Kodi pakhosi panu nthawi zonse pamakhala kupweteka? Izi zitha kukhala LPR (Laryngopharyngeal Reflux)!

Kodi nthawi zambiri mumamva ngati pali chotupa pakhosi panu, ngati kuti pali chinachake chomwe chatsekeka? Kodi nthawi zambiri mumamva ngati mukufuna kuchotsa pakhosi panu ndikunena kuti "Mm... Mm..."? Mungaganize kuti ndi chimfine kapena chifuwa cha fumbi. Koma ngati sichinathe kwa miyezi ingapo, chifukwa chake chingakhale chosiyana pang'ono komanso chakuya kuposa momwe mukuganizira. Lero tikulankhula za vuto "lobisika" lomwe anthu ambiri sadziwa, koma lomwe anthu ambiri ali nalo. Timatcha izi LPR, kapena Laryngopharyngeal Reflux.

Kodi LPR ndi chiyani? Kodi izi zimatchedwanso 'silent reflux'?

Chabwino, tiyeni tisunge izi mophweka. Mwina munamvapo za "gastritis" kapena "acid reflux." Apa ndi pamene madzi am'mimba omwe amathandiza kugaya chakudya amabwerera m'mimba. Nthawi zambiri, izi zikachitika, timamva kutentha pachifuwa kapena m'mimba mwathu. Matendawa timawatcha GERD (Gastroesophageal Reflux Disease).

Koma LPR ndi nkhani yosiyana pang'ono, yapadera. Chomwe chimachitika apa ndi chakuti asidi wotuluka m'mimba saima pachifuwa, koma amapitirira mpaka pakhosi (pharynx) ndi m'bokosi lomwe mawu anu ali (larynx).

Mwachidule, GERD ndi vuto lomwe limayambira pachifuwa. LPR ndi vuto lomwe limakula kwambiri ndipo limakhudza pakhosi. Anthu ena amatha kukhala ndi zonse ziwiri. Ena amatha kukhala ndi LPR yokha.

Kodi zizindikiro ziti zomwe zimasonyeza kuti munthu ali ndi matenda a LPR?

Ngati mwakhala ndi chimodzi kapena zingapo mwa zizindikirozi kwa nthawi yayitali, khalani ndi nkhawa. Tiyeni tiwone zazikulu.

N’chifukwa chiyani zinthu zomwe zili m’mimba zimafika pakhosi motere?

Kuti timvetse izi, tifunika kudziwa pang'ono za mmero wathu. Taganizirani izi ngati chubu chokhala ndi ma valve awiri pamwamba ndi pansi. Timatcha ma valve sphincters .

1. Valavu yomwe ili pansipa (Lower Esophageal Sphincter - LES):Izi zili pakati pa m'mero ​​ndi m'mimba (m'mero). Tikameza chakudya, chimatseguka kuti chakudya chilowe m'mimba, kenako chimatsekanso mwamphamvu. Izi zimaletsa asidi m'mimba kubwereranso.

2. Upper Esophageal Sphincter (UES): Valavu iyi ili pakati pa m'mero ​​ndi pakhosi. Ntchito yake ndikuletsa chilichonse chomwe chalowa m'mero ​​kuti chisabwerere mmwamba kupita kukhosi.

Kuti LPR ichitike, ma valve onsewa sayenera kugwira ntchito bwino. Choyamba, valavu yotsika (LES) iyenera kufooka, zomwe zimalola asidi m'mimba kubwerera mu mkodzo. Kenako, valavu yapamwamba (UES) iyenera kufooka, zomwe zimalola asidi kubwerera mu mkodzo.

Nanga n’chifukwa chiyani ma valve amenewa ndi ofooka?

Pakhoza kukhala zifukwa zambiri za izi. Zina ndi zakanthawi, zina ndi za nthawi yayitali.

1. Zinthu zomwe zimafooketsa LES

Nthawi zambiri, zifukwa zomwezo zomwe zimakhudza gastritis wamba zimakhudzanso izi.

• Mankhwala ena: Mankhwala ochepetsa ululu (NSAIDs), mankhwala ena ochepetsa kuthamanga kwa magazi (Calcium channel blockers), ndi mankhwala a matenda amisala (Tricyclic antidepressants) angayambitse kumasuka kwa valavu iyi.
• Izi zitha kuchitikanso ndi zakudya ndi zakumwa zina: khofi, chokoleti, timbewu ta ...
• Zizolowezi zoipa:
• Kugona pansi maola 2-3 mutadya.
• Kudya kwambiri nthawi imodzi kungayambitse kutupa m'mimba. Izi zimawonjezera kupanikizika m'mimba ndikukweza asidi.
• Kuvala zovala zothina pamimba, makamaka mozungulira chiuno.
• Zifukwa za nthawi yayitali:
• Hiatal Hernia: Izi zimachitika pamene gawo laling'ono la mimba limatuluka m'chifuwa. Izi zimafooketsa ntchito ya valavu ya LES.
• Kunenepa kwambiri: Pamene kulemera kukukwera, kupanikizika m'mimba kumawonjezeka. Ichi ndi chifukwa chachikulu chomwe chimayambitsa vutoli.
• Mimba: Kusintha kwa mahomoni ndi kupanikizika kwakukulu m'mimba panthawiyi kungayambitse gastritis ndi LPR kwakanthawi.
• Kusuta: Kusuta ndi mdani wamkulu amene amamasula valavu iyi.

2. Zinthu zomwe zimafooketsa sphincter ya upper esophageal (UES)

Asidi akatuluka kudzera mu valavu yapansi, valavu yapamwamba ndiye chotetezera pakhosi. Pakhosi pathu sipanapangidwe kuti pakhale asidi monga m'mero. Choncho ngakhale asidi wochepa kwambiri akhoza kuwononga kwambiri.

• Kugona pansi: Tikagona pansi, ma valve onsewa amakhala omasuka pang'ono. Izi zimapangitsa kuti LPR ichitike usiku tikamagona.
• Kuboola: Mukaboola, ma valve onse awiri amatseguka, zomwe zimapangitsa kuti asidi pang'ono alowe pakhosi panu pamodzi ndi mpweya.
• Kuwerama patsogolo, kuchita masewera olimbitsa thupi, kuimba: Zochita ngati izi zitha kuwonjezera kupanikizika pansi pa valavu yapamwamba, ndikuyifooketsa.
• Kusuta ndi mowa: Zonsezi ndi zovulaza mofanana ma valve onse awiri.

Kodi n'koopsa kunyalanyaza momwe munthu alili ndi matenda a LPR?

Inde, ngati vutoli lipitirira kwa nthawi yayitali, mavuto ena angachitike.

• Matenda obwera pafupipafupi: Asidi pakhosi amasokoneza njira yoyeretsera yachilengedwe pakhosi ndi m'mphuno. Izi zingayambitse kusungunuka kwa mamina ndi matenda obwera pafupipafupi pakhosi ndi m'mapapo.
• Mavuto a mawu ndi pakhosi kwa nthawi yayitali: Kukumana ndi asidi nthawi zonse kumatha kuwononga mitsempha ya mawu, zomwe zimayambitsa zinthu monga zilonda za mitsempha ya mawu. Kukumana ndi vutoli kwa nthawi yayitali kungawonjezere pang'ono chiopsezo cha khansa ya m'khosi.
• Mavuto a kupuma: Asidi wochepa amene amalowa pakhosi amatha kuyenda m'mapapo popanda kuzindikira, makamaka tikagona. Izi zimatchedwa silent aspiration . Izi zingayambitse matenda a m'mapapo ndi matenda monga bronchitis.

Kodi ndingadziwe bwanji bwino lomwe kuti LPR ndi chiyani?

Ngati mwakhala mukukumana ndi zizindikiro zomwe takambirana kale kwa nthawi yayitali, chinthu chabwino kuchita ndikuwonana ndi katswiri wa khutu, mphuno, ndi pakhosi (ENT Surgeon) . Iye adzamvetsera zizindikiro zanu ndikufufuza pakhosi panu.

Mayeso akuluakulu omwe nthawi zambiri amachitidwa pa izi ndi laryngoscopy yosinthasintha . Izi zimaphatikizapo kulowetsa chubu chopyapyala kwambiri, chokhala ndi kamera kudzera mu mphuno yanu ndikutsika pakhosi kuti muwone mkati mwa mawu ndi pakhosi panu. Iyi ndi njira yopanda ululu yomwe ingathe kuchitika mumphindi zochepa.

Kuyezetsa kumeneku kungayang'ane kufiira ndi kutupa pakhosi. Nthawi zina, mayeso ena angafunike kuti atsimikizire matenda kapena kuti apeze zifukwa zina.

• Upper Endoscopy: Izi zimaphatikizapo kulowetsa kamera kudzera pakamwa kuti ione m'mero ​​ndi m'mimba. Ikhoza kuyang'ana mavuto a m'mero ​​ndi m'mimba.
• Kuyesa kwa pH ya m'mimba: Izi zimayesa kuchuluka kwa asidi pakhosi ndi m'mero ​​kwa maola 24.
• Esophageal Manometry: Mayeso omwe amayesa ntchito ndi mphamvu ya minofu ya m'mero ​​ndi ma valve ake.

Chabwino, kodi tichite chiyani pa izi tsopano? Kodi mankhwala ake ndi otani?

Chofunika kwambiri pochiza matenda a LPR ndikusintha moyo ndi zakudya zomwe munthu amadya . Mankhwala ndi achiwiri.

1. Kusintha moyo ndi kadyedwe (izi ndiye zofunika kwambiri)

Ngati mutsatira bwino zizolowezi zimenezi, nthawi zambiri mutha kuwongolera vutoli popanda mankhwala.

2. Chithandizo cha mankhwala osokoneza bongo

Pamene mukusintha moyo wanu, dokotala wanu angakupatseni mankhwala othandizira minofu ya pakhosi yowonongeka kuchira.

• Mankhwala Oletsa Pump ya Proton (PPIs): Mankhwala monga Omeprazole ndi Pantoprazole amagwira ntchito pochepetsa kupanga asidi m'mimba. Mankhwalawa nthawi zambiri amaperekedwa kwa miyezi ingapo.
• Mankhwala Oletsa H2: Mankhwala monga Famotidine amathandizanso kuchepetsa asidi.
• Ma Alginates: Izi zimapanga gawo loteteza m'mimba, zomwe zimaletsa asidi kutuluka.

3. Opaleshoni

Izi sizimafunikira kawirikawiri. Opaleshoni imaganiziridwa pokhapokha ngati pali vuto linalake lakuthupi, monga hernia yobadwa nayo, kapena ngati palibe chithandizo china chomwe chathandiza.

Pomaliza, LPR ndi vuto losasangalatsa, koma lingathe kuthandizidwa bwino ngati litathandizidwa bwino. Chofunika kwambiri ndi kusanyalanyaza zizindikiro, kupeza matenda olondola, komanso makamaka kukhala oleza mtima ndi kusintha kofunikira kwa moyo.