Ukuhlinzwa kwe-anti-reflux

Ukuhlinzwa kwe-anti-reflux kuyindlela yokwelapha i-acid reflux, eyaziwa nangokuthi yi-GERD (isifo se-reflux se-gastroesophageal). I-GERD yisimo lapho ukudla noma isisu esiswini sibuya esiswini sakho singene emphinjeni. I-esophagus yishubhu elisuka emlonyeni wakho liye esiswini.

I-Reflux ivame ukwenzeka uma imisipha lapho i-esophagus ihlangana khona nesisu ingavali ngokuqinile ngokwanele. I-hernia yokubeletha ingenza izimpawu ze-GERD zibe zimbi kakhulu. Kwenzeka lapho isisu sikhukhula ngalolu vulo esifubeni sakho.

Izimpawu ze-reflux noma isilungulela ziyasha esiswini ongazizwa nasemphinjeni noma esifubeni sakho, ukuqhuma noma amagwebu egesi, noma unenkinga yokugwinya ukudla noma uketshezi.

Inqubo ejwayelekile yalolu hlobo ibizwa ngokuthi yi-fundoplication. Kulokhu kuhlinzwa, udokotela wakho ohlinzayo uzo:

• Okokuqala lungisa i-hernia yokubeletha, uma umuntu ekhona. Lokhu kuhilela ukuqinisa ukuvulwa kwesifafazi sakho ngeziqu ukuze ugcine isisu sakho singakhuphuki phezulu ngokuvula odongeni lwemisipha. Abanye odokotela abahlinzayo bafaka isiqeshana semeshi endaweni elungisiwe ukuze ivikeleke kakhulu.
• Songa ingxenye engenhla yesisu sakho ngasekupheleni kwesisu sakho ngemithungo. Izitishi zidala ingcindezi ekugcineni kwesifo sakho, okusiza ukuvimbela i-asidi yesisu nokudla ukuthi kungagobhozi kusuka esiswini kuya esimphagus.

Ukuhlinzwa kwenziwa ngenkathi ungaphansi kwe-anesthesia ejwayelekile, ngakho-ke ulele futhi awunazinhlungu. Ukuhlinzwa kuvame ukuthatha amahora amabili kuya kwangu-3. Udokotela wakho ohlinzayo angakhetha kumasu ahlukene.

UKULUNGISWA KOKUVULA

• Udokotela wakho ohlinzayo uzokwenza ukusika oku-1 okukhulu esiswini sakho.
• Ishubhu ingafakwa esiswini sakho ngokusebenzisa isisu ukugcina udonga lwesisu lusendaweni. Le tube izokhishwa esikhathini esingangesonto.

UKULUNGISWA KWE-LAPAROSCOPIC

• Udokotela wakho ohlinzayo uzokwenza ukusikeka okuncane okungu-3 kuya ku-5 esiswini sakho. Ishubhu elincanyana elinekhamera encane ekugcineni lifakwa ngalokhu kusikeka.
• Amathuluzi okuhlinza afakwa ngokusebenzisa okunye ukusikeka. I-laparoscope ixhunywe kumqapha wevidiyo egumbini lokusebenza.
• Udokotela wakho ohlinzayo uyalungisa ngenkathi ebuka ingaphakathi lesisu sakho kumonitha.
• Udokotela ohlinzayo angadinga ukushintshela kunqubo evulekile uma kunezinkinga.

ISISEKELO SOKUQEDELA

• Le yinqubo entsha engenziwa ngaphandle kokusika. Ikhamera ekhethekile kuthuluzi eliguquguqukayo (i-endoscope) idluliselwa phansi ngomlomo wakho nangaphakathi kwesigaxa sakho.
• Usebenzisa leli thuluzi, udokotela uzobeka iziqeshana ezincane endaweni lapho umqala uhlangana khona nesisu. Lezi ziqeshana zisiza ukuvimbela ukudla noma i-asidi yesisu ekusekeleni.

Ngaphambi kokucatshangelwa ukuhlinzwa, umhlinzeki wakho wezokunakekelwa kwempilo uzokuzama:

• Imithi efana ne-H2 blocker noma i-PPIs (proton pump inhibitors)
• Izinguquko zendlela yokuphila

Ukuhlinzwa ukwelapha isilungulela noma izimpawu ze-reflux kunganconywa lapho:

• Izimpawu zakho azibi ngcono kakhulu uma usebenzisa imithi.
• Awufuni ukuqhubeka uthatha le mithi.
• Unezinkinga ezinzima kakhulu emgodini wakho, njengokuqothuka noma ukunciphisa, izilonda, noma ukuphuma kwegazi.
• Unesifo se-reflux esibangela i-aspiration pneumonia, ukukhwehlela okungapheli, noma ukushuba.

Ukuhlinzwa kwe-anti-reflux kuyasetshenziswa ukwelapha inkinga lapho ingxenye yesisu sakho ibambeka esifubeni sakho noma isontekile. Lokhu kubizwa nge-para-esophageal hernia.

Izingozi zanoma iyiphi i-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukusabela emithini
• Izinkinga zokuphefumula
• Ukopha, amahlule, noma izifo

Izingozi zalokhu kuhlinzwa yilezi:

• Ukulimala esiswini, esophagus, isibindi, noma amathumbu amancane. Lokhu akuvamile.
• Ukuqunjelwa kwegesi. Lokhu kulapho isisu sigcwala umoya noma ukudla futhi ungakwazi ukwehlisa ingcindezi ngokubhoboza noma ngokuhlanza. Lezi zimpawu ziba ngcono kubantu abaningi.
• Ubuhlungu nobunzima lapho ugwinya. Lokhu kubizwa nge-dysphagia. Kubantu abaningi, lokhu kuyaphela phakathi nezinyanga ezintathu zokuqala ngemuva kokuhlinzwa.
• Ukubuyiselwa kwe-hernia yokuzalwa noma i-reflux.

Ungadinga izivivinyo ezilandelayo:

• Ukuhlolwa kwegazi (ukubalwa okuphelele kwegazi, ama-electrolyte, noma ukuhlolwa kwesibindi).
• I-Esophageal manometry (ukukala izingcindezi ku-esophagus) noma ukuqapha i-pH (ukubona ukuthi ingakanani i-asidi yesisu ebuyela emuva esophagus yakho).
• I-endoscopy ephezulu. Cishe bonke abantu abanalokhu kuhlinzekwa kwe-anti-reflux sebenalo lolu vivinyo. Uma ungakaze uthole lolu vivinyo, kuzodingeka ukwenze.
• Ama-X-ray womphimbo.

Hlala utshela umhlinzeki wakho uma:

• Ungakhulelwa.
• Uthatha noma imuphi umuthi, noma izithasiselo noma amakhambi owathengile ngaphandle kwemithi kadokotela.

Ngaphambi kokuhlinzwa kwakho:

• Kungase kudingeke uyeke ukuthatha i-aspirin, ibuprofen (Advil, Motrin), uvithamini E, i-clopidogrel (i-Plavix), i-warfarin (i-Coumadin), nanoma iziphi ezinye izidakamizwa noma izithasiselo ezithinta ukujiya kwegazi ezinsukwini ezimbalwa ngaphambi kokuhlinzwa. Buza udokotela wakho ohlinzayo ukuthi yini okufanele uyenze.
• Buza umhlinzeki wakho ukuthi yiziphi izidakamizwa okufanele usaziphuza ngosuku lokuhlinzwa kwakho.

Ngosuku lokuhlinzwa kwakho:

• Landela imiyalo yomhlinzeki wakho mayelana nokuthi ungayeka nini ukudla nokuphuza.
• Thatha izidakamizwa udokotela wakho akutshele ukuthi uziphuze ngophuzo oluncane lwamanzi.
• Landela imiyalo yokugeza ngaphambi kokuhlinzwa.

Umhlinzeki wakho uzokutshela ukuthi ufika nini esibhedlela. Qiniseka ukuthi ufika ngesikhathi.

Iningi labantu abahlinzwa i-laparoscopic bangashiya esibhedlela kungakapheli izinsuku ezi-1 kuye kwezi-3 ngemuva kwenqubo. Ungadinga ukuhlala esibhedlela izinsuku ezimbili kuya kwezi-6 uma uhlinzeka ngokuvula. Abantu abaningi bangabuyela emisebenzini ejwayelekile emavikini amane kuya kwayisithupha.

Isilungulela nezinye izimpawu kufanele zithuthuke ngemuva kokuhlinzwa. Abanye abantu basadinga ukuthatha izidakamizwa zokushaya isilungulela ngemuva kokuhlinzwa.

Ungadinga okunye ukuhlinzwa ngokuzayo uma uba nezimpawu ezintsha ze-reflux noma izinkinga zokugwinya. Lokhu kungenzeka uma isisu sasigoqwe sasiqiniswa ngqi, ukuqina kuyadedela, noma kuvela i-hernia entsha yokubeletha.

Ukusetshenziswa kwemali; Ukusetshenziswa kwemali kweNissen; Belsey (Mark IV) ukusetshenziswa kwemali; I-Toupet fundoplication; Ukusetshenziswa kwemali kweThal; Ukulungiswa kweHiaatal hernia; I-Endoluminal fundoplication; I-reflux ye-gastroesophageal - ukuhlinzwa; GERD - ukuhlinzwa; Reflux - ukuhlinzwa; I-hernia ye-Hiatal - ukuhlinzwa

• Ukuhlinzwa kwe-anti-reflux - ukukhishwa
• Ukukhishwa kwe-gastroesophageal - ukukhipha
• Isilungulela - okufanele ukubuze kudokotela wakho
• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile

• Ukulungiswa kwe-hernia hernia - uchungechunge
• I-hernia ye-Hiatal - i-x-ray

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.

UMazer LM, Azagury DE. Ukuphathwa kokuhlinzwa kwesifo se-reflux se-gastroesophageal. Ku: UCameron AM, uCameron JL, ama-eds. Ukwelashwa Kwamanje. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2020: 8-15.

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

I-Yates RB, i-Oelschlager BK, iPellegrini CA. Isifo se-reflux se-gastroesophageal kanye ne-hernia yokubeletha. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 42.