I-Hiatal Hernias ne-Acid Reflux

-Delile

• Ukubuka konke
• Izimpawu
• Ukuxilongwa
• Ukwelashwa
• Ukuhlinzwa

Ngo-Ephreli 2020, kwacelwa ukuthi zonke izinhlobo zemithi kadokotela kanye ne-over-the-counter (OTC) ranitidine (Zantac) zisuswe emakethe yase-U.S. Lesi sincomo senziwe ngoba amazinga angamukeleki we-NDMA, i-carcinogen engahle (amakhemikhali abangela umdlavuza), atholakala kweminye imikhiqizo ye-ranitidine. Uma unikezwe i-ranitidine, khuluma nodokotela wakho mayelana nezinye izindlela eziphephile ngaphambi kokumisa umuthi. Uma uthatha i-OTC ranitidine, yeka ukuthatha lesi sidakamizwa bese ukhuluma nomhlinzeki wakho wezokunakekelwa kwezempilo mayelana nezinye izinketho. Esikhundleni sokuthatha imikhiqizo ye-ranitidine engasetshenzisiwe isiza sokubuyisa izidakamizwa, yilahle ngokwemiyalo yomkhiqizo noma ngokulandela i-FDA's.

Ukubuka konke

I-hernia yokubeletha yisimo lapho ingxenye encane yesisu sakho iqhuma khona ngembobo ku-diaphragm yakho. Lo mgodi ubizwa ngokuthi yi-hiatus. Kuyinto evulekile, evulekile ngokwendlela evumayo evumela ukuthi umhosha wakho uxhume esiswini sakho.

Imbangela ye-hernia yokuzalwa ngokuvamile ayaziwa. Izicubu ezisekelayo ezibuthakathaka nokwanda kwengcindezi yesisu kungaba nomthelela kulesi simo. I-hernia uqobo ingadlala indima ekuthuthukiseni i-acid reflux kanye nefomu elingapheli le-acid reflux ebizwa nge-gastroesophageal reflux disease (GERD).

Ama-hernias aseHiatal angadinga izindlela ezahlukahlukene zokwelashwa, kusuka kokulinda ngokubuka ezimweni ezimnene kuya ekuhlinzweni ezimweni ezinzima.

Izimpawu

Ama-hernias ase-Hiatal awavami ukudala izimpawu ongazibona kuze kube yilapho ukuphuma kwesisu nge-hiatus kukhulu impela. Ama-hernias amancane alolu hlobo avame ukungabonakali. Ungahle ungazi eyodwa ngaphandle kokuthi uhlolwe udokotela ngesimo esingahlobene.

Ama-hernias amakhulu okuzala makhulu ngokwanele ukuvumela ukudla okungadliwe kanye nezicubu zesisu ukuthi ziphinde zingene esophagus yakho. Lokhu kusho ukuthi kungenzeka ubonise izimpawu ezijwayelekile ze-GERD. Lokhu kufaka phakathi:

• isilungulela
• ubuhlungu besifuba obukhulayo lapho ugoba noma ulele
• ukukhathala
• ubuhlungu besisu
• i-dysphagia (inkinga yokugwinya)
• ukubhoboza njalo
• Umphimbo obuhlungu

I-Acid reflux ingadalwa yizinto ezahlukahlukene ezingaphansi. Ukuhlolwa kungadingeka ukunquma ukuthi ngabe une-hernia yokubeletha noma okunye ukungahleleki okuhlelekile okungaba ngemuva kwezimpawu zakho ze-GERD.

Khuluma nodokotela wakho mayelana nezimpawu ze-reflux ezingabi ngcono ngokushintsha kwendlela yokuphila nokudla noma ama-antacids angaphezu kwamanani.

Ukuxilongwa

Ukuhlolwa kokufanekisa kusetshenziselwa ukuthola i-hernia yokuzalwa kanye nanoma yimuphi umonakalo obengenziwa yi-acid reflux. Esinye sezivivinyo ezivame kakhulu ze-imaging i-barium swallow X-ray, kwesinye isikhathi ebizwa ngokuthi i-GI engenhla noma i-esophagram.

Uzodinga ukuzila ukudla amahora ayisishiyagalombili ngaphambi kokuhlolwa ukuze uqiniseke ukuthi ingxenye ephezulu yomgudu wakho wamathumbu (isisu sakho, isisu sakho, nengxenye yamathumbu akho amancane) ibonakala ngokusobala ku-X-ray.

Uzophuza ukuzamazama kwe-barium ngaphambi kokuhlolwa. I-Shake yinto emhlophe, eshokozayo. I-barium yenza izitho zakho zibonakale kalula kwi-X-ray njengoba ihamba emgodleni wakho wamathumbu.

Amathuluzi wokuxilonga e-Endoscopic nawo asetshenziselwa ukuxilonga ama-hernias okuzala. I-endoscope (ishubhu elincanyana, eliguquguqukayo elifakwe ilambu elincane) lifakwa emqaleni wakho lapho ungaphansi kwesilaliso. Lokhu kuvumela udokotela wakho ukuthi afune ukuvuvukala noma ezinye izinto ezingadala i-acid reflux yakho. Lezi zinto zingafaka i-hernias noma izilonda.

Ukwelashwa

Ukwelashwa kwe-hernia yokubeletha kuyahlukahluka kakhulu futhi kufanele kuhambisane nokukhathazeka kwakho kwezempilo. Ama-hernias amancane avela ekuhlolweni kokuxilongwa kepha ahlala engenazimpawu angahle adinge ukubukwa ukuze aqiniseke ukuthi awabi makhulu ngokwanele ukudala ukungaphatheki kahle.

Imishanguzo yokuphuza isilonda engaphezulu-the-counter inganikeza ukukhululeka ekuzizweni okushisayo okungahle kuqhume ku-hernia esesilinganisweni sokuzalwa. Zingathathwa njengoba zidingeka usuku lonke ezimweni eziningi. Ama-antacids asuselwa ku-calcium ne-magnesium ajwayele ukufakwa endaweni yokulekelela yokugaya ukudla esitolo sakho sendawo.

Imithi kadokotela ye-GERD ayikunikeli ukukhululeka nje kuphela, eminye ingasiza nokuphulukisa ulwelwesi lwesisu sakho kusuka ku-acid reflux ehlobene ne-hernia. Le mithi yehlukaniswe ngamaqembu amabili: ama-H2 blocker nama-proton pump inhibitors (ama-PPIs). Kubandakanya:

• i-cimetidine (Tagamet)
• i-esomeprazole (Nexium)
• i-famotidine (i-Pepcid)
• I-lansoprazole (Prevacid)
• i-omeprazole (Prilosec)

Ukulungisa uhlelo lwakho lokudla nokulala nakho kungasiza ukuphatha izimpawu zakho ze-GERD lapho une-hernia yokubeletha. Yidla ukudla okuncane usuku lonke futhi ugweme ukudla okubangela isilungulela. Ukudla okungadala isilungulela kufaka:

• imikhiqizo yotamatisi
• imikhiqizo yamawolintshi
• ukudla okunamafutha
• ushokoledi
• upelepele
• i-caffeine
• utshwala

Zama ukungalali okungenani amahora amathathu ngemuva kokudla ukuvimbela ama-acid ekusebenzeni ngendlela yawo ekuvuseleleni umgudu wokugaya ukudla. Kufanele futhi uyeke ukubhema. Ukubhema kungakhuphula ubungozi be-acid reflux. Futhi, ukukhuluphala ngokweqile (ikakhulukazi uma ungowesifazane) kungakhuphula ubungozi bokuthuthukisa i-GERD ne-hiatal hernias, ngakho-ke ukwehlisa isisindo kungasiza ekunciphiseni izimpawu zakho ze-reflux.

Ukuhlinzwa

Ukuhlinzwa ukulungisa i-hernia yokubeletha kungadingeka lapho ukwelashwa kwezidakamizwa, ukuguqulwa kokudla, nokulungiswa kwendlela yokuphila kungazilawuli kahle izimpawu. Abazongenela ukhetho olulungele i-hernia hernia kungaba yilabo:

• ukuzwa isilungulela
• ube nokuqina kokuqina (ukuncipha kwesisu ngenxa ye-reflux engapheli)
• ube nokuvuvukala okunzima komphimbo
• babe nenyumoniya ebangelwa ukufisa ama-acid esiswini

Ukuhlinzwa kokulungiswa kweHernia kwenziwa ngaphansi kokubulala izinzwa okujwayelekile. Izicucu ze-laparoscopic zenziwa esiswini sakho, zivumela udokotela ohlinzayo ukuthi asikhiphe ngesinono isisu asikhiphe ku-hiatus futhi sibuyele endaweni yaso ejwayelekile. Imithungo iqinisa i-hiatus futhi igcine isisu ukuthi singashibilikisi esivulekeni futhi.

Isikhathi sokutakula ngemuva kokuhlinzwa singaqala ezinsukwini ezi-3 kuye kwezingu-10 esibhedlela. Uzothola umsoco ngokusebenzisa ithubhu le-nasogastric izinsuku ezimbalwa ngemuva kokuhlinzwa. Uma usuvunyelwe ukudla ukudla okuqinile futhi, qiniseka ukuthi udla amanani amancane usuku lonke. Lokhu kungasiza ukukhuthaza ukuphulukiswa.