So ɛyɛ den ma wo nso sɛ wobɛmene? Momma yɛnka ‘Esophageal Manometry Test’ no ho asɛm!

So wote nka sɛ worebɔ wo yaw anaasɛ wo koma ayɛ wo yaw bere a wudidi anaa wonom no? So ɛtɔ mmere bi a wote nka sɛ aduan san ba wo menewam? Sɛ wowɔ saa ɔhaw yi a, ɛnnɛ yɛbɛka sɔhwɛ titiriw bi a ebetumi aboa ma woahu nea ɛde ba no ho asɛm. Wɔfrɛ eyi ``Esophageal Manometry Test''.

Dɛn ne ‘Esophageal Manometry Test’ yi?

Sɛ yɛbɛka no tiawa a, eyi yɛ sɔhwɛ a wɔde hwɛ sɛ ebia ntini a ɛwɔ yɛn aduan mu (aduan paipu) mu no reyɛ adwuma yiye anaa. Wunim, sɛ yɛmene aduan a, efi yɛn anom kɔ yɛn yafunu mu fa saa aduan a ɛkɔ yɛn yafunu mu yi mu. Ɛte sɛ tube. Ntini a ɛwɔ saa afiri yi mu no pia aduan no kɔ fam. Afei nso, saa ntini ahorow yi boa ma aduan no nsan nkɔ yafunu no mu bio.

Nanso, ɛtɔ da bi a, mmerɛwyɛ bi betumi aba wɔ saa aduannoa ntini yi dwumadi mu, anaasɛ ɔhaw ahorow a ɛfa ``motility`` ho. Ɛno na nneɛma te sɛ ɛyɛ den sɛ wobɛmene, komayare, ne aduan a ɛsan ba menewa mu (reflux) ba. Enti, ``Esophageal Manometry Test`` no susuw sɛnea wo esophaguus ntini no twetwe, gye n'ahome, na ɛpia aduan kɔ fam yiye na ɛfata.

Dɛn nti na ehia sɛ yɛyɛ sɔhwɛ a ɛte sɛɛ? So wo nso wowɔ saa sɛnkyerɛnne ahorow yi?

Oduruyɛfo taa kamfo nhwehwɛmu yi kyerɛ sɛ wowɔ ɔhaw ahorow a ɛkɔ so wɔ mene mu anaasɛ ɛyɛ den ma wo sɛ wobɛma aduan ne anonne akɔ fam a. Ebia woayɛ wo esophaguus ho nhwehwɛmu afoforo dedaw, te sɛ endoscopy. Sɛ saa nhwehwɛmu ahorow no nhu nea ɛde wo sɛnkyerɛnne ahorow no bae pefee a, mpɛn pii no, ade a edi hɔ a wobɛyɛ ne sɛnea wodi wo yare no mu nhwehwɛmu, a wɔfrɛ no esophageal manometry test.

Hwɛ sɛ wowɔ saa sɛnkyerɛnne ahorow yi bi anaa:

• So wote ɔhaw anaa ɛyaw nka bere a woremene aduan no?
• So ɛte sɛ nea aduan san ba menewa mu bere a wɔamene (regurgitation) awie no?
• So wowɔ komayare a ɛkɔ so tra hɔ (acid reflux) a sɛ wonom nnuru mpo a, ɛnkɔ?
• So wowɔ komayare anaasɛ wo koko mu yaw a ɛnyɛ koma mu yaw a ɛnyɛ komayare nti?

Sɛ wowɔ saa sɛnkyerɛnne yi mu biako anaa nea ɛboro saa a, ɛbɛyɛ papa sɛ wo ne wo duruyɛfo bɛkasa na woabisa nhwehwɛmu yi ho asɛm.

Dɛn na wobetumi ahu wɔ sɔhwɛ yi mu?

``Manometry`` kyerɛ sɛ wɔsusu nhyɛsoɔ. Adwinnade a wɔde di dwuma wɔ sɔhwɛ yi mu no, wɔfrɛ no ``manometer``. Ɛsusuw nhyɛso a ɛba bere a aduan mu ntini ahorow no twetwe no. ``Esophageal Manometry Test`` titiriw no hwɛ ntini ahorow abien a ɛyɛ adwuma wɔ esophagus mu.

1. Wokyerɛkyerɛ ntini a ɛma aduan kɔ fam wɔ aduan mu (peristalsis) no mu dɛn?

2. Sɛ ebia valve ahorow a ɛwɔ nsu a ɛkɔ nsu no mu no atifi ne ase no rebue na ɛreto mu yiye anaa.

Sɛ nneɛma bi a ɛnteɛ wɔ nhyɛso a ɛwɔ saa ntini ahorow yi mu no mu a, ebetumi akyerɛkyerɛ nea ɛde wo sɛnkyerɛnne ahorow no ba no mu na ama woahu ayaresa tebea horow bi. Nhwɛsoɔ:

• `(Achalasia)` : Eyi y tebea a esophageal sphincter a ɛwɔ fam no mmue yiye, na ɛma ɛyɛ den sɛ aduan bɛfa yafunu no mu.
• `(Scleroderma)`: Eyi yɛ yare a ɛka nipadua no ntini a ɛka bom no, na ɛno nso tumi ma ɛwo ntini mu ntini yɛ mmerɛw.
• Esophageal spasms: Eyi yɛ ntini a ɛwɔ esophaguus no mu a ɛtwetwe mpofirim denneennen a ebetumi ama obi ate yaw.
• `(Rumination syndrome)` : Eyi yɛ tebea a ɛma nnuan a wɔamene nnansa yi a wɔannye no san ba anom.

Ɔkwan bɛn so na wɔyɛ saa ‘Esophageal Manometry’ sɔhwɛ yi? Momma yɛnkyerɛkyerɛ mu kakra.

Ɔkwan a ɛkɔ anim sen biara a wɔfa so yɛ eyi mprempren no, wɔfrɛ no ``High-resolution manometry (HRM)``. Eyi ne nea ɛba: Wɔde ``catheter`` a ɛyɛ tratraa na ɛyɛ teateaa yiye fa wo menewam. Saa afiri yi wɔ nhyɛso a ɛma wohu nneɛma nketenkete pii, ebia ɛbɛyɛ 36. Saa nneɛma a ɛma wohu nneɛma yi ntam kwan bɛyɛ sɛntimita biako. Enti, saa nneɛma a ɛma wohu nneɛma yi susuw sɛnea ntini a ɛwɔ wo menewam no twetwe bere a womene aduan no.

Wɔde nsɛm a saa sensor ahorow yi boaboa ano no kɔ kɔmputa so. Kɔmputa no hwehwɛ nsɛm no mu na ɛyɛ nhyɛso a ɛwɔ wo menewam no ho mfonini a wɔfrɛ no esophageal pressure topography, anaa EPT. Saa asase mfonini yi ma wo duruyɛfo hu sɛnea wo menewa mu ntini ahorow no reyɛ adwuma pɛpɛɛpɛ.

Ɔkwan bɛn so na ɛsɛ sɛ yesiesie yɛn ho ansa na sɔhwɛ no aba?

Ɛsɛ sɛ woyɛ ahosiesie kakra ansa na sɔhwɛ yi aba.

• Ɛyɛ papa sɛ worendidi anaa worennom biribiara nnɔnhwerew asia ansa na wɔayɛ sɔhwɛ no. Ɛsɛ sɛ wo yafunu da mpan.
• Sɛ worenom nnuru bi a, ebia wo duruyɛfo bɛka akyerɛ wo sɛ gyae nom nnɔnhwerew 24 ansa na wɔayɛ nhwehwɛmu no. Nhwɛsoɔ:
• `(Calcium akwan a wɔde siw kwan)`
• `(Nitrates)`
• `(Opioids)` (nnuru a wɔde kum ɛyaw) .
• `(Sedatives)` (nnuru a ɛma obi da) .

Enti, ɛho hia paa sɛ wudi kan ka nnuru a wonom nyinaa ho asɛm kyerɛ wo duruyɛfo.

So wode nnuru a wɔde kum nipadua no di dwuma bere a woreyɛ eyi no? Minnim sɛ ɛyɛ yaw anaa, ɛnte saa?

Mpɛn pii no, wɔmfa aduru a ɛma obi dwensɔ koraa wɔ sɔhwɛ yi mu. Eyi kyerɛ sɛ wowɔ n’adwene. Nanso, sɛ wosuro anaasɛ wo ho yeraw wo kɛse wɔ eyi ho a, wubetumi adi kan ne wo duruyɛfo akasa afa ho, na sɛ ɛho hia a, woasusuw aduru a wɔde kum nipadua no a emu nyɛ duru (aduru a ɛma obi dwo) ho.

Esophageal Manometry Test nyɛ sɔhwɛ a ɛyɛ yaw . Nanso, ebia wobɛte nka sɛ wo ho yeraw wo kakra anaasɛ wo ho ayɛ wo den bere a afiri no wɔ wo menewam no. Nea ɛbɛyɛ na saa ɔhaw yi so atew no, wɔde aduru a wɔde kum nipadua no petepete wo menewam ansa na wɔde afiri no ahyɛ wo menewam. Ebia wo menewa bɛte yaw da koro anaa nnanu wɔ sɔhwɛ no akyi, na ɛno yɛ ade a ɛfata.

Ɔkwan bɛn so ankasa na wɔyɛ sɔhwɛ no?

Okay, enti momma yɛnhwɛ sɛnea wɔyɛ sɔhwɛ no kakra.

1. Nea edi kan no, oduruyɛfo anaa ɔyarehwɛfo a wɔatete no de afiri a ɛyɛ tratraa bi a ɛwɔ sensor ahorow, a wɔfrɛ no ``catheter``, bɛhyɛ wo hwene mu ntokuru biako mu na ɔde nkakrankakra akɔ fam wɔ wo hwene mu kosi sɛ ebedu wo yafunu mu. Wɔsan frɛ eyi sɛ ``nasogastric tube``.

2. Ansa na wɔde afiri no bɛhyɛ mu no, wɔde srade bi gu ano. Wɔde aduru a wɔde kum wo hwene ne wo menewa nso gu wo hwene mu. Eyi bɛtew sɛnea afiri no mu ayɛ no yaw no so kɛse.

3. Sɛ tube no si baabi a, wɔbɛka akyerɛ wo sɛ da mpa so na home sɛnea ɛsɛ, na wɔbɛyɛ mfitiase akenkan.

4. Afei, wɔbɛka akyerɛ wo sɛ mene nsuo kakra. Mpɛn pii no, ɛsɛ sɛ womene bɛyɛ mpɛn ason anaa awotwe. Saa bere yi mu no, wɔbɛka akyerɛ wo sɛ da fam anaasɛ fa wo ho to fam kakra.

5. Afei, sɛ oduruyɛfo no pɛ a, wobetumi afa akwan foforo so asɔ eyi ahwɛ. Sɛ nhwɛso no, ebia wɔbɛka akyerɛ wo sɛ mene tẽẽ, anaasɛ wɔbɛma woamene biribi a ɛyɛ den kakra te sɛ apɔw-mu-teɛteɛ.

Fa no sɛ apɔw-mu-teɛteɛ a ɛsusuw "ahoɔden" a ɛwɔ wo esophageal ntini ahorow mu. Bere biara a wobɛmene no, wɔresusuw sɛnea saa ntini ahorow no reyɛ adwuma yiye no.

So asiane anaa nsunsuanso bɔne bi wɔ eyi mu?

Mpɛn pii no, sɔhwɛ yi yɛ nea ahobammɔ wom kɛse. Nanso, ebia nnipa binom bɛfefe, ate nka sɛ akisikuru bi wɔ wɔn menewam, anaasɛ wɔbɛte nka sɛ wɔn ho ayɛ wɔn yaw (wɔayɛ wɔn anom) bere a wɔreyɛ oprehyɛn no. Nanso, saa sɛnkyerɛnne ahorow yi befi hɔ bere tiaa bi akyi. Ɛntaa mma sɛ nnipa binom betumi anya mogya ketewaa bi a ɛbɛtɔ wɔn hwene mu efisɛ wɔde afiri no fa wɔn hwene mu. Eyi nyɛ aniberesɛm.

Bere tenten ahe na sɔhwɛ yi gye?

Sɔhwɛ yi nyinaa gye bɛyɛ simma 15 ansa na wɔawie . Enti, ɛnyɛ adeyɛ a egye bere pii.

Ɔkwan bɛn so na yɛbɛte nea efi sɔhwɛ amanneɛbɔ no mu ba no ase?

Sɛ wowie sɔhwɛ no a, wo duruyɛfo no bɛhwɛ kɔmputa so esophageal pressure topography map no na wakyerɛkyerɛ nea ebefi mu aba no mu. Ɛyɛ den kakra ma yɛn sɛ yɛn ankasa bɛte ase.

Nea afi mu aba no kyerɛ nea edidi so yi titiriw:

• Peristaltic vigor: Eyi kyerɛ sɛnea ntini a ɛpia aduan kɔ aduan no mu no mu ntini a ɛtwetwe no mu yɛ den anaasɛ ɛyɛ mmerɛw .
• Peristaltic integrity: Sɛ́ ebia ntini a ɛwɔ esophageal sphincter no ho no twetwe kɔ so, entwa mu, anaasɛ sɛ ebia nsonsonoe wɔ ntam.
• Bere dodow a ntini a ɛtwetwe no brɛ ase wɔ baabi a ɛbɛn esophageal sphincter (LES) a ɛwɔ fam no (distal latency at the contractile deceleration point) : Eyi ne bere dodow a saa ntini ahorow yi brɛ ase ansa na atwetwe a etwa to no aba, ansa na wɔde aduan akɔ yafunu no mu. Eyi yɛ nea ɛyɛ den kakra, nanso ɛho hia ma oduruyɛfo no.
• Bere dodow a esophageal sphincter a ɛwɔ fam no bue bere a woamene (`deglutitive LES relaxation`) : Eyi ne sɛnea saa valve yi bue yiye ma aduan kɔ yafunu no mu bere a womene no.

Dɛn na wopɛ sɛ woka sɛ nea efi mu ba a ɛnyɛ ne kwan so?

Nea efi mu ba a ɛnteɛ kyerɛ sɛ ntini a ɛwɔ urethra no mu no ntumi nyɛ adwuma yiye. Nhwɛso kakraa bi ni:

• Hypertensive anaa hypercontractile peristalsis : Ntini a ɛwɔ aduan mu no twetwe denneennen dodo anaasɛ ɛtaa twetwe dodo. Eyi betumi ama obi koko ayɛ no yaw.
• Weak or absent peristalsis : Sɛ ntini no ntumi ntwitwiw yiye a, ɛyɛ den sɛ aduan bɛkɔ fam.
• Distal latency a ɛso tew ne mene a ɛba ntɛm: Ɛfa esophageal sphincter a ɛwɔ fam no mu a ɛmma ntini no twetwe ntɛmntɛm.
• Abnormal deglutitive LES relaxation: Valve no mmue yiye na ama aduan atwam, anaasɛ ɛyɛ den mpofirim. Wobetumi ahu eyi wɔ tebea horow te sɛ achalasia mu.

So yebetumi anya ayaresa a ɛyɛ adwuma afi nea efi mu ba yi mu?

Yiw, koraa. Nea efi ``Esophageal Manometry Test'' mu ba no betumi aboa wo duruyɛfo ma wahu nea ɛrekɔ so wɔ wo esophaguus mu bere a woremene ne baabi a ɔhaw no wɔ no ankasa . Eyi bɛboa wɔn ma wɔakamfo ayaresa a ɛfata wo sen biara akyerɛ wo.

Ebia wo duruyɛfo akamfo ayaresa bi akyerɛ dedaw, te sɛ oprehyɛn a ɛko tia nsu a ɛsan kɔ nipadua no mu anaasɛ hiatal hernia repair. Sɛ saa a, sɔhwɛ yi betumi aboa wo ma woahu sɛnea saa ayaresa no yɛ nea ahobammɔ wom na etu mpɔn ma wo.

Nsonsonoe bɛn na ɛwɔ ‘Esophageal Manometry’ ne ‘Barium Swallow’ nhwehwɛmu ahorow ntam?

`(Barium swallow)` yɛ ɔkwan foforo a wɔfa so hwehwɛ aduannoa mu. Wɔsan frɛ no `(esophagram)`. Nanso, ɛyɛ `(mfonini sɔhwɛ)` sen sɛ ɛbɛyɛ sɔhwɛ a ɛsusuw ntini dwumadi te sɛ `(Manometry)`.

Wɔ `(Barium swallow)` mu no, wɔma wo nsuo soronko bi a wɔfrɛ no `(barium)` sɛ fa nom. Sɛ wɔde saa nsuo yi gu aduane no mu a, wotumi hu aduane no pefee wɔ `(X-ray)` so. Bere a womene saa nsu yi no, oduruyɛfo no hwɛ wɔ `(X-ray)` video so.

Eyi betumi ahu biribiara a ɛnteɛ anaasɛ asiw wɔ aduan no mu. Ɛwom mpo sɛ video no kyerɛ sɛ ɛyɛ den ma wo sɛ wobɛmene de, nanso entumi nkyerɛ wo nea ɛrekɔ so ankasa wɔ esophagus ntini ahorow no mu, nea ɛrekɔ so wɔ mfiri kwan so. Ɛno nti na manometry sɔhwɛ no ho hia no.

Mpɛn pii no, nnuruyɛfo di kan yɛ `(Barium swallow)` na sɛ ɛno kyerɛ sɛ ɔhaw bi wɔ hɔ a, wɔyɛ `(Manometry)` sɔhwɛ de hwehwɛ mu kɔ akyiri.

Awiei koraa no, kae eyi (Take-Home Message) .

Dwumadi atitiriw abien a wo menewam yɛ ne sɛ ɛbɛboa wo ma woamene aduan ne anonne, na amma aduan no ansan ankɔ wo yafunu mu bio. Sɛ ɔhaw ketewaa bi mpo wɔ abien yi mu biara ho a, wubetumi anya ɔhaw ahorow.

Enti, `(Esophageal Manometry Test)` no te sɛ ahwehwɛ a ɛkyerɛ oduruyɛfo no baabi pɔtee ne sɛnea ɔhaw no wɔ wɔ saa adeyɛ yi mu. Eyi bɛboa wo ma woahu nea ɛde wo tebea no ba ankasa na woapaw ayaresa a ɛfata sen biara ama no . Enti, sɛ oduruyɛfo bi kamfo nhwehwɛmu yi kyerɛ a, nsuro. Te ase sɛ ɛyɛ biribi a wɔyɛ ma w’ankasa yiyedi. Mepɛ sɛ wo ho tɔ wo ntɛm!

` Esophagus, ɛyɛ den sɛ wɔbɛmene, manometry, esophageal nhwehwɛmu, koko mu ɔfe, acid reflux, achalasia