Sezvo mishonga yakawanda isingarambi ichikonzera zviratidzo, inowanzowanikwa munguva yechiito chechifukidzo che X-ray nokuda kwekusawirirana. Pane dzimwe nguva, pfuma inoberekwa inogona kunge ichifungidzirwa kune vanhu vane acid acid yakanyanya reflux iyo inokundikana kupindura kune zvinoputika kana mamwe marapirwo. Nezviitiko zvakadaro, kune uwandu hwekuedzwa kwachiremba vanachiremba vanogona kushandisa kusimbisa kuongororwa, kusanganisira X-rays, endoscopy, uye esophageal manometry.
Imaging
Zvishoma zvishoma mahara anonzi mahara anowanzooma kuona pa -X-ray nguva dzose uye inogona kungoita seyakagadzirwa gasi mubhokisi. Kupa tsanangudzo iri nani, kufungidzira zviyero zvakadai sepamusoro yeGI barium kudzidza kana computed tomography (CT) scan inogonawo kurayirwa.
Chidzidzo cheBarum
Nzira inosarudzwa yekuongororwa kwehutano hwechizvarwa ichi ndicho chirwere chepamusoro chepamusoro (GI) bhinzium study. Kazhinji inonzi inonzi barium swallow , chiyero chinoda kuti unwe zvinokwana imwe nehafu yenguva dzemvura yakasviba ine barium sulfate uye, inenge maminitsi makumi matatu gare gare, iine mhando ye X-rays. Iyo metallic inopfeka inophagus uye mudumbu, zvichibatsira kudziparadzanisa mumigumisiro yekufungidzira.
Kana iwe ukawana muedzo uyu, tarisira kuiswa pamatafura sezvaunenge uine X-rays. Munguva yekudzidza, tafura inosungirirwa apo iwe unonwa mamwe bhaumumu.
Kunyange zvazvo nzira yacho inonzi yakachengeteka, inogona kukonzera kudzimba uye, mune zvisingashamisi, fecal impaction .
Kana iwe usingakwanisi kuva nechirwere chemuviri chemazuva maviri kana matatu mushure mekugadzirisa, danaidza chiremba wako.
CT Scan
Kuongorora bhayoum kunowanzokwanira kujekesa. Kana isingakwanisi kudaro, computed tomography (CT) scan ingarayirwa. Izvi zvingave zvakakosha kune vanhu vakaoma kana kuti vakave nekuvhiyiwa kwepamuviri yapfuura.
A CT scan inogona kuve yakakosha mumamiriro ekukurumidzira, akadai segastric volvulus (chirwere chakakomba umo mudumbu chinokanganisa kudarika 180 degrees) kana kuparadzanisa (uko kudzvinyirira kana kukanganisa kwemadzimai inoparadza zvachose ropa).
Maitiro uye Miedzo
Chiremba wako angada kuongorora zvakanyanya kuita kuti aongororwe, kana achida zvimwe zviitiko kuti ubatsire kusimbisa mumwe kana kutsanangura kuoma kwemamiriro ako. Mune zviitiko izvi, izvi zvingasarudzwa zvingafungidzirwa:
Upper GI Endoscopy
Nhengo yemhuka inoberekwa inogona kuonekwa zvakare ine nzira inozivikanwa yepamusoro yeGI endoscopy . Iyi ndiyo nzira yakatarisa yekuona iyo iyo yakawanda yakareba, inonzi endoscope, inowanikwa mumutsipa wako kuti uwane mifananidzo mhenyu yeeophagus, stomach, uye duodenum (chikamu chekutanga chematumbo maduku).
Nzira yacho inoda kuti iwe urege kudya kana kunwa maawa mana kusvika masere vasati vaedzwa. Usati waita, iwe unopiwa chido chekuita kuti uwane rusununguko iwe. Chimwe chinoputika pamutsipa wako chinogona kushandiswa zvakare. Nzira yacho inowanzopedza pakati pemaminitsi gumi nemakumi maviri, neawa yakawedzerwa inodiwa kuti idzoke kubva kune sedation.
Endoscopy dzimwe nguva inogona kukonzera kubvongodza, gesi, kuputika, uye kurwadziwa kwehuro. Dana chiremba wako kana iwe uchitanga fever, chills, kurwadziwa mumimba, kana kubuda kubva pamutsipa.
Esophageal Manometry
Esophageal manometry inyanzvi itsva inotarisa kuti masumbu eesophagus uye esophageal sphincter (valve) ari kushanda sei. Iyo inogona kubatsira chiremba wako kuti aone motokari dzinokanganisa, zvakadai se dysphagia (kunetseka kunomedza), uye kuti yako hernia ingave iri kuwedzera sei kwavari.
Nzira yacho inoshandiswa nokutanga anesthetizing a nostril ane mafuta anonyangadza. A tube ine tsvina, yakagadzikana nemasikisi, inobva yatengeswa kuburikidza nemhino dzako uye pasi kusvika panopa yako. Dhijitari inoongorora inobvumira kuti nyanzvi aone uye achinyore kuchinja pane zvakanyanya kumanikidzwa sezvaunomedza.
Manometry mhinduro inogona kubatsira chiremba wako kutsanangura nzira yakakodzera yekurapa.
Muromo unorwadza uye kushungurudzwa kwemapapiro ndiyo inowanzovhiringidza.
Esophageal pH Kuchengeta
Esophageal pH kutarisa ishandiso inoshandiswa kunyora kuchinja mu acidity yeropa rako pane imwe nguva (sekuenzaniswa ne pH ). Iko kunosanganisira kuiswa kwehuputi-se-sensor kuburikidza nemhino inosangana nechitarisiko chaunopfeka pa bhanhire rako. Mumaawa makumi maviri anotevera, chekuita rinonyora nguva dzose paunosangana neA acid reflux uye unonyora kuchinja kwakasiyana kwehuwandu hwepH.
Kurongwa
Pane imwe nguva hutano hwekuzvarwa hunoonekwa kuti hunorongwa nehuwandu, iyo inogona kubatsira kurapa zvakananga uye / kana kushandiswa kutarisa chero kuchinja kwehutano hwako. Mhando idzi dzinosarudzwa nehukuru uye humiro hwemunda wake:
- Rudzi rwekutanga 1 runozivikanwa seti sliding hernia; dumbu rinoramba riri mumigero yaro yakagadzirika apo chikamu chemukati chinopindira uye chichibva kunze kweiyo hiatus (iyo gomba riri mudirasi iyo iyo inoputi inopfuura).
- Rudzi rwechipiri rwuri paresophageal hernia, rusingatauri mukati uye ruchibva kune hiatus asi rucharamba ruchigadzikana pedyo necheputi.
- Rudzi rwechitatu runoitika apo gastroesophageal junction (iyo magetsi pakati pepopu uye mudumbu) inotanga kuwedzera kuburikidza ne hiatus.
- Rudzi rwechina runoitika apo herniation inobvumira mudumbu uye dzimwe nhengo, dzakadai sekoloni kana chiropa, kuti dzipinde mubhokisi.
Kusiyanisa Kuongorora
Acid reflux zviratidzo hazvijairika kune vanhu vane chibereko chekuzvarwa. Zvipembenene zvakakura zvinogona kukonzera zvimwe, zviratidzo zvakakura zvakadai sekurwadziwa kwepfupa, kurutsira, retching, uye aspiration pneumonia (inokonzerwa nekukandira zvokudya mumapapu).
Kunyangwe kana hutano huripo hunosimbiswa, kusiyana kwekusiyanisa kunogona kudiwa kuti usabvisa zvimwe zvinokonzera, kunyanya kana hernia iri duku uye isingapindirani nekuoma kwezviratidzo. Zvimwe zvezvimwe zvinokonzera zvinosanganisira:
- Angina , iyo inogona kusiyaniswa panguva yekuedzwa kwepfungwa yepfungwa
- Chirwere chinokonzerwa nemhepo, izvo zvinokonzera izvo zvinogona kusiyaniswa nebhokisi X-ray uye kuongorora ropa
- Gastroesophageal reflux chirwere (GERD) , iyo inogona kusiyaniswa nehupenyu husingagumi hwezviratidzo, pamwe chete nezviratidzo zvekutsvaira kana kuora kwezino
- Gastric outlet kudzivirira, iyo inogona kusiyaniswa nehutachiona pa pylorus (kuvhura kubva mudumbu kusvika mu duodenum) panzvimbo ye hiatus
> 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 yeHurumende yeHiatal Hernia." Los Angeles, California; shandisa April 2013.