Kei a koe anō hoki te āhua o te wera tonu i roto i tō uma, me te reka kawa i roto i tō korokoro? Ka kino ake tēnei āhua mēnā he paku kakara te kai e kainga ana e koe, mēnā rānei ka takoto koe mō tētahi wā i muri i te kai i te pō? Koinei te tohu matua o tētahi āhua e kiia nei e te tini he "gastritis", engari i roto i ngā kupu hauora ka kiia e mātou ko te Gastroesophageal Reflux Disease, ko te GERD rānei te poto. I ētahi wā, ahakoa te tango rongoā me te huri i te āhua noho, kāore e whakaiti i tēnei āhua whakarihariha. I ēnei wā, i tēnei rā ka kōrero tātou mō tētahi pokanga motuhake e taunakihia ana e ngā tākuta.
Tuatahi, he aha te GERD?
I te whakarapopototanga, he mate te GERD e puta ana i roto i tā tātou pūnaha nakunaku. He ngongo kei reira e kawe ana i te kai e kainga ana e tātou mai i tō tātou waha ki tō tātou puku (puku), ā, e kiia ana e tātou ko te esophagus . I te nuinga o te wā, he takirere kei waenganui i te esophagus me te puku hei ārai i ngā waikawa kaha i roto i te puku, e āwhina ana ki te nakunaku i te kai, kei hoki ki runga i te esophagus.
Engari i roto i te GERD, kāore tēnei takirere e mahi tika, nō reira ka rere anō te waikawa o te puku me te kai kua nakunaku ki roto i te korokoro. Kāore he aha mēnā ka puta kotahi, e rua rānei, engari ki te puta tonu, ka roa rānei, ka kiia ko te GERD. Ko tēnei waikawa te mea e meinga ai koe kia rongo i ngā mea pēnei i te wera i roto i tō uma me te mamae o te korokoro.
Nā, he aha tēnei pokanga Nissen Fundoplication?
Āe, me kōrero tātou mō tēnei pokanga. Ko te Nissen Fundoplication he pokanga i kōrerotia e au i mua ake nei hei whakatika i te mate GERD. Ko tā tēnei he whakapakari i te wāhanga e mahi ana pērā i te takirere e tūtaki ai te korokoro me te puku.
Me pēhea te mahi? Whakaarohia ka tangohia e tā mātou taote pokanga te pito o runga o te puku (e kiia ana ko te fundus) ka takai ki te pito o raro o te esophagus ka whakau. He rite ki te tango i tētahi wahi kakahu ka takai ki tētahi ngongo ka herea he pona. Ka whakau tēnei i te wāhanga wetekina, he rite ki te takirere, ka ārai i te waikawa o te puku kia hoki ake. Koinei te mea matua e tupu ana me tēnei pokanga.
E rua ngā huarahi hei mahi i tēnei pokanga.
E rua ngā huarahi matua e whakahaerehia ai tēnei pokanga e ngā tākuta. Mā tō tākuta e whakatau ko tēhea tikanga te mea pai mōu i runga i tō āhua.
| Tikanga pokanga | Whakaahuatanga |
|---|---|
| Tukanga Laparoscopic | Koinei te tikanga hou, e whakamahia whānuitia ana. I konei, kāore he tapahi nui e mahia ana ki te puku. Engari, ka mahia te pokanga mā te hanga i ngā tapahi iti rawa e 4, e 5 rānei, ka whakauruhia he kāmera (Laparoscope) mā roto i tētahi o ngā tapahi, ā, ka whakauruhia he taputapu pokanga iti rawa mā roto i ngā tapahi kē atu. Ka tirohia ngā whakaahua mai i te kāmera ki runga i te aroturuki, ā, ka taea te mahi i te pokanga me te tino ātaahua. |
| Tukanga Tuwhera | Koinei te tikanga tuku iho. I konei, ka tapahia he tapahi nui ake i roto i te puku, kia taea ai e te taote pokanga te kite tika i ngā whekau. Ka whakamahia tēnei tikanga ina he raruraru kē atu, ina kore rānei e taea te whakamahi i te tikanga laparoscopic. |
Ko wai e hiahia ana kia mahia tēnei pokanga?
Ehara i te mea ko te hunga katoa e pāngia ana e te GERD e hiahia ana ki tēnei pokanga.
I te tīmatanga, ka ngana tō tākuta ki te whakahaere i te mate mā te rongoā me te whakarerekē i te āhua noho (hei tauira, te whakaiti i ngā kai raukikī me ngā kai hinuhinu, me te tango i tētahi okiokinga roa atu i te kai i te pō i mua i te moe).
Heoi, ki te kore ō tohumate e pai ake ahakoa ēnei mahi, ki te kore rānei koe e pai ki te tango rongoā mō te wā roa, ki te pāngia rānei koe e ētahi atu pānga taha o te rongoā, ka tūtohu pea tō tākuta i te Nissen Fundoplication. Ka taea te mahi i tēnei pokanga ki ngā tamariki me ngā pakeke.
He aha tāu e mahi ai i mua i te pokanga?
I muri i te whakatau kia pokangahia, ka whakahaua e tō tākuta ētahi whakamātautau hei aromatawai tika i te āhua o tō korokoro me tō puku.
- Ngā hihi-X o te puku (Horomanga Pāriuma): Ka horomia he wai motuhake e kiia nei ko te pāriuma, ā, ka tangohia ngā whakaahua o te hihi-X i a ia e heke ana i te korokoro. Ka āwhina tēnei ki te whakatau mēnā he aukati kei roto i te korokoro.
- Manometri Esophageal: Ka whakauruhia he ngongo iti mā roto i tō ihu ki roto i tō esophagus, ka ine i te pēhanga i roto i ngā uaua o tō esophagus ina horomia e koe tetahi mea.
- Endoscopy o Runga: Ko te whakamātautau "endoscopy" e mōhiotia ana e tātou katoa. Ka whakauruhia he ngongo me te kāmera e piri ana mā te waha, ā, ka tirohia te korokoro, te puku, me te wāhanga tuatahi o te whekau iti.
- Pūwhakamātautau pH: He whakamātautau e ine ana i te nui o te waikawa i roto i te korokoro me te roa o tōna noho ki reira.
Ka taea e ēnei whakamātautau te kite i tētahi āhuatanga e kiia nei ko te hernia hiatal . Koinei te wā e puta ai te wāhanga o runga o te puku ki roto i te kōhao o te uma. Ka taea hoki e tēnei te whakanui ake i ngā tohu GERD. Ka taea hoki te whakatika i tēnei āhuatanga mā te pokanga.
He aha ngā mea ka tupu i muri i te pokanga?
Ina oho ake koe i muri i te pokanga, kei roto koe i te wāhanga tiaki.
- Tērā pea ka mamae tō korokoro i ngā rā tuatahi e rua.
- Mena i pokanga tuwhera koe, ka whakauruhia he ngongo (Nasogastric - NG tube) mā roto i tō ihu hei tango i te wai e kohia ana i roto i tō puku. Ka tangohia i muri i tētahi wā.
- Kia taea rā anō e koe te kai me te inu anō, ka hoatu he wai ki a koe mā te raina IV.
- Ina puta te hau, ina puta rānei te puku, ko te tikanga kei te tīmata anō te pūnaha nakunaku ki te mahi i te āhua noa. Whai muri i tēnā, ka taea e koe te tīmata kai mārire.
I te nuinga o te wā, ki te pokanga laparoscopic koe, ka taea e koe te hoki ki te kāinga i roto i te rā kotahi, e rua rānei. Ki te pokanga tuwhera koe, me noho koe ki te hōhipera mō ētahi rā.
He aha ngā painga me ngā mōrearea o tēnei pokanga?
Pērā i tētahi atu kōwhiringa, he painga, he iti hoki ngā mōrearea o tēnei.
Ko te painga matua ko te whakaora nui i ngā tohumate GERD. Kua kore te mamae o te puku me te ruaki tonu. Ka āwhina hoki ki te whakaiti i te tūponotanga o te mate pukupuku korokoro (te korokoro a Barrett) nā te GERD i te wā roa. Ina koa mēnā ka mahia te pokanga mā te laparoscopy, ka iti ake te mamae, ka tere ake te ora, ā, ka poto ake te noho hōhipera.
Mō ngā mōrearea , ko te mea nui, i ētahi wā, kāore e pumau te whakaoranga mai i tēnei pokanga. Tērā pea he tokoiti noa iho ngā tāngata e hiahia ana kia pokanga anō i roto i ētahi tau. Waihoki, pērā i ngā pokanga katoa, he iti noa te mōrearea o te pangia o te patunga.
Kia pēhea te roa o te wā e ora ai?
I muri i tō hokinga ki te kāinga, tera pea ka tūtohu tō tākuta i tētahi kai wai, kai ngohengohe rānei mō ngā wiki tuatahi, e rua rānei. Hei tauira, he hupa, he miraka kawa, he pāreti, me ngā rīwai penupenu. Whai muri i tēnā, ka taea e koe te neke haere ki ngā kai noa.
Ka taea e koe te hoki anō ki ngā mahi o ia rā i roto i ētahi rā i muri i te pokanga. Heoi, he mea pai kia kaua e hiki taumaha, e whakakorikori tinana rānei mō te toru wiki pea te roa. Ma tō tākuta koe e hoatu he tohutohu motuhake mō tēnei.
Āhea koe e hiahia ana ki te kite anō i te tākuta?
Ki te hoki mai ō tohu i muri i te pokanga, me toro atu ki tō tākuta. He mea noa anō hoki te pupuhi i te taha o te patunga pokanga. Heoi, ki te pāngia koe e tētahi o ēnei tohu e whai ake nei, waea atu ki tō tākuta tonu.
- Mena kei te toto te patunga
- Mena ka nui haere te pupuhi
- Ki te pāngia koe e te kirika
- Mena he whero te kiri huri noa i te patunga, ā, he wera hoki te āhua
- Mena ka puta te ruaki
Karere Tangohia ki te Kāinga
- He pokanga angitu te Nissen Fundoplication mō te GERD kino (ngā mamae o te puku/reflux) e kore e taea te whakahaere mā te rongoā.
- Ka aukatihia e tēnei pokanga te pikinga anō o te waikawa o te puku ki roto i te korokoro.
- He maha ngā wā ka mahia tēnei pokanga mā te whakamahi i tētahi kāmera (laparoscopic), kia iti ake ai te mamae, kia tere ake ai hoki te ora.
- I muri i te pokanga, he mea tino nui kia whai i te kai me ngā tohutohu a te tākuta kia tere ai te ora.
- Ki te puta anō ngā tohu, ngā tohu rānei o te mate pāwera i te patunga, me toro atu ki tō tākuta i taua wā tonu.











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