I-Gastroesophageal Reflux Disease (GERD): Izimpawu, Izimbangela, Ukuxilongwa kanye Nokwelashwa

Isifo se-reflux ye-gastroesophageal (GERD) yisifo esingelapheki inkinga yesisu lapho i-asidi esuka esiswini ibuyela phezulu epayipini lakho lokudla. Abantu abaningi babhekana ne-acid reflux kaningi. Kodwa-ke, i-acid reflux yesikhathi eside ingabangela i-GERD.

Ukudla kuhamba ngomminzo, ishubhu, kusuka emlonyeni kuya esiswini. I-valve ebuthakathaka noma ephukile ehlukanisa isisu kanye ne-esophagus ingaba imbangela ye-GERD. Ngaphezu kokubangela isilungulela nezinye izimpawu, ama-asidi emmizweni angase abangele ukulimala kwezicubu. Ukubuyela emuva njalo (i-reflux) ye-asidi kungabangela ukungakhululeki kanye nezinkinga, kuthinte izinga lempilo yomuntu. 

Izimpawu ze-GERD

Ukuhlonza izimpawu ze-GERD kungasiza ekungeneleleni kusenesikhathi nokuphatha. Ezinye izimpawu ezivamile zihlanganisa:

• Ukuzwa ukushisa esifubeni, ngokuvamile ngemva kokudla noma lapho ulele.
• Uketshezi olunambitheka muncu lubuyela emphinjeni noma emlonyeni.
• Ubunzima bokugwinya noma ukuzwa isigaxa emphinjeni.
• Ukungakhululeki kwesifuba okukhulu okungazwakala sengathi a isifo senhliziyo.
• Ukucasuka komphimbo ngenxa ye-acid reflux.

Ngaphezu kwalezi zimpawu, i-acid reflux ubusuku bonke ingase ibangele:

• Ukukhwehlela okuqhubekayo okungahlobene nezinye izimo zokuphefumula.
• Asthma lokho okusha noma okuba kubi kakhulu

Uzoyibona Nini Udokotela

Bonana nodokotela ngokushesha uma:

• Izimpawu ziyaqhubeka naphezu kokushintsha kwendlela yokuphila noma imithi etholakala ngaphandle kwekhawunta.
• Ubunzima bokugwinya buyaqhubeka noma buba bubi nakakhulu.
• Akuhlosiwe kwesisindo noma isicanucanu esibeleselayo.

Izinkinga ze-GERD

I-reflux ye-asidi esiswini njalo noma i-reflux yezinto ezingenayo i-asidi yimbangela ye-GERD. I-esophageal sphincter engezansi, ibhande eliyindilinga lomsipha elizungeze phansi komgudu wakho, liyakhululeka lapho ugwinya ukuze kudlule ukudla noketshezi esiswini sakho. I-sphincter ibe isivala futhi. 

I-Acid evela esiswini sakho ingase ibuyele emuva ku-esophagus yakho uma i-sphincter iba buthaka noma yehluleka ukuphumula njengoba kufanele. Ulwelwesi lwakho lommimbo luyacasulwa yilokhu kugeza okungapheli kwe-asidi, okuvame ukuholela ekuvuvukeni.

Okulandelayo yizici ezimbalwa ezingase zibhebhethekise i-GERD:

• Ukuba ngokweqile
• Ukudla ngokweqile
• Ukudla ushokoledi, izithelo ezisawolintshi, nokudla okunamafutha noma okubabayo
• Ukuphuza ikhofi
• Ukusetshenziswa kotshwala
• Ukusebenzisa ugwayi
• Ukuthatha i-aspirin kanye nezinhlungu ezingabhalwanga kanye nezidambisi zomkhuhlane. Lezi zihlanganisa ama-NSAID, noma imithi elwa nokuvuvukala, njenge-naproxen ne-ibuprofen. 

Ezinye izimo zezokwelapha ezingase zibangele isilungulela noma zandise amathuba okuba zibandakanye:

• I-Hiatal hernia (ukuqina kodonga lwesisu)
• Ukukhuluphala
• Ukukhulelwa ngenxa yezinguquko ze-hormonal kanye nokwanda kwengcindezi yesisu
• Izimo ezifana ne-scleroderma (i-connective tissue disorder) 
• Ukukhipha isisu okubambezelekile ezimeni ezifana ne-gastroparesis

Izinkinga ze-GERD

I-Gastroesophageal Reflux Disorder (GERD) ingaholela ezinkingeni ezihlukahlukene uma ingelashwa, ibe nomthelela omkhulu empilweni yomuntu. Ezinye zezinkinga ezinkulu zihlanganisa:

• I-Esophagitis: I-Acid evela esiswini ingalimaza izicubu ezixhumeke ku-esophagus, okuholela ekubuhlungu, ukopha, futhi ngezinye izikhathi isilonda. Ukugwinya kungaba buhlungu futhi kube yinselele uma une-esophagitis.
• I-Barrett's Esophagus: Izicubu eziklelisa umphimbo ongezansi zingashintsha ngenxa yokulimala kwe-asidi. Ingozi ephakeme yomdlavuza we-esophageal ixhunyaniswa nalezi zinguquko.
• Izinkinga zamaphaphu: I-Reflux ingaholela ekucasukeni komphimbo lapho i-asidi yesisu ifika ngemuva komphimbo. Ungase uzwe i-hoarseness ezwini lakho. Kungenzeka futhi ukuthi uhlangabezana nokuphikelela ukhwehlela nokucinana kwesifuba. Ungaba sengozini yokuthola inyumoniya, i-bronchitis, nesifuba somoya uma amaphaphu akho ecasuka.
• Izinkinga Zamazinyo: Ukuchayeka kaningi ku-asidi yesisu kungase kucekele phansi uqweqwe lwamazinyo, okuholela ekuboleni kwamazinyo noma ukuzwela.
• Izilonda ze-Oesophageal kanye Nokopha: Ukucasuka okuqhubekayo kungabangela izilonda ku-esophagus, okuholela ekopheni kanye ne-anemia.
• Ukuqina kwe-Oesophageal: I-Acid Reflux ibangela ukuthi izicubu ezibomvu zikhule kummizo ongezansi. Ukugwinya ukudla okudlulayo kubangelwa izicubu ezibomvu, okwenza ukugwinya kube nzima.

Ukuxilongwa kweGERD

Ngokusekelwe emlandweni wakho wezokwelapha, ukuhlolwa ngokomzimba, nezimpawu, udokotela wakho angase akwazi ukuxilonga i-GERD. Ukuze kuqinisekiswe ukuxilongwa kwe-GERD noma ukubheka noma yiziphi izinkinga, udokotela angase aluleke:

• I-Endoscopy Engenhla: Udokotela ubeka i-endoscope—ishubhu elincane, eliguquguqukayo elinokukhanya nekhamera—emqaleni wakho. Udokotela wakho angabuka ngaphakathi kwesisu sakho kanye ne-esophagus ngokusebenzisa i-endoscope. Uma i-reflux ikhona, imiphumela yokuhlolwa ingase ingabonisi inkinga; noma kunjalo, i-endoscopy ingase yembule ubunzima obengeziwe, okuhlanganisa i-oesophagitis, noma ukuvuvukala kommizo. I-biopsy, noma isampula yezicubu, ingabuye ithathwe ngesikhathi se-endoscopy ukuze kubhekwe izinkinga ezifana ne-Barrett esophagus. 
• I-Esophageal pH Monitoring: Umphimbo wakho ufakwe imonitha ukuze urekhode ubude nesikhathi sokuqunjelwa kwe-asidi yesisu. Isibonisi sixhunywe kukhompuyutha encane ongayigqoka ehlombe noma okhalweni lwakho. Ishubhu elincane, eliguquguqukayo elibizwa ngokuthi i-catheter elishutheka ekhaleni lakho nakumgobho wakho lingase lisebenze njengomqapha. Ngaphandle kwalokho, kungase kube isiqeshana esifakwe ku-esophagus yakho ngesikhathi se-endoscopy. Ezinsukwini ezimbili, isiqeshana singena esitulweni sakho.
• I-X-Ray: Lokhu kuhilela ukuphuza into eshokali evala futhi igcwalise ulwelwesi lwangaphakathi lomgudu wokugaya ukudla, bese uthathwa ama-X ray. Isembozo senza ukuthi udokotela akwazi ukubuka uhlaka lwesisu sakho kanye nomminzo. Labo abanenkinga yokugwinya bayokuthola kuwusizo ngokukhethekile lokhu. Ukuze uthole ukufinyela kommizo okungase kubangele ubunzima bokugwinya, ungaphinda ucelwe ukuthi uthathe ithebhulethi ye-barium.
• I-Oesophageal Manometry: Ukufinyela kwemisipha ye-oesophageal yakho ngesikhathi sokugwinya kukalwa ngalokhu kuhlolwa. Ukuxhumanisa namandla asetshenziswa imisipha yakho yomphimbo nakho kukalwa nge-esophageal manometry. Abantu abanenkinga yokugwinya ngokuvamile yibona ababhekana nalokhu.

Ukwelashwa kwe-GERD

Ukwelashwa kwesifo se-reflux ye-gastroesophageal (GERD) kuhloswe ukudambisa izimpawu, ukuphulukisa ukulimala komphimbo, nokuvimbela izinkinga. Zombili izindlela zezokwelapha nezokuhlinzwa ziyatholakala ekulawuleni i-GERD:

• zokwelashwa
  • Ama-Antacids: Nikeza ukukhululeka okusheshayo kodwa kwesikhashana ngokuqeda i-asidi yesisu.
  • Ama-H2 Blockers: Yehlisa ukukhiqizwa kwe-asidi yesisu futhi unikeze ukukhululeka okuhlala isikhathi eside.
  • I-Proton Pump Inhibitors (PPIs): Isebenza kakhulu ekwehliseni ukukhiqizwa kwe-asidi nasekukhuthazeni ukuphulukiswa kommizo. Isetshenziselwa ukukhululeka kwesikhashana kanye nokuphatha isikhathi eside.
  • I-Prokinetics: Siza ukuqinisa i-esophageal sphincter ephansi futhi isize ekuthululeni isisu ngokushesha.
• Ukwelashwa Kokuhlinzwa
  • I-Fundoplication: Inqubo yokuhlinzwa lapho ingxenye engaphezulu yesisu isongwe ngomminzo ongezansi ukuze kuqiniswe i-sphincter, ukuvimbela i-acid reflux. Ukuze uqinise imisipha futhi ayeke ukuguquguquka, udokotela ohlinzayo ugoqa ingxenye engenhla yesisu sakho eduze kwe-esophageal sphincter engezansi. Ukuhlinzwa kwe-laparoscopic, okungavamisile, ngokuvamile kusetshenziselwa ukwenza i-fundoplications.
• Idivayisi ye-LINX: Indandatho yobuhlalu obuzibuthe obuncane ibekwa endaweni okuhlangana kuyo isisu kanye nomminzo ukuze kuvinjelwe i-acid reflux kuyilapho ivumela ukudla kudlule. Nakuba ukukhangana kazibuthe phakathi kobuhlalu kubuthakathaka ngokwanele ukuvumela ukudla kudlule, kuqine ngokwanele ukugcina ukuhlangana kuvaliwe ngokumelene ne-acid reflux. Inqubo yokuhlinzwa engavamile kakhulu ingasetshenziswa ukufaka idivayisi ye-LINX. 
• I-Transoral incisionless fundoplication (TIF): Ngalokhu kuhlinzwa kwenoveli, i-esophageal sphincter engezansi iqiniswa ngokusonga ingxenye yomgudu ongezansi ngezinsimbi zokubopha nge-polypropylene. Akukho ukuhlinza okudingekayo kwe-TIF njengoba kwenziwa ngomlomo nge-endoscope. Izinzuzo zayo zihlanganisa isikhathi esifushane sokululama kanye nokubekezelelana okuphezulu. Akwenzeki ukwelapha i-hernia enkulu yokuzala nge-TIF iyodwa. I-TIF ingenzeka, nokho, uma ibhangqwe ne-laparoscopic hiatal hernia.

Indlela Yokuphila Nezokwelapha Zasekhaya

Imvamisa ye-acid reflux ingase yehliswe ngoshintsho endleleni yokuphila. Zama uku:

• Gcina isisindo esinempilo
• Yeka ukubhema
• Phakamisa ikhanda lombhede wakho.
• Gwema ukudla ukudla okune-asidi neziphuzo.
• Hlafuna yonke into kahle futhi kancane njengoba udla.
• Ungalokothi ulale phansi ngemva kokudla.
• Uma ufuna ukunciphisa ingozi ye-reflux, qala ukulala kwakho kwasebusuku ngohlangothi lwakho lwesobunxele.

Isiphetho

Xhumana nodokotela wezempilo uma uthola i-acid reflux njalo. Kubalulekile ukuthola imiphumela emzimbeni wakho. I-GERD ingaphezu nje kokuphazamiseka; kungase kube yingozi ngempela. Kuyalawuleka futhi. Ungase ube ne-GERD uma uvame ukuba ne-acid reflux futhi inomthelela omkhulu empilweni yakho. Kuhle ukuxoxa ngezimpawu zakho nochwepheshe bezokwelapha. Bangakwazi ukunquma ukuthi ukwelashwa kungase kube yinzuzo yini.