Ua loaʻa anei iā ʻoe kahi ʻeha koke a ʻoi i kou umauma, e like me ke ʻūlū ʻana o kekahi i kou puʻu, i ka wā e ʻai ana a inu ana paha? Me he mea lā ua paʻa ka meaʻai i loko o kou puʻu? Makaʻu ka poʻe he nui he hōʻeha puʻuwai kēia, akā ʻaʻole ia ka hihia mau. Hiki ke hana ʻia kēia e kahi spasm maʻamau ʻole o nā ʻiʻo i loko o kou esophagus. I kēia lā, e kamaʻilio mākou e pili ana i nā spasms esophageal, a i ʻole "Esophageal Spasms", ma ke ʻano maʻalahi e hiki ai iā ʻoe ke hoʻomaopopo.
He aha nā spasms esophageal?
I ka ʻōlelo maʻalahi, ʻo ko kākou esophagus he ʻōmole i hana ʻia me nā ʻiʻo e lawe ana i ka meaʻai a kākou e moni ai mai ko kākou puʻu a i ko kākou ʻōpū. ʻO ka maʻamau, ke moni kākou i kahi mea, ʻūlū nā ʻiʻo o kēia ʻōmole ma ke ʻano rhythmic, e like me ka nalu, e hoʻokuke i ka meaʻai i lalo i loko o ko kākou ʻōpū. I ka lāʻau lapaʻau, kapa mākou i kēia kaʻina hana he "peristalsis".
Eia nō naʻe, inā loaʻa iā ʻoe kahi maʻi i kapa ʻia ʻo "Esophageal Spasms", lilo ke ʻano o kēia mau ʻūmiʻi ʻiʻo i mea ʻano ʻē. Hoʻopaʻa wale lākou me ka ʻole o ka pilina, a i ʻole hoʻi e hoʻopaʻa nui a ikaika. E noʻonoʻo e like me kahi paipu wai e ālai koke ʻia ana ma kahi hoʻokahi.
Ke paʻakikī a ʻūlū nā ʻiʻo, ʻaʻole hiki i ka meaʻai a me ka mea inu ke iho maʻalahi i lalo. ʻO kēia ka manawa e paʻakikī ai ʻoe i ka ale ʻana a ʻeha ka umauma. I kekahi manawa, hiki i ka meaʻai i ale ʻia ke piʻi hou mai (regurgitate).
Aia kekahi mau ʻano nui o kēia maʻi?
ʻAe, ʻelua ʻano nui. He mea nui e hoʻomaopopo i kēia mau mea.
| ʻAno o ka Spasm | I ka ʻōlelo maʻalahi, he aha ka mea e hana ʻia? |
|---|---|
| ʻO ka spasm esophageal distal (a i ʻole diffuse) | Ma kēia ʻano, ʻūmiʻi nui nā ʻiʻo ma ka ʻaoʻao haʻahaʻa o ka esophagus ma ke ʻano haunaele a kūlike ʻole. ʻO ia ke kumu he mea maʻamau ka ʻike ʻana i ka meaʻai i moni ʻia e hoʻāʻo ana e hoʻi i luna i loko o ka puʻu. |
| ʻO ka esophagus hypercontractile (nutcracker a i ʻole jackhammer) | I kēia hihia, ʻoiai ke ʻano o ka ʻūlū ʻana o nā ʻiʻo, ʻoi aku ka ikaika a me ka leo nui o nā ʻūlū ma mua o ka mea maʻamau. E like me ke kuʻi ʻia ʻana me ka hāmare. Hiki i kēia ke hana i ka ʻeha nui i ka wā e moni ai a me ka manaʻo o ka paʻa i ka umauma. |
He aha nā hōʻailona? Pehea kona manaʻo?
ʻO nā hōʻailona nui ʻelua a ʻo ka mea maʻamau o kēia ʻano, ʻo ia ka paʻakikī i ke ale ʻana (dysphagia) a me ka ʻeha umauma ʻaʻole puʻuwai . Eia nō naʻe, hiki i kekahi poʻe ke loaʻa i kēia ʻano me ka ʻole o nā hōʻailona.
He mea nui loa: ʻO ka mea weliweli ma ʻaneʻi, hiki i kēia ʻeha umauma ke like me ka hōʻeha puʻuwai i kekahi manawa. No laila, inā loaʻa iā ʻoe ka ʻeha umauma koʻikoʻi a wehewehe ʻole ʻia e mau ana ma mua o ʻelima mau minuke, mai manaʻo wale he mea ʻē aʻe ia. E hele koke i ka ʻOihana Pilikia o ka haukapila (ETU). He mea nui e hōʻoia mua ʻaʻole ia he mea koʻikoʻi e like me ka hōʻeha puʻuwai.
Hiki ke ʻoluʻolu nā hōʻailona, akā i kekahi manawa koʻikoʻi. No kekahi poʻe, ʻike wale ʻia lākou ma hope o ka ʻai ʻana. No kekahi poʻe, hiki koke mai lākou me ke kumu ʻole. Hiki iā lākou ke mau no kekahi mau minuke a i ʻole hoʻokahi hola a ʻoi aku paha.
| Pehea kou manaʻo | Wehewehena |
|---|---|
| Paʻa/ʻūmiʻi ka umauma | Hiki paha ke manaʻo ʻia e like me kekahi e kaomi ana i lalo i waenakonu o ka umauma, ma lalo pono o ka sternum, me he mea lā e kau ʻia ana kekahi kaumaha ma luna. |
| ʻĀʻī puʻuwai | E manaʻo paha ʻoe i kahi ʻano wela i loko o kou umauma. |
| Ka hoʻolaha ʻana i ka ʻeha | ʻO ka ʻeha, e hoʻomaka ana ma waenakonu o ka umauma, hiki ke ʻike ʻia i kekahi manawa me he mea lā e hele ana i ka ʻāʻī, ka lima hema, a i ʻole ke kua. |
| Ka paʻakikī i ka moni ʻana (Dysphagia) |
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No ke aha lā kēia e hana nei? He aha nā kumu?
ʻO kaʻoiaʻiʻo, ʻaʻole ʻike nā kauka i ke kumu pololei o kēia. Eia nō naʻe, ua manaʻo nui ʻia ua hana ʻia e kahi hana hewa i loko o nā aʻalolo e kaohi ana i nā ʻiʻo o ka esophagus. E like me ke ala pōkole i loko o kahi kaapuni uila, ua hoʻopilikia ʻia nā hōʻailona mai nā aʻalolo i nā ʻiʻo.
Aia kekahi mau kumu ʻē aʻe e hiki ke hoʻopilikia i kēia:
- Maʻi GERD: I ka manawa pinepine, loaʻa i ka poʻe me kēia maʻi ka GERD (Gastroesophageal Reflux Disease). Ua manaʻoʻiʻo ʻia hiki i ka hoʻohana lōʻihi ʻana i kēia waikawa ke hōʻino i nā aʻalolo i loko o ka esophagus.
- Kekahi mau lāʻau lapaʻau: Ua ʻike ʻia kahi noiʻi hou e hiki i ka poʻe e hoʻohana ana i nā lāʻau hōʻeha ikaika e like me nā opioids no nā mahina ʻekolu a ʻoi aku ka nui o ka hoʻomohala ʻana i kēia maʻi.
Nā mea hoʻoulu no kēia ʻulaʻula
No kekahi poʻe, hoʻoulu ʻia kēia mau hōʻailona e kekahi mau mea. Hiki paha iā ʻoe ke hopohopo iki e pili ana i kēia mau mea.
- I ka wā e ʻai ai a inu paha, inā paha he wela loa a he anu loa paha.
- I nā wā o ke kaumaha nui a i ʻole ka hopohopo nui .
- I kekahi manawa i ka wā e hoʻoikaika kino ai .
Akā hiki ke loaʻa kēia ʻeha i kēlā me kēia manawa, me ke kumu ʻole.
Pehea ʻoe e ʻike ai i kēia, e Kauka?
Ma muli o ke ʻano like o kēia mau hōʻailona me nā maʻi ʻē aʻe he nui, hiki ke paʻakikī iki ka ʻike ʻana i ke ʻano maoli o ka "Esophageal Spasms".
1. Ke hōʻoia ʻana ʻaʻole ʻoe i loaʻa i ka maʻi puʻuwai: Ke hele ʻoe i ke kauka me ka ʻeha umauma, ʻo ka mea mua a ke kauka e hana ai, ʻo ia ka hōʻoia ʻana ʻaʻole ʻoe i loaʻa i kahi mea koʻikoʻi e like me ka hōʻeha puʻuwai. No kēlā, e hana lākou i nā hoʻokolohua e like me ka ECG (Electrocardiogram) .
2. Ke kāpae nei i nā kumu maʻamau ʻē aʻe: ʻO ka mea aʻe, e hana ʻia kekahi mau hoʻokolohua e hōʻoia i ʻaʻohe mau kūlana maʻamau ʻē aʻe e hiki ke hoʻoulu i kēia mau hōʻailona.
- ʻO ka Endoscopy Kiʻekiʻe: Ma kēia, ua hoʻokomo ʻia kahi ʻōmole liʻiliʻi a palupalu me kahi kāmela i hoʻopili ʻia ma o ka waha a i loko o ka esophagus a me ka ʻōpū e nānā i loko. Kōkua kēia i ka ʻike inā he mau loli, nā kīnā kūkulu, a i ʻole nā mea ālai.
- ʻEsophagram (Barium Swallow): Ma kēia, hāʻawi ʻia ʻoe i kahi wai i kapa ʻia ʻo barium e inu a lawe ʻia nā kiʻi X-ray. Hiki iā ʻoe ke ʻike maopopo inā he poloka a ʻūlū paha (stricture) ma nā wahi āpau o ka esophagus.
3. Nā hoʻokolohua kūikawā: Inā ʻaʻole hiki ke loaʻa ke kumu mai luna, hana ʻia kēia mau hoʻokolohua e hoʻoholo ai inā ʻo kēia ka maʻi pololei.
- Manometry Esophageal: ʻO kēia ka hoʻāʻo maikaʻi loa a hilinaʻi hoʻi e ʻike pololei i kēia maʻi (kūlana gula).. Ma kēia, ua hoʻokomo ʻia kahi ʻōmole lahilahi loa i lalo o ka puʻu ma o ka ihu. A laila ua noi ʻia ʻoe e ale i kahi wai liʻiliʻi, a loli ke kaomi i loko o nā ʻiʻo puʻu i kou ale ʻana, a ua ana ʻia ke ʻano o nā ʻūlū. Inā he nui nā ʻūlū kūpono ʻole e hana ʻia i ka manawa like, ʻo ia kekahi hōʻailona koʻikoʻi o kēia maʻi.
He aha nā lāʻau lapaʻau no kēia?
ʻO ka pahuhopu nui o ka mālama ʻana, ʻo ia ka hoʻomaha ʻana i nā ʻiʻo i loko o ka urethra a hōʻemi i nā hōʻailona. Inā ʻaʻohe ou hōʻailona, ʻaʻole paha ʻoe e pono i kekahi lāʻau lapaʻau.
Nā mea hiki iā ʻoe ke hana ma ka home
Ua hōʻike ʻia e ka noiʻi hiki i ka ʻaila peppermint ke hoʻomaha i nā ʻiʻo laumania o ka esophagus. ʻO ka hoʻohui ʻana i kekahi mau kulu o ka ʻaila peppermint i loko o ke aniani wai a me ka inu ʻana e kōkua paha i ka hōʻoluʻolu ʻana i kekahi mau hōʻailona liʻiliʻi. Hiki nō hoʻi ke kōkua i ka ʻike ʻana i ka manawa a me nā meaʻai e hoʻoulu ai i kou ʻeha puʻuwai a pale i kēlā mau meaʻai.
Lāʻau lapaʻau
Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e like me kēia e kāohi i nā hōʻailona:
- Nā mea pale i ke kahawai kalipuna: He mau lāʻau lapaʻau kēia no ke koko kiʻekiʻe. Ke lawe ʻia ma mua o ka ʻai ʻana, hoʻomaha lākou i nā ʻiʻo o ka esophagus, e maʻalahi ai ke ale.
- Nitrates: Kōkua i ka hōʻemi ʻana i ka ʻeha o ka umauma.
- Nā antidepressants Tricyclic: Ke hāʻawi ʻia i nā haʻahaʻa haʻahaʻa, kōkua kēia i ka hōʻemi ʻana i ka ʻeha ma ka kaohi ʻana i nā aʻalolo e pili ana i ka ʻeha.
Nā inikini botulinum toxin (Botox®)
Inā ʻaʻole holomua nā lāʻau ʻē aʻe, hoʻokomo ʻia kahi ʻōmole, e like me ka endoscopy, a hoʻokomo ʻia ʻo Botox i loko o nā ʻiʻo o ka esophagus. Hoʻopau kēia i kēlā mau ʻiʻo no kekahi manawa. A laila pau ka spasm. Eia naʻe, ʻo ka hopena o kēia e mau ana no kahi o 6 mau mahina wale nō.
ʻoki kino
Hana ʻia kēia i nā hihia koʻikoʻi loa kahi i holo pono ʻole ai kekahi lāʻau ʻē aʻe. Ua kapa ʻia kēia ʻoki ʻana he "Myotomy." Hana ke kauka i kahi ʻoki liʻiliʻi i nā ʻiʻo ma lalo o ka esophagus. A laila, nalowale nā ʻiʻo i ko lākou hiki ke ʻaelike. A laila, ʻae ka umekaumaha i ka meaʻai e neʻe i lalo.
Āhea wau e ʻike ai i ke kauka?
He mea nui loa kēia no ka mea ua like nā hōʻailona me ka hāʻule puʻuwai.
| Inā loaʻa iā ʻoe kēia mau hōʻailona, e hele koke i ka Emergency Treatment Unit (ETU) o ka haukapila! | |
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| Inā hoʻomau kēia mau hōʻailona no nā pule ʻelua a ʻoi aku, e ʻike i ke kauka. | |
Inā hoʻomau nā hōʻailona e like me ka ʻeha o ka umauma a i ʻole ka paʻakikī i ka moni ʻana, mai hoʻowahāwahā iā ia e like me ka mea maʻamau a kamaʻilio me kāu kauka e pili ana i ia mea. |
Leka Lawe-Home
- ʻO ka Esophageal Spasms kahi maʻi e hoʻoulu ai i ka ʻeha o ka umauma a me ka paʻa i ka wā e moni ai i ka meaʻai, hiki ke hoʻopilikia i ke ola o kēlā me kēia lā.
- Hiki i kēia ʻeha umauma ke like me ka hāʻule puʻuwai i kekahi manawa. No laila, inā loaʻa iā ʻoe ka ʻeha umauma koke a wehewehe ʻole ʻia, e hele koke i ka ʻOihana Pilikia o ka haukapila (ETU) me ka noʻonoʻo ʻole i kekahi mea ʻē aʻe.
- ʻOiai ʻaʻole ʻike ʻia ke kumu pololei o kēia, hiki i ka GERD a me kekahi mau lāʻau lapaʻau ke pāʻani i kahi kuleana.
- Aia nā lāʻau lapaʻau maikaʻi e kāohi ai i kēia maʻi, no laila inā loaʻa iā ʻoe nā hōʻailona, mai hoʻowahāwahā wale iā lākou a kamaʻilio me kāu kauka.
- ʻAʻole kēia he maʻi koʻikoʻi e hoʻoweliweli i ke ola a i ʻole ke kumu o nā maʻi koʻikoʻi e like me ke kanesa. No laila, mai makaʻu pono ʻole.
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