutya kwakho. Yazi kakuhle ukutya okubangela ukutshabalalisa ngakumbi, kunye nokutya okunyamezelayo kubantu abanentshukumo .
Ncipha utywala. Ukusela kubenokubangela ukutshabalalisa abanye abantu.

ILizwi

Ukuba unemibuzo malunga neyeza lakho lokukhubaza, nceda uthetha nodokotela wakho. Kwakhona kubalulekile ukuthatha amayeza akho njengoko kuchaziwe, kuquka ukunamathela kwiqondo elichanekileyo kunye nexesha lokungenisa. Kanye kunye namachiza, jonga iindlela ongenza ngayo utshintsho oluthile lokuphila oluya kunciphisa ukutshabalalisa kwakho.

> Imithombo:

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> I-Scarpignato C, i-Gatta L, i-Zullo A, i-Blandizzi C. Iprotonthi esebenzayo kunye nekhuselekileyo I-proton Pump Inhibitor Therapy kwi-Acid-Related Related aids-A Paper Position Addressing Benefits and Potential Harms of Acid Suppression. BMC Medicine . Ishicilelwe kwi-intanethi 2016 uNgo-9.

> Shin JM, Kim N. > Pharmacokinetics > kunye ne-Pharmacodynamics ye-Proton Pump Inhibitors. I-Journal ye-Neurogastroenterology kunye ne-Motility . 2013; 19 (1): 25-35. i-doi: 10.5056 / jnm.2013.19.1.25.

> Zhang Y, Qing L, B B, Liu R, Zuo-Jing L. Iproton Pump Inhibitors Ukwelashwa vs H2 Receptor Antagonists Ukwelapha Ukunyuka Okuphezulu Kwamathumbu Emva kwe-Endoscopy: I-Meta-Analysis. I-World Journal yeGastroenterology . 2015. 21 (20): 6341-6351.