Ua loaʻa iā kākou a pau kēia ʻike i kekahi manawa. Ke ʻai wikiwiki kākou a inu paha i kahi mea, e paʻa koke ana ko kākou puʻu, e kani ana ka leo, a e like me ka ʻū ʻana o ka waha. ʻŌlelo mākou, "Ua hele hewa kākou." ʻO ka maʻamau, nalowale ia ma hope o ko kākou inu ʻana i ka wai. Inā hana pinepine kēia, ʻaʻohe mea e hopohopo ai. Akā inā pilikia ʻoe i ka ale ʻana i ka meaʻai a me ka mea inu i kēlā me kēia manawa, ʻo ia hoʻi, aia kekahi mea e ālai ana i ke ala e hele ai ka meaʻai mai kou waha a i kou ʻōpū. I ka lāʻau lapaʻau, kapa mākou i kēia ʻano he dysphagia .
ʻAʻole kēia he mea hoʻopilikia wale nō. I kekahi manawa hiki ke lilo i hōʻailona o kahi maʻi koʻikoʻi. No ka laʻana, he mea maʻamau kēia ʻano i ka poʻe i loaʻa i ka hahau. Inā ʻaʻole mālama ʻia, hiki i ka meaʻai a i ʻole ka mea inu ke komo i loko o kou mau ala ea, ʻo ia hoʻi kou mau māmā. I ka lāʻau lapaʻau, kapa mākou i kēia he aspiration . Hiki i kēia ke alakaʻi i nā maʻi koʻikoʻi e like me nā maʻi māmā a me ka pneumonia. No laila, he mea nui loa ka makaʻala i kēia.
Aia kekahi mau ʻano dysphagia?
I ka ʻōlelo maʻalahi, ʻae. Hiki ke hoʻokaʻawale ʻia kēia mau pilikia ale i ʻekolu ʻano nui ma muli o kahi e loaʻa ai. E noʻonoʻo e like me kahi huakaʻi mai ka waha a i ka ʻōpū. ʻEkolu mau wahi kū nui ma kēia huakaʻi: ka waha (waha waha), ka ʻāʻī (pharynx), a me ka ʻōmole e lawe ana i ka meaʻai i ka ʻōpū, ʻo ia hoʻi ka esophagus. Inā he pilikia ma kekahi o kēia mau wahi kū, e pōkole ka huakaʻi, ʻo ia hoʻi ka paʻakikī o ka ale ʻana.
| ʻAno o ka dysphagia | I ka ʻōlelo maʻalahi... |
|---|---|
| ʻO ka dysphagia waha | Aia ka pilikia i loko o kou waha. Hiki ke hana ʻia kēia ke nāwaliwali nā ʻiʻo e pili ana i ka nau ʻana i ka meaʻai, ka hana ʻana i nā pōpō meaʻai me kou alelo, a me ke kāwili ʻana me ka lawai. |
| ʻO ka Oropharyngeal Dysphagia (pilikia e pili ana i ka puʻu) | Hiki mai kahi pilikia ke paʻi ʻia kahi puʻupuʻu meaʻai i hana ʻia ma ka waha i lalo o ka puʻu. Nui nā mea e hana koke ʻia ma ʻaneʻi. No ka laʻana, pani ʻia ka larynx (pahu leo) e pale i ka meaʻai mai ke komo ʻana i ka ʻōpū hanu. Hiki ke hana ʻia kēia kūlana ma muli o kahi kīnā i kēia kaʻina hana. |
| ʻO ka Dysphagia Esophageal | Hiki mai kahi pilikia ke neʻe ka meaʻai i lalo o ka puʻu, i lalo o ka esophagus, a i loko o ka ʻōpū. Paʻi ʻia ka meaʻai i lalo e nā ʻūlū e like me ka nalu (peristalsis) o ka esophagus. Hiki mai kēia ʻoluʻolu ʻole inā e hoʻopau ʻia kēia kaʻina hana a i ʻole ua ālai ʻia ka esophagus. |
He aha nā kumu o ka dysphagia?
ʻO kēlā me kēia kūlana e hoʻopilikia ai i nā aʻalolo a i ʻole nā ʻiʻo e kōkua ana i ke kaʻina hana ale ʻana hiki ke hana i kēia.
Nā maʻi o ka ʻōnaehana nerve a me ka lolo
Hoʻokele ʻia nā neʻe ʻana o ko mākou kino e ka lolo a me ka ʻōnaehana nerve. Hiki i nā maʻi e hoʻopilikia i kēia ʻōnaehana ke hana i nā pilikia ale.
- Hahau: ʻO ka pale ʻana i ke kahe o ke koko i ka lolo hiki ke hōʻino i nā ʻāpana e kaohi ana i ke kaʻina hana ale.
- ʻO ka maʻi o Parkinson: Ka nāwaliwali mālie ʻana o nā ʻāpana o ka lolo e hoʻopilikia ai i ka hoʻonohonoho ʻana o nā neʻe ʻana.
- Sclerosis lehulehu (MS): He maʻi autoimmune e hōʻino ai i nā ʻūpā aʻalolo.
- ʻAmyotrophic Lateral Sclerosis (ALS): He maʻi e hoʻonāwaliwali ai i nā aʻalolo e kaohi ana i nā ʻiʻo.
- Dementia: He kūlana e hoʻopilikia ai i ka hoʻomanaʻo a me ka hoʻonohonoho ʻana o nā neʻe ʻana.
- Nā puʻupuʻu lolo: Hiki i kēia ke maʻi kanesa a maikaʻi ʻole paha. Hiki iā lākou ke hoʻopilikia i nā hōʻailona aʻalolo.
- ʻO ka lolo lolo: He kūlana e kū mai ana i ka wā hānau a hoʻopilikia i ka hoʻonohonoho ʻana o nā ʻiʻo.
Nā maʻi ʻiʻo
Hiki ke hana ʻia ka dysphagia e nā maʻi e hoʻopilikia ai i nā ʻiʻo i ka puʻu a me ka esophagus e kōkua ai i ka moni ʻana.
- ʻAkalasia: He ʻano kakaikahi kahi e hoʻomaha ʻole ai nā ʻiʻo ma ka ʻaoʻao haʻahaʻa o ka esophagus, e pale ana i ka meaʻai mai ke komo ʻana i loko o ka ʻōpū.
- ʻO Scleroderma: He maʻi autoimmune e hoʻopaʻakikī ai nā ʻiʻo o ka esophagus, e paʻakikī ai i nā ʻiʻo ke kaomi i ka meaʻai i lalo.
- ʻO ka dystrophy muscular: He hui o nā maʻi hoʻoilina e hoʻoulu ai i ka nāwaliwali o nā ʻiʻo.
- ʻO Myasthenia gravis: He maʻi autoimmune e hoʻopilikia ai i nā hōʻailona mai nā aʻalolo a i nā ʻiʻo.
Ka hāiki ʻana o ka esophageal, ka pale ʻana, a me nā pilikia kūkulu
- Kanesa: Hiki i nā ʻōpū kanesa ma ke poʻo, ka ʻāʻī, a i ʻole ka esophagus ke ālai i ke ala o ka meaʻai.
- GERD (Acid Reflux): ʻO ke kahe mau ʻana o ka waikawa o ka ʻōpū i luna o ka esophagus hiki ke hōʻino i nā ʻiʻo, e hana ana i ka ʻeha a me ka haiki. Ua kapa ʻia kēia he esophageal strictures .
- ʻO ka esophagitis eosinophilic: Hoʻākoakoa kahi ʻano o ke koko keʻokeʻo (eosinophils) i loko o ka esophagus, e lilo ai i mea paʻakikī a paʻakikī ke ale.
- ʻO ka diverticulum esophageal:Hoʻokumu ʻia kahi ʻāpana liʻiliʻi e like me ka ʻeke ma kahi nāwaliwali o ka paia o ka esophagus. Hiki i nā ʻāpana meaʻai ke paʻa ma kēia wahi, e hana ana i kahi manaʻo e like me kahi mea i paʻa i ka puʻu.
ʻO ka mea nui, ʻoiai ʻaʻole ka ʻelemakule ke kumu pololei o ka dysphagia, he kumu pilikia nui ia. ʻOi aku ka maʻamau o kēia ʻano i waena o ka poʻe ʻelemakule ma muli o ka hoʻonui ʻia o ka pilikia o ka nāwaliwali o nā ʻiʻo a me nā maʻi neurological he nui i ʻōlelo ʻia ma luna.
Pehea e ʻike ai i kēia maʻi?
Ke ʻike ʻoe i ke kauka, e hoʻolohe pono ʻo ia i kāu mau hōʻailona a hana i kahi hoʻokolokolo kino. A laila, e paipai paha lākou i kekahi mau hoʻokolohua kūikawā e ʻike ai i ke kumu.
- ʻAi ʻia ka Barium (hoʻāʻo ale ʻana i ka Esophagram a i ʻole Barium): Ma kēia hoʻāʻo, inu ʻoe i kahi wai i kapa ʻia ʻo barium. ʻIke ʻia kēia wai keʻokeʻo ma kahi X-ray, no laila hiki iā ʻoe ke nānā i ka hana a ka esophagus e like me ke wikiō i kou ale ʻana.
- ʻO ka endoscopy kiʻekiʻe (EGD): Ma kēia kaʻina hana, hoʻokomo kāu kauka i kahi ʻōmole liʻiliʻi i hoʻolako ʻia me ke kāmela i lalo o kou puʻu e nānā i kou puʻu, esophagus, a me ka ʻōpū. Hiki i kēia ke kōkua i ka nānā ʻana i nā puʻupuʻu a me nā mea e ālai ai.
- Nā uku (Fiberoptic Endoscopic Evaluation of Swallowing): He hoʻāʻo i hana ʻia e kahi Speech-Language Pathologist (SLP). Hoʻokomo ʻia kahi kāmela liʻiliʻi ma kou ihu e ʻike inā komo ka meaʻai a mea inu kala paha i loko o kou ala ea ke moni ʻoe.
- Manometry Esophageal: Hoʻokomo ʻia kahi paipu ma kou ihu i loko o kou ʻōpū a ana i ke kaomi, a i ʻole ka ʻūlū ʻana, o nā ʻiʻo i loko o kou esophagus ke inu ʻoe i ka wai.
Pehea e mālama ʻia ai?
Hoʻopili ʻia ka lāʻau lapaʻau i ke kumu o kou dysphagia a me kona koʻikoʻi.
- Nā lāʻau lapaʻau: Hiki ke kuhikuhi ʻia nā lāʻau antibiotic no kahi maʻi, a hiki ke kuhikuhi ʻia nā lāʻau lapaʻau e kaohi ana i ka waikawa no nā kūlana e like me GERD.
- Nā hoʻololi ʻana i ke ʻano o ka nohona: Hiki i kāu kauka a mea lapaʻau ʻōlelo paha ke haʻi aku iā ʻoe e hana i nā hoʻololi i ka ʻai. Hiki iā lākou ke aʻo aku iā ʻoe e ʻai i nā meaʻai palupalu a wāwahi maikaʻi ʻia, e nau pono i kāu meaʻai, a lawe i nā waha liʻiliʻi.
- Nā lāʻau lapaʻau ʻē aʻe: Inā ua haiki ka esophagus, aia nā ala e hoʻonui ai. Hoʻohana ʻia nā inikini Botox® e mālama i kekahi mau pilikia ʻiʻo.
- ʻŌmole hānai: I nā hihia koʻikoʻi loa, ʻo ia hoʻi, i ka wā ʻaʻole hiki ke ʻai a inu a nui aʻe ka pilikia o ka ʻū ʻana, hoʻohana ʻia kēia ʻano hana e hāʻawi i ka meaʻai.
- Nā hoʻomaʻamaʻa hoʻōla: Hiki i kahi mea lapaʻau ʻōlelo a me ka ʻōlelo (SLP) ke aʻo iā ʻoe i nā hoʻomaʻamaʻa e hoʻoikaika i kou mau ʻiʻo ale. Hiki iā lākou ke aʻo iā ʻoe pehea e ʻai palekana ai, pehea e paʻa ai i kou poʻo, a me ke ala kūpono e wehe ai i ka meaʻai inā paʻa.
He aha nā pilikia e hiki mai ana inā ʻaʻole mālama ʻia?
Inā ʻaʻole mālama ʻia, hiki i kēia maʻi ke alakaʻi i nā pilikia olakino koʻikoʻi, a hiki i ka make. No laila, he mea nui loa ka mālama ʻana i kēia.
ʻO nā pilikia nui:
- Dehydration: Ka nele o ka wai i loko o ke kino ma muli o ka hiki ʻole ke inu i ka wai lawa.
- ʻAi ʻole: ʻAʻohe meaʻai kūpono.
- ʻUmiʻumi: Hiki ke hoʻoweliweli i ke ola.
- Pneumonia Aspiration: He niumonia koʻikoʻi i hoʻokumu ʻia e ka hanu ʻia ʻana o ka meaʻai a mea inu paha i loko o nā māmā. I kekahi manawa, ʻoi aku hoʻi i ka poʻe i loaʻa i ka hahau, hiki ke hanu ʻia ka meaʻai i loko o nā māmā me ka ʻole o ka ʻū ʻana (ka hanu leo ʻole). He mea weliweli loa kēia.
Āhea ʻoe e ʻike ai i ke kauka?
Inā ʻike ʻoe e pilikia ana ʻoe i ka moni ʻana ma mua o hoʻokahi a ʻelua paha manawa, e ʻike koke i kāu kauka. He mea nui e ʻimi a mālama i ke kumu.
| Pilikia! E hele koke i ka ETU (Emergency Treatment Unit). | |
|---|---|
| Kūlana | Inā manaʻo ʻoe ua paʻa kekahi mea i loko o kou puʻu a paʻakikī iā ʻoe ke hanu . |
| Kūlana | Ka nāwaliwali koke o nā ʻiʻo, ka nalowale ʻana o ka hana o kekahi ʻāpana o ke kino (paralysis), a i ʻole ka hiki ʻole ke ale . |
ʻOiai hiki i nā mea e like me ke kuni ʻana a me ka hanu ʻana ke lilo i mea ʻoluʻolu ʻole, he ʻōlelo aʻo ia mai kou kino mai. No laila, mai hoʻowahāwahā i kēlā mau hōʻailona.
Leka Lawe-Home
- Inā pilikia ʻoe i ka ale ʻana i ka meaʻai, a hana pinepine ia, mai manaʻo wale ua "hele i ke ala hewa."
- ʻAʻole wale ka Dysphagia he mea hoʻopilikia, hiki ke lilo i hōʻailona o kahi maʻi koʻikoʻi e like me ka hahau ʻana, ke kanesa, a i ʻole nā maʻi neurological.
- Mai hoʻowahāwahā i ka pilikia o ka moni ʻana, e ʻike koke i kāu kauka no ka hōʻoia kūpono.
- Hiki i nā mea hoʻoponopono ʻōlelo a me ka ʻōlelo (SLP) ke kōkua nui ma ke aʻo ʻana i nā hoʻoikaika kino a me nā ʻano ʻai palekana.
- Inā pilikia koke ʻoe i ka hanu ʻana a i ʻole ke ale ʻana, he pilikia ia. E hele koke i ka ETU o ka haukapila.
👩🏽⚕️ Nā nīnau hou aku (FAQs)
💬 He lāʻau lapaʻau nā papa Gemfibrozil (Lopid) i hoʻohana ʻia no ka mālama ʻana i ka maʻi hea?
ʻAʻole kēia he pila cholesterol (Statin) maʻamau! He lāʻau lapaʻau (Fibrate) ikaika loa kēia e hiki ke hoʻemi koke i ka pae o kahi ʻano momona weliweli i kapa ʻia ʻo 'Very High Triglycerides' ma kahi o 50% no nā poʻe maʻi me nā triglycerides kiʻekiʻe loa/kiʻekiʻe loa! Hāʻawi koke nā kauka i kēia pila no ka mea inā piʻi nui nā triglycerides, hiki i ka pancreas ke pahū (Pancreatitis) a make.
💬 Pehea e hoʻoheheʻe ai kēia pila ʻaila ikaika (Gemfibrozil) i nā triglycerides i kona komo ʻana i loko o ko kākou kino?
ʻAʻole kēia he mīkini cholesterol e pani ai i ke akepaʻa! Hele kēia pila i ko kākou akepaʻa a me nā hunaola momona (hoʻāla ʻana o PPAR-alpha), a hoʻāla piha/hoʻohuli i ka 'enzyme wāwahi momona (Lipoprotein lipase)' i loko o ke kino! A laila, wāwahi kēlā mau enzymes i ka momona (VLDL/Triglycerides) i loko o ke koko e like me ka muliwai i mau ʻāpana a luku iā ia (a hoʻonui nui kēia i ka cholesterol maikaʻi/HDL).
💬 No ke aha i ʻōlelo ʻia ai ʻaʻole e lawe i kēia (Gemfibrozil) me nā pila cholesterol maʻamau (Statins)? He aha nā pilikia?
ʻO ia ka pōʻino nui loa a make loa o kēia! Inā ʻoe e lawe i kēia pila i ka wā e lawe ana i kahi pila cholesterol maʻamau (Atorvastatin/Simvastatin), i loko o ka pule mua, e heheʻe ka 100% o kou mau ʻiʻo (Severe Rhabdomyolysis) a e pala loa kou mau puʻupaʻa a e make ʻoe. He mea make loa kēia a hiki ke make! Eia kekahi, kiʻekiʻe loa ka pilikia o ka loaʻa ʻana o nā 'Gallstones / Cholelithiasis'.
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