- 由Grace Tom姊妹(已退休的註冊護士)撰寫  

 - Written by Grace Tom (Retired RN) 

 

 

 

 

文章使用中英對照  Article is in both Chinese & English

常見的腸胃小毛病

A. 胃酸倒流

頻頻倒流=GERD=Gastro-esophagealreflux disease

症狀

  1. 胃感覚灼熱或從腹部中間至胸骨之下有燃燒的感覺
  2. 同時在口裏有酸味的感覺, 或有很多口水
  3. 晚上躺下時, 在口內有返胃的感覺

起因

  1. 在懷孕時-通常在前三個月, 女性荷爾蒙的分泌過多而引致排出過多胃酸
  2. 服用某些藥物---例如抗生素
  3. 攝取酒精
  4. 食用某些食物---如辣, 酸或油炸的食物
  5. 有哮喘症狀---呼吸急速或氣喘
  6. 有吞嚥困難
  7. 乾咳

治療

  1. 生活的改變

    胃酸倒流多數都是發生在晚上

    • 提高牀頭---使頭部位置高於腹部
    • 提升床頭至少30角度, 可放堅固的楔形枕頭在您的頭及肩膊之下
    • 飯後不可立刻躺平, 讓食物消化三十分鐘以上才可躺下
  2. 躺下時應睡在左邊---  睡在右邊及俯伏地睡, 會使胃酸倒流更惡化
  3. 仔細咀嚼食物---至少要花20秒鐘去咀嚼每一口食物．消化程序從口開始. 若食物在口中没有經過仔細咀嚼會導致消化不良而引致胃酸倒流
  4. 少食多餐---能夠控制食量是處理胃酸倒流的最佳辦法, 建議進食時不可過飽, 因過飽可使胃礦張
  5. 減低高脂肪及澱粉質食物(麵包, 飯, 意大利粉及粉麵類).
  6. 選擇適當的飯後活動---建議飯後等一個半小時才做運動. 若曾有胃酸倒流症狀, 最好不要做彎腰動作
  7. 戒煙及減少攝取酒精---吸煙及飲過量的酒會激發胃排出過量的胃酸.
  8. 保持健康的體重會有幫助, 因為多餘的脂肪會壓着食道下部的括約肌. 
  9. 咀嚼香口膠---嚼香口膠會幫助排出多些口水, 可中和胃酸.睡前可嚼一兩片香口膠會有幫助.  若有輕微的消化不良, 可飲一杯溫暖的清水. 最好在睡前不飲含有咖啡因的飲品, 如咖啡或茶.

     

B. 便秘

日常不須要每天都排便----若一天三次或一星期三次都屬正常, 只要不是長期有大便稀溏或有黑色及大便有血, 便是正常.

嚴重的便秘

  • 感覺有肚子不舒服及/或有肚痛,
  • 一星期沒有大便
  • 曾試用藥房自購的通便藥物, 如瀉藥及金油條, 還未能緩解便秘. 並持續有以上的症狀,便 應去見醫生. 或有嚴重的作悶及嘔吐應要立刻去急症室檢驗是否有更嚴重的病症.

預防便秘

  1. 整日飲多量的流質
  2. 選擇進食高纖維的食物, 如全穀類, 生果及疏菜
  3. 小心服用任何藥物,含有麻醉劑及鴉片劑的藥物, 可引致便秘

便秘的併發症

便秘, 太硬的大便, 及長期需要使勁排便, 可引發痔瘡, 肛門流血會導致有貧血, 嚴重會導致有肛裂.

Common Gastrointestinal Complaints

A. Reflux

Frequent reflux = GERD = Gastro-esophageal reflux disease

Symptoms

  1. Heartburn-hot or burning feeling arising up from the center of the abdominal area and into the chest under the breast bone.
  2. This may accompany a sour taste in the mouth, or hypersalivation.
  3. Feeling regurgitation of gastric fluid in the mouth especially lying down or at night.

Causes

  1. Pregnancy – usually in the first trimester of pregnancy, with over production of female hormones causing over secretion of stomach acid.
  2. Some medications-like some antibiotics
  3. Alcohol consumptions
  4. Certain food:-spicy, sour or fried food.
  5. Asthma like symptoms:-short of breath or wheezing
  6. Trouble swallowing
  7. Dry cough

Treatment

  1. Life style changes

    Most reflux happens at night:-

    • Raise your head of bed up-position your head higher than your abdomen.
    • Elevate the head of bed at a minimum of 30 degrees by putting a firm foam rubber wedge pillow under your head and shoulder
    • Do not lie down flat immediately after a meal. Give yourself at least 30 minutes to digest your food before lying down.
  2. Sleep on your left side - Sleeping on your right side and lying prone will worsen gastric reflux.
  3. Chew your food well - Chew each bite for at least 20 seconds. Digestion starts in the mouth, if you do not chew your food well you are prone to indigestion leading to reflux.
  4. Eat less but more frequently - Portion control is the best management for acid reflux. Eat until satisfied but not “stuffed”. Over eating causes the stomach to stretch and over production of stomach acid, leading to reflux of acid.
  5. Cut fat and carbohydrates – like fried food, bulky starchy food( bread, rice, pastas and noodles ).
  6. Choose post meal activities wisely – exercise only one and half hour after a meal and try not to do bending exercise if you are experiencing reflux.
  7. Quit smoking and cut back on alcohol consumption. Smoking and drinking excessively stimulates production of stomach acid.
  8. Maintaining a healthy weight will be helpful as extra fat puts pressure on the lower esophageal sphincter.
  9. Chew gums – chewing gums will produce more saliva which helps to neutralize stomach acid. Chew a piece or two before bedtime.Or have slight feeling of indigestion, simply drink a cup of plain warm water. Do not drink caffeinated drinks like coffee or tea before bedtime.

     

B. Constipation

No need to be obsessed with having daily bowel movements – any where between 3 times a day to 3 times a week is normal, as long as it is not always watery or runny or with black stool or blood.

Severe constipation

  • Experiencing abdominal discomfort/pain and/or
  • One week without a bowel movement.
  • Have tried over the counter remedy or laxatives, and glycerin suppository and still constipated. Any above symptoms persist should check in with the doctor, or if severe with nausea and vomiting should go to ER for checkups.

Prevention of constipation

  1. Drink a lot of liquid throughout the day.
  2. Eat a high fiber diet from whole grains, fruit and vegetables.
  3. Beware of any medications that can lead to constipation e.g. narcotics and opiates.

Complications of constipation

Constipation, hard stools, and constant straining can lead to hemorrhoids, causing rectal bleeding and anemia and serious enough will lead to anal fissure.

預防勝於治療  wink

Prevention is better than cure  wink