Kei te mamae hoki tō uma? Kāore au i te mōhio mēnā he hernia hiatal! Me kōrero tāua?

He maha hoki ngā wā ka pāngia koe e te mamae o te ngākau? Kei te ahua kawa tō korokoro i muri i te kai, kei te ahua rānei kei te piki ake te kai ki roto i tō korokoro i ētahi wā? He uaua rānei ki a koe te horomi kai, kei te ahua rānei kei te mau tetahi mea ki roto i tō korokoro? Ahakoa kāore tātou e aro nui ki ēnei i ētahi wā, tera pea he mate e kiia nei ko te "Hiatal Hernia" kei muri i ēnei. Kaua e manukanuka, he mea tēnei e pā ana ki te tini o te tangata, ā, ka taea te rongoā. I tēnei rā, ka kōrerohia e tātou tēnei me te taipitopito, me te mea kei te kōrero tātou ki tētahi mema o te whānau.

He aha te Hernia Hiatal?

I te whakarapopototanga, ko te hernia hiatal te wā e pana ana te wāhanga o runga o tō puku mā roto i tētahi kōhao iti i roto i te diaphragm, te uaua e wehe ana i tō uma i tō puku. Whakaarohia he rite ki tētahi pakitara. He kōhao iti tō tēnei pakitara (hiatus esophageal) e hono ai tō esophagus ki tō puku. I ētahi wā, ina nui haere tēnei kōhao, ka pana tētahi wāhanga o tō puku mā roto. Koinei te mea e kīia nei e mātou he hernia hiatal. Ko te tikanga o te kupu hernia he pana tētahi okana, he kiko rānei mā roto i tētahi wāhi ngoikore i roto i te ārai kiko e karapoti ana i a ia, kaua ki te wāhi e tū ana i te nuinga o te wā. He mea noa ngā hernia, ā, he maha ngā tāngata e pāngia ana e tēnei hernia hiatal. I te nuinga o te wā ka tupu haere tēnei i roto i ngā tau maha. Ehara i te mea ka huri ohorere.

He aha ngā momo o te Hernia Hiatal?

E rua ngā momo matua o ngā hernia hiatal: te hernia hiatal retireti me te hernia hiatal paraesophageal . He maha ngā tāngata e pāngia ana e tēnei momo retireti.

• Momo 1: Hernia Hiatal Pahekeheke

Koinei te momo tino noa (tata ki te 95%) . Ko te mea ka tupu, ka piki ake tō korokoro (paipa kai) mā roto i tētahi kōhao i te diaphragm, ka hono atu ki tō puku (gastroesophageal junction), kātahi ka hoki ki raro anō. Me te mea kei te paheke. Koia i huaina ai ko te hernia paheke.

• Momo 2: Paraesophageal Hiatal Hernia - E kiia ana hoki ko te Rolling Hiatal Hernia.

I tēnei momo, ka puta te wāhanga o runga o te puku mai i te whakatuwheratanga o te korokoro, ki tua atu i te korokoro. Ka rite te āhua ki tētahi puku porotaka.

• Momo 3: Hernia whakauru

He rite tēnei ki te huinga o ngā momo e rua kua whakahuatia ake nei. Ka puta te korokoro i te wāhi e hono ana ki te puku, ā, ka puta pea tētahi atu wāhanga o te puku i taua wā anō.

• Momo 4: Hernia matatini

He mea onge tēnei, ā, he uaua pea. Ko te mea ka tupu, ka nui haere te kōhao i roto i te diaphragm, ā, ka puta tahi mai te puku me tētahi atu okana puku, hei tauira, te wāhanga o te whekau, te repeure, te whēkau rānei.

He pēhea te noa o te ingoa o tēnei āhuatanga ko te Hiatal Hernia?

He mea noa ake tēnei i tō whakaaro, inā koa ka pakeke haere koe. I tētahi whenua pērā i Amerika, e 20% o te taupori whānui e pāngia ana e tēnei mate. E kiia ana i te 50 tau, ka pāngia e tēnei mate te 50%, i te 60 tau, 60%, ā, i te 70 tau, ka pāngia e tēnei mate te 70%. He mea noa anō hoki tēnei mate i Sri Lanka.

He aha ngā tohu o te Hiatal Hernia?

Mēnā he hernia hiatal retireti tēnei e pāngia ana e te tini tāngata, tērā pea kāore koe e rongo i te hernia. Kāore e puta mai he puku i waho pērā i ētahi atu momo hernia.

He tokomaha ngā tāngata whai hernia hiatal kāore e whakaatu i ngā tohu. Heoi, ko te nuinga o te hunga e pāngia ana e ngā tohu he tohu e pā ana ki te mate reflux waikawa roa (Gastroesophageal Reflux Disease - GERD ) .

Ko rātou ēnei:

• Ngākau wera : He kare ā-wera i roto i te uma, inā koa i muri i te kai.
• Mamae uma ehara i te mamae ngākau : He mamae uma auau , he rite ki te angina , engari kāore e pā ana ki te ngākau .
• Mate nakunaku: He kare ā-roto e kī ana i muri i te kai i tētahi wahi iti o te kai, me te mamae hoki o te puku.
• Te ruaki me te ruaki: Te ruakitanga o te kai, te hau, me te waikawa ki roto i te korokoro.
• He uaua ki te horomi, he pupuhi rānei i roto i tō korokoro.
• Te korokoro mamae me te pāorooro: Ka mamae te korokoro i te waikawa o te korokoro, ka rerekē hoki te reo.

Engari 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. Engari ki te mea he maha ake ōu pānga ki ēnei tohu, he hernia pea. Ko ētahi atu tohu whakatūpato ko:

• Whakapairuaki: Ka puta te whakapairuaki i te pēhanga o te puku, te rerenga waikawa, ngā mea e rua rānei.
• Te poto o te manawa:Mena ka pēhia ngā pukahukahu e te hernia, ka uaua pea te manawa.
• Te pēhanga, te mamae rānei i te puku o runga, i te uma rānei o raro.

Ko ēnei tohu ka kitea nuitia i roto i te hunga he nui ngā hernia paraesophageal.

He aha te mamae o te hiatal hernia?

Ko te hernia hiatal te wāhi e tūtaki ai tō puku me tō uma. Nō reira, ki te mamae koe i te hernia, ka rite ki te mamae o te uma, ki te mamae puku rānei. Ka puta te mamae ina mahi koe i ētahi mea, ina pēhi, ina kōpiri rānei te hernia. Hei tauira, ki te nui tō hernia, ka mamae pea koe ina piko whakamua koe, ina maremare, ina hiki rānei i tētahi mea. He tohu anō hoki te mamae kei te hē tetahi mea. Engari i te nuinga o te wā, ehara i te hernia tonu te mamae o te hernia hiatal, engari nā te waikawa whakapūpū. Ka whakapataritari te waikawa i tō korokoro. Nā te mea ka rere tēnei korokoro mai i waenganui o tō uma ki tō korokoro, ka rite te mamae ki te horapa ki runga, ki raro, ki tō uma katoa rānei. He maha ngā tāngata e rongo ana i te mamae e mura ana. Ko ētahi tāngata ka rongo i te mamae o te ngākau. Ki te ruarua koe, ki te mamae rānei tō uma, he pai ake te toro atu ki te tākuta me te tirotiro.

Me pēhea te urunga o te waikawa ki te korokoro nā te hernia?

Whakaarohia, te wāhi e hono ai tō tātou korokoro ki tō tātou puku (gastroesophageal junction). Koinei te wāhi e haere ai te diaphragm, ā, ka kikī ngā uaua e āwhina ana ki te aukati i te waikawa kia piki ki roto i te korokoro. Ina kikī ēnei uaua, ā, kāore e taea te kati tika i te korokoro, ka tīmata te waikawa o te puku ki te hoki ake ki roto i te korokoro. Nā te hernia hoki, ka mau ētahi o te waikawa ki te taha o runga o te puku, ā, kāore e ngāwari te heke. Koinei noa te mea ka tupu.

He aha ngā take o te Hiatal Hernia?

Ka puta te hernia ina he ngoikore te kiko e wehe ana i ngā wāhanga rerekē o te tinana. Ko taua ngoikore te wāhi e puta mai ai te hernia. Ka puta te hernia hiatal, e ai ki te kōrero i mua ake nei, ina nui rawa te kōhao i roto i te diaphragm e kiia nei ko te hiatus esophageal. I ētahi wā ka puta tēnei ngoikore nā tētahi aituā motuhake, pokanga, whānautanga rānei. Engari i te nuinga o te wā ka puta mai i ngā tau maha o te ahotea me te taumahatanga o ia rā kua kohia i roto i te wā. Ko tētahi mea e hanga ana i te pēhanga tāpiri i roto i tō kōhao puku ka taea te pēhi i te diaphragm i roto i te wā. Anei ētahi o ngā take matua ka puta ai te hernia hiatal:

• Te maremare roa, te tihe rānei: Whakaarohia, he maremare roa ētahi tāngata. Ina maremare tonu koe, ka tihe tonu, ka piki ake te pēhanga i roto i tō puku.
• Te mate kōroke: E mōhio ana te hunga e pāngia ana e te mate kōroke ki tēnei.
• Momonatanga: Mena he nui ake te taupū papatipu tinana (BMI) i te 30.
• Te ruaki pinepine.
• Te whakakori tinana kaha, te hiki taumaha rānei: Ina hiki ana i ngā taumaha taumaha, pērā i te whare takaro.
• Te haputanga me te whānautanga: Ka piki ake hoki te pēhanga o te puku i ēnei wā.

He mate kino tēnei Hiatal Hernia?

I te nuinga o te wā, kāore. Ko te nuinga o ngā hernia hiatal kāore i te kino. Ko te nuinga kāore e puta he tohu. Kāore pea koe e mōhio kei a koe tētahi. Heoi, ka taea e te hernia nui te kino haere i roto i te wā. Ki te mea he nui, ka maha ngā wā ka puta ngā tohu.

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 tika te whakahaere mā te rongoā, ka taea e ia te kino i tō korokoro. Ko ngā raruraru o te reflux waikawa mau tonu ko:

• Esophagitis: Ka pupuhi, ka mumura hoki te arai o te esophagus nā te waikawa recurrence ki roto i te esophagus. Ka mamae pea, ka uaua ki te horomi, ka puta he mate pukupuku, tae noa ki te toto.
• Te whakawhāititanga o te korokoro: Ki te haere tonu te whara, ka puta he kiko koha ki te korokoro. Ka taea e tēnei koha te whakararuraru i ngā uaua e mahi ana i te wā e horomia ana, ka whaiti te korokoro.
• Te korokoro o Barrett: I ētahi wā ka puta he huringa i roto i te arai o te korokoro (he āhuatanga e kiia nei ko te "korokoro o Barrett". Ahakoa ehara tēnei i te mea kino, e kiia ana he āhuatanga o mua i te matepukupuku .

He tino onge te puta o ngā raruraru mēnā ka mau, ka panaia rānei te hernia hiatal ki roto i te pūaha. He maha ngā wā ka puta tēnei i ngā momo hernia kāore i te tino kitea. Ko ēnei raruraru ko:

• Te aukati i te puku: Ka taea e tō puku, e tētahi atu okana rānei te piri, te kōpiri, te piko rānei i te whakatuwheratanga, ka aukati i tō ara nakunaku.
• Gastritis: Ka taea e te rerenga waikawa ki roto i te wahi herniated o te puku te pupuhi, te mate puku, me te toto o roto.
• Ischemia: Mena ka tino pēhia te hernia, ka taea te motu te rere o te toto ki reira. Ka pupuhi, ka mamae, ā, ka mate pea ngā kiko i te mutunga. He āhuatanga ohorere tēnei.

Me pēhea te tautuhi i te hernia hiatal?

Mā te titiro ki ngā whakaahua o tō korokoro me tō puku ka tātaritatia e ngā tākuta he hernia hiatal. I ētahi wā ka kitea noa iho i a koe e rapu ana i tētahi atu mea. Heoi, ka hiahia pea te tākuta ki te rapu mēnā kei a koe ngā tohu o te reflux waikawa. Tuatahi, ka whakahaerehia e rātou he whakamātautau pH korokoro hei tirotiro i te waikawa i roto i tō korokoro.Mena he waikawa pēnei, ka whakahaerehia he whakamātautau whakaahua hei kimi i te pūtake. Ko ngā whakamātautau hei tautuhi i te hernia hiatal ko:

• X-ray o te uma: Ka tangohia he pikitia pango me te mā o roto o tō uma, te wāhi kei reira te trachea.
• Esophagram / Barium Swallow: He rite tēnei ki tētahi ataata o tō esophagus. Mā tēnei ka taea e koe te kite i te roto o tō esophagus i te wā tonu i a koe e horomi ana. I mua i tēnei, ka hoatu he wai e kiia nei ko te barium hei inu māu.
• Endoscopy o runga: Ka whakauruhia he ngongo roa me te kāmera iti e piri ana mā te waha hei tirotiro i roto i te korokoro me te puku. Mā tēnei ka taea e koe te kite i te roto o te korokoro i runga i te mata ora. Mena e tika ana, ka taea te tango i ngā wahi kiko iti (biopsy) hei tirotiro.
• Manometri esophageal: Ka whakauruhia he catheter ki roto i te esophagus hei ine i te pēhanga i roto i ngā uaua o te esophagus.

Ka memeha noa iho rānei tēnei hernia?

Kāo. Kāore ngā hernia e ora ake i a rātou anō. Ka ora ake i te nuinga o te wā. Heoi, ehara i te mea kāore tō hernia e pāngia e tetahi raruraru. Ki te kore he tohu o tō hernia hiatal, kāore pea koe e hiahia ki te rongoā. Engari ki te mea he tohu kei a koe, ka roa pea, ka kino haere. Ka taea te whakahaere i te reflux waikawa ngawari mā te rongoā. Engari ko ngā kēhi kino ake, me mahi pokanga pea.

He aha ngā maimoatanga hauora mō te hiatal hernia?

Ka tirotirohia e tō tākuta te āhua o tō hernia, te rahi o tō hernia, me ō tohumate hei whakatau i te kōwhiringa maimoatanga pai rawa atu mōu mō te wā roa. Ko ngā kōwhiringa e wātea ana ko:

• Taria, mātakitaki: Ki te kore tō hernia e whakararuraru i a koe, kāore pea e hiahiatia he maimoatanga. Engari ka tirotirohia e tō tākuta, nā te mea ka nui haere pea i roto i te wā.
• Whakamahia ngā rongoā: Kāore e taea e ngā rongoā te aukati katoa i te pikinga ake o te waikawa ki te korokoro. Engari ka taea e rātou te whakaiti i te nui o te waikawa i roto i te puku. Ahakoa ka piki ake ki te korokoro, ka iti ake te kino ka puta, ā, ka whakaiti i te mamae.
• Pokanga: Mā te pokanga iti ka taea te whakatika i tō hernia hiatal. He kōwhiringa te pokanga mō te katoa, engari kāore e hiahiatia ana e te katoa. Tērā pea ka hiahiatia wawetia e ētahi, ko ētahi ia ka hiahiatia ā muri ake nei.

Ngā rongoā

Mena ka pāngia koe e te mamae o te puku i ētahi wā, ka kitea pea he whakamarie mā te whakamahi i ngā rongoā antacid ka taea te hoko kore utu (pērā i a Digene, Gelusil). Heoi, ki te roa, ka tohua pea e tō tākuta he rongoā mō te wā roa, ia rā. Kei roto i tēnei ko ngā aukati papu proton (PPI).(hei tauira, Omeprazole, Esomeprazole, Pantoprazole). Ka taea e ēnei te āwhina ki te ārai i te kino o te waikawa ki te korokoro me te whakaora i ngā wāhi kua pakaru. Heoi, kāore e taea e ēnei rongoā te aukati i te kai kia hoki mai ki roto i te korokoro (regurgitation) me te aukati i te hernia kia nui haere.

Pokanga

Ka tūtohu ngā tākuta i te pokanga whakatika hernia i roto i ēnei āhuatanga:

• Mena kāore e taea te ārai i ngā tohu, i ngā raruraru rānei i puta mai i tō hernia mā te rongoā.
• Mena ka pā mai ngā pānga taha o ngā rongoā ki tō hauora, ki te kounga rānei o te oranga.
• Mena he nui tō hernia ka pā mai he raruraru nui ā muri ake nei.

Mā te pokanga hernia hiatal ka whakatikatikahia te hernia me te reflux waikawa penei:

• Ka whakahokia tō puku me te korokoro o raro ki tō rātou tūranga tika i raro i te diaphragm.
• Kua katia te kōhao i te diaphragm i puta ai te hernia.
• Ka whakakukū te hononga i waenga i te puku me te korokoro.

Ko te ingoa o tēnei pokanga he fundoplication . Nō te kupu "fundus" te ingoa, e pā ana ki te wāhanga o runga o te puku. I te wā o te pokanga, ka tangohia e te taote pokanga te fundus o tō puku, ka takai ki te wāhanga o raro o tō korokoro, ka mau ki ngā topenga pokanga (staples) me ngā tuitui rānei. Whakaarohia he rite ki te takai i tētahi hāri ki tō kaki. Ka whakau tēnei i te uaua e wehe ana i ngā whekau e rua (te sphincter korokoro o raro). I ngā wā katoa e taea ai, ka mahia tēnei mā te pokanga laparoscopic iti rawa te whakaekenga . Arā, ko te pokanga e uru ana ki te whakauru i tētahi kāmera me ngā taputapu mā roto i ētahi tapahi iti.

Kei te pēhea te whakaoranga i muri i te pokanga?

I runga i tō āhua me te momo pokanga, me noho pea koe ki te hōhipera mō te rā kotahi, e rua rānei. Ko te whakaoranga mai i te pokanga laparoscopic , robotic rānei he tere ake, he māmā ake hoki. Nā te mea ka mahia mā roto i ngā tapahi iti, kaua mā roto i ngā tapahi nui pērā i te pokanga tuwhera. Heoi, i ētahi wā ka hiahiatia te pokanga tuwhera. Ahakoa kua hoki koe ki te kāinga, me whakaora anō koe mō ētahi atu wiki e rua ki te ono. I tēnei wā, kāore pea koe e taea te kai noa nā ngā tohu me ngā pānga taha rangitahi i te wā e ora ana tō pokanga. Ka tohua e tō tākuta he kai tino iti. Ka tīmata koe me ngā wai, ka neke haere ki ngā kai ngawari, ā, ka mutu ki ngā kai totoka. He mea noa te whakaiti i te taumaha i muri i te pokanga hernia hiatal - tata ki te 10-15 pauna (4.5-6.8 kirokaramu).

He pēhea te angitu o te pokanga hiatal hernia?

E 90% te angitu o te pokanga hernia hiatal.Ka taea e te nuinga o te tangata te mutu te tango i ā rātou rongoā i muri i te pokanga, ā, ka noho noa i te oranga noa me te kore he raruraru o te reflux waikawa. I muri i te whakaoranga, me toro atu koe ki tō tākuta i te iti rawa kotahi i te tau ki te tirotiro i te hernia kua whakatikatikaina, me te whakarite kei te pai te mahi o ngā mea katoa. Mena ka puta he raruraru hou, ka hoki mai rānei ngā raruraru tawhito, ka tirohia e tō tākuta aua mea. Kua whakaatuhia e ngā rangahau roa e tata ana ki te 50% o ngā hernia hiatal ka hoki mai anō i muri i tētahi wā (he maha ngā tau te nuinga) i muri i te pokanga. Tērā pea nā te mea kāore i tika te mahi i tētahi wāhanga o te pokanga, nā te mea rānei kei te kaha tonu ngā āhuatanga i puta ai te hernia taketake, ā, kua puta he mea hou. Heoi, ehara i te mea ko ngā hernia katoa e hoki mai ana ka rite tonu ngā tohu. Heoi, ki te puta, ka taea e te pokanga hou te whakatika tonu i aua tohu.

He aha taku e taea ai te mahi i te kāinga mō taku hernia hiatal?

Mena kei te noho koe me te hernia hiatal e puta ai ngā tohumate i ētahi wā, ka taea e koe te rapu whakaora i te kāinga mā te whakamahi i ngā rongoā kore-tohu me ngā huringa āhua noho. Ka taea e ngā antacids - pērā i a Tums®, Rolaids®, Pepto-Bismol® (kei te wātea ngā rongoā rite i Sri Lanka, pātai atu ki tō tākuta, ki tō kaiwhakahaere rongoā rānei) - te āwhina ki te whakahaere i te mamae o te uma i ētahi wā, engari kāore i te tūtohutia kia whakamahia i ia wā. Ka taea hoki e koe te whakaiti i te auau me te kaha o te mamae o te uma mā te whakamahi i ētahi huringa āhua noho. Hei tauira:

• Kia mau ki te taupū papatipu tinana hauora (BMI) māu: Mena ko te taumaha rawa te take o ngā raruraru waikawa, he āwhina te whakaiti i te taumaha.
• Kai iti: Engari i te kai nui i te wā kotahi, kai iti. Mā tēnei ka whakaiti i te pēhanga ki tō puku.
• Whakaitihia ngā kai hinuhinu: Ko ngā kai he nui te hinu me te ngako ka nui ake te waikawa me ngā whākōkī ka puta i te puku.
• Kai wawe i te tina: Kaua e takoto mō ētahi haora i muri i te kai. Mā te kaha ā-papa koe e āwhina.
• Hurihia tō tūnga moe: Mā te moe me tō mahunga kia paku teitei ake i te pō, me te moe ki tō taha maui, ka āwhina i te ārai i te pikinga o te waikawa ki roto i tō korokoro. He urunga tinana kua hangaia mō tēnei.
• Kati te momi hikareti: Ka ngoikore te uaua o te uaua o raro o te esophagus i te momi hikareti. Ka taea hoki e ia te puta he maremare roa, ka pēhi i ngā uaua huri noa i te hernia hiatal.

Tērā pea ka kitea he hernia hiatal koe mā te tūpono ina haere koe ki te tākuta mō tētahi atu take. He mea tino noa tēnei, ā, ki te mea he iti tō hernia, ā, kāore he raruraru māu, ehara i te mea hei manukanuka. Tērā pea ka kitea he hernia hiatal koe i muri i ngā tau maha o ngā tohu, ā, i te mutunga ka rapu whakautu me te whakaora. Tērā pea ka miharo koe ki te mōhio ko tō reflux waikawa i puta mai i te hernia. Waimarie, kei reira ngā maimoatanga mō te reflux waikawa me te hernia hiatal. Ka whakawhirinaki te maimoatanga e hiahiatia ana e koe ki te momo hernia me ō tohu. I roto i te nuinga o ngā wā, ka taea e te rongoā me ngā huringa āhua noho te āwhina ki te whakahaere i tō reflux waikawa. I roto i ngā wā tino kino, ka hiahiatia pea he pokanga hei whakatika i te hernia. He tino angitu tēnei pokanga. Kia mārama tō tautuhi, ka haere koe ki te kimi whakaora i ō tohu.

Hei whakamutunga, ngā mea hei maumahara

Kāore he mea e wehi ai te hernia hiatal. He tokomaha te hunga e pāngia ana e tēnei mate, ā, kāore he tohu e whakaatu ana.

Heoi, ki te mea kei te mau tonu ngā tohu pēnei i te mamae o te uma, te kai e puta mai ana i roto i tō korokoro, te uaua rānei ki te horomi, me rapu tohutohu hauora koe. Nā te mea he mea nui kia mōhio pū koe mēnā he hernia hiatal te take, he mea kē atu rānei, ā, kia whiwhi ai koe i te maimoatanga e tika ana.

Ka taea te whakahaere pai i tēnei āhuatanga mā te whakarerekē i te momo noho, me te rongoā i ētahi wā. Ahakoa me mahi pokanga, kua oti inaianei mā ngā tikanga tino matatau, ā, he angitu ngā hua. Nō reira, kaua e mataku. Kōrero ki tō tākuta, ā, kimihia te otinga pai mōu. Te hernia hiatal, te mamae o te uma, te reflux waikawa, te GERD, te pokanga puku, te korokoro, te hernia.