Ua manaʻo paha ʻoe ua paʻa kāu meaʻai i loko o kou umauma ma kahi o ka iho ʻana i lalo o kou ʻōpū? A i ʻole ke manaʻo nei paha ʻoe e hoʻi mau ana ia i luna o kou puʻu ma hope o ka inu ʻana i kahi wai liʻiliʻi? He mea maʻamau kēia e hana i kekahi manawa. Akā inā hoʻomau ia, ʻaʻole ia he mea hiki iā mākou ke hoʻowahāwahā. I kēia lā, e kamaʻilio mākou e pili ana i kahi kūlana e hoʻoulu ai i kēlā ʻano ʻoluʻolu ʻole, akā ʻaʻole i ʻike nui ʻia. ʻO ia ʻo Achalasia.
I ka ʻōlelo maʻalahi, he aha ka Achalasia?
He maʻi laha ʻole ʻo Achalasia e hoʻopilikia ana i ko kākou esophagus. No ka hoʻomaopopo maʻalahi ʻana i kēia, e nānā mua kākou i ke ʻano o ka hana maʻamau o ko kākou esophagus.
E noʻonoʻo i ko kākou esophagus he paipu i hana ʻia me nā ʻiʻo e holo ana mai ko kākou waha a i ko kākou ʻōpū (ʻōpū). Ke moni kākou i ka meaʻai, ʻuʻuku nā ʻiʻo o kēia paipu mai luna a lalo i kahi neʻe e like me ka nalu (ua kapa ʻia kēia he peristalsis ma nā ʻōlelo lapaʻau), e paʻi ana i ka pōpō meaʻai i lalo.
Ma ka lalo loa o kēia esophagus, kahi e pili ai i ka ʻōpū, aia ke apo o nā ʻiʻo e hana ana e like me ka valve. Kāhea mākou i kēia ʻo Lower Esophageal Sphincter (LES) . Ua like ia me ka puka. Wehe kēia puka (LES) i ka manawa kūpono e iho mai ai ka pōpō meaʻai, a ma hope o ke komo ʻana o ka meaʻai i loko o ka ʻōpū, pani hou ia me ka paʻa. Ma muli o kēia pani ʻana, ʻaʻole e hoʻi hou mai nā waikawa o ka ʻōpū i loko o ka esophagus.
I kēia manawa, ʻike kahi kanaka me Achalasia i ʻelua mau pilikia i kēia kaʻina hana.
1. ʻAʻole hana pono nā ʻiʻo o ka esophagus: ʻAʻole hana pono ke kaʻina hana e like me ka nalu e hoʻokuke ana i ka meaʻai i lalo (peristalsis) aʻu i ʻōlelo ai. ʻAʻole paha ia e hana iki, a i ʻole ia e hana nāwaliwali loa.
2. ʻAʻole e wehe ka sphincter esophageal haʻahaʻa (LES): ʻOiai ke iho mai nei ka meaʻai, ʻaʻole e wehe ka ʻāpana e like me ka valve i manaʻo ʻia e komo i loko o ka ʻōpū (LES) e like me ka mea e pono ai. Noho paʻa ia.
No laila e noʻonoʻo, ʻaʻole i hoʻokiʻekiʻe ʻia ka meaʻai i luna, a ʻaʻole wehe ʻia ka puka ma lalo. He aha ka mea e hana ʻia? ʻO nā meaʻai a me nā mea inu a pau a mākou e moni ai e paʻa i loko o ka esophagus. ʻAʻole ia e komo i loko o ka ʻōpū. ʻO ia ka mea e hana ʻia ma Achalasia.
Hoʻopilikia wale kēia maʻi i hoʻokahi i loko o 100,000 mau kānaka ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa. ʻO ia hoʻi, he mea kākaʻikahi loa ia. Hoʻopilikia pinepine ia i nā pākeke ma waena o 25 a me 60 mau makahiki, akā hiki i kekahi manawa ke hoʻopilikia i nā poʻe ʻōpio ma mua o kēlā.
He aha nā hōʻailona o kekahi kanaka me Achalasia?
ʻAʻole ʻike ʻia nā hōʻailona o ka achalasia i ka manawa hoʻokahi. Hele mālie lākou. Loaʻa paha iā ʻoe ke ʻano no nā mahina a i ʻole nā makahiki, akā ʻaʻole paha ʻoe e ʻike i ka ʻokoʻa nui. E ʻoi aku ka ʻino o nā hōʻailona i ka hala ʻana o ka manawa.
E nānā kākou i kēia mau hōʻailona ma ka papa ma lalo nei.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| Ka paʻakikī i ka moni ʻana (Dysphagia) | ʻO kēia ka hōʻailona nui a maʻamau. Manaʻo ia he mea paʻa i ka puʻu a i ʻole ka umauma i ka wā e ʻai ai. I ka wā mua, hoʻopilikia wale ia i nā meaʻai paʻa, akā ma hope, hiki ke loaʻa kēia ʻehaʻeha i ka wā e inu ai i nā wai. |
| Regurgitation (e hoʻi mai ana ka meaʻai i loko o ka puʻu) | ʻO ka meaʻai i ale ʻia a ʻeli ʻole ʻia e hoʻi hou mai ana i loko o ka waha. ʻAʻole like kēia me ka luaʻi ʻana. ʻAʻole ia he ʻono ʻawaʻawa no ka mea ʻaʻole i hui pū ʻia me nā waikawa o ka ʻōpū. Hiki ke hana ʻia kēia i ka wā e hiamoe ana. |
| ʻEha umauma | Hiki ke loaʻa ka ʻeha umauma e hele mai a hele aku. Hiki i kekahi poʻe ke kuhihewa i kēia no ka hōʻeha puʻuwai. |
| Ka emi ʻana o ke kaumaha | No ka mea, ʻaʻole komo pono ka meaʻai i loko o ka ʻōpū a no ka paʻakikī o ka ʻai ʻana, hoʻomaka ke kino e emi ke kaumaha me ke kumu ʻole. |
| Nā hiʻohiʻona ʻē aʻe | Hiki ke pilikia i ka ale ʻana, ka ʻeha puʻuwai, a me nā hiccups pinepine. |
No ke aha lā kēia e hana nei? He aha ke kumu?
ʻO kaʻoiaʻiʻo, ʻaʻole maopopo loa i nā kauka ke kumu o Achalasia. Akā ʻo kekahi o nā manaʻo nui, he maʻi autoimmune ia.
I ka ʻōlelo maʻalahi, ʻo ia hoʻi, ua hoʻouka hewa ka ʻōnaehana pale o ko mākou kino (ʻōnaehana pale) i kā mākou mau hunaola maikaʻi ponoʻī. Eia ka mea i manaʻo ʻia e hana ʻia ma Achalasia:
- Hoʻoulu ʻia kā mākou ʻōnaehana pale e kahi mea e like me ka maʻi viral.
- A laila hoʻomaka hewa kēia ʻōnaehana pale i ka hoʻouka ʻana i nā hunaola nerve e kaohi ana i ka hana o nā ʻiʻo i loko o ko kākou esophagus.
- Ma muli o kēia hoʻouka kaua, ua luku mālie ʻia kēlā mau hunaola aʻalolo.
- Ke nalowale kēlā mau hunaola aʻalolo, ʻaʻole e loaʻa i nā ʻiʻo o ka esophagus nā hōʻailona e ʻaelike pono ai. A ʻaʻole e loaʻa i ka sphincter esophageal haʻahaʻa (LES) nā hōʻailona e hoʻomaha ai. ʻO ia ke kumu o kēia pilikia.
ʻO ka mea nui loa, ʻaʻole kēia he maʻi hoʻoilina a maʻi lele paha. No laila, ʻaʻohe pono e hopohopo no ia mea.
He aha nā pilikia e hiki ke hana ma muli o kēia ʻano?
Inā ʻaʻole mālama pono ʻia ka achalasia, hiki iā ia ke alakaʻi i kekahi mau pilikia koʻikoʻi. Hiki i ka meaʻai a me ka mea inu e hōʻiliʻili ana i loko o ka esophagus ke piʻi hou i luna i loko o ka puʻu a hele hewa i luna o ka windpipe i loko o nā māmā. Inā hana ʻia kēlā, hiki ke loaʻa nā pilikia e like me kēia.
- ʻO ka niumonia aspiration: He niumonia koʻikoʻi i hoʻokumu ʻia e ka meaʻai a mea inu paha e komo ana i loko o nā māmā.
- Nā maʻi māmā a me ka bronchiectasis: ʻO ka hoʻomoʻa pinepine ʻana i ka meaʻai i loko o nā māmā hiki ke hōʻeha mau loa i nā māmā.
- ʻO ka hoʻonui ʻia o ka pilikia o ka maʻi ʻaʻai esophageal: Ke loaʻa ka achalasia no ka manawa lōʻihi, kū mai nā loli i loko o nā pūnaewele o ka esophagus, a ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai esophageal ma mua o ke kanaka maʻamau.
- ʻAi ʻole i ka meaʻai: Ma muli o ka omo pono ʻole ʻia o ka meaʻai e ke kino, hiki i ke kino ke wīwī a ʻaʻole e loaʻa i ka meaʻai e pono ai.
ʻO ia ke kumu a mākou e ʻōlelo nei inā pilikia ʻoe i ka moni ʻana, pono ʻoe e hoʻowahāwahā iā ia a e ʻike koke i kāu kauka .
Pehea e ʻike ai ke kauka i kēia maʻi?
Ke hele ʻoe i ke kauka, e nīnau ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona a hana i kahi hoʻokolokolo kino. A laila e paipai ʻo ia i kekahi mau hoʻokolohua e hōʻoia inā he Achalasia kou. ʻO nā hoʻokolohua ʻekolu maʻamau:
1. Hoʻāʻo ʻana i ka Esophagram (Barium Swallow): Ma kēia hoʻāʻo, hāʻawi ʻia ʻoe i kahi wai kūikawā i kapa ʻia ʻo barium e inu. ʻIke ʻia kēia wai keʻokeʻo ma nā kukuna X. I kou moni ʻana, lawe ʻia kekahi mau kiʻi X-ray. ʻAe kēia iā ʻoe e ʻike maopopo i ke ʻano o ka neʻe ʻana o ka wai ma o ka esophagus, inā ua ālai ʻia ma kekahi wahi, inā he ākea ka esophagus, a inā paha ua haiki ka ʻaoʻao haʻahaʻa (ua kapa ʻia hoʻi kēia ʻo ka hōʻailona 'nuku manu').
2. Manometry Esophageal: ʻO kēia ka hoʻāʻo maikaʻi loa a pololei loa e ʻike ai i ka Achalasia. Ma kēia, ua hoʻokomo ʻia kahi paipu lahilahi a palupalu ma kou ihu i loko o kou esophagus. ʻOiai ke noi ʻia nei ʻoe e ale i kahi wai liʻiliʻi, hiki i nā mea ʻike ma ka paipu ke ana pololei i ke kaomi o nā ʻūlū ʻiʻo i loko o kou esophagus, inā paha e neʻe ana ka neʻe ʻana e like me ka nalu (peristalsis), a inā paha e hoʻomaha pono ana ka sphincter esophageal haʻahaʻa (LES).
3. Endoscopy Kiʻekiʻe: Ma kēia hoʻāʻo , ua hoʻokomo ʻia kahi ʻōmole palupalu (endoscope) me kahi kāmela i hoʻopili ʻia ma o ka waha i loko o ka esophagus a nānā pololei ʻia ka ʻaoʻao o loko ma kahi pale. Hiki i kēia ke hōʻoia inā ua ālai ʻia ka esophagus, inā ua paʻa ka meaʻai, a inā paha he mau maʻi ʻē aʻe e like me ke kanesa.
He aha nā lāʻau lapaʻau no Achalasia?
ʻO ka pahuhopu nui o ka mālama ʻana i ka achalasia, ʻo ia ka hoʻomaha ʻana i ka sphincter esophageal haʻahaʻa (LES), e ʻae ana i ka meaʻai e hele maʻalahi i loko o ka ʻōpū.
ʻO ka mea nui, ʻaʻole hiki i kēia mau lāʻau ke ho'ōla loa iā Achalasia, ʻoiai ʻaʻole hiki ke hana hou ʻia nā hunaola aʻalolo i nalowale. Eia nō naʻe, hiki i kēia mau lāʻau ke kōkua iā ʻoe e kāohi i kāu mau hōʻailona a alakaʻi i kahi ola maʻamau .
Hiki ke hoʻokaʻawale ʻia nā koho lapaʻau i ʻelua mau māhele: ʻoki kino ʻole a me ke ʻoki kino. E kūkākūkā kāu kauka me ʻoe i ka lāʻau lapaʻau kūpono loa e pili ana i kou kūlana, makahiki, a me nā makemake.
| ʻAno lapaʻau | Pehea e hana ai a me ka wehewehe ʻana |
|---|---|
| Nā Lapaʻau ʻAʻole ʻoki kino | |
| Hoʻonui ʻana o ka Balloon | I ka wā o ka endoscopy, hoʻokomo ʻia kahi pōpō ma o kahi paipu i loko o ka ʻāpana haiki o ka esophagus a hoʻopiha ʻia. Hoʻomaha ka ʻiʻo haiki, e hoʻonui iki i ka puka. Hana ʻia kēia ma lalo o ka anesthesia māmā. Pono paha ʻoe e hana i kēia lāʻau i nā manawa he nui. |
| Lāʻau lapaʻau | Hiki ke hoʻohana ʻia nā lāʻau lapaʻau e hoʻomaha ai i ka ʻiʻo LES. ʻO kekahi ala, ʻo ia ke hoʻokomo ʻana i ka Botox® (botulinum toxin) i loko o ka ʻiʻo. Aia kekahi mau pila e like me ka nifedipine a me ka isosorbide. Eia nō naʻe, he manawa pōkole wale nō nā hopena o kēia mau mea. |
| Nā Hana Lapaʻau | |
| ʻO ka Myotomy Heller Laparoscopic | ʻO kēia ke ʻoki kino maʻamau a holomua hoʻi. Hana ʻia kekahi mau ʻoki liʻiliʻi loa i loko o ka ʻōpū, hoʻokomo ʻia kahi kāmela a me nā mea hana palupalu, a ʻoki mālie ʻia nā olonā ʻiʻo i paʻa ma lalo o ka esophagus a hoʻokaʻawale ʻia mai waho. A laila hoʻokuʻu ʻia ke paʻa a wehe ʻia ka puka. |
| ʻO ka Myotomy Endoscopic Peroral (POEM) | He ʻano hana hou kēia. Me ka ʻole o ka hana ʻana i kekahi ʻoki ma waho o ke kino, hoʻokomo ʻia kahi endoscope ma ka waha a ʻoki ʻia ke ʻiʻo paʻa mai loko mai o ka esophagus. |
He mea kākaʻikahi loa, inā koʻikoʻi loa nā hōʻailona a ʻaʻole holomua nā lāʻau ʻē aʻe, pono paha ke ʻoki ʻana e wehe i ka esophagus holoʻokoʻa (esophagectomy) .
He aha kaʻu mea e hopohopo ai ma hope o ka mālama ʻana?
Hiki ke hoʻi hou mai nā hōʻailona o ka Achalasia ma hope o ka mālama ʻana. No laila, pono ʻoe e noho mau me kāu kauka no ka manawa lōʻihi. E nānā mau ʻo ia no kēia mau mea:
- Hiki iā ʻoe ke hoʻokomo i ka meaʻai a me ka mea inu lawa ma o kou esophagus i loko o kou ʻōpū?
- Ma muli o ka wehe ʻia ʻana o ka puka lalo, ua ulu aʻe kahi kūlana e kahe hou ai nā waikawa o ka ʻōpū i loko o ka esophagus (GERD) .
- Aia kekahi pilikia o ka hoʻomohala ʻana i ka maʻi ʻaʻai esophageal?
ʻAʻole kēia maʻi e hoʻopilikia i kou ola, akā pono ia i ka mālama pono ʻana a me ka hahai ʻana .
He aha kaʻu e hana ai i koʻu wā e noho ana me Achalasia?
Me ka mālama ʻana, ʻo ka hana ʻana i nā loli liʻiliʻi i kou nohona a me nā ʻano ʻai e hiki ke hōʻemi nui i kēia mau pilikia.
- E hoʻololi i kāu mau ʻano ʻai: Ke ʻai ʻoe, e wāwahi i kāu meaʻai i mau ʻāpana liʻiliʻi, e nau maikaʻi, a ale iā ia. E inu i ka wai he nui me kāu mau meaʻai. E kōkua kēia i ka meaʻai e noho pulu a iho maʻalahi.
- ʻAi me ka noho pololei ʻana: E noho pololei i ka wā e ʻai ana. Mai moe i lalo no hoʻokahi a ʻelua paha hola ma hope o ka ʻai ʻana. E kōkua kēia i ka umekaumaha e hoʻoneʻe i ka meaʻai i lalo.
- Mai ʻai ma mua o ka hiamoe ʻana: E hoʻōki i ka ʻai ʻana i nā meaʻai paʻa ma ka liʻiliʻi he 3-4 mau hola ma mua o ka hiamoe ʻana. E hāʻawi kēia i kou ʻōpū i ka manawa e hoʻoheheʻe ai i ka meaʻai ma mua o kou moe ʻana.
- E hiamoe me kou poʻo i hoʻokiʻekiʻe ʻia: E hoʻokiʻekiʻe iki i kou poʻo ma ka hoʻohana ʻana i kahi uluna keu i ka wā e hiamoe ana. E hōʻemi kēia i ka pilikia o ka meaʻai i loko o ka esophagus e hele ana i loko o ka windpipe.
He aha nā meaʻai e pono ʻole iaʻu e ʻai?
Hiki i ke kanaka me ka achalasia ke paʻakikī i ka ale ʻana i kekahi mau meaʻai. E akahele loa me kēia ʻano meaʻai.
- Nā meaʻai e hiki ke paʻa i loko o ka esophagus: nā ʻāpala i ʻili ʻole ʻia, nā hua waina, nā mea kanu maka, nā ʻiʻo kaula a maloʻo paha.
- ʻO nā meaʻai e hiki ke lilo i mea paʻa i loko o ka esophagus: Hiki i nā mea e like me ka berena, ka laiki, ka ʻuala, nā ʻuala palai, a me ka pasta ke hoʻopili pū i loko o ka esophagus a lilo i mea paʻa.
- Nā mea e hoʻonāukiuki ai i ka esophagus: nā meaʻai ʻala, nā mea inu kalapona (e like me ka soda), ka waiʻona.
ʻAʻole pono ʻoe e hoʻōki loa i ka ʻai ʻana i kēia mau meaʻai, akā inā ʻoluʻolu ʻole ʻoe, ʻoi aku ka maikaʻi o ka noho mamao aku mai ia mau mea.
Leka Lawe-Home
- He maʻi laha ʻole ʻo Achalasia i hoʻokumu ʻia e nā ʻiʻo o ka esophagus a me ka sphincter esophageal haʻahaʻa (LES) ʻaʻole e hana pono.
- ʻO ka paʻakikī i ke ale ʻana, ka regurgitation, a me ka ʻeha o ka umauma nā hōʻailona nui.
- Hōʻike pinepine ʻia kēia mau hōʻailona, no laila mai hoʻowahāwahā i kahi pilikia iki e ale ai.
- ʻOiai ʻaʻole hiki ke ho'ōla piha ʻia, hiki i ke ʻoki kino a me nā lāʻau ʻē aʻe ke hoʻomalu pono i nā hōʻailona a hiki i nā kānaka ke ola i ke ola maʻamau.
- Inā loaʻa iā ʻoe kēia mau hōʻailona, he mea nui loa e ʻike koke i kāu kauka ʻohana no ka ʻōlelo aʻo.
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