Ua manaʻo paha ʻoe ua paʻa kekahi mea i loko o kou puʻu a i ʻole kou umauma i ka wā e ʻai ai ʻoe, inu i kahi wai liʻiliʻi, a i ʻole e ale i kahi pila? Manaʻo anei ʻoe ʻaʻole hiki iā ʻoe ke ale maʻalahi i ka meaʻai e like me ka wā ma mua? Malia paha ke pale aku nei ʻoe me ka ʻike ʻole i nā meaʻai e like me nā meaʻai ʻino a me ka ʻiʻo. Inā manaʻo ʻoe pēlā, mai hoʻokuke aku iā ia me he mea maʻamau. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi olakino e hiki ke kumu o kēia. ʻO ia ka haiki ʻana o ka esophagus, i kapa ʻia ma ke ʻano lapaʻau ʻo Esophageal Stricture .
He aha ka Esophageal Stricture?
ʻAe, e hoʻomaopopo maʻalahi kākou i kēia. ʻIke ʻoe, aia kahi ʻāpana e like me ka paipu o ko kākou kino e lawe ana i ka meaʻai mai ko kākou waha a i ko kākou ʻōpū (ʻōpū). Kāhea mākou i kēia ʻo ka esophagus . Ua like ia me ka paipu wai. ʻO 'Stricture' ke ʻano o kekahi paipu, alahele, a paipu paha i loko o ko kākou kino i lilo i mea haiki a ālai ʻia paha. No laila, ʻo ka Esophageal Stricture ka wā e lilo ai kēlā paipu i mea haiki ʻole no kekahi kumu.
E noʻonoʻo i ka hōʻiliʻili ʻana o ka lepo a me ka ʻōpala i loko o kahi paipu wai, e hoʻohaiki mālie ana i ka paipu. Pēlā nō ka mea e hana ʻia i ko kākou esophagus. Ke hoʻohaiki ʻia, hoʻemi ia i ka hakahaka no ka meaʻai a me ka mea inu e hele maʻalahi i lalo. ʻO ia ke kumu e paʻakikī ai iā kākou ke ale.
Hiki ke hana ʻia kēia ālai ʻana mai loko mai o ka esophagus a i ʻole mai waho mai. Hiki i ka uhi palupalu o ka esophagus (i kapa ʻia ʻo `mucosa`) ke lilo i pehu a ʻeha a mānoanoa. Ke hana ʻia kēia, ʻaʻole e kīkoʻo ka uhi i ka wā e ale ai mākou. I kekahi manawa, hiki i kahi mea e like me ka puʻupuʻu ma kekahi ʻano ʻē aʻe a puni ka esophagus ke kumu e ālai ʻia ai ka esophagus ma kēia ʻano, ʻoiai inā he kaomi mai waho mai. ʻO ka hapa nui o ka manawa, hana mālie loa kēia kaʻina hana, i ka hala ʻana o ka manawa.
He koʻikoʻi anei kēia kūlana?
I kēia manawa, ke noʻonoʻo nei paha ʻoe inā he mea weliweli kēia. ʻOiaʻiʻo, ma ke ʻano he mau kauka, ʻaʻole mākou e lawe māmā i kēia kūlana. No ka mea, pili pololei ia i kou hiki ke ale i ka meaʻai, a inā ʻaʻole mālama ʻia, hiki ke lilo i mea ʻino i ka hala ʻana o ka manawa.
ʻO ka mea maikaʻi loa, i ka hapanui o nā hihia, hiki ke ho'ōla loa ʻia kēia maʻi me nā hana lapaʻau maʻalahi a liʻiliʻi. Eia nō naʻe, ma kahi pakeneka liʻiliʻi loa, ʻo ia hoʻi, he kakaikahi loa, ʻo ke kumu o kēia ālai ʻana he maʻi kanesa paha. He maʻi koʻikoʻi kēlā. ʻO ia ke kumu a mākou e ʻōlelo nei inā pilikia ʻoe i ka ale ʻana, mai hoʻowahāwahā iā ia a e ʻike koke i kāu kauka .
He aha nā hōʻailona o kēia? Pehea kou manaʻo?
ʻO ka hōʻailona mua a maʻamau ka paʻakikī i ka ale ʻana.. Hiki iā ʻoe ke hoʻokele i kēia ma ka lawe ʻana i nā ʻāpana liʻiliʻi o ka meaʻai i ka hoʻomaka ʻana, e nau maikaʻi iā lākou, a moni iā lākou. Hiki paha iā ʻoe ke pale aku i nā meaʻai ʻala a ʻinoʻino (e laʻa me ka laiki palai, nā ʻiʻo). Akā i ka wā e paʻa nui ai kou puʻu, ʻaʻole e kōkua hou kēia mau mea. Manaʻo paha ʻoe he puʻupuʻu i loko o kou puʻu, a i ʻole ʻaʻole hana pono nā ʻiʻo o kou puʻu.
E noʻonoʻo, ʻo kahi ʻāpana moa āu i makemake nui ai e ʻai, i kēia manawa e hoʻopaʻa ai i kou puʻu. No laila ua hōʻemi ʻoe i ka ʻai ʻana i ka moa. Manaʻo ʻoe no ka "gastritis." Akā ʻo ke kumu maoli paha he mea ʻē aʻe.
Ma waho aʻe o kēia hōʻailona nui, hiki ke ʻike ʻia kekahi mau hōʻailona ʻē aʻe.
| Hōʻailona | Ua wehewehe maʻalahi ʻia |
|---|---|
| ʻEha umauma ʻaʻole puʻuwai | ʻEha koʻu umauma, ʻaʻole naʻe no ka pilikia o ka puʻuwai. No ka pilikia ia ma koʻu esophagus. |
| ʻUmi a ʻūʻū paha i ka wā e moni ai i ka meaʻai | Hiki paha iā ʻoe ke ʻū koke a ʻū paha i ka moni ʻana i ka meaʻai. ʻO kēia paha no ka mea ʻaʻole e iho pono ana ka meaʻai. |
| Regurgitation | Hoʻi hou mai ka meaʻai i ale ʻia i loko o ka puʻu. ʻAʻole like me ka luaʻi ʻana, manaʻo wale ia e piʻi mai ana. |
| Ka pohō kaumaha i manaʻo ʻole ʻia | Ma muli o kāu ʻai liʻiliʻi ʻana, e hoʻomaka ana kou kaumaha o ke kino e emi iho me ka ʻike ʻole ʻia. |
He aha nā kumu nui no kēia?
Aia kekahi mau kumu e hiki ai i ka esophagus ke lilo i mea haiki. E hoʻokaʻawale kākou iā lākou i ʻekolu mau ʻano nui.
1. ʻO ka Esophagitis mau loa
ʻO kēia ke kumu maʻamau . Hana ʻia ia i ka wā e pehu ai ka paia o loko o ka esophagus no kahi manawa lōʻihi. E like me ka waiho ʻana o kahi ʻeha ma ko mākou ʻili i kahi ʻōpala i kona ho'ōla ʻana, pēlā nō hoʻi, i ka wā e hōʻeha mau ʻia ai ka esophagus, hana ʻia nā ʻiʻo ʻōpala (i ʻike ʻia hoʻi he fibrosis). ʻAʻole e kīkoʻo kēia ʻiʻo ʻōpala e like me nā ʻiʻo maʻamau, mānoanoa ia. ʻO ia ke kumu e wili ai ka esophagus.
ʻO ke kumu nui o kēia, ʻo ia ka reflux waikawa mau loa . He nui ka poʻe o mākou e kapa nei i kēia he "gastritis." I ka ʻōlelo maʻalahi, ʻo ia ka wā e piʻi ai ka waikawa i loko o ka ʻōpū a komo i loko o ka esophagus. Ke hana pinepine ʻia kēia, puhi ka waikawa a hōʻeha i ka uhi palupalu o ka esophagus. I ka hala ʻana o ka manawa, lilo kēia mau ʻeha i mau ʻōpala a ālai i ka esophagus. ʻO kēia ke kumu o ka ʻoi aku ma mua o 75% o nā hihia.
Eia kekahi, aia kekahi mau kumu ʻē aʻe:
- Pill Esophagitis: ʻO kekahi mau lāʻau ʻeha, ʻoiai ʻo NSAID (nā lāʻau anti-inflammatory nonsteroidal) a me acetaminophen (paracetamol), hiki ke paʻa i loko o ka esophagus a hōʻino i kona paia ke hoʻohana mau ʻia, ʻoiai ke moni ʻia me ka wai liʻiliʻi.
- ʻO ka Esophagitis Pipili: I nā poʻe me nā ʻōnaehana pale nawaliwali (e like me nā maʻi HIV a me nā maʻi kanesa), hiki i kekahi mau maʻi (HPV, HSV-1) a me nā fungi (Candida albicans) ke hoʻoulu i ka mumū o ka esophagus.
- ʻEosinophilic Esophagitis: He maʻi laha ʻole kēia i hoʻokumu ʻia e kahi pilikia me ka ʻōnaehana pale. Hoʻonui nui ke kino i kekahi mau allergens, e hoʻoulu ai i ka mumū mau o ka esophagus. Hiki i kēia ke hoʻomaka i ka wā kamaliʻi.
2. ʻEha a i ʻole Trauma i ka esophagus
Hiki ke loaʻa nā ʻōpala a me nā mea e ālai ʻia ai ma muli o kekahi ʻeha i ka paia o loko o ka esophagus. Hiki i kēia mau mea ke hana ʻia ma ke ʻano he hopena ʻaoʻao o nā ulia a i ʻole nā lāʻau lapaʻau.
- ʻAi ʻona: ʻO ka inu ʻana i kahi wai ʻona e like me ka waikawa, ma ke kuhihewa a i ʻole me ka manaʻo e pepehi iā ia iho, hiki ke hana i nā kuni nui a me nā ʻeha o ka esophagus.
- ʻEha Wela: ʻO ka moni ʻana i kahi mea wela loa (e like me ke kī wela, ka porridge wela) hiki ke puhi koke i ka ʻōpū.
- Ka lāʻau lapaʻau no ka maʻi kanesa:I ka wā e loaʻa ai ka radiation therapy no ke kanesa ma ka ʻāʻī a i ʻole ka umauma, hiki ke loaʻa ka mumū o ka esophagus (mucositis) a me ke ālai ʻana ma hope (RIES) ma ke ʻano he hopena ʻaoʻao.
- Lāʻau lapaʻau: ʻOiai e hoʻonui ʻia ana ka esophagus, hiki i ka hoʻokomo ʻana i nā steroid i loko o ka wahi i ālai ʻia ke hōʻemi i ka mumū a pale i ka hana hou ʻana.
- Endoscopic Stricturoplasty: Ma kēia, ua hoʻokomo ʻia kahi mea hana like me ka pahi ma o ka endoscope, kahi e ʻoki ai i ka ʻiʻo ʻeha e hana ana i ka poloka ma kekahi mau wahi, e hoʻonui ana i ka wahi.
- Ke kau ʻana i ka stenting: Hoʻokomo ʻia kahi ʻōmole liʻiliʻi e like me ka ʻupena (he `stent`) ma kahi i paʻa ʻia e wehe mau ai. Ua like kēia me kahi stent no kahi aʻa i paʻa ʻia.
- ʻOki kino: Hana kākaʻikahi loa kēia. I nā hihia o ke kanesa a me ka pale nui ʻana i pane ʻole i nā lāʻau ʻē aʻe, pono paha ke ʻoki kino e wehe i ka ʻāpana i hōʻino ʻia o ka esophagus ('Esophagectomy`).
- Inā pilikia ʻoe i ka ale ʻana i ka meaʻai.
- Inā loaʻa pinepine iā ʻoe ka ʻeha puʻuwai a i ʻole ka manaʻo o ka waikawa e piʻi mai ana i loko o kou puʻu.
- Inā ʻoe e lilo i ke kaumaha no ke kumu ʻike ʻole ʻia.
- Inā paʻa loa kahi ʻāpana meaʻai i loko o ka puʻu.
- Inā ʻaʻole hiki iā ʻoe ke ale i ka meaʻai paʻa.
- Inā komo ka meaʻai i loko o ka trachea i ka wā e moni ʻia ai a pilikia ai ka hanu ʻana.
- Inā loaʻa iā ʻoe ka ʻeha nui o ka umauma.
- ʻAʻole maʻamau ka paʻakikī i ke ale ʻana. He hōʻailona ia. No laila, mai hoʻowahāwahā iā ia.
- ʻO ke kumu nui o ka ʻāʻī ʻana o ka puʻuwai, ʻo ia ka gastritis lōʻihi a i ʻole ka reflux acid . Inā loaʻa pinepine iā ʻoe ka ʻāʻī ʻana o ka puʻuwai, e mālama ʻia.
- ʻO ka ʻike mua ʻana a me ka mālama ʻana i kēia maʻi hiki ke alakaʻi i kahi hoʻōla maikaʻi loa. No laila, inā loaʻa iā ʻoe nā hōʻailona, mai makaʻu e ʻike i ke kauka.
- Hiki ke ho'ōla ʻia nā mea āpau he nui me kahi kaʻina hana maʻalahi i kapa ʻia ʻo dilation.
- Inā loaʻa iā ʻoe ka ʻū ʻana koke a i ʻole ka ʻeha nui o ka umauma, e hele koke i ke Keʻena Pilikia (ETU) .
He mea nui loa: Inā ale kekahi i kēlā ʻano mea ʻawahia, e kāhea koke aku i ke Kikowaena ʻIke Poisons National ma ka Halemai Lahui ʻo Colombo . Eia kekahi, e lawe i ka mea maʻi i kahi Emergency Treatment Unit (ETU) o ka haukapila i ka hikiwawe loa.
3. Ka maʻi ʻaʻai
He mea weliweli paha kēia, akā he mea nui e ʻike. Hiki i ke kanesa esophageal ke hana i kēia ʻano ʻūlū. Eia naʻe, ʻaʻole like me nā kumu ʻē aʻe, ʻike koke ʻia nā hōʻailona o ka ʻūlū ma muli o ke kanesa. Inā pilikia kekahi kanaka i ka ʻai maikaʻi ʻana no kekahi mau pule i ka ale ʻana, he mea nui loa ia e hopohopo. Aia kekahi mau ʻano kanesa esophageal (Adenocarcinoma, Squamous cell carcinoma).
Pehea e hana ʻia ai ka hōʻailona?
Inā loaʻa iā ʻoe kēia mau hōʻailona, e kuhikuhi paha kāu kauka iā ʻoe i kahi gastroenterologist. E hoʻolohe pono ʻo ia i kāu mau hōʻailona a paipai i kekahi mau hoʻokolohua e hōʻoia i ke kūlana.
| Hoʻāʻo | He aha ka mea e hana nei? |
|---|---|
| Hoʻāʻo ale ʻia ʻo Barium | He hoʻāʻo X-ray kēia. Hāʻawi ʻia ʻoe i kahi wai keʻokeʻo ʻōniʻoniʻo i kapa ʻia ʻo barium e inu. I kou moni ʻana, lawe ʻia kahi wikiō X-ray e ʻike ai pehea e neʻe ai ka wai i lalo o kou esophagus. Hiki i kēia ke ʻike maopopo inā he poloka a i ʻole ka haʻahaʻa ma kekahi wahi. |
| Hoʻāʻo Endoscopy / EGD o luna | ʻO kēia ka hoʻāʻo maʻamau a pololei loa e ʻike ai i ka maʻi. Hāʻawi ʻia ʻoe i kahi mea hoʻomaha, a ua hoʻokomo ʻia kahi ʻōmole lahilahi a palupalu (kahi `endoscope`) me kahi kāmela liʻiliʻi i hoʻopili ʻia ma kou waha e nānā i kou esophagus, ʻōpū, a me ka hapa mua o kou ʻōpū liʻiliʻi. ʻAe kēia i ke kauka e ʻike i loko o kou esophagus ma kahi pale. Hiki ke ʻike ʻia kahi o ka poloka, kona kumu, a me ke ʻano o ka mumū. Inā pono, hiki ke lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo mai kahi wahi kānalua a hoʻouna ʻia i kahi keʻena hoʻokolohua no ka hoʻokolokolo ʻana (kahi `biopsy`). |
Pehea e mālama ʻia ai?
ʻO ka pahuhopu nui o ka mālama ʻana i kēia, ʻo ia ka hoʻonui hou ʻana i ka esophagus i paʻa i hiki iā ʻoe ke ale i ka meaʻai me ka ʻole o ka pilikia.
ʻO ka lāʻau lapaʻau nui: Hoʻonui ʻana i ka Esophageal
ʻO kēia ka lāʻau lapaʻau maʻamau. I ka ʻōlelo maʻalahi, pili ia i ka hoʻonui mālie ʻana i ka mea paʻa. E like me ka endoscopy, hoʻokomo ʻia kahi mea hana kūikawā (e like me ka scope a i ʻole cylinder) i loko o ka esophagus e hoʻonui mālie i ka mea paʻa. ʻAʻole hana ʻia kēia i ka manawa hoʻokahi, akā i nā manawa he nui i ka pule. Ke hoʻonui mālie ʻia ka haiki, e emi mālie ana kou paʻakikī i ka ale ʻana. He kūpono loa kēia lāʻau lapaʻau no nā mea paʻa maʻalahi.
Nā lāʻau lapaʻau ʻē aʻe
No kekahi mau ālai paʻakikī, a i ʻole i nā hihia i pane ʻole i ka mālama ʻana i ka dilation, pono paha e hoʻohana ʻia nā ʻano lapaʻau ʻē aʻe.
Āhea ʻoe e ʻike ai i ke kauka?
He mea nui loa ia e ʻike i kēia mau hōʻailona, no ka mea, ʻo ka wikiwiki o ka ʻike ʻia ʻana, ʻo ka maʻalahi ka mālama ʻana.
| I ka manawa hea e ʻimi ai i ke aʻo lapaʻau | |
|---|---|
| Nā kūlana maʻamau i ka wā e pono ai ʻoe e ʻike i ke kauka: | |
| E hele koke aku i ka Emergency Treatment Unit (ETU) o ka haukapila! | |
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