Hiatal Hernias a me Acid Reflux

Anter

• Hōʻike Overview
• Nā ʻōuli
• Kānāwai
• Lapaʻau
• ʻOki kino

I ʻApelila 2020, ua noi ʻia e hoʻopau i nā ʻano o ke kuhikuhi a me ka over-the-counter (OTC) ranitidine (Zantac) mai ka mākeke U.S. Ua hana ʻia kēia ʻōlelo aʻoaʻo no ka mea ʻaʻole i ʻāpono nā pae o NDMA, kahi carcinogen paha (kemikō e hoʻomaka ana i ka maʻi ʻaʻai), i loaʻa i kekahi mau huahana ranitidine. Inā kuhikuhi ʻoe iā ranitidine, e kamaʻilio me kāu kauka e pili ana i nā koho koho palekana ma mua o ka hoʻokū ʻana i ka lāʻau. Inā lawe ʻoe i ka OTC ranitidine, e hoʻōki i ka lawe ʻana i ka lāʻau a kamaʻilio pū me kāu kauka no nā koho ʻē aʻe. Ma kahi o ka lawe ʻana i nā huahana ranitidine i hoʻohana ʻole ʻia i kahi pūnaewele hoʻihoʻi i ka lāʻau, hoʻolei iā lākou e like me nā ʻōlelo a ka huahana a i ʻole ma ka mālama ʻana iā FDA.

Hōʻike Overview

ʻO kahi hernia hiatal kahi kūlana kahi e liʻiliʻi ai kahi ʻāpana o kou ʻōpū ma o kahi puka o kāu diaphragm. Kapa ʻia kēia puka he hiatus. He wehe maʻamau, anatomically pololei e hiki ai i kāu esophagus e hoʻohui i kou ʻōpū.

ʻAʻole ʻike ʻia ke kumu o ka hernia hiatal. Hiki i nā mea kōkua nāwaliwali a hoʻonui i ka ʻōpū o ka ʻōpū ke kōkua i ke ʻano. Hiki i ka hernia ponoʻī ke pāʻani i ka hoʻomohala ʻana o ka reflux waikawa a me kahi ʻano mau o ka reflux acid i kapa ʻia ʻo gastroesophageal reflux disease (GERD).

Hiki i nā Hiatal hernias ke koi aku i nā ʻano hana like ʻole, mai ke kali kiaʻi ʻana i nā hihia māmā i ke ʻoki ʻana i nā hihia koʻikoʻi.

Nā ʻōuli

ʻAʻole hana maʻamau ʻo Hiatal hernias i nā ʻōuli āu e ʻike ai a hiki i ka nui ʻana o ka ʻōpū ma loko o ka hiatus. ʻO nā hernia liʻiliʻi o kēia ʻano pinepine asymptomat. ʻAʻole paha ʻoe e noʻonoʻo i kekahi ke ʻole ʻoe e hoʻokolohua olakino no kahi ʻano pili ʻole.

Nui ka hernias hiatal nui e ʻae i nā meaʻai a me nā waikiko ʻole i hoʻoheheʻe ʻia e reflux i loko o kou esophagus. ʻO kēia ke hōʻike paha ʻoe i nā hōʻailona maʻamau o GERD. Pākuʻi ʻia kēia mau mea:

• puʻuwai puʻuwai
• ʻeha o ka umauma ke hoʻonui aʻe ke kūlou ʻoe a moe i lalo paha
• luhi
• abdominal eha
• dysphagia (pilikia i ka ale ʻana)
• kanu pinepine ʻana
• eha ka 'ā'ī

Hiki ke hoʻopili ʻia ka reflux waikawa e nā ʻano kumumea like ʻole. Pono paha e hoʻāʻo e hoʻoholo inā loaʻa iā ʻoe ka hiatal hernia a i ʻole nā ​​hanana ʻē aʻe ʻē aʻe i hiki ma hope o kāu hōʻailona GERD.

E kamaʻilio me kāu kauka e pili ana i nā hōʻailona reflux ʻaʻole maikaʻi me ka nohona a me nā loliʻai a i ʻole nā ​​antacid over-the-counter.

Kānāwai

Hoʻohana ʻia nā hoʻokolohua kiʻi e ʻike i kahi hernia hiatal a me nā hōʻino i hiki ke hana ʻia e ka reflux acid. ʻO kekahi o nā hoʻokolohua kiʻi maʻamau ʻo ka barium e ale i ka X-ray, i kekahi manawa i kapa ʻia ʻo GI a i ʻole esophagram.

Pono ʻoe e hoʻokē ʻai no ʻewalu mau hola ma mua o ka hoʻāʻo e ʻike pono ai i ka ʻāpana kiʻekiʻe o kāu gastrointestinal tract (kou esophagus, ʻōpū, a me kahi hapa o kou ʻōpū liʻiliʻi) ʻike maopopo ʻia ma ka X-ray.

E inu ʻoe i kahi haʻalulu barium ma mua o ka hoʻāʻo. ʻO ka hoʻoluliluli kahi mea keʻokeʻo, chalky. Māmā ka barium i kou mau ʻōpū e ʻike ma ka X-ray ke neʻe nei i loko o kāu ʻōpū.

Hoʻohana pū ʻia nā pono hana diagnostical Endoscopic e ʻike pono i nā hernia hiatal. ʻO kahi endoscope (kahi paipu lahilahi, maʻalahi hiki ke hoʻolako ʻia me kahi kukui liʻiliʻi) i wili ʻia i kou puʻu ke loaʻa ʻoe i ka sedation. ʻAe kēia i kāu kauka e nānā no ka mumū a i ʻole nā ​​kumu ʻē aʻe e hoʻonāukiuki paha i kāu acid reflux. Hiki i kēia mau mea ke hoʻopili pū i nā hernias a i ʻole nā ​​ulcer.

Lapaʻau

Hoʻololi ka lapaʻau ʻana no ka hernia hiatal a hoʻololi ʻia i kāu mau olakino pilikino. Hōʻike nā hernia liʻiliʻi e hōʻike i nā hoʻokolohua diagnostics akā e hoʻomau i ka asymptomatic e kiaʻi wale nō e ʻike ʻaʻole lawa ka nui e hoʻonāukiuki.

Hiki i nā lāpuna puʻuwai puʻuwai over-the-counter ke hāʻawi i ke kōkua mai ke ʻano wela i kekahi manawa e kū mai paha mai kahi hernia hiatal liʻiliʻi liʻiliʻi. Hiki iā lākou ke lawe ʻia e like me ka mea e pono ai a puni ka lā i ka nui o nā hihia. Hoʻohui pinepine ʻia nā kalima a me nā antacid i hoʻokumu ʻia me ka magnesium i nā ʻaoʻao kōkua digestive o kāu hale kūʻai lāʻau kūloko.

ʻAʻole hāʻawi wale nā ​​lāʻau lapaʻau no GERD iā ʻoe i ke kōkua, hiki i kekahi ke kōkua i ka hoʻōla ʻana i ka uhi o kāu esophagus mai ka reflux acid pili i ka hernia. Hoʻokaʻawale ʻia kēia mau lāʻau i ʻelua mau hui: H2 blockers and proton pump inhibitors (PPI). Pākuʻi ʻia lākou:

• cimetidine (Tagamet)
• esomeprazole (Nexium)
• famotidine (Pepcid)
• lansoprazole (Prevacid)
• omeprazole (Prilosec)

Hiki ke kōkua i ka hoʻoponopono ʻana i kāu papaʻai a me ka manawa hiamoe e mālama i kāu mau hōʻailona GERD ke loaʻa ʻoe i kahi hernia hiatal. E ʻai i nā meaʻai liʻiliʻi a puni ka lā a pale i nā meaʻai e hoʻonāukiuki i ka ʻeha puʻuwai. ʻO nā meaʻai e hiki ke hoʻoulu i ka puʻuwai pū me:

• huahana Tomato
• huahana citrus
• meaʻai momona
• kokoleka
• Pepelu
• caffeine
• ʻalekohola

E hoʻāʻo ʻaʻole e moe i lalo no ʻekolu mau hola ma hope o ka ʻai ʻana e pale ai i nā waikawa mai ka hana ʻana i kā lākou ala digestive. E haʻalele ʻoe i ka puhipaka. Hiki i ka puhihihi ke hoʻonui i kou makaʻu i ka reflux acid. Eia kekahi, ʻo ka nui o ke kaumaha (ʻoiai inā he wahine ʻoe) hiki ke hoʻonui i kou makaʻu i ka hoʻomohala ʻana i nā GERD a me ka hiatal hernias, no laila ʻo ka lilo ʻana o ke kaumaha e kōkua ai i ka hōʻemi i kāu mau hōʻailona reflux.

ʻOki kino

Pono paha ke ʻoki e hoʻomaikaʻi i kahi hernia hiatal ke pono ke mālama pono i nā lāʻau lapaʻau, nā hoʻololi o ka papaʻai, a me nā hoʻoponopono nohona. ʻO nā moho kūpono no ka hoʻoponopono ʻana i ka hernia hiatal ʻoi paha ka poʻe nāna:

• ʻike i ka huhū nui
• loaʻa i kahi esophageal koʻikoʻi (kahi liʻiliʻi o ka esophagus ma muli o ka reflux mau)
• loaʻa ka wela nui o ka esophagus
• i loaʻa i ka pulumonia e ka moemoeā o nā ʻōpū o ka ʻōpū

Hana ʻia ʻo Hernia ʻoki kino ma lalo o ka anesthetic ākea. Hana ʻia nā ʻoki laparoscopic i loko o kou ʻōpū, e ʻae i ke kaukipō e hoʻoku mālie i ka ʻōpū mai ka hiatus a hoʻi i kāna kūlana maʻamau. Hoʻopaʻa nā kuʻi i ka hiatus a mālama i ka ʻōpū mai ka heʻe ʻana ma ka wehe hou.

ʻO ka manawa hoʻōla ma hope o ke kahakaha ʻana mai 3 a 10 mau lā i ka haukapila. E loaʻa ʻoe i ka meaʻai ma o ka ʻōmole nasogastric no kekahi mau lā ma hope o ke kaha ʻana. Ke ʻae ʻia ʻoe e ʻai hou i nā meaʻai paʻa, e ʻike pono e ʻai i nā mea liʻiliʻi i ka lā holoʻokoʻa. Hiki i kēia ke kōkua i ka hāpai i ka hoʻōla.