Ka Maʻi Hoʻi O Ka ʻōpū A Me Ka ʻāʻī (Gerd)

Hoʻokumu ʻia ka acid reflux i ka wā e hoʻomaha ai ka ʻiʻo sphincter ma ka hopena haʻahaʻa o ka esophagus i ka manawa kūpono ʻole, e ʻae ana i ka waikawa o ka ʻōpū e hoʻi i loko o ka esophagus. Hiki i kēia ke hoʻoulu i ka puʻuwai a me nā hōʻailona ʻē aʻe. Hiki i ka reflux pinepine a mau loa ke alakaʻi i ka GERD.

ʻO ka maʻi gastroesophageal reflux he kūlana ia kahi e kahe hou ai ka waikawa o ka ʻōpū i loko o ka paipa e hoʻohui ana i ka waha a me ka ʻōpū, i kapa ʻia ʻo ka esophagus. Ua kapa pinepine ʻia ʻo GERD no ka pōkole. ʻO kēia backwash i ʻike ʻia ʻo ka acid reflux, a hiki ke hoʻonāukiuki i ka papa o ka esophagus.

He nui nā kānaka e ʻike i ka acid reflux i kēia manawa a me kēlā manawa. Eia naʻe, i ka wā e hana hou ai ka acid reflux ma luna o ka manawa, hiki ke hoʻoulu i ka GERD.

Hiki i ka hapa nui o nā kānaka ke hoʻokele i ka ʻoluʻolu ʻole o ka GERD me nā loli o ke ola a me nā lāʻau lapaʻau. A ʻoiai he mea maʻamau ʻole ia, pono paha kekahi poʻe i ka ʻoki kino e kōkua i nā hōʻailona.

Nā hōʻailona maʻamau o ka GERD e komo pū ai:

• Kahi ʻāʻā ma ka umauma, i kapa pinepine ʻia ʻo ka puʻuwai ʻāʻā. Hoʻomaka pinepine ka puʻuwai ʻāʻā ma hope o ka ʻai ʻana a ʻoi aku paha ka ʻino i ka pō a i ʻole ke moe ʻana.
• Ke kāʻili ʻana o ka meaʻai a i ʻole ka wai ʻawaʻawa i loko o ka puʻu.
• ʻEha o ka ʻōpū luna a i ʻole ka umauma.
• Pilikia i ka ʻai ʻana, i kapa ʻia ʻo dysphagia.
• Manaʻo o kahi ʻāpana i loko o ka puʻu.

Inā loaʻa iā ʻoe ka acid reflux i ka pō, hiki iā ʻoe ke ʻike pū:

• Kahi hū mau.
• Ka mumū ʻana o nā kaula leo, i ʻike ʻia ʻo laryngitis.
• Asthma hou a i ʻole ka ʻino.

E ʻimi koke i ka kōkua lapaʻau inā loaʻa iā ʻoe ka ʻeha umauma, ʻoi aku hoʻi inā loaʻa pū iā ʻoe ka hanu pōkole, a i ʻole ka ʻeha i ka ihu a i ka lima paha. Hiki paha kēia mau mea he mau hōʻailona o ka maʻi naʻau. E hana i kahi kūkā me kahi limahana mālama ola inā: - Loaʻa iā ʻoe nā hōʻailona GERD koʻikoʻi a pinepine paha. - Lawe ʻoe i nā lāʻau lapaʻau ʻole no ka puʻuwai ʻoi aku ma mua o ʻelua manawa i ka hebedoma.

Hoʻokumu ʻia ka GERD e ka hoʻi pinepine ʻana o ka waikawa a i ʻole ka hoʻi ʻana o ka mea ʻole i ka waikawa mai ka ʻōpū.

Ke ʻai ʻoe, e hoʻomaha kahi kāʻei poepoe o nā ʻiʻo a puni ka lalo o ka ʻōpū, i kapa ʻia ʻo ka lower esophageal sphincter, e ʻae ai i ka meaʻai a me ka wai e kahe i loko o ka ʻōpū. A laila e pani hou ka sphincter.

Inā ʻaʻole hoʻomaha ka sphincter e like me ke ʻano maʻamau a i ʻole e nāwaliwali, hiki i ka waikawa o ka ʻōpū ke kahe hou i loko o ka ʻōpū. ʻO kēia kahe mau ʻana o ka waikawa e hoʻonāukiuki i ka papa o ka ʻōpū, a pinepine e hoʻoulu ai i ka mumū.

Hoʻokumu ʻia ka hernia hiatal i ka wā e puʻupuʻu ai ka ʻāpana luna o ka ʻōpū ma o ka diaphragm i loko o ka lua o ka umauma.

ʻO nā kūlana e hiki ke hoʻonui i ka pilikia o ka GERD, ʻo ia hoʻi:

• Ka momona.
• Ka puʻupuʻu ʻana o ka piko o ka ʻōpū i luna o ka diaphragm, i ʻike ʻia he hernia hiatal.
• Ke hapai nei.
• Nā maʻi o ka pūnaewele hoʻopili, e like me ka scleroderma.
• Ka lohi ʻana o ka hoʻopau ʻana o ka ʻōpū.

ʻO nā mea e hiki ke hoʻonāukiuki i ka acid reflux:

• Ka puhipaka.
• Ka ʻai ʻana i nā ʻai nui a i ʻole ka ʻai ʻana i ka pō.
• Ka ʻai ʻana i kekahi mau meaʻai, e like me nā meaʻai momona a i ʻole nā meaʻai palai.
• Ka inu ʻana i kekahi mau mea inu, e like me ka waiʻona a i ʻole ke kope.
• Ka lawe ʻana i kekahi mau lāʻau lapaʻau, e like me ka aspirin.

Ma hope o ka manawa, ʻo ka mumū lōʻihi ma ka esophagus hiki ke kumu i:

• Ka mumū ʻana o ka ʻiʻo ma ka esophagus, i ʻike ʻia ʻo ka esophagitis. Hiki i ka waikawa o ka ʻōpū ke wāwahi i ka ʻiʻo ma ka esophagus. Hiki i kēia ke kumu i ka mumū, ka koko a i kekahi manawa i ka ʻeha hāmama, i kapa ʻia ʻo ka ulcer. Hiki i ka esophagitis ke kumu i ka ʻeha a me ka paʻakikī o ka ʻai ʻana.
• Ka hoʻoliʻiliʻi ʻana o ka esophagus, i kapa ʻia ʻo ka esophageal stricture. ʻO ka pōʻino i ka esophagus haʻahaʻa mai ka waikawa o ka ʻōpū ke kumu i ka ʻili ʻili. Hoʻoliʻiliʻi ka ʻili ʻili i ke ala o ka ʻai, e alakaʻi ana i nā pilikia me ka ʻai ʻana.
• Nā loli ma mua o ke kanesa i ka esophagus, i ʻike ʻia ʻo Barrett esophagus. Hiki i ka pōʻino mai ka waikawa ke kumu i nā loli i ka ʻili o ka esophagus haʻahaʻa. Hoʻopili ʻia kēia mau loli me ka hoʻonui ʻana o ka pilikia o ke kanesa esophagus.

I ka wā o ka endoscopy o luna, e hoʻokomo kekahi limahana ola kino i kahi pahū lahilahi, palupalu i hoʻolako ʻia me kahi kukui a me ke kāmela i lalo o ka ʻāʻī a komo i loko o ka esophagus. Hāʻawi ka kāmela liʻiliʻi i kahi hiʻohiʻona o ka esophagus, ka ʻōpū a me ka hoʻomaka ʻana o ka ʻōpū liʻiliʻi, i kapa ʻia ʻo ka duodenum.

Hiki paha i kekahi limahana ola kino ke hōʻoia i ka GERD ma muli o ka mōʻaukala o nā hōʻailona a me kahi hoʻokolohua kino.

No ka hōʻoia ʻana i kahi hōʻoia o ka GERD, a i ʻole no ka nānā ʻana i nā pilikia, hiki i kahi limahana mālama ke ʻōlelo aku:

• Ka hoʻokolohua probe waikawa (pH) ambulatory. Hoʻonoho ʻia kahi mea nānā i loko o ka esophagus e ʻike i ka wā, a no ka lōʻihi, e hoʻi hou mai ka waikawa o ka ʻōpū ma laila. Hoʻohui ka mea nānā i kahi kamepiula liʻiliʻi i komo ʻia a puni ka pūhaka a i ʻole me kahi kāʻei ma luna o ka poʻohiwi.

  Hiki paha i ka mea nānā ke lilo i kahi pahū lahilahi, palupalu, i kapa ʻia ʻo catheter, i kaula ʻia ma o ka ihu i loko o ka esophagus. A i ʻole paha he kapu i waiho ʻia i loko o ka esophagus i ka wā o ka endoscopy. E hele ka kapu i loko o ka wai ʻōpala ma hope o ʻelua lā.

• X-ray o ka ʻōnaehana digestive o luna. Lawe ʻia nā X-rays ma hope o ka inu ʻana i kahi wai chalky e uhi a hoʻopiha i ka ʻaoʻao o loko o ka ʻōnaehana digestive. ʻAe ka uhi i kekahi limahana ola kino e ʻike i kahi silhouette o ka esophagus a me ka ʻōpū. He mea pono loa kēia no nā poʻe e pilikia ana i ka ʻai ʻana.

  I kekahi manawa, hana ʻia kahi X-ray ma hope o ka ʻai ʻana i kahi pīni barium. Hiki i kēia ke kōkua i ka hōʻoia ʻana i kahi hoʻonui ʻana o ka esophagus e hoʻopilikia ana i ka ʻai ʻana.

• Manometry esophageal. Ana kēia hoʻokolohua i nā ʻoihana ʻiʻo rhythmic i loko o ka esophagus i ka wā e ʻai ai. Ana pū ka manometry esophageal i ka hoʻonohonoho ʻana a me ka ikaika i hoʻohana ʻia e nā ʻiʻo o ka esophagus. Hana pinepine ʻia kēia i nā poʻe e pilikia ana i ka ʻai ʻana.

• Esophagoscopy transnasal. Hana ʻia kēia hoʻokolohua e ʻimi i nā pōʻino i loko o ka esophagus. Hoʻokomo ʻia kahi pahū lahilahi, palupalu me kahi kāmela wikiō ma o ka ihu a hoʻoneʻe ʻia i lalo o ka ʻāʻī i loko o ka esophagus. Hoʻouna ka kāmela i nā kiʻi i kahi pale wikiō.

Endoscopy o luna. Hoʻohana ka endoscopy o luna i kahi kāmela liʻiliʻi ma ka hopena o kahi pahū palupalu e nānā pono i ka ʻōnaehana digestive o luna. Kōkua ka kāmela e hāʻawi i kahi hiʻohiʻona o loko o ka esophagus a me ka ʻōpū. Hiki paha ʻaʻole e hōʻike nā hopena hoʻokolohua i ka wā e loaʻa ai ka reflux, akā hiki i ka endoscopy ke loaʻa ka mumū o ka esophagus a i ʻole nā ​​pilikia ʻē aʻe.

Hiki ke hoʻohana ʻia ka endoscopy e hōʻiliʻili i kahi laʻana o ka ʻiʻo, i kapa ʻia ʻo ka biopsy, e hoʻokolohua ʻia no nā pilikia e like me ka Barrett esophagus. I kekahi mau hihia, inā ʻike ʻia kahi hoʻonui ʻana i loko o ka esophagus, hiki ke hoʻolōʻihi a hoʻonui ʻia i ka wā o kēia kaʻina hana. Hana ʻia kēia e hoʻomaikaʻi i ka pilikia o ka ʻai ʻana.

Ka hoʻokolohua probe waikawa (pH) ambulatory. Hoʻonoho ʻia kahi mea nānā i loko o ka esophagus e ʻike i ka wā, a no ka lōʻihi, e hoʻi hou mai ka waikawa o ka ʻōpū ma laila. Hoʻohui ka mea nānā i kahi kamepiula liʻiliʻi i komo ʻia a puni ka pūhaka a i ʻole me kahi kāʻei ma luna o ka poʻohiwi.

Hiki paha i ka mea nānā ke lilo i kahi pahū lahilahi, palupalu, i kapa ʻia ʻo catheter, i kaula ʻia ma o ka ihu i loko o ka esophagus. A i ʻole paha he kapu i waiho ʻia i loko o ka esophagus i ka wā o ka endoscopy. E hele ka kapu i loko o ka wai ʻōpala ma hope o ʻelua lā.

X-ray o ka ʻōnaehana digestive o luna. Lawe ʻia nā X-rays ma hope o ka inu ʻana i kahi wai chalky e uhi a hoʻopiha i ka ʻaoʻao o loko o ka ʻōnaehana digestive. ʻAe ka uhi i kekahi limahana ola kino e ʻike i kahi silhouette o ka esophagus a me ka ʻōpū. He mea pono loa kēia no nā poʻe e pilikia ana i ka ʻai ʻana.

I kekahi manawa, hana ʻia kahi X-ray ma hope o ka ʻai ʻana i kahi pīni barium. Hiki i kēia ke kōkua i ka hōʻoia ʻana i kahi hoʻonui ʻana o ka esophagus e hoʻopilikia ana i ka ʻai ʻana.

Hiki i ka ʻoki kino no ka GERD ke komo pū i kahi hana e hoʻoikaika ai i ka sphincter esophageal haʻahaʻa. ʻO ka hana ʻo ia ka Nissen fundoplication. I loko o kēia hana, e kāʻei ka kauka i ka piko o ka ʻōpū a puni ka esophagus haʻahaʻa. E hoʻoikaika kēia i ka sphincter esophageal haʻahaʻa, e emi ai ka hiki ke hoʻi hou mai ka waikawa i loko o ka esophagus.ʻO ka mea hana LINX he apo hoʻonui ʻia o nā pōhaku ʻume mākenēki e mālama ana i ka waikawa o ka ʻōpū mai ka hoʻi ʻana i loko o ka esophagus, akā e ʻae ana i ka ʻai e komo i loko o ka ʻōpū.He mea mālama ola ke kino e ʻōlelo paha e ho'āʻo i nā hoʻololi o ke ola a me nā lāʻau lapaʻau ʻole i ka lāʻau mua. Inā ʻaʻole ʻoe e ʻike i ka hōʻoluʻolu i loko o kekahi mau pule, hiki ke ʻōlelo ʻia ka lāʻau lapaʻau a me nā hoʻokolohua hou aku.ʻO nā koho e komo pū ana:- Nā antacid e hoʻoneʻe i ka waikawa o ka ʻōpū. Hiki i nā antacid e loaʻa ana i ka calcium carbonate, e like me Mylanta, Rolaids a me Tums, ke hāʻawi aku i ka hōʻoluʻolu koke. Akā, ʻaʻole e ho'ōla wale nā ​​antacid i kahi esophagus inflamed i hōʻino ʻia e ka waikawa o ka ʻōpū. Hiki i ka hoʻohana nui ʻana o kekahi mau antacid ke hoʻokumu i nā hopena ʻaoʻao, e like me ka diarrhea a i ʻole kekahi manawa nā pilikia o ka puʻupaʻa.- Nā lāʻau lapaʻau e ho'emi i ka hana ʻana o ka waikawa. ʻO kēia mau lāʻau lapaʻau - i ʻike ʻia ʻo nā mea pale histamine (H-2) - e komo pū ana ʻo cimetidine (Tagamet HB), famotidine (Pepcid AC) a me nizatidine (Axid). ʻAʻole hana wikiwiki nā mea pale H-2 e like me nā antacid, akā hāʻawi lākou i ka hōʻoluʻolu lōʻihi a hiki ke ho'emi i ka hana ʻana o ka waikawa mai ka ʻōpū a hiki i ka 12 mau hola. Loaʻa nā mana ikaika ma ke kauoha.- Nā lāʻau lapaʻau e pale i ka hana ʻana o ka waikawa a hoʻōla i ka esophagus. ʻO kēia mau lāʻau lapaʻau - i ʻike ʻia ʻo nā mea pale proton pump - he mau mea pale waikawa ikaika ma mua o nā mea pale H-2 a hāʻawi i ka manawa e hoʻōla ai i ka ʻiʻo esophageal i hōʻino ʻia. ʻO nā mea pale proton pump ʻole i ka lāʻau lapaʻau e komo pū ana ʻo lansoprazole (Prevacid), omeprazole (Prilosec OTC) a me esomeprazole (Nexium).Inā hoʻomaka ʻoe e lawe i kahi lāʻau lapaʻau ʻole no ka GERD, e hōʻoia e haʻi aku i kāu mea mālama ola.ʻO nā lāʻau lapaʻau ikaika no ka GERD e komo pū ana:- Nā mea pale proton pump ikaika. ʻO kēia mau mea e komo pū ana ʻo esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) a me dexlansoprazole (Dexilant).ʻOiai maʻamau ka maikaʻi o ka hoʻomanawanui, hiki i kēia mau lāʻau lapaʻau ke hoʻokumu i ka diarrhea, nā headaches, ka nausea a i ʻole, i nā hihia kakaikahi, nā pae haʻahaʻa o ka huaora B-12 a i ʻole magnesium.- Nā mea pale H-2 ikaika. ʻO kēia mau mea e komo pū ana i ka famotidine a me nizatidine ikaika. Maʻamau ka māmā a maikaʻi ka hoʻomanawanui i nā hopena ʻaoʻao mai kēia mau lāʻau lapaʻau.Nā mea pale proton pump ikaika. ʻO kēia mau mea e komo pū ana ʻo esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) a me dexlansoprazole (Dexilant).ʻOiai maʻamau ka maikaʻi o ka hoʻomanawanui, hiki i kēia mau lāʻau lapaʻau ke hoʻokumu i ka diarrhea, nā headaches, ka nausea a i ʻole, i nā hihia kakaikahi, nā pae haʻahaʻa o ka huaora B-12 a i ʻole magnesium.Hiki ke kāohi ʻia ka GERD me ka lāʻau lapaʻau. Akā inā ʻaʻole kōkua nā lāʻau lapaʻau a makemake ʻoe e pale aku i ka hoʻohana lōʻihi ʻana o ka lāʻau lapaʻau, hiki i kahi mea mālama ola ke ʻōlelo aku:- Fundoplication. E kāʻei ka kauka i ka piko o ka ʻōpū a puni ka sphincter esophageal haʻahaʻa, e hoʻopaʻa i ka ʻiʻo a pale i ka reflux. Maʻamau ka hana ʻana o ka fundoplication me kahi hana liʻiliʻi, i kapa ʻia ʻo laparoscopic. Hiki ke hapa a piha ka kāʻei ʻana o ka ʻāpana luna o ka ʻōpū, i ʻike ʻia ʻo Nissen fundoplication. ʻO ka hana hapa maʻamau ʻo ia ka Toupet fundoplication. Maʻamau ka ʻōlelo a kāu kauka i ke ʻano maikaʻi loa no ʻoe.- Mea hana LINX. Hoʻopuni ʻia kahi apo o nā pōhaku ʻume mākenēki liʻiliʻi a puni ka hui ʻana o ka ʻōpū a me ka esophagus. He ikaika lawa ka huki mākenēki ma waena o nā pōhaku e mālama i ka hui ʻana i pani ʻia i ka waikawa refluxing, akā nāwaliwali lawa e ʻae i ka ʻai e hele ma. Hiki ke hoʻokomo ʻia ka mea hana LINX me ka ʻoki kino liʻiliʻi. ʻAʻole hoʻopili nā pōhaku mākenēki i ka palekana o ka mokulele a i ʻole ka magnetic resonance imaging.- Transoral incisionless fundoplication (TIF). ʻO kēia hana hou e komo pū ana i ka hoʻopaʻa ʻana i ka sphincter esophageal haʻahaʻa ma ka hana ʻana i kahi kāʻei hapa a puni ka esophagus haʻahaʻa me ka hoʻohana ʻana i nā mea hoʻopaʻa polypropylene. Hana ʻia ka TIF ma o ka waha ma ka hoʻohana ʻana i kahi endoscope a ʻaʻole pono i ka ʻoki kino. ʻO kona mau pono e komo pū ana i ka manawa hoʻōla wikiwiki a me ka hoʻomanawanui kiʻekiʻe.Inā loaʻa iā ʻoe kahi hiatal hernia nui, ʻaʻole he koho ka TIF wale nō. Eia naʻe, hiki paha ke TIF inā hui pū ʻia me ka hoʻoponopono laparoscopic hiatal hernia.Transoral incisionless fundoplication (TIF). ʻO kēia hana hou e komo pū ana i ka hoʻopaʻa ʻana i ka sphincter esophageal haʻahaʻa ma ka hana ʻana i kahi kāʻei hapa a puni ka esophagus haʻahaʻa me ka hoʻohana ʻana i nā mea hoʻopaʻa polypropylene. Hana ʻia ka TIF ma o ka waha ma ka hoʻohana ʻana i kahi endoscope a ʻaʻole pono i ka ʻoki kino. ʻO kona mau pono e komo pū ana i ka manawa hoʻōla wikiwiki a me ka hoʻomanawanui kiʻekiʻe.Inā loaʻa iā ʻoe kahi hiatal hernia nui, ʻaʻole he koho ka TIF wale nō. Eia naʻe, hiki paha ke TIF inā hui pū ʻia me ka hoʻoponopono laparoscopic hiatal hernia.No ka mea hiki i ka momona ke lilo i mea pilikia no ka GERD, hiki i kahi mea mālama ola ke manaʻo i ka ʻoki kino kaumaha ma ke ʻano he koho no ka mālama ʻana. E kamaʻilio me kāu hui mālama ola e ʻike inā he moho ʻoe no kēia ʻano ʻoki kino.

Hiki i nā loli o ke ola e kōkua i ka hōʻemi ʻana i ka pinepine o ka reflux waikawa. E ho'āʻo e:

• E haʻalele i ka puhipaka. Hoʻemi ka puhipaka i ka hana pono ʻana o ka sphincter esophageal haʻahaʻa.
• E hoʻokiʻekiʻe i ke poʻo o kou moe. Inā loaʻa pinepine iā ʻoe ka heartburn i kou ho'āʻo ʻana e hiamoe, e kau i nā poloka lāʻau a i ʻole semento ma lalo o nā wāwae ma ka piko o kou moe. E hoʻokiʻekiʻe i ke poʻo ma 6 a 9 iniha. Inā ʻaʻole hiki iā ʻoe ke hoʻokiʻekiʻe i kou moe, hiki iā ʻoe ke hoʻokomo i kahi wedge ma waena o kāu moena a me ka pahu puna e hoʻokiʻekiʻe ai i kou kino mai ka pūhaka i luna. ʻAʻole pono ka hoʻokiʻekiʻe ʻana i kou poʻo me nā uluna keu.
• E hoʻomaka ma kou ʻaoʻao hema. I kou hele ʻana e moe, e hoʻomaka ma ka moe ʻana ma kou ʻaoʻao hema e kōkua ai i ka emi ʻana o ka reflux.
• Mai moe ma hope o ka ʻaina. E kali ma kahi o ʻekolu hola ma hope o ka ʻai ʻana ma mua o ka moe ʻana a i ʻole ka hele ʻana e moe.
• E ʻai mālie a ʻai pono. E kau i lalo i kāu ʻōmole ma hope o kēlā me kēia ʻai a lawe hou iā ia i ka wā i ʻai a ʻai ai ʻoe i kēlā ʻai.
• Mai ʻai i nā meaʻai a me nā mea inu e hoʻonāukiuki i ka reflux. ʻO nā mea hoʻonāukiuki maʻamau, ʻo ia ka waiʻona, ke kokoleka, ka caffeine, nā meaʻai momona a i ʻole ka peppermint.

Hiki ke kuhikuhi ʻia kekahi mau lāʻau lapaʻau hoʻohui a me nā koho, e like me ka ginger, chamomile a me ka slippery elm, e mālama ai i ka GERD. Eia naʻe, ʻaʻohe mea i hōʻoia ʻia e mālama i ka GERD a i ʻole e hoʻihoʻi i ka pōʻino i ka esophagus. E kamaʻilio me kahi limahana olakino inā ke noʻonoʻo nei ʻoe e lawe i nā lāʻau lapaʻau koho e mālama ai i ka GERD.