Reflux ya m'mimba ndi chizindikiro chodabwitsa chomwe chimayenda m'mimba mosiyana (mkati mwake). Nthawi zina izi zikhoza kukhala zachilendo, mwa zina zimatha kukwiyitsa matenda aakulu.
Reflux ya m'mimba imayambitsa
Kutaya zakuthupi kuchokera m'mimba, kumachitika kumadera akutali mwamsanga mutangodya, zomwe sizimamupweteka munthuyo ndipo sizimayambitsa matenda ena, zimatengedwa ngati zosiyana ndi zomwe zimachitika. Ngati izi zimachitika nthawi zambiri, kuphatikizapo usiku, zimatsatidwa ndi zizindikilo zoonekeratu, ndi funso la kupatuka kumene kumatsogolera ku chitukuko cha matenda a reflux a gastroesophageal.
Poganizira zomwe zimayambitsa reflux ya gastroesophageal, m'pofunika kumvetsetsa momwe mungayankhire zinthuzo molakwika. Chofunika kwambiri popewera chozizwitsachi chimakhala ndi mchere wochepa kwambiri wotchedwa spopincter - minofu pafupifupi nthawi zonse yomwe imakhala yotsekedwa ndi kutseguka m'magulu awiri - pamene chakudya chimayenda m'mimba komanso pamene mpweya wouma umachoka.
Kupuma kwapansi kwa sphincter ya m'mimbayi kungagwirizane ndi mavuto ake onse ogwira ntchito komanso kuchepa kwa minofu. Otsatirawa nthawi zambiri amakwiya ndi zinthu izi:
- kumwa zakumwa za khofi;
- kugwiritsa ntchito mbale zotentha ndi zakumwa;
- kutenga mankhwala ena (antispasmodics, analgesics, nitrates, etc.);
- kusuta;
- kumwa;
- zochitika zolimbitsa thupi;
- kusintha kwa mahomoni.
Kuonjezerapo, chidziwitso cha kuponyera pansi nthawi zina kumawonjezeredwa m'mimba, kumakhala ndi kulemera kwa thupi, ascites, kudzimbidwa, flatulence. Kupsyinjika kwakukulu kumayambitsidwa ndi kugwiritsa ntchito carbonated zakumwa, zokazinga zakudya, zonunkhira zonunkhira. Komanso, zizindikiro za reflux zimapezeka ndi nthendayi yomwe imapezeka pachimake, chilonda cham'mimba, chifuwa chachikulu cha mphumu.
M'thupi la reflux, zimakhala zofunikira osati kungowonongeka mwachindunji, komanso kuti mphamvu ya mtheradi imamasulidwe kuchoka ku zomwe zimayambitsa. Kawirikawiri, ngati zakumwa za m'mimba zimatha, kubwezeretsedwa kwa pH ndi kubwerera mmimba mwa kuwonjezereka kwa chidziwitso ndi kusungunuka msanga kumachitika mofulumira (luso limeneli limatchedwa kutsegula kwa osakaniza).
Zizindikiro za reflux za m'mimba
Mu chithunzi chachipatala, zizindikiro zotsatirazi za reflux ya gastroesophageal ndizofunika:
- kupweteka ;
- mphunzitsi;
- kumverera kwa mtanda pammero;
- osamvetsetsa pamene akumeza chakudya;
- kukhetsa ;
- kusanza;
- chisokonezo;
- kupweteka kwanthawi yaitali komwe kukufanana ndi kusokonezeka kwa angina.
Nthaŵi zambiri, makamaka chifukwa cha "high" refluxes, zizindikiro zambiri zotchedwa ooperative oesophageal amadziwika:
- chifuwa;
- mpweya wochepa;
- kutukusira kwa phula la mucous, nasopharynx, bronchi;
- mawu osasunthika;
- amalephera, kutupa kwa chingamu .
Mawonetseredwe amatsitsimutso amatha usiku, atatha kudya, pakuchita mwakuthupi. Pamaso pa zizindikilo za matenda a gluroesophageal reflux matenda angathe kuchitika mwa mitundu iwiri:
- ndi kusintha kwaukali m'makoma osungunuka, omwe amavumbulutsidwa ndi njira yotchedwa endoscopic (ndi eophagitis);
- popanda kutupa kwa mimba, yomwe imakhazikitsidwa pogwiritsa ntchito endoscope (popanda matenda opatsirana).
Reflux yamagastroesophageal popanda esophagitis
Pachifukwa ichi, matenda a reflux otchedwa gastroesophageal amatchedwa osalimba. Pachifukwa ichi, mucosa yosungunuka imatetezedwa kuchokera ku kulowa mu thupi la zomwe zili mkati mwake, zomwe sizitengera izi, mwachitsanzo, chivomerezo ndi chachilendo. Kuonjezera apo, kachilombo kameneka kamene kali m'ziwiya ndi mitsempha yamadzimadzi amathandiza kwambiri kuti kachilombo ka epithelium kasinthidwe. Mipukutu ya reflux ndi mawonetseredwe samabwerezedwa mobwerezabwereza, koma izi zikhoza kukhala ndondomeko yoyamba ya ndondomeko yowonongeka.
Reflux yamagastroesophageal ndi esophagitis
Ngati reflux ya gastroesophageal ikugwirizanitsidwa ndi msinkhu wambiri wa kumeza kwa zakumwa za m'mimba, chiopsezo cha kusintha kwa chifuwa cha mucosa cha tsambali chikuwonjezeka. Zimathandizira pazinthu izi ndi kuwonjezeka kwachisokonezo cha reflux yokhudzana ndi matenda ena (mwachitsanzo, ndi kuchuluka acidity, kukhalapo kwa bile acid). Chithunzi cha kuchipatala, makamaka, chiri ndi mawonetseredwe a m'mimba. Pankhaniyi, nthawi zambiri zimaphatikizapo chifuwa cha reflux - chouma, nthawi zambiri chimapezeka masana, kukula ndi kusintha kwa thupi.
Matenda a reflux - digiri
Reflux yapathological gastroesophageal ndi chifukwa cha kufooketsa njira zowonongeka ndi zoopsa za zovulaza. Malinga ndi kuchuluka kwa kuwonongeka, matenda amagawidwa mu madigiri. Pano pali chimodzi mwazigawo zomwe zimagwiritsidwa ntchito:
- Digiri 0 - palibe mawonetseredwe a chipatala:
- Degree - kukhalapo kwa kutentha kwa nthaka kumbali ya minofu ya chithokomiro, osagwiranso ntchito 10 peresenti ya kutalika kwake;
- Dipatimenti yachiwiri - pali malo osokoneza bwinja, omwe ali ndi gawo la 50% pa gawo la distal;
- Matenda atatu - zilonda zam'mimba zambiri zam'mimba, kuika pamwamba pa mbali ya distal kwathunthu;
- Vuto la IV - Kukula kwa mavuto: zilonda zam'mimba, kupopera kwa mpweya, kapangidwe ka Barrett, ndi zina zotero.
Matenda opatsirana pogonana
Kafukufuku wam'mbuyomu kawirikawiri amapangidwa chifukwa cha madandaulo ndi anamnesis. Kuti mudziwe mtundu wa reflux ya gastroesophageal, kuwonetsa zithunzi ndi kofunikira kwambiri. Kupanga esophagogastroduodenoscopy kumapereka chithunzithunzi chachikulu cha zilondazi komanso kumaphatikizapo zolakwika. Ngati kuli kotheka, biopsy ikuchitidwa. Kuonjezerapo, njira zotsatirazi zingafunike:
- X-ray matenda ndi barium;
- kuyang'anitsitsa tsiku ndi tsiku pH ya phokoso;
- esophagotho-kymography;
- bimetry;
- zojambula.
Kodi gastroesophageal reflux amachitira bwanji?
Matenda okhudzidwa ndi matenda odwala matenda okhudzidwa ndi matendawa ayenera kukhala ndi zovuta, zomwe zimawathandiza kuti azigwiritsa ntchito mankhwala osokoneza bongo. Ndikofunika kutsatira zakudya ndi zotsatirazi:
- kulemera kwa thupi;
- Kuletsedwa kwa kukweza katundu (zosapitirira 10 kg);
- Kupewa kutsetsereka ndi kupanikizika kwa makina;
- kukana kuletsa zovala;
- kugona pa mkulu;
- kukana zizoloŵezi zoipa.
Matenda a mitsempha yotchedwa gastroesophageal - mankhwala, mankhwala
Pofuna kupeŵa mavuto, reflux yogwidwa ndi matenda opatsirana amafunika kukhala ndi chithandizo chamankhwala. Malingana ndi kuopsa kwa matenda, mankhwalawa amaperekedwa kwa magulu awa:
- nthendayi - (Fosfalugel, Maaloks);
- alginates (Gaviscon);
- prokinetics (Motilium);
- proton pump inhibitors (Omez, Lansoptol);
- blockers wa H2-receptor histamine (Ranisan, Famotidine).
Zina mwa mankhwalawa zimatengedwa nthawi zina pofuna kuthandizira zizindikiro, ena amafunika kuchiritsidwa mpaka kupitiriza kuthetsa zizindikiro. Ndi reflux popanda esophagitis, kokha kugwiritsa ntchito antacids ndi alginates akuwonetsedwa. Pa milandu yoopsa, opaleshoni yotenga opaleshoni ingafunike (mwachitsanzo, Nissen fundoplication).
Reflux yochizira - mankhwala ndi mankhwala ochiritsira
Pachiyambi cha kukhululukira, pamene reflux ya gastroesophageal sinawonetsere mawonetseredwe, ndiloledwa kugwiritsa ntchito njira zomwe sizinali zachikhalidwe kuti zisawonongeke. Odwala omwe amapezeka kuti ali ndi reflux ya gastroesophageal, operekedwa mankhwala ochizira, makamaka, ntchito ya phytotherapeutic wothandizira pachitetezo chotsitsimutsa ndi chotsutsa. Apa pali imodzi mwa maphikidwe.
Zitsamba kulowetsedwa
Zosakaniza:
- Mbewu ya thonje - tebulo limodzi. supuni;
- tsamba la amayi ndi amayi opeza-tebulo 1. supuni;
- Mizu ya licorice - 1 tebulo. supuni;
- madzi - 200 ml.
Kukonzekera ndi ntchito:
- Konzani zosonkhanitsa.
- Thirani supuni 2 za osakaniza ndi madzi otentha ndikutsanulira pa madzi osambira kwa kotala la ora.
- Koperani, tani.
- Tengani pamaso pa chakudya pa supuni 5 pa tsiku.
Reflux yamagastroesophageal - zakudya
Zakudya zofatsa ndi reflux ya gastroesophageal ndi esophagitis ndipo popanda - gawo lovomerezeka la mankhwala. Analimbikitsa zakudya zazing'ono 5-6 pa tsiku, pamene mbale zimaloledwa, osati zolimba, osati zolimba. Simungathe, kuimirira kuchokera pa tebulo, nthawi yomweyo tengani malo osakwanira ndikudya musanagone. Sankhani:
- chokoleti;
- khofi, tiyi wamphamvu;
- tomato;
- zipatso za citrus;
- mafuta.