He maha ngā wā ka pāngia koe e te mamae o te uma? Me kōrero tātou ki Nirogi Lanka mō tēnei!

Kua pāngia koe e te mamae, te werawera i waenganui o tō uma? Me te mea he mura wera e piri ana ki roto? Ahakoa he tokomaha e kī ana i tēnei he "ngāwerewere o te ngākau," ehara i te mea he raruraru e pā ana ki te ngākau. Ka puta tēnei ina rere te waikawa o te puku ki runga ki roto i tō korokoro—te ngongo e kawe ana i te kai ki tō puku. Nā te mea ka rere tika tēnei ngongo mā waenganui o tō uma, e tata ana ki tō ngākau, he māmā noa te kite he aha i rite ai ki te āwangawanga o te ngākau. Ki ētahi, he mea whakararuraru tēnei i ētahi wā, engari ki ētahi atu, he maha tonu te puta. Ki te pāngia koe e tēnei i ngā wā katoa, he tohu pea tēnei o tētahi mate e kiia nei ko te GERD (Gastroesophageal Reflux Disease). Me tirotiro tātou i tēnei mea me Nirogi Lanka, me pēhea?

He aha rawa te mamae o te ngākau?

I te whakarapopototanga, ka puta te mamae o te puku ina hoki te waikawa o te puku ki roto i tō korokoro (te paipa kai). Ahakoa he arai hūpē tiaki tō puku.Ki te kore e taea e tō korokoro te tu atu ki ēnei waikawa. Ina puta te waikawa ki roto i te korokoro, ka whakapataritari i te kiko ngawari, ka puta te ahua wera, mamae hoki.

Tata ki te katoa ka pāngia e te mamae o te puku i tētahi wā o ō rātou oranga—tērā pea i muri i te kai kakara, hinuhinu rānei, i ngā wā rānei e piki haere ana te pēhanga o te puku, pērā i te hāputanga. Heoi, ki te pāngia koe e tēnei kare ā-wera i ia rā, i ia rā rānei, he tohu pea tēnei o tētahi mate mau tonu e kiia nei ko te GERD (Gastroesophageal Reflux Disease). E kiia ana tata ki te 20% o te iwi i ngā whenua pērā i te US e pāngia ana e te GERD.

Ko wai te mea tino mōrearea ki te mamae o te uma?

Ahakoa ka pāngia te tangata katoa e tēnei mate, tera pea ētahi āhuatanga ka whakanui ake i tō mōrearea:

• Momona: Ngā tāngata he 30, neke atu rānei te Taupū Papatipu Tinana (BMI).
• Taumaha rawa: Ngā tāngata he nui ake i te 25 te BMI.
• Te momi hikareti me te paowa tuarua: Ka nui ake te tūponotanga o te whakawhanaketanga o ngā tohu e rua.

He aha te āhua o te mamae o te ngākau?

Ko te ngau o te puku he rite ki te wera e ara ake ana i muri i tō uma. Nā te mea e rere ana tō korokoro mā waenganui o tō uma, koinei te wāhi ka rongo koe i te mamae. I ētahi wā, ka horapa atu tēnei wera ki runga ki tō korokoro, ki runga rānei i tō uma, mai i te riri ngawari ki te mamae nui, mamae.

Āhea te wā e tino kaha ai te mamae?

Tērā pea ka kitea e koe ka kino haere ō tohu i ngā wā motuhake:

• Ina takoto koe, inā koa i muri tata i te kai.
• Ina piko koe.
• I muri i te kai i te kai o te pō.
• I muri i te kai i ngā kai momona, waikawa, raukikini rānei.

Kia pēhea te roa o te mamae o te ngākau?

Ka roa pea te mamae o te puku i waenga i ētahi meneti ki ētahi hāora. I te nuinga o te wā, ka memeha haere ina pau katoa ngā mea o roto i te puku. I runga i tāu i kai ai, e rua ki te rima hāora te roa o te nakunaku; ka roa ake te nakunaku o ngā kai momona, ngā kai ngako nui rānei, ā, ka roa ake te tūponotanga o te reflux.

He aha atu ngā tohu ka puta mai i te mamae o te uma?

He uaua pea i ētahi wā te wehewehe i waenga i te mamae o te uma me te mamae o te uma kino rawa atu. Mena kāore koe i te tino mōhio ki te take o tō mamae o te uma, tēnā whakapā atu ki te tākuta, rapua rānei ngā ratonga ohorere tonu. Mā te mōhio ki ētahi atu tohu ka āwhina i a koe me tō tākuta ki te wehewehe i waenga i te GERD me ētahi atu āhuatanga pēnei i te mate ngakau.

Ko ngā tohu noa o te reflux waikawa ko:

• Te pupuhi pinepine.
• He reka kawa, he reka kawa rānei i roto i tō waha.
• Whakapairuaki.
• Te ruaki kai (te hoki mai o te kai ki roto i tō korokoro).

Tērā pea ka pāngia ētahi tāngata e ngā tohu rerekē, pērā i:

• Te pupuhi, te kare rānei e kī ana te puku.
• Ngā hīkoi.
• He maremare mau tonu, he roa hoki.
• Te kino haere o te mate huango.
• Korokoro mamae.
• Te mate pūkahukahu.
• Te uaua ki te horomi, te ahua rānei o te pupuhi i roto i tō korokoro.
• He mamae uma ehara i te mamae o te ngākau, he rite ki te angina.

He aha tēnei i tupu ai? (He panui mai i Nirogi Lanka)

Ko te nuinga o te wā, ko te mamae o te puku ka puta mai i te rerenga mai o te waikawa puku me ngā whākōkī ki roto i te korokoro. E ai ki te kōrero, kāore i roto i te korokoro te arai tiaki o te puku. I te hononga e tūtaki ai tō korokoro ki tō puku, he uaua porohita e kiia nei ko te Lower Esophageal Sphincter (LES) , e mahi ana pērā i te takirere. Ko tana mahi he pupuri i ngā mea kei roto i te puku. Ina ngoikore tēnei takirere, ina kore rānei e kati tika, ka puta ake ngā mea kei roto i te puku ki runga.

Ko ngā āhuatanga ka ngoikore ai, ka whakangāwari rānei te LES i te kore e tika ko:

• Te momi hikareti, te pāngia rānei e te auahi tupeka.
• Te pikinga o te pēhanga o te puku nā te momona, ngā kākahu piripono, te haputanga rānei.
• Hiatal Hernia: He āhuatanga e pana ake ai tetahi wāhanga o te puku mā roto i te diaphragm.
• Te kai i ngā kai tino nui, ka totoro te puku, ka whakaroa hoki i te takoto kau.
• Te mate puku me ngā mirumiru hau e heke ana ki te ara GI.
• Te takoto i muri tata i te kai.
• Ngā mea hei whakaoho i te kai: Kawhe, tiakarete, hua citrus, miniti, ngā ranu tōmato rānei.
• Ko ētahi rongoā, pērā i ētahi pire ārai whānau, rongoā toto toto tiketike rānei.

I te nuinga o te wā, ka puta te mamae o te uma me te reflux waikawa i te huinga o ngā āhuatanga maha e mahi tahi ana.

He aha i tīmata ohorere ai tō mamae ngākau mēnā kāore anō kia pā ki a koe i mua?

Mena kāore anō kia pāngia koe e te mamae nui o te uma i mua, ā, kua tīmata ohorere mai—kāore he huringa nui ki tō kai, ki tō momo noho rānei—tērā pea he take kei raro iho. He maha ngā wā, ka puta mārire ēnei raruraru i roto i te wā.

• Te koroheketanga: I a tātou e pakeke haere ana, ka ngoikore haere ō tātou uaua. Kei roto i tēnei ko te Lower Esophageal Sphincter , te uaua e ārai ana i te pikinga o te waikawa o te puku.
• Te pikinga taumaha: He tukanga āta haere te pikinga taumaha. Heoi, ka puta ohorere pea ngā tohu o te mamae o te uma ina whiti tō tinana i tētahi threshold .
• Ngā Rongoā: Mena kua tīmata koe i tētahi rongoā hou, kua whakarerekē rānei i tō horopeta, me toro atu ki tō tākuta kia kite ai mēnā koinei pea te take o tō rerenga waikawa.

He take tonu te mamae o te ngākau nā te reflux waikawa?

Ahakoa he raruraru te ngau o te puku i te nuinga o te wā he raruraru esophageal e hua mai ana i Acid Reflux , ka taea e ētahi atu āhuatanga te whai i ēnei tohu:

• Ngā mate puku: He mate mamae ēnei nā te mimiti o te arai o tō ara nakunaku. Ahakoa he iti ake te kitea i ngā mate puku, i ngā mate puku rānei, he maha tonu te hononga ki te rerenga waikawa. Heoi, mā te whakamahi nui i NSAIDs (pēnei i te Aspirin, i te Ibuprofen rānei) ka puta ai ēnei mate.
• Esophagitis: Ka puta te wera i te mumura nui o te esophagus. Ka puta pea tēnei i GERD mau tonu, i ngā mate huaketo, i ngā mate harore rānei, i ētahi rongoā, i ngā mate pāwera rānei pērā i Eosinophilic Esophagitis .
• Te pāwera o te ngau tinana/te aro nui ki te reflux: Ko ēnei ngā mate o te gut-brain connection , te wāhi e tukatuka rerekē ai tō pūnaha io i ngā tohu mai i te ara nakunaku. He rite tonu te āhua ki te pāwera o te ngau tinana tuku iho, engari he maha ngā wā kāore e whakaatuhia he tohu o te reflux waikawa, te horo, te mumura rānei i roto i ngā whakamātautau. Ko Visceral Hypersensitivity (he urupare io kaha rawa) tētahi o ngā take matua o tēnei mamae.

He mate kino te mamae o te uma?

He mea whakararuraru te mamae o te puku i ētahi wā, engari he onge te pānga o te kino roa. Inaa, he mea noa te iti o te reflux. Heoi, ki te rongo koe i tēnei, tera pea kei te uaua tō korokoro ki te whakahaere i te nui o te waikawa e tae atu ana ki reira. Ki te onge te puta o tēnei, ka taea e tō tinana te whakaora pērā i te patunga iti. Engari ki te puta pinepine tēnei, kāore e ranea te wā o te arai o tō korokoro ki te whakatika i a ia anō.

Mā te whara roa o te arai o te korokoro ka arahi pea ki ngā raruraru roa:

• Ngā uauatanga o te korokoro: Ka puta scar tissue mau tonu. Ka taea e tēnei te whakawhāiti i te korokoro, ka uaua ai te horomi, ka piri rānei te kai.
• Te metaplasia o te puku: I ētahi wā, ka huri ngā pūtau arai kia rite ki ērā e kitea ana i roto i ngā puku. E mōhiotia ana tēnei āhuatanga ko Barrett's Esophagus , ā, e kiia ana he precancerous conditione hiahia ana kia aroturukitia e te hauora.
• Matepukupuku korokoro: Ahakoa he iti noa te ōrau o ngā mate ka tae ki tēnei wāhanga, he hononga mārama kei waenganui i Esophagitis pumau, Barrett's Esophagus , me te whanaketanga o te matepukupuku. Ko tō mōrearea ka whakawhirinaki ki te kaha me te roa o te mamae o te puku kāore i rongoatia.

I Nirogi Lanka, e whakamahara atu ana mātou ka taea hoki e te reflux waikawa te huna i ētahi atu raruraru nakunaku. Tērā pea he nui rawa te waikawa o te puku e arahi ana ki Gastritis , ki Stomach ulcers rānei. Ka taea hoki e te reflux waikawa te whakanui ake i Asthma , i ētahi atu mate manawa mau tonu rānei. Ki te tae te waikawa ki te korokoro, ka arahi pea ki te pupuhi, ki ngā mate puku, me ngā tipu.

Me pēhea koe e mōhio ai mēnā he mamae tō ngākau?

He kare ā-tangata te mamae o te puku. Ina whakaahuahia e koe ō tohu ki tō tākuta, ka taea e rātou te whakatau i te mate. Mena he ngawari, he koretake hoki, kāore pea e hiahiatia he whakamātautau whānui. Heoi, ki te whakapaehia he mate mau tonu tōu, ka tūtohu pea tō tākuta i ngā whakamātautau hei tirotiro i te kino o tō korokoro, ā, tera pea ka tukuna koe ki tētahi Gastroenterologist .

Ko ngā whakamātautau tātaritanga noa ko:

• Te Endoscopy o Runga (tikanga EGD): Mā te Endoscopy ka taea e mātou te titiro ki roto i tō ara nakunaku. Ka arahina e mātou he ngongo angiangi, ngāwari me te kāmera iti (endoscope) ki roto i tō tinana. Mā te Upper Endoscopy, ka tirohia e mātou tō ara nakunaku o runga—mai i tō korokoro, mā roto i tō puku, ā, ki te tīmatanga o tō whekau iti. Ka tukuna te ngongo mā roto i tō korokoro (ka whakaratohia e mātou he rongoā hei whakarite kia pai koe). Mā tēnei ka taea e mātou te tirotiro mō ngā mate pēnei i te Esophagitis, te hernias, te Barrett's Esophagus rānei.
• Whakamātautau pH o te korokoro: I roto i tēnei whakamātautau, ka whakanohoia he kāpū iti, ahokore ki roto i tō korokoro hei ine i tōna taumata pH (waikawa) mō tētahi wā. Ka taea tēnei te whakanoho i te wā o te Endoscopy o Runga, mā te ngongo ihu rānei (ngongo nasogastric). Ka tukuna ngā raraunga ki tētahi taputapu hopu e mau ana i tō hope. Ka tono mātou kia tuhia e koe ō tohu i a rātou e puta ana kia taea ai e mātou te whakarite ki ngā raraunga waikawa. I muri i te wā kua whakaritea, ka tikina e tō tākuta te kāpū ka tātarihia ngā hua.

He aha ngā maimoatanga mō te mamae o te uma?

Ka taea te whakahaere i te mamae o te uma i ētahi wā mā te whakamahi i ngā rongoā kore-tohu (OTC) me ngā whakarerekētanga āhua noho māmā. Heoi, ki te pāngia koe e te mamae o te uma i ngā wā katoa, me tono pea koe i ngā rongoā mai i tō tākuta. Ka mahi ēnei rongoā mā te whakaiti i te nui o te waikawa e tae atu ana ki tō korokoro mai i tō puku. Kia mōhio koe, kāore pea ēnei rongoā e whakatika i te raruraru matua o tō Porokoro o raro. Ki te mau tonu ngā tohu ahakoa te rongoā, me whai maimoatanga motuhake anō pea.

Ngā rongoā rongonui mō te mamae o te uma:

• Ngā rongoā ārai waikawa:Ka mahi ngā rongoā antacid (hei tauira, Tums®, Rolaids®) mā te whakakore i te waikawa o te puku, kia kore ai e kino tō korokoro mēnā ka puta te hau. Kei roto i ētahi rongoā ētahi atu kai, pērā i te Simethicone hei whakaora i te hau, te Magnesium rānei, hei āwhina i te mate puku mārō. He pai ngā rongoā antacid mō te whakamahi i ētahi wā, engari ko te whakamahinga auau, mō te wā roa, ka pā mai pea ngā pānga taha.
• Ngā Ārai: I ahu mai i te rimu tūturu, ka hangaia e ngā ārai he ārai tinana mā te rere ki runga i te waikawa o te puku, ka ārai i te pikinga ki roto i te korokoro. Mena kāore e taea e koe te tango i ngā rongoā aukati waikawa noa nā ētahi atu mate hauora, he pai te ārai hei whakakapi. Ko ētahi hua ka whakakotahi i ngā rongoā aukati waikawa me ngā ārai hei whakarei ake i te whai huatanga.
• Ngā Ārai H2 (ngā kaitukino i ngā kaiwhakawhiwhi histamine): Ka whakaitihia e ēnei te hanga waikawa mā te aukati i ngā histamine e tohu ana i tō puku kia whakaputa waikawa. Ko ētahi e wātea ana i te OTC, ko ētahi e hiahiatia ana he whakahaunga. Ahakoa ka taea te whakamahi pinepine atu i ngā antacids, ka heke te whai huatanga i roto i te wā i te mea ka urutau tō tinana ki a rātou.
• Ngā Ārai Papu Porotene (PPI): He rongoā aukati waikawa kaha ēnei e whakatairanga ana i te whakaora o ngā kiko kua pakaru. Mena he kino te mamae o tō puku, he tohu rānei kua pakaru te kiko, ka tohua pea ēnei e tō tākuta hei maimoatanga matua. E 90% te whai huatanga o ēnei ki te whakaiti i te reflux waikawa, ā, he mea nui hoki mō te whakaora i ngā mate pukupuku korokoro.

Ngā maimoatanga tāpiri mō te mamae o te uma:

• Ngā rongoā paturopi, ngā rongoā ārai huaketo rānei mēnā ka kitea he mate.
• Ngā steroids ā-papa, ngā Dupilumab rānei hei rongoā i te mumura o te korokoro.
• Ngā neuromodulators iti-hopu me ngā rongoā tāpiri mō te ngau o te uma.
• Te pokanga whakatika hernia mēnā ko te hiatal hernia te take o tō mamae ngākau.

Mena kei a koe te GERD kāore e aro ki te rongoā, ki te hiahia rānei koe ki tētahi atu rongoā hei whakakapi i te rongoā mō te wā roa, ka kōrero pea tō tākuta mō ēnei tikanga:

• Nissen Fundoplication: He tikanga pokanga e whakau ana i te hononga i waenga i tō puku me tō korokoro. He tino whai hua ki te rongoā i te GERD me ōna tohu.
• Te Tātaritanga Kore-Waha (TIF): He tikanga e rite ana ngā hua ki te pokanga tuku iho engari ka mahia mā te endoscopically, kāore he tapahi o waho.
• Pūrere LINX: He tikanga iti rawa te whakaekenga e whakanohoia ai he mowhiti aukume iti, ngāwari huri noa i te hononga o tō puku me tō korokoro hei ārai i te rerenga waikawa.

Ka taea te rongoā i te mamae o te ngākau?

He tino ngāwari te rongoā i te ngaunga o te puku. He maha ngā wā, mā te whakarerekētanga o te kai me te momo noho me te whakamahi i ngā rongoā ā-waikawa i ētahi wā ka ranea hei whakahaere i tēnei mate. Mō te hunga e hiahia ana ki te tiaki mō te wā roa, he tino angitu ngā rongoā o nāianei ki te aukati i te reflux waikawa. Ahakoa me nui ake te whakapau kaha mō ngā mate mahi, mā te huarahi pumau me te mahere maimoatanga kua whakaritea e tō rōpū hauora o Nirogi Lanka ka nui ake te whakapainga i roto i te wā.

He aha ngā huringa āhua noho ka āwhina i te whakahaere i te mamae o te uma?

Whakamātauria ēnei mahi hei āwhina i te aukati i te rerenga waikawa:

• Kai i ētahi kai iti i te roanga o te rā. Mā te whakaiti i te nui o te waikawa e nakunaku ana e tō puku i te wā kotahi, ka whakaitihia hoki te nui o te waikawa e whakaputaina ana e ia.
• Wetekina tō whitiki. Ka panaia te waikawa o te puku ki roto i tō korokoro e te pikinga o te pēhanga o te puku. Ka taea hoki e te whakaiti i tō taumaha te āwhina nui.
• Kaua e kai i mua tonu i te moe. Taria kia toru ki te rima hāora i muri i tō kai whakamutunga i mua i te takoto.
• Moe ki tō taha maui. Mā tēnei tūnga ka noho tō pūkahukahu o raro ki runga ake i ngā mea o roto o te puku, he rite tonu ki te pute hau. Mā te takoto papatahi, ki tō taha matau rānei ka taea te waikawa te kohi ki te takirere.
• Āta karohia ngā kai whakaohooho. Kia tūpato ki ngā kai me ngā inu e whakanui ake ana i tō mamae, ā, karohia atu.
• Kati te kai paipa. Ko te mamae o te ngākau tētahi o ngā take maha hei whakamutu i te kai paipa. Ka taea e tō tākuta te whakarato tautoko me ngā rauemi hei āwhina i a koe ki te whakamutu.

Āhea koe me toro atu ki te tākuta?

Me toro atu koe ki tētahi tohunga hauora mēnā:

• Ka pāngia koe e te mamae o te uma i te iti rawa kotahi i te wiki.
• He rerekē ngā tohumate kei a koe.
• He uaua ki a koe te horomi, kāore rānei e taea e koe te kai i ngā kaora e tika ana.
• Neke atu i te 60 tau tō pakeke.
• He mamae tō uma, he rite ki te pēhanga, kikī rānei (he rite ki te angina). Mēnā he pēnei, rapua tonutia te ratonga whawhati tata/911.
• Kāore ō tohu e pai ake ana mā te maimoatanga.

Ngā whakaaro whakamutunga…

He mea noa te mamae o te puku i ētahi wā. Mō te nuinga o te tangata, mā ngā whakarerekētanga āhua noho noa ka taea te whakahaere. Heoi, ki te pāngia koe e ngā tohumate pumau, me rongoā pea koe e te hauora. Kaua e warewarehia te mamae o te puku mau tonu. Ko te mamae o tō korokoro he tohu kino, ka piki haere pea i roto i te wā. Ko te mamae o te puku mau tonu he tohu pea nō ngā mate e hiahia ana kia arohia. Kōrerohia ō tohumate ki tētahi tākuta i Nirogi Lanka.

Ngā Kupumatua: Te Ngaungau, GERD, Te Whakarerenga Waikawa, Te Korokoro, Te Puku, Te Ngaungau o te Uma