Isifo reflux Gastroesophageal: iimpawu, iimpawu isifo, kunye nonyango

German gqirha, ugqirha kunye Isazinzulu Heinrich Quincke ngo-1879 yachaza inkqubo komzimba ukuba kwenzeka ometyiso ngabantu emva kokuthatha ukutya, waza wabiza reflux yakhe gastroesophageal (sule ukuncipha). Ntonye lo gama nzima ukuthetha - reflux gastroesophageal. Igama elithi "reflux" yi Latin for "kumpompoza emva", yaye eli gama kuthiwa amayeza intshukumo kwicala malunga kuthelekiswa inkqubela eziqhelekileyo okuqulethwe nayiphi na intshukumo imizimba vuphukuphuku. Ukuba ufake isigulo eso, akukho mfuneko yokuba kucaphuka, ekubeni ngokwayo isifo sule akakho, yaye akafuni kufuna unyango. Kodwa ngamanye amaxesha ezisebenza nokomzimba abaphumeleli, ukutya, emva ukusuka esiswini emphinjeni, uqala ukudla kude ezitokisini zayo epithelial, kwaye umntu onamava kakhulu ezingemnandi. Kule meko, uxilongo ibonisa gastroesophageal reflux ne esophagitis - isifo kakhulu ngokwaneleyo enokukhokelela umhlaza esophageal.

Indlela of reflux gastroesophageal

Siyazi izifundo ukwakheka komzimba Batyunyuzwa emlonyeni xa yokuginya ukutya emphinjeni, nto leyo ityhubhu umngxuma. imisebenzi yayo ziphelele unikezelo nkqi ngentlama ukutya esiswini, apho iqala ukuba kwetyiswe. Ubude emphinjeni ngabantu abaninzi yi-30 cm. Emazantsi Imicu izihlunu kweendonga zawo ukuze amalungiselelo asebenza inxalenye vana (sphincter). Xa ngentlama intshukumo ukutya niziphumlele ukuba naye esiswini, uze emva koko zixinaniswe, nokuthintela uphume ukutya emva emphinjeni. Ukuba sicatshulwa ukuvimbile ngokwaneleyo, imixholo nesisu (ukutya kunye nesisu acid) ngokuyinxenye wabuyela emphinjeni, oko kukuthi, kukho gastro-esophageal reflux. Iimpawu kunye nonyango le meko ixhomekeke iindlela yokhuselo indlela kakuhle emphinjeni. Kuba abantu abaninzi, le nkqubo akuthethi esingenakubangela naliphi na mizwa ekhathazayo okanye kube buhlungu, ke ngoko, musa ukuba unyango. Noko ke, ezinye ukubuya ukutya umva ukusuka esiswini emphinjeni kunye nobunzima kabuhlungu okanye nje. Kwezi meko kufuneka udibane nogqirha kunye nonyango.

Njengokuba umsebenzi iindlela zokukhusela

Kutheni kwezinye iimeko akuyongozi reflux zesisu ukutya kunye nezinye yingozi? Into yokuba kuvuleke iminxunya lomntu "esetwe" ngemvelo ukwenza uqhagamshelwano kuphela ne eliphakathi obrak, owaphulelwa ukutya etshisa esiza emlonyeni wakhe. Isisu nje ifumana amanqathana ukutya, luqala kugaya, kuba oveliswa incindi esiswini - umxube ulwelo enqanda, yencindi yomlomo, kwaye icandelo engundoqo - zehydrochloric acid. Kanye kuvuleke iminxunya, iqalisa "okugaya" iiseli epithelial kweendonga zayo kwakunye iziqwenga ukutya. Ukuba umntu anayo ngokuchasene iindlela ndlongondlongo asidi yokhuselo, reflux ukutya akukho eyoyikekayo. Ezi iindlela:

- ithoni kunokuba eliphezulu sphincter ke kuvuleke iminxunya enqanda ukutya ukuya ngaphaya ummandla gastroesophageal;

- zavunyelwa Good (kugqitywe ngokukhawuleza kuvuleke iminxunya ukusuka imixholo isisu engenayo);

- iiseli epithelial yenkcaso kuvuleke iminxunya ukuya zehydrochloric acid;

- ukulawula asidi esiswini.

Impawu GERD, akukho sifo

Cinga xa isenzo kunokuthathwa amalungu oluntu reflux zesisu ukutya eqhelekileyo. Iimpawu inkqubo ingozi enjalo kwinkqubo yokwetyisa zezi zilandelayo:

- umntu uziva waziva (oku yenye iimpawu lubalaseleyo);

- lokuphosa ukutya emphinjeni ukusuka esiswini emsebenzini ngoko nangoko kuphela emva kwesidlo;

- reflux ihlala mifutshane, kube njalo isibini amaxesha ngemini;

- ngexesha ebusuku ubuthongo reflux kwenzeka.

Kufuneka kuqatshelwe ukuba reflux komzimba zokutya esiswini emphinjeni kwenzeka xa abantu nayiphi na ubudala, kuquka nabantwana.

Prevention nge- ingozi

Kwiimeko apho reflux gastro esophageal akuthethi kunokubangela iingxaki, ungakwazi ukuthatha ezinye iinzame ezilula zokukunceda imizimba yazo ukusebenza iphecana zesisu. Nciphisa imbonakalo reflux ngamanyathelo alula ezifana:

- musa ukuya kulala lokuphumla ngoko nangoko emva kwesidlo;

- ukuba ingaqhubeli phambili umsebenzi elibonakalayo, ingakumbi enxulumene ithambeka, sasinda wadla;

- musa nditye;

- unciphise ukutya (chocolate, utywala, sauce ezithile), uyekelela sphincter le umphimbo;

- ukuba uqale ukudla zibe iimpahla iqine kakhulu, ukuba qinisa umbhinqo;

- ukunciphisa isixa servings kunye nenani izidlo landa.

Impawu GERD, nto leyo a ngezifo

Isifo igqalwa reflux gastroesophageal kunye esophagitis. Oku kwenzeka xa iindlela sokhuselo sohlolo kuvuleke iminxunya kwaye awukwazi ukukhusela iiseli isikhumba umhlwa of zehydrochloric acid. Kule sifo kukho iintlobo ezimbini iimpawu.

1. Esophageal. Izigulane ingxelo kabi ezifana:

- heartburn;

- ekugqibeleni kuba emuncu emlonyeni;

- belching (ikakhulu asidi);

- dysphagia (ukutya ukomiwa kunokwenzeka);

- iintlungu esifubeni (zithande ukuba siqinise xa wakhothama elele isikhundla, ingahlakazeki ukuya iingalo kunye entanyeni).

2. Nepischevodnye. Izigulane bangase ezinye okanye zonke ezi mpawu zilandelayo:

- iingxaki zamazinyo (yidityaniso, i iziphene wayesebenzisa);

- sinusitis;

- laryngitis;

- pharyngitis;

- ekhohlela;

- intlungu entliziyweni.

Ngenxa yezi mpawu GERD basoloko ngoxilongo ngokungachanekanga kwaye iphathwe ngabantu ukuba azikho izifo zabo.

izizathu

Yezifo gastroesophageal reflux kunokwenzeka ngenxa yezi zizathu zilandelayo:

- ukutyeba;

- utywala, ukutshaya;

- Ithemba hiatal;

- nezingafezekanga;

- amayeza zokunciphisa umoya okanye ubunzulu sphincter;

- lweenkcukacha ukugabha (ngamanye amaxesha kunye ityhefu);

- scleroderma systemic;

- tube nasogastric.

reflux Gastroesophageal kwiintsana

Ngemihla zokuqala neenyanga ubomi nama-80% zeentsana ezi ukugabha zaphawula emva feedings. reflux gastroesophageal kakhulu kwiintsana ayikho isifo kwaye kwenzeka ngenxa ukungafezeki nkqubo yakhe zesisu. Regurgitation ukwakhusela usana ukusuka kukuzingxala ngokutya kunye nomoya emathunjini akhe. Abazali nje ukubamba kwiimvuthuluka nkqo malunga 10 imizuzu emva zisitya, ukuba regurgitation ayizange yenzeke. Kwi kwiingxaki ezimandundu kakhulu kunye esiswini kunye kuvuleke iminxunya kuvezwa iimpawu ezifana:

- waphikelela ikhala nexhala;

- belching;

- Ukuphalaza (hayi mazingabhidaniswa regurgitation) emva ukondla;

- ukwala ukuba adle;

- hiccups;

- elimsulwa ukhohlokhohlo;

- umntwana abalali kakuhle kusingise kancinane ubunzima.

Izenzo ezibonisa Ugqirha unakho ukumisela i imixube kweentsana kunye thickeners namayeza "Cisapride", "Domperidone", "Metoclopramide", "cimetidine". Ukuba reflux ibangelwa ezingaqhelekanga xa isakhiwo iphecana zesisu, ungenelelo ngotyando kunokwenzeka.

Gastroesophageal reflux kubantwana konyaka abadala ngaphezu kwesinye

Uninzi abantwana iinyanga 12-18 ukuya nokugabha emva feedings unyamalale ngokupheleleyo. Kids bakhula besempilweni kwaye musa namava waziva emva kokutya. Kodwa abanye abantwana kukho ezinye izikhalazo olwalatha iingxaki esiswini okanye kuvuleke iminxunya:

- heartburn (mntwana ucacisa oku uphawu njengoko 'umlilo "okanye" mlilo ");

- regurgitation;

- intlungu kwentamo;

- isicaphucaphu;

- imvakalelo nenzaliseko esiswini;

- regurgitation ebusuku xa ulele (oku kubonakala kwi umzila phezu komqamelo).

Amaxesha amaninzi abonisa iimpawu reflux gastroesophageal kubantwana, nto leyo enxulumene izitho zokugaya:

- khohlo;

- ngelizwi elitshothozayo;

- iqhuma okanye umqala obuhlungu;

- ulangazelela;

- uphelelwa ngumphefumlo;

- ubunzima ukuginya;

- pneumonia rhoqo.

Ngokuqhelekileyo, xa ezi mpawu ziyaqala okunyanga ingqele eqhelekileyo, kodwa GERD loo therapy asilele.

ekuxilongweni

Ukuba isigulana uneempawu ezingemnandi okanye esibuhlungu sisifo reflux gastroesophageal, uphethwe kufuneka kwenziwe ukusetyenziswa kwelebhu mihla kunye neendlela zomculo. Ngelo kwinqanaba lokuqala ugqirha-gastroenterologist uqokelela imbali, kuquka ulwazi malunga izifo ezifana emizalwaneni yomguli, ixesha kunye ngobunzulu iimpawu reflux. Inqanaba lesibini sikuko zokwenza uvavanyo elebhu, ezifana:

- uvavanyo lwegazi (kwemichiza kunye jikelele);

- coprogram;

- urinalysis.

Isigaba sesithathu ibandakanya izixhobo zophando diagnostic:

- manometry Esophageal;

- EGD (esophagogastroduodenoscopy);

- ukulingwa inkanuko;

- ray usebenzisa barium zokumiswa;

- ultrasound.

unyango

Ukuba unesifo isifo lwezidumbu reflux gastroesophageal, unyango oluqhutywa ezintathu:

1. Ukusetyenziswa-free. Oku kuquka ezi zinto zilandelayo:

- ukulungisa ubunzima;

- ukudla (musa iziqhamo chocolate, utywala, okunamafutha, okuneziqholo, ikofu, igalikhi, yesitrasi);

- ordering amandla;

- basuke ngubo isinxibo tight, amabhanti tight;

- nokuvela kwentloko yesingqengqelo yi-20 cm.

2. Amayeza:

inhibitor of impompo Proton (kuncitshiswa kukhuthaza zehydrochloric acid esiswini "Rapeprazol" "Omeprazole");

- asidi (la machiza Nokwethisa i zehydrochloric acid "Fosfalyugel", "Almagel");

- prokinetics (ukukhawulezisa intshukumo ukutya ukusuka esiswini ukuya emathunjini "metoclopramide").

3. Surgery. Isebenza ukuba iintlobo ezimbini ezidlulileyo musa ukunika uphuculo ezibonakalayo.

Ukuba washiya lunganyangwa, zehydrochloric acid, emphinjeni, oko kunokubangela inaba iindonga perforation, ukopha, ebizwa kuvuleke iminxunya Barrett kaThixo, apho amaxesha 10 kwandisa umngcipheko ukuqala ithumba.