ʻO ka maʻi reflux Gastroesophageal

ʻO ka maʻi reflux Gastroesophageal (GERD) kahi ʻano kahi e hemo hope ai ka ʻōpū mai ka ʻōpū i loko o ka esophagus (paipu meaʻai). Hele ka meaʻai mai kou waha a hiki i ka ʻōpū ma o kou esophagus. Hiki i ka GERD ke hoʻonāukiuki i ka paipu meaʻai a hana i ka puʻuwai puʻuwai a me nā ʻōuli ʻē aʻe.

Ke ʻai ʻoe, hele ka ʻai mai ka puʻu a i ka ʻōpū ma o ka esophagus. ʻO ke apo o nā olonā i loko o ka esophagus o lalo e pale ai i ka ale ʻia o ka meaʻai mai ka neʻe ʻana i luna. Kapa ʻia kēia mau olonā i ka sphincter esophageal haʻahaʻa (LES).

Ke pani ʻole kēia apo o kaʻiʻo i nā ala āpau, hiki i nā ʻōpū o ka ʻōpū ke liu hou i loko o ka esophagus. Kapa ʻia kēia reflux a i ʻole reflux gastroesophageal. Hiki i ka Reflux ke hana i nā ʻōuli. Hiki i nā waikawa ʻōpū nui ke hōʻino i ka uhi o ka esophagus.

ʻO nā kumu pilikia no ka reflux:

• Hoʻohana o ka ʻalekohola (maliʻa paha)
• Hiatal hernia (kahi ʻano o ka ʻōpū e neʻe ai ma luna o ka diaphragm, ʻo ia ka mākala e hoʻokaʻawale i ka umauma a me nā ʻōpū o ka ʻōpū)
• Ka momona
• Hapai keiki
• Scleroderma
• Puhipaka
• Noho i loko o 3 mau hola ma hope o ka ʻai ʻana

Hiki ke lawe ʻia a hōʻino ʻia paha ʻo Heartburn a me gastroesophageal reflux e ka hāpai ʻana. Hiki ke hoʻokumu ʻia nā ʻōuli e kekahi mau lāʻau, e like me:

• Anticholinergics (ʻo kahi laʻana, lāʻau lāʻau maʻi kai)
• Bronchodilators no ka hānō
• Nā poloka ʻauana kalipuna no ke koko kiʻekiʻe
• ʻO nā lāʻau hana Dopamine no ka maʻi Parkinson
• ʻO Progestin no ka hoʻokahe ʻana o ka menstrual a me ka kaohi hānau
• ʻO nā sedatives no ka hiamoe a hopohopo paha
• Nā lāʻau antidepressants Tricyclic

E kamaʻilio me kāu mea mālama ola inā manaʻo ʻoe hiki i kekahi o kāu lāʻau ke hoʻonāukiuki i ka puʻuwai. Mai hoʻololi a kāpae paha i ka lawe ʻana i ka lāʻau me ke kamaʻilio mua ʻole ʻana i kāu mea hāʻawi.

ʻO nā ʻōuli maʻamau o GERD me:

• ʻO ka manaʻo ua paʻa ka ʻai ma hope o ka umauma
• Puʻuwai a i ʻole ʻeha ʻeha i ka umauma
• Lohi ma hope o ka ʻai ʻana

ʻO nā ʻōuli liʻiliʻi ʻoi aku ka:

• Ke lawe nei i ka meaʻai i hope (regurgitation)
• Cough a i ʻole wheezing
• Pilikia i ka ale ʻana
• Hiccups
• Hoarseness a hoʻololi paha i ka leo
• Eha ka 'ā'ī

Eʻoi aku paha ka maikaʻi o nā ʻōuli ke piʻo ʻoe a moe i lalo, a ma hope paha o kāu ʻai ʻana. ʻOi aku paha ka maikaʻi o nā ʻōuli ma ka pō.

ʻAʻole paha ʻoe e pono i kekahi mau hōʻike inā akahai kāu mau ʻōuli.

Inā koʻikoʻi kāu mau ʻōuli a hoʻi mai paha lākou ma hope o kou mālama ʻia ʻana, hana paha kāu kauka i kahi hoʻokolohua i kapa ʻia ʻo endoscopy luna (EGD).

• He hoʻāʻo kēia e nānā ai i ka uhi ʻana o ka esophagus, ʻōpū, a me ka ʻāpana mua o ka ʻōpū liʻiliʻi.
• Hana ʻia me kahi kāmela liʻiliʻi (endoscope maʻalahi) i hoʻokomo ʻia i lalo i ka ʻāʻī.

Pono paha ʻoe i hoʻokahi a ʻoi paha o nā hōʻike aʻe:

• ʻO kahi hoʻāʻo e ana ana i ka pinepine o ke komo ʻana o ka waikawa ʻōpū ma loko o ka paipu e alakaʻi ai mai ka waha a i ka ʻōpū (kapa ʻia ka esophagus)
• ʻO kahi hoʻāʻo e ana i ke kaomi i loko o ka ʻaoʻao haʻahaʻa o ka esophagus (manometry esophageal)

ʻO kahi hoʻokolohua koko hoʻokalakupua maikaʻi paha e hōʻoia i ke kahe ʻana o ke kahe e hele mai ana mai ka huhū i ka esophagus, ʻōpū, a me nā ʻōpū.

Hiki iā ʻoe ke hoʻololi i nā ʻano nohona e kōkua i ka mālama ʻana i kāu mau ʻōuli.

ʻO nā ʻōlelo aʻoaʻo ʻē aʻe:

• Inā ʻoi aku ka momona a momona paha ʻoe, i nā manawa he nui, hiki i ka lilo ʻana o ke kaumaha ke kōkua.
• E hoʻokiʻekiʻe i ke poʻo o kahi moe inā ʻoi aku ka maikaʻi o kāu mau ʻōuli i ka pō.
  
• Hana i kāu ʻaina ahiahi 2 a 3 mau hola ma mua o ka hiamoe.
  
• Hōʻalo i nā lāʻau e like me aspirin, ibuprofen (Advil, Motrin), a i ʻole naproxen (Aleve, Naprosyn). E lawe i ka acetaminophen (Tylenol) e hoʻomaha i ka ʻeha.
• E lawe i kāu mau lāʻau āpau me ka nui o ka wai. Ke hāʻawi aku kāu mea hāʻawi iā ʻoe i lāʻau hou, nīnau inā e hōʻeha loa ia i kou puʻuwai.

Hiki iā ʻoe ke hoʻohana i nā antacids over-the-counter ma hope o ka pāʻina ʻana a me ka wā moe, ʻoiai ʻaʻole lōʻihi lōʻihi ke kōkua. ʻO nā hopena ʻē aʻe o nā antacids me ka diarrhea a i ʻole ka constipation.

Hiki i nā lāʻau ʻē aʻe ke kūʻai aku a hiki i ka lāʻau lapaʻau ke mālama iā GERD. Hana mālie kā lākou hana ma mua o nā antacids, akā hāʻawi iā ʻoe i ka hoʻomaha lōʻihi. Hiki i kāu kauka, kauka, a kahu wahine paha ke haʻi iā ʻoe pehea e lawe ai i kēia mau lāʻau.

• Hoʻoemi nā mea hōʻoki proton (PPI) i ka nui o nā waikawa i hana ʻia i kou ʻōpū.
• Hoʻoiho ka H2 blockers i ka nui o ka waikawa i hoʻokuʻu ʻia i loko o ka ʻōpū.

ʻO ke kīʻaha anti-reflux kahi koho no nā poʻe i hele ʻole nā ​​ʻōuli me nā loli o ka nohona a me nā lāʻau. Pono e hoʻomaikaʻi i ka ʻāʻī a me nā ʻōuli ʻē aʻe ma hope o ke kaha ʻana. Akā pono paha ʻoe e lawe i nā lāʻau no kou puʻuwai puʻuwai.

Aia kekahi mau mea hoʻoponopono hou no ka reflux i hiki ke hana ʻia ma o ka endoscope (kahi ʻōwili maʻalahi i hala i ka waha i loko o ka ʻōpū).

Pane ka hapa nui o ka poʻe i nā loli nohona a me nā lāʻau. Eia nō naʻe, pono i nā poʻe he nui e hoʻomau i ka lawe ʻana i nā lāʻau e kāohi ai i kā lākou mau ʻōuli.

Komo pū nā pilikia:

• Worsening o ka hānō
• ʻO kahi loli i ka pale o ka esophagus i hiki ke hoʻonui i ka makaʻu o ka maʻi ʻaʻai (Barrett esophagus)
• ʻO Bronchospasm (hoʻonāukiuki a me ka spasm o nā alaloa ma muli o ka acid)
• Lohi wā lōʻihi (mau) a hoarseness paha
• Nā pilikia kahua niho
• Ulcer i loko o ka esophagus
• Stricture (kahi ākea o ka esophagus ma muli o ka scarring)

Kāhea i kāu mea hāʻawi inā ʻaʻole hoʻomaikaʻi nā ʻōuli me nā loli nohona a lāʻau lapaʻau paha.

Kāhea pū inā loaʻa iā ʻoe:

• Kahena
• Kaukā (kahe ʻana, ka pōkole o ka hanu)
• Ua hoʻopiha koke ʻia ka manaʻo ke ʻai
• Luai pinepine
• Hoarseness
• Loaʻa ka ʻai ʻole
• Hoʻopilikia i ka ale ʻana (dysphagia) a i ʻole ʻeha me ka ale ʻana (odynophagia)
• Kaumaha emi
• Pili ka manaʻo e like me ka meaʻai a i ʻole nā ​​pila i hope o ka iwi umauma
  

ʻO ka pale ʻana i nā mea e kū ai ka puʻuwai e kōkua paha i ka pale ʻana i nā hōʻailona. Pili ʻo Obesity iā GERD. ʻO ka mālama ʻana i ke kaumaha o ke kino olakino hiki ke kōkua i ka pale ʻana i ke ʻano.

Peptic esophagitis; Reflux esophagitis; GERD; Puʻuwai puʻuwai - maʻi mau; Dyspepsia - GERD

• ʻOihana anti-reflux - keiki - hoʻokuʻu
• ʻOki kino Anti-reflux - hoʻokuʻu
• Reflux Gastroesophageal - hoʻokuʻu
• Heartburn - he aha e nīnau aku ai i kāu kauka
• Lawe i nā antacids

• ʻŌnaehana Digestive
• ʻO ka maʻi reflux Gastroesophageal
• ʻO reflux Gastroesophageal - moʻo

Abdul-Hussein M, Castell DO. ʻO ka maʻi reflux Gastroesophageal (GERD). I: Kellerman RD, Rakel DP, eds. ʻO Conn's Current Therapy 2020. Piladelapia, PA: Elsevier 2020: 219-222.

Kōmike Kūlana Kūlana ASGE, Muthusamy VR, Lightdale JR, et al. Ke kuleana o ka endoscopy i ka hoʻokele o GERD. ʻO Gastrointest Endosc. 2015; 81 (6): 1305-1310. PMID: 25863867 www.ncbi.nlm.nih.gov/pubmed/25863867.

ʻO Falk GW, Katzka DA. Nā maʻi o ka esophagus. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 129.

Katz PO, Gerson LB, Vela MF. Nā ʻōkuhi no ka ʻike a me ka mālama ʻana i ka maʻi reflux gastroesophageal. ʻO Am J Gastroenterol. 2013; 108 (3): 308-328. PMID: 23419381 www.ncbi.nlm.nih.gov/pubmed/23419381.

Pūnaewele Institute of Diabetes a me Digestive a me nā maʻi maʻi puʻuwai. Acid reflux (GER & GERD) i nā mākua. www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/all-content. Hoʻohou Nowemapa 2015. Loaʻa iā Pepeluali 26, 2020.

Richter JE, Friedenberg FK. ʻO ka maʻi reflux Gastroesophageal. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 44.