Unowanzo nzwa sekuti pane bundu pahuro pako, sekunge pane chinhu chakanamira here? Unowanzo nzwa kuda kuchenesa pahuro pako woti "Mm... Mm..."? Ungafunga kuti dzihwa kana kuti allergy yeguruva. Asi kana risina kupera kwemwedzi yakati wandei, chikonzero chingave chimwe chinhu chakasiyana uye chakadzama kupfuura zvaunofunga. Nhasi tiri kutaura nezvedambudziko "rakavanzika" iro vanhu vazhinji vasingazive nezvaro, asi iro vanhu vazhinji vane. Tinoridaidza kuti LPR, kana kuti Laryngopharyngeal Reflux.
Chii chinonzi LPR? Izvi zvinonziwo 'silent reflux' here?
Zvakanaka, ngatirambei tichiita izvi zviri nyore. Ungave wakambonzwa nezve "gastritis" kana "acid reflux." Apa ndipo apo muto wemudumbu unobatsira kugaya chikafu unodzokera mugurokuro. Kazhinji, kana izvi zvikaitika, tinonzwa kupisa muchipfuva kana mudumbu. Tinodaidza chirwere ichi kuti GERD (Gastroesophageal Reflux Disease).
Asi LPR yakasiyana zvishoma, inokosha. Chinoitika pano ndechekuti acid inobuda mudumbu haimire pachipfuva, asi inofamba ichienda muhuro (pharynx) uye mubhokisi rine tambo dzenzwi (larynx).
Chinhu chakakosha ndechekuti havasi vese vane LPR vanotambura nechirungurira. Vanhu vazhinji havazivi kuti vane dambudziko reacid reflux. Ndosaka ichinziwo " silent reflux." Nekuti zviratidzo zviri pahuro, inzwi, uye mhino, vanhu vazhinji vanofunga kuti chimwe chinhu chakasiyana.
Zvichitaurwa zviri nyore, GERD idambudziko rinotangira muchipfuva. LPR idambudziko rinokwira zvakanyanya uye rinokanganisa pahuro. Vamwe vanhu vanogona kuva nezvose zviri zviviri. Vamwe vanhu vanogona kuva neLPR chete.
Ndezvipi zviratidzo zvinoratidza kuti munhu ane LPR?
Kana wave uine chimwe chezviratidzo izvi kwenguva yakareba, netseka. Ngatitarisei zvikuru.
| Chiratidzo | Izvi zvinokuita kuti unzwe sei? |
|---|---|
| Kushoshoma kwezwi | Inzwi rangu rinonzwa zvakasiyana pandinomuka mangwanani. Izwi rangu harinzwiki zvakanaka mukati mezuva rose. |
| Kunzwa sekunge pane chinhu chakabatwa pahuro | Zvinogara zvichiita sekunge pane bundu kana bhora remanyoka rakanamira pahuro pangu. |
| Kuchenesa pahuro nguva nenguva | Vanogara vachiedza 'kusunungura' huro dzavo kusvika pakukonzera matambudziko kune vamwe. |
| Kukosora kwenguva refu | Ndine chikosoro chakaoma chave chichindinetsa kwemwedzi yakawanda, pasina chikonzero chakajeka. |
| Manyoka akawandisa kana kuti phlegm | Muhuro munogara muine madzihwa. Zvinoita sekunge madzihwa ari kuyerera muhuro achibva mumhino (postnasal drip). |
| Kuoma kumedza | Zvinoita sekunge pane bundu pahuro pako paunomedza chikafu kana chinwiwa. |
| Huro inorwadza nguva dzose | Ndinogara ndichinzwa kurwadziwa pahuro pasina fivha kana dzihwa. |
| Kuwedzera kweasthma | Kana uchitova neasthma, zvinova zvakaoma kudzora kana kuti zviratidzo zvitsva zvakafanana neasthma zvinoonekwa. |
Sei zvinhu zviri mudumbu zvichikwira muhuro seizvi?
Kuti tinzwisise izvi, tinofanira kuziva zvishoma nezvegurokuro redu. Funga nezvaro sechubhu ine mavharuvhu maviri kumusoro nepasi. Tinodaidza mavharuvhu aya kuti sphincters .
1. Vharuvhu iri pazasi (Lower Esophageal Sphincter - LES):Izvi zviri pakati pegurokuro nedumbu (sophagus). Patinomedza chikafu, chinovhurika kuti chikafu chipinde mudumbu, uye chinovhara zvakasimba zvakare. Izvi zvinodzivirira acid yemudumbu kuti isadzoke zvakare.
2. Upper Esophageal Sphincter (UES): Vharuvhu iyi iri pakati pegurokuro nepahuro. Basa rayo nderekumisa chero chinhu chapinda mugurokuro kuti chisadzokere kumusoro muhuro.
Kuti LPR iitike, mavharuvhu ese aya haafanire kushanda nemazvo. Kutanga, vharuvhu repasi (LES) rinofanira kupera simba, zvichiita kuti acid yemudumbu idzokere mugurokuro. Zvadaro, vharuvhu repamusoro (UES) rinofanira kupera simba, zvichiita kuti acid idzokere mugurokuro.
Saka, nei mavharuvhu aya asina simba?
Panogona kuva nezvikonzero zvakawanda zveizvi. Zvimwe ndezvenguva pfupi, zvimwe ndezvenguva refu.
1. Zvinhu zvinoderedza simba reLES
Kazhinji, zvikonzero zvakafanana zvinokanganisa gastritis yakajairika zvinokanganisawo izvi.
- Mimwe mishonga: Mishonga inouraya marwadzo (NSAIDs), mimwe mishonga yeBP yakakwira (Calcium channel blockers), uye mishonga yezvinetso zvepfungwa (Tricyclic antidepressants) zvinogona kukonzera kuti vharuvhu iyi isashande zvakanaka.
- Izvi zvinogonawo kukonzerwa nezvimwe zvekudya nezvinwiwa: kofi, chokoreti, mint, gariki, hanyanisi, uye doro.
- Tsika dzakaipa:
- Kurara pasi maawa 2-3 mushure mekudya.
- Kudya zvakawanda panguva imwe chete kunogona kukonzera kuzvimba mudumbu. Izvi zvinowedzera kumanikidzwa mukati medumbu uye zvinosundidzira acid kumusoro.
- Kupfeka mbatya dzakabatirira padumbu, kunyanya dzakatenderedza chiuno.
- Zvikonzero zvenguva refu:
- Hernia yeHiatal: Apa ndipo apo chikamu chidiki chedumbu chinobuda muchipfuva. Izvi zvinoderedza kushanda kwevharuvhu yeLES.
- Kufuta: Sezvo huremu huchiwedzera, kumanikidzwa mukati medumbu kunowedzera. Ichi ndicho chikonzero chikuru zvakare.
- Kubata Pamuviri: Kuchinja kwemahormone uye kuwedzera kwekumanikidzwa mukati medumbu panguva iyi zvinogona kukonzera gastritis neLPR kwenguva pfupi.
- Kusvuta: Kusvuta muvengi mukuru anosunungura vharuvhu iyi.
2. Zvinhu zvinoderedza simba remudumbu reupper esophageal sphincter (UES)
Kana acid yabuda nepavharuvhu repazasi, vharuvhu repamusoro ndiro rinodzivirira pahuro. Huro dzedu hadzina kugadzirwa kuti dzikwanise kumira seasidhi seyegurokuro. Saka kunyangwe acid shoma inogona kukonzera kukuvara kukuru.
- Kurara pasi: Patinorara pasi, mavharuvhu ese aya anorerutswa zvishoma. Izvi zvinoita kuti LPR iitike kakawanda usiku patinenge takarara.
- Kubvoora: Paunobvoora, mavharuvhu ese ari maviri anovhurika, zvichiita kuti acid shoma ipinde muhuro mako pamwe chete nemhepo.
- Kukotama mberi, kurovedza muviri, kuimba: Mabasa akadai anogona kuwedzera kumanikidzwa pasi pevharuvhu repamusoro, zvichiita kuti rishaye simba.
- Kusvuta nedoro: Zvese zvinokuvadza zvakaenzana mavharuvhu ese ari maviri.
Zvine njodzi here kuregeredza mamiriro eLPR?
Ehe, kana chirwere ichi chikaramba chiripo kwenguva yakareba, mamwe matambudziko anogona kuitika.
- Kutapukirwa nezvirwere: Asidhi iri muhuro inokanganisa kucheneswa kwehuro ne sinuses. Izvi zvinogona kukonzera kuungana kwemanyoka uye hutachiona hwepahuro nehwekufema kakawanda.
- Matambudziko ezwi nepahuro kwenguva refu: Kugara uchinwa acid kunogona kukuvadza tsinga dzezwi, zvichikonzera zvinhu zvakaita semaronda etsinga dzezwi. Kugara uchinwa chirwere ichi kwenguva refu kunogona kuwedzera njodzi yekubatwa nekenza yemudumbu.
- Matambudziko ekufema: Asidhi shoma inopinda muhuro inogona kufamba ichikwira mu trachea ichipinda mumapapu tisingatombozvizivi, kunyanya panguva yekurara. Izvi zvinonzi silent aspiration . Izvi zvinogona kutungamira kuhutachiona hwemapapu uye zvirwere zvakaita sebronchitis.
Ndingaziva sei chaizvo kuti LPR chii?
Kana wagara uine zviratidzo zvatakambotaura kare, chinhu chakanakisa chekuita ndechekuona chiremba wezvenzeve, mhino, nepahuro (ENT Surgeon) . Iye achateerera zviratidzo zvako uye achaongorora pahuro pako.
Bvunzo huru inowanzoitwa pakuita izvi ndeye laryngoscopy inochinjika . Izvi zvinosanganisira kupinza chubhu yakatetepa, ine kamera kuburikidza nemhino dzako uye pasi pehuro kuti uongorore mukati metsinga dzenzwi nepahuro. Iyi inzira isingarwadzi inogona kuitwa mumaminitsi mashoma.
Kuongororwa uku kunogona kutarisa kutsvuka uye kuzvimba pahuro. Dzimwe nguva, bvunzo dzakawanda dzingadiwa kusimbisa chirwere kana kuti kubvisa zvimwe zvinokonzera.
- Endoscopy Yepamusoro: Izvi zvinosanganisira kuisa kamera nemuromo kuti iongorore gumbo nedumbu. Inogona kutarisa matambudziko ane dumbu repasi remudumbu (LES) uye hernia yemudumbu.
- Kuongororwa kwepH yemudumbu: Izvi zvinoyera huwandu hweasidhi muhuro nemugurokuro kwemaawa makumi maviri nemana.
- Esophageal Manometry: Muedzo unoyera mashandiro uye simba remhasuru dzegurokuro nemavharuvhu aro.
Zvakanaka, toita sei neizvi? Marapirwo acho ndeapi?
Chinhu chinonyanya kukosha pakurapa chirwere cheLPR ndechekuchinja mararamiro uye maitiro ekudya . Mishonga iri panzvimbo yechipiri.
1. Kuchinja mararamiro netsika dzekudya (izvi ndizvo zvinonyanya kukosha)
Kana ukanyatsotevedzera maitiro aya, unogona kudzora dambudziko iri usingashandise mushonga.
| Zvekuita | Tsananguro |
|---|---|
| Ita kuti chikafu chive chidiki. | Pane kudya chikafu chikuru panguva imwe chete, idya zvishoma kashanu kana katanhatu pazuva. |
| Dzivisa zvimwe zvekudya | Deredza kudya zvekudya zvine mafuta, zvinopisa, zvine acid yakawanda (matomatisi, maranjisi, marimu), kofi, chokoreti, minti, nezvinwiwa zvine carbonated (soda) zvakanyanya sezvinobvira. |
| Idyai kudya kwemanheru nguva isati yakwana. | Idyai kudya kwemanheru maawa matatu musati marara. Musarara pasi mushure mekudya. |
| Chinja nzvimbo yako yekurara. | Rara musoro wemubhedha wakasimudzwa masendimita angangoita matanhatu. Usangosimudza musoro wako nemapiro maviri kana matatu chete, asi simudza mubhedha wacho. Kurara nerutivi rwako rweruboshwe kunoderedzawo acid reflux. |
| Rega kusvuta nekunwa doro. | Vaviri ava vari kuita kuti mamiriro ezvinhu eLPR ave akaoma zvikuru. Zvakakosha kuti varege zvachose. |
| Dzora huremu hwako. | Kana wakafuta, kuderedza uremu kunogona kuderedza kumanikidzwa kwemudumbu uye kudzora zviratidzo zvikuru. |
2. Kurapwa nemishonga
Paunenge uchichinja mararamiro ako, chiremba wako anogona kukupa mishonga yekubatsira kuti nyama yehuro yakakuvara ipore.
- Proton Pump Inhibitors (PPIs): Mishonga yakaita seOmeprazole nePantoprazole inoshanda nekuderedza kugadzirwa kweacid mudumbu. Iyi inowanzopihwa kwemwedzi yakati wandei.
- H2 Blockers: Mishonga yakaita seFamotidine inobatsirawo kudzora acid.
- MaAlginates: Aya anogadzira jira rinodzivirira dumbu, zvichidzivirira acid kuti isabude.
Zvakakosha: Chero mishonga iyi inofanira kushandiswa chete kana chiremba wako akuudza. Usazvirape wega.
3. Kuvhiyiwa
Izvi hazviwanzodiwa. Kuvhiyiwa kunongoonekwa chete kana paine dambudziko remuviri, senge hernia yekusununguka, kana kana pasina imwe nzira yekurapa yakabatsira.
Mukupedzisa, LPR chirwere chinonetsa zvishoma, asi chinogona kurapwa zvakanaka kana chikarapwa nemazvo. Chinhu chakakosha ndechekusafuratira zviratidzo, kuwana chirwere chakarurama, uye kunyanya kuva nemoyo murefu nekuchinja mararamiro kunodiwa.
Mharidzo Yekuenda Nayo Kumba
- LPR chirwere chinoitika kana acid yemudumbu ichipinda mugurokuro. Inowanzonzi "silent reflux" nekuti hapana kunzwa kupisa muchipfuva.
- Zviratidzo zvikuru kukosora kunoramba kuripo, manyoka pahuro, kuchema, uye kunzwa sekuti pane chinhu chakanamira pahuro.
- Usafunge kuti zviratidzo izvi ndizvo zvakaita sechikosoro kana kuti allergies. Kana zvikaramba zviripo, enda kuna chiremba.
- Danho rekutanga uye rinokosha pakurapa nderekuchinja kudya kwako nemararamiro ako. Mishonga ine basa rekutsigira.
- Usarara pasi kwemaawa matatu mushure mekudya. Rara wakasimudza musoro wemubhedha husiku. Rega kusvuta nedoro zvachose.
- Kana usina chokwadi nezvezviratidzo zvako, bvunza nyanzvi yezvenzeve, mhino, uye pahuro (ENT Surgeon) kuti akupe mazano akakodzera.
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