Uvame ukuzizwa sengathi kukhona iqhubu emphinjeni wakho, sengathi kukhona okubhajwe kulo? Uvame ukuzizwa sengathi ufuna ukusula umphimbo wakho bese uthi "Mm... Mm..."? Ungase ucabange ukuthi umkhuhlane noma ukungezwani nothuli. Kodwa uma kungapheli izinyanga, imbangela ingaba yinto ehlukile futhi ejulile kunalokho ocabanga. Namuhla sikhuluma ngenkinga "efihliwe" abantu abaningi abangazi ngayo, kodwa abantu abaningi abanayo. Lokhu sikubiza ngokuthi i-LPR, noma i-Laryngopharyngeal Reflux.
Kuyini i-LPR? Ingabe lokhu kubizwa nangokuthi 'i-buthule reflux'?
Kulungile, ake sikwenze lokhu kube lula. Kungenzeka ukuthi uke wezwa nge-"gastritis" noma "i-acid reflux." Yilapho amajusi esiswini asiza ekugayeni ukudla ebuyela emuva emphinjeni. Ngokuvamile, uma lokhu kwenzeka, sizwa umuzwa oshisayo esifubeni noma esiswini sethu. Lesi simo sibizwa ngokuthi i-GERD (Gastroesophageal Reflux Disease).
Kodwa i-LPR ihlukile kancane, ikhethekile. Okwenzekayo lapha ukuthi i-asidi ephuma esiswini ayimi esifubeni, kodwa iqhubekela phambili emphinjeni wakho (epharynx) kanye nebhokisi lapho kukhona khona izintambo zakho zezwi (i-larynx).
Into ebalulekile ukuthi akubona bonke abantu abane-LPR ababhekana nokushisa kwesilungulela. Abantu abaningi abazi ukuthi banenkinga nge-acid reflux. Yingakho ibizwa nangokuthi " i-buthule reflux." Ngenxa yokuthi izimpawu zisemphinjeni, ezwini, nasekhaleni, abantu abaningi bacabanga ukuthi kuyinto ehlukile.
Kalula nje, i-GERD iyinkinga eqala esifubeni. I-LPR iyinkinga eqhubeka ikhuphuke futhi ithinte umphimbo. Abanye abantu bangaba nazo zombili. Abanye abantu bangaba ne-LPR kuphela.
Yiziphi izimpawu ezibonisa i-LPR?
Uma usunesinye noma ngaphezulu salezi zimpawu isikhathi eside, khathazeka. Ake sibone ukuthi yiziphi izimpawu eziyinhloko.
| Isibonakaliso | Lokhu kukwenza uzizwe kanjani? |
|---|---|
| Ukuhosha kwezwi | Izwi lami lizwakala lihlukile ngokushesha nje lapho ngivuka ekuseni. Izwi lami alicaci usuku lonke. |
| Ukuzwa sengathi kukhona okubambeke emphinjeni | Kuhlala kuzwakala sengathi kukhona iqhubu noma ibhola le-mucus elinamathele emphinjeni wami. |
| Ukuhlanza umphimbo njalo | Bahlala bezama 'ukuhlanza' imiphimbo yabo baze babangele abanye izinkinga. |
| Ukukhwehlela isikhathi eside | Nginokukhwehlela okomile osekuqhubeke izinyanga eziningi, ngaphandle kwesizathu esibonakalayo. |
| I-mucus noma i-phlegm eningi kakhulu | Kukhona umphimbo ongapheli emphinjeni. Kuzwakala sengathi umphimbo ugeleza emphinjeni usuka ekhaleni (i-postnasal drip). |
| Ubunzima bokugwinya | Kuzwakala sengathi kukhona iqhubu emphinjeni wakho uma ugwinya ukudla noma isiphuzo. |
| Umphimbo obuhlungu oqhubekayo | Ngihlala nginomphimbo obuhlungu ngaphandle komkhuhlane noma umkhuhlane. |
| Ukubhebhetheka kwe-asthma | Uma usuvele une-asthma, kuba nzima ukuyilawula noma kuvela izimpawu ezintsha ezifana ne-asthma. |
Kungani izinto ezisesiswini zikhuphukela emphinjeni kanje?
Ukuze siqonde lokhu, sidinga ukwazi okuncane ngomqala wethu. Cabanga ngawo njengepayipi elinama-valve amabili phezulu nangaphansi. Siwabiza ngokuthi ama-valve sphincters .
1. Ivalvu engezansi (i-Lower Esophageal Sphincter - LES):Lokhu kuphakathi komphimbo nesisu (umphimbo). Uma sigwinya ukudla, kuyavuleka ukuze kudlule ukudla esiswini, bese kuvala kahle futhi. Lokhu kuvimbela i-asidi yesisu ukuthi ingabuyi phezulu.
2. I-Upper Esophageal Sphincter (UES): Le valve itholakala phakathi kwe-esophagus nomphimbo. Umsebenzi wayo ukuvimba noma yini engene ku-esophagus ukuthi ingabuyeli emphinjeni.
Ukuze i-LPR yenzeke, womabili la ma-valve akumele asebenze kahle. Okokuqala, i-valve engezansi (LES) kumele ibe buthaka, ivumele i-asidi yesisu ukuthi ibuyele emuva ku-esophagus. Ngemuva kwalokho, i-valve ephezulu (UES) kumele ibe buthaka, ivumele i-asidi ukuthi ibuyele emuva ku-esophagus.
Ngakho-ke, kungani la ma-valve ebuthakathaka?
Kungaba nezizathu eziningi zalokhu. Ezinye zingezesikhashana, ezinye zihlala isikhathi eside.
1. Izinto ezenza buthaka i-LES
Ezimweni eziningi, izimbangela ezifanayo ezithinta i-gastritis evamile nazo ziyakuthinta lokhu.
- Eminye imithi: Ama-painkiller (ama-NSAID), eminye imithi yokucindezeleka kwegazi okuphezulu (ama-Calcium channel blockers), kanye nemithi yezinkinga zempilo yengqondo (ama-Tricyclic antidepressants) ingabangela ukuthi le valve ikhululeke.
- Lokhu kungabangelwa nokudla neziphuzo ezithile: ikhofi, ushokoledi, iminti, ugalikhi, u-anyanisi kanye notshwala.
- Imikhuba emibi:
- Ukulala phansi amahora angu-2-3 ngemva kokudla.
- Ukudla kakhulu ngesikhathi esisodwa kungabangela ukuvuvuka kwesisu. Lokhu kwandisa ingcindezi ngaphakathi esiswini futhi kusunduze i-asidi phezulu.
- Ukugqoka izingubo eziqinile esiswini, ikakhulukazi okhalweni.
- Izimbangela zesikhathi eside:
- I-Hiatal Hernia: Lokhu kwenzeka lapho ingxenye encane yesisu iphuma iye esifubeni. Lokhu kwenza buthaka ukusebenza kwe-valve ye-LES.
- Ukukhuluphala ngokweqile: Njengoba isisindo sikhula, ingcindezi ngaphakathi esiswini iyanda. Lokhu nakho kuyimbangela enkulu.
- Ukukhulelwa: Izinguquko zama-hormone kanye nokucindezela okukhulu esiswini phakathi nalesi sikhathi kungabangela i-gastritis kanye ne-LPR okwesikhashana.
- Ukubhema: Ukubhema kuyisitha esikhulu esikhulula leli valvu.
2. Izinto ezenza buthaka i-sphincter ephezulu yomphimbo (UES)
Ngemva kokuba i-asidi ikhuphuke nge-valve engezansi, i-valve ephezulu iyisivikelo sokugcina esivikela umphimbo. Imiphimbo yethu ayiklanyelwe ukumelana ne-asidi njenge-esophagus. Ngakho-ke ngisho nenani elincane kakhulu le-asidi lingabangela umonakalo omkhulu.
- Ukulala phansi: Uma silala phansi, womabili la ma-valve ayaxega kancane. Lokhu kwenza i-LPR ibe nokwenzeka kakhulu ebusuku ngesikhathi silele.
- Ukubhodla: Uma ubhodla, womabili ama-valve ayavuleka, okuvumela inani elincane le-asidi ukuthi lingene emphinjeni wakho kanye nomoya.
- Ukugoba phambili, ukuzivocavoca, ukucula: Imisebenzi efana nale ingandisa ingcindezi ngaphansi kwevalvu engenhla, iyenze ibe buthaka.
- Ukubhema notshwala: Kokubili kuyingozi ngokulinganayo kuzo zombili izivalo.
Ingabe kuyingozi ukungasinaki isimo se-LPR?
Yebo, uma lesi simo siqhubeka isikhathi eside, kungase kube nezinkinga ezithile.
- Ukutheleleka okuvamile: I-asidi emphinjeni iphazamisa inqubo yokuhlanza yemvelo emphinjeni nasema-sinuses. Lokhu kungaholela ekuqongeleleni kwamafinyila kanye nokutheleleka okuvamile komphimbo kanye nokuphefumula.
- Izinkinga zezwi nomphimbo zesikhathi eside: Ukuchayeka njalo ku-asidi kungalimaza izintambo zezwi, kubangele izinto ezifana nokulimala kwezintambo zezwi. Ukuchayeka isikhathi eside kulesi simo kungandisa kancane ingozi yomdlavuza we-laryngeal.
- Izinkinga zokuphefumula: Inani elincane le-asidi elingena emphinjeni lingahamba nge-trachea liye emaphashini ngaphandle kokuqaphela, ikakhulukazi ngesikhathi sokulala. Lokhu kubizwa ngokuthi i-buthule aspiration . Lokhu kungaholela ezifweni zamaphaphu kanye nezimo ezifana ne-bronchitis.
Ngingazi kanjani kahle ukuthi iyini i-LPR?
Uma usunezimpawu esixoxe ngazo ngaphambilini isikhathi eside, into engcono kakhulu ongayenza ukubonana nodokotela wezindlebe, ikhala, nomphimbo (ENT Surgeon) . Uzolalela izimpawu zakho futhi ahlole umphimbo wakho.
Ukuhlolwa okuyinhloko okuvame ukwenziwa kulokhu i-laryngoscopy eguquguqukayo . Lokhu kuhilela ukudlulisa ipayipi elincane kakhulu, elifakwe ikhamera ngekhala lakho bese lehla emphinjeni wakho ukuze kuhlolwe ingaphakathi lezintambo zakho zezwi nomphimbo. Lena inqubo engenabuhlungu engenziwa ngemizuzu embalwa.
Lokhu kuhlolwa kungahlola ukubomvu nokuvuvukala emphinjeni. Ngezinye izikhathi, kungadingeka ukuhlolwa okwengeziwe ukuqinisekisa ukuxilongwa noma ukuqeda ezinye izimbangela.
- I-Upper Endoscopy: Lokhu kuhilela ukufaka ikhamera ngomlomo ukuhlola umphimbo nesisu. Kungahlola izinkinga nge-sphincter engezansi yomphimbo (LES) kanye ne-hernia yokubeletha.
- Ukuhlolwa kwe-pH ye-Esophageal: Lokhu kulinganisa amazinga e-asidi emphinjeni nasemphinjeni esikhathini esingamahora angama-24.
- I-Esophageal Manometry: Ukuhlolwa okulinganisa ukusebenza kanye namandla emisipha ye-esophagus kanye nama-valve ayo.
Kulungile, senzani ngalokhu manje? Yiziphi izindlela zokwelapha?
Into ebaluleke kakhulu ekwelapheni i-LPR ukwenza izinguquko endleleni yokuphila kanye nemikhuba yokudla . Imithi iza endaweni yesibili.
1. Ukushintsha indlela yokuphila kanye nemikhuba yokudla (lokhu kubaluleke kakhulu)
Uma ulandela le mikhuba kahle, uvame ukulawula lesi simo ngaphandle kwemithi.
| Okufanele ngikwenze | Incazelo |
|---|---|
| Yenza ukudla kube kuncane. | Esikhundleni sokudla ukudla okukhulu ngesikhathi esisodwa, yidla kancane izikhathi ezinhlanu noma eziyisithupha ngosuku. |
| Gwema ukudla okuthile | Nciphisa ukudla okunamafutha, okubabayo, okune-asidi ephezulu (utamatisi, amawolintshi, ama-lime), ikhofi, ushokoledi, iminti, kanye neziphuzo ezine-carbonated (i-soda) ngangokunokwenzeka. |
| Yidla isidlo sakusihlwa kusenesikhathi. | Yidla isidlo sakusihlwa okungenani amahora amathathu ngaphambi kokulala. Ungalali phansi ngemva kokudla. |
| Shintsha indawo yakho yokulala. | Lala ikhanda lombhede liphakanyisiwe cishe ngamasentimitha angu-6. Ungagcini nje ngokuphakamisa ikhanda lakho ngemicamelo emibili noma emithathu, kodwa phakamisa umbhede ngokwawo. Ukulala ngohlangothi lwakho lwesobunxele kunciphisa ne-acid reflux. |
| Yeka ukubhema nokuphuza utshwala. | Laba ababili benza isimo se-LPR sibe sibi kakhulu. Kubalulekile ukubavimba ngokuphelele. |
| Lawula isisindo sakho. | Uma ukhuluphele ngokweqile, ukwehlisa isisindo kunganciphisa ukucindezeleka esiswini sakho futhi kulawule kakhulu izimpawu. |
2. Ukwelashwa ngezidakamizwa
Ngesikhathi enza izinguquko endleleni yokuphila, udokotela wakho angase akunike imithi yokusiza izicubu zomphimbo ezonakele ukuba zelapheke.
- Ama-Proton Pump Inhibitors (PPI): Imithi efana ne-Omeprazole ne-Pantoprazole isebenza ngokunciphisa ukukhiqizwa kwe-asidi esiswini. Lokhu kuvame ukunikezwa izinyanga eziningana.
- Ama-H2 Blockers: Imithi efana ne-Famotidine nayo iyasiza ekulawuleni i-asidi.
- Ama-Alginates: Lawa adala ungqimba oluvikelayo esiswini, avimbele i-asidi ukuthi ingakhuphuki.
Okubalulekile: Noma yimiphi yale mithi kufanele isetshenziswe kuphela ngaphansi kweseluleko sikadokotela wakho. Ungaziphilisi.
3. Ukuhlinzwa
Lokhu akuvamile ukudingeka. Ukuhlinzwa kucatshangelwa kuphela uma kunenkinga ethile yomzimba, njenge-hernia yokubeletha, noma uma kungekho okunye ukwelashwa okuye kwasiza.
Ekuphetheni, i-LPR iyisimo esicasulayo kancane, kodwa singaphathwa kahle uma siphathwa kahle. Into ebaluleke kakhulu ukungazinaki izimpawu, ukuthola ukuxilongwa okunembile, futhi ikakhulukazi ukubekezela ngezinguquko ezidingekayo zendlela yokuphila.
Umlayezo Wokuya Nawe Ekhaya
- I-LPR yisimo esenzeka lapho i-asidi yesisu igeleza iye emhubheni. Ngokuvamile ibizwa ngokuthi "i-buthule reflux" ngoba akukho mizwa yokusha esifubeni.
- Izimpawu eziyinhloko ukukhwehlela okuqhubekayo, umphimbo obuhlungu, ukusha, kanye nomuzwa wokuthi kukhona okubhajwe emphinjeni.
- Ungaphambanisi lezi zimpawu nomkhuhlane noma ukungezwani komzimba. Uma ziqhubeka, bona udokotela.
- Isinyathelo esibaluleke kakhulu nesiqalayo ekwelashweni ukushintsha indlela odla ngayo nendlela ophila ngayo. Imithi inendima yokusekela.
- Ungalali phansi amahora amathathu ngemva kokudla. Lala ikhanda lombhede liphakanyisiwe ebusuku. Yeka ukubhema nokuphuza utshwala ngokuphelele.
- Uma ungabaza ngezimpawu zakho, thintana nochwepheshe wezindlebe, impumulo, nomphimbo (ENT Surgeon) ukuze uthole iseluleko esifanele.
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