Chaw ei harsatna i nei em? Achalasia a ni thei ang em? Hemi chungchang hi han sawi ila!

I ei tur emaw, i in tur emaw chu i chaw kawng (esophagus)-ah a tlakbuak ang maiin i inhriat ngai em? A nih loh leh i rilru natna leh ei tur i rilruah a rawn chho leh tawh em? Hengte hi i nitin nunah a tithinur thei hle. Vawiin hian kan sawi dawn a, chutiang bawka symptoms nei thei, mahse a awm vak lo. Chu chu `Achalasia` (aka `Cardiospasm`) an tih dinhmun a ni.

`Achalasia` chu eng nge ni? A awlsam zawngin i hrethiam ang u!

A awlsam zawngin sawi ila, `Achalasia` hi thil awm lo tak a ni a, kan ka atanga kan pum thlenga chaw phurtu tube kan esophagus hian hna a thawk tha lo. Kan chaw kawng hi tube mai a ni lo tih i hria em? Muscle atanga siam tube a ni. Thil kan ei hian heng ruhte hi a inzawm khawm (wave ang maiin) a, chaw chu a hnuai lamah a nawr thla thin. Hetiang kalphung hi `(Perstalsis)` kan ti a.

Tunah chuan chaw kawng hnuai ber, chaw kawng chhunga chaw a luhna hmunah hian kawngkhar ang maia thau zungbun (ring of muscle) a awm tih han ngaihtuah teh. Hei hi ``Lower Esophageal Sphincter`` emaw ``LES`` emaw an ti a.A tlangpuiin he ``LES`` hi ei tur a hnaih chuan a inhawng (relax) a, ei tur chu pum chhungah a kal lut thei a ni. Tichuan a khar leh a, chaw kawng chhunga thil awmte chu chaw kawng chhunga a rawn chho leh loh nan a titawp ta a ni.

Mahse, `Achalasia` nei mi pakhatah chuan he kalphung hi a buai hle.

1. Digestive tract-a peristalsis ang deuha chetna hi a thleng dik lo a, a chak lo hle bawk.

2. Chu kawngkhar `LES` an tih chu ei tur a lo thlen chuan a inhawng tha lo. A tang tlat mai.

Chuti a nih chuan eng nge thleng? I ei leh in te chu i chaw kawng chhungah a tang a, i pum chhungah a lut lo. Hei hian ei harsa a ti a, rilru a ti na a, ei tur chu i rilruah a rawn chho leh thin. Hun a kal zel a, taksain ei tur a hmuh tlem avangin taksa rihna a tlahniam thei a, ei leh in lama harsatna a nei thei bawk .

`Achalasia` hi natna tlanglawn tak a ni lo. America ang ramah chuan mi sang za zinga pakhat vel a nghawng a ni. Kum upa lam, kum 25 leh 60 inkar te a nghawng tlangpui a, mahse, a chang chuan naupang te te pawhin he natna hi an nei thei bawk.

`Achalasia` natna lan chhuah dan chu engte nge ni? Engtin nge a hriat chhuah?

`Achalasia` symptoms hi a lang nghal lo. A tam zawkah chuan zawi zawiin an lo thang lian thin. Thla tam tak emaw, kum tam tak emaw chhung chu a danglamna chu i hre lo mai thei. A lan chhuah dan tlangpui chu:

• Chaw ei harsa (Dysphagia): Hei hi a lan chhuahna ber a ni. Chaw solid ei hmasak a harsa thei a, chutah chuan tui ei a harsa thei bawk.
• Regurgitation: Hei hi luak chhuak nen a inang lo va, mahse chaw ei loh chu rilruah a rawn chho leh thin. Hei hi a bik takin zanah mut laiin a thleng thei.
• Chest pain: Sudden, a chang chuan na tak, rilru natna hi a nasat em avangin heart attack anga ngaih theih a ni.
• Bathroom pan harsat.
• Heartburn: Mahse hei hi normal gastritis inflammation nen a danglam thei.
• Hiccups a ni.
• Sawifiah loha taksa rihna tlahniam: Taksain ei tur a lakluh that loh avangin hun kal zelah taksa rihna tlahniam a awm thin.

Hun kal zelah heng symptoms te hi a na zual zel tih hre reng la, chuvangin a danglamna tlemte pawh i hmuh chuan doctor lam pan a pawimawh hle.

Eng thilin nge `Achalasia` hi a thlen?

Dik tak chuan mithiamte chuan achalasia awm chhan dik tak hi an la hre lo. Mahse, theory lian ber pakhat a awm. Chu chu autoimmune disease a ni tihna a ni a, keimahni immune system hian kan taksa cell ngei a bei tihna a ni. He theory ang hian hetiang hi a thleng thin:

1. Kan immune system hi virus ang chi thilin a tichak a.

2. Mahse, tihsual palh takin he immune system hian kan esophagus-a muscle activity control tu nerve cells te chu a bei tan ta a ni.

3. Heng nerve cell te hi a chhe zauh zauh a.

4. Tichuan chaw kawng (esophagus) hnuai lama ei tur nawr chhuaktu movement (peristalsis) leh LES hawnna chu a thleng dik lo.

Hei hi tuna ngaihdan pawm a ni a, mahse zirchianna dang neih belh zel a ni.

`Achalasia` avanga harsatna awm thei te chu engte nge ni?

Achalasia-ah chuan ei tur chu chaw kawng chhungah a tang a, chu chuan a rilruah a rawn chho leh thei a, a chang chuan thlipui chhungah a rawn lut leh thei bawk. Hetiang a nih chuan harsatna chi hrang hrang a thlen thei a ni. Entir nan:

• Aspiration pneumonia: Chuap chhunga ei tur a luh avanga pneumonia natna.
• Bronchiectasis: Chuap chhunga thawkna kawng a chhiat.
• Lung natna a awm.
• Esophageal cancer vei theihna a sang: He risk hi chaw ei tur kawngkhar chhunga rei tak a awm vang leh a inflammation vang a ni.
• Malnutrition: Hei hi taksaa ei tur tlakchham vang a ni.

Chuvangin Achalasia natna hi hriatchhuah leh enkawl vat a pawimawh hle.

Engtin nge doctor-te hian `Achalasia` hi an hriat chhuah?

A chunga kan sawi tak symptoms i neih chuan Doctor i hmuh hunah i symptoms te, eng chen nge a awm tawh tih te, etc. te an zawt ang che a, chutah chuan taksa enfiahna an nei ang. Achalasia natna hriat chian nan hian test lian pathum hman a ni a, chungte chu:

1. Esophagram (Barium Swallow): He test-ah hian tui in tur barium an tih chu pek i ni. Chumi hnuah chuan X-ray an la a, ei tur chu chaw kawng hnuai lam a kal dan an enfiah a ni. Achalasia i neih chuan esophagus a hring a, LES a inhawng tha lo.

2. Esophageal manometry test neih dan tur: 1.1.Chutah chuan hnar kaltlangin tube te tak te chu chaw kawng chhungah dahin chaw kawng ruhte inzawmkhawm dan leh `LES` pressure tehna a ni. `Achalasia` ah chuan `LES` pressure a sang a, chaw kawng (esophagus) a che thei lo (peristalsis) tih hmuhchhuah theih a ni. Hei hi `Achalasia` hriat theihna atana test tha ber a ni.

3. Upper endoscopy: Tube te tak te, flexible tak, camera vuah chu ka kaltlangin esophagus leh pum chhungah dahin a chhung lam en theih a ni. Hei hian chaw kawng chhunga harsatna dang (cancer ang chi) a awm leh awm loh enfiah nan a pui thei bawk. A chang chuan biopsy, tissue te tak te te chu enfiah nan lak theih a ni.

`Achalasia` enkawl dan tur chu engte nge ni?

Achalasia enkawlna tum ber chu chaw kawng hnuai lama LES muscle tih hahdam a, ei tur chu pum chhungah a kal theih nan a ni. Heng enkawlnate hian achalasia , a tidam kim thei lo va , mahse a natna lan chhuah dan a thunun thei a, nun a ti awlsam thei bawk. I doctor chuan i natna lan chhuah dan te, i kum te, leh i duhzawng te chu a ngaihtuah ang a, enkawlna tha ber a ruat ang.

Nonsurgical hmanga enkawl a ni

• Balloon dilation: Hetah hian endoscopy ang chi esophagus kaltlangin balloon bik chu LES awmna hmunah an kalpui a, balloon chu an inflated a ni. Tichuan, tight muscle ring chu a inzawm khawm a, a relax deuh bawk. Hei hian ei tur kal tlang theihna tur kawng a siam a ni. Hei hi light anesthesia hmanga tih a ni. He enkawlna hi vawi tam tak tih nawn leh a ngai mai thei.
• Damdawi: LES ti hahdam thei damdawi thenkhat a awm.
• Botox® (botulinum toxin) injection: Botox hi endoscopy hmangin LES chhungah inject a ni. Hei hian hun engemaw chen chu ruh chu a ti paralyze a, a ti relax bawk. Mahse, a nghawng chu thla engemaw zat chauh a awm a, tih nawn leh a ngai a ni.
• Tablet te chu `Nifedipine` (`Procardia XL®`, `Adalat CC®`) emaw `Isosorbide` (`Imdur®`, `Monoket®`) emaw a ni. Chungte chu chaw ei hmaa ei tur a ni a, `LES` tih hahdam tur a ni. Mahse, hengte hian mi zawng zawng tan hna a thawk lo va, side effect a nei thei bawk.

Surgery hmanga enkawl a ni

LES tih hahdam nan hian surgical procedure engemaw zat a awm a. Hengte hi incision lian tak nei lovin, incision tenau (`Laparoscopic` / `Minimally invasive`) hmangin an ti fo thin.

• Laparoscopic Heller myotomy: Hei hi surgery neih tam ber a ni. Hetah hian endoscope ang chi instrument pakhat chu pum chhunga incision te te hmangin dahin LES-a muscle fibers te chu an tan a (myotomy tih awmzia chu muscle cut tihna a ni). Hei hian LES chu a ti relax a ni. Vawi tam tak chu fundoplication an tih pawh hi tih a ni a, chu chu chaw kawng chunglam chu chaw kawng chhungah khuh a, chu chuan chaw kawng chhunga acid reflux (GERD) a tihtlem phah a ni.
• Peroral endoscopic myotomy (POEM): Hei hi tih dan thar a ni. Hetah hian endoscope chu ka chhungah dahin, chaw kawng lining hnuaiah a lut a, LES ruh chu a tikehsawm a ni. Hei hian pawn lam atanga incision a ngai lo.

A tlem hle a, symptoms a nasat em em a, enkawlna dangin a hlawhtlin loh chuan i doctor chuan esophagus pumpui (esophagectomy) chhuah vek tura operation neih a rawt thei ang.

Enkawlna avanga harsatna awm thei

Laparoscopic Heller myotomy leh POEM surgery te hi a hlawhtling hle. Mahse, harsatna thenkhat a awm thei a:

• `Achalasia` natna lan chhuah lehna.
• GERD (Gastroesophageal reflux disease) (a bik takin Heller myotomy hnua fundoplication tih a nih loh chuan).
• A tlem hle, operation laiin chaw kawng (esophagus) perforation.

`Achalasia` i neih chuan eng nge i beisei theih ang?

Achalasia symptoms hi a chang chuan enkawl hnuah pawh a lo lang leh thei. Chuvangin hun rei tak chhung damdawi lam enkawlna (`follow-up`) neih a pawimawh hle. I doctor chuan a check fo ang che:

• Chaw leh tui te chu chaw kawng (esophagus) kaltlangin pum chhungah a kal tha em tih enfiah thin a ni.
• GERD chhinchhiahna a awm leh awm loh enfiah thin ang che.
• Esophageal cancer chhinchhiahna hmasa berte enfiah thin ang che (he risk hi achalasia nen chuan a sang deuh hlek).

Achalasia hi enkawl loh chuan ei leh in lama harsatna a thlen thei a, nunna atana hlauhawm tak a ni thei bawk. Mahse, enkawl dan dik a nih chuan achalasia nei lo chu dam chhung pangngaiin a nung thei a ni.

Engtin nge ka in enkawl ang?

`Achalasia` tih natna neia i nun hian ei leh in tur awlsam zawka chaw kawng kaltlanga kalpui theihna tur leh natna lan chhuah dan tur enkawl dan tur thil engemaw zat i tih theih a ni:

• Chaw chu a te tein then la, uluk takin chew rawh.
• Chaw ei laiin tui tam tak in thin ang che. Hei hian chaw chu a ti hnim ang a, awlsam zawkin a tlahniam thei bawk ang.
• Thut ding chungin chaw ei rawh. Hei hian gravity chu chaw chu a hnuai lam pan turin a pui ang.
• Mut hma darkar thum atanga darkar li chhunga solid foods ei loh tur. Hei hian i pumin i mut hmain chaw ei tur chu a ei theih nan hun a pe ang.
• I mut dawnin i lu hnuaiah extra pillow dah la. I lu chawi sang reng chuan chaw kawng atanga ei tur chu thlipui chhunga a luh theihna tur a tihtlem phah ang.

`Achalasia` i neih chuan eng ei tur nge ei loh tur?

Achalasia hian chaw chu chaw kawng (esophagus) kal tlang a tiharsa avangin ei tur thenkhat chuan natna lan chhuahna a ti na zual thei a ni. A bik takin hetiang ei tur hi fimkhur rawh:

• Chaw ei kawng tikhawlo thei ei tur: Entirnan, apple hrual loh, grape, thlai raw, fibrous emaw sa hring emaw.
• Chaw ei tur thick thei leh esophagus-a awm khawm thei: Entirnan, chhang (a bik takin chhang var), buhfai var, alu, chips, leh pasta.
• Hlohna tithinur thei ei tur: Entirnan, chaw tui tak, carbonated drinks, leh zu in tur te.

Heng chawte hian mi zawng zawng a nghawng dan inang vek lo. Eng ei tur nge i tan harsa tih chu experience hmangin nangmah ngeiin i ngaihtuah chhuak tur a ni.

Engtikah nge Doctor ka hmuh ang?

I taksaah inthlak danglamna thar i hmuh chuan, a bik takin Achalasia chhinchhiahna thar, ei harsa tih ang chi i hmuh chuan doctor pan nghal rawh.

Achalasia hi thil awm lo tak a ni a, hun kal zelah a symptoms a lo lang zauh zauh thin. A lan chhuah dan chu thinlung natna atanga hiccups thlengin ei harsa thlengin a awm thei. Chuvângin, heng chhinchhiahna zawng zawng hi natna pakhat nêna inzawm vek niin i ngai nghâl lo mai thei.

Mahse, natna lan chhuahna awm reng reng reng, inzawmna nei lo anga lang pawh ni se, doctor nen inbiakna neih a pawimawh hle. Achalasia hi enkawlna hrang hrang a awm a. I doctor chuan enkawlna tinte chu a hrilhfiah thei che a, i tana ṭha ber tur thlang turin a pui thei che a ni. Ngaihtuah buai suh, i natna hmuhchhuah leh enkawl hmasak i nih chuan i dinhmun hi i enkawl tha thei ang.

Thupui tawi (Take-Home Message) 1.1.

`Achalasia` hi chaw kawng hnuai lam ruhte a thawk tha lo va, chaw ei tur chu pum chhungah a kal thei lo. A lan chhuah dan chu ei harsa, rilru na, leh ei tur chu rilru chhunga lut te a ni. Hei hi hriat theih nan test bik a awm bawk. Enkawlna hrang hrangah chuan taksa ruhte chu balloon hmanga tihzauh te, damdawi te, operation te a ni. Damdawi famkim awm lo mah se, a natna lan chhuah dan chu uluk taka thunun theih a ni a, nun pangngaiin i nung thei a ni. Heng symptoms te hi i neih chuan doctor thurawn la hreh suh. I hriselna chu i kutah a awm!

` Achalasia, Cardiospasm, Chaw ei harsa, Esophagus, LES, Dysphagia, Esophageal Manometry te a ni