Kei te pāngia hoki koe e te mamae o te uma me te mamae o te uma? Me ako tātou mō te reflux waikawa me te GERD!

I muri i tō kai, ka rongo koe i te wera o tō uma, i te kawa o tō korokoro, i te kōpiri rānei o tō puku, he rite ki te mamae o te puku? Koinei ngā tohu noa o te waikawa pūkahukahu e pāngia ana e te tini o te tangata. Ahakoa he mea noa te puta o tēnei i ētahi wā, he mea hei āwangawanga mēnā ka puta pinepine.

He aha te Acid Reflux? Kia mārama tātou!

Ki te kī ngāwari, ko te waikawa pūkahukahu te wā e rere ake ai ngā ihirangi o te puku, inā koa te waikawa o te puku , arā, ka hoki ki roto i te korokoro. I te nuinga o te wā, ka haere te kai e kainga ana e tātou ki roto i te puku, kātahi ka heke iho. Engari i tēnei wā, ko te ritenga kē te mea ka tupu.

Whakaarohia, he tino kaha tēnei waikawa i roto i tō tātou puku. He mea hanga hei nakunaku i te kai. Nō reira, ina uru tētahi mea pēnei ki roto i te korokoro – te paipa kai – ka taea te kino i ngā kiko ngawari i roto i te korokoro, ka puta te mumura. He maha ngā tāngata e pāngia ana e tēnei i ētahi wā. Ko ētahi e kī ana ko te "indicision" , ko ētahi e kī ana ko te "heartburn" , he ahua wera e pā ana ki waenganui o te uma, e tata ana ki te sternum.

Ehara tēnei mate whakapūpū waikawa i te mate kino. Engari mō ētahi tāngata, ka puta tonu mai. Mēnā he pēnei te whakapūpū waikawa, he uaua ki te noho i te oranga noa, ā, ka taea hoki e ia te kino i tō tātou korokoro.

Nā, he aha te GERD?

Ko te GERD te ingoa poto mō te Mate Reflux Gastroesophageal . I ētahi whenua, ka tuhia hoki ko GORD (Mate Reflux Gastro-oesophageal) . Ahakoa te āhua o te tuhi, e pā ana ki tētahi āhuatanga e puta ai te reflux waikawa i roto i tō tātou esophagus mō te wā roa (reflux waikawa mau tonu) . Mena ka puta mai te waikawa pēnei i te iti rawa i te rua i te wiki, mō ētahi wiki, ka kiia e ngā tākuta he āhuatanga GERD.

Ka puta ake te waikawa mō ētahi take rangitahi. Hei tauira, te takoto i muri i te kai nui. Engari ehara te GERD i te mea rangitahi. He raruraru ā-tinana, tūturu . Ara, kāore ngā tikanga e ārai ana i te waikawa kia piki ake ki te korokoro e mahi tika ana.

E hia te auau o ēnei āhuatanga?

He tino noa ngā mate e rua e kiia nei ko te mate reflux gastroesophageal (GERD) me te GERD. I tētahi whenua pēnei i Amerika, e kiia ana he tata ki te 20% o ngā pakeke me te tata ki te 10% o ngā tamariki he GERD. Ka kitea tēnei mate i tō tātou whenua i te nui, i te iti rānei.

He aha ngā tohu o tēnei? Tirohia mēnā kei a koe anō ēnei!

He maha ngā tohu o te reflux waikawa me te GERD. Tirohia mēnā kei te mōhio koe ki ētahi o ēnei:

• Te ruaki/te ruaki: I muri i te kai, tera pea ka rite koe ki te waikawa o te puku, ngā matūkai kai, me ngā wai e hoki mai ana ki roto i tō korokoro. Ka kiia tēnei ko te ruaki . I ētahi wā ka haere tahi me te reka kawa .
• He kare ā-wera: Nā te mea he matū kaha te waikawa, ka puta he kare ā-wera i roto i te korokoro. Mēnā ka pāngia te uma, ka kiia ko te mamae o te puku . Mēnā ka pāngia te puku, ka kiia ko te koretake o te waikawa .
• Mamae uma kore-ngākau: Ka pāngia ētahi tāngata e te mamae uma, kāore e rite ki te wera. He rite ngā io e rongo ana i te mamae i roto i te korokoro ki ngā io e rongo ana i te mamae i roto i te ngākau, nō reira ka taea te pohehe i ētahi wā he mate ngakau.
• Whakapairuaki: Ka pā te whakapairuaki me te ngaronga o te hiahia kai i te waikawa reflux. Ahakoa kua roa te wā, ka kī tonu pea te puku.
• Korokoro mamae: Ki te uru te waikawa ki roto i tō korokoro, ka mamae pea tō korokoro, ka puta he ahua kei te mau tetahi mea i roto i tō korokoro, ā, ka uaua ki te horomi. I te nuinga o te wā, ka uru te waikawa ki roto i tō korokoro i te pō i a koe e moe ana.
• Ngā tohu o te mate huango: Ka taea e te GERD te whakararu i ngā tohu o te mate huango i roto i te hunga whai mate huango, ā, ahakoa i roto i te hunga kāore he mate huango, ka taea e ia te maremare, te wheezing, me te uaua ki te manawa . Nā te mea ka taea e ngā matūriki waikawa te whakawhāiti i ngā ara manawa mēnā ka uru ki roto.

Āhea te wā e tino kitea ai ēnei tohu?

• I te wā e moe ana, e takoto ana rānei i te pō .
• I muri i te kai nui , i te kai momona rānei.
• Ina piko koe ki mua.
• I te wā e momi hikareti ana , e inu waipiro ana rānei.

Ka pāngia hoki ngā pēpi nohinohi e te GERD?

He mea tino noa te ruaki miraka a ngā pēpi hou. Ahakoa he iti noa te waikawa e puta mai ana i te waiū, kāore e raru nui te pēpi. Heoi, he mate kino rawa atu te GERD. Ka pāngia te pēpi e te kore whakamarie me ngā raruraru ki te whāngai.

Ko ngā pēpi e whānau wawe ana , e pāngia ana rānei e tētahi mate hauora e pā ana ki te korokoro, ka nui ake te tūponotanga ka pāngia rātou e te GERD. He mea pai kia toro atu ki tētahi tākuta tamariki mēnā kei tō pēpi tētahi o ēnei tohu:

• Mena kei te tangi tonu koe, kāore he take .
• Mena he uaua ki a koe te moe .
• Ki te kore koe e pai ki te inu miraka .
• Mena kei te ruaki tonu koe i te iti .
• Ki te puta he tangi wheezing i a koe e manawa ana , ki te mea rānei he pākū tō reo .
• Ki te mea he haunga kino kei te waha .

He aha i puta ake ai tēnei waikawa? He aha ngā take?

Hei uru atu ki te korokoro, me haere te waikawa mā roto i tētahi takirere kei te pito o raro o te korokoro e ārai ana i ngā mea kei piki ake anō. Ko te ingoa o tēnei takirere ko te Lower Esophageal Sphincter (LES) .

He uaua porohita tēnei LES. Ka tuwhera ina horomia te kai, kātahi ka kati anō kia mau tonu ngā mea o roto o te puku. Ka tuwhera paku anō hoki ina tupa ana tātou, pērā i te wā e whāwhā ana tātou, kia puta ai te hau.

Ka puta te waikawa ina ngoikore, ina tino mārō rānei te LES . Ka taea e ētahi mea rangitahi te whakangāwari i te LES. Hei tauira, te takoto i muri i te kai nui. Engari ki te mea he GERD tōu, kei te whakangāwari tonu tō LES.

Ko ngā take noa o te ngoikore o te LES ko:

• Hernia Hiatal: Koinei te wā e pana ake ai te taha o runga o te puku mā roto i te kōhao o te diaphragm e heke iho ana te esophagus. Kātahi ka piri ki te esophagus, ka hanga waikawa. Waihoki, nā te mea kei runga ake te LES i te puku, he iti ake te tautoko uaua. Ka nui ake te kitea o tēnei mate i te pakeketanga , ā, ka piki haere haere.
• Hapūtanga: He mea tino noa te puta o te waikawa pūmau i te wā e hapū ana. Ka taea e te pēhanga o te pēpi e tipu haere ana i roto i te puku te totoro me te ngoikore i ngā uaua e tautoko ana i te LES. Waihoki, ko ngā homoni e tukuna ana i te wā e hapū ana, pērā i te relaxin ( e whakangāwari ana i ngā uaua kia wātea ai te wāhi mō te pēpi), te estrogen, me te progesterone, ka taea hoki te whakangāwari i te LES.
• Momona: Ka taea hoki e te momona te whakanui ake i te pēhanga o roto i te puku, ka pā ki te LES, pērā i te hāputanga. Ka roa ake te wā o te momona i te hāputanga, ā, ka ngoikore tonu ngā uaua. He tino take nui hoki tēnei o ngā hernia hiatal. Nā te mea ka tukuna e te kiko ngako te estrogen, ka piki ake hoki ngā taumata estrogen i roto i te hunga momona.
• Te Auahi Momi: Ka whakangāwari ngā matū o te tupeka i te LES. Ka puta pea tēnei pānga ahakoa e momi hikareti ana koe, e hongi ana rānei i te auahi ina momi hikareti ētahi atu (te auahi tuarua). Ka puta te maremare i te momi hikareti, ā, ina maremare koe, ka tuwhera te LES. Mā te momi hikareti tonu me te maremare ka ngoikore ngā uaua o te pakitara puku, ka puta he hernia hiatal. Ehara i te mea koinā anake, ka whakaroa hoki te momi hikareti i te nakunaku , ā, ka nui ake te waikawa o te puku .

Ko ētahi atu take pea o te GERD ko:

• Ētahi hapa whānau: Hei tauira, ngā āhuatanga e pā ana ki te korokoro pērā i te atresia o te korokoro .
• Ngā mate hononga kiko: Ka pāngia ngā uaua o te korokoro e ngā mate pēnei i te scleroderma .
• Pokanga o mua: Tērā pea kua pakaru te korokoro i te pokanga i te uma, i te puku o runga rānei.
• Ētahi rongoā: Ka taea e ētahi rongoā te whakangāwari i te LES.
• Benzodiazepines (rongoā whakamarie)
• Ngā aukati hongere konupūmā ( ngā rongoā mō te toto toto tiketike)
• Ngā rongoā ārai pouri tricyclic (ngā rongoā mō te pouri me te mamae)
• Ngā NSAID (Nonsteroidal anti-inflammatory drugs) - ngā rongoā whakamamae mamae pērā i te aspirin me te ibuprofen
• Theophylline (he rongoā huango noa)
• Te rongoā homoni (HT) mō te menopause

He pānga tō te kai me te inu ki tēnei?

Ahakoa te kai me te inu anake, kāore pea e puta ai te waikawa o te puku, engari ka taea e rāua te whakanui ake i te kino. Ka taea e te kai nui rawa i ngā mea pēnei i te tiakarete, te kawhe, te waipiro, te miniti, te kāriki, me te riki te whakangāwari i te LES.

Ka whakanui ake ngā kai momona i te waikawa o te puku, ā, ka roa ake te nakunaku. Nō reira, he nui ake te tūponotanga o te mate huka. Ki te kai nui koe i te tina, tērā pea kāore e nakunaku i mua i te moe.

He aha ngā raruraru ka puta mai mēnā ka haere tonu tēnei?

He tino kaha te waikawa o roto i tō tātou puku. He mea hanga hei nakunaku i te kai e kainga ana e tātou. He matotoru te arai o roto o tō tātou puku hei tiaki i a ia mai i tēnei waikawa. Engari kāore i te rite tēnei tiaki ki ō tātou whekau kē atu.

Ko te nuinga o te wā ka pā te waikawa ki te korokoro. Engari i ētahi wā ka piki ake te waikawa ki roto i te puku, ki ngā ara manawa rānei. Ahakoa he iti noa te waikawa ka puta, ka pāngia pea ēnei whekau e te mamae, engari ki te puta tonu mai, ka kino pea ēnei whekau.

Ngā raruraru pea:

• Esophagitis: He mumura tēnei o te arai o te esophagus. Mēnā ka roa te wā, ka mamae tonu, ka puta hoki ngā mate pukupuku i roto i te esophagus nā te esophagitis . I roto i te wā, ka puta he kiriuhi, he mate puku rānei, he mate pukupuku kei mua i te mate pukupuku ka taea te arahi ki te mate pukupuku.
• Te korokoro o Barrett: Koinei te ingoa i hoatu ki tētahi āhuatanga e kiia nei ko te metaplasia intestinal i roto i te korokoro. Koinei te wā e huri ai te arai o te korokoro, ā, ka rite ki te arai o ngā whekau. Ka puta tēnei i te roanga o te pānga ki te waikawa me te mumura. He take mōrearea tēnei mō te mate pukupuku korokoro .
• Te whakawhāiti i te korokoro: Ka puta he kiko koha i roto i te korokoro hei tiaki i a ia mai i te mumura me te kino mō te wā roa. Ka taea e tēnei kiko koha te whakawhāiti i te korokoro. Ka kiia tēnei he whakawhāiti . Ka uaua pea te horomi me te kai.
• Te rerenga waikawa ki roto i te korokoro me te larynx (Laryngopharyngeal reflux - LPR):Ka pāngia hoki ētahi tāngata whai GERD e te LPR, arā, ko te wā e piki ake ai te waikawa ki roto i te korokoro. Ka taea e te waikawa te piki puku ki roto i tō korokoro i a koe e moe ana. Ka pupuhi pea tō korokoro, ka pāorooro tō reo, ka tupu hoki ngā taura reo . Ka taea hoki te mimiti i ngā matūriki waikawa ki roto i ō ara manawa.
• Huakita: Ka taea e te manawa waikawa te whakararu i te huakita i roto i te hunga kua pāngia e te huakita, ā, ahakoa i roto i te hunga kāore i pāngia e te mate manawa o mua, ka puta pea ngā tohumate rite ki te huakita. Ka taea e ngā matūriki waikawa ririki te pangia ngā ngongo pūkahukahu, ka whaiti, ka maremare, ka uaua hoki te manawa.

Me pēhea koe e mōhio ai mēnā kei a koe te GERD? He aha ngā whakamātautau hauora?

Ka tirohia tō korokoro e te tākuta puku hei whakatau mēnā he GERD tōu. He maha ngā whakamātautau ka taea te mahi hei whakatau i tēnei:

• Esophagram: He whakamātautau hihi-X tēnei. Ka tirohia te esophagus mā te whakamahi i ngā hihi-X (fluoroscopy) e neke ana i a koe e horomi ana. Ka hoatu he wai kōwhai e kiia nei ko te barium hei inu māu.
• Te tirotiro i te puku o runga: Ko te whakaurunga o tētahi ngongo angiangi me tētahi kāmera mā roto i tō waha hei tirotiro i te roto o tō korokoro. Ka hoatu he rongoā whakamoe māmā ki a koe, kātahi ka meinga kia moe.
• Whakamātautau pH o te korokoro: Mā tēnei ka ine i te nui o te waikawa i roto i te korokoro. I te wā o te endoscopy, ka whakanohoia e te tākuta he pūoko ahokore iti (he kaiwhiwhi ahokore) ki roto i te korokoro.
• Manometri esophageal: Ka ine tēnei i te mahi a ngā uaua i roto i te esophagus. Ka mahia tēnei mā te whakamahi i ngā pūoko pēhanga kua whakanohoia ki roto i te ngongo nasogastric. Ka taea e tēnei te whakatau mēnā kei te mahi tika te LES, ētahi atu uaua rānei.

He aha ngā maimoatanga hauora mō tēnei?

Ka taea e ētahi tāngata te whakaiti i te waikawa o te puku mā te whakarerekē i te āhua o te noho, pērā i te whakarerekē i ā rātou tikanga kai, te whakaiti i te waipiro me te momi hikareti, me te whakaiti i te taumaha. Ka akiakihia hoki e ngā tākuta te iwi kia whai i ēnei tikanga.

Engari ki te mea he mate pūkahukahu tonu tōu, he GERD rānei, ka tohua pea e ngā tākuta he rongoā hei whakaiti i te waikawa o te puku. Ahakoa ka puta te waikawa, kāore e nui ake te kino. He ngāwari te tiki i ēnei rongoā, ā, he tino whai hua mō te GERD.

Rongoā

Ngā rongoā kore-tohu (OTC) e wātea ana i ngā whare rongoā me te kore he whakahaunga:

• Ngā rongoā whakangāwari waikawa: Ka whakakorengia te waikawa o te puku e ngā rongoā whakangāwari waikawa, pērā i a Tums® me Rolaids®. Ko te tikanga, ahakoa ka puta te waikawa, kāore e nui te kino ki te korokoro. He pai ēnei mō te reflux waikawa i ētahi wā, engari ka pāngia pea e ngā pānga taha mēnā ka tangohia i ia wā, nō reira ehara i te otinga pai mō te wā roa.
• Ngā ārikiti:He huka tūturu te alginate i tangohia mai i te rimu. Ka mānu i runga i te waikawa, ka hanga he ārai ā-tinana i waenganui i te waikawa me te korokoro. He rongoā kei roto ko te alginate anake, me ngā rongoā e whakakotahi ana i te alginate me ngā antacids.

Ngā rongoā kua tohua:

• Ngā kaiārai i te kaiwhakawhiwhi histamine (ngā aukati H2): Ka whakaitihia e ngā aukati H2 te hanga waikawa o te puku. Nā te mea ka aukatia e rātou te matū (histamine) e kī ana ki te tinana kia hanga waikawa. Ka taea te tango i ēnei i ngā wā maha atu i ngā antacids, engari kāore e roa te whai hua. Ka taea e te tinana te taunga ki ēnei.
• Ngā aukati papu pūwero (PPI): He momo rongoā ngā PPI e ārai pai ake ana i te waikawa, e whakatairanga ana hoki i te whakaora kiko. Tērā pea ka tūtohu tuatahitia ēnei e tō tākuta mēnā he kino rawa tō GERD, mēnā rānei he tohu kino kei roto i tō korokoro. E 90% te whai huatanga o ēnei ki te whakaiti i te reflux waikawa.
• Baclofen: He rongoā whakangāwari uaua te Baclofen. He maha ngā wā ka hoatu hei whakaiti i ngā mamae o te uaua. Ka taea hoki e ia te whakaiti i te maha o ngā wā e whakangāwari ana te LES, ka taea ai te whakaiti i te nui o te waikawa e puta ake ana. Ehara i te rongoā raina tuatahi mō te reflux waikawa, engari tera pea he wāhanga o tō mahere maimoatanga.

Kāore he huarahi hei whakamutu, hei whakaora rānei i te waikawa pūkahukahu?

Ahakoa ka taea e ngā rongoā te whakaiti i ngā tohu me ngā pānga o te GERD, kāore e taea te aukati katoa. Ahakoa kei te tango rongoā te tangata he GERD kino, tera pea ka pāngia koe e ngā raruraru, ahakoa kāore koe e mōhio.

I ēnei āhuatanga, me whai otinga pumau ake hei aukati i te putanga mai o te waikawa. Ko te tikanga o tēnei he pokanga hei whakau i te LES . Ehara ēnei i te pokanga nui, he tikanga mahi ā-waho, ā, he tino angitu.

Pokanga

Ngā pokanga mō te GERD:

• Te pokanga Nissen fundoplication: Koinei te pokanga tino noa mō te GERD. Mēnā ka taea, ka mahia mā te laparoscopically . Ko te tikanga ka mahia mā roto i ngā tapahi iti, ko te tikanga he poto ake te wā whakaora. Ka tangohia e te taote pokanga te wāhanga o runga o te puku, ka takai ki te wāhanga o raro o te esophagus, ka tuitui tahi. Ka mahia hoki tēnei pokanga mō te hunga whai hernia hiatal.
• Pūrere LINX: He tikanga hou tēnei. Ka whakauruhia he pūrere e kiia nei ko LINX mā te pokanga. He mowhiti iti o ngā aukume te pūrere LINX. Ka āwhina i te pupuri i te hononga i waenga i te puku me te korokoro kia kati.

He aha ngā mea ka taea e koe te mahi hei whakahaere i te reflux waikawa i te kāinga?

Whakamātauria ēnei mea hei whakahaere i te reflux waikawa i te kāinga:

• Kai i ngā kai iti:Ka whakakīia te puku e ngā kai nui, ka pēhia te LES. Ka tere te nakunaku o ngā kai iti, ā, kāore e nui te waikawa e puta i roto i te puku.
• Kai wawe i te tina: He pai ake te kai i mua i te takoto, kātahi ka haere ki te moe i te pō, nā te mea ka āwhina te kaha ā-papa ki te pupuri i te waikawa kia heke.
• Moe ki tō taha maui: Ina moe pēnei koe, ka noho tō LES ki runga ake i ngā mea o roto o tō puku, pērā i te pute hau. Mā te moe ki tō taha, ki tō taha matau rānei ka pakaru te takirere.
• Whakaitihia te pēhanga ki tō puku: Kākahuria he kākahu koretake. Ki te taumaha rawa koe, ngana ki te whakaiti i tō taumaha. Ka āwhina tēnei i te wā poto me te wā roa.
• Kati te momi hikareti me te inu waipiro: Ka ngoikore te LES i te tupeka me te waipiro. Ka whakanuia hoki e rāua te waikawa o te puku, ka roa ake te wā nakunaku.
• Ngā rongoā kore utu: Kia mau tonu ngā rongoā pēnei i te antacids me te alginates . Whakamahia ēnei ina koa mēnā e mōhio ana koe ka kai koe i tētahi kai taumaha, waikawa hoki.

Ka aha koe mēnā ka puta whakarere mai te waikawa?

Ngāna ki te mahi i ēnei mea i taua wā tonu:

• Tū ake: kei tō taha te kaha ā-papa.
• Inuhia he inu wai: Kaua e inu nui, engari mā te inu iti noa i te wai ka taea te tango i te waikawa.
• Wetekina te whitiki: Wetekina te pātene o te whitiki, whakawhiti tarau rānei mēnā ka taea.
• Tangohia he rongoā whakaiti waikawa: Ki te kore he rongoā tata ki a koe, he mea pēnei i te Pepto Bismol® pea hei āwhina.

Āhea ahau me toro atu ki te tākuta mō tēnei mea?

Ki te pāngia koe e te mamae o te puku, me toro atu ki te tākuta . He mea nui kia mārama koe ki tōna pānga ki tō tinana. Ehara i te mea he mamae noa te GERD - engari he kino anō hoki. Ā, he pai ngā maimoatanga mōna.

He tokomaha te hunga e pāngia ana e te mamae o te puku i ētahi wā. Ka uaua pea te mahi i te rā nā te mamae o te puku, te mamae o te puku, me te rerenga waikawa. Tērā ētahi mea ka taea e koe te mahi hei whakaiti i te auau o ēnei tohu.

Engari ki te mea he maha tonu tō mamae o te uma, ā, kei te pā ki tō oranga, tera pea he GERD tōu. He mea pai kia kōrero koe ki te tākuta mō ō tohu. Ka taea e rātou te āwhina i a koe ki te whakatau mēnā he pai te maimoatanga.

Kia maumahara ki te mea tino nui (Karere hei kawe ki te kāinga)

He mate pāwera te reflux waikawa me te GERD ki te tini tāngata. Ahakoa he mea noa te pāngia i ētahi wā, he mea nui kia mōhio ki ēnei mate mena he mate auau.

• Tāutuhia ō tohumate. Kia mataara ki ngā mea pēnei i te reka kawa i te korokoro, te mamae o te uma, me te uaua ki te horomi.
• Ka taea e ngā whakarerekētanga ngāwari o te āhua noho te hanga i tētahi rerekētanga nui. Whakaarohia tāu e kai ana, te wā e kai ai koe, me te āhua o tō moe.
• Kaua e kai hikareti me te waipiro.Kei te whakanui ake ēnei i tēnei raruraru.
• Ki te kore e taea te whakahaere i tēnei mate mā te whakamahi i ngā rongoā kāinga, me rapu tohutohu hauora . He mate ka taea te rongoā i te GERD. Heoi, ki te kore e rongoatia, ka pā mai pea ngā raruraru.
• Kaua e manukanuka. Ka taea te whakahaere pai i tēnei āhuatanga mā te tohutohu me te maimoatanga tika. Kōrero mā te mahorahora ki tō tākuta.

Ko tāku tumanako ka whai hua ēnei kōrero ki a koe. Kia ora tonu!

` Te whakapūngao waikawa, te GERD, te mamae o te puku, te mumura o te puku, te koretake o te kai, te esophagitis, te maimoatanga hauora