Ingaba umqala wakho uhlala ubuhlungu? Oku kusenokuba yi-LPR (Laryngopharyngeal Reflux)!

Ngaba uhlala uziva ngathi kukho iqhuma emqaleni wakho, ngathi kukho into ebambekileyo kuyo? Ngaba uhlala uziva ngathi ufuna ukucoca umqala wakho uthi "Mm... Mm..."? Usenokucinga ukuba ngumkhuhlane okanye yi-allergy kuthuli. Kodwa ukuba ayikapheli kangangeenyanga, unobangela usenokuba yinto eyahlukileyo kancinci kwaye enzulu kunokuba ucinga. Namhlanje sithetha ngengxaki "efihliweyo" abantu abaninzi abangayaziyo, kodwa abantu abaninzi banayo. Le nto siyibiza ngokuba yi-LPR, okanye i-Laryngopharyngeal Reflux.

Yintoni i-LPR? Ingaba oku kukwabizwa ngokuba yi-'silence reflux'?

Kulungile, masiyigcine le nto ilula. Usenokuba ukhe weva nge "gastritis" okanye "acid reflux." Kulapho iijusi zesisu ezinceda ekugayeni ukutya zibuyela kwi-esophagus. Ngokwesiqhelo, xa oku kusenzeka, siva imvakalelo yokutshisa esifubeni okanye esiswini. Le meko siyibiza ngokuba yi-GERD (Gastroesophageal Reflux Disease).

Kodwa i-LPR yinto eyahlukileyo kancinci, ekhethekileyo. Okwenzekayo apha kukuba i-asidi ephuma esiswini ayimi esifubeni, kodwa ihambela phezulu iye emqaleni wakho (pharynx) nakwibhokisi apho kukho khona ii-vocal cords (i-larynx).

Ngamafutshane, i-GERD yingxaki eqala esifubeni. I-LPR yingxaki enyuka kakhulu ize ichaphazele umqala. Abanye abantu banokuba nazo zombini. Abanye abantu banokuba ne-LPR kuphela.

Ziziphi iimpawu ezibonisa ukuba umntu une-LPR?

Ukuba sele unenye okanye ngaphezulu kwezi mpawu ixesha elide, xhalaba. Makhe sijonge ezona ziphambili.

Kutheni le nto izinto ezisesiswini zinyuka ziye emqaleni ngolu hlobo?

Ukuze sikuqonde oku, kufuneka sazi kancinci nge-esophagus yethu. Cinga ngayo njengetyhubhu ene-valve ezimbini phezulu nasezantsi. Ezi valve sizibiza ngokuba yi- sphincters .

1. Ivalvu engezantsi (iLower Esophageal Sphincter - LES):Oku kuphakathi komqala kunye nesisu (umlomo). Xa siginya ukutya, kuyavuleka ukuze ukutya kudlulele esiswini, kuze kuvaleke kwakhona. Oku kuyayithintela i-asidi yesisu ukuba ingabuyi.

2. I-Upper Esophageal Sphincter (UES): Le valve iphakathi kwe-esophagus nomqala. Umsebenzi wayo kukuthintela nantoni na engene kwi-esophagus ukuba ingabuyeli phezulu emqaleni.

Ukuze i-LPR yenzeke, zombini ezi valve akufuneki zisebenze kakuhle. Okokuqala, ivalvu esezantsi (LES) kufuneka ibe buthathaka, ivumele i-asidi yesisu ukuba ibuyele kwi-esophagus. Emva koko, ivalvu ephezulu (UES) kufuneka ibe buthathaka, ivumele i-asidi ukuba ibuyele kwi-esophagus.

Ngoko ke, kutheni ezi valve zibuthathaka?

Zininzi izizathu zoku. Ezinye zezexeshana, ezinye zezexesha elide.

1. Izinto ezenza buthathaka i-LES

Kwiimeko ezininzi, izizathu ezifanayo ezichaphazela i-gastritis eqhelekileyo nazo ziyayichaphazela le nto.

• Amanye amayeza: Iipilisi zokunciphisa iintlungu (ii-NSAID), amanye amayeza oxinzelelo lwegazi oluphezulu (iiCalcium channel blockers), kunye namayeza eengxaki zempilo yengqondo (iiTricyclic antidepressants) anokubangela ukuba le valve ikhululeke.
• Oku kunokubangelwa kukutya okuthile neziselo: ikofu, itshokolethi, iminti, igalikhi, itswele kunye notywala.
• Imikhwa emibi:
• Ukulala phantsi emva kweeyure ezi-2-3 emva kokutya.
• Ukutya kakhulu ngexesha elinye kunokubangela ukudumba kwesisu. Oku kwandisa uxinzelelo ngaphakathi esiswini kwaye kunyuse i-asidi.
• Ukunxiba iimpahla eziqinileyo esiswini, ingakumbi esinqeni.
• Izizathu zexesha elide:
• I-Hiatal Hernia: Oku kwenzeka xa inxalenye encinci yesisu iphuma iye esifubeni. Oku kwenza buthathaka ukusebenza kwevalvu ye-LES.
• Ukutyeba kakhulu: Njengoko ubunzima busanda, uxinzelelo olungaphakathi esiswini luyanda. Oku nako kuyimbangela enkulu.
• Ukukhulelwa: Utshintsho lweehomoni kunye noxinzelelo oluphezulu esiswini ngeli xesha kunokubangela i-gastritis kunye ne-LPR okwethutyana.
• Ukutshaya: Ukutshaya lutshaba olukhulu olukhulula le valve.

2. Izinto ezenza buthathaka i-sphincter ephezulu ye-esophageal (UES)

Emva kokuba i-asidi iphume ngevalvu esezantsi, ivalvu ephezulu yindlela yokugqibela yokukhusela umqala. Imiqala yethu ayenzelwanga ukumelana ne-asidi njenge-esophagus. Ngoko ke nokuba incinci kakhulu i-asidi inokubangela umonakalo omkhulu.

• Ukulala phantsi: Xa silala phantsi, zombini ezi valves ziyakhululeka kancinci. Oku kwenza ukuba i-LPR ivele ebusuku xa silele.
• Ukubhodla: Xa ubhodla, zombini iivalvu ziyavuleka, nto leyo evumela ukuba i-asidi encinci ingene emqaleni wakho kunye nomoya.
• Ukugoba phambili, ukuzilolonga, ukucula: Imisebenzi efana nale inokunyusa uxinzelelo phantsi kwevalvu ephezulu, iyenze buthathaka.
• Ukutshaya notywala: Zombini ziyingozi ngokulinganayo kuzo zombini iivalvu.

Ingaba kuyingozi ukungawunaki umgangatho we-LPR?

Ewe, ukuba le meko iqhubeka ixesha elide, ezinye iingxaki zinokubakho.

• Usulelo oluqhelekileyo: I-asidi emqaleni iphazamisana nenkqubo yendalo yokucoca umqala kunye neempumlo. Oku kunokukhokelela ekuqokeleleni kwe-mucus kunye nosulelo oluqhelekileyo lomqala kunye neendlela zokuphefumla.
• Iingxaki zelizwi nomqala ixesha elide: Ukuhlala ujongene ne-asidi kungonakalisa ii-vocal cords, okubangela izinto ezifana nezilonda ze-vocal cord. Ukuhlala ujongene nale meko ixesha elide kunokunyusa kancinci umngcipheko womhlaza we-laryngeal.
• Iingxaki zokuphefumla: I-asidi encinci engena emqaleni inokunyuka nge-trachea iye emiphungeni singazi nokuba ithini, ingakumbi xa silele. Oku kubizwa ngokuba yi -silent aspiration . Oku kunokukhokelela kwiintsholongwane zemiphunga kunye neemeko ezifana ne-bronchitis.

Ndingayazi njani kanye kanye ukuba yintoni i-LPR?

Ukuba ubusoloko uhlangabezana nezi mpawu besizikhankanyile ngaphambili, eyona nto ingcono onokuyenza kukubona ingcali yendlebe, impumlo, kunye nomphimbo (ENT Surgeon) . Yena uza kumamela iimpawu zakho aze ahlole umqala wakho.

Uvavanyo oluphambili oludla ngokwenziwa koku yi -laryngoscopy eguquguqukayo . Oku kuquka ukudlulisa umbhobho omncinci kakhulu, oxhotyiswe ngekhamera ngempumlo yakho uye entanyeni yakho ukuze kuhlolwe ingaphakathi leentambo zakho zelizwi kunye nomphimbo. Le yinkqubo engenabuhlungu enokwenziwa ngemizuzu embalwa.

Olu vavanyo lunokujonga ukuba kukho ukubomvu kunye nokudumba emqaleni. Ngamanye amaxesha, kunokufuneka uvavanyo olongezelelweyo ukuqinisekisa ukuxilongwa okanye ukuthintela ezinye izizathu.

• I-Upper Endoscopy: Oku kuquka ukufaka ikhamera ngomlomo ukuze kuhlolwe umphimbo nesisu. Ingajonga iingxaki ze-sphincter esezantsi ye-esophageal (LES) kunye ne-hernia ye-hiatal.
• Uvavanyo lwe-pH yesisu: Olu vavanyo lulinganisa amanqanaba e-asidi emqaleni nakwi-esophagus kwixesha leeyure ezingama-24.
• I-Esophageal Manometry: Uvavanyo olulinganisa ukusebenza kunye namandla emisipha ye-esophagus kunye neevalvu zayo.

Kulungile, siza kwenza ntoni ngoku ngale nto? Zithini iindlela zonyango?

Eyona nto ibalulekileyo ekunyangeni i-LPR kukutshintsha indlela yokuphila kunye nendlela yokutya . Amayeza akwindawo yesibini.

1. Ukutshintsha indlela yokuphila kunye nemikhwa yokutya (oku yeyona nto ibalulekileyo)

Ukuba ulandela le mikhwa ngokuchanekileyo, unokuhlala ungayilawula le meko ngaphandle kwamayeza.

2. Unyango ngamayeza

Ngelixa esenza utshintsho kwindlela yokuphila, ugqirha wakho unokukunika amayeza okunceda izicubu zomqala ezonakeleyo ziphilise.

• IiProton Pump Inhibitors (PPIs): Amayeza afana ne-Omeprazole kunye nePantoprazole asebenza ngokunciphisa ukuveliswa kwe-asidi esiswini. La mayeza adla ngokumiselwa iinyanga ezininzi.
• Ii-H2 Blockers: Amayeza afana neFamotidine akwanceda ekulawuleni i-asidi.
• IiAlginates: Ezi zenza umaleko okhuselayo esiswini, zithintela i-asidi ukuba inganyuki.

3. Utyando

Oku akufuneki kakhulu. Utyando luqwalaselwa kuphela xa kukho ingxaki ethile yomzimba, njenge-hernia yokuzala, okanye ukuba akukho nyango lumbi oluye lwanceda.

Ukuqukumbela, i-LPR yimeko ecaphukisayo kancinci, kodwa inokulawulwa kakuhle ukuba ilawulwa ngokufanelekileyo. Eyona nto ibalulekileyo kukungawutyesheli iimpawu, ufumane uxilongo oluchanekileyo, kwaye ngakumbi ube nomonde ngotshintsho olufunekayo kwindlela ophila ngayo.