Kune vanhu vazhinji, hiatal hernias inokonzera chete zvinyoro, zvinokonzera kushungurudza kunogona kuraswa nyore ne antacids uye acid-blockers. Kunze kwekuti hupfumi hwacho hukuru, kunyanya-the-counter (OTC) mishonga, kuora muviri, uye kuchinja kwezvokudya zvinowanzokwanira kuti uve nechokwadi chekununurwa. Mumatambudziko akaoma, zvisinei, kuvhiyiwa kunogona kudiwa kana chirongwa chinokonzera kuvhiringidza kana kubvisa ropa.
Zvichienderana nekuoma kwebasa racho, kuzarura kana kuti laparoscopic ("keyhole") kuvhiyiwa kunogona kushandiswa kugadzirisa kukanganisa.
Mishonga yeMusha uye Upenyu
Zviratidzo zvehutano hwechibereko hunowanzoenderana nekusavhiringidza kwechepasi esophageal sphincter (LES), iyo inoparadzanisa dumbu kubva mudumbu rekudya (esophagus). Nemhaka yekuti hernia inogona kuchinja mamiriro eEAT, mudumbu weAidhi uye kudya dzimwe nguva kunogona kupindira mukati mekugadzira uye kunokonzera kuvhiringidza uye kusagadzikana.
Izvi zvinowanzoitika kune vanhu vane uremu hwepamusoro kana vakawandisa. Mukuwedzera pakuisa kudzvinyirira kwakanyanya pamudumbu uye kumusoro mudumbu, kuneta kunokurudzira reflux kuburikidza nekupindira nekuperera kwemaitiro ekudya. Zvakare, zvokudya zvinopedzerwa mune zvakajairika, kudya kwakakora-mafuta kunowedzera kukonzera asidi kuitira kuputsa mafuta akawandisa uye ma carbohydrates ari nyore .
Kuti ukunde izvi, unoda kugadzirisa zvinokonzera zvinokonzera reflux.
Pane humwe hutano hukuru hwekuchinja hupenyu hunogona kubatsira:
- Kurasikirwa kwemahombekero kunobvisa kumanikidzwa kwemuviri kunokurudzira mishonga. Kunyange zvazvo zvisingamborevi kutendesa hupfumi, zvinogona kudzivirira hunyoro hwakasimba kubva pakukura kuva chinotyisa zvikuru cheparaesophageal hernia . Ichi ndicho chimiro chinowanikwa nehuwandu hwehutachiwana hwegastroesophageal reflux disease (GERD) .
- Izvo zvakaderera-mafuta, zvakanyanya-fiber kudya zvinongobatsira kuti uremu hurasike, zvinogona kubatsira kuisa chimiro chemaitiro uye kubvisa kuzvidzora kunobatsira kumanikidza. Yakakwirira-fibhi zvokudya ndiyo nzira inobatsira yekuzorodza.
- Hydration yakakodzera , kureva kunwa zvisingaiti masereji masereji emvura zuva rimwe nerimwe, inogona kuderedza dambudziko rekudzivirirwa kwepakati nekuderedza huwandu hweasiti mudumbu.
- Kudzivisa kutora kudya kunogona kupa zororo chero yezera rako kana uremu hwako. Zvinhu zvinowanzokonzera zvinosanganisira nyama tsvuku, zvokudya zvakabikwa, zvokudya zvinonaka, mafuta ose-mafuta, tomato-based sauces, macrovirus, carbonated drinks, caffeine, doro, uye kunyanyisa munyu . Kusiyana neizvi, zvokudya "zvakachengeteka" zvakadai sekuonda kwehuchi, hove, mafuta asina mafuta, zviyo, nemiriwo zvinogona kubatsira kubata zviratidzo zve reflux.
- Kusiya fodya ndeyekufanirwa kana iwe uri kurwisana nekuora mwoyo. Apo kusvuta hakuiti kukonzera hutano hwekuzvarwa, kunogona kusunungura kakatove kutadza PF uye kunobvumira kudya uye asidi kuti irege kuratidza nyore nyore. Ndicho chikonzero nei vanosvuta vanowanzotanga kuora mwoyo mushure mekunge vazaruka kana kuti nei vachikwanisa zvikuru kukura GERD pane vasiri vese vasiri kusvuta.
Mishonga
OTC mishonga ndiyo yekutanga yekudzivirirwa kwekurapa kurwisa kwakanyanya kwepfungwa uye acid reflux. Izvi zvinogona kubatsira mukuderedza zviratidzo apo iwe unoshanda pakugadzirisa mhaka yavo, reflux pachayo, nekunyoreswa kwepamusoro.
Iyi mishonga inonzi yakachengeteka kushandiswa kwepakati asi inogona kukonzera matambudziko kana inoshandiswa zvakanyanya.
Pakati peimwe yemishonga inowanzoshandiswa:
- Antacids , kufanana neTums, Rolaids, uye Gaviscon, inoshanda nekutapudza musimba weAidhiya nemishonga yakadai sealuminium hydroxide uye magnesium hydroxide. Kunyanya kushandiswa kunogona kutungamirira kudzimba (magnesium-based antacids) uye chirwere (aluminium-based antacids).
- H2 receptor blockers , iyo inoderedza kubudiswa kwemarimba acid, inosanganisira mazita akadaro eOTC marudzi sePepcid (famotidine), Tagamet (cimetidine), uye Zantac (ranitidine). Zvimwe zvinokonzera zvinosanganisira kuvhiringidzika, chirwere, chirwere chakaoma, misoro, uye kuchema munzeve ( tinnitus ).
- Proton pump inhibitors (PPIs) inopa chiito chakafanana neH2 blockers asi yakasimba uye ichikurumidza. Dzinosanganisira Nexium (esomeprazole), Prevacid (lansoprazole), uye Prilosec (omeprazole). PPIs yakawanda inowanzoshandiswa kana H2 blocker inokundikana kupa rubatsiro. Kusuruvara, kuvimbiswa, chirwere, uye flatulence zvinowanzovhiringidza.
Shanduro dzakasimba dzeH2 blockers uye PPIs dzinowanikwa nemutemo.
Surgeries
Kuvhiya kwehutano hwechibereko kunongoratidzwa chete kana chironga cheparaeophageal chiri kuita zviratidzo zvisingagoni kurapwa nemishonga kana mararamiro ehupenyu. Izvi ndechokuti kuonekwa kwezviratidzo kunoratidza kuti dumbu rakapfuurira mberi muchipfuva chechifu uye ikozvino riri kuchinja nzvimbo yeLATS. Sezvo chirongwa cheparaesophageal chinowedzera kuva chifambira mberi, zviri nani chaizvo kuti uzviite pane yapfuura kupfuura gare gare.
Zvimwe zvezvinetso zvakaoma zvikuru, zvakadai sevolvulus (chirwere umo mudumbu inoshandura zvinodarika 180 degrees) uye kuchenesa (uko kupararira kweropa kuchibviswa), kunoonekwa sehutano hurumende.
Kana iwe uine hupfumi hwakawanda, kusarudzwa kwekuvhiya kuchazogadziriswa nehutano uye hutsinye hwezvinetso.
Kuvhura kana kuRaparoscopic Kugadzirisa
Zvichida sarsthoracic ("yakazaruka") kana gavhuna (laparoscopic, kana "keyhole") kuvhiyiwa kunogona kushandiswa kugadzirisa pesa yeparaesophageal.
- Kuvhiyiwa pachena kunosanganisira kupindira mumuviri kuburikidza nekukanganiswa, kazhinji kuruboshwe rwemuviri. Iyo inowanzoshandiswa mumamiriro ezvinhu anononoka apo kune kubuda kukuru kweropa kana nhengo inopera. Inogonawo kushandiswa mune zvisiri izvo zvinotyisa, zvakadai sekuti apo dumbu rose rakapinda muchipfuva cavity (inozivikanwa sechirwere chinonzi intrathoracic).
- Kuvhiyiwa kwepadoscopic kunosanganisira kuiswa kwezvinhu zvakawanda zvokuvhiya muzvikamu zvitatu zvakakosha zvakagadziriswa mudumbu. Nokuda kwezvisizvo zvisingaiti, zvinotaridzika sechinhu chinoshanda sechinhu chekuvhiya chinogadziriswa asi neine zvipingamupinyi zvishoma uye nguva yekudzidzira nguva.
Nissen Fundoplication
Nissen fundoplication ndiyo nzira itsva inoshandiswa laparoscopically. Chinangwa chekuvhiya ndechekuvhara zvakasimba chikamu chepamusoro chemuviri (chinonzi fundus) chakakomberedza sopu uye ichichengeteka panzvimbo yacho nemashizha kana zvigadzirwa kuitira kuti ichengetwe yakarurama uye inotsigirwa. Kana yakaitwa zvakanaka, fundoplication inogona kuisa iLes panzvimbo iyo inoshanda zvakanaka.
Nissen fundoplication inofungidzirwa yakachengeteka uye inoshanda, ine inopfuura 1 muzana yehutano hwekufa uye nehuwandu hwehutano hwe 89.5 muzana kupfuura makore gumi. Kuvhara, kurutsira, uye kushungurudza chirwere chemawere (IBS) chinowanzouya shure-operative migumisiro inowanzogadzirisa ivo pachavo mukati memavhiki maviri kusvika mana.
Complementary Medicine (CAM)
Mukuwedzera kune antacids uye acid-blockers, kune huwandu hwemishonga inobatanidza iyo inogona kupa ruzivo rwakakura rwezviratidzo zvakaoma.
Licorice
Licorice, inobva mumidzi ye licorice , yakagara ishandiswa kurapa kushungurudza mwoyo uye zvimwe zviratidzo zvepamuviri. Kunyange zvazvo kutsvakurudza kuri kuramba kusina, dzimwe dzidzo dzakaratidza kuti dzine nzvimbo yayo pamwe chete nemishonga yemazuva ano-kudzivirira.
Chidzidzo che2013 chakabudiswa muCliniki neIchirongwa cheGastroenterology chakashuma kuti kushandiswa pamwe chete kwekukura kweti licorice uye chiremba-simba PPI (pantoprazole) zvakaita kuti zviratidzo zvishoma zvekurwadziwa kwepfungwa, kurwadziwa kwepfupa, uye kuzvimba kwemuviri zvichienzaniswa nekushandisa PPI chete.
Teji yeLisorice ndeimwe yemafomu anowanzoshandiswa. Chimwe, chinonzi deglycyrrhizinated licorice (DGL) , chinowanikwa sekuwedzera kwezvokudya uye inogona kuvhiringidzika pamusana pekubviswa kwe glycyrrhizin (chinhu chinozivikanwa pakuderedza ropa potassium mazinga).
Tsangamidzi
Ginger ndeimwe nzira yakakurumbira inogona kubatsira kuderedza zviratidzo zvekuora mwoyo. Ginger midzi yakazara mune antioxidants uye ine phenolic michina inofanirwa kuderedza gastric contractions uye, nokudaro, kuderedza mikana ye acid acid reflux.
Zvisinei, kana inoshandiswa zvakanyanyisa, ginger inogona kunge yakashata. Chidzidzo chegore ra2014 kubva kuStanford University chakataura kuti, apo ginger inotora kana fomu fomu inogona kubvisa mararamiro uye inovandudza utachiona hwemhepo , maitiro ezuva nezuva epamusoro pemagiramu mashanu anogona kunyanya kuwedzera njodzi yekuora mwoyo uye kusuruvara kwepamuviri.
Ginger inogona kutengwa seiyi kana muupfu, capsule, kana mvura inogadzirwa.
Sezvo kune chero CAM zvingasarudzwa, zvakanakisisa kukurukura licorice uye ginger nechiremba wako usati waedza.
> Sources:
> Di Pierro, F .; Gatti, M .; uye Rapacioli, G. "Migumisiro kune varwere vane chirwere chisingaverengeki reflux chinorapwa neproton pump inhibitor uye alginic acid ± glycyrrhetinic acid uye anthocyanosides." Clin Exp Gastroenterol. 2013; 6: 27-33. DOI: 10.2147 / CEG.S42512.
> Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). "Mirayiridzo yeHurumende yeHiatal Hernia." Los Angeles, California; shandisa April 2013.
> Yeh, A. uye Golianu, B. "Kurapa Kunobatsira kweReflux uye Kushanda Dyspepsia muvana." Vana (Basel). 2014; 1 (2): 119-33. DOI: 10.3390 / vana1020119.