Ingabe uvame ukuba nesilungulela? Ake sixoxe ngalokhu (Isilungulela)!

Wake wazizwa umuzwa wokushisa phakathi kwesifuba sakho? Kuzwakala sengathi umuzwa wokushisa esifubeni sakho? Abantu abaningi bakubiza ngokuthi "isicanucanu," kodwa empeleni akuyona inkinga yenhliziyo. Kubangelwa yi-asidi esiswini sakho ekhuphukela epayipini lakho lokudla (esophagus). Le payipi lokudla lidlula esifubeni sakho, eduze kwenhliziyo yakho. Yingakho ngezinye izikhathi lingaphambaniswa nenkinga yenhliziyo. Kwabanye abantu, kuyinto eyenzeka ngezikhathi ezithile, kodwa kwabanye, kuyinkinga eqhubekayo. Uma kwenzeka njalo, kungaba uphawu lwesimo esibizwa ngokuthi i-GERD (Gastroesophageal Reflux Disease). Ake sixoxe kabanzi ngalokhu, akunjalo?

Kuyini ngempela isilungulela?

Kalula nje, isilungulela sisho ukuthi i-asidi yesisu igeleza ibuyele emphinjeni. Isisu sethu sinolwelwesi olujiyile oluvikela kula ma-asidi. Kodwa-ke, i-asophagus yethu ayinalo isivikelo esinjalo. Ngakho-ke, lapho i-asidi yesisu ifika emphinjeni, ishisa izicubu ezithambile lapho, okubangela ukuvuvukala.

Abantu abaningi bake baba nesishiso senhliziyo ngesikhathi esithile empilweni yabo. Ngezinye izikhathi kungenzeka ngemva kokudla ukudla okunongwe kakhulu noma okunamafutha, noma lapho kunengcindezi enkulu esiswini, njengasesikhathini sokukhulelwa. Kodwa uma lesi sishiso senhliziyo sivela njalo, usuku nosuku, kungaba uphawu lwesifo esingamahlalakhona esibizwa ngokuthi i-'GERD (Gastroesophageal Reflux Disease). Ezweni elifana neMelika, kuthiwa cishe abantu abangama-20% bane-'GERD'.

Ubani othola kakhulu lokhu kutheleleka esifubeni?

Empeleni, noma ubani angakuthuthukisa lokhu, kodwa kwabanye abantu, ingozi iphakeme kancane.

• Kulabo abanokukhuluphala ngokweqile: Okusho ukuthi, labo abane-body mass index (BMI) engaphezu kuka-30.
• Kulabo abakhuluphele ngokweqile: Uma inani le-'BMI' lingaphezu kuka-25.
• Abantu ababhemayo kanye nalabo ababhemayo banamathuba amaningi okuba nayo.

Ukutheleleka esifubeni kuzwakala kanjani-ke?

Ubuhlungu besifuba, uma sikhuluma iqiniso, buwumuzwa wokushisa ovela ngaphakathi kwesifuba sakho, njenge-acid reflux. Umphimbo wakho utholakala phakathi kwesifuba sakho. Ngakho-ke lobu buhlungu buqala lapho. Kodwa ngezinye izikhathi lobu buhlungu bungasakazeka esifubeni sakho sonke, ngisho nasemqaleni wakho. Bungasukela ekushiseni okuncane kuya ebuhlungwini obukhulu.

Uzizwa nini kakhulu lobu buhlungu?

Kungenzeka ukuthi nawe uke wabhekana nalokhu. Ngezinye izikhathi uzizwa ubuhlungu obukhulu esifubeni.

• Uma ulala phansi, ikakhulukazi uma ulala phansi ngokushesha ngemva kokudla.
• Uma ugoba phambili.
• Uma udla isidlo sakusihlwa sekwephuzile kakhulu.
• Uma udla ukudla okunamafutha, okumuncu, noma okunongwe.

Umphimbo obuhlungu ungahlala isikhathi esingakanani?

Lokhu kungahlala kusukela emizuzwini embalwa kuya emahoreni ambalwa.Ngokuvamile, lokhu kuvuvukala kuyaphela uma ukudla kokugcina okudlile sekuphumile esiswini sakho. Lokhu kungenxa yokuthi akukho lutho olubuyela esiswini. Kuye ngokuthi udle ini, kungathatha amahora amabili kuya kwamahlanu ukugaya. Kungathatha isikhathi eside ukugaya ukudla okunamafutha nokunamafutha.

Yiziphi ezinye izimpawu ezihambisana nokuvuvukala kwesifuba?

Ngezinye izikhathi kungaba nzima ukubona ukuthi une-angina noma olunye uhlobo lobuhlungu besifuba. Uma ungaqiniseki ngobuhlungu obuzwayo, kungcono ukukhuluma nodokotela. Kubalulekile futhi ukubheka ezinye izimpawu ezihambisana nobuhlungu. Lezi ezinye izimpawu zingakusiza ukuhlukanisa phakathi kokuhlaselwa yinhliziyo nesinye isimo sesifuba.

Ukushisa kwenhliziyo okubangelwa yi-acid reflux kungahambisana nezimpawu ezilandelayo:

• Ukuchama njalo.
• Ukunambitheka okumuncu emlonyeni.
• Isicanucanu.
• Ukudla kungena emphinjeni.

Abanye abantu bangase babonise nezimpawu ezingavamile ezifana nalezi:

• Ukugcwala kwesisu, ukuqunjelwa.
• Ukuquleka.
• Ukukhwehlela okuqhubekayo.
• Ukwanda kwesifo sofuba.
• Umphimbo obuhlungu.
• Ukuvuvukala kwe-larynx (`Laryngitis`).
• Ubunzima bokugwinya noma umuzwa wokuthi kukhona okubhajwe emphinjeni.
• Ubuhlungu besifuba obungabangelwa yisifo senhliziyo, njenge-`(Angina)`.

Kungani sithola lokhu kutheleleka esifubeni?

Ngokuvamile okuhambisana nesimo esifana ne-GERD, isilungulela sivela lapho amajusi esisu, okungukuthi i-asidi nama-enzyme, ebuyela phezulu e-esophagus. Njengoba ngishilo ngaphambili, isisu sinolwelwesi oluvikelayo, kodwa i-esophagus ayinalo. Lapho i-esophagus yethu ixhumana nesisu, kukhona i-valve ebizwa ngokuthi i-Lower Esophageal Sphincter (LES). Umsebenzi wayo ukuvimba okuqukethwe yisisu ukuthi kungabuyeli phezulu. Kodwa ngezinye izikhathi, uma le valve iba buthakathaka noma ingavali kahle, okuqukethwe yisisu kungaqala ukukhuphuka.

Kunezizathu eziningana zokuthi kungani i-Lower Esophageal Sphincter ingaba buthakathaka noma ikhululeke kakhulu:

• Ukuphefumula intuthu kagwayi (ukubhema).
• Ukucindezeleka okwengeziwe esiswini ngenxa yezici ezifana nesisindo somzimba esiningi, ukugqoka izingubo eziqinile, nokukhulelwa.
• Isimo esibizwa ngokuthi 'i-Hiatal Hernia'. Lokhu kwenzeka lapho ingxenye yesisu isunduza phezulu nge-diaphragm.
• Ukudla ukudla okukhulu ngesikhathi esisodwa kunganweba isisu futhi kubangele ukuthi ukudla kuhlale esiswini isikhathi eside.
• Ukungagayeki kahle kanye negesi. Lapho amabhamuza egesi enyuka ngendlela ye-GI.
• Ukulala phansi ngokushesha ngemva kokudla.
• Ukudla okuthile: izinto ezifana nekhofi, ushokoledi, ama-lime, iminti, isosi katamatisi.
• Imithi ethile: njengamaphilisi okuvimbela inzalo kanye neminye imithi yokucindezeleka kwegazi okuphezulu.

Ngokuvamile, izimbangela ezingaphezu kweyodwa ziyahlanganiswa ukuze kubangele i-acid reflux kanye nesilungulela.

Kungani ukutheleleka kwesifuba kuvela ngokuzumayo ngaphandle kwezimpawu zangaphambilini?

Uma ungakaze ube nobuhlungu besifuba obubi ngaphambili futhi buqale ngokuzumayo, futhi ungenzanga izinguquko ezinkulu ekudleni kwakho noma endleleni yakho yokuphila muva nje, kungenzeka ukuthi kungenxa yezinye izizathu. Lezi yizinto ezikhula kancane kancane ngokuhamba kwesikhathi.

• Ukuguga: Njengoba sikhula, imisipha yethu iba buthaka. Enye yaleyo misipha yi-sphincter engezansi komphimbo.
• Ukukhuluphala: Iningi labantu likhula kancane kancane. Kodwa-ke, izimpawu zokukhuluphala (njengokuqunjelwa) zingavela ngokuzumayo, uma umkhawulo othile usuweqiwe.
• Imithi: Uma usanda kuqala umuthi omusha noma ushintshe imithi, buza udokotela wakho ukuthi lowo muthi ubangela yini ukwanda kwe-acid reflux.

Ingabe isilungulela sihlala sivela ku-acid reflux eshiwo ngenhla?

Ngokuvamile, isilungulela siyinkinga ngomqala. Imbangela eyinhloko yi-acid reflux. Kodwa-ke, kunezinye izimo eziningana ezingabangela isilungulela. Isibonelo:

• Izilonda zomqala: Izilonda ziyizilonda ezibuhlungu ezibangelwa ukuguguleka kolwelwesi lomgudu wokugaya ukudla. Izilonda zomqala azivamile njengezilonda esiswini noma emathunjini. Uma zenzeka, zivame ukubangelwa yi-acid reflux. Kodwa-ke, i-acid reflux akuyona yodwa imbangela. Ukusetshenziswa ngokweqile kwemithi elwa nokuvuvukala engeyona i-steroidal (ama-NSAID) njenge-aspirin ne-ibuprofen nakho kungabangela izilonda.
• I-Esophagitis: Uma umphimbo uvuvukala kakhulu, ungase uzizwe uvutha. I-GERD, amagciwane, izifo zesikhunta, kanye neminye imithi kungabangela lokhu. I-Eosinophilic esophagitis, isimo sokungezwani komzimba nomphimbo, nayo ingabangela ubuhlungu besifuba.
• Ukushisa kwenhliziyo okusebenzayo/ukuzwela kwe-reflux: Lokhu kuyizinkinga zokuxhumana kwamathumbu nobuchopho. Okusho ukuthi, kunenkinga ngendlela uhlelo lwakho lwezinzwa oluthumela ngayo izimpawu kusuka ohlelweni lwakho lokugaya ukudla luye ebuchosheni bakho. Ukushisa kwenhliziyo okusebenzayo kuzwakala njengokushiswa kwenhliziyo okuvamile. Kodwa-ke, ukuhlolwa akubonisi noma yikuphi ukushiswa kwe-acid, ukusha, noma ukucasuka. Ukuzwela kwe-reflux kubangelwa izinto ezingenayo i-asidi ezifika emphinjeni wakho. Ukuzwela kwe-visceral nakho kungaba nomthelela kulokhu kuvuvukala.

Ingabe lokhu kutheleleka esifubeni kuyingozi kakhulu?

Nakuba isilungulela ngezinye izikhathi singaba buhlungu, asibangeli umonakalo omkhulu. Eqinisweni, kuyinto evamile ukuthi i-asidi ethile ikhuphukele emphinjeni wakho, futhi abantu abaningi abakuboni nokukubona. Uma ukwenza, kungenzeka ukuthi i-esophagus yakho ithola i-asidi eningi kunaleyo engayiphatha. Uma kwenzeka ngezikhathi ezithile, kufana nesilonda esincane esiphola ngokushesha. Kodwa uma kwenzeka njalo, ulwelwesi lwe-esophagus yakho alunaso isikhathi esanele sokuphola.

Njengoba ulwelwesi lwe-esophagus luqhubeka nokulimala, kungaholela ezinkingeni zesikhathi eside, njenge:

• Ukuqina Komqala: Lapho izicubu zomqala ziqhubeka nokuvuvukala, izicubu zesibazi ziqala ukwakheka ngokuhamba kwesikhathi. Umqala ufana nepayipi elide. Lokhu kuvuvukala nezibazi kungabangela ukuthi umqala unciphe (i-stricture). Lokhu kungabangela ubunzima bokugwinya nokudla kubhajwe emqala.
• I-metaplasia yamathumbu: Ngezinye izikhathi, esikhundleni sokubangela izibazi, izicubu ziyashintsha zibukeke njengolwelwesi lwamathumbu . Lokhu kubizwa ngokuthi i-metaplasia yamathumbu ngoba izicubu ziyashintsha zibukeke njengolwelwesi lwamathumbu. Uma lokhu kwenzeka emgudwini womchamo, kubizwa nangokuthi i-Barrett's Esophagus. Lokhu kubhekwa njengesimo esingaphambi komdlavuza.
• Umdlavuza wesisu: Umdlavuza wesisu uvela kubantu abambalwa kakhulu. Kodwa-ke, kunendlela ecacile kusukela ekuvuvukeni okuqhubekayo (`i-Esophagitis`) kuya ekushintsheni kwamaseli (`i-Barrett's Esophagus`) kuya kumdlavuza. Ingozi iyanda kuye ngokuthi ukuvuvukala kwakho kukhulu kangakanani nokuthi sekuyisikhathi esingakanani kungelashwa.

I-acid reflux, ebangela isilungulela, ingabonisa nezinye izinkinga eziyisisekelo ohlelweni lwakho lokugaya ukudla. Isibonelo, ungase ube ne-acid eningi kakhulu esiswini sakho. Lokhu kungaholela ezinkingeni ezifana ne-gastritis kanye nezilonda zesisu. I-acid reflux ingadala futhi i-asthma yakho noma ezinye izimo zokuphefumula ezingamahlalakhona. Uma le-acid ingena emphinjeni wakho, ingabangela ukuvuvukala, izilonda, kanye nokukhula.

Wazi kanjani ukuthi unesifo se-sinus?

Isilungulela siwumuzwa onawo. Odokotela abaningi bangakubona uma uwuchazela udokotela. Uma kwenzeka ngezikhathi ezithile futhi kungekubi kakhulu, cishe ngeke udinge ukuhlolwa okukhulu. Kodwa-ke, uma besola ukuthi unesifo esingamahlalakhona, bangenza izivivinyo ukuze babone ukuthi kukhona yini umonakalo emqaleni wakho. Ngaleso sikhathi, ungathunyelwa kudokotela wezifo zamathumbu.

Nazi ezinye izivivinyo ezenziwayo ukuhlola umphimbo wakho:

• I-Endoscopy (`Inqubo ye-Endoscopy Ephezulu` / `Inqubo ye-EGD`):I-Endoscopy ukuhlolwa okubheka ngaphakathi emzimbeni wakho. Lokhu kuhilela ukudlulisa ithubhu elide elinekhamera encane (i-endoscope) emzimbeni wakho. I-endoscopy ephezulu ihlola umgudu wakho wokugaya ukudla ongaphezulu, kusukela emhubheni wakho kuya esiswini sakho kuya phezulu kwamathumbu akho amancane. Le thubhu ifakwa ngomphimbo wakho (unikezwa umuthi wokuyithulisa). Ingahlola izimo ezifana ne-esophagitis, i-hernias, kanye ne-Barrett's esophagus.
• Ukuhlolwa kwe-pH yomlomo wesibeletho: Lokhu kuhilela ukufaka i-capsule encane engenantambo emqaleni wakho. Ilinganisa i-pH, noma i-acidity, yomqala wakho ngokuhamba kwesikhathi. Lokhu kungenziwa ngesikhathi se-endoscopy ephezulu noma ngepayipi le-nasogastric. Idatha idluliselwa kumuntu ogqoka okhalweni lwakho. Uzocelwa ukuthi urekhode izimpawu zakho bese uziqhathanisa nedatha. Ngemva kwesikhathi esithile, udokotela uzosusa i-capsule bese ehlaziya idatha.

Yiziphi izindlela zokwelapha i-pneumonia?

Ungathola impumuzo ekushisweni yisisu ngezikhathi ezithile ngemithi yasekhaya, imithi ethengiswa ngaphandle kwemithi kadokotela (OTC), kanye nezinguquko zendlela yokuphila. Kodwa-ke, ukuze uthole isishisi esivame kakhulu, kungadingeka ukuthi uthathe imithi kadokotela. Le mithi isebenza ngokunciphisa inani le-asidi eliphuma esiswini liye emhubheni. Kodwa-ke, inkinga eyisisekelo nge-Lower Esophageal Sphincter yinto le mithi engayixazululi. Uma imithi ingasebenzi, ungadinga ezinye izindlela zokwelapha.

Izinhlobo eziningana zemithi yokuvuvukala kwesifuba:

• Ama-antacid: Ama-antacid (njenge-Tums® ne-Rolaids®) aqeda i-asidi esiswini sakho. Lokhu kusho ukuthi noma i-asidi ingangena emphinjeni wakho, ngeke ilimaze umphimbo wakho. Ngezinye izikhathi angaqukatha ezinye izithako ezingasiza ekunciphiseni izimpawu. Isibonelo, i-Simethicone ingasiza ekunciphiseni ukucasuka kwesisu, kanti i-Magnesium ingasiza ekunciphiseni ukuqunjelwa. Ama-antacid alungele isilungulela ngezikhathi ezithile. Kodwa-ke, angaba nemiphumela emibi uma ethathwa njalo.
• Ama-Alginates: Ama-Alginates awushukela wemvelo otholakala olwandle. Antanta phezu kwe-asidi futhi adale umgoqo ongokoqobo phakathi kwe-asidi kanye nomphimbo, okusiza ekuvimbeleni ukuthi ingabuyeli emphinjeni. Uma ungakwazi ukuthatha ama-antacid ngenxa yesinye isimo, ungathatha ama-alginates wedwa. Ngaphandle kwalokho, kunemithi equkethe ama-alginates kanye nama-antacid ukuthuthukisa imiphumela yawo.
• Ama-histamine receptor antagonists (ama-H2 blockers):Le mithi isebenza ngokuvimbela ama-histamine amakhemikhali abonisa umzimba ukuthi wenze i-asidi. Amanye ama-H2 blockers atholakala ngaphandle kwemithi kadokotela, kanti amanye atholakala ngodokotela kuphela. Nakuba angathathwa kaningi kune-antacids, awasebenzi ngaso sonke isikhathi isikhathi eside. Uma umzimba wakho uwajwayela, angase angasebenzi kahle.
• Ama-Proton Pump Inhibitors (PPI): Lawa uhlobo olunamandla kakhulu lwemithi yokuvimbela i-asidi. Aphinde asize ekwelapheni kwezicubu. Uma isilungulela sakho sibi kakhulu, noma uma kunezimpawu zokulimala kwezicubu emgudwini wakho, udokotela wakho angakunikeza lokhu njengokwelashwa kokuqala. Asebenza kahle ngo-90% ekunciphiseni i-acid reflux. Uma unezilonda zomgudwini, yiwona kuphela umuthi ozosiza ukuthi zelapheke.

Ukwelashwa okwengeziwe kwe-sinusitis:

• Uma kukhona ukutheleleka, ama-antibiotic noma ama-antiviral.
• Yelapha ukuvuvukala ngokwakho nge-`(Topical Steroids)` noma `(Dupilumab)`.
• Ama-neuromodulator anesilinganiso esiphansi kanye nokwelashwa okuhambisanayo kwe-pneumonia esebenzayo.
• Uma ubuhlungu besifuba sakho bubangelwa i-hernia yokubeletha, kudingeka ukuhlinzwa ukuze kulungiswe (ukuhlinzwa kokulungisa i-hernia).

Ku-GERD engaphenduli emithini - noma njengenye indlela esikhundleni semithi yesikhathi eside - udokotela wakho angase asikisele inqubo efana nale:

• I-Nissen Fundoplication: Lokhu ukuhlinzwa okuncane okuqinisa isikhala phakathi kwesisu nomphimbo. Kusebenza kahle kakhulu ekwelapheni i-GERD kanye nezimpawu zayo.
• `I-Transoral Incircuitless Fundoplication`: Lokhu ukuhlinzwa okufanayo okukhulunywe ngakho ngenhla ngaphandle kokuhlinzwa, kodwa nge-`endoscope`.
• `Idivayisi ye-LINX`: Lokhu kungenye indlela yokuhlinzwa engangenisi kakhulu. Kulokhu, kubekwa `idivayisi ye-LINX`, indandatho encane yamagnetic, endaweni ehlangana ngayo isisu nomphimbo. Lokhu kusiza ukuvimbela i-asidi ukuthi ingangeni emphinjeni.

Ingabe ukwelapha umphimbo obuhlungu kuzoyelapha?

Isilungulela siyisimo esingelapheka. Into engcono kakhulu ukuthi ungasilawula ngokwenza izinguquko ezincane ekudleni kwakho nasendleleni yakho yokuphila, futhi ugcine ama-antacid eseduze ukuze uwasebenzise ngezikhathi ezithile. Uma kudingeka, imithi yesikhathi eside ingaba wusizo kakhulu ekulawuleni i-acid reflux. Izinkinga zokusebenza zingaba nzima kancane ukuzilawula. Kodwa-ke, ngomzamo oqhubekayo kanye nenhlanganisela yokwelashwa, zingathuthuka ngokuhamba kwesikhathi.

Yiziphi izinguquko zendlela yokuphila esingazenza ukuze silawule ukuvuvukala?

Ukuze uvimbele i-acid reflux, zama lezi zinto:

• Yidla ukudla okuncane okumbalwa usuku lonke. Uma unokuncane kokugaya ngesikhathi esisodwa, inani le-asidi elikhiqizwa yisisu sakho nalo liyancipha.
• Khulula ibhande lakho. Ukucindezeleka kwesisu kungabangela ukuvuvukala kwesisu. Ukunciphisa isisindo nakho kungasiza.
• Ungalali unesisu esigcwele. Linda okungenani amahora amathathu kuya kwamahlanu ngaphambi kokulala.
• Lala ngohlangothi lwakho lwesobunxele. Lokhu kubeka i-Lower Esophageal Sphincter yakho ngaphezu kokuqukethwe yisisu sakho, njengesikhwama somoya. Uma ulala ngohlangothi lwakho noma ngohlangothi lwakho lwesokudla, lelo valve licwiliswa kokuqukethwe.
• Gwema ukudla okubangela ukucasuka. Naka ukuthi yikuphi ukudla okwenza ubuhlungu besifuba sakho bube bubi kakhulu.
• Yeka ukubhema. Ubuhlungu besifuba bungenye yezizathu zokuyeka ukubhema. Udokotela wakho angakusiza ngalokhu.

Kufanele ubonane nini nodokotela?

Bona udokotela ezimweni ezilandelayo:

• Uma uthola ubuhlungu esifubeni okungenani kanye ngesonto.
• Uma unezimpawu ezingavamile.
• Uma unenkinga yokugwinya noma ungakwazi ukuthola amakhalori anele.
• Uma uneminyaka engaphezu kwengu-60 ubudala.
• Uma unezinhlungu zesifuba ezifana ne-"Angina" (eziqinile, ezinciphile).
• Uma ukwelashwa kwakho kunganikezi impumuzo.

Ekugcineni, kufanele ngithi...

Umphimbo obuhlungu ngezikhathi ezithile uvamile. Iningi labantu lingakwazi ukuwulawula ngezinguquko ezimbalwa ezilula. Kodwa-ke, uma unawo ngaso sonke isikhathi, ungadinga usizo lwezokwelapha. Ungawunaki umphimbo obuhlungu ongapheli. Ukuzwa ubuhlungu emphinjeni wakho kuvame ukusho ukuthi uyalimala. Lokhu kungabangela umonakalo wangempela ngokuhamba kwesikhathi. Futhi, umphimbo obuhlungu ongapheli kungaba uphawu lokuthi kunezinye izinkinga ezidinga ukwelashwa. Ngakho-ke, khuluma nodokotela mayelana nomphimbo obuhlungu ongapheli.

Isilungulela , i-GERD, i-Acid Reflux, i-Esophagus, isisu, ukuvuvukala kwesifuba