\u00c7ocuk Sa\u011fl\u0131\u011f\u0131 ve Hastal\u0131klar\u0131 Uzman\u0131 Dr. Osman Ayata\u00e7,yeti\u015fkin hastal\u0131\u011f\u0131 ve ‘mide yanmas\u0131’ olarak bilinen refl\u00fcn\u00fcn, asl\u0131nda bebeklerde daha \u00e7ok g\u00f6r\u00fcld\u00fc\u011f\u00fcn\u00fc s\u00f6yledi<\/p>\n
<\/p>\n
Dr. Osman Ayata\u00e7, ”Son y\u0131llarda bebeklerin t\u00fcm kusmalar\u0131n\u0131n refl\u00fc \u015feklinde tan\u0131mlanmas\u0131, hastalar\u0131n fizyolojik (do\u011fal) kusmalar\u0131 iyi \u00f6yk\u00fc al\u0131nmadan ve gerekli fiziki muayene yap\u0131lmadan aileleri endi\u015felendiren a\u011f\u0131r ve zahmetli refl\u00fc tetkiklerine y\u00f6nlendirilmesi gereksizdir” dedi.<\/p>\n
Avusturya Sen Jorj Hastanesi Dr. Osman Ayata\u00e7, ayl\u0131k kontrollerde normal fiziki bulgu saptanan ve geli\u015fimi (kilo, boy, ba\u015f \u00e7evresi, n\u00f6rolojik) iyi olan bebeklerde olu\u015fan kusmalarda ilk olas\u0131l\u0131\u011f\u0131n refl\u00fc olmad\u0131\u011f\u0131n\u0131 dile getirerek, \u201cAnne s\u00fct\u00fc ile beslenemeyen bebeklerde, premat\u00fcre bebeklerde, hatal\u0131 beslenen bebeklerde, viral, bakteriyel enfeksiyonu olan bebeklerde, do\u011fumsal metabolik bozuklu\u011fu olan bebeklerde yaln\u0131zca (refl\u00fc) d\u00fc\u015f\u00fcnmek aldat\u0131c\u0131d\u0131r. Refl\u00fc bir belirtidir, refl\u00fc hastal\u0131\u011f\u0131 ise ciddi bir tan\u0131d\u0131r, ciddi t\u0131bbi tedavi ve gerekirse cerrahi uygulama yap\u0131l\u0131r. Bu iki durumu birbirinden ay\u0131rmak gerekir. Basit bir Gastro-enteritte bebek olu\u015fan toksini v\u00fccuttan atmak i\u00e7in \u00f6ncelikle kusar, bu v\u00fccudun ve ba\u011f\u0131\u015f\u0131kl\u0131k sisteminin olumlu bir refleksidir, bazen aileler bunu refl\u00fc gibi tan\u0131mlayabilir. Otuz, k\u0131rk sene \u00f6nce \u0131srarl\u0131, s\u0131k kusan bebeklerde mide ile \u00f6zofagus (yemek borusu) aras\u0131ndaki kap\u0131da yetersizlik sonucu (akalazya) diye isimlendirilen ve bebek b\u00fcy\u00fcd\u00fck\u00e7e azalan kusmalara s\u0131k\u00e7a rastlan\u0131rd\u0131. Daha ciddi, do\u011fumdan iki ile \u00fc\u00e7 hafta sonra g\u00f6r\u00fclen ila\u00e7 ile durdurulamayan, cerrahi tedavi uygulanarak d\u00fczelen (pilor stenozu, mide ile barsak aras\u0131nda olu\u015fan do\u011fumsal darl\u0131k) vakalar\u0131 o g\u00fcnk\u00fc t\u0131bbi imkanlarla te\u015fhis etmek \u00e7ok zordu” diye konu\u015ftu.<\/p>\n
\u00c7ocuk Sa\u011fl\u0131\u011f\u0131 ve Hastal\u0131klar\u0131 Uzman\u0131 Dr. Osman Ayata\u00e7, g\u00fcn\u00fcm\u00fczde ileri t\u0131bbi ve teknolojik imkanlarla refl\u00fc ve refl\u00fc hastal\u0131\u011f\u0131 tan\u0131s\u0131 koyman\u0131n kolayla\u015ft\u0131\u011f\u0131n\u0131 ifade ederek, \u201cBebek ve \u00e7ocuk \u00f6l\u00fcm oranlar\u0131n\u0131n binde ikiy\u00fczlerden binde be\u015flere kadar indi\u011fi \u00fclkemizde, ciddi pre ve perinatal, postnatal takipli anne ve bebekler, 0-1 ya\u015f aras\u0131 peryodik t\u0131bbi kontrol\u00fc yap\u0131lan bebekler, do\u011fum salonlar\u0131 ve sezaryen do\u011fumda \u00e7ocuk hekimlerinin ameliyathaneye girerek do\u011fum sonras\u0131 bebekte olu\u015fan t\u0131bbi olumsuzluklara an\u0131nda m\u00fcdehale etmesi, do\u011fumsal metabolik ve genetik hastal\u0131klar\u0131n erken tan\u0131 testlerinin uygulanmas\u0131, anne s\u00fct\u00fcn\u00fcn yayg\u0131n kullan\u0131m\u0131, bebek ve \u00e7ocuk a\u015f\u0131lama oranlar\u0131n\u0131n y\u00fczde doksanlara \u00e7\u0131kar\u0131lmas\u0131, etkin enfeksiyon \u00f6nlemleri bebeklerde refl\u00fc ve refl\u00fc hastal\u0131\u011f\u0131n\u0131n tan\u0131 ve tedavisinin kolayla\u015fmas\u0131n\u0131 sa\u011flam\u0131\u015ft\u0131r, ancak radyasyon ve n\u00fckleer tehlikenin b\u00fcy\u00fck boyutlara ula\u015farak \u00e7evre kirlili\u011finin artmas\u0131, genetik de\u011fi\u015fimli ve katk\u0131 maddeli g\u0131dalar\u0131n bolca t\u00fcketildi\u011fi, endokrin bozucu maddelerin yayg\u0131nla\u015ft\u0131\u011f\u0131, ki\u015filerin a\u015f\u0131r\u0131 stres ve depresyonlar\u0131, az hareketli ya\u015fam tarz\u0131, obezite, yayg\u0131n alerji, yayg\u0131n sigara kullan\u0131m\u0131, adolesan (ergenlik) problemleri, sonucu bebeklerde refl\u00fc ve refl\u00fc hastal\u0131\u011f\u0131n\u0131n giderek artt\u0131\u011f\u0131n\u0131 g\u00f6zlemlemekteyiz\u201d dedi.
\nDr. Osman Ayata\u00e7, daha sonra \u015funlar\u0131 kaydetti: \u201c(G\u0130S) dedi\u011fimiz mide barsak sisteminin \u00fcst (\u00f6zofagus yemek borusu), orta (mide, pilor duodenum) ve alt (barsaklar) do\u011fumsal ciddi bozukluk ve darl\u0131klar, refl\u00fc hastal\u0131\u011f\u0131 ile kar\u0131\u015fa bilecek hastal\u0131klardan baz\u0131lar\u0131d\u0131r.<\/p>\n
\u00d6ZOFAGUSUN DO\u011eUMSAL DARLIKLARI<\/strong> Refl\u00fc hastal\u0131\u011f\u0131nda \u015fu hastal\u0131klar ile ayr\u0131ca tan\u0131 yap\u0131lmal\u0131d\u0131r. Kusmaya yol a\u00e7an (pilor stenozu, \u00fcriner (idrar) enfeksiyonlar\u0131, metabolik hastal\u0131klar vb. Alerjik ve enfeksiy\u00f6z nedenli solunum yolu hastal\u0131klar\u0131 Besin alerjisi, Kar\u0131n a\u011fr\u0131s\u0131 ve kanama, kusma yapan (gastrit, \u00f6zofagus varisi, \u00fclser vb.) hastal\u0131klar. Davran\u0131\u015f bozuklu\u011fu yapan hastal\u0131klar<\/p>\n Refl\u00fc hastal\u0131\u011f\u0131n\u0131n tan\u0131s\u0131nda ileri g\u00f6r\u00fcnt\u00fcleme (Endoskopi Ve Biyopsi, Radyoloji, Sintigrafi, Manometre, Ultrasonografi, Elektro Gastrografi ve \u00f6zellikle PH metre gibi) y\u00f6ntemler kullan\u0131l\u0131r. Bu y\u00f6ntemler pahal\u0131 ve invazifdir (riskli). Tan\u0131da halen \u00f6yk\u00fc ve klinik muayene \u00f6n plandad\u0131r.\u201d Dr. Ayata\u00e7, \u201cBebe\u011fin en az otuz derece y\u00fckseltilmi\u015f bir pozisyonda beslenmesi ve sol yan pozisyonda yat\u0131r\u0131lmas\u0131 ideal yat\u0131\u015f \u015feklidir. Bebe\u011fin midesinin h\u0131zla bo\u015falmas\u0131n\u0131, besinin solunum yollar\u0131na ka\u00e7mas\u0131n\u0131 azalt\u0131r. Mamalar\u0131n koyula\u015ft\u0131r\u0131lmas\u0131, s\u0131k ve az az besleme, \u015fi\u015fman bebeklerin zay\u0131flat\u0131lmas\u0131, \u00e7ikolata, a\u015f\u0131r\u0131 ya\u011fl\u0131 g\u0131dalar, so\u011fan, sar\u0131msak, haz\u0131r meyve sular\u0131, ac\u0131l\u0131, baharatl\u0131, ket\u00e7ap, tur\u015fu gibi g\u0131dalardan kola, gazoz ve gazl\u0131 i\u00e7eceklerden ka\u00e7\u0131n\u0131lmal\u0131d\u0131r. Mide asidini dengeleyen ve di\u011fer ila\u00e7lardan fayda g\u00f6rmeyen, tekrarlayan solunum yolu hastal\u0131klar\u0131, b\u00fcy\u00fcme ve geli\u015fme gerili\u011fi olan, dindirilemeyen kusma ve \u00f6ks\u00fcr\u00fckler, apne ve siyanozu olan vakalarda cerrahi tedavi (ameliyat) uygulan\u0131r. \u00d6zet olarak;Her kusma refl\u00fc de\u011fildir, refl\u00fc hastal\u0131k de\u011fil belirtidir. Refl\u00fc hastal\u0131\u011f\u0131 (G\u00d6RH) ciddi ve \u00f6nemli bir hastal\u0131kt\u0131r, tan\u0131da \u00f6yk\u00fc ve klinik muayene \u00e7ok \u00f6nemlidir, \u00f6ncelikle bebek ve ailenin huzursuz olmamas\u0131 i\u00e7in riskli, invazif ve pahal\u0131 ileri tan\u0131 y\u00f6ntemlerini se\u00e7ici olarak kullanmak ak\u0131lc\u0131 olur\u201d diye konu\u015ftu.<\/p>\n","protected":false},"excerpt":{"rendered":" \u00c7ocuk Sa\u011fl\u0131\u011f\u0131 ve Hastal\u0131klar\u0131 Uzman\u0131 Dr. Osman Ayata\u00e7,yeti\u015fkin hastal\u0131\u011f\u0131 ve ‘mide yanmas\u0131’ olarak bilinen refl\u00fcn\u00fcn, asl\u0131nda bebeklerde daha \u00e7ok g\u00f6r\u00fcld\u00fc\u011f\u00fcn\u00fc s\u00f6yledi Dr. Osman Ayata\u00e7, ”Son y\u0131llarda bebeklerin t\u00fcm kusmalar\u0131n\u0131n refl\u00fc \u015feklinde tan\u0131mlanmas\u0131, hastalar\u0131n fizyolojik (do\u011fal) kusmalar\u0131 iyi \u00f6yk\u00fc al\u0131nmadan ve gerekli fiziki muayene yap\u0131lmadan aileleri endi\u015felendiren a\u011f\u0131r ve zahmetli refl\u00fc tetkiklerine y\u00f6nlendirilmesi gereksizdir” dedi. […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14],"tags":[7324,12657,12658],"class_list":["post-84028","post","type-post","status-publish","format-standard","hentry","category-saglik","tag-bebek","tag-reflu","tag-sik"],"_links":{"self":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/posts\/84028","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=84028"}],"version-history":[{"count":0,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=\/wp\/v2\/posts\/84028\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=84028"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=84028"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.erzhaber.com.tr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=84028"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nTrakeo – \u00d6zofagol (Soluk borusu ile yemek borusu aras\u0131ndaki kanal)fist\u00fclleri.
\n\u00d6zofagus ile mide aras\u0131ndaki kap\u0131n\u0131n yetersiz kapanmas\u0131 (disfonksiyonu)
\nMidenin do\u011fumsal, enfeksiy\u00f6z ve de\u011fi\u015fik sebeplerle disfoksiyonu.
\nKongenite hipertrofik pilor (mide ile barsak aras\u0131ndaki b\u00f6lgenin stenozu (darl\u0131\u011f\u0131)
\nDuodenum (oniki parmak barsa\u011f\u0131) atrezisi (darl\u0131k)
\nBu hastal\u0131klarda ay\u0131r\u0131c\u0131 tan\u0131lar\u0131n\u0131n (\u00f6yk\u00fc, klinik muayene ve tetkikler) dikkatli yap\u0131larak (G\u00d6RH – gastro-\u00f6zofagal refl\u00fc) hastal\u0131\u011f\u0131ndan ay\u0131rt edilmesi \u00e7ok \u00f6nemlidir, \u00e7\u00fcnk\u00fc bu hastal\u0131klar\u0131n t\u00fcm\u00fcnde bebek ve \u00e7ocuklarda ciddi geli\u015fme gerilikleri ile metabolik sendromlar geli\u015fmekte ve tedavileri ciddi ameliyatlarla yap\u0131l\u0131r, refl\u00fc hastal\u0131\u011f\u0131nda t\u0131bbi (ila\u00e7 tedavisi) etkindir, ancak baz\u0131 vakalarda cerrahi tedavi uygulan\u0131r. Kusmalar\u0131n \u00f6n planda oldu\u011fu bu hastal\u0131kta mide i\u00e7eri\u011fi yemek borusuna geri ka\u00e7ar, bebek ve \u00e7ocuklarda \u00f6zellikle yenido\u011fan bebeklerin (1-4 ay aras\u0131) \\%40 – 60\u2019\u0131nda fizyolojik (do\u011fal) refl\u00fc vard\u0131r, oysa patalojik (hastal\u0131k) G\u00d6RH daha nadir (y\u00fczde 10) civar\u0131ndad\u0131r.
\nRefl\u00fc hastal\u0131\u011f\u0131nda belirtti\u011fimiz etkenler d\u0131\u015f\u0131nda genetik yap\u0131da etkili olmaktad\u0131r. Belirtiler genellikle, Reg\u00fcrjitasyon (Mide s\u0131v\u0131s\u0131n\u0131n a\u011fza gelmesi ve gevi\u015f getirme)
\nKusma, A\u011f\u0131z kokusu, Tekrarlayan \u00fcst ve alt solunum yolu hastal\u0131\u011f\u0131 (\u00fcsye, otit, sin\u00fczit, bron\u015fit, astma belirtileri, pn\u00f6moni (zat\u00fcre) \u00d6ks\u00fcr\u00fck, Ses k\u0131s\u0131kl\u0131\u011f\u0131, Apne (Solunum durmas\u0131) ve siyanoz (morarma) ataklar\u0131, Ani bebek \u00f6l\u00fcmleri Konv\u00fclsiyon (havale) , \u0130\u015ftahs\u0131zl\u0131k, Uyku bozukluklar\u0131, Huzursuzluk, B\u00fcy\u00fcme ve geli\u015fme gerili\u011fi, Kar\u0131n a\u011fr\u0131s\u0131Hematemez (mide kanamas\u0131) \u00d6yk\u00fc ve fiziki muayene en \u00f6nemli tan\u0131 y\u00f6ntemidir.<\/p>\n
\nDr. Osman Ayata\u00e7, tedavi y\u00f6ntemlerini ise Pozisyon, Diyet, \u0130la\u00e7 Tedavisi ve Cerrahi Tedavi olarak s\u0131ralanabilece\u011fini kaydetti.<\/p>\n