Y Gastroesophageal reflux yog ib yam kab mob ntawm txoj hlab pas los ntawm kev noj zaub mov tsis raug. Muaj ntau yam tshwm sim uas tshwm sim hauv plab zom mov. Thiab tsis muaj acidic ib puag ncig nyob rau hauv kab noj hniav ntawm lub plab, ib tug neeg yuav tsis nyob. Tab sis yog tias cov kua qaub nkag mus rau hauv txoj hlab pas, cov phab ntsa pib tawg, daim ntawv rwj. Thiab, ntawm chav kawm, qhov no tsis zoo rau lub cev, vim nws tuaj yeem xaus rau hauv kev mob qog noj ntshav yam tsis tau kho kom raug.
Reflux yog lub npe yooj yim rau tus kab mob. Hauv cov tshuaj, nws muaj lub npe tag nrho - kab mob gastroesophageal reflux lossis GERD. Nws yog ib qho teeb meem ntawm plab hnyuv loj tshaj plaws hauv ntiaj teb.
Symptoms
Cov tsos mob ntawm gastroesophageal reflux hauv cov neeg laus yog dab tsi? GERD feem ntau tshwm sim los ntawm qhov kub siab heev. Nws ua rau muaj zog thaum ua kev tawm dag zog hauv txoj haujlwm yooj yim, lossis thaum tus neeg koom nrog kev ua si lub cev.
Muaj lwm cov tsos mob tsis tshwj xeeb. Qhov no yog dysphagia (mob nqos),nquag laryngitis, bronchospasm, xeev siab thiab belching tom qab noj mov. Vim lub fact tias cov kua qaub nkag mus rau hauv lub qhov ncauj kab noj hniav thiab rhuav tshem cov hniav enamel, xws li ib tug neeg mob yuav muaj ib tug nquag teeb meem hniav. Kuj tseem muaj cov tsos mob otolaryngological. Nquag o ntawm pob ntseg nruab nrab kuj tseem qhia tau tias tus kab mob no.
Cov tsos mob ntawm gastroesophageal reflux - belching nrog qaub saj nyob rau hauv lub qhov ncauj, nquag hiccups, mob thaum nqos zaub mov. Nrog rau qhov teeb meem loj, ntuav ntuav tshwm sim, uas yog, ntuav ntawm lub plab uas tsis tau noj nyob rau lub sijhawm luv luv tom qab noj mov.
Yog vim li cas reflux
Qhov laj thawj tseem ceeb ntawm gastroesophageal reflux yog kev noj zaub mov tsis zoo, haus luam yeeb thiab noj zaub mov nrawm. Thaum ib tug neeg nqus cua los ntawm lub qhov ncauj, lub siab nyob rau hauv lub plab nce.
Dab tsi yuav yog qhov laj thawj?
- Kev cuam tshuam ntawm cov leeg sphincter.
- Ntau tshaj.
- Pob cawv.
- Kev noj haus tsis zoo.
- Diaphragmatic hernia.
Cov khoom uas ua rau muaj kev nyuaj siab ntawm tus kab mob suav nrog kev haus kas fes thiab haus luam yeeb ntau zaus. Raws li qee cov lus ceeb toom, chocolate kuj muaj teeb meem. Teeb meem plab xws li gastroesophageal reflux feem ntau nrog cov poj niam cev xeeb tub.
Tshuaj tuaj yeem ua rau lub plab zom mov. Peb tab tom tham txog nitrates, anticholinergics, beta-blockers.
Vim li cas sphincter tawg?
Lub sphincter lossis cardia nws tus kheej yog lub nplhaib pob txha,kaw tam sim tom qab tau txais khoom noj. Qhov no ua kom nws txoj kev txav mus los ntawm txoj hnyuv. Thaum lub plab valve tsis kaw tag nrho, hydrochloric acid tam sim ntawd "nkag mus" hauv txoj hlab pas. Lub valve nres ua haujlwm rau ib lossis ntau qhov laj thawj:
- teeb meem nrog cov thyroid thiab yog li ntawd nrog cov tshuaj hormones;
- overeating;
- kev nyuaj siab;
- nkag mus rau hauv plab ntawm cov kab mob hnyav xws li cawv, kua txob kub, kas fes;
- qee yam tshuaj uas muaj kev phiv;
- hnoos hnoos ntev heev.
Tseem, qhov tseem ceeb tshaj plaws yog kev noj ntau dhau, thiab nws yog kev siv roj. Thaum lub plab kab noj hniav nthuav dav heev, lub kaum sab xis ntawm txoj hlab pas thiab lub plab nws tus kheej hloov, thiab cov zaub mov tuaj yeem nkag mus rau hauv cov hlab pas. Sijhawm dhau mus, cov txheej txheem yuav phem zuj zus.
Ib qho ntawm qhov tsis txaus siab tshaj plaws ntawm kev ncab cov leeg nqaij yog achalasia. Tus neeg zoo li no tsis tuaj yeem noj ib txwm. Yog li ntawd, koj yuav tsum to taub tias gastroesophageal reflux tsis yog ib yam kab mob tsis kaj siab xwb. Nws tuaj yeem ua rau muaj qhov tshwm sim loj heev.
Types of GERD
Raws li tus kab mob, gastroesophageal reflux, qib uas tau muab hauv qab no, muaj qee yam nta. Ua ntej, thawj degree - uas tsis yog-erosive reflux - tshwm sim nyob rau hauv yuav luag txhua txhua tus neeg nyob hauv lub ntiaj teb ib ntus. Thiab thaum hmo ntuj, vim txoj hauj lwm kab rov tav ntawm lub cev, acid reflux yog ib qho tshwm sim tiag tiag. Thiab qhov thib ob, tus kab mob qiv nws tus kheej zoo heevkev kho mob.
Raws li kev faib tawm kho mob, muaj 3 hom kab mob:
- Tsis yog-erosive reflux. Hom mob me tshaj plaws, tsis muaj teeb meem ntawm esophagitis. Feem ntau.
- Erosive-ulcerative form - reflux nyuaj los ntawm rwj lossis streaks.
- Barrett's esophagus.
Raws li rau theem ntawm kev txhim kho, txhua yam yooj yim. Nonerosive reflux yog tus kab mob me tshaj plaws. Daim ntawv ulcerative yog nruab nrab ntawm qhov hnyav, thiab qhov kawg loj tshaj plaws - precancerous theem - yog qhov thib 3 ntawm peb daim ntawv teev npe.
Barrett's esophagus yog dab tsi?
Lub sijhawm ntev ntawm tus kabmob nrog kev nce ntxiv ntawm cov kua qaub reflux sab nraum lub plab ua rau tus neeg mob mus rau kws kho mob. Qee zaum, nrog rau cov kua qaub, pancreatic thiab bile enzymes kuj nkag mus rau hauv txoj hlab pas. Cov tshuaj no ntxiv ua rau mob mucosa. Vim yog kev ua ntawm cov kua tsib ntawm cov phab ntsa ntawm txoj hlab pas, cyclooxygenase-2 tau qhib. Lub xub ntiag ntawm cov khoom no twb yog ib tug harbiner ntawm Barrett's esophagus.
Thaum cov hlab ntsha tawg tau npog nrog cov cell txuas tshiab tom qab rwj, nws txhais tau tias theem 3 ntawm cov kab mob xws li gastroesophageal reflux tuaj.
Thaum lub sijhawm kuaj endoscope, columnar epithelium nrog cov cell tshwj xeeb goblet es tsis txhob stratified squamous epithelium pom. Qhov no yog theem kawg hauv kev txhim kho GERD thiab yog qhov tseeb, tus mob precancerous. Qhov kev kuaj mob tau lees paub tsuas yog tom qab kuaj histological.
Cell hloov pauv tshwm sim hauv lub cev raws li kev hloov kho kom muaj zogirritants, i.e. acids thiab alkalis. Tom qab tag nrho, lub cylindrical epithelium yog ntau "muaj zog", nws yog ib qho nyuaj rau hlawv nws. Tab sis thaum tiv thaiv cov hlwb loj hlob sai heev, qhov no twb yog ib qho mob qog noj ntshav.
Qhov kev pheej hmoo ntawm adenocarcinoma yog siab heev, txawm tias tom qab kho nrog cov twj tso kua mis proton, thiab cov tshuaj no muaj zog heev.
Huab cua
Thaum thawj theem, tus kab mob no tsis muaj mob. Txawm li cas los xij, tsis txhob cia reflux ua ntau zaus thiab mob. Kwv yees li 10-15% ntawm cov neeg uas twb muaj reflux tsim teeb meem loj. Qhov no tuaj yeem suav nrog kev nqaim ntawm txoj hlab pas, rwj, esophageal los ntshav, thiab adenocarcinomas.
Dab tsi ntxiv yuav ceeb toom txog kev phom sij ntawm gastroesophageal reflux? Kev kho tus kab mob no muaj txiaj ntsig yog tias pib raws sijhawm.
Kab mob hauv me nyuam
Tsis yog cov neeg laus xwb, tab sis cov menyuam yaus kuj raug rau GERD. Muaj ntau ntau yam ntawm gastroesophageal reflux hauv cov menyuam yaus. Kev kho mob yeej tseem zoo ib yam li cov neeg laus.
Vim li cas me nyuam thiaj mob? Yog hais tias ib tug ntawm cov niam txiv muaj mob plab, thiab muaj lwm tus neeg nyob rau hauv nws tsev neeg uas kuj raug kev txom nyem los ntawm ntau yam keeb kwm, ces tus me nyuam kuj yuav muaj teeb meem ib yam nkaus thiab.
Tseem kuj yuav muaj lwm yam laj thawj:
- vegetative dysfunction;
- kab mob kab mob;
- -gastritis, gastroduoddenitis;
- incipient hernia of the esophagus;
- siv cov tshuaj muaj barbiturates lossis nitrates;
- noj ntau dhau ntawm cov chips, crackers, dej haus.
Tsis yogIb qho laj thawj tsis tseem ceeb rau kev loj hlob ntawm tus kab mob gastroesophageal hauv tus menyuam yog txoj kev ua neej ntawm leej niam thaum cev xeeb tub. Yog tias thaum lub sij hawm nqa tus me nyuam hauv plab, thiab tom qab ntawd thaum pub mis, tus poj niam tsis tau tshem ntawm tus cwj pwm ntawm kev haus luam yeeb, feem ntau tus me nyuam yuav muaj kev sib txawv. Piv txwv li, plab deformity, diaphragmatic hernia thaum yug los, thiab ntau dua.
Ua rau GERD txij thaum yau cov kab mob xws li:
- mob hawb pob, bronchitis;
- cem quav;
- cystic fibrosis;
- siab load hauv cov kis las.
Raws li kev txheeb cais, cov tub hluas raug kev txom nyem los ntawm GERD ntau dua li cov ntxhais. Tej zaum vim lawv ua hauj lwm tawm ntau dua ntawm qhov chaw ua si. Thiab yog hais tias ob leeg niam txiv muaj mob gastritis, nws muaj feem ntau tias tus tub yuav pib muaj cov tsos mob thawj zaug ntawm reflux ua ntej thaum hluas.
GERD Diagnosis
Nrog kev kub siab tsis tu ncua, nws tseem pom zoo kom nrhiav lub sijhawm thiab mus dhau ntau cov txheej txheem tseem ceeb. Rau kev tshuaj ntsuam xyuas dav siv:
- 24/7 saib xyuas ntawm intraesophageal acidity;
- egofagoscopy;
- X-ray nrog barium;
- pH-metry hloov acidity;
- CBC.
Ib x-ray nrog qhov sib txawv yog siv los saib seb puas muaj lub diaphragm herniated. Yog tias nws yog, kev kho mob twb muaj kev phais lawm, vim tias cov tshuaj tiv thaiv kab mob yuav tsis pab.
YGastroesophageal reflux. Kev kho mob
Yog tias tus neeg laus raug kuaj pom ib yamtsis muaj zog uas tsis yog-erosive daim ntawv, los yog twb ulcerative, ces qhov no yog ib tug teeb liab rau kev hloov tam sim ntawd nyob rau hauv kev noj haus thiab tag nrho txoj kev ua neej. Txoj cai tseem ceeb yog noj nruab nrab thiab los ntawm ib teev, thiaj li tsis txhob overstrain lub plab nrog ib pluag mov ntau. Mob, belching thiab heartburn yog relieved los ntawm ib co tshuaj. Qhov no, piv txwv li, "Phosfalugel", "Almagel", "Maalox". Qhov no yog ib pawg ntawm antacids. Txawm li cas los xij, lawv txoj kev siv tsuas yog ua rau muaj kev pab ib ntus xwb.
Txhua lub sijhawm, kev kho mob los ntawm cov tshuaj yooj yim rau lub neej kom pab mob hnyav. Tam sim no muaj xws li cov tshuaj xws li proton twj tso kua mis inhibitors. Cov no suav nrog "Rabeprazole". Cov tshuaj no yog lwm txoj hauv kev zoo rau cov tshuaj tua kab mob raws li nws pab tiv thaiv kev mob hnyav dua.
Cov tshuaj no ua haujlwm li cas? Xws li cov tshuaj los ntawm cov koob no, zoo li Omeprazole, tsuas yog txo qis cov kua qaub hauv plab, thiab tus kab mob no tsis tuaj. Txawm li cas los xij, qhov no tsis tau txhais hais tias koj tuaj yeem haus luam yeeb. Cov pa luam yeeb tsis tsuas yog nkag mus rau hauv lub ntsws xwb, tab sis kuj ua mob rau tag nrho lub cev.
Surgery
Yog tias cov teeb meem hauv lub cev hnyav dua, kev noj zaub mov yooj yim tsis txwv. Tej zaum yuav muaj kev phais los txhim kho tus mob.
Thaum lub sijhawm ua haujlwm, cov kws kho mob txo qis hiatal hernia. Tsis muaj tshuaj yuav kho tau tus kab mob no. Tsis tas li, kev ua haujlwm pab ua kom cov zaub mov ntawm lub plab mus rau cov hnyuv kom nrawm dua vim qhov nce ntawm cov leeg nqaij sphincters.
Kev Tiv Thaivkab mob
Yog li peb paub yuav ua li cas kho gastroesophageal reflux. Tab sis yuav ua li cas tiv thaiv kev txhim kho ntawm GERD? Koj yuav tsum noj 4 zaug hauv ib hnub me ntsis. Yog hais tias muaj erosive tshwm sim nyob rau hauv lub plab, ces 6 zaug. Tom qab noj mov, koj tsis tuaj yeem ua lub cev qoj ib ce. Noj hmo yuav tsum yog peb teev ua ntej yuav mus pw. Los ntawm kev ua raws li cov kev cai tseem ceeb no, koj yuav tiv thaiv koj tus kheej los ntawm kev pheej hmoo kis mob qog noj ntshav.
Ib txoj cai ntxiv. Pw rau ib lub txaj nrog me ntsis tsa lub taub hau. Thaum lub taub hau nce txog 15-20 °, txoj hlab pas tsis tshua muaj kev cuam tshuam los ntawm sphincter so thiab acid reflux.
Txoj cai dab tsi tseem ceeb uas yuav tsum tau ua yog tias tus kab mob reflux nce zuj zus ua rau nws tus kheej muaj kev ntxhov siab, mob thiab kub siab? Qhov tseem ceeb tshaj plaws yog kom tsis txhob noj zaub mov ntsim, rog dhau. Tshem tawm kas fes thiab chocolate los ntawm koj cov khoom noj. Rau kev noj qab haus huv, koj yuav tau noj cereals, zaub thiab txiv hmab txiv ntoo.
Zoo kawg
Koj tuaj yeem sau dab tsi? Gastroesophageal reflux, cov tsos mob thiab kev kho mob uas peb tau soj ntsuam nyob rau hauv cov ntaub ntawv no, yog tsis txaus ntshai mus txog rau thaum nws tua cov epithelial hlwb ntawm lub esophageal phab ntsa thiab tsis ua rau ib tug meej deterioration nyob rau hauv kev noj qab nyob zoo. Kev noj zaub mov tsis zoo sai sai thiab kev ntxhov siab hauv ntau txoj hauv kev provoke cov kab mob, tshwj xeeb tshaj yog thaum muaj kev hloov pauv hloov pauv. Thiab qhov no txhais tau tias koj yuav tsum tau ua raws li kev noj haus kom zoo dua.
gastritis, ulcers thiab duodenitis yog feem ntau ua rau gastroesophageal reflux. Kev kho mob yuav tsum raug xaiv, suav nrog qhov xwm txheej tiag tiag. Qhov twg txhais tau tiasNws yog ib qho tsim nyog kom dhau tag nrho cov kev ntsuam xyuas, nco ntsoov ua egophagoscopy thiab pH-metry.
