{"id":11385587,"date":"2013-05-15T00:00:00","date_gmt":"2013-05-14T22:00:00","guid":{"rendered":"https:\/\/alertdiver.eu\/uncategorized-cs_cz\/je-zaludecni-reflux-pri-potapeni-vazny-problem\/"},"modified":"2013-05-15T00:00:00","modified_gmt":"2013-05-14T22:00:00","slug":"je-zaludecni-reflux-pri-potapeni-vazny-problem","status":"publish","type":"post","link":"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/je-zaludecni-reflux-pri-potapeni-vazny-problem\/","title":{"rendered":"Je \u017ealude\u010dn\u00ed reflux p\u0159i pot\u00e1p\u011bn\u00ed v\u00e1\u017en\u00fd probl\u00e9m?"},"content":{"rendered":"

V minul\u00e9m desetilet\u00ed se n\u00e1sledkem zm\u011bn \u017eivotn\u00edho stylu zv\u00fd\u0161il po\u010det lid\u00ed posti\u017een\u00fdch onemocn\u011bn\u00edm ozna\u010dovan\u00fdm jako gastroezofage\u00e1ln\u00ed reflux (zp\u011btn\u00fd tok \u017ealude\u010dn\u00edch \u0161\u0165\u00e1v ze \u017ealudku do j\u00edcnu), kter\u00e9 lze z klinick\u00e9ho hlediska pova\u017eovat za \u010dast\u00e9 a zn\u00e1m\u00e9 onemocn\u011bn\u00ed.<\/p>\n

Mnohem m\u00e9n\u011b je v\u0161ak zn\u00e1mo, jak p\u016fsob\u00ed kyselina chlorovod\u00edkov\u00e1, produkovan\u00e1 \u017ealudkem, na u\u0161i, nos, hrdlo a d\u00fdchac\u00ed cesty.<\/p>\n

Prvn\u00ed souvislost mezi \u017ealude\u010dn\u00edm refluxem a probl\u00e9my typu ORL byla nazna\u010dena ji\u017e v roce 1903, kdy doktor L. A. Coffin vyslovil hypot\u00e9zu, \u017ee inhalace kysel\u00e9ho materi\u00e1lu p\u0159ich\u00e1zej\u00edc\u00edho ze \u017ealudku souvis\u00ed se suchem v hrdle i se zadn\u00ed r\u00fdmou (posterior rhinorrhoea*) u pacient\u016f s chronick\u00fdmi larynge\u00e1ln\u00edmi a naz\u00e1ln\u00edmi probl\u00e9my.<\/p>\n

O sto let pozd\u011bji se na tuto souvislost zam\u011b\u0159ily dal\u0161\u00ed v\u00fdzkumy a dnes o laryngofringe\u00e1ln\u00edm refluxu (LPR) v\u00edme, \u017ee zp\u016fsobuje poruchy a r\u016fzn\u00e1 onemocn\u011bn\u00ed hrtanu, hltanu, \u00fastn\u00ed dutiny, zub\u016f, pr\u016fdu\u0161ek, u\u0161\u00ed, nosu a nosn\u00edch dutin.<\/p>\n

V roce 2002 zve\u0159ejnil jeden n\u011bmeck\u00fd v\u011bdeck\u00fd pracovn\u00edk v renomovan\u00e9m \u010dasopise p\u0159ekvapuj\u00edc\u00ed zji\u0161t\u011bn\u00ed:  80% d\u011bt\u00ed posti\u017een\u00fdch u\u0161n\u00edmi infekcemi, kter\u00fdm byly na klinice odstran\u011bny nosn\u00ed mandle, m\u011blo ve st\u0159edn\u00edm uchu p\u0159\u00edtomn\u00fd \u017ealude\u010dn\u00ed tr\u00e1vic\u00ed enzym. Tento enzym se mohl dostat do st\u0159edn\u00edho ucha pouze nosohltanem a Eustachovou trubic\u00ed. <\/p>\n

Zjednodu\u0161en\u011b \u0159e\u010deno lze konstatovat, \u017ee 80% d\u011bt\u00ed, kter\u00e9 v n\u00edzk\u00e9m v\u011bku trp\u00ed u\u0161n\u00edmi infekcemi, maj\u00ed \u0161patnou funkci Eustachov\u00fdch trubic, co\u017e zp\u016fsobuje reflux. Existuj\u00ed i dal\u0161\u00ed v\u00fdzkumy, kter\u00e9 tuto tezi podporuj\u00ed – zve\u0159ejn\u011bn\u00e9 v\u00fdsledky ukazuj\u00ed, jak kyselina chlorovod\u00edkov\u00e1 a enzym pepsin souvis\u00ed s refluxem zp\u016fsoben\u00fdmi z\u00e1n\u011bty, otoky a tvorbou v\u0159ed\u016f sliznic d\u00fdchac\u00edch cest.   <\/p>\n

Na z\u00e1klad\u011b t\u00e9to hypot\u00e9zy jsme si polo\u017eili ot\u00e1zku: “Mohl by \u017ealude\u010dn\u00ed reflux tak\u00e9 zp\u016fsobovat probl\u00e9my s vyrovn\u00e1v\u00e1n\u00edm tlaku ve st\u0159edn\u00edm uchu u pot\u00e1p\u011b\u010d\u016f?”<\/p>\n

P\u0159i zdravotn\u00edch prohl\u00eddk\u00e1ch pot\u00e1p\u011b\u010d\u016f s probl\u00e9mem vyrovn\u00e1v\u00e1n\u00ed tlaku ve st\u0159edn\u00edm uchu jsme zjistili, \u017ee mnoho z nich, p\u0159esto\u017ee netrp\u011bli specifick\u00fdmi ORL probl\u00e9my, nebo prod\u011blali chirurgick\u00fd z\u00e1krok k zaji\u0161t\u011bn\u00ed probl\u00e9mu v nosn\u00ed dutin\u011b (bez v\u00fdznamn\u00e9ho zlep\u0161en\u00ed), si st\u011b\u017eovalo na “p\u00e1len\u00ed” \u017ealudku p\u0159i zah\u00e1jen\u00ed ponoru a zhor\u0161ov\u00e1n\u00ed tohoto probl\u00e9mu p\u0159i vyrovn\u00e1v\u00e1n\u00ed tlak\u016f.<\/p>\n

Proto jsme od roku 2009 za\u010dali spojovat probl\u00e9my s vyrovn\u00e1v\u00e1n\u00edm tlaku p\u0159i pot\u00e1p\u011bn\u00ed s inhalaci kyseliny chlorovod\u00edkov\u00e9 a v sou\u010dasn\u00e9 dob\u011b m\u016f\u017eeme na shora uvedenou ot\u00e1zku odpov\u011bd\u011bt jednozna\u010dn\u011b “ano” – co\u017e lze prok\u00e1zat v\u00fdsledky \u0159ady pokus\u016f.<\/p>\n

Polohy, kter\u00e9 pot\u00e1p\u011b\u010d zauj\u00edm\u00e1 (obzvl\u00e1\u0161t\u011b p\u0159i voln\u00e9m pot\u00e1p\u011bn\u00ed, ale plat\u00ed to i u p\u0159\u00edstrojov\u00e9ho pot\u00e1p\u011bn\u00ed), podporuj\u00ed hromad\u011bn\u00ed \u017ealude\u010dn\u00edho obsahu kolem \u017ealude\u010dn\u00edho sv\u011bra\u010de, jako\u017e i k inhalaci kyseliny, co\u017e vede k z\u00e1n\u011bt\u016fm tr\u00e1vic\u00edch cest a k zablokov\u00e1n\u00ed Eustachovy trubice. P\u0159i sestupech do hloubky vede poloha “hlavou vp\u0159ed” k \u017ealude\u010dn\u00edmu refluxu v horn\u00edm d\u00fdchac\u00edm traktu a to zt\u011b\u017euje vyrovn\u00e1v\u00e1n\u00ed tlaku ve st\u0159edn\u00edm uchu.<\/p>\n

Pot\u00ed\u017ee s vyrovn\u00e1v\u00e1n\u00edm tlaku ve st\u0159edn\u00edm uchu jsou v sou\u010dasnosti zdaleka nej\u010dast\u011bj\u0161\u00edm pot\u00e1p\u011b\u010dsk\u00fdm zdravotn\u00edm probl\u00e9mem a tyto pot\u00ed\u017ee tak\u00e9 nejv\u00edce lidem v pot\u00e1p\u011bn\u00ed br\u00e1n\u00ed. Proto je nutn\u00e9 prov\u00e1d\u011bt v tomto sm\u011bru dal\u0161\u00ed v\u00fdkumy, aby se zv\u00fd\u0161ila bezpe\u010dnost i pohoda pot\u00e1p\u011b\u010d\u016f.<\/p>\n

Jeliko\u017e reflux zat\u00edm nen\u00ed za\u0159azen mezi konkr\u00e9tn\u00ed zdravotn\u00ed poruchy p\u0159\u00edmo souvisej\u00edc\u00ed s vyrovn\u00e1v\u00e1n\u00edm tlaku p\u0159i pot\u00e1p\u011bn\u00ed, stanovili jsme si za c\u00edl prok\u00e1zat zv\u00fd\u0161en\u00ed kyselosti v horn\u00edm d\u00fdchac\u00edm traktu pot\u00e1p\u011b\u010d\u016f pomoc\u00ed syst\u00e9mu, kter\u00fdm se m\u011b\u0159\u00ed pH v nosohltanu b\u011bhem ponoru; nam\u011b\u0159en\u00e9 hodnoty se n\u00e1sledn\u011b budou porovn\u00e1vat s v\u00fdsledky z\u00edskan\u00fdmi p\u0159ed ponorem p\u0159i vzp\u0159\u00edmen\u00e9m (norm\u00e1ln\u00edm) postoji t\u011bla.<\/p>\n

Douf\u00e1me (ve skute\u010dnosti jsme p\u0159esv\u011bd\u010deni), \u017ee z\u00edskan\u00e9 \u00fadaje na\u0161i teorii potvrd\u00ed.<\/p>\n

POZN\u00c1MKA<\/strong><\/p>\n

*Rhinorrhoea (r\u00fdma) znamen\u00e1 nadm\u011brn\u00e9 mno\u017estv\u00ed tekutiny p\u0159ich\u00e1zej\u00edc\u00ed z nosu a z nosn\u00edch dutin. V p\u0159\u00edpad\u011b p\u0159edn\u00ed r\u00fdmy se tekutina shroma\u017e\u010fuje v ch\u0159\u00edp\u00ed, v p\u0159\u00edpad\u011b zadn\u00ed r\u00fdmy v\u0161ak proch\u00e1z\u00ed tekutina nosn\u00ed dutinou a je spolknuta nebo se odstra\u0148uje \u00fasty.<\/p>\n

LITERATURA<\/strong><\/p>\n

    \n
  1. \n

    D’Imporzano L. Bolognini A. <\/span>PATHOLOGY OF GASTRO-OESOPHAGEAL REFLUX HOW PROBLEM OF COMPENSATORY.<\/em><\/span> Jury award all’International Project Competition on Underwater Research, Cyprus International University. <\/span>18-20 March 2009.<\/p>\n<\/li>\n

  2. \n

    Bolognini A. D’Imporzano L. Rinopatia, disfunzione tubarica e reflusso gastroesofageo nelle attivit\u00e0 subacquee.<\/em> 2° Raduno di otorinolaringoiatria subacquea, Isola d’Elba 2-3 ottobre 2009.<\/p>\n<\/li>\n

  3. \n

    Bolognini A. Reflusso gastroesofageo: effetti in immersione. IV Raduno di Otorinolaringoiatria subacquea.<\/em> Hotel Terme Z\u00ec Carmela, Forio d’Ischia (NA), 28-30 ottobre 2011.<\/p>\n<\/li>\n

  4. \n

    Tasker A, Dettmar PW, Panetti M, Koufman JA, Birchall JP, Pearson JP. <\/span>Is gastric reflux a cause of otitis media with effusion in children? <\/em><\/span>Laryngoscope 2002;112:1930-4.<\/p>\n<\/li>\n

  5. \n

    G. Caruso, FM. Passali ACTA OTORHINOLARYNGOL ITAL<\/em><\/span> 26, 252-255, 2006<\/span><\/p>\n<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    V minul\u00e9m desetilet\u00ed se n\u00e1sledkem zm\u011bn \u017eivotn\u00edho stylu zv\u00fd\u0161il po\u010det lid\u00ed posti\u017een\u00fdch onemocn\u011bn\u00edm ozna\u010dovan\u00fdm jako gastroezofage\u00e1ln\u00ed reflux (zp\u011btn\u00fd tok \u017ealude\u010dn\u00edch \u0161\u0165\u00e1v ze \u017ealudku do j\u00edcnu),…<\/p>\n","protected":false},"author":1,"featured_media":11374673,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[384],"tags":[],"authors":[],"class_list":["post-11385587","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clanky"],"acf":[],"yoast_head":"\nJe \u017ealude\u010dn\u00ed reflux p\u0159i pot\u00e1p\u011bn\u00ed v\u00e1\u017en\u00fd probl\u00e9m? - Alert Diver<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/je-zaludecni-reflux-pri-potapeni-vazny-problem\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Je \u017ealude\u010dn\u00ed reflux p\u0159i pot\u00e1p\u011bn\u00ed v\u00e1\u017en\u00fd probl\u00e9m? 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