I rilruah hian lump a awm ang maiin i inhria fo thin em, thil pakhat a inkhung ang maiin i inhria fo thin em? I rilru tifai a, "Mm... Mm..." tih duhna i nei fo em? Khawsik emaw, leivut allergy emaw a ni mai thei. Mahse thla tam tak chhung a reh lo a nih chuan a chhan chu i ngaihtuah aiin thil danglam deuh leh thuk zawk a ni thei. Vawiin hian harsatna "thup" tak, mi tam takin an hriat loh, mahse mi tam takin an neih thu kan sawi dawn a ni. Hei hi LPR, a nih loh leh Laryngopharyngeal Reflux kan ti a.
LPR chu eng nge ni? Hei hi ‘silent reflux’ an ti bawk em?
Okay, hei hi awlsam takin i vawng ang. "Gastritis" emaw "acid reflux" emaw tih hi i hre tawh mai thei. Hei hi chaw ei tura puitu pum tui te chu chaw kawng chhungah a luang chhuak leh thin a ni. A tlangpuiin hetiang thil a lo thlen hian kan rilruah emaw, kan pum chhungah emaw kang kan nei thin. Hetiang dinhmun hi GERD (Gastroesophageal Reflux Disease) kan ti a.
Mahse LPR hi a danglam deuh a, special case a ni. Heta thil thleng chu, pum atanga acid lo chhuak chu i rilruah a tawp lo va, i rilru (pharynx) leh i vocal cord awmna box (larynx)-ah a kal chho lehzual zawk a ni.
A pawimawh ber chu LPR vei zawng zawng hian heartburn an nei vek lo. Chuvangin mi tam tak chuan acid reflux chungchangah harsatna an nei tih an hre lo. Chuvangin " silent reflux" an ti bawk. A natna lan chhuah dan chu kawr, aw leh hnar-ah a awm avangin mi tam tak chuan thil dangah an ngai a.
A awlsam zawngin GERD hi rilru atanga intan a ni. LPR hi harsatna a ni a, a sang zawk a, rilru a nghawng nasa hle. Mi thenkhat chuan an nei ve thei bawk. Mi thenkhat chuan LPR chauh an nei thei.
LPR tih theihna tur symptoms te chu engte nge ni?
Hun rei tak chhung heng symptoms pakhat emaw a aia tam emaw i neih tawh chuan ngaihtuahawm rawh. A bulpui berte han thlir ila.
| Symptom a ni | Hei hian engtin nge i rilru a put tir? |
|---|---|
| Aw ri bengchheng tak | Zing ka thawh veleh ka aw chu a danglamin ka hria. Nilengin ka aw a fiah lo. |
| Thil pakhat chu rilruah a inkhung ang maia hriatna | Ka rilruah hian lump emaw, mucus ball emaw a awm ang maiin ka hria fo thin. |
| Thlalak tihfai fo thin | Midangte tana buaina thlen thei khawpin an rilru ‘tifai’ an tum reng a ni. |
| Hun rei tak chhung khuh | Thla tam tak chhung chu dry cough ka nei a, chhan hriat lohvin. |
| Mucus emaw phlegm emaw a tam lutuk | Kawngkhar chhungah hian mucus a awm reng a. Hnar atanga mucus (postnasal drip) atanga rilru atanga chhuak ang maiin a lang. |
| Chaw ei harsat | Chaw emaw, in emaw i ei hian i rilruah lump a awm ang maiin a lang. |
| Hloro na reng reng | Khawsik leh khawsik nei loin ka rilru a na fo thin. |
| Asthma a zual zel | Asthma i neih tawh chuan control a harsa emaw, asthma ang chi symptom thar a lo lang emaw a ni. |
Engvangin nge pum chhunga thil awmte hi hetiang hian rilru chhungah a rawn chhoh?
Hei hi hrethiam tur chuan kan chaw kawng (esophagus) chungchang tlem kan hriat a ngai a ni. Tube angin ngaihtuah la, a chung leh a hnuai lamah valve pahnih a awm. Heng valve te hi sphincter kan ti a .
1. A hnuaia valve (Lower Esophageal Sphincter - LES) awm chu:Hei hi esophagus leh stomach (oesophagus) inkar a ni. Chaw kan ei hian chaw ei chu pum chhungah a kal theih nan a inhawng a, chutah chuan nghet takin a khar leh thin. Hei hian stomach acid chu a rawn chho leh thei tawh lo.
2. Upper Esophageal Sphincter (UES): He valve hi chaw kawng leh kawr inkarah a awm a. A hnathawh chu chaw kawng chhunga lut tawh zawng zawng chu rilru chhunga a chho leh tawh loh nan a titawp a ni.
LPR a awm theih nan heng valve pahnih hi a thawk tha lo tur a ni. Pakhatnaah chuan lower valve (LES) chu a chak lo tur a ni a, chu chuan stomach acid chu esophagus-ah a luang lut leh thei a ni. Tichuan, upper valve (UES) chu a chak lo tur a ni a, chu chuan acid chu chaw kawng chhungah a luang lut leh thei ta a ni.
Chuti a nih chuan, engvangin nge heng valve te hi an chak loh?
Hei hi chhan tam tak a awm thei. Ṭhenkhat chu hun rei lote chhûnga awm, ṭhenkhat chu hun rei tak chhûnga awm a ni.
1. LES tichak lo thei thil
A tam zawkah chuan normal gastritis tibuaitu chhan ang chiah hian hei hi a nghawng bawk.
- Damdawi thenkhat: Painkillers (NSAIDs), thisen sang damdawi thenkhat (Calcium channel blockers), leh rilru lam harsatna damdawi (Tricyclic antidepressants) te hian he valve hi a tizau thei a ni.
- Hei hi ei leh in thenkhat: coffee, chocolate, mint, garlic, onion, leh zu te vang pawh a ni thei.
- Thiltih \ha lo: 1.1.
- Chaw ei hnu darkar 2-3 vel mut.
- Vawi khata ei tam hian pum a ti na thei. Hei hian pum chhunga pressure a ti sang a, acid a ti sang bawk.
- Pum chunga thawmhnaw hak, a bik takin kawr vel a inbel.
- Hun rei tak chhunga a chhan:
- Hiatal Hernia: Hei hi pum chhung hmun tlemte chu rilru chhunga a rawn chhuah chuan a ni. Hei hian LES valve hnathawh a tichak lo hle.
- Thau lutuk: Rihna a san chuan pum chhunga pressure a sang chho zel a. Hei pawh hi a chhan lian tak a ni.
- Naupai: Hetih hun chhunga hormone inthlak danglam leh pum chhunga pressure sang hian rei lo te chhungin gastritis leh LPR a thlen thei a ni.
- Meizial: Meizial hi he valve tizautu hmêlma lian tak a ni.
2. Upper esophageal sphincter (UES) tichak lo thei thil .
Acid chu lower valve kaltlangin a rawn chhoh hnuah chuan upper valve hi rilru vengtu guardrail hnuhnung ber a ni. Kan ril hi chaw kawng (esophagus) angin acid tuar thei tura siam a ni lo. Chuvangin acid tlemte pawh hian chhiatna nasa tak a thlen thei a ni.
- Mut: Kan mut hian heng valve pahnih hi a lo hrual deuh deuh thin. Hei hian kan mut laiin zanah LPR a awm tam zawk a ni.
- Burping: I burp hian valve pahnih hi a inhawng a, chu chuan boruak nen acid tlem te te chu i kawr chhungah a lut thei a ni.
- Hmalam pan, exercise lak, hla sak: Hetiang thiltih hian upper valve hnuaia pressure a tisang thei a, a tichak lo thei bawk.
- Meizial leh zu in: An pahnih hian valve pahnih tan hian a inang tlangin an tichhe thei a ni.
LPR dinhmun ngaihthah hi a hlauhawm em?
Ni e, he natna hi rei tak a awm reng chuan harsatna engemaw zat a awm thei.
- Infection awm fo: Thlalak chhunga acid awm hian ril leh sinus-a natural cleansing process a tibuai a. Hei hian mucus a tipung thei a, rilru leh thawkna kawngah natna a thlen fo thei bawk.
- Hun rei tak chhunga aw leh rilru lama harsatna: Acid ei chhunzawm zel hian vocal cords a tichhe thei a, vocal cord lesions ang chi thil a thlen thei a ni. Hun rei tak chhung he natna hi a awm chuan laryngeal cancer vei theihna a tipung deuh thei a ni.
- Thluak lama harsatna: Acid tlemte lo lut chu kan hriat loh pawhin trachea atanga lung chhungah a kal thei a, a bik takin mut laiin. Hei hi silent aspiration an ti a . Hei hian lung infection leh bronchitis ang chi condition a thlen thei a ni.
Engtin nge LPR chu eng nge a nih chiang taka ka hriat theih ang?
A hmaa kan sawi tawh ang khan natna lan chhuah dan hi hun rei tak i lo tawng tawh a nih chuan a tha ber chu beng, hnar leh rilru lam specialist (ENT Surgeon) hmuh hi a ni. I natna lan chhuah dan a ngaithla ang a, i rilru a enfiah ang.
Chumi atana test tih tlangpui chu flexible laryngoscopy a ni . Hei hian i hnar kal tlang leh i rilru hnuai lam, i vocal cord leh i rilru chhung lam enfiah turin tube te tak te, camera hmanga siam chu i pass a ngai a ni. Hei hi natna nei lo, minute tlemte chhunga tih theih a ni.
He test hian kawchhung a sen leh hring a awm leh awm loh a enfiah thei a ni. A châng chuan, a natna hriat chian nân emaw, a chhan dang hriat chian nân emaw test dang neih belh a ngai thei bawk.
- Upper Endoscopy: Hei hi ka chhunga camera dahin chaw kawng leh pum enfiah a ni. Lower esophageal sphincter (LES) leh hiatal hernia-a harsatna awm leh awm loh a enfiah thei.
- Esophageal pH test: Hei hian darkar 24 chhunga ril leh esophagus-a acid awm zat a teh thin.
- Esophageal Manometry: Esophagus ruh leh a valve te hnathawh leh chakna tehna test a ni.
Okay, tunah hian he thil hi engtin nge kan tih ang? Enkawlnate chu engte nge ni?
LPR enkawlna atana pawimawh ber chu nunphung leh ei leh in lama inthlak danglamna siam hi a ni . Damdawi chu pahnihnaah a awm.
1. Nunphung leh ei leh in thlak danglam (hei hi a pawimawh ber) .
Heng tih dan dik tak hi i zawm chuan damdawi tel lovin he natna hi i thunun thei fo thin.
| Eng nge tih tur | Hrilhfiahna |
|---|---|
| Chaw ei chu a te zawkin siam rawh. | Vawi khata chaw lian tak ei ai chuan ni khatah vawi nga emaw vawi ruk emaw tlem te ei thin ang che. |
| Chaw thenkhat ei loh tur | A theih ang anga ei tur hriak, spicy, acidic tam tak (tomato, orange, limes), coffee, chocolate, mint, leh carbonated drinks (soda) te ei tlem rawh. |
| Zanriah ei hma rawh. | Zanriah mut hma darkar 3 tal ei thin ang che. Chaw ei zawhah muhil suh. |
| I mut dan tur thlak rawh. | Khum lu chu inches 6 vel chawi sangin mu rawh. Pillow pahnih pathum hmangin i lu chu chawi sang mai suh, khum ngei pawh chawi sang rawh. I veilam sir a mut hian acid reflux a ti tlem bawk. |
| Meizial zu leh zu in kha bansan rawh. | Heng pahnih hian LPR dinhmun hi a ti na hle a ni. Anni hi tihtawp vek a pawimawh. |
| I rihna control rawh. | I thau lutuk a nih chuan i thau tihtlem hian i pum a pressure a tihziaawm thei a, symptoms pawh nasa takin a control thei bawk. |
2. Ruihhlo hmanga enkawl
Nunphung i tihdanglam lai hian i doctor chuan i rilru tissue chhia chu a dam theih nan damdawi a pe thei a ni.
- Proton Pump Inhibitors (PPIs): Damdawi Omeprazole leh Pantoprazole te hian pum chhunga acid siam chhuah tihtlem nan hna an thawk a. Hengte hi thla engemaw zat chhung atan an pe tlangpui.
- H2 Blockers: Famotidine ang damdawi te hian acid control nan a pui bawk.
- Alginates: Hengte hian pum chhungah venhimna layer a siam a, acid lo chhuak tur a veng a ni.
Pawimawh: Heng damdawi zinga eng pawh hi doctor thurawn hnuaiah chauh hman tur a ni. Mahni indahdam suh.
3. Surgery tih a ni
Hei hi a tul lo hle. Surgery hi taksa lama harsatna bik, hiatal hernia ang chi a awm emaw, enkawlna dangin a puih loh emaw chauhvin ngaihtuah a ni.
Thutawp atan chuan LPR hi thil tibuaitu deuh a ni a, mahse uluk taka enkawl a nih chuan enkawl tha theih a ni. A pawimawh ber chu a natna lan chhuah dan ngaihthah loh a, diagnosis dik tak neih a, a bik takin nunphung tihdanglam tulte chu dawhthei taka awm hi a ni.
Take-Home Thuchah a ni
- LPR hi chaw kawng chhunga acid a luang chhoh chuan a lo awm thin a ni. Chu chu "silent reflux" tia koh a ni fo a, a chhan chu rilruah kang natna a awm loh vang a ni.
- A lan chhuah dan ber chu khuh chhunzawm zel, rilru chhunga mucus, ri bengchheng, leh rilru chhunga thil awm ang maia inhriatna te hi a ni.
- Heng symptoms te hi khawsik emaw allergy emaw angin ngai sual suh. An awm reng chuan doctor pan rawh.
- Enkawlna atana pawimawh ber leh hmasa ber chu i ei leh in leh nunphung thlak danglam hi a ni. Damdawi hian puitu hna a thawk a ni.
- Chaw ei zawhah darkar 3 chhung mut loh tur. Zanah khum lu chawi sangin mu rawh. Meizial zu leh zu hi bansan vek rawh.
- I natna lan chhuah dan i rinhlelh chuan beng, hnar leh kawr lam thiam (ENT Surgeon) hnenah thurawn dik tak zawt la.
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