I a au i te whare wānanga, he hoa piri tōku ko Chamari tōna ingoa. He maha ngā amuamu a Chamari mō te mamae o te puku me te mamae o te uma i muri i te kai, inā koa i muri i te kai i tētahi kai reka o Sri Lanka, i muri rānei i te tina. I mahara ia he koretake noa iho. Engari i te roanga o te wā, ka tino kaha te mamae o te uma, ā, ka whakararuraru i tana moe i te pō.
"E Tākuta Priya, he mura tonu te uma i ia pō. He wai kawa kei roto i tōku waha. Kāore e taea te whakapai ake ahakoa te rongoā noa," te pātai a Chamari i tētahi rā.
I whakamārama mārire atu ahau ki a Chamari: "E Chamari, ko tāu i wareware noa ai, i whakaaro ai he mate puku noa iho, he mate e kiia nei ko te GERD (Gastroesophageal Reflux Disease) . He mate tēnei e hoki ake ai te waikawa o te puku ki roto i te korokoro. He mate tino noa tēnei i waenga i te hunga rangatahi i ēnei rā. Engari kaua e manukanuka, ka taea te whakahaere katoa mā te whakarerekē i te āhua noho me te maimoatanga hauora tika."
🚨 Ngā tohu whero e hiahia ana kia rapu awhina hauora tonu
Ahakoa kāore te waikawa reflux e tino mōrearea ki te ora, me toro atu koe ki te tākuta tonu mēnā ka pāngia koe e tētahi o ngā tohu kino e whai ake nei:
- He uaua rawa te horomi i te kai, i te huware rānei, he mamae rānei i te wā e horomi ana (Dysphagia/Odynophagia).
- Te whakahekenga taumaha tere, kāore he take (Te whakahekenga taumaha kāore i te mārama).
- Te ruaki pinepine, te ruaki toto rānei.
- He tūtae mangu (he tohu toto i roto i te puku, i te korokoro rānei).
He aha te take e puta ai te GERD? He māmā noa iho ngā take
Kei te hononga o te korokoro me te puku he uaua porowhita te āhua, e kiia nei ko te LES (Lower Esophageal Sphincter) . He rite tana mahi ki te "takirere" e tuwhera ana i te taha kotahi.
Ina kai tātou, ka tuwhera tēnei takirere kia taea ai te kai te tomo ki te puku, kātahi ka kati pūmau ina pahemo te kai, ka ārai i ngā waikawa kaha o te puku kei hoki ake ki te korokoro.
Engari, ki te ngoikore te takirere LES, ki te kore rānei e kati i te wā tika, ka ngawari te turuturu o te waikawa o te puku ki roto i te korokoro. Ka kiia tēnei ko te reflux waikawa .
He maha ngā take matua e ngoikore ai tēnei takirere:
1. Hiatal Hernia: Ka puta te wāhanga o runga o te puku ki roto i te uma mā roto i tētahi kōhao i te diaphragm, ka kore ai e mahi tika te takirere.
2. Te momona me te hapūtanga: Ka nui ake te tuwhera o te takirere nā te pikinga o te pēhanga i roto i te puku.
3. Ngā tikanga kai hē: Te kai nui i te wā tonu, ā, te takoto tonu i muri i te kai.
4. Te waipiro, te momi hikareti me ngā raau taero:Ka whakangāwari te takirere LES i te kai hikareti, ā, ka taea hoki e ngā rongoā whakamamae mamae te hoko kore utu pērā i te ibuprofen te kino i ngā pakitara o te puku.
Ngā whakamātautau hauora hei tautuhi i te mate reflux waikawa
Hei tautuhi tika i te mate, ka tūtohu ngā tākuta i ngā whakamātautau e whai ake nei:
- Endoscopy o Runga: Ka whakauruhia he ngongo me te kāmera iti mā te waha hei tirotiro i ngā pakitara o te korokoro mō te mumura, ngā whara, ngā tohu rānei o te mate pukupuku.
- Aroturukitanga pH ā-Waewae: He whakamātautau e mahia ana mā te whakamahi i tētahi taputapu iti e ine ana i te nui o te waikawa e rere ana ki roto i te korokoro mō te wā 24-hāora.
- Esophagram (x-ray barium): Ka whakamahia e tēnei whakamātautau he whakamātautau horomi barium hei tango i ngā hihi-x o te esophagus hei kite i te whaiti, i te hernia rānei.
Me pēhea te whakahaere i te mate reflux waikawa?
Hei ora tonu i tēnei mate, me taurite ngā huringa āhua noho me te maimoatanga rongoā:
1. Ngā huringa nui o te āhua noho:
- Ngā kai iti: Engari i te kai i tētahi kai nui hei whakakī i tō puku i te wā kotahi, me kai pinepine i ngā kai iti e maha.
- Te mokowā i waenga i ngā kai me te moe: Kaua e takoto, e haere rānei ki te moenga mō te iti rawa i te 3 hāora i muri i te kai.
- Te whakaara ake i te pane o te moenga: Mā te whakaara ake i te pane o te moenga kia 6 inihi te teitei ka ārai i te pikinga o te waikawa nā te kaha o te kaha ā-papa (kāore e ranea te whakamahi i ngā urunga anake).
- Te whakahaere taumaha: Whakaitihia te ngako puku kāore e hiahiatia.
2. Maimoatanga Hauora:
- Ngā PPI (Ngā Ārai Papu Proton): Ka tino whakaitihia e ngā rongoā pēnei i te Omeprazole , te Esomeprazole rānei te hanga waikawa i roto i te puku.
- Ngā Ārai H2 (Ngā Ārai Kaiwhakawhiwhi H2): Ka whakahaere anō hoki ngā rongoā pēnei i a Famotidine i te waikawa.
- Ngā rongoā antacid: Ngā rongoā wai hei whakaora wawe i te mamae o te uma.
Ngā Mea Me Mahi, Ngā Mea Kaua e Mahi
| ✔️ Ngā mea hei mahi (Mahi) | ❌ Ngā mea kāore e tika ana |
|---|---|
| Ki te mau tonu te mamae o te uma, me toro atu ki te tākuta, me te tiki i tētahi mahere maimoatanga tika. | Āta karohia te kai i ngā tōmato, ngā hua citrus, te tiakarete, te kawheine (tī/kawhe), me ngā kai raukikī he nui te ngako. |
| Kia mau ki ngā kākahu taratara; karohia ngā whitiki piri, inā koa ko ērā e piri ana ki te puku. | Kaua e takoto, e piko rānei, e mahi i ngā mahi taumaha i muri tonu i te kai. |
| Ki te mau tonu te maremare rerekē, te reo pāorooro rānei i roto i tō korokoro, me kōrero ki tō tākuta, nā te mea pea he hua anō hoki o te waikawa pūkahukahu. | Kaua e tango i ngā pire PPI mō ngā marama me te kore he tohutohu hauora (ka pā pea ki ngā whatukuhu). |
❓ Ētahi atu pātai pea āu (FAQ)
Me pēhea te wehewehe i waenga i te mamae o te ngākau me te mamae o te whakaeke ngakau? ▼
Ko te mamae o te uma ka puta i te takoto i muri i te kai, ā, ka whakamamaetia e ngā rongoā ārai mate. Heoi, ko te mamae o te mate manawa he ahua pēhi, he taumaha i roto i te uma ka horapa ki te ringa maui, ki te kauae rānei, ā, ka haere tahi me te poto o te manawa me te werawera. Mena he ruarua, me mahi tonu he ECG.
Ka aha mēnā ka roa te wā e kore ai e rongoatia te GERD ?
Ki te kore e rongoatia, ka taea e te waikawa te kino i te korokoro, ka puta te **Esophagitis**. I roto i te wā, ka whaiti te korokoro (**Esophageal Stricture**), ka uaua ki te horomi, ā, i ngā wā tino kino, ka puta te **Barrett's Esophagus**, e whakanui ana i te mōrearea o te mate pukupuku.
Ka taea e te waikawa i roto i te korokoro te pirau i ngā niho? ▼
Ae, ka taea e te waikawa hauwaiora kaha i roto i te puku te rere pōrearea ki roto i te waha i te pō, ka whakarewa i te paparanga enamel o ngā niho, ka pirau ai ngā niho, ka pirau ai hoki.
He mea tika kia pokanga kia ora katoa ai i te GERD? ▼
Kāo, neke atu i te 90% o ngā tūroro ka ora ake mā te kai tika me ngā pire whakahaere waikawa i whakaritea e te tākuta. Ko te pokanga (hei tauira, te Fundoplication) me mahi anake mō ngā tūroro he hernia tino kino, he hernia hernia rānei kāore e pai ki tētahi rongoā.
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