He pilikia puʻuwai mau anei ka ʻeha o ka umauma? E aʻo kākou e pili ana i ka ʻeha umauma ʻaʻole puʻuwai!

Ke manaʻo nei ʻoe i kekahi manawa i ka ʻūmiʻi , ka paʻa, a i ʻole ka ʻeha i loko o kou umauma? Makaʻu pinepine mākou i ka wā e manaʻo ai mākou he hewa kekahi mea me ko mākou puʻuwai, ʻeā? Akā ua ʻike anei ʻoe, ʻaʻole nā ​​ʻeha umauma a pau i hana ʻia e ka puʻuwai. I kekahi manawa ke hele ʻoe i ke kauka, hana lākou i nā hoʻokolohua a ʻōlelo, 'ʻAʻohe pilikia me ka puʻuwai.' No laila he aha ka mea e hana nei? ʻO ia ka mea a mākou e kamaʻilio ai i kēia lā, ʻo ka ʻeha umauma ʻaʻole pili i ka puʻuwai. Ua kapa ʻia kēia ma ke ʻano lapaʻau ʻo 'Noncardiac Chest Pain (NCCP)'.

No laila, he aha kēia ʻeha umauma ʻaʻole puʻuwai?

I ka ʻōlelo maʻalahi, ʻo ka ʻeha ʻeha o ka umauma ʻaʻole i hoʻopaʻa ʻia (NCCP) he ʻeha ia e kū pinepine ana i loko o kou umauma, ʻoiai ma waenakonu o ka umauma, kahi o ka puʻuwai. Eia naʻe, ʻaʻole kēia i hana ʻia e kekahi maʻi puʻuwai. No nā kānaka he nui, ʻo ke kumu nui o kēia ʻano ʻeha he pilikia me ka esophagus (ka paipu e lawe ana i ka meaʻai mai ka waha a i ka ʻōpū i ka wā e moni ai mākou). I waena o lākou, ʻo kahi kūlana i kapa ʻia ʻo 'Gastroesophageal Reflux Disease (GERD)' ka mea maʻamau. I waena o mākou, he hoʻonui kēia o ka "gastritis" a i ʻole "reflux", ʻeā? Eia kekahi, hiki i nā mea e like me ke kaumaha, ka hopohopo, a me ke kaumaha ke ʻike ʻia he ʻeha mau o ka umauma. I kekahi manawa, hiki i nā mea e like me nā pilikia o ka māmā a me nā ʻūlū ʻiʻo ke kumu koke i ka ʻeha o ka umauma. Akā ua ʻike ʻia ʻo 'NCCP' he kūlana mau a mau loa.

Pehea ke ʻano o kēia ʻeha? Ua like anei ia me ka hāʻule puʻuwai?

ʻAe, ʻo ka hapa nui o ka manawa, ʻo kēia ʻeha umauma ʻaʻole puʻuwai e like me ka angina . Hiki ke manaʻo ʻia e like me ke ʻūlū ʻana o kekahi i kou umauma, e ʻūlū ana iā ia, a i ʻole ke kau ʻia ʻana o kahi kaumaha kaumaha ma kou umauma. ʻO ka hapa nui o kēia ʻeha e ʻike ʻia ma hope o ka iwi waena o kou umauma (sternum) . I kekahi manawa hiki ke kau ʻia ma ka ʻaoʻao ʻākau, ʻaoʻao hema, a i ʻole ma waenakonu. E like me ka hōʻeha puʻuwai, hiki i kēia ʻeha ke manaʻo ʻia e like me ka hele ʻana i kou ʻāʻī, lima hema, a i ʻole ke kua.

Hiki paha iā ʻoe ke hoʻomaopopo i kekahi mea ʻē aʻe me kēia mau mea. No ka laʻana, hiki mai kēia ʻeha ma hope o kou pau ʻana i ka ʻai ʻana. A i ʻole, hiki ke hele mai kahi ʻeha wela i loko o ka umauma, a mākou e kapa nei he "heartburn" , me kēia ʻeha. Hiki i kēia ʻeha ke mau no kekahi mau minuke, a i kekahi manawa hiki ke mau no kekahi mau hola.

E noʻonoʻo, ʻai ʻoe i kahi ʻaina ahiahi maikaʻi, me kahi mea ʻala iki, a ma hope o kekahi manawa, i kou hele ʻana e hiamoe, manaʻo ʻoe i kahi ʻano wela i waenakonu o kou umauma. Manaʻo kekahi poʻe, 'He kinoea paha ia.' Akā inā hana pinepine ʻia kēia, hiki ke lilo i hōʻailona o ka 'GERD', hiki ke hōʻeha i ka umauma.

No ke aha i like ai ka ʻeha o ka puʻu me ka puʻuwai?

He mea kupanaha paha kēia, akā aia ke kumu no ia mea. I loko o ko kākou umauma, aia ka trachea ma kahi kokoke loa i ka puʻuwai.Lawe ʻia nā hōʻailona ʻeha mai nā ʻōpū ʻelua i ka lolo ma o ka ʻōnaehana nerve like. No laila, he mea paʻakikī loa i kekahi manawa ke hoʻokaʻawale ma waena o kēia mau ʻano ʻeha ʻelua ma muli o nā hōʻailona wale nō.

Eia nō naʻe, inā loaʻa iā ʻoe nā hōʻailona ʻē aʻe e pili ana i ka reflux esophageal, ʻo ia ka manawa āu e manaʻo ai e hoʻi mai ana nā mea o loko o ka ʻōpū i luna o kou esophagus, he hōʻailona paha ia ʻaʻole pili ka ʻeha i kou puʻuwai. Eia nō naʻe, ʻo nā kūlana e like me ka spasms muscle i loko o kou esophagus a i ʻole ka visceral hypersensitivity hiki ke paʻakikī iki ke ʻike.

Pehea ka maʻamau o kēia ʻano?

ʻOi aku ka maʻamau o kēia ʻeha umauma ʻaʻole no ka puʻuwai ma mua o ko mākou manaʻo. Wahi a kekahi mau hōʻike, ma kahi o 25% o nā pākeke e ʻeha nei i kēia maʻi. Ma waena o 50% a me 75% o ka poʻe e hele mai ana i ka lumi pilikia me ka ʻeha umauma e hoʻouna ʻia i ka home ma hope o ka ʻike ʻia ʻana he maʻi puʻuwai. I ka manawa pinepine, ua hoʻokaʻawale ʻia kēia mau hihia e like me ka mea i wehewehe ʻole ʻia, i hoʻokumu ʻia e ke kaumaha a i ʻole ka hopohopo, a i ʻole "NCCP."

Pehea ʻoe e ʻike ai inā he koʻikoʻi ka ʻeha o ka umauma?

ʻO kēia ka mea nui loa. ʻAʻole paha ʻoe e hiki ke ʻike i ka ʻokoʻa ma waena o ka hōʻeha puʻuwai a me ka ʻeha umauma ʻaʻole naʻau ma kāu iho. No laila, pono e noʻonoʻo pono ʻia kekahi ʻeha umauma.

• Inā he mea hou ka ʻeha a ua mau ma mua o ʻelima mau minuke, e hele koke i ka lumi pilikia.
• ʻOiai inā e pau ana ka ʻeha i loko o kekahi mau minuke a ʻaʻole ia he pilikia, he mea nui loa e ʻike koke i ke kauka e ʻike ai i ke kumu.

E hoʻomanaʻo, hiki i ka ʻeha umauma ʻaʻole no ka puʻuwai, me ka nānā ʻole i ke kumu, ke hoʻi hou mai. Hiki iā ia ke hoʻopilikia i kou ʻano ola.

He aha nā kumu nui o ka ʻeha o ka umauma i pili ʻole i ka puʻuwai?

E like me kā mākou i ʻōlelo ai ma mua, ʻo kēia kūlana `NCCP` i hoʻokumu pinepine ʻia e kahi pilikia me kou esophagus (ka ʻōmole e lawe ana i ka meaʻai mai kou waha a i kou ʻōpū). Aia kekahi mau maʻi o ka esophagus e hiki ke hoʻopilikia i kēia:

ʻO ka maʻi Reflux Gastroesophageal (GERD)

ʻO kēia ke kumu maʻamau . Ma waena o 50 a me 60 pakeneka o nā maʻi NCCP i loaʻa i kēia maʻi. I ka ʻōlelo maʻalahi, ʻo ia ka manawa e piʻi ai ka waikawa o ka ʻōpū i ka esophagus.

Nā ʻūmiʻi ʻiʻo esophageal

Hiki nō hoʻi ke ʻano o kēia ʻeha ma muli o nā ʻūmiʻi ʻano ʻē aʻe o nā ʻiʻo i loko o ka esophagus. Hiki nō hoʻi ke ʻano o ia mea i loko o ka esophagus, e like me kahi puʻupuʻu ma ka wāwae.

ʻAkalasia

He kūlana kākaʻikahi kēia. ʻO ka mea e hana ʻia ma ʻaneʻi, ʻaʻole e wehe pono ka valve (sphincter) ma ka ʻaoʻao haʻahaʻa o ka esophagus. A laila, ʻaʻole hiki i ka meaʻai ke hele i loko o ka ʻōpū a paʻa i loko o ka esophagus.

ʻO ka hypersensitivity o ka esophagus

He maʻi sensory kēia. ʻO ia hoʻi, lilo nā ʻiʻo, nā aʻalolo, a me nā mea loaʻa i loko o nā paia o ka esophagus i mea ʻeha loa. ʻOiai ke kaomi, ka huki ʻana, a me ka waikawa i ʻike mau ʻia ua ʻike ʻia he ʻeha e kēia poʻe.

Ka mumū o ka esophagus

ʻO nā maʻi, nā maʻi ʻaleka meaʻai (e like me ka eosinophilic esophagitis) , a i ʻole ka maʻi ʻōpū peptic hiki ke hoʻoulu i ka esophagus e pehu a ʻeha, a hiki nō hoʻi ke hōʻeha i ka umauma.

ʻO nā ʻiʻo ʻē aʻe i loko o ka esophagus

I kekahi manawa, hiki i nā ʻiʻo ʻē aʻe, e like me nā apo a i ʻole nā ​​​​pūnaewele, ke ulu i loko o ka esophagus, e ālai ana i ka esophagus.

I kekahi manawa, ʻaʻole hiki i nā kauka ke loaʻa kekahi o kēia mau kumu. Akā i ka wā e hōʻoia ʻia ai ʻaʻohe pilikia puʻuwai, ua kapa ʻia ia he "ʻeha umauma hana i manaʻo ʻia he kumu esophageal."

He aha nā mea ʻē aʻe e hiki ai ke hoʻoulu i ka ʻeha o ka umauma e like me kēia?

Ma waho aʻe o nā pilikia me ka esophagus, aia kekahi mau kumu ʻē aʻe e hiki ai ke loaʻa kēia kūlana `NCCP`. Eia naʻe, ʻaʻole i maʻamau kēia mau mea:

• Nā pilikia ʻiʻo a iwi paha ma ka umauma, ka paia umauma, a i ʻole ka iwi kuamoʻo. E like me ka ʻiʻo i huki ʻia a i ʻole ka pilikia me ka iwi ʻaoʻao.
• Nā maʻi māmā mau loa, ʻoiai nā mea e pili ana i ka pleura, ka membrane e uhi ana i nā māmā.
• Nā pilikia ʻōpū, no ka laʻana nā ʻōpū ʻōpū.
• Nā pilikia noʻonoʻo. Nā mea e like me nā maʻi ʻeha, ke kaumaha, ka hopohopo, a me ke kaumaha .

Aia kekahi mau hōʻailona ʻē aʻe me kēia ʻeha umauma?

ʻAe, he nui ka poʻe me ka ʻeha umauma ʻaʻole no ka puʻuwai he mau hōʻailona ʻē aʻe e pili ana i ka GERD. No ka laʻana, ka heartburn a me ka reflux acid. ʻO nā hoʻopiʻi ʻē aʻe o ka digestive, e like me ka ʻeha o ka puʻu, ka regurgitation, a me ka paʻakikī i ka moni ʻana, he mea maʻamau nō hoʻi. Ma kahi o 80% o ka poʻe me ka NCCP hana i loaʻa i nā maʻi digestive hana ʻē aʻe me ke kumu ʻole. ʻO ka mea maʻamau o kēia mau mea ʻo ia ka Irritable Bowel Syndrome (IBS) (ma kahi o 27%) a me ka pehu ʻōpū hana (ma kahi o 22%).

No kekahi poʻe, pili pū kēia ʻeha umauma me nā hōʻailona noʻonoʻo. ʻO ia hoʻi, nā mea e like me ke kaumaha, ka hopohopo, a me ke kaumaha. ʻOiai inā ʻike ʻia ke kumu o ka ʻeha he mea ʻē aʻe, hiki ke pili pū kēia ʻano noʻonoʻo me ia. ʻO ka ʻoiaʻiʻo, aia kahi pilina ikaika ma waena o nā hōʻailona noʻonoʻo a me ka hypersensitivity esophageal, a me ka mumū o ka umauma. Hiki i ke kaumaha ke hana i nā hōʻailona o ka ʻōnaehana digestive, a hiki i kēlā mau hōʻailona ke hoʻonui i ke kaumaha. Manaʻo nā kauka he hiki ke kumu kēia o kekahi nāwaliwali i ka pilina ʻōpū-lolo ma waena o ko kākou mau ʻōpū a me ka lolo .

He aha nā kumu pilikia e hoʻohuli i kēia?

ʻOiai ʻaʻole ia he kumu pololei, ua ʻike ʻia kēia mau mea e pili ana me ka ʻeha umauma ʻaʻole ka puʻuwai:

• Kuhikuhi Nui o ke Kino (BMI) - ʻO ke ʻano kēia o ka loaʻa ʻana o ke kaumaha ma mua o ke kūpono no kou kiʻekiʻe.
• Ka puhipaka a i ʻole ka hoʻohana ʻana i ka paka.
• ʻO nā `NSAID` (Nonsteroidal Anti-inflammatory Drugs) - ʻO ia hoʻi ka hoʻohana pinepine ʻana i nā lāʻau anti-inflammatory non-steroidal (e.g. nā lāʻau hōʻeha ʻeha e like me ibuprofen a me diclofenac).
• Hopohopo .

Pehea e ʻike ʻia ai kēia maʻi?

Inā ʻoe e ʻeha ana i ka umauma e like me ka hōʻeha puʻuwai, ʻo ka mea mua āu e hana ai, ʻo ia ke hele i ka lumi pilikia. Ma laila, e lawe lākou i nā hōʻailona koʻikoʻi a pau , e like me kou koko a me ka helu o ka puʻuwai, a hana i kahi hoʻokolokolo kino piha. A laila, e nānā lākou no ka hōʻeha puʻuwai a i ʻole ka maʻi puʻuwai. E komo pū kēia me kahi hoʻāʻo `EKG (Electrocardiogram)` (kahi hoʻāʻo ʻeha ʻole e hoʻopaʻa ana i ka hana uila o ka puʻuwai) a me nā hoʻāʻo koko. Hiki i kēia mau hoʻāʻo koko ke ʻike i ke alo o kekahi mau protein i hoʻokuʻu ʻia e ka puʻuwai i ka wā o ka hōʻeha puʻuwai. Ma hope wale nō o ka hōʻoia ʻana ʻaʻohe pilikia puʻuwai, e ʻike ʻia ʻoe me ka ``ʻeha umauma ʻaʻole cardiac'' (NCCP).

Ma hope o ka hōʻoia ʻana o kahi kauka puʻuwai a i ʻole kāu kauka ʻohana ʻaʻohe pilikia puʻuwai, e kuhikuhi paha lākou iā ʻoe i kahi gastroenterologist . E nānā ʻo ia no nā kūlana esophageal, ʻoiai ʻo GERD.

ʻO kahi ala e hana ai i kēia, ʻo ke kuhikuhi ʻana i kahi lāʻau i kapa ʻia he proton-pump inhibitor (PPI) . He mau lāʻau lapaʻau maikaʻi loa kēia no GERD. Inā hoʻomaikaʻi kāu mau hōʻailona ma hope o ka hoʻohana ʻana i kēia lāʻau, hiki ke kōkua i ka hoʻoholo ʻana i ke kumu.

ʻO nā hoʻokolohua ʻē aʻe e komo pū paha me kahi haʻawina pH o ka esophagus , kahi hoʻāʻo neʻe esophageal , kahi endoscopy luna, a i ʻole kahi ultrasound . Ma waho aʻe o kēia mau hoʻokolohua kino, e nīnau ke kauka e pili ana i kou mōʻaukala olakino a kūkākūkā i kou kaumaha a me nā mea pili i ka naʻau.

He aha nā lāʻau lapaʻau no kēia?

I mea e hāʻawi ai i ka lāʻau lapaʻau kūpono, pono ʻoe e ʻimi i ke kumu pololei o kou ʻeha umauma ʻaʻole no ka puʻuwai. Aia kekahi mau koho lapaʻau:

Nā lāʻau lapaʻau reflux waikawa

Inā, e like me ka hapa nui o ka poʻe, ua hoʻokumu ʻia kāu NCCP e GERD, maʻalahi a maikaʻi ka lāʻau lapaʻau. Nā mea pale pump proton (PPIs)ʻo ia ka lāʻau lapaʻau i hoʻohana pinepine ʻia no GERD. Hana nā PPI ma ka hoʻemi ʻana i ka nui o ka waikawa i hana ʻia e nā ʻōpū ʻōpū. Kōkua kēia i ka ho'ōla ʻana i nā ʻōpū a hoʻemi i ka pōʻino i hana ʻia e ka waikawa. Hoʻomaka ka lāʻau lapaʻau me kahi mahele nui e kāohi i nā hōʻailona. A laila, hoʻomau ʻia kahi mahele haʻahaʻa no ʻelua a ʻehā mahina. He 90% ka maikaʻi o nā PPI i ka mālama ʻana iā GERD a me kona mau hopena ʻaoʻao. Inā ʻaʻole holo pono kēia mau mea, hiki ke hana ʻia kāu NCCP e kekahi mea ʻē aʻe.

Nā mea pale ʻeha

ʻO ka lāʻau lapaʻau kūpono aʻe i hoʻohana pinepine ʻia, ʻo ia nā lāʻau pale ʻeha. No kēia mau mea i kahi papa o nā lāʻau i kapa ʻia ʻo tricyclic antidepressants (TCAs) . Eia nō naʻe, hāʻawi ʻia lākou i nā dosis haʻahaʻa loa ma mua o nā mea i hoʻohana ʻia no ke kaumaha. Inā ʻike ʻoe he paʻakikī ke ʻae i nā hopena ʻaoʻao o nā TCA, hiki i nā ʻano antidepressants ʻē aʻe ke kōkua pū kekahi. Ua hōʻike nā Selective serotonin reuptake inhibitors (SSRIs) i kekahi holomua me NCCP, akā ʻaʻole lākou i hoʻokumu maikaʻi ʻia e like me nā TCA.

Nā hoʻōla naʻau a me nā ʻano hana

Ua ʻōlelo mākou ʻo ka ʻeha umauma i pili ʻole i ka puʻuwai hiki ke pili i kekahi manawa me ke kaumaha, ka hopohopo, a i ʻole ke kaumaha. Hiki i ka Psychotherapy ke kōkua i ka hoʻoponopono ʻana i kēia mau pilikia a hōʻemi i ke alapine o ka ʻeha umauma. Aʻo ka Cognitive Behavioral Therapy (CBT) iā ʻoe e hoʻololi a hoʻopau paha i nā ʻano noʻonoʻo e hoʻoulu ai i ke kaumaha a i ʻole ka hopohopo. ʻO Biofeedback kahi lāʻau lapaʻau noʻonoʻo-kino i alakaʻi ʻia. Kōkua ia iā ʻoe e hoʻololi i ke ʻano o ka pane ʻana o kou kino i kekahi mau stimuli (me nā manaʻo). Hiki iā ʻoe ke hoʻāʻo i nā ʻano hana hoʻokele kaumaha ma ka home (e.g., noʻonoʻo, hoʻoikaika kino, nā ʻano hana hoʻomaha).

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

Hiki i ka ʻeha o ka umauma ke lilo i mea weliweli, ʻoiai ke manaʻo ʻia e like me ke kumu o kahi maʻi puʻuwai. ʻO ka loaʻa ʻana o kēia ʻano ʻeha i kēlā me kēia manawa hiki ke hoʻoluhi a hiki ke hoʻopilikia i kou hiki ke hauʻoli i ke ola.

No laila, inā loaʻa iā ʻoe ka ʻeha mau o ka umauma, e lawe koʻikoʻi iā ia. Mai hoʻokaʻulua i ka ʻimi ʻana i ke aʻo lapaʻau.

ʻO ka ʻimi ʻana i ke kumu o kou ʻeha umauma e pono ai kekahi hoʻoikaika a me kekahi mau hoʻāʻo. Akā, he mea kūpono ia. No ka mea , i ka hapa nui o ka manawa, ke loaʻa iā ʻoe ke kumu, he mea maʻalahi loa ia e mālama. ʻOiai inā he paʻakikī iki ke kumu, hiki iā ʻoe ke aʻo nui e pili ana i ke ʻano o ka pane ʻana o kou kino i ka meaʻai, ke kaumaha, a me nā manaʻo. E kōkua kēlā ʻike iā ʻoe ma ke ala i ka hoʻōla lōʻihi. No laila, e mālama i kou olakino kino.

ʻEha umauma, Maʻi puʻuwai, GERD, ʻEsophagus, Kaumaha, ʻŌnaehana hoʻoheheʻe, ʻEha umauma ʻaʻole puʻuwai