Kuziva mamiriro ezvinhu anogona kuita kuti acid reflux
Vanenge mamiriyoni makumi maviri evanhu vakuru veAmerica vane acid reflux , kana kuora mwoyo, zuva rega rega, uye vanopfuura mamiriyoni makumi matanhatu veAmerica vanotambura nokuputika kamwechete pamwedzi. Chero munhu anokwanisa kutambura nekunyorova uye kunononoka kuora mwoyo kana vachidya zvokudya zvakashata kana zvinonaka. Kana ivo, kunyange zvakadaro, vanotambura nekusingaperi kushungurudzika kunoitika kaviri kana kupfuura pavhiki, vangave vane gastroesophageal reflux chirwere (GERD).
GERD inogona kunge yakakonzerwa nemamiriro akasiyana-siyana, kusanganisira kusagadzikana kwechiologic kana zvimwe zvikonzero. Zvakakosha kuti vanhu vanotambura nevanowanzochera mwoyo vauye navanachiremba vavo kuti vawane chinokonzera asidi yavo reflux, uye vanobvumirana pane chirongwa chekurapa.
Kusashandira kweSep Esgehaal Sphincter (LES) Muscles
Bhenu remisungo iri pamagetsi pakati pepopu uye mudumbu inonzi " low esophageal sphincter" (LES). Iyi musumbu inokonzera kupfiga nekuzarura mugumo wepasi weeophagus uye inoita sekumanikidza kunopesana nezviri mukati memudumbu. Kana iine simba kana kuti inorasikirwa nehutoni, iLes haizovhari zvachose mushure mokunge zvokudya zvichisvika mudumbu. Dumbu remasidhoni rinokwanisa zvakare kudzokera mudenga. Zvimwe zvokudya uye zvinwiwa, zvinodhaka, uye manzwiro emamiriro ezvinhu zvinogona kuderedza LA uye kuparadza basa racho.
Kusakanganiswa muEsophagus
Kune zvimwe zvidzidzo zvinoratidza kuti vanhu vazhinji vane maziso asinganzwisisiki GERD angave (sekutya, kunzwa sokuti kune bundu riri mumutsipa, kusagunzva kusingaperi) kune zvimwe zvisinganzwisisiki mune imwe nharaunda iyo vamwe varwere veGERD havaiti.
Dambudziko reDumbu Basa
Chimwe chidzidzo chakaratidza kuti hafu yevarwere veGERD yakaratidza nharo isina kuchena kana musumbu inoshanda mumimba yavo. Izvi zvisingakoshi zvinokonzera kusagadzikana. Izvi zvinoitika apo misumbu iri mudumbu haigoni kuita chimwe chinhu. Mishonga haibvumirane nechekare, inokonzera kukanganisa mukati mekugona kwemukati kubvisa.
Izvi zvinogona kuwedzera kudzvinyirira mumudumbu iyo, zvakare, inogona kuwedzera kungozi yemudumbu asidi kusvika kumashure.
Motility Kuipa .
Muzvokudya zvinowanzogadzirwa, zvokudya zvinoshandiswa kuburikidza nehutano hwekudya nekunyora kwemashoko kunonzi peristalsis. Apo mumwe munhu ane chirwere chekudya chinokanganisa, izvi zvinopesana hazvina kujairika. Izvi zvinogona kuitika nekuda kwechimwe chezvikonzero zviviri: Dambudziko mukati memisumbu pachayo, kana dambudziko nemisungo kana mahomoni anodzora maitiro emisumbu. Zvinetso muzvirevo zvinowanikwa muGERD, kunyange zvazvo izvi zvisingaoneki kana zviitiko zvakadaro zvikonzero kana kuti zvinokonzerwa nemigumisiro yakareba yeGERD.
Hiatal Hernia
Chirwere chekuzvarwa chinowanikwa apo chikamu chepamusoro chemudumbu chinoputika nepamukova muchera, uye kusvika muchipfuva. Uyu mukova unonzi isophageal hiatus kana hiaphus diaphragmatic. Zvinotendwa kuti hutano hwechibereko hunogona kuderedza (LES) uye hunokonzera reflux. Zvisinei, zvidzidzo zvakakundikana kuratidza kuti iyo inowanzokonzera GERD. Chirwere chekuzvarwa, zvisinei, chinogona kuwedzera zviratidzo zveGERD kune varwere vane zvinhu zviviri.
Asthma
Vanachiremba vangave vasinganzwisisi zvachose ukama huripo pakati peAIDS neGERD, asi nyanzvi dzakawanda dzinobvumirana kune hukama hunokosha.
Dzimwe nyanzvi dzinofungidzira kuti kukohwa kunofamba nekurwiswa kwechirwere kunogona kukonzera kuchinja mukumanikidzwa mubhokisi, izvo zvino zvinogona kutora reflux. Zvimwe zvinodhaka zvinokonzerwa nehutema izvo zvinoderedza mhepo zvinogonawo kugadzirisa IE uye inobatsira kuGERD. Saizvozvowo, GERD yave ichibatanidzwa nedzimwe dzakawanda dzepamusoro zvinetso zvekufema uye inogona kunge iri chikonzero chechirwere, panzvimbo yegumisiro.
Genetic Factors
Zvidzidzo zvakaratidza kuti kune dambudziko rakagara nhaka munyaya dzakawanda dzeGERD. Izvi zvinogona kuva nekuda kwehutano hwakakonzerwa nematambudziko kana maitiro muhuputi kana mudumbu. Izvozvo zvinogonawo kuva chinhu chinokosha mukurwara kwemurwere kuBarrett, iyo inokonzera chirwere chakakomba zvikuru chegastroesophageal reflux .
Zvinodhaka zvinowedzera Dambudziko reGERD
NSAIDs.
Nonsteroidal anti-inflammatory drugs ( NSAIDs ) zvinowanzokonzera zvipembenene zvinonzi peptic ulcers . Zvinogonawo kukonzera GERD uye kuwedzera zviratidzo uye kusuruvara kweGERD kune vanhu vagara vaine. Mune rumwe ruzivo rwemakore matatu rwevanhu 25 000, vashandisi veNSAID vaiwanzoita kaviri kuti vane zviratidzo zveGERD sevasingadi. Zviratidzo hazvina kuonekwa kusvikira mushure memwedzi mitanhatu yekushandisa nguva dzose. NSAIDs dzinosanganisira:
- Aspirin
- Ibuprofen (Motrin, Advil, Nuprin, Rufen)
- Naproxen (Aleve)
Chimwe chinhu chinonakidza ndechokuti NSAIDs dzine zvinhu zvingabatsira kudzivirira kushanduka kwakasimba kunobva pakurongwa kwaBarrett. NSAID idzva dzinonzi COX-2 inhibitors dzinogona kuratidza kuti dzine kenza inochengetedza varwere ava pasina kubudisa GERD. COX-2 inhibitors inosanganisira: Celecoxib (Celebrex) Valdecoxib (Bextra).
Zvimwe Zvinodhaka.
Mimwe mishonga yakawanda inogona kukonzera GERD, kana kuti kuwedzera kuoma kwezviratidzo kune avo vagara vane chirwere ichi. Izvi zvinosanganisira:
- Anticholinergic zvinodhaka (urinary tract disorders, antihistamines)
- Inosanganisira natural belladonna alkaloids (atropine, belladonna, hyoscyamine, uye scopolamine) nezvimwe zvinhu zvakagadzirwa.
- Beta-2 agonists (bronchodilators [Inhalation] - asthma)
- Inosanganisira Alupent, Bronkaid Mist, Primatene Mist, Proventil, Ventolin, Ventolin Rotacaps.
- Calcium channel blockers ( high blood pressure )
- Inosanganisira Cardizem, Dilacor-XR, Norvasc, Procardia, Vascor.
- Diazepam (kushungurudzika kwepfungwa, kugumburwa)
- Inosanganisira Librium, Paxipam, Valium, Xanax.
- Nitrates (angina)
- Inosanganisira Nitrogard, Nitrostat, Nitroglyn ER, Sorbitrate.
- Opioid analgesics
- Inosanganisira morphine, oxycodone, yakagadzirirwa nyuchi dzinodhaka.
- Theophylline (bronchodilators [muromo] - chifubu)
- Bronchodilators. Inosanganisira Aerolate Sr, Choledyl, Respbid, Slo-Bid Gyrocaps, Theobid Duracaps, Theo-Dur.
- Tricyclic (psychotherapeutic agents, antidepressants)
- Inosanganisira Anafranil, Elavil, Norpramin, Pamelor.