Yu gɛt prɔblɛm fɔ swɛla? Yu tink se i kin bi Achalasia? Lɛ wi tɔk bɔt dis!

Yu dɔn ɛva fil lɛk se yu it ɔ drink dɔn stɔp na yu ɛsophagus? Ɔ yu dɔn gɛt pen na yu chɛst ɛn it de kam bak na yu trot? Dɛn tin ya kin rili vɛks pan yu ɛvride layf. Tide wi go tɔk bɔt wan sik wae kin mek yu gɛt dis kayn sik, bɔt nɔr kin bɔrku. Dat na wan kכndyushכn we dεn kכl `Achalasia` (we dεn kin kכl `Cardiospasm`).

Wetin na `Achalasia`? Lɛ wi ɔndastand am simpul wan!

Fɔ tɔk am simpul wan, `Achalasia` na wan sik we nɔ kin apin so ɔltɛm we wi εsophagus, di tiub we de kɛr it frɔm wi mɔt to wi bɛlɛ, nɔ de wok fayn. Yu no se wi εsophagus nɔto jɔs tyub? Na tiub we dɛn mek wit mɔsul dɛn. We wi swɛla sɔntin, dɛn mɔsul dɛn ya kin kɔntrakt (lɛk wev) ɛn push di it dɔŋ. Wi kin kɔl dis prɔses `(Peristalsis)`.

Naw imajin se na di bottom pat na di εsophagus, usay it de go insay di bɛlɛ, wan ring we gɛt mɔsul de we tan lɛk get. dis dεn kכl am di ``Lower Esophageal Sphincter`` כ ``LES.`` nכmal wan, we it kam nia dis ``LES``, i de opin (rilaks) εn alaw di it fכ pas insay di bεlε. Dɔn i kin lɔk bak, ɛn i kin mek di tin dɛn we de insay di bɛlɛ nɔ kam bak ɔp insay di εsophagus.

Bɔt pan pɔsin we gɛt `Achalasia`, dis prɔses kin ambɔg.

1. di muvmεnt we lεk pεristalsis na di dijestiv trakt nכ de apin fayn, כ i rili wik.

2. Dat doa we dem kol `LES` no de opin fain wen di fud kam. I dɔn stɔp.

So wetin kin apin? Di tin dɛm we yu de it ɛn drink kin stɔp na yu εsophagus, nɔ kin go insay yu bɛlɛ. Dis kin mek i nɔ izi fɔ swɛla, yu chɛst kin pen, ɛn it kin kam bak ɔp na yu trot. As tɛm de go, di bɔdi kin lɔs in wet ɛn gɛt prɔblɛm wit di tin dɛn we i nid bikɔs i nɔ kin gɛt inof it.

`Achalasia` nɔto sik we kin rili kɔmɔn. Insay kɔntri lɛk Amɛrika, i kin afɛkt lɛk wan pan ɛvri ɔndrɛd tawzin pipul dɛn. Bɔrku tɛm e kin afɛkt pipul dɛm wae dɔn ol, bitwin 25 ɛn 60. Bɔt sɔmtɛm, yɔŋ pikin dɛm kin gɛt dis sik bak.

Wetin na di sayn dɛm fɔ `Achalasia`? Aw dɛn kin no se i gɛt am?

Di sayn dɛm fɔ `Achalasia` nɔ kin apia wantɛm wantɛm. Bɔku tɛm, dɛn kin divɛlɔp smɔl smɔl. Yu nɔ go notis di difrɛns fɔ sɔm mɔnt ɔ ia. De men sayn wae yu kin si na:

• I nɔ kin izi fɔ swɛla (Dysphagia): Dis na di men sayn. I kin at fɔ swɛla sɔlid it dɛn fɔs, ɛn afta dat i kin swɛla wata.
• Rigurgitation: Dis nɔto di sem tin wit fɔ vɔmit, bɔt it we yu nɔ digest kin kam bak ɔp na di trot. Dis kin apin mɔ na nɛt we yu de slip.
• Chɛst pen: Wantɛm, sɔmtɛm i kin tranga, pen na di chɛst kin so bad dat dɛn kin tink se na at atak.
• I nɔ izi fɔ go na di bafa.
• At-bɔn: Bɔt dis kin difrɛn frɔm di inflamɛns we nɔmal gastritis kin gɛt.
• Hiccups we pɔsin kin gɛt.
• We yu nɔr ɛksplen to yu wet: We yu de lɔs yu wet as tɛm de go bikɔs di bɔdi nɔ de tek di it fayn fayn wan.

Mɛmba se dɛn sik ya kin wɔs as tɛm de go, so i impɔtant fɔ go to dɔktɔ if yu notis ivin smɔl chenj.

Wetin de mek `Achalasia`?

Infakt, masta sabi pipul dɛn stil nɔ no di rayt tin we kin mek pɔsin gɛt achalasia. Bɔt wan men tin de we dɛn kin tɔk bɔt. Dat min se na ɔtoimyun sik, we min se wi yon imyun sistɛm de atak wi yon bɔdi in yon sɛl dɛn. Frɔm wetin dis tiori se, sɔntin lɛk dis kin apin:

1. Na sɔntin lɛk vayrɔs de mek wi imyun sistɛm wok.

2. כltu, bay mistek, dis imyun sistεm de bigin fכ atak di nεv sεl dεm we de kכntro di mכsul dεm we de wok na wi εsophagus.

3. Dɛn nεv sɛl ya de pwɛl smɔl smɔl.

4. afta dat di muvmεnt (peristalsis) we de push it dכn di εsophagus εn di opin fכ di LES nכ de apin fayn fayn wan.

Dis na di we aw pipul dɛn de tink naw, bɔt dɛn de du mɔ risach.

Wetin na di pɔsibul kɔmplikeshɔn dɛm fɔ `Achalasia`?

Wit achalasia, it kin stכp na di εsophagus, we kin mek i kam bak כp insay di trot εn sכmtεm insay di windpaip. If dis kin apin, i kin mek difrɛn prɔblɛm dɛn. Fɔ ɛgzampul:

• Aspiration pneumonia: Na wan sik wae de kam wit nyumonia wae de kam wae it de go insay di lכng.
• Bronchiectasis: I kin pwɛl di say dɛn we di briz de blo na di lɔng dɛn.
• Infεkshכn dεm na di lכng.
• di risk fɔ gɛt kansa na di εsophageal we de go ɔp: Dis risk de go ɔp bikɔs di it de stɔp na di εsophagus fɔ lɔng tɛm ɛn inflamɛns.
• Malnutrishɔn: Dis kin bi bikɔs i nɔ gɛt bɛtɛ tin fɔ it na di bɔdi.

Na dat mek i impɔtant fɔ no ɛn trit Achalasia kwik kwik wan.

Aw dɔktɔ dɛn kin no if pɔsin gɛt `Achalasia`?

If yu gɛt di sayn dɛm wae wi bin dɔn tɔk bɔt, we yu go to dɔktɔ, dɛn go aks yu bɔt yu sik dɛm, aw lɔng dɛn dɔn de, ɛn ɔda tin dɛm Dɔn dɛn go du wan bɔdi ɛgzam. Dɛn kin yuz tri men tɛst fɔ no if pɔsin gɛt achalasia:

1. Esophagram (Barium Swallow): Insay dis tɛst, dɛn kin gi yu wan wata we dɛn kɔl barium fɔ drink. Dɔn dɛn kin tek ɛkstrem rayt fɔ si aw di it de muv dɔŋ di εsophagus. If yu gɛt achalasia, di εsophagus dɔn swel ɛn di LES nɔ de opin fayn.

2. Tεst fכ di εsophageal manometry:insay dis, dεn de put wan tכn tכb tru di nos insay di εsophagus εn di we aw di mכsul dεm na di εsophagus de kכntrakt εn dεn de mכsu di prεshכn fכ di `LES`. insay `Achalasia`, di prεshכn fכ di `LES` de hכy, εn dεn kin fכnshכn se nכ muvmεnt de fכ di εsophagus (peristalsis). Dis na di bɛst tɛst fɔ no if pɔsin gɛt `Achalasia`.

3. כp εndoskopi: dεn de put wan tin, fleksibul tכb wit kεmεra we dεn atak tru di mכt insay di εsophagus εn bεlε fכ luk insay. Dis kin ɛp bak fɔ chɛk fɔ ɔda prɔblɛm dɛn na di εsophagus (lɛk kansa). Sɔntɛnde, dɛn kin tek bayɔpsi, we na smɔl pat pan di tisu fɔ mek dɛn chɛk am.

Wetin na di tritmɛnt dɛm fɔ `Achalasia`?

di men gol fכ tritmεnt fכ achalasia na fכ rilaks di LES mכsul na di bכtכm pat pan di εsophagus, fכ mek it pas insay di bεlε. Dɛn tritmɛnt ya nɔ kin ebul fɔ mɛn achalasia , bɔt dɛn kin kɔntrol di sayn dɛm ɛn mek layf izi. Yu dɔktɔ go tink bɔt yu sik dɛn, yu ej, ɛn wetin yu lɛk fɔ no di bɛst tritmɛnt we yu go yuz.

Tritmɛnt we nɔto ɔpreshɔn

• balכn dilayshכn: insay dis, dεn de pas wan spεshal balכn tru di εsophagus, we lεk εndoskopi, to di εria we di LES de, εn di balכn de inflate. Dɔn, di tayt mɔsul ring kin strɛch ɛn rilaks smɔl. Dis kin mek wan rod fɔ mek it pas. Dɛn kin du dis ɔnda layt anestezi. Dis tritmɛnt kin nid fɔ ripit bɔku tɛm.
• Mɛrɛsin: Sɔm mɛrɛsin dɛn de we kin mek di LES rilaks.
• Botox® (botulinum toxin) injεkshכn: dεn injεkt bכtoks insay di LES tru εndoskopi. Dis kin mek di mɔsul paralayz ɛn rilaks fɔ sɔm tɛm. Bɔt di ifɛkt kin las fɔ sɔm mɔnt nɔmɔ ɛn i fɔ ripit am.
• Tablɛt dɛn lɛk `Nifedipine` (`Procardia XL®`, `Adalat CC®`) ɔ `Isosorbide` (`Imdur®`, `Monoket®`). Dɛn fɔ tek dɛn tin ya bifo yu it ɛn rilaks di `LES`. Bɔt dɛn tin ya nɔ kin wok fɔ ɔlman ɛn dɛn kin gɛt sayd ɛfɛkt.

Ɔspitul tritmɛnt

Bɔku ɔpreshɔn dɛn de we dɛn kin du fɔ mek di LES rilaks. Bɔku tɛm dɛn kin du dɛn tin ya we dɛn nɔ kɔt big say, tru smɔl smɔl say dɛn we dɛn kɔt (`Laparoscopic` / `Minimally invasive`).

• Laparoscopic Heller myotomy: Dis na di ɔpreshɔn we dɛn kin du mɔ. insay dis, dεn de put wan instrכmεnt, we lεk εndoskop, tru sכm sכm say dεm na di bכdi εn dεn kכt di mכsul fayb dεm na di LES (myotomy min fכ kכt di mכsul). Dis de rilaks di LES. כltu, dεn kin du wan prכsidכs we dεn kכl fכndoplikεshכn bak, we involv fכ rap di כp pat pan di bεlε rawnd di εsophagus fכ ridyus di rεfluks fכ di bεlε asid insay di εsophagus (GERD).
• Peroral endoscopic myotomy (POEM): Dis na nyu we fɔ du tin. insay dis, dεn de put εndoskop tru di mכt, go כnda di layn na di εsophagus, εn kכt di mכsul na di LES. Dis nɔ nid fɔ mek dɛn kɔt am na do.

Na smɔl tɛm nɔmɔ, if di sayn dɛn rili bad ɛn ɔda tritmɛnt dɛn nɔ wok, yu dɔktɔ kin tɛl yu fɔ du ɔpreshɔn fɔ pul di wan ol ɛsophagus (we dɛn kin pul ɛsophagectomy).

Di prɔblɛm dɛn we kin apin we pɔsin de trit am

Laparoscopic Heller myotomy ɛn POEM ɔpreshɔn dɛn kin rili wok fayn. Bɔt sɔm prɔblɛm dɛn kin apin:

• Riappearance of `Achalasia` simptom dɛm.
• GERD (Gastroesophageal reflux disease) (especially if dεn nכ du fundoplication afta Heller myotomy).
• Na rεli, pεrforeshכn na di εsophagus we dεn de du כpεrayshכn.

Wetin yu kin ɛkspɛkt if yu gɛt `Achalasia`?

Sɔntɛnde, di sayn dɛm fɔ achalasia kin kam bak ivin afta dɛn dɔn trit am. fכ dat, fכ mεdikal monitarin fכ lכng tεm (`fכlכ-ap`) rili imכtant. Yu dɔktɔ go de chɛk yu ɔltɛm:

• dεn de du tεst fכ mek sכh se it εn wata de pas tru di εsophagus insay di bεlε fayn fayn wan.
• Chek fɔ sayn dɛm fɔ GERD.
• Chek fɔ di fɔs sayn dɛm fɔ εsophageal kansa (dis risk kin bɛtɛ smɔl wit achalasia).

If dɛn nɔ trit am, achalasia kin mek i nɔ gɛt bɛtɛ tin fɔ it ɛn i kin mek pɔsin in layf de pan denja. Bɔt if dɛn trit am fayn, pɔsin we nɔ gɛt achalasia kin liv nɔmal layf.

Aw a kin kia fɔ misɛf?

We yu de liv wit wan sik we dɛn kɔl `Achalasia`, sɔm tin dɛn de we yu kin du fɔ ɛp fɔ pas it ɛn drink tru di εsophagus izi wan ɛn manej di simptom dɛm:

• Kɔt it smɔl smɔl ɛn chew am fayn fayn wan.
• Drink plɛnti wata we yu de it. Dis go mek di it wet ɛn ɛp am fɔ go dɔŋ izi wan.
• It we yu sidɔm stret. Dis go ɛp di graviti fɔ mek di it go dɔŋ.
• Nɔ it tin dɛn we strɔng tri to 4 awa bifo yu go slip. Dis go gi yu bɛlɛ tɛm fɔ dayjɛst di it bifo yu slip.
• Kip wan ekstra pilo ɔnda yu ed we yu de slip. If yu kip yu ed ɔp, i go ɛp fɔ ridyus di chans fɔ mek it frɔm di εsophagus go insay di winda.

Us it dɛn yu fɔ avɔyd if yu gɛt `Achalasia`?

Bikɔs achalasia kin mek i nɔ izi fɔ mek it pas na di εsophagus, sɔm it dɛn kin mek di sik dɛn wɔs. Tek tɛm mɔ wit it dɛn lɛk dɛn tin ya:

• Fɔd dɛn we kin blok di εsophagus: Fɔ ɛgzampul, apul we dɛn nɔ pul, greps, raw vɛjitebul, mit we gɛt fayv ɔ dray.
• Fɔd dɛn we kin tik ɛn gɛda na di εsophagus: Fɔ ɛgzampul, bred (especially wayt bred), wayt rays, potato, chips, ɛn pasta.
• Fɔ it dɛn we kin mek pɔsin in trot vɛks: Fɔ ɛgzampul, it dɛn we gɛt spays, drink dɛn we gɛt kabon, ɛn drink dɛn we gɛt rɔm.

Dɛn it ya nɔ kin afɛkt ɔlman di sem we. Yu fɔ fɛnɔt fɔ yusɛf tru ɛkspiriɛns us it dɛn we at fɔ yu.

Ustɛm a fɔ go to dɔktɔ?

If yu notis ɛni nyu chenj na yu bɔdi, mɔ di nyu sayn dɛm fɔ Achalasia, lɛk fɔ at fɔ swɛla , go to dɔktɔ wantɛm wantɛm.

Achalasia na wan sik wae nɔr kin bɔrku wae de sik kin kam smɔl smɔl as tɛm de go. Di sayn dɛm kin kɔmɔt frɔm at we de bɔn to hiccups to we i nɔ izi fɔ swɛla. So yu nɔ go tink wantɛm wantɛm se ɔl dɛn sayn ya gɛt fɔ du wit wan sik.

Bɔt i impɔtant fɔ tɔk to dɔktɔ bɔt ɛni sayn we de kɔntinyu fɔ de, ilɛksɛf i tan lɛk se dɛn nɔ gɛt natin fɔ du wit am. Bɔku tritmɛnt dɛn de fɔ achalasia. Yu dɔktɔ kin ɛksplen to yu ɛni tritmɛnt ɛn ɛp yu fɔ pik di wan we go fayn fɔ yu. Nɔr wɔri, if dɛn no bɔt yu ɛn trit yu kwik, yu kin ebul fɔ manej de sik fayn fayn wan.

Sɔma (Mɛsej we dɛn kin tek go na os) .

`Achalasia` na wan kכndyushכn we di mכsul dεm na di lכw pat pan di εsophagus nכ de wok fayn, we de mek it nכ pas insay di bεlε. Di sayn dɛm na we i nɔ kin izi fɔ swɛla, i kin fil pen na in chɛst, ɛn it kin go na di trot. Spɛshal tɛst dɛn de fɔ no bɔt dis. Di tritmɛnt dɛn na fɔ mek di mɔsul dɛn big wit balyɔn, fɔ tek mɛrɛsin, ɛn fɔ ɔpreshɔn. Pan ɔl we nɔr de kɔmplit mɛrɛsin, yu kin kɔntrol di sayn dɛm fayn fayn wan ɛn yu kin liv nɔrmal layf. If yu gɛt dɛn sik ya, nɔ shem fɔ go to dɔktɔ. Yu wɛlbɔdi de na yu an!

` Achalasia, Kadiospasm, I nɔ izi fɔ swɛla, Ɛsophagus, LES, Disfagia, Ɛsophageal Manometry