Ingaba iintlungu zesifuba zihlala ziyingxaki yentliziyo? Masifunde ngeentlungu zesifuba ezingezizo ezentliziyo!

Ngaba ngamanye amaxesha uziva uxinezelekile , uxinezelekile, okanye intlungu esifubeni sakho? Sihlala soyika xa sivakalelwa kukuba kukho into engalunganga entliziyweni yethu, akunjalo? Kodwa ubusazi, ayizizo zonke iintlungu esifubeni ezibangelwa yintliziyo. Ngamanye amaxesha xa uye kugqirha, benza uvavanyo baze bathi, 'Akukho ngxaki ngentliziyo.' Ngoko ke kwenzeka ntoni? Yiloo nto siza kuthetha ngayo namhlanje, iintlungu esifubeni ezingahambelaniyo nentliziyo. Oku ngokwezonyango kubizwa ngokuba yi-'Noncardiac Chest Pain (NCCP)'.

Ngoko ke, yintoni le ntlungu yesifuba ingekho kwintliziyo?

Ngamafutshane, `Intlungu Yesifuba Engeyoyontliziyo (NCCP)` yintlungu eyenzeka rhoqo esifubeni sakho, ingakumbi embindini wesifuba, apho intliziyo ikhona. Nangona kunjalo, oku akubangelwa sisifo sentliziyo. Kubantu abaninzi, isizathu esiphambili solu hlobo lwentlungu yingxaki yomqala (ityhubhu ethwala ukutya ukusuka emlonyeni ukuya esiswini xa siginya). Phakathi kwazo, imeko ebizwa ngokuba yi -`Gastroesophageal Reflux Disease (GERD)` yeyona ixhaphakileyo. Phakathi kwethu, oku kukwanda kwe-"gastritis" okanye "reflux", akunjalo? Ukongeza, izinto ezifana noxinzelelo, ixhala, kunye nokudakumba nazo zinokubonakala njengentlungu yesifuba engapheliyo. Ngamanye amaxesha, izinto ezifana neengxaki zemiphunga kunye nokuxinana kwemisipha nazo zinokubangela intlungu yesifuba ngequbuliso. Kodwa i-`NCCP` ibonwa njengengxaki eqhubekayo, engapheliyo.

Ingaba le ntlungu ivakala njani? Ingaba ifana nokuhlaselwa yintliziyo?

Ewe, uninzi lwexesha, le ntlungu yesifuba engeyoyentliziyo ivakala ngathi yi-angina . Ingavakala ngathi kukho umntu ocinezela isifuba sakho, esicinezela, okanye umthwalo onzima ubekwa esifubeni sakho. Le ntlungu idla ngokuvakala emva kwethambo eliphakathi lesifuba sakho (sternum) . Ngamanye amaxesha inokuba kwicala lasekunene, kwicala lasekhohlo, okanye embindini. Njengokuhlaselwa yintliziyo, le ntlungu ingavakala ngathi iya entanyeni yakho, engalweni yasekhohlo, okanye emqolo.

Usenokukwazi ukuqonda enye into ngezi zinto. Umzekelo, le ntlungu isenokuvela emva kokuba ugqibile ukutya. Okanye, imvakalelo yokutsha esifubeni, esiyibiza ngokuba yi "heartburn" , inokuza nale ntlungu. Le ntlungu inokuhlala imizuzu embalwa, okanye ngamanye amaxesha inokuhlala iiyure ezimbalwa.

Khawucinge nje, utya isidlo sangokuhlwa esimnandi, kunye nencasa encinci, kwaye emva kwexesha elithile, xa usiya kulala, uziva uvutha esifubeni sakho. Abanye abantu bacinga ukuba, 'Kumele ukuba yigesi.' Kodwa ukuba oku kwenzeka rhoqo, kunokuba luphawu lwe-'GERD', olunokubangela iintlungu esifubeni.

Kutheni intlungu yomphimbo ivakala ngathi yintlungu ebuhlungu?

Oku kungabonakala kungaqhelekanga, kodwa kukho isizathu soko. Ngaphakathi esifubeni sethu, i-trachea ikufutshane kakhulu nentliziyo.Imiqondiso yentlungu evela kumalungu omabini ithwalwa iye engqondweni ngenkqubo efanayo yeemvakalelo. Ke ngoko, ngamanye amaxesha kunzima kakhulu ukwahlula phakathi kwezi ntlobo zimbini zentlungu ngokusekelwe kwiimpawu zodwa.

Nangona kunjalo, ukuba unezinye iimpawu ezinxulumene ne-esophageal reflux, apho uziva ngathi isisu sibuyela kwi-esophagus yakho, oko kungaba luphawu lokuba intlungu ayihambelani nentliziyo yakho. Nangona kunjalo, iimeko ezifana nokuxinana kwemisipha kwi-esophagus yakho okanye i-visceral hypersensitivity zinokuba nzima ukuzibona.

Ixhaphake kangakanani le meko?

Le ntlungu yesifuba engeyoyentliziyo ixhaphake kakhulu kunokuba sicinga. Ngokweengxelo ezithile, malunga nama-25% abantu abadala banengxaki yesi sifo. Phakathi kwama-50% nama-75% abantu abeza kwigumbi likaxakeka beneentlungu zesifuba bathunyelwa ekhaya emva kokuba befunyaniswe benesi sifo sentliziyo. Rhoqo, la matyala ahlelwa njengengachazwanga, abangelwa luxinzelelo okanye ixhala, okanye njenge-"NCCP."

Uyazi njani ukuba iintlungu zesifuba zinzulu?

Le yeyona nto ibalulekileyo. Usenokungakwazi ukubona umahluko phakathi kwentlungu yesifuba kunye nentlungu yesifuba engeyoyentliziyo ngokwakho. Ke ngoko, nayiphi na intlungu yesifuba kufuneka ithathwe nzulu.

• Ukuba intlungu iqala ngequbuliso kwaye ithathe imizuzu engaphezu kwemihlanu, ngokuqinisekileyo yiya kwigumbi likaxakeka ngokukhawuleza.
• Nokuba intlungu iphela emva kwemizuzu embalwa kwaye ayisiyongxaki, kubaluleke kakhulu ukubona ugqirha ngokukhawuleza ukuze kufunyaniswe ukuba yintoni ebangela loo nto.

Khumbula, iintlungu zesifuba ezingezizo ezentliziyo, nokuba zibangelwa yintoni na, zingaphinda zibuye. Zinokuchaphazela nomgangatho wobomi bakho.

Zeziphi izizathu eziphambili zentlungu yesifuba ezingahambelaniyo nentliziyo?

Njengoko besitshilo ngaphambili, le meko ye-'NCCP' idla ngokubangelwa yingxaki kwi -esophagus yakho (ityhubhu ethwala ukutya ukusuka emlonyeni wakho ukuya esiswini sakho). Kukho izifo ezininzi ze-esophagus ezinokuchaphazela oku:

Isifo seGastroesophageal Reflux (GERD)

Le yeyona nto ixhaphakileyo . Phakathi kwama-50 nama-60 ekhulwini ezigulane ze-NCCP zinale meko. Ngamafutshane, kulapho i-asidi yesisu iphuma khona kwi-esophagus.

Ukuqaqamba kwemisipha ye-Esophageal

Olu hlobo lwentlungu lunokubakho ngenxa yokuxinana okungaqhelekanga, okusebenzayo kakhulu kwemisipha kwi-usophagus. Lunokubakho nakwi-usophagus, njengeqhubu emlenzeni.

I-Achalasia

Le yimeko engaqhelekanga. Okwenzekayo apha kukuba ivalvu (i-sphincter) esezantsi komqala ayivuli kakuhle. Emva koko ukutya akunakungena esiswini kuze kubhajwe kumqala.

Ukwanda koxinzelelo lwe-esophageal

Le yingxaki yokuziva. Oko kukuthi, izihlunu, imithambo-luvo, kunye nee-receptors ezindongeni zomqala ziba novakalelo olugqithisileyo. Kwanoxinzelelo, ukutsala, kunye ne-asidi eziviwa ngokuqhelekileyo zivakala njengentlungu ngaba bantu.

Ukudumba komphimbo

Iintsholongwane, ukungakwazi ukutya (umz., i-eosinophilic esophagitis) , okanye isifo sesilonda se-peptic zinokubangela ukuba umphimbo uvuvuke kwaye wonzakale, nto leyo enokubangela iintlungu esifubeni.

Izicubu ezingaqhelekanga kwi-esophagus

Ngamanye amaxesha, izicwili ezingaqhelekanga, ezifana neeringi okanye iintambo, zinokukhula ngaphakathi kwi-esophagus, zivale i-esophagus.

Ngamanye amaxesha oogqirha abakwazi ukufumana naziphi na ezi zizathu. Kodwa xa kuqinisekiswa ukuba akukho ngxaki yentliziyo, kuthiwa "yintlungu yesifuba esebenzayo ecingelwa ukuba ivela emqaleni."

Zeziphi ezinye izinto ezinokubangela iintlungu zesifuba ezinje?

Ukongeza kwiingxaki zomqala, kukho ezinye izizathu zokuba le meko ye-'NCCP' inokwenzeka. Nangona kunjalo, ezi azixhaphakanga kangako:

• Iingxaki zemisipha okanye amathambo esifubeni, eludongeni lwesifuba, okanye emgogodleni. Njengemisipha etsaliweyo okanye ingxaki yembambo.
• Izifo zemiphunga ezingapheliyo, ingakumbi ezo zibandakanya i-pleura, ulwelwesi olugubungela imiphunga.
• Iingxaki zesisu, umzekelo izilonda zesisu.
• Iingxaki zengqondo. Izinto ezifana neengxaki zentlungu, uxinzelelo, ixhala, kunye nokudakumba .

Ngaba kukho ezinye iimpawu ezihambisana nale ntlungu yesifuba?

Ewe, abantu abaninzi abaneentlungu zesifuba ezingezizo ezentliziyo banezinye iimpawu ezinxulumene ne-GERD. Umzekelo, isitshiso sentliziyo kunye ne-acid reflux. Ezinye iingxaki zokugaya ukutya, ezifana nomphimbo obuhlungu, ukurhawuzelelwa, kunye nobunzima bokuginya, nazo zixhaphakile. Malunga nama-80% abantu abane-NCCP esebenzayo bafunyenwe benezinye iingxaki zokugaya ukutya ngaphandle kwesizathu esicacileyo. Ezona zixhaphakileyo kwezi yi -Irritable Bowel Syndrome (IBS) (malunga nama-27%) kunye nokudumba kwesisu okusebenzayo (malunga nama-22%).

Kwabanye abantu, le ntlungu yesifuba ikwanxulunyaniswa neempawu zengqondo. Oko kukuthi, izinto ezinje ngoxinzelelo, ixhala, kunye nokudakumba. Nokuba unobangela wentlungu ufunyenwe uyinto eyahlukileyo, le nkalo yengqondo nayo inokunxulunyaniswa nayo. Enyanisweni, kukho unxibelelwano oluqinileyo phakathi kweempawu zengqondo kunye nokuphazamiseka kokugaya ukutya, kunye nokudumba kwesifuba. Uxinzelelo lunokubangela iimpawu zenkqubo yokugaya ukutya, kwaye ezo mpawu zinokunyusa uxinzelelo. Oogqirha bakholelwa ukuba oku kusenokubangelwa bubuthathaka obuthile kunxibelelwano lwamathumbu nobuchopho phakathi kwamathumbu ethu kunye nengqondo .

Zeziphi izinto ezibangela umngcipheko ezichaphazela oku?

Nangona ingengonobangela othe ngqo, ezi zinto zifunyenwe zidibene neentlungu zesifuba ezingezizo ezentliziyo:

• I-High Body Mass Index (BMI) - Oku kuthetha ukuba nobunzima obungaphezulu kunobo bufanelekileyo kubude bakho.
• Ukutshaya okanye ukusebenzisa icuba.
• `Ii-NSAID` (Ii-Non-steroidal Anti-inflammatory Drugs) - Oku kuthetha ukusetyenziswa rhoqo kwe-non-steroidal anti-inflammatory drugs (umz. ii-painkillers ezifana ne-ibuprofen kunye ne-diclofenac).
• Ixhala .

Ifunyaniswa njani le meko?

Ukuba uva iintlungu zesifuba ezifana nokuhlaselwa yintliziyo, into yokuqala omawuyenze kukuya kwigumbi likaxakeka. Apho, baya kuthatha zonke iimpawu ezibalulekileyo, ezinje ngoxinzelelo lwegazi kunye nokubetha kwentliziyo yakho, baze benze uvavanyo olupheleleyo lomzimba. Emva koko, baya kujonga ukuhlaselwa yintliziyo okanye isifo sentliziyo. Oku kuya kubandakanya uvavanyo lwe -'EKG (Electrocardiogram)` (uvavanyo olungenabuhlungu olurekhoda umsebenzi wombane wentliziyo) kunye novavanyo lwegazi. Olu vavanyo lwegazi lunokufumanisa ubukho beeproteni ezithile ezikhutshwa yintliziyo ngexesha lokuhlaselwa yintliziyo. Kuphela emva kokuqinisekiswa ukuba akukho ngxaki yentliziyo, apho uya kufunyaniswa ukuba "uneentlungu zesifuba ezingezizo ezentliziyo" (NCCP).

Emva kokuba ugqirha wentliziyo okanye ugqirha wosapho lwakho eqinisekisile ukuba akukho ngxaki yentliziyo, banokukuthumela kwi -gastroenterologist . Yena uza kujonga iimeko zomqala, ingakumbi i-GERD.

Enye indlela yokwenza oku kukunika iyeza elibizwa ngokuba yi-proton-pump inhibitor (PPI) . La ngamayeza asebenzayo kakhulu kwi-GERD. Ukuba iimpawu zakho ziyaphucuka emva kokusebenzisa eli yeza, kunokunceda ukufumanisa unobangela.

Ezinye iimvavanyo zingabandakanya uphando lwe-pH ye-esophagus , uvavanyo lwe-motility ye-esophageal , i-endoscopy ephezulu, okanye i-ultrasound . Ukongeza kwezi vavanyo zomzimba, ugqirha uya kubuza ngembali yakho yezonyango aze axoxe ngoxinzelelo lwakho kunye neemeko zeemvakalelo.

Zithini iindlela zonyango zoku?

Ukuze unikeze unyango olusebenzayo, kufuneka ufumane unobangela ochanekileyo wentlungu yesifuba sakho engeyiyo eyentliziyo. Kukho iindlela ezahlukeneyo zonyango:

Unyango lwe-acid reflux

Ukuba, njengabantu abaninzi, i-NCCP yakho ibangelwa yi - GERD, unyango luhlala lulula kwaye lusebenza.lelona yeza lisetyenziswa kakhulu kwi-GERD. Ii-PPI zisebenza ngokunciphisa ubungakanani be-asidi eveliswa ziindlala zesisu. Oku kunceda ukuphilisa izilonda nokunciphisa umonakalo obangelwa yi-asidi. Unyango ludla ngokuqala ngedosi ephezulu ukulawula iimpawu. Emva koko, idosi ephantsi iyaqhubeka iinyanga ezimbini ukuya kwezine. Ii-PPI zisebenza malunga ne-90% ekunyangeni i-GERD kunye neziphumo zayo ezingezizo. Ukuba ezi azisebenzi, i-NCCP yakho inokubangelwa yenye into.

Izinto ezithintela iintlungu

Unyango olulandelayo olusebenzayo olusetyenziswa kakhulu ngamayeza okuthintela iintlungu. La mayeza adla ngokuba yinxalenye yodidi lwamayeza abizwa ngokuba yi -tricyclic antidepressants (TCAs) . Nangona kunjalo, anikwa ngeedosi eziphantsi kakhulu kunezo zisetyenziselwa ukudakumba. Ukuba ufumana iziphumo ebezingalindelekanga ze-TCA kunzima ukuzinyamezela, nezinye iintlobo ze-antidepressants nazo zinokunceda. Ii-selective serotonin reuptake inhibitors (SSRIs) zibonakalise impumelelo ethile nge-NCCP, kodwa azikabonakali kakuhle njengee-TCA.

Unyango lweemvakalelo kunye nokuziphatha

Sikhankanyile ukuba iintlungu zesifuba ezingahambelaniyo nentliziyo ngamanye amaxesha zinokunxulunyaniswa nokudakumba, ixhala, okanye uxinzelelo. Unyango lwengqondo lunokunceda ukujongana nale micimbi kwaye lunciphise ukuphindaphindeka kweentlungu zesifuba. Unyango lokuziphatha kwengqondo (i-CBT) lukufundisa ukutshintsha okanye ukususa iipatheni zokucinga ezibangela uxinzelelo okanye ixhala. I-Biofeedback lunyango olukhokelwayo lwengqondo nomzimba. Lukunceda ukutshintsha indlela umzimba wakho osabela ngayo kwizinto ezithile (kubandakanya iingcinga). Ungazama neendlela zokulawula uxinzelelo ekhaya (umz., ukucamngca, umthambo, iindlela zokuphumla).

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Iintlungu zesifuba zinokuba yinto eyoyikisayo, ingakumbi xa kuvakala ngathi zivela kwisifo sentliziyo. Ukuba nolu hlobo lwentlungu rhoqo kunokuba yingxaki kwaye kunokuphazamisana nokukwazi kwakho ukonwabela ubomi.

Ngoko ke, ukuba ufumana iintlungu zesifuba ezingapheliyo, zithathe nzulu. Musa ukulibazisa ukufuna ingcebiso kagqirha.

Ukufumana unobangela wentlungu esifubeni sakho kusenokufuna umgudu kunye novavanyo oluthile. Kodwa kufanelekile. Kuba uninzi lwexesha, wakuba usifumene unobangela, kulula kakhulu ukunyanga. Nokuba unobangela unzima kancinci, ungafunda okuninzi malunga nendlela umzimba wakho osabela ngayo ekutyeni, kuxinzelelo, nakwiingcinga. Olo lwazi luya kukunceda kwindlela yakho eya ekupholeni ixesha elide. Ngoko ke, khathalela impilo yakho yomzimba.

Iintlungu zesifuba , Isifo sentliziyo, i-GERD, umphimbo, uxinzelelo, inkqubo yokugaya ukutya, iintlungu zesifuba ezingezizo ezentliziyo