I-Hiatal Hernia

I-Hiatal hernia yisifo esivamile esithinta izigidi zabantu emhlabeni jikelele. Lesi simo singabangela izimpawu eziningi, kusukela ekuzweleni okuncane kuya ebuhlungu obukhulu, futhi kwezinye izimo, kungase kudinge ukuhlinzwa. Ukuqonda izimpawu ze-hiatal hernia kanye nezinkinga ezingase zibe khona kubalulekile kulabo abathintekayo kulesi simo. 

Lesi sihloko sibheka kabanzi nge-hernia yokuzala, ihlola izinhlobo zayo, izimpawu, kanye nezimbangela. Icubungula izindlela zokwelapha ezehlukene, okuhlanganisa imithi kanye nokungenelela kokuhlinzwa kwe-hernia enkulu yokuzala. 

Iyini i-Hiatal Hernia? 

I-hernia yokuzala ikhula lapho ingxenye yesisu noma ezinye izitho zesisu zisunduzela phezulu ngembobo ye-diaphragmic (i-diaphragm imisipha ehlukanisa isifuba nesisu sesisu). Lokhu kuvuleka okubizwa ngokuthi i-oesophageal hiatus, ngokuvamile kuvumela umphimbo ukuthi udlule futhi uxhumeke esiswini. Kodwa-ke, lapho le khefu ikhula noma iba buthaka, ingenza ingxenye yesisu iphumele esifubeni, okubangele izimpawu nezinkinga eziningi. 

Izinhlobo ze-Hiatal Hernia 

I-Hiatal hernia yizinhlobo ezine ezihlukene, ngayinye enezici ezihlukile: 

• Uhlobo loku-1: Okuphinde kubizwe nge-sliding hiatal hernia, uhlobo oluvame kakhulu lwe-hiatal hernia, olubalelwa cishe ku-95% wazo zonke izimo. Kuleli fomu, i-gastroesophageal junction, lapho umminzo uxhumeka khona nesisu, ishelela phezulu nge-hiatus enwetshiwe bese ibuyela phansi kancane kancane. 
• Uhlobo 2: Okwaziwa nangokuthi i-rolling hiatal hernia, ibandakanya ingxenye engaphezulu yesisu iphushela phezulu nge-hiatus eduze komqalazo, yenze iqhubu eduze kwayo. 
• Uhlobo 3: Lolu hlobo luhilela ukushelela kwe-gastroesophageal junction phakathi ne-hiatus ngezinye izikhathi, kuyilapho enye ingxenye yesisu nayo iqhuma eduze kwayo. 
• Thayipha 4: Lolu hlobo luwuhlobo oluyivelakancane futhi oluyinkimbinkimbi kakhulu lwe-hiatal hernia. Kwenzeka lapho i-hiatus ivuleke ngokwanele ukuvumela izitho ezimbili ezihlukene ukuthi zingene kuyo. 

Izinhlobo ze-hiatal hernia 2, 3, kanye no-4 zihlangene zaziwa ngokuthi i-paraesophageal hernias, okusho ukuthi zenzeka eduze kommizo. 

Izimpawu ze-Hiatal Hernia 

Iningi lezibonakaliso ze-hiatal hernia disease zihlobene nesifo se-reflux ye-gastroesophageal (GERD) futhi zingabandakanya: 

• isilungulela noma ukuzwa ukushisa esifubeni, ikakhulukazi ngemva kokudla 
• Ubuhlungu besifuba obungenasifo senhliziyo, okungase kwenziwe iphutha nge-angina. 
• Ukuzithoba noma umuzwa wokugcwala ngokushesha ngemva kokudla, okuhambisana nohlobo oluvuthayo lobuhlungu besisu. 
• Ubunzima bokugwinya noma ukuzwa isigaxa emphinjeni lapho begwinya. 
• Umphimbo obuhlungu nokuhoshozela lapho ukhuluma 

Izimbangela kanye Nezici Zengozi Ye-Hiatal Hernia 

Isizathu esiqondile se-hiatal hernia isifo asikacaci, kodwa izici eziningana zinomthelela ekuthuthukisweni kwayo. 

Ngenkathi abanye abantu bezalwa bene-hiatus enkulu ngokungavamile, abanye bangase babe ne-hiatal hernia ngenxa yokulimala okwandayo okuvela eminyakeni yokucindezeleka kwansuku zonke kanye nobunzima. Izinto ezandisa umfutho wesisu futhi zibe nomthelela ekukhuleni kwe-hiatal zihlanganisa: 

• Ukukhwehlela okungapheli noma ukuthimula 
• Ukuqunjelwa okungapheli 
• Ukukhuluphala (BMI ngaphezu kuka-30) 
• Ukuhlanza njalo 
• Ukuzivocavoca okukhulu 
• Ukuphakamisa ubuso obunzima 
• ukukhulelwa kanye nokubeletha (njengoba bebeka ingcindezi enkulu emgodini wesisu) 
• Ukulimala noma ukuhlukumezeka endaweni engenhla yesisu, njengamandla asuka ebhandeni lesihlalo phakathi nengozi Iminyaka enalesi simo ivame kakhulu kubantu abangaphezu kweminyaka engama-50, okungenzeka ngenxa yokuba buthaka kwemvelo kwemisipha nezicubu njengoba abantu bekhula. 

Izinkinga ze-Hiatal Hernia 

I-Hiatal hernia ingaholela ezinkingeni ezinkulu kwezinye izimo, njenge: 

• I-Oesophagitis: I-reflux ye-acid engapheli ingabangela i-oesophagitis, ukuvuvukala kolwelwesi lommizo okuholela ebuhlungu, ubunzima bokugwinya, futhi, ezimweni ezimbi kakhulu, izilonda nokopha noma ukuqina kommizo ngokuhamba kwesikhathi, lapho izicubu ezibomvu zinciphisa umminzo, okwenza ukugwinya kube yinselele futhi kube buhlungu. 
• I-Barrett's Esophagus: I-Barrett's esophagus ibhekwa njengeyingozi futhi ingandisa ingozi yomdlavuza we-oesophageal. 
• Ukuvinjelwa Kwesisu: Kulesi simo, isisu noma esinye isitho sivaleleka ku-hiatus, okubangela ukuvinjelwa. 
• I-Ischaemia: Akuvamile, i-hernia ecindezelwe ngokuqinile inganqamula ukutholakala kwegazi layo, okuholela ekufeni kwezicubu futhi kudinga ukunakekelwa kwezokwelapha ngokushesha. 

Sifo 

Ukuxilongwa kwe-hiatal hernia kuhilela inhlanganisela yezinqubo zezokwelapha, ezihlanganisa: 

• I-Gastroscopy: Udokotela ufaka ishubhu elide, elincanyana, eligobekayo elibizwa ngokuthi i-gastroscope emlonyeni wesiguli futhi liye phansi emphinjeni. Le divayisi, efakwe ikhamera ekhanyayo neyevidiyo, ithumela izithombe eziningi kumqapha wangaphandle, okuvumela ukuhlolwa okuningiliziwe kommizo nesisu. 
• I-Barium Meal X-ray (i-Barium Swallow Test): Phakathi nalokhu kuhlolwa, isiguli siphuza isixazululo se-barium, isixazululo samakhemikhali esingenabuthi esibonakala ngokucacile kuma-X-reyi. Njengoba i-barium ihamba ohlelweni lokugaya ukudla, izazi ze-radiologists zithatha uchungechunge lwama-X-ray ukuze zibone noma yikuphi ukungahambi kahle, okuhlanganisa nezimpawu ze-hernia yokuzala. 
• I-Endoscope Engenhla: Le nqubo yokuxilonga ihilela ukufaka i-endoscope phansi emphinjeni, inikeze umbono we-esophagus, isisu, nokuqala kwamathumbu amancane. 
• I-Oesophageal Manometry: Ikala ukufinyela kwemisipha ku-esophagus. Lokhu kuhlola kuhlola ukusebenzisana namandla asetshenziswa imisipha yomminzo ngesikhathi sokugwinya. 

Ukwelashwa kwe-Hiatal Hernia 

Ukushintsha indlela yokuphila kanye nemithi kungase kwanele kubantu abaningi abanezimpawu ezithambile. Lokhu kubandakanya: 

• Ukudla okuncane 
• Ukudla okuvamile 
• Ukugwema ukucambalala ngemva kokudla 
• Ukuqeda ukudla okudala i-acid reflux 
• Ama-Antacids angaphezu kwe-counter: Le mithi ingasiza ekunciphiseni izimpawu zesifo se-reflux ye-gastroesophageal (GERD) ehlobene ne-hiatal hernia. 
• Ukuhlinzwa: Odokotela batusa ukuhlinzwa uma i-hernia inkulu futhi ibangela izimpawu ezinzima. Inqubo yokuhlinzwa evame kakhulu i-laparoscopic Nissen fundoplication. Le ndlela yokuhlasela kancane ihilela ukuthinta ingxenye engaphezulu yesisu eduze kwengxenye engezansi yomminzo ukuze kuqiniswe umgoqo ophakathi kwesisu nomminzo. 

Uzoyibona Nini Udokotela 

Abantu kufanele bahlele isikhathi sokubonana nodokotela wabo uma bethola izimpawu eziqhubekayo ze-hernia yokuzala ezibangela ukukhathazeka. Lokhu kungase kuhlanganise: 

• Isilungulela njalo 
• Ubunzima bokugwinya, 
• Umuzwa wokusutha ngokushesha ngemva kokudla. 
• ubuhlungu besifuba 
• Uma i-indigestion noma i-acid reflux ihambisana ukwehla kwesisindo okungachazwanga, ukuhlanza njalo, noma igazi emhlanzweni 

Prevention 

Nakuba kungase kungenzeki ukuvimbela zonke izimo ze-hiatal hernia, kunezinyathelo ezimbalwa abantu abangazithatha ukuze banciphise ubungozi babo futhi balawule izimpawu: 

• Ukugcina isisindo esinempilo 
• Ukudla okulinganiselayo nokuzivocavoca njalo 
• Ukugwema ukudla okukhulu futhi ukhethe ukudla okuncane, okuvame kakhulu usuku lonke kungasiza ekuvimbeleni ukucindezela okukhulu esiswini. Ukugwema ukudla okungenani amahora amathathu ngaphambi kokulala kuyancomeka ukunciphisa ingozi ye-acid reflux. 
• Ukuphakamisa ikhanda lombhede ngamasentimitha ayi-10 kuye kwangama-20 nakho kungasiza ekuvimbeleni i-asidi yesisu ukuthi ikhuphuke iye emphinjeni ngesikhathi sokulala. 
• Ukuyeka ukubhema nokunciphisa ukuphuza utshwala 
• Ukugwema izingubo ezimpintshayo okhalweni 
• Ukuhlonza nokugwema ukudla okuyizicucu okwenza izimpawu zibe zimbi kakhulu, okufana nokudla okunamafutha, okubabayo, noma okune-acidic 
• Ukuhlanganisa amasu okuphumula emisebenzini yansuku zonke kungasiza ekulawuleni ingcindezi, okungase kubhebhethekise izimpawu ze-hernia yokubeletha. 

Isiphetho 

I-Hiatal hernia yisimo esivamile esinomthelela ezigidini zabantu emhlabeni jikelele. Ukulawula i-hernia yokuzala kuhilela inhlanganisela yezindlela ezifanelana nezidingo zomuntu ngamunye. Nakuba abanye abantu bengathola impumuzo ngokulungisa indlela yokuphila elula, abanye bangase badinge ukungenelela kwezokwelapha ukuze babhekane nezimpawu zabo. 

FAQs 

1. Zivame kangakanani i-hiatal hernia? 

I-Hiatal hernia ivame kakhulu, ikakhulukazi kubantu abadala. Ngokusho kwe-Oesophageal Cancer Awareness Association, abantu abangafika ku-60% baba ne-hiatal hernia lapho beneminyaka engu-60 ubudala. 

2. Bunjani ubuhlungu be-hiatal hernia? 

Ubuhlungu be-hiatal hernia bungahluka. Abanye abantu bangase bazwe ubuhlungu besifuba noma ukungakhululeki kwesisu. Nokho, uphawu oluvame kakhulu isilungulela, ukuzwa ukushisa esifubeni. Kubalulekile ukuqaphela ukuthi abantu abaningi abane-hiatal hernias abekho 
izimpawu. 

3. I-hernia yokuzala ikhula kanjani i-acid reflux? 

I-hernia yokuzala ingabangela i-acid reflux ngokuphazamisa ukusebenza kwe-esophageal sphincter (LES). Lapho ingxenye yesisu iphusha ku-diaphragm, ingenza buthaka i-LES, ivumele i-asidi yesisu ukuthi igeleze ibuyele emthonjeni. Lokhu kungaholela ezimpawu zesifo se-reflux ye-gastroesophageal (GERD). 

4. Ibucayi kangakanani i-hernia yokuzala? 

Iningi le-hernia yokubeletha ayibi kakhulu futhi ayidingi ukwelashwa uma ingabangeli izimpawu. Kodwa-ke, i-hernia enkulu yokuzala noma lezo ezibangela izimpawu ezingapheli zingase ziholele ezinkingeni ezifana ne-oesophagitis, izilonda, i-Barrett's esophagus, noma i-hernia eklinyiwe (engavamile), okuyisimo esiphuthumayo sezokwelapha. 

5. Ithini inqubo yokululama ngemva kokuhlinzwa kwe-hiatal hernia? 

Ukululama ekuhlinzweni kwe-hiatal hernia ngokuvamile kuthatha amasonto amathathu kuya kwamane. Abantu abaningi bachitha okungenani ubusuku obubodwa esibhedlela. Ngesikhathi sokululama, iziguli zilandela ukudla okuthile, ziqala ngoketshezi futhi ziqhubekele ekudleni okuthambile. Bayalulekwa ukuthi bagweme ukuphakamisa izinto ezisindayo kanye nemisebenzi ekhandlayo amasonto ambalwa. 

6. Ngingayiphatha kanjani i-hernia yami yokuzala ekhaya? 

Ukwelashwa kwasekhaya kwezimpawu ze-hernia esibelethweni kuhlanganisa ukushintsha indlela yokuphila njengokudla ukudla okuncane, ukudla okuvamile, ukugwema ukulala phansi ngemva kokudla, ukuphakamisa ikhanda lombhede, nokugwema ukudla okuvusa inkanuko njengokudla okubabayo noma okunamafutha. Ama-antacid angaphandle kwe-counter angase anikeze ukukhululeka kwesilungulela ngezikhathi ezithile. 

7. Ingabe i-hernia yokubeletha ingelapheka? 

Nakuba ukushintsha kwendlela yokuphila kanye nemithi ikwazi ukulawula izimpawu, ukuhlinzwa kuwukuphela kwendlela yokwelapha i-hernia yokubeletha. Nokho, akuwona wonke umuntu one-hernia yokuzala odinga ukuhlinzwa. Abantu abaningi bangakwazi ukuphatha ngempumelelo izimpawu zabo ze-hiatal hernia ngokwelashwa okuvamile. 

8. Yikuphi ukudla okufanele ngikugweme nge-hernia yokuzala? 

Ukudla okugwema i-hernia yokuzala kuhlanganisa lokho okungase kubangele i-acid reflux, njengotamatisi, izithelo ze-citrus, ushokoledi, i-caffeine, utshwala, ukudla okunamafutha, nokudla okubabayo. Kuyatuswa futhi ukuthi ugweme ukudla okuningi nokudla sekusondele isikhathi sokulala. 

9. Ngingayinciphisa kanjani i-hernia yami ngokwemvelo? 

Nakuba kungenakwenzeka ukunciphisa i-hernia yokuzala ngokwemvelo, izinguquko ezithile zendlela yokuphila zingasiza ekulawuleni izimpawu. Lokhu kuhlanganisa ukudla ukudla okuncane, ukugcina isisindo esinempilo, ukuyeka ukubhema, nokugwema ukudla okudala izimpawu. Kodwa-ke, lezi zindlela ngeke zinciphise ubukhulu be-hernia ngokwayo. 

UDkt. Prashant Bhowate

CARE Medical Team

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