Ingabe nawe uphathwa yisisu esibuhlungu kanye nobuhlungu besifuba? Ake sifunde nge-acid reflux kanye ne-GERD!

Ngemva kokudla, ingabe ngezinye izikhathi uzizwa ushisa esifubeni sakho, umuzwa omuncu emphinjeni wakho, noma ukuqina esiswini sakho, okufana nesilungulela? Lezi yizimpawu ezivamile ze-acid reflux abantu abaningi ababhekana nazo. Nakuba kuvamile ukuthi lokhu kwenzeke ngezikhathi ezithile, kuyinto okufanele ukhathazeke ngayo uma kwenzeka njalo.

Kuyini i-Acid Reflux? Masiqonde kalula!

Kalula nje, i-acid reflux yilapho okuqukethwe yisisu sethu, ikakhulukazi i-gastric acid , kugeleza phezulu, okungukuthi, kubuyela emphinjeni. Ngokuvamile, ukudla esikudlayo kuya esiswini bese kwehla. Kodwa kulokhu, kwenzeka okuphambene nalokho.

Cabanga ngakho, le asidi esiswini sethu inamandla kakhulu. Yenzelwe ukugaya ukudla. Ngakho-ke uma into efana nale ingena emhubheni - ipayipi lokudla - ingalimaza izicubu ezithambile ngaphakathi komhubhe futhi ibangele ukuvuvukala. Abantu abaningi babhekana nalokhu ngezikhathi ezithile. Abanye bakubiza ngokuthi "ukugayeka kokudla" , abanye bakubiza ngokuthi "isilungulela" , okuwumuzwa oshisayo ozwakala phakathi kwesifuba, eduze kwe-sternum.

Le nkinga ye-acid reflux ngezikhathi ezithile ayiyona isifo esibi kakhulu. Kodwa kwabanye abantu, iyenzeka ngaso sonke isikhathi. Njengoba i-acid reflux iqhubeka njalo, kunzima ukuphila impilo evamile, futhi ingalimaza nomphimbo wethu.

Ngakho-ke iyini i-GERD?

I-GERD yigama elifushane le- Gastroesophageal Reflux Disease . Kwamanye amazwe, ibhalwa nangokuthi i-GORD (Gastro-oesophageal Reflux Disease) . Noma kunjalo, ibhekisela esimweni lapho i-acid reflux emgogodleni wethu ivele khona isikhathi eside (chronic acid reflux) . Uma i-acid ivele kanje okungenani kabili ngesonto, amasonto amaningana, odokotela bayibheka njengesimo se-GERD.

I-asidi ingavela ngenxa yezizathu zesikhashana. Isibonelo, ukulala phansi ngemva kokudla kakhulu. Kodwa i-GERD ayiyona into enjalo. Iyinkinga ehlala njalo, eyenzeka ngomshini . Okusho ukuthi, izindlela ezivimbela i-asidi ukuthi ingene emgudwini womchamo azisebenzi kahle.

Zivame kangakanani lezi zimo?

Zombili izimo ezibizwa ngokuthi isifo se-gastroesophageal reflux (GERD) kanye ne-GERD zivame kakhulu. Ezweni elifana neMelika, kulinganiselwa ukuthi cishe ama-20% abantu abadala kanye nezingane ezingaba ngu-10% bane-GERD. Lesi simo singabonakala ezweni lethu ngezinga elikhulu noma elincane.

Ziyini izimpawu zalokhu? Bheka ukuthi nawe unazo lezi!

Kunezimpawu eziningana ze-acid reflux kanye ne-GERD. Bheka ukuthi kukhona yini okuzwakala kujwayelekile kuwe:

• Ukuhlanza/Ukuhlanza Umhlane: Ngemva kokudla, ungase uzizwe sengathi i-asidi yesisu, izinhlayiya zokudla, kanye noketshezi kubuyela emphinjeni wakho. Lokhu kubizwa ngokuthi ukuhlanza . Ngezinye izikhathi kungahambisana nokunambitheka okumuncu .
• Umuzwa wokushisa: Ngenxa yokuthi i-asidi iyinto enamandla, ibangela umuzwa wokushisa emphinjeni. Uma lokhu kuzwakala esifubeni, kubizwa ngokuthi isilungulela . Uma kuzwakala esiswini, kubizwa ngokuthi i-asidi indigestion .
• Ubuhlungu besifuba obungebona obenhliziyo: Abanye abantu bazwa ubuhlungu besifuba obungazwakali sengathi buvutha. Imizwa ezwa ubuhlungu emgogodleni ifana nemizwa ezwa ubuhlungu enhliziyweni, ngakho-ke ngezinye izikhathi ingaphambaniswa nokuhlaselwa yinhliziyo.
• Isicanucanu: Ukuhlanza isisu nge-asidi kungabangela isicanucanu nokulahlekelwa yisifiso sokudla. Ngisho nangemva kwesikhathi eside, isisu singase sizizwe sigcwele.
• Umphimbo obuhlungu: Uma i-asidi ingena emphinjeni wakho, ingabangela umphimbo obuhlungu, umuzwa wokuthi kukhona okubhajwe emphinjeni wakho, kanye nobunzima bokugwinya. Ngokuvamile, i-asidi ingena emphinjeni wakho ebusuku ngenkathi ulele.
• Izimpawu ze-asthma: I-GERD ingenza izimpawu ze-asthma zibe zimbi kakhulu kubantu abane-asthma, futhi ngisho nakubantu abangenayo i-asthma, ingabangela ukukhwehlela, ukuphefumula kanzima, kanye nobunzima bokuphefumula . Lokhu kungenxa yokuthi izinhlayiya ze-asidi zinganciphisa imigudu yomoya uma zingena kuzo.

Kunini lapho lezi zimpawu zizwakala khona kakhulu?

• Uma ulele noma ulele phansi ebusuku .
• Ngemva kokudla ukudla okuningi noma ukudla okunamafutha amaningi .
• Uma ugoba phambili.
• Uma ubhema noma uphuza utshwala .

Ingabe izingane ezincane nazo ziyaba ne-GERD?

Kuvamile kakhulu ukuthi izinsana ezisanda kuzalwa ziphinde ziphuze ubisi. Inani elincane le-asidi lingase lifike nobisi, kodwa ngeke libangele izinkinga ezinkulu enganeni. Kodwa-ke, i-GERD iyisimo esibi kakhulu. Ingabangela ukungakhululeki nezinkinga ngokuncelisa.

Izingane ezizalwa ngaphambi kwesikhathi noma ezinesimo sezokwelapha esihlobene nomphimbo zinamathuba amaningi okuthola i-GERD. Kungumqondo omuhle ukubona udokotela wezingane uma ingane yakho inanoma yiziphi zalezi zimpawu:

• Uma uhlala ukhala ngaphandle kwesizathu .
• Uma unenkinga yokulala .
• Uma ungathandi ukuphuza ubisi .
• Uma uhlala uhlanza kancane .
• Uma wenza umsindo wokuphefumula lapho uphefumula noma uma izwi lakho lihoshozela .
• Uma unephunga elibi eliphuma emlonyeni wakho .

Kungani kuvela le-asidi? Yiziphi izizathu?

Ukuze ingene emgudwini womchamo, i-asidi kufanele idlule ku-valve engezansi komchamo evame ukuvimbela izinto ukuthi zingabuyi phezulu. Le valve ibizwa ngokuthi i-Lower Esophageal Sphincter (LES) .

Le LES iyisicubu esiyindilinga. Iyavuleka uma sigwinya ukudla, bese ivala futhi ukuze kugcinwe okuqukethwe yisisu endaweni yaso. Iphinde ivuleke kancane uma sibhodla, njengalapho siqhuma, ukuze kuphume amabhamuza omoya.

I-asidi iyakhuphuka lapho i-LES iba buthakathaka noma ikhululeka kakhulu . Ezinye izinto zesikhashana zingabangela i-LES ukuthi iphumule. Isibonelo, ukulala phansi ngemva kokudla okukhulu. Kodwa uma une-GERD, i-LES yakho ihlala iphumule.

Izimbangela ezivamile zobuthakathaka be-LES zifaka:

• I-Hiatal Hernia: Lokhu kwenzeka lapho ingxenye engenhla yesisu isunduza idlule emgodini okwi-diaphragm lapho i-esophagus yehla khona. Ingabe isinamathela ku-esophagus, okubangela ukuthi i-asidi iqongelelane. Futhi, ngoba i-LES itholakala ngaphezu kwesisu, ayisekeli imisipha kakhulu. Lesi simo sivame kakhulu uma umuntu ekhula futhi singakhula kancane kancane.
• Ukukhulelwa: Ukuvuvukala kwe-acid okwesikhashana kuvame kakhulu ngesikhathi sokukhulelwa. Ukucindezeleka komntwana okhulayo esiswini kunganwebeka futhi kunciphise imisipha esekela i-LES. Futhi, ama-hormone akhishwa ngesikhathi sokukhulelwa, njenge -relaxin ( ekhulula imisipha ukuze ivule isikhala somntwana), i-estrogen, ne -progesterone, nakho kungakhulula i-LES.
• Ukukhuluphala ngokweqile: Ukukhuluphala ngokweqile kungandisa nokucindezeleka kwangaphakathi kwesisu, okungathinta i-LES, njengokukhulelwa. Ukukhuluphala ngokweqile kungahlala isikhathi eside kunokukhulelwa, futhi imisipha ingaba buthakathaka unomphela. Lokhu futhi kuyimbangela enkulu ye-hernias yokubeletha. Njengoba izicubu zamafutha zikhipha i-estrogen, amazinga e-estrogen kubantu abakhuluphele nawo ayanda.
• Ukubhema: Izinto ezikugwayi ziphumuza i-LES. Lo mphumela ungenzeka noma ngabe uyabhema noma uphefumula intuthu lapho abanye bebhema (intuthu ebhemayo). Ukubhema kubangela ukukhwehlela, futhi uma ukhwehlela, i-LES iyavuleka. Ukuqhubeka nokubhema nokukhwehlela kungenza buthaka imisipha yodonga lwesisu futhi kubangele i-hernia yokubeletha. Akukhona lokho kuphela, ukubhema kunciphisa nokugaya ukudla futhi kubangele isisu ukuthi sikhiqize i-asidi eyengeziwe .

Ezinye izimbangela ezingaba khona ze-GERD zifaka:

• Ezinye izinkinga zokuzalwa: Isibonelo, izimo ezihilela umphimbo njenge- esophageal atresia .
• Izifo zezicubu ezixhumeneyo: Izifo ezifana ne -scleroderma zingathinta imisipha yomphimbo.
• Ukuhlinzwa kwangaphambilini: Ukuhlinzwa esifubeni noma esiswini esingaphezulu kungenzeka ukuthi kulimaze umphimbo.
• Imithi ethile: Eminye imithi ingaphumuza i-LES.
• Ama-Benzodiazepine (i-tranquilizer)
• Ama-calcium channel blockers ( imithi yokwelapha umfutho wegazi ophakeme)
• Ama-antidepressant e-Tricyclic (imithi yokucindezeleka nobuhlungu)
• Ama-NSAID (izidakamizwa ezingezona eze-steroidal ezilwa nokuvuvukala) - iziqeda ubuhlungu njenge-aspirin ne-ibuprofen
• I-Theophylline (umuthi ovamile we-asthma)
• Ukwelashwa ngama-hormone (HT) ngesikhathi sokunqamuka kokuya esikhathini

Ingabe ukudla neziphuzo kuyakuthinta lokhu?

Ukudla nokuphuza kuphela kungase kungabangela i-acid reflux, kodwa kungenza isimo sibe sibi kakhulu. Ukudla izinto eziningi kakhulu njengoshokoledi , ikhofi, utshwala, iminti, igalikhi, kanye no-anyanisi kungaphumuza i-LES.

Ukudla okunamafutha kwandisa i-asidi esiswini futhi kuthatha isikhathi eside ukugaya. Ngakho-ke kunethuba elikhulu lokubuyela kwe-asidi esiswini. Uma udla ukudla okunzima ngesikhathi sakusihlwa, kungase kungagaywa ngaphambi kokulala.

Yiziphi izinkinga ezingavela uma lokhu kuqhubeka?

I-asidi esesiswini sethu inamandla kakhulu. Yenzelwe ukugaya ukudla esikudlayo. Isisu sethu sinolwelwesi olujiyile ngaphakathi ukuze sivikeleke kule-asidi. Kodwa ezinye izitho zethu azinalo lolu sivikelo.

I-acid reflux ithinta kakhulu umphimbo. Kodwa ngezinye izikhathi le acid ingakhuphukela epayipini lomoya noma emigudwini yomoya. Ngisho noma inani elincane le-acid likhuphuka, lingabangela ukungakhululeki, kodwa uma likhuphuka njalo, lingalimaza lezi zitho zomzimba.

Izinkinga ezingaba khona:

• I-Esophagitis: Lokhu ukuvuvukala kolwelwesi lwe-esophagus. I- esophagitis yesikhathi eside ingabangela ubuhlungu obuqhubekayo kanye nezilonda ku-esophagus. Ngokuhamba kwesikhathi, ingaholela ekuqhekekeni noma ekuqhekekeni kwamathumbu, isimo esingaphambi komdlavuza esingaholela kumdlavuza.
• I-Barrett's esophagus: Leli igama elinikezwe isimo esibizwa ngokuthi i-intestinal metaplasia ku-esophagus. Yilapho ulwelwesi lwe-esophagus lushintsha khona futhi lufana nolwelwesi lwamathumbu. Lokhu kubangelwa ukuchayeka isikhathi eside ku-asidi nokuvuvukala. Lokhu kuyisici esiyingozi somdlavuza we-esophagus .
• Ukuqiniswa komlomo wesibeletho: Izicubu zesibeletho zingakheka emhubheni ukuze zivikeleke ekuvuvukeni nasekulimeni kwesikhathi eside. Lezi zicubu zesibeletho zingabangela ukuthi umhubhe ube mncane. Lokhu kubizwa ngokuthi ukuqiniswa . Lokhu kungenza kube nzima ukugwinya nokudla.
• Ukuvuvukala kwe-asidi emphinjeni nase-larynx (i-Laryngopharyngeal reflux - LPR):Abanye abantu abane-GERD nabo bahlakulela i-LPR, okuyilapho i-asidi ingena emphinjeni. I-asidi ingangena emphinjeni wakho ngenkathi ulele. Lokhu kungabangela umphimbo wakho ukuthi uvuvuke, izwi lakho libe likhulu, futhi kukhule nokukhula kwe-vocal cord . Izinhlayiya ze-asidi nazo zingangena emigudwini yakho yomoya.
• Isifuba somoya: Ukuhogela i-asidi kungenza i-asthma ibe yimbi kakhulu kubantu asebenayo kakade i-asthma, futhi ngisho nakubantu abangenaso isimo sokuphefumula esivele sikhona, izimpawu ezifana ne-asthma zingavela. Izinhlayiya ezincane ze-asidi zingangena emapayipini e-bronchial, zibangele ukuthi anciphe, okubangela ukukhwehlela nobunzima bokuphefumula.

Wazi kanjani ukuthi une-GERD? Yiziphi izivivinyo zezokwelapha?

Udokotela wezifo zamathumbu uzohlola umphimbo wakho ukuze athole ukuthi une-GERD yini. Kunezivivinyo eziningana ezingenziwa ukuze kutholakale lokhu:

• I-Esophagram: Lokhu ukuhlolwa kwe-X-ray. Umphimbo uhlolwa kusetshenziswa i-X-ray (fluoroscopy) ehamba njengoba ugwinya. Unikwa uketshezi olufana ne-chalk olubizwa nge -barium ukuze uluphuze.
• I-endoscopy Ephezulu: Lokhu kuhilela ukufaka ipayipi elincane elinekhamera emlonyeni wakho ukuhlola ingaphakathi lomphimbo wakho. Uzonikezwa umuthi wokudambisa ubuhlungu bese ulaliswa.
• Ukuhlolwa kwe-pH ye-Esophageal: Lokhu kulinganisa inani le-asidi ku-esophagus. Ngesikhathi se-endoscopy, udokotela ubeka inzwa encane engenantambo (isamukeli esingenantambo) ku-esophagus.
• I-Esophageal manometry: Lokhu kulinganisa ukusebenza kwemisipha emhubheni. Lokhu kwenziwa kusetshenziswa izinzwa zokucindezela ezibekwe epayipini le-nasogastric. Lokhu kunganquma ukuthi i-LES noma eminye imisipha isebenza kahle yini.

Yiziphi izindlela zokwelapha zalokhu?

Abanye abantu banganciphisa i-acid reflux yabo ngokwenza izinguquko endleleni yokuphila, njengokushintsha imikhuba yabo yokudla, ukunciphisa utshwala nokubhema, kanye nokwehlisa isisindo. Odokotela bakhuthaza nabantu ukuthi balandele lezi zindlela.

Kodwa uma une-reflux ye-acid engapheli noma i-GERD, odokotela bangase bakunike imithi enciphisa i-asidi yesisu. Khona-ke, noma ngabe i-asidi ivele, ngeke ibe yingozi kangako. Le mithi itholakala kalula futhi isebenza kahle kakhulu kwi-GERD.

Umuthi

Imithi ethengiswa ngaphandle kwemithi kadokotela (OTC) etholakala emakhemisi ngaphandle kwemithi kadokotela:

• Ama-antacid: Ama-antacid, njenge-Tums® kanye ne-Rolaids®, aqeda i-asidi yesisu. Lokhu kusho ukuthi noma ngabe i-asidi ikhuphuka, ngeke ibangele umonakalo omkhulu emgudwini womchamo. Lawa mahle ekuvuseleleni i-asidi ngezikhathi ezithile, kodwa angabangela imiphumela emibi uma ethathwa njalo, ngakho-ke awayona ikhambi elihle lesikhathi eside.
• Ama-Alginates:I-Alginate ushukela wemvelo okhishwe olwandle. Intanta phezu kwe-asidi, idale umgoqo ongokoqobo phakathi kwe-asidi nomphimbo. Kunemithi equkethe i-alginate yodwa, kanye nemithi ehlanganisa i-alginate nama-antacid.

Imithi kadokotela:

• Ama-histamine receptor antagonists (ama-H2 blockers): Ama-H2 blockers anciphisa ukukhiqizwa kwe-asidi yesisu. Lokhu kungenxa yokuthi avimba ikhemikhali (i-histamine) etshela umzimba ukuthi ukhiqize i-asidi. Lawa angathathwa kaningi kune-antacids, kodwa awasebenzi ngaso sonke isikhathi isikhathi eside. Umzimba ungawajwayela.
• Ama-proton pump inhibitors (PPI): Ama-PPI uhlobo lwemithi evimba i-asidi ngempumelelo futhi ikhuthaze ukuphulukiswa kwezicubu. Udokotela wakho angase akuncome lokhu kuqala uma i-GERD yakho inzima noma uma unezimpawu zokulimala kwezicubu emgudwini wakho. Asebenza kahle ngo-90% ekunciphiseni i-acid reflux.
• I-Baclofen: I-Baclofen iyisidakamizwa sokuphumula imisipha. Ivame ukunikezwa ukunciphisa ukuqaqamba kwemisipha. Inganciphisa nenani lezikhathi i-LES ephumula ngazo, okunganciphisa inani le-asidi elivelayo. Akuyona imithi yokuqala ye-acid reflux, kodwa ingaba yingxenye yohlelo lwakho lokwelashwa.

Ayikho indlela yokuqeda noma yokwelapha ngokuphelele i-acid reflux?

Nakuba imithi inganciphisa izimpawu nemiphumela ye-GERD, ayikwazi ukuyimisa ngokuphelele. Ngisho noma umuntu one-GERD enzima ephuza imithi, ungase ubhekane nezinkinga, noma ungaqapheli.

Ezimweni ezinjalo, kudingeka ikhambi elihlala njalo ukuze kuvinjelwe i-asidi ukuthi ingakhuphuki. Lokhu ngokuvamile kusho ukuhlinzwa ukuze kuqiniswe i-LES . Lokhu ngokuvamile akuzona ukuhlinzwa okukhulu, kuyizinqubo zokulaliswa esibhedlela, futhi kuphumelele kakhulu.

Ukuhlinzwa

Ukuhlinzwa kwe-GERD:

• I-Nissen fundoplication: Lokhu kuyindlela yokuhlinzwa evame kakhulu ye-GERD. Uma kungenzeka, kwenziwa nge-laparoscopically . Lokhu kusho ukuthi kwenziwa ngokusika okuncane, okusho ukuthi isikhathi sokululama sifushane. Udokotela ohlinzayo uthatha ingxenye engenhla yesisu, ayigoqe engxenyeni engezansi yomhubhe, bese eyithunga ndawonye. Lokhu kuhlinzwa kwenziwa nakubantu abane-hernias ye-hiatal.
• Idivayisi ye-LINX: Lena inqubo entsha. Idivayisi ebizwa ngokuthi i-LINX ifakwa ngokuhlinzwa. Idivayisi ye-LINX iyindandatho encane yamagnethi. Isiza ukugcina ukuxhumana phakathi kwesisu nomphimbo kuvaliwe.

Yini ongayenza ukuze ulawule i-acid reflux ekhaya?

Zama lezi zinto ukulawula i-acid reflux ekhaya:

• Yidla ukudla okuncane:Ukudla okukhulu kugcwalisa isisu futhi kubeke ingcindezi ku-LES. Ukudla okuncane kugaywa ngokushesha futhi akukhiqizi i-asidi eningi esiswini.
• Yidla isidlo sakusihlwa kusenesikhathi: Kungcono ukudla amahora ambalwa ngaphambi kokuba ulale bese ulala ebusuku, njengoba amandla adonsela phansi esiza ukugcina i-asidi iphansi.
• Lala ngohlangothi lwakho lwesobunxele: Uma ulala ngale ndlela, i-LES yakho ihlezi ngaphezu kokuqukethwe yisisu sakho, njengesikhwama somoya. Ukulala ngohlangothi lwakho noma ngohlangothi lwakho lwesokudla kungabangela ukuthi i-valve iwe.
• Nciphisa ingcindezi esiswini sakho: Gqoka izingubo ezikhululekile. Uma ukhuluphele kakhulu, zama ukunciphisa isisindo. Lokhu kuzosiza esikhathini esifushane kanye nesikhathi eside.
• Yeka ukubhema nokuphuza utshwala: Kokubili ugwayi notshwala kwenza buthaka i-LES. Kuphinde kwandise i-asidi yesisu, okwandisa isikhathi sokugaya ukudla.
• Imithi etholakala ngaphandle kwemithi kadokotela: Gcina imithi efana nemithi yokunciphisa i-asidi kanye nemithi ye-alginates iseduze . Sebenzisa lokhu ikakhulukazi uma wazi ukuthi uzodla ukudla okunzima nokune-asidi.

Wenzani uma kuvela i-asidi ngokuzumayo?

Zama ukwenza lezi zinto ngaleso sikhathi:

• Sukuma: amandla adonsela phansi asohlangothini lwakho.
• Phuza isiphuzo samanzi esisodwa noma ezimbili: Ungaphuzi kakhulu, kodwa ama-sips ambalwa amanzi angasiza ekususeni i-asidi.
• Khulula ibhande: Khumula ibhande, noma ushintshe ibhulukwe uma ukwazi.
• Thatha umuthi wokunciphisa i-asidi: Uma ungenayo eduze, into efana ne-Pepto Bismol® ingasiza.

Kufanele ngimbone nini udokotela ngalokhu?

Uma unesifo sokushisa kwesisu esivame ukwenzeka, qiniseka ukuthi ubona udokotela . Kubalulekile ukuqonda ukuthi sithinta kanjani umzimba wakho. I-GERD ayigcini nje ngokungathandeki - ingaba yingozi. Futhi, kunezindlela ezinhle zokwelapha lesi sifo.

Abantu abaningi babhekana nokushisa kwenhliziyo ngezikhathi ezithile. Isicanucanu, ubuhlungu besisu, kanye ne-acid reflux kungenza kube nzima ukudlula usuku. Kunezinto ongazenza ukuze unciphise ukuvama kwalezi zimpawu.

Kodwa uma unesifo sokushisa kwesisu esivamile futhi sithinta impilo yakho, kungenzeka ukuthi une-GERD. Kuhle ukukhuluma nodokotela ngezimpawu zakho. Bangakusiza ukuthi unqume ukuthi ukwelashwa kungasiza yini.

Khumbula into ebaluleke kakhulu (Umyalezo Wokuya Ekhaya)

I-acid reflux kanye ne-GERD yizimo ezithinta abantu abaningi. Nakuba kujwayelekile ukuba nazo ngezikhathi ezithile, kubalulekile ukuzazi uma ziyinkinga evamile.

• Thola izimpawu zakho. Qaphela izinto ezinjengokunambitheka okumuncu emphinjeni, ubuhlungu besifuba, kanye nobunzima bokugwinya.
• Izinguquko ezilula zendlela yokuphila zingenza umehluko omkhulu. Cabanga ngalokho okudlayo, ukuthi udla nini, nokuthi ulala kanjani.
• Gwema ukubhema notshwala.Empeleni lokhu kuyayikhulisa le nkinga.
• Uma ungakwazi ukuyilawula ngemithi yasekhaya, qiniseka ukuthi ufuna iseluleko sezokwelapha . I-GERD yisimo esingelapheka. Kodwa-ke, uma ingelashwa, ingaholela ezinkingeni.
• Ungakhathazeki. Lesi simo singaphathwa kahle ngeseluleko nokwelashwa okufanele. Khuluma nodokotela wakho ngokukhululekile.

Ngithemba ukuthi lolu lwazi luwusizo. Hlala uphilile!