Indwara Yo Gusubira Inyuma Kw'Ibintu Biri Mu Gifu No Mu Munwa (Gerd)

Umuvuduko w'amavunja ubaho iyo umusuli w'umuyoboro uri ku mpera y'umuyoboro w'ibiryo usinzira igihe kitari cyo, bikatuma aside y'umwijima isubira inyuma mu muyoboro w'ibiryo. Ibi bishobora gutera kubabara mu gituza n'ibindi bimenyetso. Kugira umuvuduko w'amavunja kenshi cyangwa buri gihe bishobora gutera GERD.

Indwara yo gusubira inyuma kw'amavunja mu muyoboro w'ibiryo ni uburwayi aho aside y'umwijima isubira kenshi mu muyoboro uhuza akanwa n'umwijima, witwa umuyoboro w'ibiryo. Akenshi bitwa GERD mu magambo make. Iyo aside isubira inyuma izwi nka reflux y'amavunja, kandi ishobora kubabaza uruhu rw'umuyoboro w'ibiryo.

Abantu benshi bagira umuvuduko w'amavunja rimwe na rimwe. Ariko, iyo umuvuduko w'amavunja ubaye kenshi igihe kinini, bishobora gutera GERD.

Abantu benshi bashobora guhangana n'ububabare bwa GERD binyuze mu guhindura imibereho n'imiti. Kandi nubwo bidafata, bamwe bashobora gukenera kubagwa kugira ngo bafashwe ku bimenyetso.

Ibimenyetso bisanzwe bya GERD birimo:

• Umuriro mwinshi mu gituza, akenshi bita gucana umutima. Gucana umutima bisanzwe bibaho nyuma yo kurya kandi bishobora kuba bibi nijoro cyangwa uri kuryamye.
• Ifunguro cyangwa amazi meza asubira inyuma mu muhogo.
• Kubabara mu nda yo hejuru cyangwa mu gituza.
• Kugira ikibazo cyo kwishima, bita dysphagia.
• Kumva nk'aho hari ikintu kinini mu muhogo.

Niba ufite reflux ya aside nijoro, ushobora kandi kugira:

• Inkondo idashira.
• Kubyimba kw'umuyoboro w'amajwi, bizwi nka laryngite.
• Asthme nshya cyangwa irushaho kuba mbi.

Shaka ubufasha bwa muganga ako kanya niba ufite ububabare mu gituza, cyane cyane niba ufite n'ubuhumeka buke, cyangwa ububabare mu gahanga cyangwa mu kuboko. Ibi bishobora kuba ibimenyetso by'igitero cy'umutima. Teguramo gahunda yo kubonana n'umuganga niba: -Ufite ibimenyetso bikomeye cyangwa bikunze kugaragara bya GERD. -Unywa imiti idasaba amabwiriza y'umuganga yo kurwanya ibicurane inshuro zirenze ebyiri mu cyumweru.

GERD iterwa no kugaruka kenshi kw'amavunja cyangwa ibintu bidatanga amavunja bivuye mu gifu.

Umuntu iyo anyoye, umukandara w'imitsi ukozwe nk'umuringa uri hasi y'umuyoboro w'ibiryo, witwa umuyoboro ufungura umuyoboro w'ibiryo, uruhuka kugira ngo ibiryo n'ibinyobwa bijye mu gifu. Hanyuma uwo muyoboro ugafata ukongera ugafata.

Iyo uwo muyoboro udashobora kuruhuka nk'uko bisanzwe cyangwa ukaba warahenze, amavunja yo mu gifu ashobora kugaruka mu muyoboro w'ibiryo. Uko kugaruka kenshi kw'amavunja kurakaza uruhu rw'umuyoboro w'ibiryo, bikunze gutera umuriro.

Hernia ya hiatal ibaho iyo igice cyo hejuru cy'igifu gikubita hejuru ya diafragme kijya mu kibaya cy'amabere.

Uburwayi bushobora kongera ibyago bya GERD burimo:

• Indwara y'ubunavu.
• Kubyimba kw'igice cyo hejuru cy'igifu hejuru ya diafragme, bizwi nka hernia ya hiatal.
• Gutwita.
• Indwara zifata imyanya y'umubiri, nka scleroderma.
• Igifu kidindira gushaka.

Ibintu bishobora kurushaho kuba bibi bya reflux y'amavunja birimo:

• Kuvuza itabi.
• Kurya amafunguro manini cyangwa kurya nijoro.
• Kurya ibiryo bimwe na bimwe, nka ibiryo bikozwe mu mafuta menshi cyangwa ibyashyutswe.
• Kunywa ibinyobwa bimwe na bimwe, nka inzoga cyangwa kawa.
• Gufata imiti imwe na imwe, nka aspirine.

Mu gihe kinini, kubyimbagira mu mara bikomeye bishobora gutera:

• Kubyimbagira mu mubiri w'umuyoboro w'ibiryo, bizwi nka esofagite. Asidi y'umwijima ishobora kwangiza umubiri w'umuyoboro w'ibiryo. Ibi bishobora gutera kubyimbagira, kuva amaraso, rimwe na rimwe no kuboroga kw'ibikomere, bizwi nka ulcere. Esofagite ishobora gutera ububabare no kugorana kw'ibiryo.
• Kugabanyuka kw'umuyoboro w'ibiryo, bizwi nka stenosisi y'umuyoboro w'ibiryo. Kwangirika kw'igice cyo hasi cy'umuyoboro w'ibiryo biturutse kuri aside y'umwijima bituma habaho udukoba. Udukoba tugabanya inzira y'ibiryo, bigatuma habaho ibibazo mu kurya.
• Impinduka z'indwara ya kanseri mu muyoboro w'ibiryo, bizwi nka Barrett esophagus. Kwibasirwa na aside bishobora gutera impinduka mu mubiri upfundikira igice cyo hasi cy'umuyoboro w'ibiryo. Izi mpinduka zifitanye isano n'ingaruka nyinshi z'uburwayi bwa kanseri y'umuyoboro w'ibiryo.

Mu gihe cyo gukora endoscopie y'imbere, umukozi w'ubuzima ashyiramo umuyoboro muto, woroshye ufite amatara na kamera munsi y'umunwa no mu kibuno. Kamera ntoya itanga igishushanyo cy'umuyoboro, igifu, n'intangiriro z'umwanya muto, witwa duodenum.

Umuntu wita ku buzima ashobora kubona indwara ya GERD hashingiwe ku mateka y'ibimenyetso no ku isuzuma ry'umubiri.

Kugira ngo hamenyekane neza indwara ya GERD, cyangwa ngo harebwe ingaruka, umukozi wita ku buzima ashobora kugutegeka gukora ibi bikurikira:

• Isuzuma rya pH ry'umusemburo (probe). Icyuma gipima gishyirwa mu muyoboro kugira ngo kimenye igihe, n'igihe kingana iki, aside y'igifu isubira inyuma. Icyuma gipima gikora kuri mudasobwa ntoya yambarwa ku kiuno cyangwa ku rutugu.

  Icyuma gipima gishobora kuba umuyoboro muto, woroshye, witwa catheter, ushyirwa mu mazuru ujya mu muyoboro. Cyangwa gishobora kuba igice gito gishyirwa mu muyoboro mu gihe cyo gukora endoscopie. Igice gito kijya mu ntebe nyuma y'iminsi ibiri.

• X-ray y'ubwonko bw'imbere. X-rays ifatwa nyuma yo kunywa amazi ameze nk'ifu, ashyiraho kandi yuzuza imbere y'ubwonko bw'imbere. Iyo myenda ifasha umukozi w'ubuzima kubona ishusho y'umuyoboro n'igifu. Ibi bifasha cyane abantu bagira ikibazo cyo kurya.

  Rimwe na rimwe, X-ray ikorwa nyuma yo kunywa igice cya barium. Ibi bishobora gufasha kumenya neza umuyoboro ugomba gufungwa, bigatuma bigoye kurya.

• Ubugenzuzi bw'umuyoboro. Iki kizamini kipima imikorere y'imitsi mu muyoboro mu gihe cyo kurya. Ubugenzuzi bw'umuyoboro bunapima ubufatanye n'imbaraga zikoreshwa n'imitsi y'umuyoboro. Ibi bikorwa cyane ku bantu bagira ikibazo cyo kurya.

• Endoscopie ya transnasal. Iki kizamini gikora kugira ngo harebwe ibyangiritse mu muyoboro. Umuyoboro muto, woroshye ufite kamera ya videwo ushyirwa mu mazuru ujya munsi y'umunwa ujya mu muyoboro. Kamera ituma amashusho ajya kuri ecran ya videwo.

Endoscopie y'imbere. Endoscopie y'imbere ikoresha kamera ntoya ku mpera y'umuyoboro woroshye kugira ngo irebane neza ubwonko bw'imbere. Kamera ifasha kubona imbere y'umuyoboro n'igifu. Ibisubizo by'ibizamini bishobora kutagaragaza igihe reflux ibaho, ariko endoscopie ishobora kubona ububabare bw'umuyoboro cyangwa izindi ngaruka.

Endoscopie ishobora kandi gukoreshwa mu gufata igice cy'umubiri, kitwa biopsy, kugira ngo harebwe ingaruka nka Barrett esophagus. Mu bihe bimwe bimwe, niba hari umuyoboro ugaragara mu muyoboro, ushobora gusukurwa cyangwa kwaguka muri ubu buryo. Ibi bikorwa kugira ngo bigabanye ikibazo cyo kurya.

Isuzuma rya pH ry'umusemburo (probe). Icyuma gipima gishyirwa mu muyoboro kugira ngo kimenye igihe, n'igihe kingana iki, aside y'igifu isubira inyuma. Icyuma gipima gikora kuri mudasobwa ntoya yambarwa ku kiuno cyangwa ku rutugu.

Icyuma gipima gishobora kuba umuyoboro muto, woroshye, witwa catheter, ushyirwa mu mazuru ujya mu muyoboro. Cyangwa gishobora kuba igice gito gishyirwa mu muyoboro mu gihe cyo gukora endoscopie. Igice gito kijya mu ntebe nyuma y'iminsi ibiri.

X-ray y'ubwonko bw'imbere. X-rays ifatwa nyuma yo kunywa amazi ameze nk'ifu, ashyiraho kandi yuzuza imbere y'ubwonko bw'imbere. Iyo myenda ifasha umukozi w'ubuzima kubona ishusho y'umuyoboro n'igifu. Ibi bifasha cyane abantu bagira ikibazo cyo kurya.

Rimwe na rimwe, X-ray ikorwa nyuma yo kunywa igice cya barium. Ibi bishobora gufasha kumenya neza umuyoboro ugomba gufungwa, bigatuma bigoye kurya.

Ubuganga bwo kuvura indwara ya GERD bushobora kuba burimo uburyo bwo gushimangira umusemburo wo hasi w'umuyoboro w'ibiryo. Ubu buryo bwitwa Nissen fundoplication. Muri ubu buryo, umuganga ashyira hejuru y'igifu ku muyoboro w'ibiryo wo hasi. Ibi bishimangira umusemburo wo hasi w'umuyoboro w'ibiryo, bigatuma bigoye ko aside ishobora gusubira inyuma mu muyoboro w'ibiryo. Iki gikorwa cya LINX ni impeta ishobora kwaguka y'amasaro ya magneti irindika aside y'igifu itagaruka mu muyoboro w'ibiryo, ariko ikemerera ibiryo kunyura mu gifu. Umuhanga mu by'ubuzima arashobora kugutegeka kugerageza guhindura imibereho n'imiti idasaba amabwiriza nk'uburyo bwa mbere bwo kuvura. Niba utarongeye kumererwa neza mu byumweru bike, imiti isaba amabwiriza n'ibizamini by'inyongera bishobora gusabwa. Hariho amahitamo arimo:

• Imiti igabanya aside y'igifu. Imiti igabanya aside irimo calcium carbonate, nka Mylanta, Rolaids na Tums, ishobora gufasha vuba. Ariko imiti igabanya aside bonyine ntizakiza umuyoboro w'ibiryo warabayeho kubera aside y'igifu. Gukoresha imiti igabanya aside cyane bishobora gutera ingaruka mbi, nko kuribwa umunaniro cyangwa rimwe na rimwe ibibazo by'impyiko.
• Imiti igabanya umusaruro w'aside. Iyi miti — izwi nka histamine (H-2) blockers — irimo cimetidine (Tagamet HB), famotidine (Pepcid AC) na nizatidine (Axid). H-2 blockers ntizikorera vuba nk'imiti igabanya aside, ariko zitanga ubuvuzi bw'igihe kirekire kandi zishobora kugabanya umusaruro w'aside ukomoka mu gifu kugeza amasaha 12. Hariho izindi zikomeye zisabwa amabwiriza.
• Imiti ibuza umusaruro w'aside kandi ikavura umuyoboro w'ibiryo. Iyi miti — izwi nka proton pump inhibitors — ni imiti ikomeye kurusha H-2 blockers mu gukumira aside kandi ituma umwanya uhagije kugira ngo imyenda y'umuyoboro w'ibiryo yangiritse ikire. Imiti igabanya aside idasaba amabwiriza irimo lansoprazole (Prevacid), omeprazole (Prilosec OTC) na esomeprazole (Nexium). Niba utangiye gufata imiti idasaba amabwiriza yo kuvura GERD, menya ko ugomba kubibwira umuvuzi wawe. Imiti ikomeye isaba amabwiriza yo kuvura GERD irimo:
• Imiti ikomeye isaba amabwiriza yo gukumira aside. Irimo esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) na dexlansoprazole (Dexilant). Nubwo muri rusange zihanganirwa neza, iyi miti ishobora gutera kuribwa umunaniro, kubabara umutwe, isereri cyangwa, mu bihe bitoroshye, kugabanuka kwa vitamine B-12 cyangwa magnésium.
• Imiti ikomeye isaba amabwiriza yo gukumira aside. Irimo famotidine na nizatidine zikomeye zisaba amabwiriza. Ingaruka mbi ziterwa n'iyi miti muri rusange ni nto kandi zihanganirwa neza. Imiti ikomeye isaba amabwiriza yo gukumira aside. Irimo esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) na dexlansoprazole (Dexilant). Nubwo muri rusange zihanganirwa neza, iyi miti ishobora gutera kuribwa umunaniro, kubabara umutwe, isereri cyangwa, mu bihe bitoroshye, kugabanuka kwa vitamine B-12 cyangwa magnésium. GERD isanzwe ishobora kugenzurwa hakoreshejwe imiti. Ariko niba imiti itabafasha cyangwa ushaka kwirinda gukoresha imiti igihe kirekire, umuhanga mu by'ubuzima ashobora kugutegeka:
• Fundoplication. Umuganga ashyira hejuru y'igifu ku musemburo wo hasi w'umuyoboro w'ibiryo, kugira ngo akomeze umusemburo kandi akumirane gusubira inyuma. Fundoplication isanzwe ikorwa hifashishijwe uburyo buto bwo kubaga, bwitwa laparoscopic. Gushyira hejuru y'igifu bishobora kuba bimwe cyangwa byose, bizwi nka Nissen fundoplication. Uburyo busanzwe bwo gushyira hejuru y'igifu ni Toupet fundoplication. Umuganga wawe asanzwe ategeka ubwoko bwiza kuri we.
• Iki gikorwa cya LINX. Impeta y'amasaro mato ya magneti ishyirwa ku isano ry'igifu n'umuyoboro w'ibiryo. Imbaraga z'amagnetic hagati y'amasaro ni zikomeye bihagije kugira ngo bikomeze isano ifunze kugira ngo aside itagaruke, ariko ni nto bihagije kugira ngo ibiryo bishobore kunyura. Iki gikorwa cya LINX gishobora gushyirwa mu gifu hakoreshejwe uburyo buto bwo kubaga. Amasaro ya magneti ntakora ku mutekano w'ikibuga cy'indege cyangwa magnetic resonance imaging.
• Transoral incisionless fundoplication (TIF). Ubu buryo bushya burimo gukomereza umusemburo wo hasi w'umuyoboro w'ibiryo hakoreshejwe impeta ya polypropylene. TIF ikorwa mu kanwa hakoreshejwe endoscope kandi ntibisaba kubaga. Ibyiza byayo birimo gukira vuba kandi kwihanganira neza. Niba ufite hiatal hernia nini, TIF bonyine si amahitamo. Ariko, TIF ishobora kuba ishoboka niba ifatanije no gusana hiatal hernia hakoreshejwe laparoscopy. Transoral incisionless fundoplication (TIF). Ubu buryo bushya burimo gukomereza umusemburo wo hasi w'umuyoboro w'ibiryo hakoreshejwe impeta ya polypropylene. TIF ikorwa mu kanwa hakoreshejwe endoscope kandi ntibisaba kubaga. Ibyiza byayo birimo gukira vuba kandi kwihanganira neza. Niba ufite hiatal hernia nini, TIF bonyine si amahitamo. Ariko, TIF ishobora kuba ishoboka niba ifatanije no gusana hiatal hernia hakoreshejwe laparoscopy. Kubera ko umubyibuho ukabije ushobora kuba ikintu gishobora gutera GERD, umuhanga mu by'ubuzima ashobora kugutegeka kubaga kugabanya ibiro nk'uburyo bwo kuvura. Ganira n'itsinda ry'abaganga bawe kugira ngo umenye niba uri umukandida w'ubu buryo bwo kubaga.

Guhindura imibereho bishobora kugabanya kenshi kw'umuriro w'amavunja. Gerageza gukora ibi bikurikira:

• Reka kunywa itabi. Kunywa itabi bigabanya ubushobozi bw'umusemburo ufungura umuyoboro ugana mu gifu kugira ngo ukore neza.
• Shyira umutwe w'igitanda cyawe hejuru. Niba usanzwe urwara umuriro w'amavunja mu gihe ugerageza gusinzira, shyira ibiti cyangwa amatafari munsi y'ibirenge ku ruhande rw'umutwe w'igitanda cyawe. Uzure ibirenge kugeza kuri santimetero 15 kugeza kuri 23. Niba udashobora kuzamura igitanda cyawe, ushobora gushyira agace k'ibiti hagati y'amatara yawe n'umusingi kugira ngo uzamure umubiri wawe uhereye ku kiuno ujya hejuru. Kuzuza umutwe wawe ibitambaro ntabwo ari ingirakamaro.
• Tangira uburere ku ruhande rw'ibumoso. Iyo ugiye kuryama, tanga uburere ku ruhande rw'ibumoso kugira ngo bigufashe kugabanya ibyago byo kurwara umuriro w'amavunja.
• Nturamire nyuma yo kurya. Tegereza byibuze amasaha atatu nyuma yo kurya mbere yo kuryama cyangwa kujya kuryama.
• Funga ibiryo buhoro kandi ubyume neza. Shyira agatoki hasi nyuma ya buri gitobe kandi ugafate ukundi umaze kubyuma no kubinywa.
• Ntukarebe ibiryo n'ibinyobwa bituma umuriro w'amavunja ukaza. Ibintu bisanzwe bituma ukaza harimo inzoga, shokola, kafeyin, ibiryo birimo amavuta cyangwa ipimenti.

Ubundi buryo bwo kuvura, nko gukoresha imbuto za jinja, kawa, na slippery elm, bishobora kugufasha kuvura GERD. Ariko kandi, nta na kimwe muri byo cyagaragaye ko kivura GERD cyangwa kikavura imyaka mu muyoboro ugana mu gifu. Ganira n'umuganga niba utekereza gukoresha ubundi buryo bwo kuvura GERD.