Loaʻa iā ʻoe kekahi pilikia o ka ʻāʻī pinepine a me ka piʻi ʻana o ka meaʻai i loko o kou puʻu? ʻOiai ke kapa nei mākou i kēia gastritis, hiki i kēia ke lilo i maʻi koʻikoʻi. Inā emi ka pilikia ma hope o ka lawe ʻana i ka lāʻau lapaʻau no kekahi mau lā, akā a laila hoʻi hou mai, e noʻonoʻo paha ʻoe inā ʻaʻohe hopena mau loa no kēia. No ia poʻe ke koʻikoʻi o ke ʻano lapaʻau hou i kapa ʻia ʻo TIF a mākou e kamaʻilio nei i kēia lā.
I ka ʻōlelo maʻalahi, he aha kēia TIF?
ʻO TIF kahi hōʻailona no "Transoral Incisionless Fundoplication." E wāwahi kākou i nā huaʻōlelo e hoʻomaopopo ai i kēia.
- Transoral: ʻO ke ʻano kēia "ma o ka waha." ʻO ke ʻano kēia, hana ʻia ka lāʻau lapaʻau ma ke hoʻokomo ʻana i nā mea hana ma o kou waha.
- ʻOki ʻole: ʻO ke ʻano kēia "ʻaʻohe ʻoki." ʻAe, ua lohe pololei ʻoe! ʻAʻole pili kēia lāʻau i kekahi ʻoki i loko o kou ʻōpū. No laila, ʻaʻohe pono e hopohopo e pili ana i ke ʻoki kino nui.
- Fundoplication: ʻO kēia ka mea i hana maoli ʻia. Pili ia i ka lawe ʻana i ka ʻaoʻao o luna o kou ʻōpū (i kapa ʻia ʻo 'fundus') a kāʻei iā ia a puni ka ʻaoʻao haʻahaʻa o kou esophagus, e hoʻopaʻa iki ana iā ia.
I ka ʻōlelo maʻalahi, ʻo TIF kahi hana invasive ʻole e hoʻohana ana i kahi kāmela (endoscope) i hoʻokomo ʻia ma o ka waha e hoʻoikaika i ka valve ma waena o ka ʻaoʻao o luna o kou ʻōpū a me kou esophagus.
Pehea e hoʻomaikaʻi ai ka lāʻau TIF i ka GERD?
I mea e hoʻomaopopo ai i kēia, e nānā mua kākou i ke kumu e loaʻa ai iā kākou ka ʻāʻī. Ma kahi e pili ai ko kākou esophagus (paipu meaʻai) i ko kākou ʻōpū, aia kahi apo o nā ʻiʻo e hana ana e like me ka valve. Ke moni kākou, wehe ia a hoʻokuʻu i ka meaʻai e hele i loko o ka ʻōpū, a laila pani hou. Pale kēia i ka waikawa ʻakika o ka ʻōpū mai ka hoʻi ʻana mai i luna i loko o ka esophagus.
Akā, inā loaʻa iā ʻoe ka GERD (Gastroesophageal Reflux Disease) , ʻo ia ka mea a mākou e kamaʻilio nei, nāwaliwali nā ʻiʻo e hana ana e like me ka valve. No laila, piʻi maʻalahi ka waikawa o ka ʻōpū. ʻO kēia ka mea āu e manaʻo ai e like me ke kuni ʻana, he ʻono ʻawaʻawa i loko o kou puʻu.
Loaʻa paha i kekahi poʻe kahi maʻi i kapa ʻia he hiatal hernia . ʻO kēia ka wā e paʻi ai ka ʻaoʻao o luna o ka ʻōpū ma o kahi lua liʻiliʻi ma ka diaphragm, ka paia nui e hoʻokaʻawale ana i ko mākou umauma a me ka ʻōpū. Hiki i ka lāʻau TIF ke hoʻopaʻa i kēia valve nāwaliwali a hiki ke hoʻoponopono i nā hernia hiatal liʻiliʻi.
No wai kēia lāʻau lapaʻau TIF i kūpono loa?
ʻAʻole no nā kānaka a pau ka TIF. He kūpono loa ia no:
- No ka poʻe me ka GERD waena a koʻikoʻi paha a i ʻole kahi hernia hiatal liʻiliʻi.
- No ka poʻe makaʻu e hana i ke ʻoki kino nui, a i ʻole ka poʻe hiki ʻole.
- No ka poʻe makemake e pale i ka lawe ʻana i ka lāʻau lapaʻau no ka gastritis no ke koena o ko lākou ola.
ʻO ka lāʻau lapaʻau maʻamau no GERD he ʻano lāʻau i kapa ʻia ʻo proton pump inhibitors (PPIs) . Eia nō naʻe, ʻaʻole hiki i kekahi poʻe ke ʻae i kēia mau lāʻau i ka hala ʻana o ka manawa. ʻAʻole makemake paha kekahi e lawe iā lākou i ka wā lōʻihi. No kēlā poʻe, he koho maikaʻi ʻo TIF ma waena o ke ʻoki kino a me ka lāʻau lapaʻau lōʻihi.
He aha ka mea e hana ʻia ma mua o ka mālama ʻana iā TIF?
Inā makemake ʻoe i kēia lāʻau lapaʻau, pono ʻoe e kamaʻilio mua me kāu kauka e pili ana i ia mea . Hiki i kahi gastroenterologist a i ʻole ke kauka lapaʻau laulā ke hana i kēia. E nānā ʻo ia iā ʻoe a hoʻoholo inā kūpono maoli kēia iā ʻoe. Pono ʻoe e hana i kekahi mau hoʻokolohua.
| Nā hoʻokolohua hiki ke hana ʻia | I ka ʻōlelo maʻalahi, he aha ka mea e hana ʻia? |
|---|---|
| ʻEsophagram | ʻOiai ʻoe e moni ai i kahi wai, e nānā ʻia ka hana o ka esophagus me kahi wikiō X-ray ('fluoroscopy'). |
| Endoscopy luna | Hoʻokomo ʻia kahi kāmela ma o ka waha a nānā pololei ʻia ke kūlana i loko o ka esophagus a me ka ʻōpū. |
| Hoʻāʻo pH esophageal | I ka wā o ka endoscopy, kau ʻia kahi sensor liʻiliʻi i loko o kou esophagus a ana i ka nui o ka waikawa e komo i loko o kou esophagus i ka lā a pau. |
| Manometry esophageal | Hoʻopaʻa ʻia ke kaomi a me ka hana o nā ʻiʻo i loko o ka esophagus me ka hoʻohana ʻana i kahi ʻōmole liʻiliʻi (ʻōmole nasogastric) i hoʻokomo ʻia ma ka ihu. |
Akā e hoʻomanaʻo, inā he hernia hiatal nui kou, paʻakikī i ka moni ʻana, erosive esophagitis koʻikoʻi, a i ʻole kahi kūlana kahi i loli mau ai ka uhi o kou esophagus (ʻo Barrett's esophagus), ʻaʻole kūpono paha ka mālama ʻana iā TIF iā ʻoe.
He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?
Hana ʻia kēia lāʻau lapaʻau ma lalo o ka anesthesia laulā, ʻo ia hoʻi ua hiamoe loa ʻoe. No laila, ʻaʻole ʻoe e manaʻo i kekahi mea.
Hoʻokomo ke kauka i kahi endoscope, kahi kāmela, a me kahi mea TIF ma kou waha. ʻOiai e nānā ana i nā kiʻi ma ka pale, pelu mālie ke kauka i ka ʻaoʻao o luna o ka ʻōpū a puni ka esophagus a hoʻohana i nā ʻūmiʻi liʻiliʻi a i ʻole nā humuhumu (`fasteners`) e hoʻopaʻa iā ia ma kahi. Ua like kēia me ka hoʻoikaika ʻana i kahi nāwaliwali, e like me ke kola o ka pālule.
Ma kahi o 45 a 60 mau minuke ka lōʻihi o ke kaʻina hana holoʻokoʻa. Ma hope o ka mālama ʻana, e nānā ʻia ʻoe a e ʻae ʻia e hoʻi i ka home i ka lā hoʻokahi, a i ʻole e noi ʻia paha ʻoe e noho i ka haukapila i ka pō hoʻokahi.
Ma hope o ka mālama ʻana ... ʻeha a me ka manawa hoʻōla
Ke ala ʻoe, e hāʻawi ʻia ʻoe i ka lāʻau ʻeha ma o ka wai saline. Loaʻa i ka hapa nui o ka poʻe ka ʻeha iki e mau ana no hoʻokahi a ʻelua paha lā. He mea maʻamau ka ʻeha ʻāʻī a me ka ʻeha iki o ka umauma.
No ka wā hoʻōla, hiki iā ʻoe ke hoʻi hou i nā hana maʻamau i loko o kekahi mau lā. Eia nō naʻe, e hala ana ma kahi o ʻelua a ʻeono pule no ka ho'ōla piha ʻana o loko o ka esophagus. I loko o kēia manawa, pono ʻoe e hoʻololi i kāu meaʻai.
- I nā lā mua: nā wai moakaka (e.g. wai sopa, wai ʻalani)
- Aʻe: Nā wai mānoanoa a me nā meaʻai i wili maikaʻi ʻia
- Ma hope o kekahi mau pule: Hiki iā ʻoe ke maʻa i ka meaʻai maʻamau.
I loko o kēia manawa, he mea nui loa e pale i nā mea e like me ka hāpai kaumaha a me ka hoʻoikaika kino no kahi o hoʻokahi mahina .
Aia kekahi mau pilikia i loko o kēia?
E like me nā kaʻina hana lapaʻau a pau, hiki i nā TIF ke lawe mai i nā pilikia liʻiliʻi loa. Eia nō naʻe, ua haʻahaʻa loa ka likelika o kēia mau mea.
| Nā pilikia hiki ke loaʻa (kākaʻikahi loa) | |
|---|---|
| Ka hōʻino ʻana i ka esophagus a i ʻole ka ʻōpū | Ke kahe ʻana o ke koko a i ʻole ka puka ʻana o ka wai. |
| Nā maʻi | Nā kūlana e like me nā maʻi umauma (mediastinitis). |
| Hoʻi hou ʻana o nā hōʻailona | Inā hoʻi hou nā hōʻailona i ka hala ʻana o ka manawa, pono paha ʻoe e hoʻololi i kahi ʻano lapaʻau ʻē aʻe. |
He aha ka ʻokoʻa ma waena o ka TIF a me ke ʻoki kino kuʻuna (Nissen Fundoplication)?
ʻO ke ʻoki maʻamau no GERD ua kapa ʻia ʻo Nissen fundoplication . ʻO ka ʻokoʻa nui, ʻo ia ke komo ʻana o ke kauka i ka ʻōpū ma o kahi ʻoki ma ka ʻōpū. I kekahi manawa, hana ʻia ia ma ke ʻano laparoscopically, ma o kekahi mau ʻoki liʻiliʻi.
ʻO kekahi ʻokoʻa ʻē aʻe, ʻo ia ka hoʻopili paʻa ʻana o ke kaʻina hana Nissen i ka ʻōpū a puni ka esophagus. ʻO kēia ka mea e lilo ai i mea kūpono loa no ka GERD koʻikoʻi. Eia nō naʻe, no kekahi poʻe, hiki i kēia paʻa ke hana i nā hopena ʻaoʻao e like me ka paʻakikī i ka ale ʻana a me ka paʻakikī i ka hoʻokuʻu ʻana i ka ea (belching) .
He mea kākaʻikahi loa nā hopena ʻaoʻao lōʻihi e like me kēia me ka mālama ʻana iā TIF. Hāʻawi ia i kahi hopena kūpono i kahi pilikia kūpono. No laila, hiki iā ia ke hāʻawi i kahi hopena maikaʻi i ka pilikia me ka ʻole o nā pilikia a me ka manawa hoʻōla lōʻihi o ke ʻoki ʻana.
He mea hou nō ka mālama ʻana iā TIF, akā hōʻike nā hopena mua i ka holomua o kahi 80% ma hope o 5 mau makahiki. ʻO ke ʻano o ka holomua ua loaʻa i nā mea maʻi ke kala ʻana no ka manawa lōʻihi a ua hiki iā lākou ke hōʻemi a hoʻōki loa paha i ka hoʻohana ʻana i nā lāʻau lapaʻau.
Leka Lawe-Home
- He lāʻau lapaʻau hou ka TIF, ʻaʻole invasive no ka maʻi reflux gastroesophageal mau loa (GERD) a me nā hernia hiatal liʻiliʻi.
- Hana ʻia kēia me ke kōkua o kahi kāmela i kau ʻia ma ka waha. No laila, ʻaʻohe pilikia a ʻeha paha e pili ana i ke ʻoki kino nui.
- He koho maikaʻi kēia no ka poʻe me ka GERD kaulike ʻole makemake ʻole e lawe i ka lāʻau lapaʻau no ke koena o ko lākou ola a i ʻole e hana i kahi ʻoki kino nui.
- Ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau, e kamaʻilio me kāu kauka e ʻike inā kūpono kēia iā ʻoe.
- He pōkole ka manawa ho'ōla, akā he mea nui e hahai i nā ʻōlelo aʻoaʻo a ke kauka a hoʻomaha a hiki i kou hoʻōla piha ʻana.
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