He maha ngā wā ka rongo koe i te ahua kei roto i tō korokoro he pūwero, me te mea kei te mau tetahi mea? He maha ngā wā ka hiahia koe ki te horoi i tō korokoro me te kī "Mm... Mm..."? Tērā pea ka whakaaro koe he makariri, he mate pāwera rānei ki te puehu. Engari, ki te kore e memeha mō ngā marama, tera pea he rerekē te take, he hohonu ake i tō whakaaro. I tēnei rā kei te kōrero tātou mō tētahi raruraru "huna" kāore i te mōhiotia e te tini o te tangata, engari he maha ngā tāngata e mōhiotia ana. Ka huaina tēnei ko te LPR, ko te Laryngopharyngeal Reflux rānei.
He aha te LPR? E kiia ana hoki tēnei ko te 'reflux puku'?
Āe, kia māmā noa iho tēnei. Kua rongo pea koe i te kupu "gastritis" me te "acid reflux" rānei. Koinei te wā e hoki ake ai ngā wai o te puku e āwhina ana ki te nakunaku kai ki roto i te esophagus. I te nuinga o te wā, ina tupu tēnei, ka rongo tātou i te werawera i roto i tō tātou uma, i te puku rānei. Ka kiia tēnei mate ko te GERD (Gastroesophageal Reflux Disease).
Engari he rerekē te LPR, he āhuatanga motuhake. Ko te mea e tupu ana i konei, kāore te waikawa e puta mai ana i te puku e mutu ki te uma, engari ka haere ki runga ki tō korokoro (pharynx) me te pouaka kei reira ō taura reo (larynx).
Ko te mea nui, ehara i te mea ko te katoa e pāngia ana e te LPR ka pāngia e te mamae o te uma. He tokomaha te hunga kāore e mōhio he raruraru kei a rātou te reflux waikawa. Koia i huaina ai ko te "reflux puku ". Nā te mea kei roto i te korokoro, te reo, me te ihu ngā tohu, he tokomaha te hunga e whakaaro ana he mea kē atu.
Ki te kī māmā noa, he raruraru te GERD e tīmata ana i te uma. He raruraru te LPR e piki haere ana, ā, ka pā ki te korokoro. Ka pāngia ētahi tāngata e rua. Ka pāngia ētahi e te LPR anake.
He aha ngā tohu e tohu ana i te LPR?
Mena kua roa koe e pāngia ana e tētahi, e ētahi rānei o ēnei tohu, kia āwangawanga koe. Me titiro tātou ki ngā mea matua.
| Tohu | He aha ngā kare ā-roto e pā ana ki a koe? |
|---|---|
| Te pāorooro o te reo | He rerekē te ahua o tōku reo i taku oho ake i te ata. Kāore i te mārama te reo i te roanga o te rā. |
| Te ahua kei te mau tetahi mea i roto i te korokoro | He rite tonu ki te mea he puku, he pōro hūpē rānei e piri ana i roto i tōku korokoro. |
| Te horoi pinepine i te korokoro | Kei te ngana tonu rātou ki te 'whakakore' i ō rātou korokoro tae noa ki te whakararuraru i ētahi atu. |
| Te maremare roa | He maremare maroke tōku kua maha ngā marama e mau tonu ana, kāore he take e kitea ana. |
| He nui rawa te hūpē, te rewharewha rānei | He hūpē tonu kei roto i te korokoro. Me te mea kei te rere te hūpē mai i te ihu i te korokoro (he maturuturunga i muri i te ihu). |
| Te uaua ki te horomi | He rite ki te mea he pupū kei roto i tō korokoro ina horomia e koe te kai, te inu rānei. |
| Te korokoro mamae tonu | He mamae tonu tōku korokoro, engari kāore he kirika, he makariri rānei. |
| Te whakanui ake i te mate huango | Mena kua pāngia koe e te mate huango, ka uaua ki te whakahaere, ka puta mai rānei ngā tohumate hou rite ki te mate huango. |
He aha te take e piki ake ai ngā mea o roto i te puku ki roto i te korokoro pēnei?
Hei mārama ki tēnei, me mōhio tātou ki te iti o te kōrero mō tō tātou korokoro. Whakaarohia he ngongo me ngā takirere e rua i te tihi me te raro. Ka kiia ēnei takirere he sphincters .
1. Ko te takirere i raro (Lower Esophageal Sphincter - LES):Kei waenganui i te korokoro me te puku (korokoro) tēnei. Ina horomia te kai, ka tuwhera kia uru te kai ki roto i te puku, kātahi ka kati pūmau anō. Mā tēnei ka ārai i te pikinga ake o te waikawa o te puku.
2. Te Pūnaha Whakapūngao o te Esophagus o Runga (UES): Kei waenganui i te esophagus me te korokoro tēnei takirere . Ko tana mahi he aukati i ngā mea katoa kua uru ki te esophagus kei hoki ki runga ki te korokoro.
Kia puta ai te LPR, me kore e tika te mahi a ēnei takirere e rua. Tuatahi, me ngoikore te takirere o raro (LES), kia hoki ai te waikawa o te puku ki roto i te korokoro. Kātahi, me ngoikore te takirere o runga (UES), kia hoki ai te waikawa ki roto i te korokoro.
Nā, he aha i ngoikore ai ēnei takirere?
He maha ngā take mō tēnei. Ko ētahi he wā poto, ko ētahi he wā roa.
1. Ngā mea e ngoikore ai te LES
I te nuinga o te wā, ka pāngia anō tēnei e ngā tino take e pā ana ki te gastritis noa.
- Ētahi rongoā: Ka taea e ngā rongoā mamae (NSAID), ētahi rongoā mō te toto toto tiketike (ngā aukati hongere konupūmā), me ngā rongoā mō ngā raruraru hauora hinengaro (ngā rongoā antidepressants Tricyclic) te whakangāwari i tēnei takirere.
- Ka taea hoki tēnei te puta mai i ētahi kai me ngā inu: kawhe, tiakarete, miniti, kāriki, riki, me te waipiro.
- Ngā whanonga kino:
- Te takoto i muri i te 2-3 haora i muri i te kai.
- Ka pupuhi te puku i te kai nui i te wā kotahi. Ka piki ake te pēhanga i roto i te puku, ka pana ake hoki te waikawa.
- Te mau i ngā kākahu piri ki te puku, inā koa ki te hope.
- Ngā take mō te wā roa:
- Hernia Hiatal: Koinei te wā e puta ai tētahi wāhanga iti o te puku ki roto i te uma. Ka ngoikore te mahi a te takirere LES.
- Momona: I te pikinga o te taumaha, ka piki ake te pēhanga i roto i te puku. He tino take nui anō hoki tēnei.
- Te Hapūtanga: Ka taea e ngā huringa homoni me te pikinga o te pēhanga i roto i te puku i tēnei wā te whakararu i te gastritis me te LPR mō tētahi wā poto.
- Te kai hikareti: Ko te kai hikareti tētahi o ngā hoariri nui e whakangāwari ana i tēnei ārai.
2. Ngā mea e ngoikore ai te uaua o te esophageal o runga (UES)
I muri i te putanga ake o te waikawa mā te takirere o raro, ko te takirere o runga te ārai whakamutunga e tiaki ana i te korokoro. Kāore ō tātou korokoro i hangaia kia tu atu ki te waikawa pērā i te korokoro. Nō reira , ahakoa he iti noa te waikawa ka pā he kino nui.
- Te takoto: Ina takoto tātou, ka paku wetekina ēnei takirere e rua. Nā tēnei ka nui ake te tūponotanga o te LPR i te pō i a tātou e moe ana.
- Te pupuhi: Ina pupuhi koe, ka tuwhera ngā takirere e rua, ka taea ai te uru o te waikawa iti ki roto i tō korokoro me te hau.
- Te piko whakamua, te whakakorikori tinana, te waiata: Ka taea e ēnei mahi te whakanui ake i te pēhanga i raro i te takirere o runga, ka ngoikore ai.
- Te momi hikareti me te waipiro: He rite tonu te kino o ngā mea e rua ki ngā takirere e rua.
He mea morearea te kore aro ki te tūnga LPR?
Āe, ki te roa te noho o tēnei āhuatanga, tera pea ka puta ētahi raruraru.
- Ngā mate pāwera auau: Ka whakararuraru te waikawa i roto i te korokoro i te tukanga horoi taiao o te korokoro me ngā ihu. Ka arahi pea tēnei ki te hanga huware me ngā mate pāwera auau o te korokoro me te ara manawa.
- Ngā raruraru roa o te reo me te korokoro: Ka taea e te pānga tonu ki te waikawa te kino i ngā taura reo, ka puta ai ngā āhuatanga pēnei i te whara o ngā taura reo. Mēnā ka roa te pānga ki tēnei āhuatanga, ka paku piki ake te mōrearea o te mate pukupuku o te korokoro.
- Ngā raruraru manawa: Ka taea e te iti o te waikawa e uru ana ki te korokoro te piki ake i te trachea ki roto i ngā pukahukahu me te kore e mōhiotia e tātou, inā koa i te wā e moe ana. Ka kiia tēnei ko te manawa puku . Ka taea e tēnei te arahi ki ngā mate pukahukahu me ngā mate pēnei i te bronchitis.
Me pēhea taku mōhio he aha te LPR?
Mena kua roa koe e pāngia ana e ngā tohu i kōrerotia i mua ake nei, ko te mea pai ko te toro atu ki tētahi tohunga taringa, ihu, me te korokoro (Taonga ENT) . Ka whakarongo ia ki ō tohu, ka tirotiro hoki i tō korokoro.
Ko te whakamātautau matua e mahia ana mō tēnei ko te laryngoscopy ngāwari . Ko te whakauru i tētahi ngongo angiangi rawa, kei roto i te kāmera, mā roto i tō ihu, ka heke ki raro i tō korokoro hei tirotiro i te roto o ō taura reo me tō korokoro. He tikanga kore mamae tēnei, ka taea te mahi i roto i ētahi meneti torutoru.
Mā tēnei whakamātautau ka tirohia te whero me te pupuhi o te korokoro. I ētahi wā, me whai atu whakamātautau hei whakaū i te mate, hei whakakore rānei i ētahi atu take.
- Endoscopy o Runga: Ko te whakaurunga o tētahi kāmera mā roto i te waha hei tirotiro i te korokoro me te puku. Ka taea te tirotiro mō ngā raruraru o te sphincter korokoro o raro (LES) me te hernia hiatal.
- Whakamātautau pH o te korokoro: Mā tēnei ka ine i ngā taumata waikawa i roto i te korokoro me te korokoro mō te wā 24-hāora.
- Manometri Esophageal: He whakamātautau e ine ana i te mahi me te kaha o ngā uaua o te esophagus me ōna takirere.
Āe, me aha tātou mō tēnei inaianei? He aha ngā maimoatanga?
Ko te mea nui i roto i te rongoā i te LPR ko te hanga i ngā huringa ki te momo noho me ngā tikanga kai . Ko te rongoā te tuarua.
1. Te whakarerekē i te āhua noho me ngā tikanga kai (koinei te mea tino nui)
Ki te whai tika koe i ēnei tikanga, ka taea e koe te whakahaere i tēnei mate me te kore rongoā.
| Me aha? | Whakaahuatanga |
|---|---|
| Whakaitihia ngā kai. | Engari kaua e kai nui i te wā kotahi, engari me kai iti noa iho e rima, e ono rānei ngā wā i te rā. |
| Āta karohia ētahi kai | Whakaitihia te kai i ngā kai hinuhinu, kai raukikī, kai waikawa nui (tōmato, karaka, raima), kawhe, tiakarete, miniti, me ngā inu waro (houra) ki te nui rawa e taea ana. |
| Kai wawe i te tina. | Kai i te tina i te iti rawa i te toru hāora i mua i te moe. Kaua e takoto i muri i te kai. |
| Hurihia tō tūranga moe. | Moe me te upoko o te moenga kia hiki ake kia 6 inihi te teitei. Kaua e hiki noa tō upoko me ngā urunga e rua, e toru rānei, engari me hiki ake te moenga. Ka whakaitihia hoki e te moe ki tō taha maui te waikawa o te tinana. |
| Kati te momi hikareti me te inu waipiro. | Kei te tino kino rawa atu te āhuatanga o te LPR nā ēnei tokorua. He mea nui kia mutu rawatia rāua. |
| Whakahaerehia tō taumaha. | Mena he taumaha rawa koe, mā te whakaiti i tō taumaha ka whakaiti i te pēhanga ki tō puku, ā, ka tino whakahaere i ngā tohumate. |
2. Te rongoā rongoā
I a koe e whakarerekē ana i te momo noho, ka tohua pea e tō tākuta he rongoā hei āwhina i te whakaora i te kiko korokoro kua pakaru.
- Ngā Ārai Papu Porotene (PPI): Ko ngā rongoā pēnei i te Omeprazole me te Pantoprazole ka whakaiti i te hanga waikawa i roto i te puku. He maha ngā marama ka tohua ai ēnei.
- Ngā Ārai H2: Ka āwhina anō hoki ngā rongoā pēnei i a Famotidine ki te whakahaere i te waikawa.
- Ngā Alginate: Ka hangaia e ēnei he paparanga tiaki ki te puku, hei ārai i te putanga mai o te waikawa.
He mea nui: Me whakamahi noa i ēnei rongoā i raro i te tohutohu a tō tākuta. Kaua e rongoā-whaiaro.
3. Pokanga
Kāore tēnei e hiahiatia ana i ētahi wā. Ka whakaarohia te pokanga mēnā he raruraru tinana motuhake, pērā i te hernia hiatal, mēnā rānei kāore he maimoatanga kē atu i āwhina.
Hei whakamutunga, he āhua whakarihariha te LPR, engari ka taea te whakahaere pai mēnā ka whakahaerea tika. Ko te mea nui ko te kaua e warewarehia ngā tohu, te tiki i tētahi tātaritanga tika, me te manawanui ki ngā huringa o te momo noho e tika ana.
Karere Tangohia ki te Kāinga
- He āhuatanga te LPR e puta ana ina piki ake te waikawa o te puku ki roto i te korokoro. E kiia ana ko te "reflux puku" nā te mea kāore he kare wera i roto i te uma.
- Ko ngā tohu matua ko te maremare tonu, te hūpē i roto i te korokoro, te reo pārū, me te āhua kei te mau tetahi mea i roto i te korokoro.
- Kaua e whakaaro he makariri, he mate pāwera rānei ēnei tohu. Mēnā ka mau tonu, tirohia he tākuta.
- Ko te taahiraa tuatahi, ko te mea nui rawa atu hoki, ko te whakarerekē i tō kai me tō momo noho. He mahi tautoko tā ngā rongoā.
- Kaua e takoto mō ngā haora e toru i muri i te kai. Moe me te upoko o te moenga kia teitei ake i te pō. Kati rawa te kai hikareti me te waipiro.
- Mena kei te ruarua koe mō ō tohu, me toro atu ki tētahi tohunga taringa, ihu, me te korokoro (Taonga ENT) mō ngā tohutohu tika.
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