Ngaba uhlala unesitshiso sentliziyo? Makhe sithethe ngale nto (ukutshisa kwentliziyo)!

Ngaba wakha waziva ukutshisa phakathi kwesifuba sakho? Kuvakala ngathi kukutshisa esifubeni sakho? Abantu abaninzi bakubiza ngokuba "kukutshisa kwentliziyo," kodwa asiyongxaki yentliziyo ngokwenene. Kubangelwa yi-asidi esesiswini sakho enyuka iye kumbhobho wakho wokutya (esophagus). Lo mbhobho wokutya uhamba ngqo esifubeni sakho, kufutshane nentliziyo yakho. Yiyo loo nto ngamanye amaxesha unokubhidaniswa nengxaki yentliziyo. Kwabanye abantu, yinto eyenzeka ngamaxesha athile, kodwa kwabanye, yingxaki eqhubekayo. Ukuba kwenzeka rhoqo, kunokuba luphawu lwemeko ebizwa ngokuba yi-GERD (Gastroesophageal Reflux Disease). Makhe sithethe ngakumbi ngale nto, akunjalo?

Yintoni kanye kanye isitshiso sentliziyo?

Ngamafutshane, isitshiso sentliziyo sibakho xa i-asidi yesisu ibuyela kwi-esophagus. Isisu sethu sinolwelo oluqinileyo lwe-mucous olusikhusela kwezi asidi. Nangona kunjalo, i-esophagus yethu ayinalo olo khuselo. Ngoko ke, xa i-asidi yesisu ifika kwi-esophagus, itshisa izicubu ezithambileyo apho, nto leyo ebangela ukudumba.

Abantu abaninzi baye bavelelwa sisitshiso sentliziyo ngaxa lithile ebomini babo. Ngamanye amaxesha singenzeka emva kokutya isidlo esinongwe kakhulu okanye esinamafutha, okanye xa kukho uxinzelelo olukhulu esiswini, njengaxa ukhulelwe. Kodwa ukuba esi sitshiso sentliziyo sivela rhoqo, imihla ngemihla, sisenokuba luphawu lwesifo esingapheliyo esibizwa ngokuba yi-'GERD (Gastroesophageal Reflux Disease). Kwilizwe elifana neMelika, kuthiwa malunga nama-20% abantu bane-'GERD'.

Ngubani ofumana olu sulelo lwesifuba kakhulu?

Enyanisweni, nabani na angayihlakulela le nto, kodwa kwabanye abantu, umngcipheko uphezulu kancinci.

• Kwabo batyebe kakhulu: Oko kukuthi, abo bane-body mass index (BMI) engaphezulu kwama-30.
• Kwabo batyebe kakhulu: Ukuba ixabiso le-`BMI` lingaphezulu kwama-25.
• Abantu abatshayayo kunye nabo batshaya umsi ophuma komnye umntu nabo banamathuba amaninzi okuba nawo.

Usulelo lwesifuba luvakala njani ke ngoko?

Iintlungu zesifuba, ukuba zichanekile, kukutshisa okuvela ngaphakathi esifubeni sakho, njenge-acid reflux. Umphimbo wakho uphakathi esifubeni sakho. Ngoko ke le ntlungu iqala apho. Kodwa ngamanye amaxesha le ntlungu inokusasazeka esifubeni sakho, ide iye kufikelela emqaleni wakho. Ingaqala kwimvakalelo yokutsha okuncinci ukuya kwintlungu enzima.

Uziva nini kakhulu ezi ntlungu?

Usenokuba ukhe wakubona oku. Ngamanye amaxesha uziva iintlungu ezingakumbi esifubeni.

• Xa ulala phantsi, ingakumbi ukuba ulala phantsi ngokukhawuleza emva kokutya.
• Xa ugoba phambili.
• Xa usitya isidlo sangokuhlwa emva kwexesha kakhulu.
• Xa usitya ukutya okunamafutha, okumuncu, okanye okuneziqholo.

Umphimbo obuhlungu ungahlala ixesha elingakanani?

Oku kungathatha imizuzu embalwa ukuya kwiiyure ezimbalwa.Ngokwesiqhelo, oku kurhawuzelela kuyaphela xa ukutya okutyileyo kokugqibela kuphumile esiswini sakho. Oku kungenxa yokuba akukho nto ibuyela esiswini. Ngokuxhomekeke kwinto oyityileyo, kungathatha naphi na ukusuka kwiiyure ezimbini ukuya kwezintlanu ukugaya. Kungathatha ixesha elide ukugaya ukutya okunamafutha nokunamafutha.

Ziziphi ezinye iimpawu ezihambisana nokudumba kwesifuba?

Ngamanye amaxesha kunokuba nzima ukufumanisa ukuba une-angina okanye olunye uhlobo lwentlungu esifubeni. Ukuba awuqinisekanga ngentlungu oyifumanayo, kungcono ukuthetha nogqirha. Kubalulekile nokujonga ezinye iimpawu ezihamba nentlungu. Ezi mpawu zinokukunceda ukwahlula phakathi kokuhlaselwa yintliziyo kunye nenye imeko esifubeni.

Ukutshisa kwentliziyo okubangelwa yi-acid reflux kunokuhamba kunye nezi mpawu zilandelayo:

• Ukuchama rhoqo.
• Incasa emuncu emlonyeni.
• Isicaphucaphu.
• Ukutya kungena emqaleni.

Abanye abantu banokubonisa iimpawu ezingaqhelekanga ezifana nezi:

• Ukugcwala kwesisu, ukudumba.
• Iingxaki.
• Ukukhohlela okungapheliyo.
• Ukwanda kwesifo sesifuba.
• Umqala obuhkungu.
• Ukudumba kwengqula (`Laryngitis`).
• Ubunzima bokuginya okanye ukuziva ngathi kukho into ebambeke emqaleni.
• Iintlungu zesifuba ezingabangelwa sisifo sentliziyo, ezifana `(Angina)`.

Kutheni sifumana olu sulelo esifubeni?

Ngokwesiqhelo xa kunxulunyaniswa nemeko efana neGERD, isitshiso sentliziyo senzeka xa iijusi zesisu, ezizezi i-asidi kunye nee-enzymes, zibuyela kwi-esophagus. Njengoko benditshilo ngaphambili, isisu sinomgca okhuselayo, kodwa i-esophagus ayinawo. Apho i-esophagus yethu idibana nesisu, kukho i-valve ebizwa ngokuba yi-Lower Esophageal Sphincter (LES). Umsebenzi wayo kukuthintela umxholo wesisu ukuba ungabuyi unyuke. Kodwa ngamanye amaxesha, ukuba le valve iba buthathaka okanye ayivaleki kakuhle, umxholo wesisu unokuqala unyuke.

Kukho izizathu ezininzi zokuba i-Lower Esophageal Sphincter inokuba buthathaka okanye ikhululeke kakhulu:

• Ukuphefumla umsi wecuba (ukutshaya).
• Uxinzelelo olongezelelekileyo esiswini ngenxa yezinto ezifana nobunzima bomzimba obugqithisileyo, ukunxiba impahla ebambekayo, kunye nokukhulelwa.
• Ingxaki ebizwa ngokuba yi-'Hiatal Hernia'. Oku kwenzeka xa inxalenye yesisu ityhala phezulu nge-diaphragm.
• Ukutya isidlo esikhulu ngaxeshanye kunokolula isisu kwaye kubangele ukuba ukutya kuhlale esiswini ixesha elide.
• Ukungagayi kakuhle kokutya kunye negesi. Xa amaqamza egesi ehamba kwi-GI tract.
• Ukulala phantsi kwangoko emva kokutya.
• Ezinye izinto zokutya: izinto ezifana nekofu, itshokolethi, iilayimu, iminti, isosi yetumato.
• Amayeza athile: afana neepilisi zokulawula ukukhulelwa kunye namanye amayeza oxinzelelo lwegazi oluphezulu.

Amaxesha amaninzi, zininzi ezi zizathu ezidityanisiweyo ukuze kubangele i-acid reflux kunye ne-heartburn.

Kutheni isifo sesifuba sivela ngequbuliso ngaphandle kwempawu zangaphambili?

Ukuba awuzange ube nentlungu yesifuba embi ngaphambili kwaye yaqala ngequbuliso, kwaye awuzange wenze naluphi na utshintsho olukhulu kwindlela otya ngayo okanye kwindlela ophila ngayo kutshanje, kusenokwenzeka ukuba kungenxa yezinye izizathu. Ezi zizinto ezikhula kancinci kancinci ngokuhamba kwexesha.

• Ukwaluphala: Njengoko sikhula, izihlunu zethu ziyabuthathaka. Enye yezo zihlunu yi-sphincter esezantsi kwesophagus.
• Ukutyeba: Uninzi lwabantu luyatyeba kancinci kancinci. Nangona kunjalo, iimpawu zokutyeba (ezifana nokudumba) zinokuvela ngequbuliso, xa sele kudlule umda othile.
• Amayeza: Ukuba usandul’ ukuqala amayeza amatsha okanye utshintshe amayeza, buza ugqirha wakho ukuba loo mayeza abangela ukunyuka kwe-acid reflux.

Ngaba isitshiso sentliziyo sisoloko sivela kwi-acid reflux ekhankanyiweyo ngaphambili?

Amaxesha amaninzi, isitshiso sentliziyo siyinkinga kwi-esophagus. Eyona nto ibangela yi-acid reflux. Nangona kunjalo, kukho nezinye iimeko ezininzi ezinokubangela isitshiso sentliziyo. Umzekelo:

• Izilonda zomqala: Izilonda zizilonda ezibuhlungu ezibangelwa kukuguguleka kolwelo lwendlela yokugaya ukutya. Izilonda zomqala azixhaphakanga kangako kunezilonda esiswini okanye emathunjini. Xa zisenzeka, zihlala zibangelwa yi-acid reflux. Nangona kunjalo, i-acid reflux ayisiyo yodwa imbangela. Ukusetyenziswa kakhulu kweziyobisi ezichasene nokuvuvukala (ii-NSAID) ezifana ne-aspirin kunye ne-ibuprofen nako kunokubangela izilonda.
• I-Esophagitis: Ukuba i-esophagus ivuvukala kakhulu, ungaziva uvutha. I-GERD, iintsholongwane, usulelo lwefungus, kunye namanye amayeza anokubangela oku. I-Eosinophilic esophagitis, imeko ye-allergy ye-esophagus, inokubangela neentlungu zesifuba.
• Ukurhawuzelelwa yintliziyo okusebenzayo/ukurhawuzelelwa yintliziyo okubangelwa kukungasebenzi kakuhle: Ezi ziingxaki zonxibelelwano lwamathumbu nobuchopho. Oko kukuthi, kukho ingxaki ngendlela inkqubo yakho yemithambo-luvo ethumela ngayo imiqondiso esuka kwinkqubo yakho yokugaya ukutya iye engqondweni yakho. Ukurhawuzelelwa yintliziyo okusebenzayo kufana nokurhawuzelelwa yintliziyo okuqhelekileyo. Nangona kunjalo, uvavanyo alubonisi ukuba kukho ukurhawuzelelwa yintliziyo okubangelwa yi-asidi, ukutsha, okanye ukucaphuka. Ukurhawuzelelwa yintliziyo okubangelwa zizinto ezingena-asidi ezifika emqaleni wakho. Ukurhawuzelelwa yi-visceral nako kunokubangela oku kurhawuzelelwa yintliziyo.

Ingaba olu sulelo lwesifuba luyingozi kakhulu?

Nangona isitshiso sentliziyo ngamanye amaxesha sinokuba buhlungu, asibangeli monakalo mkhulu. Enyanisweni, kuyinto eqhelekileyo ukuba i-asidi ethile inyuke emqaleni wakho, kwaye uninzi lwabantu aluyiqapheli loo nto. Ukuba uyayenza, kusenokwenzeka ukuba i-esophagus yakho ifumana i-asidi engaphezulu kunokuba inokukwazi ukuyiphatha. Ukuba iyenzeka ngamanye amaxesha, ifana nenxeba elincinci eliphola ngokukhawuleza. Kodwa ukuba iyenzeka rhoqo, ulwelo lwe-esophagus yakho alunaxesha laneleyo lokuphola.

Njengoko ulwelo lwe-esophagus luqhubeka nokulimala, oku kunokukhokelela kwiingxaki ezihlala ixesha elide, ezinje:

• Ukuqingqa kwesisu: Xa izicubu zomqala ziqhubeka nokudumba, izicubu ezibomvu ziqala ukwakheka ngokuhamba kwexesha. Umqala ufana nombhobho omde. Oku kuvutha kunye nokuqingqa kunokubangela ukuba umqala ube mxinwa (i-stricture). Oku kunokubangela ubunzima bokuginya kunye nokutya kubambeke kumqala.
• Ukuqhekeka kwamathumbu: Ngamanye amaxesha, endaweni yokuba kubekho amanxeba, izicubu ziyatshintsha zifane nolwelwesi lwamathumbu . Oku kubizwa ngokuba yi-intestinal metaplasia kuba izicubu ziyatshintsha zifane nolwelwesi lwamathumbu. Xa oku kwenzeka kwi-esophagus, kukwabizwa ngokuba yi-Barrett's Esophagus. Oku kuthathwa njengemeko engaphambi komhlaza.
• Umhlaza wesisu: Umhlaza wesisu uvela kwipesenti encinci kakhulu yabantu. Nangona kunjalo, kukho indlela ecacileyo ukusuka ekuvuvukeni okuqhubekayo (`i-Esophagitis`) ukuya kutshintsho lweeseli (`i-Barrett's Esophagus`) ukuya kumhlaza. Umngcipheko uyanda ngokuxhomekeke ekubeni ukuvuvuka kwakho kunzulu kangakanani kwaye ixesha elide kangakanani kunganyangwa.

I-acid reflux, ebangela isitshiso sentliziyo, ingabonisa nezinye iingxaki ezisisiseko kwinkqubo yakho yokugaya ukutya. Umzekelo, usenokuba ne-acid eninzi esiswini sakho. Oku kungakhokelela kwiingxaki ezifana ne-gastritis kunye nezilonda zesisu. I-acid reflux ingenza i-asthma yakho ibe mandundu okanye ezinye izifo zokuphefumla ezingapheliyo. Ukuba le acid ingena emqaleni wakho, ingabangela ukudumba, izilonda, kunye nokukhula.

Ungazi njani ngokuqinisekileyo ukuba une-sinus sulelo?

Isitshiso sentliziyo yimvakalelo onayo. Uninzi loogqirha banokuyibona xa uyichazela ugqirha. Ukuba iyenzeka ngamaxesha athile kwaye ayibi qatha kakhulu, mhlawumbi akuyi kufuneka uvavanyo olukhulu. Nangona kunjalo, ukuba bacinga ukuba unesifo esingapheliyo, banokwenza uvavanyo ukuze babone ukuba kukho umonakalo na kwi-esophagus yakho. Ngelo xesha, ungathunyelwa kwi-gastroenterologist.

Nazi ezinye iimvavanyo ezenziwayo ukujonga umphimbo wakho:

• I-Endoscopy (`Inkqubo ye-Endoscopy ePhezulu` / `inkqubo ye-EGD`):I-Endoscopy luvavanyo olujonga ngaphakathi emzimbeni wakho. Oku kuquka ukudlulisa ityhubhu ende enekhamera encinci (i-endoscope) emzimbeni wakho. I-endoscopy ephezulu ihlola indlela yakho yokugaya engasentla, ukusuka kwi-esophagus ukuya esiswini sakho ukuya phezulu kwamathumbu akho amancinci. Le tyhubhu ifakwa ngomqala wakho (unikwa amayeza okuyenza ingasebenzi kakuhle). Ingajonga iimeko ezifana ne-esophagitis, i-hernias, kunye ne-Barrett's esophagus.
• Uvavanyo lwe-pH ye-Esophageal: Oku kuquka ukubeka i-capsule encinci engenazingcingo kwi-esophagus yakho. Ilinganisa i-pH, okanye i-asidi, ye-esophagus yakho ngokuhamba kwexesha. Oku kungenziwa ngexesha le-endoscopy ephezulu okanye ngetyhubhu ye-nasogastric. Idatha idluliselwa kwi-receiver oyinxiba esinqeni sakho. Uya kucelwa ukuba urekhode iimpawu zakho kwaye uzithelekise nedatha. Emva kwexesha elithile, ugqirha uya kuyisusa i-capsule aze ayihlalutye idatha.

Ziziphi iindlela zonyango lwe-pneumonia?

Unokufumana isiqabu kwisifo sokutshaya kwentliziyo ngamanye amaxesha ngamayeza asekhaya, amayeza athengiswa ngaphandle kwemvume kagqirha (OTC), kunye notshintsho kwindlela yokuphila. Nangona kunjalo, ukuze utye isitshiso sentliziyo rhoqo, kunokufuneka uthathe amayeza kagqirha. La mayeza asebenza ngokunciphisa ubungakanani be-asidi ephuma esiswini iye kwi-esophagus. Nangona kunjalo, ingxaki esisiseko nge-Lower Esophageal Sphincter yinto la mayeza angayilungisiyo. Ukuba amayeza awasebenzi, unokufuna olunye unyango.

Iindidi ezahlukeneyo zamayeza okudumba esifubeni:

• Ii-antacids: Ii-antacids (ezifana neTums® kunye neRolaids®) ziyayithomalalisa i-asidi esiswini sakho. Oku kuthetha ukuba nokuba i-asidi ingena emqaleni wakho, ayizukulimaza umphimbo wakho. Ngamanye amaxesha zinokuqulatha ezinye izithako ezinokunceda ekunciphiseni iimpawu. Umzekelo, iSimethicone inokunceda ekunciphiseni ukudumba kwesisu, kwaye iMagnesium inokunceda ekunciphiseni ukuqhina. Ii-antacids zilungile kwi-heartburn ngamanye amaxesha. Nangona kunjalo, zinokuba nemiphumo emibi ukuba zithathwa rhoqo.
• IiAlginates: IiAlginates ziswekile yendalo efumaneka kwiilwandle. Zidada kwi-asidi kwaye zenze umqobo obonakalayo phakathi kwe-asidi kunye nomqala, nto leyo enceda ekuthinteleni ukuba ingabuyeli phezulu emphinjeni. Ukuba awukwazi ukuthatha ii-antacids ngenxa yesinye isifo, ungathatha ii-alginates zodwa. Okanye, kukho amayeza aqulethe ii-alginates kunye nee-antacids ukuphucula imiphumo yazo.
• Ii-histamine receptor antagonists (ii-H2 blockers):La mayeza asebenza ngokuthintela ii-histamines zekhemikhali ezibonisa umzimba ukuba wenze i-asidi. Ezinye ii-H2 blockers ziyafumaneka ngaphandle kwemvume kagqirha, ngelixa ezinye zifumaneka kuphela ngogqirha. Nangona zinokuthathwa rhoqo kunee-antacids, azisoloko zisebenza ixesha elide. Ukuba umzimba wakho uyaziqhela, zisenokungasebenzi kakuhle.
• IiProton Pump Inhibitors (PPIs): Ezi luhlobo olunamandla ngakumbi lwamayeza okuthintela i-asidi. Zikwanceda ekuphilisweni kwezicubu. Ukuba isitshiso sakho sibi kakhulu, okanye ukuba kukho iimpawu zokonakala kwezicubu kwi-esophagus yakho, ugqirha wakho unokukunika ezi njengonyango lokuqala. Zisebenza kakuhle nge-90% ekunciphiseni i-acid reflux. Ukuba unezilonda ze-esophagus, zezona kuphela amayeza aza kuzinceda ziphilise.

Ezinye iindlela zonyango lwe-sinusitis:

• Ukuba kukho usulelo, ii-antibiotics okanye ii-antivirals.
• Nyanga ukudumba ngokwakho nge-`(Topical Steroids)` okanye `(Dupilumab)`.
• Ii-neuromodulators zedosi ephantsi kunye nonyango oluncedisayo lwe-pneumonia esebenzayo.
• Ukuba intlungu yesifuba sakho ibangelwa yi-hernia ye-hiatal, kufuneka utyando lokulungisa (utyando lokulungisa i-hernia).

Kwi-GERD engaphenduliyo kumayeza – okanye njengendlela yokutshintsha amayeza exesha elide – ugqirha wakho angacebisa inkqubo efana nale:

• I-Nissen Fundoplication: Olu lutyando oluncinci oluqinisa isithuba esiphakathi kwesisu kunye nomqala. Lusebenza kakhulu ekunyangeni i-GERD kunye neempawu zayo.
• `Transoral Inciled Fundoplication`: Olu lutyando olufanayo olukhankanyiweyo apha ngasentla ngaphandle kotyando, kodwa nge-`endoscope`.
• `Isixhobo se-LINX`: Olu lolunye utyando olungenabungozi kangako. Kule nto, `Isixhobo se-LINX`, isangqa esincinci semagnethi, sibekwa kwindawo edibanisa isisu kunye nomqala. Oku kunceda ukuthintela i-asidi ukuba ingangeni emqaleni.

Ngaba ukunyanga umphimbo obuhlungu kuya kuyiphilisa?

Isitshiso sentliziyo sisifo esinokunyangeka. Eyona nto ingcono kukuba ungayilawula ngokwenza utshintsho oluncinci kwindlela otya ngayo nendlela ophila ngayo, kwaye ugcine ii-antacids zilungele ukusetyenziswa ngamaxesha athile. Ukuba kuyimfuneko, amayeza exesha elide anokuba luncedo kakhulu ekulawuleni i-acid reflux. Iziphazamiso zokusebenza zinokuba nzima ngakumbi ukuzilawula. Nangona kunjalo, ngomzamo oqhubekayo kunye nokudibanisa unyango, zinokuphucuka ngokuhamba kwexesha.

Zeziphi iinguqu zendlela yokuphila esinokuzenza ukulawula ukudumba?

Ukuze uthintele i-acid reflux, zama ezi zinto:

• Yitya izidlo ezincinci ezimbalwa imini yonke. Xa unokuncinci kokwetyisa ngaxeshanye, ubungakanani beasidi eveliswa sisisu sakho nabo buyancipha.
• Khulula ibhanti yakho. Uxinzelelo lwesisu lunokubangela i-acid reflux. Ukunciphisa umzimba nako kunokunceda.
• Musa ukuya kulala unesisu esipheleleyo. Linda ubuncinane iiyure ezintathu ukuya kwezintlanu ngaphambi kokuba ulale.
• Lala ngecala lakho lasekhohlo. Oku kubeka iLower Esophageal Sphincter yakho ngaphezu kwesisu sakho, njengepokotho yomoya. Xa ulala ngecala lakho okanye ngecala lasekunene, loo valve ingena ngaphakathi kwesisu.
• Kuphephe ukutya okubangela intlungu. Nika ingqalelo kwizinto ezibangela intlungu esifubeni sakho.
• Yeka ukutshaya. Iintlungu zesifuba zesinye sezizathu zokuyeka ukutshaya. Ugqirha wakho anokukunceda ngale nto.

Ufanele uye nini kugqirha?

Bona ugqirha kwezi meko zilandelayo:

• Ukuba ufumana iintlungu esifubeni ubuncinane kanye ngeveki.
• Ukuba uneempawu ezingaqhelekanga.
• Ukuba unengxaki yokuginya okanye awukwazi ukufumana iikhalori ezaneleyo.
• Ukuba uneminyaka engaphezu kwama-60 ubudala.
• Ukuba unentlungu yesifuba efana ne-"Angina" (eqinileyo, exineneyo).
• Ukuba unyango lwakho aluniki ncedo.

Okokugqibela, ndimele ndithi...

Ukuqaqamba komphimbo ngamanye amaxesha kuqhelekile. Uninzi lwabantu lunokukulawula ngotshintsho olulula. Nangona kunjalo, ukuba uhlala unazo, unokufuna uncedo lwezonyango. Musa ukuzityeshela iintlungu zomphimbo ezingapheliyo. Ukuva iintlungu emqaleni wakho kudla ngokuthetha ukuba zonakele. Oku kunokubangela umonakalo omkhulu ekuhambeni kwexesha. Kwakhona, iintlungu zomphimbo ezingapheliyo zingaba luphawu lokuba kukho ezinye iingxaki ezifuna unyango. Ngoko ke, thetha nogqirha malunga neentlungu zomphimbo ezingapheliyo.

Isitshiso sentliziyo, iGERD, i-Acid Reflux, i-Esophagus, isisu, ukudumba kwesifuba