Chirwere Chekuyerera Kwemudumbu (Gerd)

Kurutsa kwemvura inorwadza kunoitika apo tsandanyama ye sphincter iri kumagumo e esophagus inozorora panguva isiriyo, ichibvumira asidhi yemudumbu kuti idzokere ku esophagus. Izvi zvinogona kukonzera kupisa kwemoyo nezvimwe zviratidzo. Kurutsa kwemvura inorwadza kazhinji kana nguva dzose kunogona kukonzera GERD.

Gastroesophageal reflux disease chirwere chinoitika apo asidhi yemudumbu inoyerera zvakare mudumbu rinobatanidza muromo nedumbu, rinonzi esophagus. Kazhinji inonzi GERD muchidimbu. Iyi mvura inodzokera inonzi kurutsa kwemvura inorwadza, uye inogona kukuvadza lining ye esophagus.

Vanhu vazhinji vanorwara nekurutsa kwemvura inorwadza dzimwe nguva. Zvisinei, kana kurutsa kwemvura inorwadza kuchitika kakawanda panguva, kunogona kukonzera GERD.

Vanhu vazhinji vanogona kudzora kusagadzikana kweGERD nekuchinja mararamiro nemishonga. Uye kunyangwe zvisingawanzoitika, vamwe vangada kuvhiyiwa kuti vabatsirwe nezviratidzo.

Zviratidzo zvakajairika zveGERD zvinosanganisira:

• Kunzwa kwekupisa muchipfuva, kazhinji kunonzi heartburn. Heartburn kazhinji kunoitika mushure mekudya uye kungangove kuipa usiku kana uri kurara.
• Kudzoka kwechikafu kana mvura inonaka muhuro.
• Kurwadziwa mudumbu rekumusoro kana chipfuva.
• Dambudziko rekumera, rinonzi dysphagia.
• Kunzwa senge pane chidimbu muhuro.

Kana uine acid reflux usiku, unogonawo kuwana:

• Kukosora kunoramba kuripo.
• Kutemwa kwetambo dzezwi, kunonzi laryngitis.
• Asthma itsva kana iri kuipa.

Tsvaga rubatsiro rwekurapa nekukurumidza kana uine kurwadziwa kwepfupa, kunyanya kana iwe uinewo kufema kwenguva pfupi, kana kurwadziwa kumeso kana paruoko. Izvi zvinogona kuva zviratidzo zvekurwisa kwemoyo. Rongai nguva yekushanya nachiremba kana iwe uine:

• Zviratidzo zvakakomba kana zvinowanzoitika zveGERD.
• Unotora mishonga isina kurapwa yekupisa kwemoyo kanopfuura kaviri pasvondo.

GERD inokonzerwa nekuyerera kwakasimba kweacid kana kuti kuyerera kwezvinhu zvisina acid kubva mudumbu.

Paunomedza, bhandi retsinga rinoumba denderedzwa riri pasi peesophagus, rinonzi lower esophageal sphincter, rinopfumbuka kuti zvokudya nezvinwiwa zvipinde mudumbu. Ipapo sphincter inozvitsvagira zvakare.

Kana sphincter ikasapfumbuka sezvinoita kazhinji kana ikasimba, acid yemudumbu inogona kudzoka kuenda ku esophagus. Kuyerera uku kwakasimba kwe acid kunokonzera kutsamwa kwe lining ye esophagus, kazhinji kuchikonzeresa kuti ive nekuzvimba.

Hernia ye hiatal inoitika kana chikamu chekumusoro chemudumbu chikabuda ne diaphragm richipinda mu cavity yechipfuva.

Zvinetso zvinogona kuwedzera njodzi yeGERD zvinosanganisira:

• Kuonda.
• Kubuda kwechikamu chekumusoro chemudumbu pamusoro pe diaphragm, kunozivikanwa se hernia ye hiatal.
• Pamuviri.
• Zvirwere zve connective tissue, senge scleroderma.
• Kudzoka kwemudumbu kunonoka.

Zvinhu zvinogona kuwedzera acid reflux zvinosanganisira:

• Kusvuta.
• Kudya zvokudya zvakawanda kana kudya usiku.
• Kudya zvimwe zvokudya, senge mafuta kana zvokudya zvakakangwa.
• Kunwa zvimwe zvinwiwa, senge doro kana kofi.
• Kutora mishonga yakati, senge aspirin.

Nekufamba kwenguva, kuzvimba kwenguva refu mu esophagus kunogona kukonzera:

• Kuzvimba kwetsinga iri mu esophagus, kunonzi esophagitis. Acid ye dumbu inogona kuputsa tsinga iri mu esophagus. Izvi zvinogona kukonzera kuzvimba, kubuda ropa uye dzimwe nguva kuvhunduka kwakavhurika, kunonzi chironda. Esophagitis inogona kukonzera kurwadziwa uye kuita kuti kudya zvive kwakaoma.
• Kuomarara kwe esophagus, kunonzi esophageal stricture. Kukuvadzwa kwe esophagus yepasi kubva ku acid ye dumbu kunokonzera kuti tishu rechisimba riumbwe. Tishu rechisimba rinoita kuti nzira yekudya ive yakamanikana, zvichikonzera matambudziko ekuruma.
• Kushanduka kwe precancerous kuenda ku esophagus, kunonzi Barrett esophagus. Kukuvadzwa kubva ku acid kunogona kukonzera shanduko mu tishu rinofukidza esophagus yepasi. Shanduko idzi dzakabatana nenjodzi yakawedzera yekenza ye esophagus.

Panguva yekuongororwa kwe endoscopic yepamusoro, mushandi wehutano anoisa chubhu yakatetepa, inopindika ine chiedza nekamera pasi petsoka uye mukati meesophagus. Kamera diki inopa maonero e esophagus, mudumbu uye kutanga kweura duku, kunonzi duodenum.

Mushandi wehutano angakwanisa kuona GERD zvichienderana ne nhoroondo yezviratidzo uye bvunzo yemuviri.

Kusimbisa chirwere cheGERD, kana kuti kuongorora matambudziko, mushandi wehutano angakurudzira:

• bvunzo yekutarisa asidhi (pH) inofamba-famba. Monitor inoisirwa mu esophagus kuziva kuti, uye kwenguva yakareba sei, asidhi yemudumbu inodzokera ikoko. Monitor inobatanidza kukombiyuta diki inopfekwa kumativi echidya kana nebhandi pamusoro pemafudzi.

  Monitor ingave chubhu yakatetepa, inopindika, inonzi catheter, inopfuudzwa nemuromo mukati meesophagus. Kana ingave kapusuru inoisirwa mu esophagus panguva yekuongororwa kwe endoscopic. Kapusuru inopinda mumutanda mushure memazuva maviri.

• X-ray yesystem yekugaya yekumusoro. X-rays inotorwa mushure mekunwa mvura yakaita sechoku, inopfeka uye inozadza mukati memukati we digestive tract. Kupfeka kunobvumira mushandi wehutano kuona chimiro che esophagus nemuviri. Izvi zvinobatsira zvikuru kune vanhu vane dambudziko rekumeza.

  Dzimwe nguva, X-ray inoitirwa mushure mekumeza piritsi re barium. Izvi zvinogona kubatsira kuona kuomarara kwe esophagus kunokanganisa kumedza.

• Esophageal manometry. Bvunzo iyi inoyeresa kuita kwemisungo yemhasuru mu esophagus panguva yekumeza. Esophageal manometry inoyeresawo kubatanidzwa nesimba rinopihwa nemisungo ye esophagus. Izvi zvinowanzoitwa kune vanhu vane dambudziko rekumeza.

• Transnasal esophagoscopy. Bvunzo iyi inoitirwa kutsvaga kukuvara mu esophagus. Chubhu yakatetepa, inopindika ine kamera yemavhidhiyo inoisirwa nemuromo uye inofambiswa pasi petsoka mukati me esophagus. Kamera inotumira mifananidzo ku screen yemavhidhiyo.

Upper endoscopy. Upper endoscopy inoshandisa kamera diki pamugumo wechubhu inopindika kuongorora ziso system yekugaya yekumusoro. Kamera inobatsira kupa maonero emukati me esophagus nemuviri. Mhedzisiro yebvunzo ingasaonekwa kana reflux iripo, asi endoscopy inogona kuwana kuzvimba kwe esophagus kana mamwe matambudziko.

Endoscopy inogona kushandiswawo kuunganidza sampuli yetsinga, inonzi biopsy, kuongororwa nezvinetso senge Barrett esophagus. Muzviitiko zvimwe, kana kuomarara kuchionekwa mu esophagus, kunogona kuwedzerwa kana kuwedzerwa panguva iyi. Izvi zvinoitwa kuti zvandudze dambudziko rekumeza.

bvunzo yekutarisa asidhi (pH) inofamba-famba. Monitor inoisirwa mu esophagus kuziva kuti, uye kwenguva yakareba sei, asidhi yemudumbu inodzokera ikoko. Monitor inobatanidza kukombiyuta diki inopfekwa kumativi echidya kana nebhandi pamusoro pemafudzi.

Monitor ingave chubhu yakatetepa, inopindika, inonzi catheter, inopfuudzwa nemuromo mukati meesophagus. Kana ingave kapusuru inoisirwa mu esophagus panguva yekuongororwa kwe endoscopic. Kapusuru inopinda mumutanda mushure memazuva maviri.

X-ray yesystem yekugaya yekumusoro. X-rays inotorwa mushure mekunwa mvura yakaita sechoku, inopfeka uye inozadza mukati memukati we digestive tract. Kupfeka kunobvumira mushandi wehutano kuona chimiro che esophagus nemuviri. Izvi zvinobatsira zvikuru kune vanhu vane dambudziko rekumeza.

Dzimwe nguva, X-ray inoitirwa mushure mekumeza piritsi re barium. Izvi zvinogona kubatsira kuona kuomarara kwe esophagus kunokanganisa kumedza.

Kuoperetisheni yeGERD inogona kusanganisira nzira yekusimbisa lower esophageal sphincter. Nzira iyi inonzi Nissen fundoplication. Munzira iyi, chiremba anokotama pamusoro pemudumbu akapoteredza esophagus yepasi. Izvi zvinosimbisa lower esophageal sphincter, zvichiita kuti zvisave nyore kuti acid igone kudzoka mu esophagus. Chishandiso cheLINX chiri mhete inowedzera ye magnetic beads inodzivirira acid yemudumbu kuti isadzokere mu esophagus, asi inobvumira chikafu kupinda mudumbu. Munhu ane hutano anogona kukurudzira kuchinja mararamiro uye mishonga isina kunyorwa semushonga wekutanga. Kana iwe usinganzwi zvakanaka mukati memavhiki mashoma, mushonga unonyorwa uye bvunzo yekuwedzera inogona kukurudzirwa. Sarudzo dzinosanganisira:

• Antacids inodzima acid yemudumbu. Antacids ine calcium carbonate, senge Mylanta, Rolaids neTums, inogona kupa zororo nekukurumidza. Asi antacids chete haizorapi esophagus yakatsvuka yakakuvadzwa ne acid yemudumbu. Kushandisa zvakanyanya antacids kunogona kukonzera matambudziko, senge manyoka kana dzimwe nguva matambudziko eitsvo.
• Mishonga yekuderedza kugadzirwa kwe acid. Mishonga iyi — inozivikanwa se histamine (H-2) blockers — inosanganisira cimetidine (Tagamet HB), famotidine (Pepcid AC) uye nizatidine (Axid). H-2 blockers haishande nekukurumidza se antacids, asi inopa zororo kwenguva refu uye inogona kuderedza kugadzirwa kwe acid kubva mudumbu kwemaawa anenge 12. Maitiro akasimba anowanikwa nekunyorwa.
• Mishonga inodzivirira kugadzirwa kwe acid uye inorapira esophagus. Mishonga iyi — inozivikanwa se proton pump inhibitors — ndiyo inodzivirira acid yakasimba kupfuura H-2 blockers uye inopa nguva yekuti tishu ye esophagus yakakuvadzwa ipore. Proton pump inhibitors isina kunyorwa inosanganisira lansoprazole (Prevacid), omeprazole (Prilosec OTC) uye esomeprazole (Nexium). Kana iwe uchitanga kutora mushonga usinganyorwi weGERD, iva nechokwadi chekuzivisa chiremba wako. Kurapwa kwesimba rinonyorwa kweGERD kunosanganisira:
• Proton pump inhibitors ine simba rinonyorwa. Izvi zvinosanganisira esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) uye dexlansoprazole (Dexilant). Kunyangwe kazhinji inonzwisisika zvakanaka, mishonga iyi inogona kukonzera manyoka, misoro, kurutsa kana, mumamiriro ezvinhu mashoma, mazinga e vitamin B-12 kana magnesium ari pasi.
• H-2 blockers ine simba rinonyorwa. Izvi zvinosanganisira famotidine ine simba rinonyorwa uye nizatidine. Matambudziko kubva kumishonga iyi kazhinji anenge akapfava uye anonzwisisika zvakanaka. Proton pump inhibitors ine simba rinonyorwa. Izvi zvinosanganisira esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) uye dexlansoprazole (Dexilant). Kunyangwe kazhinji inonzwisisika zvakanaka, mishonga iyi inogona kukonzera manyoka, misoro, kurutsa kana, mumamiriro ezvinhu mashoma, mazinga e vitamin B-12 kana magnesium ari pasi. GERD inogona kazhinji kudzorwa nemushonga. Asi kana mishonga isingabatsiri kana uchida kudzivisa kushandisa mushonga kwenguva refu, munhu ane hutano anogona kukurudzira:
• Fundoplication. Chiremba anokotama pamusoro pemudumbu akapoteredza lower esophageal sphincter, kuti aome tsandanyama uye kudzivirira reflux. Fundoplication kazhinji inoitirwa ne nzira isingakuvadzi zvakanyanya, inonzi laparoscopic, nzira. Kuita kotama kwepamusoro pemudumbu kunogona kuva kwakapfava kana kwakazara, kunozivikanwa seNissen fundoplication. Nzira yakajairika yakapfava ndeye Toupet fundoplication. Chiremba wako kazhinji anokurudzira rudzi rwakanakira iwe.
• Chishandiso cheLINX. Mhete ye magnetic beads diki inokotwa akapoteredza kubatana kwemudumbu ne esophagus. Kuve nechokwadi kwe magnetic pakati pe beads kwakasimba zvakakwana kuchengeta kubatana kwakavharwa ku refluxing acid, asi kusina simba zvakakwana kubvumira chikafu kupfuura. Chishandiso cheLINX chinogona kuiswa uchishandisa kuvhiya kusina kukuvadza zvakanyanya. Magnetic beads haikanganisi kuchengetedzwa kwepa airport kana magnetic resonance imaging.
• Transoral incisionless fundoplication (TIF). Nzira itsva iyi inosanganisira kuoma lower esophageal sphincter nekugadzira kotama yakapfava akapoteredza esophagus yepasi uchishandisa polypropylene fasteners. TIF inoitirwa mumuromo uchishandisa endoscope uye haidi kucheka. Zvakanakira zvinosanganisira nguva yekudzorera nekukurumidza uye kuvimbika kukuru. Kana uine hiatal hernia huru, TIF yoga haisi sarudzo. Zvisinei, TIF inogona kunge ichiita kana yakasanganiswa ne laparoscopic hiatal hernia repair. Transoral incisionless fundoplication (TIF). Nzira itsva iyi inosanganisira kuoma lower esophageal sphincter nekugadzira kotama yakapfava akapoteredza esophagus yepasi uchishandisa polypropylene fasteners. TIF inoitirwa mumuromo uchishandisa endoscope uye haidi kucheka. Zvakanakira zvinosanganisira nguva yekudzorera nekukurumidza uye kuvimbika kukuru. Kana uine hiatal hernia huru, TIF yoga haisi sarudzo. Zvisinei, TIF inogona kunge ichiita kana yakasanganiswa ne laparoscopic hiatal hernia repair. Nekuti kuzara kunogona kuva njodzi yeGERD, munhu ane hutano anogona kukurudzira kuvhiya kwekueredza uremu sesarudzo yekurapa. Taura nechikwata chako chehutano kuti uone kana uri munhu anokodzera rudzi urwu rwekuvhiya.

'Kushandura mararamiro kunogona kubatsira kuderedza huwandu hwekudzoka kweacid. Edza ku: \n\n- Rega kusvuta. Kusvuta kunoderedza simba re lower esophageal sphincter rekuita basa zvakanaka.\n- Simudza musoro wechigaro chako chokurara. Kana iwe uchitambura kazhinji nekurwadziwa kwemoyo paunenge uchirara, isa matanda kana mabhuroko e simende pasi pemitsipa kumusoro kwechigaro chako. Simudza musoro nemasentimita 6 kusvika ku9. Kana usingakwanisi kusimudza mubhedha wako, unogona kuisa wedge pakati pemamatresi ako nebox spring kuti usimudze muviri wako kubva muchiuno kumusoro. Kusimudza musoro wako nemapillow akawedzerwa hakushande.\n- Tangira kuruboshwe rwako. Paunenge uchienda kunorara, tanga nekurara kuruboshwe rwako kuti zviite kuti zvisave nyore kuva ne reflux.\n- Usarare mushure mekudya. Mira kwemaawa anenge matatu mushure mekudya usati warara kana kuenda kunorara.\n- Dya zvokudya zvishoma nezvishoma uye chewa zvakanaka. Isa forogo yako pasi mushure memukana mumwe nemumwe wobva waiwana zvakare kana wapedza kuchewa nekumera mukati.\n- Usadya zvokudya nezvinwiwa zvinokonzera reflux. Zvinokonzera zvakajairika zvinosanganisira doro, chokoreti, caffeine, mafuta kana peppermint.\n\nMamwe mishonga inowedzerwa uye inosarudzwa, senge ginger, chamomile uye slippery elm, inogona kukurudzirwa kurapa GERD. Zvisinei, hapana chimwe chacho chakabvumikiswa kurapa GERD kana kudzorera kukuvara kwe esophagus. Taura nachiremba kana uri kufunga kutora mishonga inosarudzwa kurapa GERD.'