Isifo se-reflux sesifo se-Gastroesophageal

Isifo se-reflux se-Gastroesophageal (GERD) yimeko apho isisu sivuza ngasemva sisuka kwisisu (kumbhobho wokutya). Ukutya kuhamba ukusuka emlonyeni wakho ukuya esiswini nge-esophagus yakho. I-GERD inokucaphukisa umbhobho wokutya kwaye ibangele ukutsha kwentliziyo kunye nezinye iimpawu.

Xa usitya, ukutya kudlula ukusuka emqaleni kuye esiswini nge-esophagus. Iringi yemicu yemisipha kumphantsi osezantsi ithintela ukutya okuginyiwe ekubuyeni umva. Ezi fayibha zemisipha zibizwa ngokuba yi-sphincter esezantsi esophageal (LES).

Xa le ndandatho yemisipha ingavali yonke indlela, imixholo yesisu inokuvuza ibuyele kumqala. Oku kubizwa ngokuba yi-reflux okanye i-reflux ye-gastroesophageal. I-Reflux inokubangela iimpawu. Isisu esiswini esine-asidi sinokuphazamisa ulwelwesi lwe-esophagus.

Imiba yomngcipheko we-reflux ibandakanya:

• Ukusetyenziswa kotywala (mhlawumbi)
• I-hiatal hernia (imeko apho inxenye yesisu ihamba ngaphezulu kwesithambisi, esisisihlunu esahlula isifuba kunye nesisu esiswini)
• Ukutyeba kakhulu
• Ukukhulelwa
• Iscleroderma
• Ukutshaya
• Ukuhlala ngaphakathi kweeyure ezi-3 emva kokutya

Isitshisa se-Heartburn kunye ne-gastroesophageal reflux zinokuziswa okanye zenziwe mandundu kukukhulelwa. Iimpawu zisenokubangelwa ngamanye amayeza, anje ngala:

• Anticholinergics (umzekelo, iyeza lokugula elwandle)
• Iibronchodilators zesifuba
• I-calcium channel blockers yoxinzelelo lwegazi oluphezulu
• Amachiza asebenzayo eDopamine kwisifo sikaParkinson
• Iprogestin yokuphuma gazi okungaqhelekanga okanye ulawulo lokuzalwa
• Izindlela zokulala okanye unxunguphalo
• I-Tricyclic yoxinzelelo

Thetha nomboneleli wakho wezempilo ukuba ucinga ukuba elinye lamayeza akho linokubangela ukutsha kwentliziyo. Ungaze utshintshe okanye uyeke ukuthatha iyeza ngaphandle kokuqala uthethe nomboneleli wakho.

Iimpawu eziqhelekileyo zeGERD zibandakanya:

• Ndiva ukuba ukutya kunamathele ngasemva kwethambo lesifuba
• Isitshisa okanye iintlungu ezivuthayo esifubeni
• Isicaphucaphu emva kokutya

Iimpawu eziqhelekileyo zezi:

• Ukubuyisa ukutya kwakhona (ukuphinda kwenziwe kwakhona)
• Ukukhohlela okanye ukuvutha
• Kunzima ukugwinya
• Iingqungquthela
• Ukugquma okanye ukutshintsha kwelizwi
• Umqala obuhkungu

Iimpawu zisenokuba mandundu xa ugobile okanye ulele phantsi, okanye emva kokuba utyile. Iimpawu zisenokuba mandundu ebusuku.

Awunakudinga naluphi na uvavanyo ukuba iimpawu zakho ziphakathi.

Ukuba iimpawu zakho zinzima okanye zibuya emva kokuba uphathwe, ugqirha wakho angenza uvavanyo olubizwa ngokuba yi-endoscopy ephezulu (EGD).

• Olu luvavanyo lokuvavanya ulwelwesi lwe-esophagus, isisu, kunye nenxalenye yokuqala yamathumbu amancinci.
• Yenziwe ngekhamera encinci (i-endoscope eguqukayo) efakwa ezantsi emqaleni.

Unokufuna olunye okanye nangaphezulu kwezi mvavanyo zilandelayo:

• Uvavanyo olulinganisa ukuba i-asidi esiswini ingena kangakanani kumbhobho okhokelela emlonyeni ukuya esiswini (ebizwa ngokuba yi-esophagus)
• Uvavanyo lokulinganisa uxinzelelo ngaphakathi kwenxalenye esezantsi ye-esophagus (esophageal manometry)

Uvavanyo lwegazi oluqinisekileyo lokugcina igazi kunokuchonga ukopha okuvela kukucaphuka kwisisu, isisu, okanye amathumbu.

Unokwenza utshintsho oluninzi kwindlela yakho yokuphila ukunceda ukunyanga iimpawu zakho.

Ezinye iingcebiso zibandakanya:

• Ukuba utyebile okanye utyebe kakhulu, kwiimeko ezininzi, ukunciphisa umzimba kunokunceda.
• Phakamisa intloko yebhedi ukuba iimpawu zakho ziya zisiba mbi ebusuku.
  
• Yiba nesidlo sangokuhlwa iiyure ezi-2 ukuya kwezi-3 ngaphambi kokuba ulale.
  
• Gwema iziyobisi ezifana ne-aspirin, ibuprofen (Advil, Motrin), okanye naproxen (Aleve, Naprosyn). Thatha i-acetaminophen (iTylenol) ukunciphisa iintlungu.
• Thatha onke amayeza akho ngamanzi amaninzi. Xa umboneleli wakho ekunika iyeza elitsha, buza ukuba ngaba liza kwenza ukuba ube nentliziyo ebuhlungu ngakumbi.

Unokusebenzisa ii-antacids ezingaphezulu kwekhawunta emva kokutya nangexesha lokulala, nangona isiqabu sinokungahlali ixesha elide. Iziphumo eziqhelekileyo ezichaphazelekayo zibandakanya urhudo okanye ukuqhina.

Amanye amayeza angaphaya kwekhawuntari kunye nonyango anokuyinyanga i-GERD. Basebenza ngokuthe chu kune-antacids, kodwa bakunika isiqabu eside. Usokhemesti wakho, ugqirha, okanye umongikazi angakuxelela ukuba ungawathatha njani na la mayeza.

• Iiproton pump inhibitors (ii-PPIs) zinciphisa inani leasidi eveliswe esiswini sakho.
• Iibhlokhi ze-H2 zehlisa nomyinge weasidi ekhutshwe esiswini.

Utyando oluchasene ne-reflux lunokuba yinto enokukhetha kubantu abaneempawu ezingahambiyo notshintsho kwindlela yokuphila kunye namayeza. Isitshisa kunye nezinye iimpawu kufuneka ziphuculwe emva kotyando. Kodwa kusenokufuneka ukuba uthathe amayeza ukuze ube nesiqhumiso.

Kukwakho nonyango olutsha lwe-Reflux olunokwenziwa nge-endoscope (ityhubhu eguqukayo edluliselwe emlonyeni ukuya esiswini).

Uninzi lwabantu lusabela kutshintsho lwendlela yokuphila kunye namayeza. Nangona kunjalo, abantu abaninzi kufuneka baqhubeke nokusela amayeza ukulawula iimpawu zabo.

Iingxaki zinokubandakanya:

• Ukwandiswa kwesifuba
• Utshintsho kumngxunya we-esophagus onokwandisa umngcipheko womhlaza (iBarrett esophagus)
• I-Bronchospasm (ukucaphuka kunye ne-spasm yomoya ngenxa ye-asidi)
• Ixesha elide (elingapheliyo) lokukhwehlela okanye ukugungqa
• Iingxaki zamazinyo
• Isilonda esophagus
• Uxinzelelo (ukunciphisa umqala ngenxa yokuqhekeka)

Tsalela umnxeba umboneleli wakho ukuba iimpawu aziphucuki notshintsho kwindlela yokuphila okanye amayeza.

Fowuna kwakhona ukuba unayo:

• Ukopha
• Ukutswina (ukukhohlela, ukuphefumla kancinci)
• Ukuziva ugcwele ngokukhawuleza xa usitya
• Ukugabha rhoqo
• Ukurhabaxa
• Ukuphelelwa ngumdla wokutya
• Ingxaki yokuginya (i-dysphagia) okanye iintlungu ngokuginya (odynophagia)
• Ukuhla ukusinda
• Ukuziva ngathi ukutya okanye iipilisi kunamathele ngasemva kwethambo lebele
  

Ukuphepha izinto ezibangela ukutsha kwentliziyo kunokunceda ukuthintela iimpawu. Ukutyeba kakhulu kunxulunyaniswa ne-GERD. Ukugcina ubunzima bomzimba obusempilweni kunokunceda ukukhusela imeko.

IPeptic esophagitis; Reflux esophagitis; IGERD; Isibilini - esinganyangekiyo; IDyspepsia -GERD

• Utyando lwe-anti-reflux-abantwana-ukukhutshwa
• Utyando lwe-anti-reflux-ukukhutshwa
• I-reflux ye-Gastroesophageal-ukukhutshwa
• Isitshisa - yintoni ekufuneka uyibuze kugqirha
• Ukuthatha ii-antacids

• Inkqubo yokwetyisa
• Isifo se-reflux sesifo se-Gastroesophageal
• I-reflux ye-Gastroesophageal-uthotho

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Imigangatho yeKomiti yokuziQhelanisa, UMuthusamy VR, uLightdale JR, et al. Indima ye-endoscopy kulawulo lwe-GERD. Isisu endosc. 2015; 81 (6): 1305-1310. IINKCUKACHA: 25863867 www.ncbi.nlm.nih.gov/pubmed/25863867.

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IZiko leLizwe leSwekile kunye neWebhusayithi kunye neZifo zeZintso. I-Acid Reflux (GER & GERD) kubantu abadala. www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/all-content. Ukuhlaziywa kweyeNkanga ngo-2015. Kufikeleleke ngoFebruwari 26, 2020.

URichter JE, uFriedenberg FK. Isifo se-reflux sesifo se-Gastroesophageal. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 44.