He maha ngā wā ka pāngia koe e te mamae o te ngākau? Me kōrero tātou mō tēnei '(Te mamae o te ngākau)'!

Kua rongo koe i te werawera i waenganui o tō uma? He rite ki te werawera i roto i tō uma? He tokomaha e kī ana ko te "ngāwerewere o te ngākau," engari ehara i te mea he raruraru ngākau. Nā te waikawa o tō puku e piki ake ana ki roto i tō paipa kai (esophagus) te take. Ka rere tika tēnei paipa kai mā roto i tō uma, e tata ana ki tō ngākau. Koia te take ka taea ai te pohehe he raruraru ngākau. Ki ētahi tāngata, he mea noa iho, engari ki ētahi atu, he raruraru tonu. Ki te puta pinepine, he tohu pea nō te mate e kiia nei ko te GERD (Gastroesophageal Reflux Disease). Me kōrero anō tātou mō tēnei, me pēhea?

He aha rawa te mamae o te ngākau?

He māmā noa iho, ko te mamae o te puku te wā e hoki ake ai te waikawa o te puku ki roto i te korokoro. He matotoru te arai o te hūpē o roto o tō tātou puku hei tiaki i a ia mai i ēnei waikawa. Heoi, kāore he parenga pēnei i roto i tō tātou korokoro. Nō reira, ina tae te waikawa o te puku ki te korokoro, ka tahuna te kiko ngawari o reira, ka puta te mumura.

He tokomaha ngā tāngata kua pāngia e te mamae o te puku i tētahi wā o ō rātou oranga. I ētahi wā ka pā mai i muri i te kai i tētahi kai tino kakara, hinuhinu rānei, i te wā rānei e pēhia ana te puku, pērā i te wā e hapu ana. Engari , ki te puta pinepine tēnei mamae o te puku, i ia rā, i ia rā, he tohu pea tēnei o tētahi mate mau tonu e kiia nei ko te `GERD` (Gastroesophageal Reflux Disease). I tētahi whenua pērā i Amerika, e kiia ana e 20% o ngā tāngata he `GERD`.

Ko wai te mea ka tino pāngia e tēnei mate uma?

Ina hoki, ka taea e te tangata katoa te pāngia e tēnei mate, engari mō ētahi tāngata, he nui ake te mōrearea.

• Mō te hunga momona: Arā, ko te hunga he nui ake i te 30 te taupū papatipu tinana (BMI).
• Mō te hunga taumaha rawa: Mena he nui ake te uara 'BMI' i te 25.
• Ko te hunga e momi hikareti ana me te hunga e pāngia ana e te auahi tuarua, he nui ake te tūponotanga ka pāngia rātou e te auahi.

He aha te āhua o te mate pukupuku o te uma?

Ko te mamae o te uma, he rite ki te mura o te uma, he rite ki te waikawa o te puku. Kei waenganui o te uma tō korokoro. Nō reira, ka tīmata tēnei mamae i reira. Engari i ētahi wā ka horapa tēnei mamae puta noa i tō uma, tae noa ki tō korokoro. Ka taea te horapa mai i te mura ngawari ki te mamae nui.

Āhea koe e tino pāngia ai e tēnei mamae?

Tērā pea kua pāngia koe e tēnei āhuatanga. I ētahi wā ka nui ake te mamae o te uma.

• Ina takoto koe, ina koa ka takoto wawe koe i muri i te kai.
• Ina piko whakamua.
• Ina kai pō koe i te pō roa rawa.
• Ina kai koe i ngā kai hinuhinu, kawa, raukikī rānei.

Kia pēhea te roa ka mau tonu te mamae o te korokoro?

Ka roa pea tēnei mai i ētahi meneti ki ētahi hāora.I te nuinga o te wā, ka memeha haere tēnei mumura ina puta te kai whakamutunga i kainga e koe i roto i tō puku. Nā te mea kāore he mea hei hoki ake ki roto i te puku. I runga anō i te mea i kainga e koe, ka roa pea te keri i waenga i te rua ki te rima hāora. Ka roa ake pea te keri i ngā kai ngako, hinuhinu.

He aha atu ngā tohu e puta mai ana me te mumura o te uma?

I ētahi wā, he uaua ki te kī mēnā he angina tōu, he momo mamae uma rānei. Mēnā kāore koe i te tino mōhio ki te mamae e pā ana ki a koe, he pai ake te kōrero ki te tākuta. He mea nui anō hoki kia rapua ētahi atu tohu e haere tahi ana me te mamae. Mā ēnei atu tohu ka taea e koe te wehewehe i waenga i te mate manawa me tētahi atu mate uma.

Ko te mamae o te puku e puta mai ana i te reflux waikawa ka haere tahi me nga tohu e whai ake nei:

• Te mimi pinepine.
• He reka kawa i roto i te mangai.
• Whakapairuaki.
• Te kai e uru ana ki te korokoro.

Tērā pea ka whakaatu ētahi tāngata i ngā tohu rerekē pēnei i:

• Te kī o te puku, te pupuhi.
• Ngā hīkoi.
• Te maremare tonu.
• Te pikinga ake o te mate huango.
• Korokoro mamae.
• Te mumura o te arai ('Laryngitis').
• Te uaua ki te horomi, te ahua rānei kei te mau tetahi mea i roto i te korokoro.
• Te mamae o te uma ehara i te mate manawa, pērā i te `(Angina)`.

He aha tātou ka pāngia ai e tēnei mate pukupuku o te uma?

He mea hono tonu ki tētahi āhuatanga pēnei i te GERD, ka puta te mamae o te puku ina hoki ake ngā wai o te puku, arā, te waikawa me ngā whākōkī, ki roto i te korokoro. E ai ki taku kōrero i mua, he arai tiaki kei roto i te puku, engari kāore te korokoro. I te wāhi e hono ai tō tātou korokoro ki te puku, kei reira tētahi takirere e kiia nei ko te Lower Esophageal Sphincter (LES). Ko tāna mahi he aukati i te pikinga ake o ngā mea o roto i te puku. Engari i ētahi wā, ki te ngoikore tēnei takirere, ki te kore rānei e kati tika, ka tīmata te piki ake o ngā mea o roto i te puku.

He maha ngā take e ngoikore ai, e ngāwari ai rānei te uaua o te uaua o raro o te esophagus:

• Te hongi i te paoa hikareti (te momi hikareti).
• Te pēhanga nui atu i roto i te puku nā ngā āhuatanga pēnei i te taumaha rawa o te tinana, te mau kākahu kikī, me te haputanga.
• He āhuatanga e kiia nei ko te 'Hiatal Hernia'. Koinei te wā e pana ake ai tetahi wāhanga o te puku mā roto i te diaphragm.
• Mā te kai i tētahi kai nui i te wā kotahi ka totoro te puku, ā, ka noho roa te kai i roto i te puku.
• Te korenga o te kai me te hau. Ina piki ake ngā mirumiru hau i te ara GI.
• Te takoto wawe rawa i muri i te kai.
• Ētahi kai: ngā mea pēnei i te kawhe, te tiakarete, te raima, te miniti, te ranu tōmato.
• Ngā rongoā motuhake: pērā i ngā pire ārai whānau me ētahi rongoā mō te toto toto tiketike.

He maha ngā wā, ka honoa ngā take maha atu i te kotahi hei hua o te reflux waikawa me te heartburn.

He aha i puta whakarere mai ai te mate o te uma, kāore he tohu o mua?

Mena kāore anō kia pāngia koe e te mamae nui o te uma i mua, ā, ka tīmata ohorere mai, ā, kāore anō kia nui ngā huringa o tō kai, o tō momo noho rānei i ēnei rā tata nei, tera pea nā ētahi atu take. He āhuatanga ēnei e whanake haere ana i roto i te wā.

• Te koroheketanga: I a tātou e pakeke haere ana, ka ngoikore haere ō tātou uaua. Ko tētahi o aua uaua ko te uaua o raro o te esophagus.
• Te pikinga o te taumaha: Ka piki haere te taumaha o te nuinga o te tangata. Heoi, ka puta ohorere mai ngā tohu o te pikinga o te taumaha (pēnei i te pupuhi), ina kua whiti i tētahi paepae.
• Ngā Rongoā: Mena kua tīmata koe i tētahi rongoā hou, kua huri rānei i tētahi rongoā, pātai atu ki tō tākuta mēnā ko taua rongoā te take o te pikinga o te waikawa o te waikawa.

Nō te reflux waikawa kua whakahuatia ake nei tonu te pūtake o te mamae o te ngākau?

I te nuinga o te wā, ko te mamae o te puku he raruraru nō te korokoro. Ko te take matua ko te reflux waikawa. Heoi, he maha atu anō ngā āhuatanga ka taea te whakararu i te mamae o te puku. Hei tauira:

• Mate puku: He mate puku mamae ngā mate puku e puta mai ana i te memeha o te arai o te nakunaku. He iti ake te kitea o ngā mate puku i ngā mate puku i roto i te puku, i ngā whekau rānei. Mēnā ka puta, he maha ngā wā ka puta mai i te rerenga waikawa. Heoi, ehara i te mea ko te rerenga waikawa anake te take. Ka taea hoki e te whakamahi nui i ngā rongoā anti-inflammatory kore-steroidal (NSAID) pērā i te aspirin me te ibuprofen te puta o ngā mate puku.
• Esophagitis: Ki te mumura rawa te esophagus, tera pea ka pāngia koe e te werawera. Ka taea tēnei e te GERD, ngā huaketo, ngā mate harore, me ētahi rongoā. Ka taea hoki e te esophagitis eosinophilic, he mate pāwera o te esophagus, te mamae o te uma.
• Te mamae o te puku/te aro nui ki te reflux: He mate ēnei o te hononga puku-roro. Arā, he raruraru kei te huarahi e tukuna ai e tō pūnaha io ngā tohu mai i tō pūnaha nakunaku ki tō roro. He rite tonu te ahua o te mamae o te puku ki te mamae noa. Heoi, kāore ngā whakamātautau e whakaatu ana i te reflux waikawa, te wera, te riri rānei. Ko te aro nui ki te reflux ka puta mai i ngā mea ehara i te waikawa e uru ana ki tō korokoro. Ka taea hoki e te aro nui ki te visceral te whai wāhi ki tēnei mumura.

He mate kino tēnei o te uma?

Ahakoa he koretake te mamae o te puku i ētahi wā, kāore e nui te kino e puta. Inaa, he mea noa te pikinga o te waikawa ki roto i tō korokoro, ā, kāore te nuinga o te tangata e kite ana. Ki te kite koe, tera pea nā te nui haere o te waikawa o tō korokoro i tōna kaha. Ki te puta i ētahi wā, he rite ki tētahi patunga iti e tere te ora. Engari ki te puta i ngā wā katoa, kāore e ranea te wā e ora ai te arai o tō korokoro.

I te mea ka whara tonu te arai o te korokoro, ka arahi pea ki ngā raruraru roa, pēnei i:

• Ngā uauatanga o te korokoro: Ina mumura tonu ngā kiko o te korokoro, ka tīmata te hanga kiko whara i roto i te wā. He rite te korokoro ki tētahi ngongo roa. Ka taea e tēnei mumura me te whara te whakawhāiti i te korokoro (he whara). Ka uaua pea te horomi me te piri o te kai ki roto i te korokoro.
• Te metaplasia o te puku: I ētahi wā, hei utu mō te whara, ka huri te kiko kia rite ki te arai o ngā whekau . Ka kiia tēnei ko te metaplasia o te puku nā te mea ka huri te kiko kia rite ki te arai o ngā whekau. Ina puta tēnei i roto i te korokoro, ka kiia hoki ko te Barrett's Esophagus. E kiia ana tēnei he mate pukupuku-mua.
• Matepukupuku korokoro: He iti noa te ōrau o te tangata ka pāngia e te matepukupuku korokoro. Heoi, he ara mārama kei waenganui i te mumura pumau (`Esophagitis`) ki ngā huringa pūtau (`Barrett's Esophagus`) ki te matepukupuku. Ka piki ake te mōrearea i runga i te kaha o tō mumura me te roa o te wā kāore anō kia rongoatia.

Ko te waikawa pūkahukahu, e puta ai te mamae o te puku, ka tohu pea i ētahi atu raruraru kei roto i tō pūnaha nakunaku. Hei tauira, tera pea he nui rawa te waikawa i roto i tō puku. Ka arahi pea tēnei ki ngā raruraru pēnei i te gastritis me ngā mate puku. Ka taea hoki e te waikawa pūkahukahu te whakararu i tō mate huango, i ētahi atu mate manawa mau tonu rānei. Ki te uru tēnei waikawa ki roto i tō korokoro, ka pupuhi, ka puta he mate, he tipu rānei.

Me pēhea koe e tino mōhio ai mēnā he mate sinus tōu?

He kare ā-roto te ngau o te puku. Ka taea e te nuinga o ngā tākuta te mōhio ki tēnei kare ā-roto ina whakamāramahia e koe ki te tākuta. Mena he wā poto noa iho, ā, kāore i te tino kino, kāore pea koe e hiahia ki tētahi whakamātautau nui. Heoi, ki te whakapae rātou he mate pūmau tōu, ka whakahaerehia pea e rātou he whakamātautau hei tirotiro mena he kino kei tō korokoro. I taua wā, ka tukuna pea koe ki tētahi tohunga puku.

Anei ētahi whakamātautau hei tirotiro i tō korokoro:

• Endoscopy ('Endoscopy o Runga' / 'Tukanga EGD'):He whakamātautau te Endoscopy e titiro ana ki roto i tō tinana. Ko te tikanga o tēnei ko te tuku i tētahi ngongo roa me tētahi kāmera iti (endoscope) mā roto i tō tinana. Ka tirohia e te endoscopy o runga tō ara nakunaku o runga, mai i tō korokoro mā roto i tō puku ki te tihi o tō whekau iti. Ka whakaurua tēnei ngongo mā roto i tō korokoro (ka hoatu he rongoā hei whakangāwari i a ia). Ka taea e ia te tirotiro mō ngā mate pēnei i te esophagitis, te hernias, me te Barrett's esophagus.
• Whakamātautau pH o te korokoro: Ko te whakaurunga o tētahi kāpū iti, ahokore ki roto i tō korokoro. Ka ine i te pH, te waikawa rānei, o tō korokoro i roto i te wā. Ka taea tēnei i te wā o te endoscopy o runga, mā roto rānei i tētahi ngongo nasogastric. Ka tukuna ngā raraunga ki tētahi kaiwhiwhi ka mau koe ki tō hope. Ka tonoa koe kia tuhi i ō tohumate, ka whakataurite ki ngā raraunga. I muri i tētahi wā, ka tangohia e te tākuta te kāpū, ka tātari i ngā raraunga.

He aha ngā maimoatanga mō te niumōnia?

Ka taea e koe te whakaora i te mamae o te uma i ētahi wā mā te whakamahi i ngā rongoā kāinga, ngā rongoā kore-tohu (OTC), me ngā huringa āhua noho. Heoi, mō te mamae o te uma e maha ake ana, me tango pea koe i ngā rongoā kua tohua e te tākuta. Ka mahi ēnei rongoā mā te whakaiti i te nui o te waikawa e puta ake ana i te puku ki roto i te korokoro. Heoi, ko te raruraru matua o te Lower Esophageal Sphincter he mea kāore e taea e ēnei rongoā te whakatika. Ki te kore e mahi ngā rongoā, me whakamahi pea koe i ētahi atu maimoatanga.

He maha ngā momo rongoā mō te mumura o te uma:

• Ngā rongoā ārai waikawa: Ka whakakorengia te waikawa o roto i tō puku e ngā rongoā ārai waikawa (pērā i a Tums® me Rolaids®). Ko te tikanga, ahakoa ka uru te waikawa ki roto i tō korokoro, e kore e kino ki tō korokoro. I ētahi wā ka whai wāhi atu ētahi atu kai hei āwhina i te whakamamae i ngā tohu. Hei tauira, ka taea e te Simethicone te āwhina i te whakamamae i te mamae o te puku, ā, ka taea e te Magnesium te āwhina i te whakamamae i te mate puku. He pai ngā rongoā ārai waikawa mō te mamae o te puku i ētahi wā. Heoi, ka pāngia pea koe e ngā pānga taha mēnā ka tangohia i ia wā.
• Ngā Ārai: He huka tūturu ngā ārai e kitea ana i roto i te rimu. Ka mānu i runga i te waikawa, ka hanga he ārai ā-tinana i waenganui i te waikawa me te korokoro, hei āwhina i te aukati i tōna hokinga ki runga ki te korokoro. Mena kāore e taea e koe te tango i ngā rongoā whakaiti waikawa nā tētahi atu mate, ka taea e koe anake te tango i ngā ārai. Heoi anō, kei reira ngā rongoā kei roto ngā ārai me ngā rongoā whakaiti waikawa hei whakarei ake i ō rātou pānga.
• Ngā kaiārai i te kaiwhakawhiwhi histamine (ngā aukati H2):Ko te mahi a ēnei rongoā mā te aukati i ngā matū histamine e tohu ana i te tinana kia hanga waikawa. Ko ētahi aukati H2 e wātea ana i runga i te kaute, ko ētahi he mea whakahaunga anake. Ahakoa ka taea te tango i ēnei i ngā wā maha atu i ngā antacids, kāore e roa te wā e mahi ana. Ki te taunga tō tinana ki ēnei, ka iti ake te whai huatanga.
• Ngā Ārai Papu Porotene (PPI): He momo rongoā aukati waikawa kaha ake ēnei. Ka āwhina hoki i te whakaora i ngā kiko. Mena he kino tō mamae o te puku, he tohu rānei kei te pakaru ngā kiko i roto i tō korokoro, ka tohua pea ēnei e tō tākuta hei rongoā tuatahi. E 90% te whai huatanga o ēnei ki te whakaiti i te reflux waikawa. Mena he mate korokoro tōu, koinei anake te rongoā ka āwhina i a rātou ki te whakaora.

Ngā maimoatanga taapiri mo te sinusitis:

• Mena he mate pāwera, me whakamahi he rongoā paturopi, he rongoā ārai huaketo rānei.
• Whakaorahia te mumura mā te `(Topical Steroids)` me te `(Dupilumab)` rānei.
• Ngā rongoā neuromodulators iti-horomanga me ngā maimoatanga tāpiri mō te niumōnia hohe.
• Mena nā te hernia hiatal te mamae o tō uma, me pokanga hei whakatika (pokanga whakatika hernia).

Mō te GERD kāore e pai ki te rongoā – hei whakakapi rānei i te rongoā roa – ka tūtohu pea tō tākuta i tētahi tikanga pēnei:

• Nissen Fundoplication: He pokanga iti tēnei e whakawhāiti ana i te āputa i waenganui i te puku me te korokoro. He tino whai hua ki te rongoā i te GERD me ōna tohu.
• `Fundoplication Kore-Taenga Transoral`: Koinei tonu te pokanga i whakahuatia i runga ake nei, kāore he pokanga, engari mā te `endoscope`.
• `Pūrere LINX`: He pokanga iti rawa te whakaekenga tēnei. I roto i tēnei, ka whakanohoia he `pūrere LINX`, he mowhiti aukume iti, ki te hononga i waenga i te puku me te korokoro. Ka āwhina tēnei ki te ārai i te waikawa kei piki ake ki roto i te korokoro.

Ka ora rānei te mate o te uma mā te rongoā?

He mate ka taea te rongoā i te ngaunga o te puku. Ko te mea pai rawa atu ko te whakahaere mā te hanga i ētahi huringa iti ki tō kai me tō momo noho, me te pupuri i ngā rongoā antacid kia tata mai mō te whakamahinga i ētahi wā. Mena e tika ana, ka tino whai hua hoki ngā rongoā roa ki te whakahaere i te reflux waikawa. Ka uaua ake te whakahaere i ngā mate mahi. Heoi, mā te whakapau kaha tonu me te whakakotahitanga o ngā maimoatanga, ka taea te whakapai ake i roto i te wā.

He aha ngā huringa āhua noho ka taea e tātou te mahi hei whakahaere i te mumura?

Hei āwhina i te aukati i te reflux waikawa, ngana ki ēnei mea:

• Kai i ētahi kai iti i te roanga o te rā. Ki te iti ake ngā mea hei nakunaku i te wā kotahi, ka heke hoki te nui o te waikawa e whakaputaina ana e tō puku.
• Wetekina tō whitiki. Ka taea e te pēhanga o te puku te whai wāhi ki te whakapūnga waikawa. Ka taea hoki e te whakaiti i te taumaha te āwhina.
• Kaua e haere ki te moenga i muri i te kai i te kai katoa. Taria kia toru ki te rima hāora i mua i te takoto.
• Moe ki tō taha maui. Mā tēnei ka eke tō Sphincter Esofagus o raro ki runga ake i ngā mea o roto o tō puku, pērā i te pute hau. Ina moe koe ki tō taha, ki tō taha matau rānei, ka rumakina taua takirere ki roto i ngā mea o roto.
• Āta karohia ngā kai whakaohooho. Kia tūpato ki ngā kai ka kino ake ai te mamae o tō uma.
• Kati te momi hikareti. Ko te mamae o te uma tētahi o ngā take hei whakamutu i te momi hikareti. Ka taea e tō tākuta te āwhina i a koe ki tēnei.

Āhea koe me toro atu ki te tākuta?

Tirohia he tākuta i roto i ngā take e whai ake nei:

• Mena ka mamae tō uma i te iti rawa kotahi i te wiki.
• Mena kei a koe ngā tohu rerekē.
• Mena he uaua ki te horomi, kāore rānei e taea e koe te whiwhi i te nui o ngā kaora.
• Mena kua neke atu i te 60 tau tō pakeke.
• Mena kei te mamae tō uma pērā i te "Angina" (he kikī, he whakawhāiti).
• Mena kāore tō maimoatanga e whakaora.

Hei whakamutunga, me kī atu ahau...

He mea noa te mamae o ngā korokoro i ētahi wā. Ka taea e te nuinga o te tangata te whakahaere i ēnei mā te whakamahi i ētahi whakarerekētanga māmā noa iho. Heoi, ki te pā tonu mai ēnei ki a koe, me rapu awhina hauora pea koe. Kaua e warewarehia ngā mamae korokoro mau tonu. Ko te mamae o tō korokoro te tikanga kei te pakaru. Ka taea e tēnei te whakararu i te tinana i roto i te wā. Waihoki, ko ngā mamae korokoro mau tonu he tohu kei reira ētahi atu raruraru e hiahia ana kia rongoatia. Nō reira, kōrero ki te tākuta mō ngā mamae korokoro mau tonu.

` Te Ngaungau, te GERD, te Whakahokinga Waikawa, te Esophagus, te Puku, te Mumura o te Uma