He maha ngā wā ka pāngia koe e te werawera i roto i tō uma? He maha ngā wā ka pāngia koe e te reka waikawa, kawa rānei i roto i tō waha i muri i te kai, i ētahi wā rānei ka rite ki te hoki mai o te kai? Tērā pea he uaua ki a koe te horomi, he rite rānei ki te mea kei te mau te korokoro. Ahakoa he tohu ēnei e kore e arohia e te nuinga o tātou, he tohu pea ēnei mō tētahi mate e kiia nei ko te "Hiatal Hernia." Kaua e manukanuka—he mate tino noa tēnei ka taea te rongoā. Me matapakihia e tātou tēnei āhuatanga, pērā i tā tātou e mahi ana i tētahi hui kōrero ngaio, hoahoa ki Nirogi Lanka.
He aha te Hernia Hiatal?
I roto i ngā kupu māmā noa iho, ka puta he hernia hiatal ina pana te taha whakarunga o tō puku ki roto i te kōhao o tō uma mā roto i tētahi kōhao iti i roto i tō diaphragm—te uaua nui e wehe ana i tō uma i tō puku. Whakaarohia tō diaphragm he pakitara. He kōhao iti tō tēnei pakitara (hiatus esophageal) e āhei ai tō esophagus ki te hono atu ki tō puku. Mena ka whānui rawa, ka ngoikore rawa rānei tēnei kōhao, ka pupuhi ake tētahi wāhanga o tō puku. Ko taua pupuhi te mea e kiia nei e tātou he hernia hiatal.
Ka puta te hernia ina pēhia ana tētahi okana, tētahi kiko rānei mā roto i tētahi wāhi ngoikore o te ārai uaua, kiko rānei e pupuri ana i a ia ki tōna tūranga. He mea noa ngā hernia, ā, he maha ngā tāngata e kitea ana ngā hernia hiatal. I te nuinga o te wā ka puta mārire i roto i ētahi tau, kaua e puta katoa i te wā kotahi.
He aha ngā momo o te hernia hiatal?
E rua ngā momo matua: te hernia hiatal retireti me te hernia hiatal paraesophageal . Ko te momo retireti te mea tino kitea.
- Momo 1: Hernia Hiatal Pahekeheke
Koinei te momo tino noa (tata ki te 95% o ngā take) . I tēnei wā, ka paheke ake te hononga e tūtaki ai tō korokoro ki tō puku mā roto i te whakatuwheratanga o tō diaphragm, kātahi ka hoki ki raro. Nā te mea ka "paheke" ki mua, ki mua, ka kiia he hernia paheke.
- Momo 2: Paraesophageal Hiatal Hernia – e mōhiotia ana ko te Rolling Hiatal Hernia.
I tēnei momo, ka pana ake tētahi wāhanga o te puku o runga mā te whakatuwheratanga o te diaphragm engari ka noho tonu ki te taha o te esophagus. He maha ngā wā ka rite ki tētahi pupuhi ā-rohe, ki tētahi putanga porotaka rānei.
- Momo 3: Hernia Whakaranu
He huinga tēnei o ngā momo e rua kua whakahuatia ake nei. Ko te hononga e tūtaki ai te korokoro me te puku me tētahi atu wāhanga o te puku ka neke ake ki roto i te kōhao o te uma.
- Momo 4: Hernia Matatini
He onge ake tēnei, he uaua ake hoki. Ka puta ina nui haere te whakatuwheratanga o te diaphragm, ka taea ai te neke ake i te puku, tae atu ki ētahi atu okana o te puku—pērā i tētahi wāhanga o te koroni, te repeure, te whēkau rānei.
He pēhea te noa o ngā Hernia Hiatal?
He nui ake te kitea o ēnei mate i tō whakaaro, inā koa i a koe e pakeke haere ana. E ai ki ngā rangahau, tata ki te 20% o te taupori whānui ka pāngia e tētahi. I te 50 tau te pakeke, tata ki te 50% o te tangata he hernia hiatal tōna, ka piki ake ki te 60% i te 60 tau te pakeke, ā, ki te 70% i te 70 tau te pakeke. He maha hoki ngā wā ka kitea tēnei mate i roto i ngā tūroro i konei i Sri Lanka.
He aha ngā tohu o te Hiatal Hernia?
Mena he hernia hiatal retireti tōu, tērā pea kāore koe e mōhio kei a koe tētahi. He rerekē ki ētahi atu momo hernia, kāore he puku o waho e kitea ana.
He tokomaha ngā tāngata e pāngia ana e te hernia hiatal, kāore he tohu. Heoi, mō te hunga e pāngia ana e ngā tohu, ko te nuinga o ngā raruraru e pā ana ki te mate reflux gastroesophageal ( GERD ) .
Ko ēnei tohu ko:
- Ngau Mamae : He ahua wera i roto i te uma, ina koa i muri i te kai.
- Mamae uma kore-ngākau: He mamae uma e hokihoki ana, e rite ana ki te angina ( mate uaua coronary ) engari kāore e pā ana ki tō ngākau .
- Mate nakunaku: He kare ā-roto kua kī tonu i muri i te kai, ā, he maha ngā wā ka haere tahi me te mamae o te puku.
- Te ruaki me te ruaki: Ka hoki ake te kai, te hau, me te waikawa o te puku ki roto i tō korokoro.
- He uaua ki te horomi, he ahua rānei kei te mau tetahi puku i roto i tō korokoro.
- Korokoro mamae me te pāorooro: Ka taea e te waikawa e tae atu ana ki te korokoro te whakapataritari i ngā kiko me te whakarerekē i tō reo.
Kia maumahara, ehara i te mea ko te katoa e pāngia ana e te hernia hiatal ka pāngia e te reflux waikawa, ā, ehara i te mea ko te katoa e pāngia ana e te reflux waikawa he hernia hiatal. Heoi, ki te kite koe i ēnei tohu e puta pinepine ana, ko te hernia pea te take.
Ko ētahi atu tohu whakatūpato ko:
- Whakapairuaki: Nā te pēhanga ki te puku, te waikawa rānei i roto i te korokoro.
- Te poto o te manawa: Ki te pēhia e te hernia nui ō pukahukahu, ka pā pea ki tō manawa.
- Te pēhanga, te mamae rānei i te puku o runga, i te uma rānei o raro.
He nui ake te hononga o ēnei tohu ki ngā hernia paraesophageal nui ake.
He aha te āhua o te hernia hiatal?
Nā te mea kei te tūtaki tō puku ki tō uma te hernia, ka taea te rongo i te mamae i ngā wāhi e rua. Mā te pēhanga, te here rānei o te hernia—pērā i te piko whakamua, te maremare, te hiki rānei i ngā mea taumaha—ka puta te mamae. Mēnā ka pāngia koe e te mamae ohorere, te mamae nui, tera pea he tohu tēnei i tētahi raruraru e hiahia ana kia arohia tonutia e te rata.
I te nuinga o te wā, ko te mamae e pā ana ki te hernia hiatal i puta mai i te reflux waikawa, e whakapataritari ana i te arai o te esophagus. Ka rite tēnei ki te wera e horapa ana puta noa i te uma. Nā te wāhi, ka taea e ia te whai i ngā tohu o te whakaeke ngakau. Mena ka pāngia koe e te mamae o te uma, he mea haumaru tonu te toro atu ki te tākuta tonu hei whakakore i ngā raruraru ngakau.
He aha te take o te rerenga waikawa e puta ai te hernia?
Whakaarohia te hononga e tūtaki ai tō korokoro ki tō puku. Ina neke taua hononga ki runga ake i te diaphragm, ka ngoikore, ka totoro rānei ngā muka uaua e mahi ana hei takirere hei ārai i te waikawa kia hoki whakamuri. Nā te mea kāore e taea e ēnei uaua te kati i te korokoro kia tino piri, ka ngawari te turuturu o te waikawa o te puku ki runga. Hei tāpiri, ka taea e te hernia hiatal te mau i te iti o te waikawa o te puku ki roto i te putea i hangaia e te hernia, ka uaua ake te whakawātea tika i te puku.
He aha te take o te Hiatal Hernia?
Ka puta te hernia ina he ngoikore te ārai kiko e wehe ana i ngā wāhanga o tō tinana. Ka puta te hernia hiatal ina nui haere te whakatuwheratanga o te diaphragm (te hiatus esophageal), ka taea ai e te puku te pana mā roto.
I ētahi wā ka puta tēnei ngoikore nā tētahi whara motuhake, nā tētahi pokanga, nā tētahi mate whānau rānei. Heoi, ko te nuinga o te wā ko te hua o ngā tau maha o te kino o te kiko mai i te pēhanga me te taumahatanga o ia rā. Ko tētahi mea e whakanui ana i te pēhanga i roto i tō puku ka pā ki tō diaphragm. Anei ētahi āhuatanga matua e whai wāhi ana ki te whanaketanga o te hernia hiatal:
- Te maremare roa, te tihe rānei: Whakaarohia te hunga e mate ana i te maremare tonu. Mā te maremare roa, te tihe rānei ka nui ake te pēhanga o roto i te puku.
- Te pēhi tonu i te puku i te wā e neke ana (te kōroke): Mena kei te pāngia koe e te kōroke mau tonu, e mōhio ana koe ki te pānga o tēnei momo mate ki te tinana.
- Momona: Ka pā te taumahatanga nui ki te pakitara o tō puku mēnā he 30, neke atu rānei te Taupū Papatipu Tinana (BMI).
- Te ruaki pinepine.
- Te whakakori tinana kaha, te hiki taumaha rānei: Mā te hiki i ngā taumaha tino taumaha i te whare takaro ka puta he pēhanga nui ki roto.
- Te hapūtanga me te whānautanga: Ko ēnei wā ka puta he pikinga tūturu, he pikinga nui o te pēhanga o te puku.
He mate kino te Hiatal Hernia?
I te nuinga o te wā, kāore. Ko te nuinga o ngā hernia hiatal kāore i te mōrearea. He tokomaha te hunga kāore e pāngia e ngā tohu, ā, kāore pea koe e mōhio kei a koe tētahi. Heoi, ka nui haere te kino o ngā hernia nui i roto i te wā, ā, ka nui ake te tūponotanga ka puta mai ngā tohu e kitea ana.
He aha ngā raruraru ka pā mai?
Ko te raruraru tino noa e puta mai ana i te hernia hiatal ko te reflux waikawa mau tonu. Mena he kino rawa tēnei, ā, kāore e taea te whakahaere tika mā te rongoā, ka raru pea tō korokoro mō te wā roa.
Ko ngā raruraru e puta mai ana i te reflux waikawa mau tonu ko:
- Esophagitis: Ka mumura, ka whara rānei te arai o te esophagus nā te waikawa reflux, ka mamae, ka uaua ki te horomi, ka toto pea.
- Te whakawhāiti i te esophagus: Ka taea e te mumura mau tonu te arahi ki te hanganga o te kiko whara i roto i te esophagus. Ka taea e ēnei whakawhāiti te whakawhāiti i te ara, ka uaua ai te haere a te kai.
- Te korokoro o Barrett: Ka taea e te kino tonu te whakaputa huringa ki te kiko o te korokoro. Ahakoa kāore he kino i a ia anō, e kiia ana he mate pukupuku kei mua i te mate e hiahia ana kia aroturukitia e te hauora.
He tino onge te wā ka mau, ka pēhia rānei te hernia i roto i te diaphragm. He maha ngā wā ka puta tēnei i roto i ngā momo hernia kāore i te tino kitea. Ko ēnei raruraru ko:
- Te aukati i te puku: Tērā pea ka mau, ka piko rānei tō puku, tō tetahi atu okana rānei, ka aukati i te ara nakunaku.
- Gastritis: Ka taea e te waikawa puku kua mau te mumura me ngā mate pukupuku i roto i te wāhanga hernia o te puku.
- Ischemia: Ki te pēhia rawatia te hernia, ka taea e ia te tapahi i tana ake rere toto. Ka hua ake tēnei i te pupuhi, te mamae nui, ā, ka mate ngā kiko. He āhuatanga ohorere hauora tēnei; rapua tonutia te tiaki i te rūma ohorere.
Me pēhea te tautuhi i te hernia hiatal?
Ko te tikanga, ka kitea e ngā tākuta he hernia hiatal mā te tirotiro i ngā whakaahua o tō korokoro me tō puku. I ētahi wā, ka kitea noa iho i te wā e whakamātautauhia ana mō ētahi atu āhuatanga. Heoi, tera pea ka tirotirohia anō e tō tākuta mēnā ka puta mai he tohu o te reflux waikawa. Tērā pea ka whakamātautauhia te pH o te korokoro hei whakaū i te aroaro o te waikawa. Mēnā ka whakaūtia, ka whakamahia ngā whakamātautau whakaahua hei whakatau i te take.
Ko ngā whakamātautau tātaritanga noa ko:
- X-ray o te uma: Ka kitea mārama te āhua o te uma.
- Esophagram (Horomanga Pāriuma): He rite tēnei ki te ataata tūturu o tō esophagus. I muri i te horomitanga o te wai bariuma, ka taea e tō tākuta te mātakitaki i te mahi a tō esophagus i te wā tūturu.
- Te tirotiro i te pito o runga: Ka tukuna he ngongo angiangi, ngāwari me te kāmera ki raro i tō korokoro kia taea ai e te tākuta te kite i te roto o tō korokoro me tō puku. Ka taea te tango tauira kiko (biopsy) mēnā e tika ana.
- Manometri esophageal: Ka whakauruhia he catheter hei ine i te pēhanga me ngā uaua e whakaheke ana i roto i tō esophagus.
Ka memeha noa iho te hernia?
Kāo. Kāore te hernia e ora i a ia anō. I te nuinga o te wā, ka kino haere i te roanga o te wā.Heoi, ehara tēnei i te kī ka pāngia koe e te mamae o tō hernia. Mena kāore he tohu o tō hernia hiatal, kāore pea koe e hiahia ki te rongoā. Mena he tohu kei a koe, tera pea ka mau tonu, ka haere rānei. He maha ngā wā ka taea te whakahaere i te reflux ngawari mā te rongoā, engari ko ngā take kino ka hiahiatia pea he pokanga hei whakatika.
He aha ngā maimoatanga hauora mō te hiatal hernia?
Mā tō tākuta e whakatau te rautaki pai rawa atu mō te wā roa i runga i te āhua o tō hernia, te kaha o ō tohu, me tō hauora whānui. Ko ngā kōwhiringa ko:
- Taria, mātakitaki: Ki te kore tō hernia e raru ana, ka tirotirohia pea koe kia kite mēnā ka rerekē i roto i te wā.
- Ngā Rongoā: Ahakoa kāore e taea e ngā rongoā te whakatika i te hernia, ka taea e rātou te whakaiti i te waikawa o te puku, te whakamamae i te mamae me te ārai i te kino o te korokoro.
- Pokanga: Mā te pokanga iti ka taea te whakatika i te hernia. He kōwhiringa te pokanga mō te tini, ahakoa kāore e hiahiatia mō te katoa.
Ngā rongoā
Mō te reflux waikawa i ētahi wā, ka taea e ngā antacids e hokona ana i waho o te tākuta te whakaora i te wā poto. Heoi, ki te mea he maha ngā tohu, ka tohua pea e tō tākuta he Proton Pump Inhibitors (PPIs) (pērā i te Omeprazole, i te Esomeprazole rānei). He tino whai hua ēnei ki te whakaora i te kino o te korokoro, ahakoa kāore e aukati i te tipu o te hernia, e ārai rānei i te ruaki o te kai.
Pokanga
Ka tūtohu pea ngā tākuta i Nirogi Lanka kia pokangahia mēnā:
- Kāore e taea te whakahaere i ngā tohu me ngā raruraru mā te rongoā.
- Ka puta ngā pānga taha o ngā rongoā ka pā ki te kounga o tō oranga.
- Ko te rahi o te hernia e tohu ana i te mōrearea nui o ngā raruraru kino ake a muri ake nei.
I te wā o te pokanga hernia hiatal, ko te tikanga ko:
- Te nuku i te puku me te wāhanga o raro o te korokoro ki tō rātou tūranga tika i raro i te diaphragm.
- Te whakatika i te pūaha o te diaphragm.
- Te whakapakari i te hononga i waenga i te korokoro me te puku.
Ko te ingoa o tēnei tikanga ko te Fundoplication . I ahu mai te ingoa i te "fundus," arā, te wāhanga o runga o tō puku. I te wā o te pokanga, ka tangohia e tō taote pokanga te fundus o tō puku, ka takai ki te wāhanga o raro o tō korokoro, ka whakau ki ngā tīrai pokanga, ki ngā tuitui rānei. Whakaarohia he rite ki te takai i tētahi kākahu ki tō kaki. Ka whakakīkī tēnei i te sphincter korokoro o raro, te uaua e wehe ana i ēnei whekau e rua. I ngā wā katoa e taea ai, ka mahia tēnei hei pokanga laparoscopic iti rawa te whakaekenga , ko te tikanga ka whakamahia e te taote pokanga he kāmera me ngā taputapu kua whakaurua mā roto i ētahi tapahi iti.
He aha te āhua o te tukanga whakaora i muri i te pokanga?
I runga i tō hauora me te momo pokanga e mahia ana, me noho pea koe ki te hōhipera mō te rā kotahi, e rua rānei. Ko te whakaoranga mai i te pokanga laparoscopic , i te pokanga robotic rānei he tere ake, he whakamarie ake hoki nā te mea he iti ake ngā tapahi e hiahiatia ana, kaua ko te tapahi nui e hiahiatia ana mō te pokanga tuwhera. Heoi, i ētahi wā, he mea tika pea te pokanga tuwhera mō te taha hauora.
Kia hoki koe ki te kāinga, me whai wā whakaora koe mō ngā wiki e rua ki te ono. I tēnei wā, tera pea ka pāngia koe e ngā tohu me ngā pānga taha wā poto e uaua ai te kai i te wā e ora ana tō tinana. Ka tohua e tō tākuta he kai tino motuhake. Tērā pea ka tīmata koe ki ngā wai, ka neke haere ki ngā kai ngawari, ā, i te mutunga ka huri ki ngā kai mārō. He mea noa te pāngia e te whakahekenga taumaha — te nuinga o te wā 10-15 pauna (4.5–6.8 kg) — i muri i te pokanga hernia hiatal.
He pēhea te angitu o te pokanga hernia hiatal?
E 90% te angitu o ngā pokanga hernia hiatal.He maha ngā tūroro ka taea te mutu te tango rongoā, ā, ka ora noa i te mamae o te reflux waikawa i muri i te tikanga. I muri i tō oranga ake, me toro atu koe ki tō tākuta i te iti rawa kotahi i te tau kia tika ai te mahi a te wāhi kua whakatikatikaina. Mena ka pā mai he tohu hou ki a koe, ka hoki mai rānei ngā tohu tawhito, ka tirotirohia e tō rōpū hauora.
E whakaatu ana ngā rangahau roa, i roto i te 50% o ngā take, ka hoki anō pea te hernia hiatal i roto i te wā (i muri i ētahi tau). Ka tupu pea tēnei mena kāore i mau tetahi wāhanga o te whakatikatika, mena kei te noho tonu ngā take matua i puta ai te hernia taketake. Ehara i te mea ko ngā hernia katoa e puta anō ana ngā tohu ōrite, engari ki te puta, he maha ngā wā ka taea e te pokanga whai muri te whakarato i tētahi otinga pumau.
He aha taku e taea ai te mahi ki te kāinga hei whakahaere i te hernia hiatal?
Mena kei te noho koe me te hernia hiatal e puta ai ngā tohumate wā poto noa iho, ka taea e koe te rapu whakaora i te kāinga mā te whakamahi i ngā rongoā ka taea te hoko kore-tohu me ngā huringa āhua noho. Ka taea e ngā antacids — pērā i a Tums®, Rolaids®, Pepto-Bismol® rānei — te āwhina ki te whakahaere i te reflux waikawa wā poto, engari kaua e whakamahia hei rongoā mō te wā roa, mō ia rā. Ka taea hoki e koe te whakaiti i te auau me te kaha o te reflux waikawa mā te whakamahi i ēnei whakarerekētanga āhua noho:
- Kia mau ki te Taupū Papatipu Tinana (BMI) hauora: Mena kei te whai wāhi te taumaha nui ki ō raruraru waikawa, he tino whai hua te whakaiti i tō taumaha.
- Kai iti, kai auau: Engari i ngā kai nui, kai iti ngā wāhanga puta noa i te rā hei whakaiti i te pēhanga ki tō puku.
- Whakaitihia ngā kai momona: Ka taea e ngā kai hinuhinu, nui te ngako rānei te whakanui ake i te hanga waikawa puku me ngā whākōkī.
- Kai wawe i te tina: Kaua e takoto mō ngā haora maha i muri i te kai kia pai ai te mahi a te kaha ā-papa.
- Hurihia tō tūnga moe: Mā te moe me tō mahunga e hiki ake ana, me te takoto ki tō taha maui ka āwhina i te aukati i te pikinga o te waikawa. Kei te wātea ngā urunga tinana motuhake hei āwhina i tēnei.
- Kati te momi hikareti: Ka ngoikore te uaua o raro o te esophagus i te momi hikareti. Hei tāpiri, ka puta he maremare roa, ka nui ake te pēhanga ki ngā uaua e karapoti ana i te hernia hiatal.
Tērā pea ka kitea he hernia hiatal tōu i a koe e toro atu ana ki te tākuta mō tētahi atu raruraru. He mea tino noa ēnei; ki te mea he iti tōu, ā, kāore he mamae, kāore he take e manukanuka ai. Heoi anō, tērā pea kua maha ngā tau e whawhai ana koe ki te kino haere o ngā tohu i mua i te kitenga i te pūtake. Tērā pea ka miharo koe ki te mōhio ko te hernia te take o tō reflux waikawa.
Waimarie, kei reira ngā maimoatanga whai hua mō te reflux waikawa me te hiatal hernias. Ko te maimoatanga e hiahiatia ana e koe ka whakawhirinaki ki te āhua o tō hernia me te kaha o ō tohu. I roto i te nuinga o ngā wā, he nui ngā rongoā me ngā huringa āhua noho hei whakahaere i te raruraru. I roto i ngā take kino ake, me mahi pea he pokanga hei whakatika i te hernia. He tino angitu tēnei pokanga. Kia mārama tō tautuhi, ka haere koe i te ara ki te kimi i te whakaora i ngā tohu.
Ngā Tuhipoka Whakamutunga Hira
Kāore he mea e wehi ai te hernia hiatal. He tokomaha te hunga e pāngia ana e tēnei mate, ā, kāore rawa e whakaatu i tētahi tohu.
Heoi, ki te pāngia koe e te mamae o te uma, te hoki mai o te kai, te uaua rānei ki te horomi, rapua tonutia he tohutohu hauora. He mea nui te tautuhi mēnā he hernia hiatal te take, he mea kē atu rānei, kia whiwhi ai koe i te tiaki tika.
Mā te whakarerekētanga iti o te āhua noho, me te rongoā i ētahi wā, ka taea te whakahaere pai i tēnei mate. Mena e hiahiatia ana he pokanga, kia mōhio koe he tikanga hou, angitu, me te pono hoki. Kaua e tukua te manukanuka kia aukati i a koe; kōrero ki tō tākuta o Nirogi Lanka kia kitea ai te otinga e pai ana mō ō hiahia.
Hernia Hiatal, Ngau Mamae, Reflux Waikawa, GERD, Puku, Esophagus, Pokanga Hernia
