I-Hiatal Hernias kunye ne-Acid Reflux

Umxholo

• Ushwankathelo
• Iimpawu
• Uxilongo
• Unyango
• Ugqirha

Ngo-Epreli 2020, uceliwe ukuba zonke iintlobo zokumiselwa kunye ne-over-the-counter (OTC) ranitidine (Zantac) zisuswe kwimarike yase-US. Olu ngcebiso lwenziwe kuba amanqanaba angamkelekanga e-NDMA, enokubangela i-carcinogen (imichiza ebangela umhlaza), yafunyanwa kwezinye iimveliso ze-ranitidine. Ukuba umiselwe i-ranitidine, thetha nogqirha wakho malunga nezinye iindlela ezikhuselekileyo ngaphambi kokuyeka iyeza. Ukuba uthatha i-OTC ranitidine, yeka ukuthatha ichiza kwaye uthethe nomboneleli wakho wezempilo malunga nezinye iindlela. Endaweni yokuthatha iimveliso ze-ranitidine ezingasetyenziswanga kwindawo yokubuyisela iziyobisi, zilahle ngokwemiyalelo yemveliso okanye ngokulandela i-FDA's.

Ushwankathelo

I-hernia yokubeleka yimeko apho inxenye encinci yesisu sakho iqengqeleka kumngxunya kwidayaphragm yakho. Lo mngxunya ubizwa ngokuba yi hiatus. Kukuvula okuqhelekileyo, okuchaneka ngokwasemzimbeni okuvumela ukuba umqala wakho udibane nesisu sakho.

Unobangela we-hernia yokubeleka uhlala ungaziwa. Izicubu ezixhasayo ezibuthathaka kunye nokunyusa uxinzelelo lwesisu kunokuba negalelo kwimeko. I-hernia ngokwayo inokudlala indima kuphuhliso lwe-asidi ye-asidi kunye nefomu engapheliyo ye-asidi ye-asidi ebizwa ngokuba sisifo se-gastroesophageal reflux disease (GERD).

I-hernias ye-Hiatal inokufuna unyango olwahlukeneyo, ukusukela ekubukeni kokulinda kwiimeko ezinobuzaza ukuya kutyando kwiimeko ezinobuzaza.

Iimpawu

I-hernias ze-Hiatal azihlali zibangela iimpawu oza kuthi uziqaphele de kube ukuphuma kwesisu nge-hiatus kukhulu kakhulu. I-hernias ezincinci zolu hlobo zihlala zingabonakali. Awungekhe wazi enye ngaphandle kokuba uye kuvavanyo lonyango kwimeko engahambelaniyo.

Ii-hernias ezinkulu zokubeleka zikhulu ngokwaneleyo ukuba zivumele ukutya okungafunekiyo kunye nesisu esiswini ukuba siphinde sibuyele kwi-esophagus yakho. Oku kuthetha ukuba kunokwenzeka ukuba ubonise iimpawu eziqhelekileyo ze-GERD. Oku kubandakanya:

• isilungulela
• Intlungu yesifuba eqina xa ugoba okanye ulele
• ukudinwa
• intlungu zesisu
• iDysphagia (ingxaki yokuginya)
• ukuqhekeza rhoqo
• umqala obuhkungu

I-Acid reflux inokubangelwa zizinto ezahlukeneyo ezisisiseko. Ukuvavanywa kunokufuneka ukuba unqume ukuba unayo i-hernia yokuzalwa okanye enye into engaqhelekanga enokubangela iimpawu zakho ze-GERD.

Thetha nogqirha wakho malunga neempawu ze-reflux ezingaphucuki kunye nendlela yokuphila kunye notshintsho lokutya okanye ii-antacids ezingaphezulu kwekhawuntari.

Uxilongo

Uvavanyo lokulinganisa lusetyenziselwa ukukhangela i-hernia yokuzalwa kunye nawo nawuphi na umonakalo onokuthi wenziwe yi-acid reflux. Olunye lolona vavanyo luqhelekileyo lwe-imaging yi-barium swallow X-ray, ngamanye amaxesha ebizwa ngokuba yi-GI ephezulu okanye i-esophagram.

Uya kudinga ukuzila ukutya iiyure ezisibhozo phambi kovavanyo ukuze uqiniseke ukuba icandelo eliphezulu lesisu sakho (isisu sakho, isisu, kunye nenxalenye yamathumbu akho amancinci) ibonakala ngokucacileyo kwi-X-ray.

Uya kusela i-barium shake ngaphambi kovavanyo. Ingcangcazela yinto emhlophe, enechalky. I-barium yenza ukuba amalungu akho abonakale lula kwi-X-ray njengoko ihamba kumathambo akho emathumbu.

Izixhobo zokuqonda isifo ze-Endoscopic zikwasetyenziselwa ukufumanisa ii-hernias ze-hiatal. I-endoscope (ityhubhu ecekeceke, eguqukayo exhotyiswe ngesibane esincinci) ifakwe emqaleni emqaleni xa uphantsi kwesilaliso. Oku kuvumela ugqirha wakho ukuba ajonge ukudumba okanye ezinye izinto ezinokubangela ukuba i-acid reflux yakho. Ezi zinto zinokubandakanya i-hernias okanye izilonda.

Unyango

Unyango lwe-hernia yokubeleka iyahluka kakhulu kwaye kufuneka ilungelelaniswe neenkxalabo zakho zempilo. I-hernias ezincinci ezibonisa kuvavanyo lokuqonda isifo kodwa zihlala zingenazimpawu zinokufuna nje ukubukelwa ukuze ziqiniseke ukuba azibi nkulu ngokwaneleyo ukuze zibangele ukungonwabi.

Amayeza okungcangcazela phezu kwento ethengiswa ngapha nangapha anokubonelela ngesiqabu kumoya ovuthayo ngamanye amaxesha onokuthi uvele kwi-hernia esezingeni eliphakathi. Banokuthathwa njengoko kufuneka ngalo lonke usuku kwiimeko ezininzi. I-calcium-kunye ne-magnesium esekwe kwi-antacids ixhaphake kakhulu kwindawo yokugaya ukutya kwivenkile yakho yendawo.

Amachiza amayeza e-GERD ayikuniki nje kuphela ukukhululeka, ezinye zinokukunceda ukuphilisa ulusu lomqala wakho kwi-acid enxulumene ne-hernia. La mayeza ahlulwe ngamaqela amabini: ii-H2 blockers kunye neproton pump inhibitors (PPIs). Ziquka:

• cimetidine (iTagamet)
• esomeprazole (Nexium)
• ifototidine (iPepcid)
• I-lansoprazole (Prevacid)
• omeprazole (Prilosec)

Ukuhlengahlengisa ukutya kwakho kunye neshedyuli yokulala kunokunceda ukulawula iimpawu zakho ze-GERD xa une-hernia yokubeleka. Yitya ukutya okuncinci ngalo lonke usuku kwaye uphephe ukutya okubangela ukutsha. Ukutya okunokubangela ukutsha kwentliziyo kubandakanya:

• iimveliso zetumato
• iimveliso zesitrasi
• ukutya okunamafutha
• itshokholethi
• ipermint
• ikhafeyini
• utywala

Zama ukungangqengqi ubuncinci iiyure ezintathu emva kokutya ukunqanda iiasidi ekusebenzeni ngendlela yazo ekubuyiseleni ukutya kwakho. Kuya kufuneka uyeke nokutshaya. Ukutshaya kunokunyusa umngcipheko we-acid reflux. Kwakhona, ukutyeba kakhulu (ngakumbi ukuba ungowasetyhini) kunokunyusa umngcipheko wokukhulisa zombini i-GERD kunye ne-hiatal hernias, ke ukunciphisa umzimba kunokunceda ukunciphisa iimpawu zakho ze-reflux.

Ugqirha

Utyando lokulungisa i-hernia yokubeleka lunokuba yimfuneko xa unyango lweziyobisi, ukuguqulwa kokutya, kunye nohlengahlengiso lwendlela yokuphila azilawuli iimpawu ngokwaneleyo. Abagqatswa abafanelekileyo bokulungiswa kwe-hernia yokubeleka kunokuba ngabo:

• Amava okuqunjelwa
• Unesiseko sokuqina (ukunciphisa umqala ngenxa ye-reflux engapheliyo)
• Unokudumba okukhulu komqala
• Unenyumoniya ebangelwa kukulangazelela kwesisu esiswini

Utyando lokulungiswa kweHernia lwenziwa phantsi kwe-anesthetic ngokubanzi. I-Laparoscopic incision yenziwa esiswini sakho, ivumela ugqirha ukuba atyhale ngobunono isisu ngaphandle kwe-hiatus kwaye sibuyele kwindawo yesiqhelo. Ukuthunga kuqinisa i-hiatus kwaye kugcine isisu ekutyibilikeni ngokuvula kwakhona.

Ixesha lokubuyisela emva kotyando lungaqala kwiintsuku ezi-3 ukuya kwezi-10 esibhedlele. Uya kufumana isondlo ngetyhubhu ye-nasogastric kangangeentsuku ezininzi emva kotyando. Nje ukuba uvunyelwe ukuba utye ukutya okuqinileyo kwakhona, qiniseka ukuba utya imali encinci ngalo lonke usuku. Oku kunokunceda ukukhuthaza ukuphilisa.