Hiatal Hernias ndi Acid Reflux

Zamkati

• Chidule
• Zizindikiro
• Matendawa
• Chithandizo
• Opaleshoni

Mu Epulo 2020, adapempha kuti mitundu yonse yamankhwala ndi owonjezera (OTC) ranitidine (Zantac) zichotsedwe kumsika waku U.S. Malangizowa adapangidwa chifukwa milingo yosavomerezeka ya NDMA, yomwe imayambitsa khansa (yomwe imayambitsa khansa), idapezeka muzinthu zina za ranitidine. Ngati mwalamulidwa ranitidine, lankhulani ndi dokotala wanu za njira zina zoyenera musanayimitse mankhwalawo. Ngati mukumwa OTC ranitidine, lekani kumwa mankhwalawa ndipo lankhulani ndi omwe amakuthandizani pazithandizo zina. M'malo motengera mankhwala osagwiritsidwa ntchito a ranitidine kumalo obwezeretsanso mankhwala, muzitaya malinga ndi malangizo a mankhwalawo kapena kutsatira FDA.

Chidule

Hernia yoberekera ndimkhalidwe womwe gawo laling'ono la m'mimba mwanu limabowola kudzera mu kabowo kakang'ono kanu. Bowo limatchedwa hiatus. Ndikutseguka kwabwinobwino, komwe kumathandiza kuti kummero kwanu kulumikizane ndi mimba yanu.

Zomwe zimayambitsa matenda opatsirana nthawi zambiri sizidziwika. Matenda ofooka ofewetsa komanso kuchuluka kwa kuthamanga m'mimba kumatha kuchititsa vutoli. Hernia palokha imatha kuthandizira kukulitsa asidi Reflux komanso mtundu wa asidi Reflux wotchedwa gastroesophageal reflux matenda (GERD).

Matenda a Hiatal angafunikire chithandizo chamankhwala osiyanasiyana, kuyambira kudikirira modikira pang'ono mpaka kuchitidwa opareshoni.

Zizindikiro

Matenda a Hiatal samayambitsa zisonyezo zomwe mungazindikire mpaka kutuluka m'mimba kudzera pa hiatus ndikokulirapo. Zitsamba zazing'ono zamtunduwu nthawi zambiri zimakhala zosagwirizana. Simungadziwe chimodzi pokhapokha mutakayezetsa kuchipatala ngati simukugwirizana.

Matenda akuluakulu obadwa kumene amakhala akulu mokwanira kulola chakudya chosagayidwa komanso zidulo zam'mimba kuti zibwererenso m'mimba mwanu. Izi zikutanthauza kuti mwina mutha kuwonetsa zizindikilo za GERD. Izi zikuphatikiza:

• kutentha pa chifuwa
• kupweteka pachifuwa komwe kumakulirakulira mukamawerama kapena kugona pansi
• kutopa
• kupweteka m'mimba
• dysphagia (vuto kumeza)
• kubowola pafupipafupi
• chikhure

Reflux ya acid imatha chifukwa cha zinthu zingapo zoyambitsa. Kuyesedwa kumafunikira kuti mudziwe ngati muli ndi nthenda yoberekera kapena zina zomwe zingayambitse matenda anu a GERD.

Lankhulani ndi dokotala wanu za zizindikiro za reflux zomwe sizikhala bwino ndi kusintha kwa moyo ndi zakudya kapena ma antiacids.

Matendawa

Kuyesa kuyerekezera kumagwiritsidwa ntchito kuti azindikire chophukacho chobadwa ndi kuwonongeka komwe kukadapangidwa ndi acid reflux. Chimodzi mwazomwe zimayesedwa kwambiri ndi ma X-ray a barium, omwe nthawi zina amatchedwa GI apamwamba kapena esophagram.

Muyenera kusala maola asanu ndi atatu musanayesedwe kuti muwonetsetse kuti gawo lapamwamba lam'mimba (m'mimba, m'mimba, ndi gawo la m'matumbo anu) limawoneka bwino pa X-ray.

Mudzamwa barium shake musanayesedwe. Kugwedeza ndi chinthu choyera, chalky. Barium imapangitsa ziwalo zanu kukhala zosavuta kuziwona pa X-ray pamene zimadutsa m'matumbo anu.

Zida zowunika za Endoscopic zimagwiritsidwanso ntchito pofufuza ma hernias obadwa nawo. Endoscope (chubu chowonda, chosinthika chokhala ndi nyali yaying'ono) imamangiliridwa kummero kwanu mukakhala pansi. Izi zimalola dokotala wanu kuyang'ana kutupa kapena zina zomwe zingayambitse asidi reflux. Izi zitha kuphatikizira hernias kapena zilonda.

Chithandizo

Chithandizo cha nthenda yoberekera chimasiyana mosiyanasiyana ndipo chikuyenera kutengera zovuta zaumoyo wanu. Zitsamba zazing'ono zomwe zimawoneka pamayeso azidziwitso koma zimakhalabe zopanda chizindikiro zimangofunika kuyang'aniridwa kuti zitsimikizike kuti sizikhala zazikulu zokwanira kusokoneza.

Mankhwala owotchera pamoto amatha kukupatsani mpumulo pakumva kutentha komwe kumatha kutuluka chifukwa chokhala ndi nthenda yocheperako. Amatha kutengedwa ngati amafunikira tsiku lonse nthawi zambiri. Ma antiacids ofotokoza calcium ndi magnesium amapezeka nthawi zambiri m'misewu yazogulitsa zam'malo mwanu.

Mankhwala a GERD sikuti amangokupatsani mpumulo, ena amathanso kuthandizira kuchiritsa matumbo anu am'mimba kuchokera ku asidi wokhudzana ndi hernia. Mankhwalawa amagawika m'magulu awiri: H2 blockers ndi proton pump inhibitors (PPIs). Zikuphatikizapo:

• cimetidine (Tagamet)
• esomeprazole (Wowonjezera)
• famotidine (Pepcid)
• lansoprazole (Prevacid)
• omeprazole (Prilosec)

Kusintha nthawi yomwe mumadya komanso kugona kumathandizanso kuthana ndi zizindikiritso za GERD mukakhala ndi nthenda yobereka. Idyani chakudya chochepa tsiku lonse ndikupewa zakudya zomwe zimayambitsa kutentha pa chifuwa. Zakudya zomwe zingayambitse kutentha kwa mtima ndi izi:

• mankhwala a phwetekere
• mankhwala zipatso
• chakudya chamafuta
• chokoleti
• tsabola
• tiyi kapena khofi
• mowa

Yesetsani kuti musagone kwa maola atatu mutadya kuti asidi asabwerere m'matumbo. Muyeneranso kusiya kusuta. Kusuta kumatha kuwonjezera chiopsezo cha asidi Reflux. Komanso, kunenepa kwambiri (makamaka ngati ndinu wamkazi) kumatha kukulitsa chiopsezo chokhala ndi GERD komanso hernias obadwa nawo, chifukwa chake kuonda kungathandize kuchepetsa zizindikilo zanu za reflux.

Opaleshoni

Kuchita opaleshoni yokonzanso chophukacho kungakhale kofunikira pamene mankhwala osokoneza bongo, kusintha kwa zakudya, ndi kusintha kwa moyo sikuyendetsa bwino matendawa. Omwe angakonzekere kukonza nthenda ya hernia atha kukhala omwe:

• amakhumudwa kwambiri
• khalani ndi vuto la kukhazikika m'mimba (kuchepa kwa kholingo chifukwa cha Reflux yayitali)
• khalani ndi kutupa kwakukulu kwa kholingo
• ali ndi chibayo chomwe chimayambitsa kukhumba kwa zidulo zam'mimba

Kuchita opaleshoni ya Hernia kumachitidwa pansi pa mankhwala osokoneza bongo. Mawonekedwe a laparoscopic amapangidwa m'mimba mwanu, kulola dokotalayo kuti akwaniritse bwino m'mimba kuchokera pa hiatus ndikubwerera pamalo ake abwinobwino. Zolimba zimalimbitsa hiatus ndikuti m'mimba musadutsenso potseguka.

Nthawi yobwezeretsa pambuyo pa opaleshoni imatha kuyambira masiku atatu mpaka 10 kuchipatala. Mudzalandira zakudya zopatsa thanzi kudzera mu chubu cha nasogastric masiku angapo pambuyo pa opaleshoni. Mukaloledwa kudya zakudya zolimba kachiwiri, onetsetsani kuti mwadya pang'ono tsiku lonse. Izi zitha kuthandiza kulimbikitsa machiritso.