Isifo se-reflux se-gastroesophageal

Isifo se-reflux se-Gastroesophageal (GERD) yisimo lapho okuqukethwe esiswini kuvuza khona emuva kusuka esiswini kuya emphinjeni (ipayipi lokudla). Ukudla kuhamba kusuka emlonyeni wakho kuya esiswini ngesisu sakho. I-GERD ingacasula ipayipi lokudla futhi ibangele isilungulela nezinye izimpawu.

Uma udla, ukudla kudlula kusuka emphinjeni kuya esiswini kudlule ngomphefumulo. Indandatho yemicu yemisipha endaweni engezansi ivimbela ukudla okugwinyiwe ukuthi kungabuyeli emuva. Le micu yemisipha ibizwa ngokuthi i-esophageal sphincter (LES) engezansi.

Lapho le ndandatho yemisipha ingavali yonke indlela, okuqukethwe yisisu kungaphinde kubuyele emqaleni. Lokhu kubizwa ngokuthi i-reflux noma i-reflux ye-gastroesophageal. I-Reflux ingadala izimpawu. Ama-acid esiswini anamandla nawo angalimaza ulwelwesi lwe-esophagus.

Izici ezinobungozi ze-reflux zifaka:

• Ukusetshenziswa kotshwala (mhlawumbe)
• I-hiatal hernia (isimo lapho ingxenye yesisu ihamba ngaphezu kwesifafula, okungumsipha ohlukanisa isifuba nezimbobo zesisu)
• Ukukhuluphala ngokweqile
• Ukukhulelwa
• I-Scleroderma
• Ukubhema
• Ukuhlala ngaphakathi kwamahora amathathu ngemuva kokudla

Isilungulela ne-gastroesophageal reflux kungalethwa noma kwenziwe kubi kakhulu ngokukhulelwa. Izimpawu nazo zingabangelwa yimithi ethile, njenge:

• Ama-anticholinergics (ngokwesibonelo, umuthi wokugula kwasolwandle)
• Ama-bronchodilators wesifuba somoya
• Ama-calcium block blockers we-high blood pressure
• Izidakamizwa ezisebenza nge-Dopamine zesifo seParkinson
• I-progestin yokopha okungavamile kokuya esikhathini noma ukulawulwa kokuzalwa
• Izindlela zokulala noma ukukhathazeka
• I-Tricyclic antidepressants

Khuluma nomhlinzeki wakho wezokunakekelwa kwempilo uma ucabanga ukuthi omunye wemithi yakho kungenzeka ukuthi ubanga isilungulela. Ungalokothi ushintshe noma uyeke ukuthatha umuthi ngaphandle kokuqala ukhulume nomhlinzeki wakho.

Izimpawu ezivamile ze-GERD zifaka:

• Ukuzwa ukuthi ukudla kunamathele ngemuva kwethambo lesifuba
• Isilungulela noma izinhlungu ezivuthayo esifubeni
• Isicanucanu ngemuva kokudla

Izimpawu ezingavamile kakhulu yilezi:

• Ukubuyisa ukudla (ukuphinda wenze kabusha)
• Ukukhwehlela noma ukuphefumula
• Kunzima ukugwinya
• Izikhubekiso
• Ukuduma noma ukushintsha kwezwi
• Umphimbo obuhlungu

Izimpawu zingase zibe zimbi kakhulu lapho ugoba noma ulele phansi, noma ngemuva kokudla. Izimpawu nazo zingaba zimbi kakhulu ebusuku.

Ungahle ungadingi noma yikuphi ukuhlolwa uma izimpawu zakho zimnene.

Uma izimpawu zakho zinzima noma zibuya ngemuva kokuphathwa, udokotela wakho angenza isivivinyo esibizwa nge-endoscopy ephezulu (EGD).

• Lokhu kuyisivivinyo sokuhlola ulwelwesi lwesisu, isisu, nengxenye yokuqala yamathumbu amancane.
• Kwenziwa ngekhamera encane (i-endoscope eguquguqukayo) efakwa ngomphimbo.

Ungadinga futhi ukuhlolwa okukodwa noma okuningi okulandelayo:

• Isivivinyo esilinganisa ukuthi i-asidi yesisu ingena kangaki kushubhu eliholela lisuka emlonyeni liye esiswini (elibizwa ngokuthi i-esophagus)
• Isivivinyo sokulinganisa ingcindezi engxenyeni engezansi yomphimbo (i-esophageal manometry)

Ukuhlolwa kwegazi lokuhlola okulungile kungathola ukopha okuvela ekucasukeni esiswini, esiswini, noma emathunjini.

Ungenza izinguquko eziningi zokuphila ukusiza ukuphatha izimpawu zakho.

Amanye amathiphu afaka:

• Uma ukhuluphele ngokweqile noma ukhuluphele, ezimweni eziningi, ukunciphisa isisindo kungasiza.
• Phakamisa ikhanda lombhede uma izimpawu zakho ziba zimbi ebusuku.
  
• Yidla isidlo sakho sedina amahora amabili kuya kwangu-3 ngaphambi kokulala.
  
• Gwema izidakamizwa ezifana ne-aspirin, ibuprofen (Advil, Motrin), noma naproxen (Aleve, Naprosyn). Thatha i-acetaminophen (iTylenol) ukudambisa izinhlungu.
• Thatha yonke imithi yakho ngamanzi amaningi. Lapho umhlinzeki wakho ekunika umuthi omusha, buza ukuthi uzokwenza yini isilungulela sakho sibe sibi kakhulu.

Ungasebenzisa ama-antacids athengwa ngemuva kokudla nangesikhathi sokulala, yize ukukhululeka kungahle kungahlali isikhathi eside. Imiphumela emibi ejwayelekile yama-antacids ifaka uhudo noma ukuqunjelwa.

Eminye imishanguzo etholakala esithenjini nemithi kadokotela ingalapha i-GERD. Zisebenza kancane ukudlula ama-antiacids, kepha zikunikeza ukukhululeka okude. Usokhemisi wakho, udokotela, noma umhlengikazi angakutshela ukuthi ungayithatha kanjani le mithi.

• Ama-Proton pump inhibitors (ama-PPIs) anciphisa inani le-asidi ekhiqizwa esiswini sakho.
• Ama-H2 blocker abuye ehlise inani le-asidi ekhishwe esiswini.

Ukuhlinzwa kwe-anti-reflux kungaba yindlela kubantu abanezimpawu ezingasuki ekushintsheni kwempilo nemithi. Isilungulela nezinye izimpawu kufanele zithuthuke ngemuva kokuhlinzwa. Kepha kusengadingeka uthathe imithi yesilungulela.

Kukhona nezindlela zokwelapha ezintsha ze-reflux ezingenziwa nge-endoscope (ithubhu eliguquguqukayo elidlula ngomlomo lingene esiswini).

Iningi labantu liphendula ekuguqukeni kwendlela yokuphila nasemithini. Kodwa-ke, abantu abaningi badinga ukuqhubeka nokuthatha imishanguzo ukulawula izimpawu zabo.

Izinkinga zingafaka:

• Ukuqina kwesifuba somoya
• Ushintsho kulwelwesi lwe-esophagus olungakhuphula ingozi yomdlavuza (iBarrett esophagus)
• I-Bronchospasm (ukucasuka kanye ne-spasm yemigwaqo yomoya ngenxa ye-asidi)
• Ukukhwehlela isikhathi eside (okungapheli) noma ukushuba
• Izinkinga zamazinyo
• Isilonda esiswini
• Ukuqina (ukuncipha komphimbo ngenxa yokushwabana)

Shayela umhlinzeki wakho uma izimpawu zingathuthuki ngokushintsha kwempilo noma ngemithi.

Shayela futhi uma une:

• Ukopha
• Ukuchofoza (ukukhwehlela, ukuphefumula okuncane)
• Ukuzizwa ugcwala ngokushesha lapho udla
• Ukuhlanza njalo
• Ukungahambi kahle
• Ukuphelelwa isifiso sokudla
• Inkinga yokugwinya (i-dysphagia) noma ubuhlungu ngokugwinya (i-odynophagia)
• Ukwehla kwesisindo
• Ukuzizwa sengathi ukudla noma amaphilisi kunamathele ngemuva kwethambo lesifuba
  

Ukugwema izinto ezibangela isilungulela kungasiza ukuvimbela izimpawu. Ukukhuluphala kuxhunyaniswe ne-GERD. Ukugcina isisindo somzimba esinempilo kungasiza ukuvimbela isimo.

I-peptic esophagitis; I-Reflux esophagitis; IGERD; Isilungulela - esingapheliyo; I-Dyspepsia - GERD

• Ukuhlinzwa kwe-anti-reflux - izingane - ukukhishwa
• Ukuhlinzwa kwe-anti-reflux - ukukhishwa
• Ukukhishwa kwe-gastroesophageal - ukukhipha
• Isilungulela - okufanele ukubuze kudokotela wakho
• Ukuthatha ama-antacids

• Uhlelo lokugaya ukudla
• Isifo se-reflux se-gastroesophageal
• I-reflux ye-gastroesophageal - uchungechunge

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ASGE Standards of Practice Committee, uMuthusamy VR, uLightdale JR, et al. Indima ye-endoscopy ekuphathweni kwe-GERD. Isisu Endosc. 2015; 81 (6): 1305-1310. I-PMID: 25863867 www.ncbi.nlm.nih.gov/pubmed/25863867.

I-Falk GW, i-Katzka DA. Izifo zomphimbo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 129.

Katz PO, Gerson LB, Vela MF. Imihlahlandlela yokuxilongwa nokuphathwa kwesifo se-reflux se-gastroesophageal. NginguJ Gastroenterol. 2013; 108 (3): 308-328. I-PMID: 23419381 www.ncbi.nlm.nih.gov/pubmed/23419381.

I-National Institute of Diabetes kanye newebhusayithi yezifo zeDigestive and Kidney. I-Acid reflux (GER & GERD) kubantu abadala. www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/all-content. Kubuyekezwe ngoNovemba 2015. Kufinyelelwe ngoFebhuwari 26, 2020.

URichter JE, uFriedenberg FK. Isifo se-reflux se-gastroesophageal. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 44.