Zvinowanzokonzera uye Ikozvino Kurapa Mazano
Imbeu inoberekwa inowanikwa apo chikamu chepamusoro chemuviri mako chinoputika nemucheka-musero unoparadzanisa chifuva nemimba. Pamusoro pechipfuva pane mukova muduku, unonzi hiatus, iyo inoshandiswa nayo kudyidzana (sophagus) yako. Kana dumbu rinopfurikidza nepamukova uyu, rinogona kuita kuti zvokudya uye acid zvidzoke zvakare mumusana, zvichikonzera kushungurudza mwoyo, indigestion, uye kurwadziwa.
Kunyange apo-over-the-counter (OTC) uye mishonga yemishonga, kusanganisira antacids uye acid-blockers, inogona kurapa zviratidzo zvepabonde zvakabatana, kuora muviri uye kuchinja kwekudya kunodiwa kuderedza reflux pamwe chete. Kuvhiya kunogona kudiwa mumatambudziko akaoma.
Zviratidzo
Vanopfuura hafu yevanhu vanoona kuti vane hutano hwekuzvarwa huchava vasina zviratidzo zvachose. Kune avo vanoita, kuratidzira kwegastric acid kana mhepo mukati memoyo ichava zvikonzero zvikuru nei. Zviratidzo zvingasiyana zvakasiyana nemhando yemhando yako.
Chirwere chechirwere chinotapira chiri chimiro umo kukanganiswa kweputi uye mudumbu (kunonzi segastroesophageal junction) uye chikamu chemuviri chinopinda muchipfuva. Hernias yakaita seyi inonzi "slide" nokuti chikamu chemukati chemukati chinogona kupfuurira mberi uye mberi mukati mechidzitiro apo iwe unomedza.
Zvizhinji zviduku zvinotapira mishonga hazvikonzeri zviratidzo. Kana zviratidzo zvikaonekwa, zvinowanzobatanidza:
- Kushungurudza
- Indigestion
- Kudzorera
- Belching
- Kuchengeta
- Nausea uye kurutsa
A paraesophageal hernia isiri iyo inowanzozivikanwa asi iyo inonyanya kukosha iyo inongova mudumbu chete inoputira muchipfuva. Hernias yakaita seiyi inogona kukonzera kuti zvokudya zvive zvakanyunguduka kana kuti zvive zvakakanganiswa, kubvisa ropa.
Nezvo izvo zvichitaurirwa, mapeesophageal hernias mazhinji haazoiti zviratidzo kana zviduku. Kana vakakura uye vanotanga kuomesa sophagus, vanogona kuita kuti zvokudya zvibatwe mukati mebhokisi apo iwe uchiedza kumedza. Kana mheta yacho ichiwedzera kusvika muchipfuva, inogona kukonzera (yakapfigirwa) mu hiatus uye inotungamirira ku:
- Dambudziko repfuva mushure mekudya
- Kurwadziwa kwepamuviri uye kukanganisa
- Chirwere chepachifu chechipfuva chisingagoni kutarisirwa nevanopidhi
- Dambudziko rokuedza ( dysphagia )
- Kusuruvara kwemhepo ( dyspnea )
- Kusakwanisa kuvhara
- Kurambidza kufambira mberi kuenda kune zvisingabatsiri kuwana
- Dema kana tarry zvigaro
- Kuputika kweropa
Zvose izvi zviratidzo zvehupfumi huri mujeri , chirwere chinogona kutungamirira mukugadzirisa kwekupa ropa uye gastric perforation. Nharaunda yakapfigirwa inofanira kuonekwa nguva dzose sechirwere chekukurumidzira inoda kurapwa nokukurumidza.
Zvinokonzera
Chinokonzera hutano hwechibereko hachisi nguva dzose chakajeka. Zvichida kuti iwe wakaberekwa ne hiatus yakakura zvikuru kana iyo yezera, kuvhiyiwa, kana kukuvara kwepanyama kwakaderedza kuvimbika kwemisimba yako yemawere.
Mamiriro ezvinhu akadai aya anogona kukugadzirisa kune hutano hwekuzvarwa, kunyanya kana iwe uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uching
Mienzaniso yeiyi inogona kusanganisira chifuva chisingaperi, kusimudza zvinhu zvakaremara, kurutsira zvechisimba, kana kushungurudza panguva yekufamba kwechirwere.
Kuwedzera muviri kunowedzerawo. Vanhu avo vanodarika zvakanyanya kana vakareruka vane huwandu hwepamu-mumimba hunofananidzwa nehuya hwehutano hwakanaka. Izvo zvinodzvinyirira zvinoderedza mutsara weharura paunowedzera nzvimbo yekugara. Sezvakaguma, vanhu vanofunga kuti zvakanyanya-zvinorondedzerwa sechimiro chemuviri masikirwo (BMI) chikuru kupfuura makumi matatu-vanowanzoita kuti vave nechibereko chekuberekwa kupfuura avo vane BMI vasingapfuuri 25.
Izvo zvinogona kuitika panguva yekuzvitakura, kazhinji mumatanho akazotevera sezvo kuwedzera kwechibereko kunosangana nechisimba pamadziro emimba.
Hiatal hernias inowanzokonzera vanhu vanopfuura makumi mashanu. Kunyange kusvuta kusingabatsiri chibereko chekuzvarwa, kunogona kuwedzera zviratidzo kuburikidza nekuzorodza pasi pasi esophageal sphincter (LES) yaireva kuchengetedza kudya uye asidi kubva panopa.
Kuziva
Kune huwandu hunowanikwa huripo hunoshandiswa kuongorora hutano hwekuzvarwa . Chisarudzo chakanaka kwauri chinonyanya kutarisana nemhando uye kuoma kwezviratidzo zvauri kuona.
Pakati pezvombo zvinowanzozivikanwa:
- Barium X-rays ndiyo miedzo inowanzoshandiswa kuongororwa hutano hwekuzvarwa. Izvo zvinonziwo chirongwa chinonzi barium, inoda kuti unwe mvura yakasvibira inopfeka masvingo ehuputi uye mudumbu. Izvi zvinobatsira zviri nani kusiyanisa nhengo dze X-ray.
- Kupera kwepiscopi yepamusoro inowanzochengeterwa vanhu vane zvirwere zvakakomba, zvinowanzoitika kana para-esophageal hernias yakava chiratidzo. Inosanganisira kuiswa kwechiedza chakatsvuka, chinoshandiswa mukati mako mumutsipa kuti uone nhengo yako, dumbu, uye duodenum.
- High-resolution manometry (HRM) inyanzvi itsva inoshandiswa kuyera zvipimo zvemashoko zvepopu sezvo iwe uchidya. Izvi zvingaita kuti chiremba wako anzwisise kuti kukuvadza kwako kwakanyanya sei neLes zvave zvisina kukodzera.
Kuyera ropa kunoitwawo kuti uongorore kuderedza ropa reropa uye rimwe ropa risina kunaka. Chiyero chepH chinogonawo kushandiswa kuyera asidi muhuputi.
Kurapa
Zvizhinji zviratidzo zvehutano hwekuzvarwa hunogona kurapwa zvakakodzera nemishonga yeOTC, kuchinja mararamiro, uye nzira dzokuzvitarisira. Kuvhiya hakuwanzodikanwa uye kunofungidzirwa chete pamatambudziko akaoma.
Mishonga
Mishonga yeOTC iyo inowanzoshandiswa kurapa zviratidzo zve reflux inosanganisira:
- Antacids kuti irege kuisa mutezo yemuviri, yakadai seTums, Rolaids, uye Gaviscon
- H2 receptor blockers iyo inoderedza kushandiswa kwemudumbu acid, sezvakaita Tagamet (cimetidine) uye Zantac (ranitidine)
- Proton pump inhibitors (PPIs) , iyo yakasimba kupfuura H-blockers uye inosanganisira Prevacid (lansoprazole) uye Prilosec (omeprazole)
Shanduro dzakasimba dzeH2 blockers uye PPIs dzinowanikwa nemutemo.
Lifestyle Changes
Maitiro ehupenyu ndeaya maitiro anochinja anokwanisa kuderedza kuwanda uye kuoma kwezviratidzo, kusanganisira:
- Kutanga kukodzera kuora-kurasikirwa uye chirongwa chekuita mabasa
- Kudya mafuta akaderera, e-high-fiber, izvo hazvisi nyore nyore kugadzira asi zvinogona kubatsira kuderedza kusagadzikana kusingaperi
- Kunwa zvisingasviki masereji masereji emvura pazuva, izvo zvinogona kudzivirira kupererwa nemvura uye kuderedza mutezo yemudumbu
- Kudzivisa doro uye caffeine, iyo inokurudzira reflux
- Kusiya fodya; kusvuta kunokonzera the LES
Surgery
Kuvhiya kunogona kuongororwa apo paraeophageal hernia inotanga kukonzera zviratidzo zvepamuviri. Kuchengetedza hutachiona mangwanani, iyo nzvimbo inoberekwa ichi ichiri duku, inogona kuderedza zvakanyanya dambudziko rekugadzirisa mushure mekuvhiya. Symptomatic paraesophageal hernias inenge iri nguva dzose inofambira mberi.
Hiatal hernia chirurgical is usually performed under general anesthesia on either inpatient or outpatient basis. Zvizhinji zvekuvhiya kunoitwa laparoscopically (inozivikanwawo se "keyhole" chirwere).
Imwe nzira yokuvhiya, inozivikanwa seNissen fundoplication, inoitwa nekuvhara chikamu chepamusoro chemuviri (chinonzi fundus) chakakomberedza pasi pepasi uye kana kuigadzirisa kana kuifambisa panzvimbo yacho. Izvi zvinosimbisa pasi re esophageal sphincter uye, nokuita kudaro, kunoderedza ngozi yekubvisa.
Kutsungirira
Sezvakawedzeredza sezvinoratidza zviratidzo zvehutano hwekuzvarwa, pane nzira dzekugadzirisa kupisa uye kusuruvara kuitira kuti iwe usingaiti nguva dzose kuti usvike kune antivacids. Kunze kwekudya kudya kwakanaka uye kurega fodya, pane zvimwe zviito zvinogona kukubatsira kuti uite zvakanaka kana iwe uchitambura zvirwere zvisingaperi zvinoratidza:
- Kugara wakarurama muchechi yako apo kudya kunobvumira kudya kuti zvipfuure zvakanaka pakati pechirwere chako uye mudumbu.
- Kutora zviduku zvishoma nekucheka kwenguva yakareba kunogona kuita kuti kudya kunetseke nekuderedza kudiwa kwesimba asidi.
- Kudzivisa kudya maawa matatu usati warara, kunovimbisa kuti zvokudya zvakagadzirwa uye hazvikwanisi kumira.
- Kusimudza musoro wemubhedha wako kusvika masendimita masere kusvika masere kunogona kuderedza mukana wekutsvaira apo uchirara.
- Kudzivisa mabhanhire akasungwa uye zvipfeko zvinoderedza kushanda kumadziro ekumusoro kwepamusoro, zvichiita kuti kumedza zvive nyore kana kuderedza dambudziko re acid reflux.
Shoko Rinobva
Mishonga yakawanda inobereka mahara haifaniri kutarisira kurapwa kana kutarisirwa. Kana iwe ukaita zviratidzo, unoda kuwana mazano, kunze kwemishonga chete, kuti ikubatsire kurarama. Hapana maitiro maviri akafanana, uye chii chinogona kushanda kune mumwe munhu hachigoni kukushandira.
Funga nezvehupenyu hunochinja hunoziva kuti unofanirwa kuita, kusanganisira kudya zviri nani, kushandisa nguva dzose, nekurasikirwa. Kana uine dambudziko kusvika kune zvinangwa zvako, taura nemunhu ane chikafu kana mudzidzisi wega wega anowanikwa mune chirwere chemagetsi uye mamwe matambudziko ekuremedza.
Zvisinei, kana zviratidzo zvako zvichiwedzerwa kana kuti zvinokundikana kugamuchira mushonga unochengetedza, bvunza chiremba wako kuti atumire kune gastroenterologist .
> Sources:
> Roma, S. Kuongororwa uye kutungamirirwa kweHiatus hernia. BMJ. 2014; 349: g6154. DOI: 10.1136 / bmj.g6154.
> Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Mirayiridzo yekutungamirirwa kweHeratal Hernia. Los Angeles, California; shandisa April 2013.