Ðe nu mimi hã sesẽna na wòa? Mina míaƒo nu tso ‘Esophageal Manometry Test’ ŋu!

Ðe nèsena le ɖokuiwò me be yeƒe lãme le ƒoƒom alo yeƒe dzi le ƒoƒom ne yele nu ɖum alo le nu nom? Ðe nèsena le ɖokuiwò me ɣeaɖewoɣi be nuɖuɖu gatrɔna vaa wò ŋɔti mea? Ne vevesese sia ƒomevi le ŋuwò la, egbea míele nu ƒom tso dodokpɔ tɔxɛ aɖe si ate ŋu akpe ɖe ŋuwò nàke ɖe nusi gbɔ wòtso ŋu. Woyɔa esia be ``Esophageal Manometry Test''.

Nukae nye ‘Esophageal Manometry Test’ sia?

Kpuie ko la, esia nye dodokpɔ be míakpɔe ɖa be lãmeka siwo le míaƒe nuɖuɖutome (nuɖuɖu ƒe pɔmpi) me le dɔ wɔm nyuie hã. Ènyaa, ne míemi nuɖuɖu la, etsoa míaƒe nu me yia míaƒe dɔgbo me to nuɖuɖutome sia me. Ele abe mɔ̃ aɖe ene. Lãmetsi siwo le mɔ̃ sia me ƒoa nuɖuɖua ɖe anyi. Azɔ hã, lãmeka siawo kpena ɖe ame ŋu be nuɖuɖua nagatrɔ ava ƒodoa me o.

Ke hã, ɣeaɖewoɣi la, gbɔdzɔgbɔdzɔ aɖewo ate ŋu anɔ nuɖuɖutome sia ƒe lãmekawo ƒe dɔwɔwɔ me, alo kuxiwo ate ŋu anɔ ``ʋuʋu`` ŋu. Ɣemaɣie nuwo abe nu mimi sesẽ, dzimeve, kple nuɖuɖu si trɔna yia ŋɔti me (reflux) ene dzɔna. Eyata, ``Esophageal Manometry Test`` dzidzea alesi wò nuɖuɖutome ƒe lãmekawo ƒoa ƒu nyuie eye wòsɔna, woɖea dzi ɖi, eye wotutua nuɖuɖu ɖe anyi.

Nukatae wòhiã be míawɔ dodokpɔ sia ƒomevi? Ðe dzesi siawo le ŋuwò hã?

Zi geɖe la, ɖɔkta kafua dodokpɔ sia ne nu mimi ƒe kuxiwo nɔa fu ɖem na wò atraɖii alo nuɖuɖu kple nunono dzi ɖeɖe kpɔtɔ sesẽna na wò. Ðewohĩ wowɔ wò nuɖuɖutome dodokpɔ bubuwo, abe dɔgbomekpɔmɔ̃ ene, xoxo. Ne dodokpɔ mawo mekpɔ nusi gbɔ wò dzesiawo tso nyuie o la, zi geɖe la, afɔɖeɖe si kplɔe ɖoe nyea nuɖuɖutome ƒe ʋuʋu dodokpɔ, si woyɔna be nuɖuɖutome ƒe ʋuʋu dodokpɔ.

Kpɔe ɖa be dzesi siawo dometɔ aɖe le ŋuwò hã:

• Ðe wòsesẽna na wò alo nèsea veve ne èle nuɖuɖu mimia?
• Ðe wòsena le eɖokui me abe nuɖuɖu gatrɔna yia ŋɔti me le nu mimi vɔ megbe enea (regurgitation)?
• Ðe dzidɔ si nu metsina o (acid reflux) si nu meyina ne wozã atike gɔ̃ hã o la le ŋuwòa?
• Ðe dzimeve alo akɔtave si menye dzitodzito o si menye dzidɔ gbɔe wòtso oa?

Ne dzesi siawo dometɔ ɖeka alo esi wu nenema le ŋuwò la, anyo be nàƒo nu kple wò ɖɔkta abia nu tso dodokpɔ sia ŋu.

Nukae woate ŋu akpɔ le dodokpɔ sia me?

``Manometry`` gɔmee nye be woadzidze nyaƒoɖeamenu. Woyɔa dɔwɔnu si wozãna le dodokpɔ sia me be ``manometer``. Edzidzea nyaƒoɖeamenu si dona tso eme ne nuɖuɖutome ƒe lãmekawo vuvu. ``Esophageal Manometry Test`` koŋ léa ŋku ɖe lãmeka ƒe dɔwɔwɔ ƒomevi eve ŋu le nuɖuɖutome.

1. Aleke nèɖɔa lãmeka siwo kplɔa nuɖuɖu yia nuɖuɖumeŋusẽ me (peristalsis) ƒe ʋuʋu?

2. Nenye be ʋuƒo siwo le tsidzɔƒea tame kple ete la le ʋuʋum hele tutu nyuie.

Ne lãmeka siawo ƒe nyaƒoɖeamenu mesɔ o la, ate ŋu aɖe nusi gbɔ wò dzesiawo tso la me eye wòade dzesi atikewɔwɔ me nɔnɔme aɖewo. Le kpɔɖeŋu me:

• `(Achalasia)` : Esia nye nɔnɔme si me nuɖuɖutome ƒe akpa si le ete meʋuna nyuie o, si wɔnɛ be wòsesẽna be nuɖuɖu nato dɔgboa me.
• `(Scleroderma)`: Esia nye dɔléle si gblẽa nu le ŋutilã ƒe kadodoŋusẽwo ŋu, eye ate ŋu ana nuɖuɖutome ƒe lãmekawo hã nagbɔdzɔ.
• Nuɖuɖutome ƒe ʋuʋu: Esia nye lãmeka siwo le nuɖuɖutome ƒe tete kpata vevie si ate ŋu ana ame nase veve.
• `(Rumination syndrome)` : Esia nye nɔnɔme si me nuɖuɖu siwo womi nyitsɔ laa, siwo womeɖu o la gatrɔna yia nu me.

Aleke wowɔa ‘Esophageal Manometry’ dodokpɔ siae? Mina míaɖe eme vie.

Mɔnu deŋgɔtɔ kekeake si wozãna fifia na esiae nye ``High-resolution manometry (HRM)``. Esiae nye nusi dzɔna: Wotsɔa mɔ̃ si le tsɛ ŋutɔ, si le tsɛ ŋutɔ ``catheter`` toa wò nuɖuɖutome. Nyaƒoɖeamenu ƒe dzesi suesuesue geɖe le mɔ̃ sia me, ɖewohĩ wosɔ gbɔ abe 36. Dzesi siawo dome didi tso wo nɔewo gbɔ abe sentimeta ɖeka ene. Eyata, sensor siawo dzidzea alesi lãmeka siwo le wò nuɖuɖutome la ƒoa ƒui ne èmi nuɖuɖu.

Woɖoa nyatakaka siwo sensor siawo ƒo ƒu la ɖe kɔmpiuta. Kɔmpiutaa dzroa nyatakakaawo me eye wòwɔa anyigbatata si ɖea nyaƒoɖeamenu si le wò nuɖuɖutome si woyɔna be esophageal pressure topography, alo EPT. Anyigbatata sia na wò ɖɔkta kpɔa alesi tututu wò nuɖuɖutome lãmekawo le dɔ wɔm.

Aleke wòle be míadzra ɖo hafi adze dodokpɔa gɔmee?

Ele be nàwɔ dzadzraɖo vi aɖe hafi dodokpɔ sia.

• Anyo wu be màgaɖu nu alo ano naneke gaƒoƒo ade hafi adoe kpɔ o. Ele be wò dɔgbo nanɔ ƒuƒlu.
• Ne èle atike aɖewo zãm la, wò ɖɔkta ate ŋu abia tso asiwò be nàdzudzɔ wo nono gaƒoƒo 24 do ŋgɔ na dodokpɔa. Le kpɔɖeŋu me:
• `(Calcium ƒe mɔxenuwo)`
• `(Nitrates)`
• `(Opioids)` (vevesesenutsitikewo) .
• `(Atike siwo naa ame ƒe dzi dzea eme)` (atike siwo nana ame ƒe alɔ̃dɔdɔ) .

Eyata ele vevie ŋutɔ be nàgblɔ atike siwo katã zãm nèle la na wò ɖɔkta do ŋgɔ.

Ðe nèzãa atike si naa alɔ̃dɔdɔ ne èle esia wɔma? Nyemenya ne eveam o, alo?

Zi geɖe la, wometsɔa atike si naa alɔ̃dɔdɔ wò bliboe le dodokpɔ sia me o. Esia fia be èle ŋudzɔ. Gake ne èle vɔvɔ̃m alo tsi dzimaɖi vevie ɖe esia ŋu la, àte ŋu aƒo nu tso eŋu na wò ɖɔkta do ŋgɔ eye ne ehiã la, nàdzro atike si naa alɔ̃dɔdɔ si mesẽ o (si naa ame ƒe dzi dzea eme) me.

Esophageal Manometry Test menye dodokpɔ si me vevesese le o . Gake àte ŋu ase le ɖokuiwò me be yeƒe dzi nadze eme vie alo yeƒe lãme asẽ ne mɔ̃a le wò nuɖuɖutome. Be woaɖe vevesese sia dzi akpɔtɔ la, wowua atike si naa alɔ̃dɔdɔ wò ɖe wò ŋɔti me hafi wotsɔa mɔ̃a dea wò ŋɔti me. Wò ŋɔti ate ŋu ase veve ŋkeke ɖeka alo eve le dodokpɔa megbe, si nye nusi sɔ.

Aleke tututu wowɔa dodokpɔae?

Enyo, eyata mina míagalé ŋku ɖe alesi wowɔa dodokpɔae ŋu vie.

1. Gbã la, ɖɔkta alo dɔnɔdzikpɔla si xɔ hehe ade mɔ̃ tsɛ aɖe si me sensorwo le, si woyɔna be ``catheter``, to wò ŋɔti ɖeka me eye wòaɖiɖi wò nuɖuɖutome blewu vaseɖe esime wòaɖo wò dɔgbo gbɔ. Wogayɔa esia be ``nasogastric tube``.

2. Hafi woade mɔ̃a me la, wotsɔa ami si wotsɔna ƒoa mɔ̃ae la dea eƒe nugbɔ. Wodea atike si naa alɔ̃dɔdɔ wò ŋɔti kple ŋɔti hã. Esia aɖe mɔ̃a ƒe vevesese dzi akpɔtɔ ŋutɔ.

3. Ne mɔ̃a nya ɖo teƒea ko la, woabia tso asiwò be nàmlɔ aba dzi ahagbɔ ya nyuie, eye woawɔ gɔmedzedze ƒe nuxexlẽ.

4. Emegbe, woabia tso asiwò be nàmi tsi vi aɖe. Zi geɖe la, ahiã be nàmi nu abe zi adre alo enyi ene. Le ɣeyiɣi sia me la, woabia tso asiwò be nàmlɔ anyi alo abɔbɔ vie.

5. Emegbe ne ɖɔktaa di la, woate ŋu ado esia kpɔ le mɔ bubuwo nu. Le kpɔɖeŋu me, woate ŋu abia tso asiwò be nàmi nu tẽ, alo woate ŋu aɖe mɔ na wò be nàmi nane si le ɣie vie, abe akɔɖumi ene.

Bu eŋu abe kamedede si dzidzea wò nuɖuɖutome lãmekawo ƒe "ŋusẽ" ene. Ɣesiaɣi si nàmi la, wole alesi lãmeka mawo le dɔ wɔm nyuie la dzidzem.

Ðe afɔku alo nugbegblẽ aɖewo le esia ŋua?

Zi geɖe la, dodokpɔ sia le dedie ŋutɔ. Gake ame aɖewo ate ŋu akɔ akɔta, ase le wo ɖokui me be ƒu aɖe le woƒe ŋɔti me, alo woase le wo ɖokui me be yewole ʋuʋum (nu ƒe ʋuʋu) le dɔa wɔwɔ me. Ke hã, dzesi siawo nu ayi le ɣeyiɣi aɖe megbe. Ƒã ŋutɔ la, ʋu sue aɖe ate ŋu ado le ame aɖewo ƒe ŋɔti me le esi wotsɔa mɔ̃a toa woƒe ŋɔti me ta. Esia menye nya vevi o.

Ɣeyiɣi didi kae dodokpɔ sia xɔa?

Dodokpɔ sia katã xɔa abe miniti 15 ene hafi wowua enu . Eyata, menye nusi xɔa ɣeyiɣi geɖe ŋutɔe wònye o.

Aleke míase dodokpɔa ƒe nyatakakaa me tsonu gɔmee?

Le dodokpɔa megbe la, wò ɖɔkta alé ŋku ɖe nuɖuɖutome ƒe nyaƒoɖeamenu ƒe anyigbatata si wowɔ to kɔmpiuta dzi ŋu eye wòaɖe emetsonuwo me na wò. Esesẽna vie na mí be míase egɔme le mía ɖokui si.

Nusiwo do tso eme koŋue ɖea nusiwo gbɔna fiana:

• Peristaltic vigor: Esia fia alesi lãmeka siwo tua nuɖuɖu yia nuɖuɖutome ƒe tete sesẽ alo gbɔdzɔe .
• Peristaltic integrity: Ne lãmeka siwo le nuɖuɖutome ƒe lãkusi ŋu la le ʋuʋum atraɖii, wometso wo me o, alo ne dometsotsowo le wo dome.
• Ɣeyiɣi agbɔsɔsɔme si lãmekawo ƒe ʋuʋu dzi ɖena kpɔtɔna le nuɖuɖutome ƒe akpa si le ete (LES) gbɔ (distal latency at the contractile deceleration point) : Esiae nye ɣeyiɣi si lãmekawo ƒe teteɖeanyi siawo dzi ɖena kpɔtɔna hafi ʋua ƒe tete mamlɛtɔ, hafi woɖoa nuɖuɖu ɖe dɔgboa me. Esia sesẽ vie, gake ele vevie na ɖɔktaa.
• Ɣeyiɣi agbɔsɔsɔme si nuɖuɖutome ƒe akpa si le ete ʋuna ne èmi (`deglutitive LES relaxation`) : Aleae ʋuka sia ʋuna nyuie be wòana nuɖuɖu nage ɖe dɔgboa me ne èmi.

Nukae nèdi be yeagblɔ ne ègblɔ be emetsonu siwo mesɔ o?

Nusiwo dona tso eme si mesɔ o fia be lãmeka siwo le tsinyegoea me mele dɔ wɔm nyuie o. Kpɔɖeŋu ʋɛ aɖewoe nye esi:

• Hypertensive or hypercontractile peristalsis : Lãmetsi siwo le nuɖuɖutome la ƒoa ke sesĩe akpa alo enuenu akpa. Esia ate ŋu ana akɔta nase veve.
• Weak or absent peristalsis : Ne lãmekawo meƒo nyuie o la, esesẽna be nuɖuɖu naɖiɖi.
• Distal latency dzi ɖeɖe kpɔtɔ kple nu mimi kaba: To nuɖuɖutome ƒe akpa si le ete me evɔ maɖe lãmekawo ƒe tete ƒe tsɔtsɔme dzi akpɔtɔ o.
• Abnormal deglutitive LES relaxation: Valvɔa meʋuna nyuie be wòana nuɖuɖu nato eme o, alo kasia wòsẽna. Woate ŋu akpɔ esia le nɔnɔmewo abe achalasia ene me.

Ðe míate ŋu akpɔ atike si awɔ dɔ tso emetsonu siawo mea?

Ẽ, keŋkeŋ. ``Esophageal Manometry Test'' ƒe emetsonuwo ateŋu akpeɖe wò ɖɔkta ŋu wòanya nusi tututu le dzɔdzɔm le wò nuɖuɖutome ne èle nu mimim kple afisi kuxia le. Esia akpe ɖe wo ŋu woakafu atikewɔmɔnu si sɔ na wò wu.

Ðewohĩ wò ɖɔkta kafu atike aɖe na wò xoxo, abe amekoko si axe mɔ ɖe tsi ƒe sisi nu alo hiatal hernia ɖɔɖɔɖo ene. Ne nenemae la, dodokpɔ sia ate ŋu akpe ɖe ŋuwò nànya alesi gbegbe atikewɔwɔ ma le dedie eye wòwɔa dɔ nyuie na wò.

Vovototo kae le ‘Esophageal Manometry’ kple ‘Barium Swallow’ dodokpɔwo dome?

`(Barium swallow)` nye mɔnu bubu si wozãna tsɔ doa nuɖuɖutome kpɔ. Wogayɔnae be `(esophagram)`. Ke hã, enye ` (nɔnɔmetata dodokpɔ)` tsɔ wu dodokpɔ si dzidzea lãmeka ƒe dɔwɔwɔ abe `(Manometry)` ene.

Le `(Barium swallow)` me la, wonaa tsi tɔxɛ aɖe si woyɔna be `(barium)` wò be nàno. Ne wotsɔ tsi sia de nuɖuɖutome la, nuɖuɖutome la dzena nyuie le `(X-ray)` me. Esi nèle tsi sia mimi la, ɖɔktaa le ekpɔm le video aɖe si nye `(X-ray)` me.

Esia ate ŋu ade dzesi nusiwo gblẽ alo xexe ɖesiaɖe si le nuɖuɖutome. Togbɔ be videoa ɖee fia be nu mimi sesẽ na wò hã la, mate ŋu agblɔ nusi tututu le dzɔdzɔm le nuɖuɖutome ƒe lãmekawo me, nusi le dzɔdzɔm to mɔ̃ dzi na wò o. Esia tae ``Manometry`` dodokpɔa hiã ɖo.

Zi geɖe la, ɖɔktawo wɔa `(Barium swallow)` gbã eye ne ema ɖee fia be kuxi aɖe li la, wowɔa `(Manometry)` dodokpɔ tsɔ kua nu me yi ŋgɔe.

Mlɔeba la, ɖo ŋku esia dzi (Take-Home Message) .

Dɔ vevi eve siwo wò nuɖuɖutome wɔnae nye be wòakpe ɖe ŋuwò nàmi nuɖuɖu kple nunono, eye wòaxe mɔ na nuɖuɖua be wòagatrɔ ava wò dɔgbo me o. Ne kuxi sue aɖe gɔ̃ hã le eve siawo dometɔ ɖesiaɖe ŋu la, àte ŋu akpɔ vevesese vovovowo.

Eyata, `(Esophageal Manometry Test)` le abe ahuhɔ̃e si fiaa ɖɔkta la afisi tututu kuxia le kple alesi wòle le ɖoɖo sia me. Esia akpe ɖe ŋuwò nànya nusi tututu gbɔ wò dɔlélea tso eye nàtia atike si sɔ wu na wò . Eyata ne ɖɔkta aɖe kafui be woawɔ dodokpɔ sia la, mègavɔ̃e o. Se egɔme be enye nusi wowɔna na wò ŋutɔ wò nyonyo. Medi be nàhaya kaba!

` Nuɖuɖutome, nu mimi sesẽ, manometry, nuɖuɖutome dodokpɔ, akɔta ƒe dɔdzẽ, acid reflux, achalasia