He uaua ki te horomi? Tērā pea ko te 'Akalasia'? Me kōrero tāua mō tēnei!

Kua rongo koe i te mea kei roto i tō korokoro tō kai, tō inu rānei? Kua pāngia rānei koe e te mamae o te uma, ā, ka hoki mai te kai ki roto i tō korokoro? He tino hoha ēnei i roto i tō oranga o ia rā. I tēnei rā ka kōrero tātou mō tētahi mate ka puta ai ngā tohu rite, engari kāore i te tino noa. He mate e kiia nei ko te 'Achalasia' (arā, ko te 'Cardiospasm').

He aha te 'Akalasia'? Kia mārama tātou!

Ki te kī māmā noa, he mate onge te `Akalasia` e kore ai e mahi tika tō tātou korokoro, te ngongo e kawe ana i te kai mai i tō tātou waha ki tō tātou puku. I mōhio koe ehara tō tātou korokoro i te ngongo noa iho? He ngongo i hangaia mai i ngā uaua. Ina horomia e tātou tetahi mea, ka whakawhāiti ēnei uaua (pēnei i te ngaru) ka pana i te kai ki raro. Ka kiia tēnei tukanga ko `(Peristalsis)`.

Whakaarohia i te pito rawa o te korokoro, te wāhi e tomo ai te kai ki te puku, he mowhiti uaua e rite ana ki te kuaha. Ko te ingoa o tēnei ko te "Lower Esophageal Sphincter" ko te "LES" rānei. I te nuinga o te wā, ina tata te kai ki tēnei "LES", ka tuwhera (ka whakangā) ka tukuna te kai kia haere ki roto i te puku. Kātahi ka kati anō, ka aukati i ngā ihirangi o te puku kia hoki ake ki roto i te korokoro.

Heoi, mō te tangata e pāngia ana e te `Akalasia`, ka whakararuraruhia tēnei tukanga.

1. Kāore te nekehanga rite ki te peristalsis i roto i te ara nakunaku e tupu tika ana, e ngoikore rawa rānei.

2. Kāore te tatau e kiia nei ko `LES` e tuwhera tika ana ina tae mai te kai. Kua mau.

Nā, he aha te mea ka tupu? Ka piri ngā mea e kainga ana e koe, e inu ana koe ki roto i tō korokoro, kāore e uru ki roto i tō puku. Ka uaua te horomi, ka mamae te uma, ā, ka hoki mai te kai ki roto i tō korokoro. I roto i te wā, ka taea e te tinana te whakaiti i tōna taumaha me te whakawhanake i ngā ngoikoretanga kai nā te mea kāore e nui te kai e whiwhi ana.

Ehara te 'Akalasia' i te mate tino noa. I tētahi whenua pērā i Amerika, kotahi i roto i te kotahi rau mano tāngata e pāngia ana. Ko te nuinga o te wā ka pāngia ngā kaumātua, i waenga i te 25 me te 60 tau te pakeke. Heoi, i ētahi wā ka pāngia hoki ngā tamariki nohinohi e tēnei mate.

He aha ngā tohu o te 'Akalasia'? Me pēhea te tautuhi i tōna mate?

Kāore ngā tohu o te 'Akalasia' e puta ohorere mai. I te nuinga o te wā, ka āta haere te whanaketanga. Tērā pea kāore koe e kite i te rerekētanga mō ngā marama, mō ngā tau rānei. Ko ngā tohu matua ka kitea ko:

• Te uaua ki te horomi (Dysphagia): Koinei te tohu matua. Tērā pea he uaua ki te horomi i ngā kai mārō i te tuatahi, kātahi ka horomi i ngā wai.
• Te ruaki: Kāore tēnei i rite ki te ruaki, engari ka hoki mai te kai kāore anō kia nakunaku ki roto i te korokoro. Tērā pea ka puta tēnei i te pō i a koe e moe ana.
• Mamae o te uma: Ka taea e te mamae ohorere o te uma, engari i ētahi wā he kino rawa, te mamae o te uma, ā, ka taea te whakaaro he mate manawa.
• Te uaua ki te mimi.
• Te ngaunga o te uma: Engari he rerekē pea tēnei i te mumura o te gastritis noa.
• Ngā hīkoi.
• Te whakahekenga taumaha kāore i te mārama: Ka puta te whakahekenga taumaha i roto i te wā nā te mea kāore te kai e mimiti tika ana e te tinana.

Kia maumahara, ka kino haere ēnei tohu i te roanga o te wā, nō reira he mea nui kia rapu tohutohu hauora mēnā ka kite koe i tētahi panoni iti noa iho.

He aha te take o te 'Akalasia'?

Ina hoki, kāore anō kia mōhiotia e ngā tohunga te tino take o te achalasia. Heoi, kotahi te ariā matua. Arā, he mate pūnaha ārai mate tēnei, arā, ka whakaekea e tō tātou ake pūnaha ārai mate ngā pūtau o tō tātou ake tinana. E ai ki tēnei ariā, ka puta tētahi mea pēnei:

1. Ka whakahohehia tō tātou pūnaha ārai mate e tētahi mea pērā i te huaketo.

2. Heoi, nā te hē, ka tīmata tēnei pūnaha ārai mate ki te whakaeke i ngā pūtau io e whakahaere ana i te mahi uaua i roto i tō tātou korokoro.

3. Kei te whakangaromia haeretia ēnei pūtau io.

4. Kātahi ka kore e tika te nekehanga (peristalsis) e pana ana i te kai ki raro i te korokoro me te whakatuwheratanga o te LES.

Koinei te tirohanga e whakaaetia ana i tēnei wā, engari kei te whakahaerehia he rangahau anō.

He aha ngā raruraru pea ka pā mai i te 'Akalasia'?

Mō te achalasia, ka mau te kai ki roto i te korokoro, ka hoki ake ai ki roto i te korokoro, ā, i ētahi wā ki roto i te puku o te manawa. Mēnā ka tupu tēnei, ka puta he maha ngā raruraru. Hei tauira:

• Pūkahukahu manawa: He mate pūkahukahu e puta mai ana i te kai e uru ana ki roto i ngā pukahukahu.
• Bronchiectasis: Te kino o ngā ara manawa o roto i ngā pukahukahu.
• Ngā mate pūkahukahu.
• Te pikinga ake o te mōrearea ki te mate pukupuku korokoro: Ka piki ake tēnei mōrearea nā te mea ka mau te kai ki roto i te korokoro mō te wā roa me te mumura.
• Te kore kai pai: Nā te kore kai i roto i te tinana tēnei.

Koia te mea nui kia tere te tautuhi me te rongoā i te Achalasia.

Me pēhea te tautuhi a ngā tākuta i te mate "Akalasia"?

Mena kei a koe ngā tohu kua whakahuatia ake nei, ina kite koe i te tākuta, ka pātai atu rātou mō ō tohu, kia pēhea te roa o te noho, me ērā atu mea. Kātahi ka whakahaerehia he whakamātautau tinana. E toru ngā whakamātautau matua e whakamahia ana hei whakaū i te mate achalasia:

1. Esophagram (Horomanga Pāriuma): I tēnei whakamātautau, ka hoatu he wai e kīia nei ko te barium hei inu māu. Kātahi ka tangohia he hihi-X hei tirotiro i te nekehanga o te kai ki raro i te esophagus. Mena he achalasia tōu, kua pupuhi te esophagus, ā, kāore te LES e tuwhera tika.

2. Whakamātautau manometri korokoro:I roto i tēnei, ka whakaurua he ngongo angiangi mā te ihu ki roto i te korokoro, ā, ka inehia te āhua o te kōpiritanga o ngā uaua o te korokoro me te pēhanga o te `LES`. I roto i te `Akalasia`, he teitei te pēhanga o te `LES`, ā, ka kitea kāore he nekehanga o te korokoro (peristalsis). Koinei te whakamātautau pai rawa atu hei tautuhi i te `Akalasia`.

3. Endoscopy o runga: Ka whakauruhia he ngongo angiangi, ngāwari me te kāmera e piri ana mā te waha ki roto i te esophagus me te puku hei tirotiro ki roto. Ka āwhina hoki tēnei ki te tirotiro mō ētahi atu raruraru i roto i te esophagus (pēnei i te mate pukupuku). I ētahi wā ka tangohia he biopsy, he wahi kiko iti, hei tirotiro.

He aha ngā rongoā mō te 'Akalasia'?

Ko te whāinga matua o te maimoatanga mō te achalasia ko te whakangāwari i te uaua LES i te raro o te korokoro, kia taea ai e te kai te uru ki roto i te puku. Kāore e taea e ēnei maimoatanga te whakaora katoa i te achalasia , engari ka taea e rātou te whakahaere i ngā tohu me te whakangawari ake i te oranga. Ka whakaarohia e tō tākuta ō tohu, tō tau, me ō hiahia hei whakatau i te kōwhiringa maimoatanga pai rawa atu.

Maimoatanga kore-pokanga

• Te whakanui i te poihau: I roto i tēnei, ka tukuna he poihau motuhake mā roto i te korokoro, he rite ki te endoscopy, ki te wāhi kei reira te LES, ā, ka pupuhihia te poihau. Kātahi ka totoro te mowhiti uaua piri, ka whakangāwari. Mā tēnei ka hangaia he ara mō te kai kia puta. Ka mahia tēnei i raro i te whakamoe māmā. Me mahi anō pea tēnei maimoatanga i ētahi wā.
• Rongoā: Tērā ētahi rongoā ka taea te whakangāwari i te LES.
• Werohanga Botox® (paitini botulinum): Ka werohia te Botox ki roto i te LES mā te endoscopy. Ka whakararuraru tēnei i te uaua mō te wā poto, ka whakangāwari hoki. Heoi, he torutoru noa ngā marama e mau ana te pānga, ā, me mahi anō.
• Ngā papa rongoā pēnei i te `Nifedipine` (`Procardia XL®`, `Adalat CC®`) `Isosorbide` rānei (`Imdur®`, `Monoket®`). Me tango ēnei i mua i te kai hei whakangāwari i te `LES`. Heoi, kāore ēnei e mahi mō te katoa, ā, ka pāngia pea e ngā pānga taha.

Te maimoatanga pokanga

He maha ngā tikanga pokanga ka taea te mahi hei whakangāwari i te LES. He maha ngā wā ka mahia ēnei me te kore he tapahi nui, mā roto i ngā tapahi iti (`Laparoscopic` / `Minimally invasive`).

• Te pokanga Laparoscopic Heller myotomy: Koinei te pokanga tino noa. I roto i tēnei, ka whakauruhia he taputapu, he rite ki te endoscope, mā roto i ngā tapahi iti i roto i te puku, ā, ka tapahia ngā muka uaua o te LES (ko te tikanga o te myotomy ko te tapahi i te uaua). Mā tēnei ka whakangāwari i te LES. He maha ngā wā, ka mahia hoki he tikanga e kiia nei ko te fundoplication, arā, ko te takai i te wāhanga o runga o te puku ki te esophagus hei whakaiti i te rerenga mai o te waikawa puku ki roto i te esophagus (GERD).
• Te pokanga endoscopic peroral (POEM): He tikanga hou tēnei. I roto i tēnei, ka whakaurua he endoscope mā te waha, ka haere ki raro i te arai o te korokoro, ka tapahia te uaua o te LES. Kāore e hiahiatia he tapahi o waho.

He tino onge, mēnā he tino kino ngā tohu, ā, kāore i angitu ētahi atu maimoatanga, ka tūtohu pea tō tākuta kia pokangahia te korokoro katoa (he esophagectomy).

Ngā raruraru o te maimoatanga

He tino angitu ngā pokanga Laparoscopic Heller myotomy me te POEM. Heoi anō, ka puta pea ētahi raruraru:

• Te putanga mai anō o ngā tohu o te 'Akalasia'.
• GERD (mate reflux Gastroesophageal) (ina koa mēnā kāore te fundoplication e mahia i muri i te Heller myotomy).
• He tino onge, ka pakaru te korokoro i te wā e pokanga ana.

He aha ngā mea ka taea e koe te tumanako mēnā kei a koe te 'Akalasia'?

Ahakoa kua rongoatia, ka hoki anō pea ngā tohu o te achalasia. Nō reira, he mea nui te aroturuki hauora mō te wā roa ('whai muri'). Ka tirotirohia koe e tō tākuta i ia wā:

• Ka whakahaerehia ngā whakamātautau hei whakarite kei te tika te haere o te kai me te wai mā te korokoro ki roto i te puku.
• Tirohia mēnā he tohu o te GERD.
• Tirohia mēnā he tohu tōmua o te matepukupuku korokoro (he paku teitei ake tēnei mōrearea me te achalasia).

Ki te kore e rongoatia, ka arahi pea te achalasia ki te korenga o ngā kai totika, ā, ka mate pea. Heoi, mā te maimoatanga tika, ka taea e te tangata kāore he achalasia te ora mō te roanga o tōna oranga.

Me pēhea taku tiaki i ahau anō?

I a koe e noho ana me te mate e kiia nei ko te 'Akalasia', he maha ngā mea ka taea e koe te mahi hei āwhina i te tuku i te kai me te inu mā te korokoro me te whakahaere i ngā tohu:

• Tapatapahia te kai kia iti, ka ngaungau pai.
• Inumia he nui te wai i a koe e kai ana. Mā tēnei ka whakamakuku i te kai, ā, ka ngāwari ake te mimiti.
• Kai tika i te mea e noho ana. Mā tēnei ka āwhina i te kaha ā-papa kia nekehia te kai ki raro.
• Kaua e kai i ngā kai totoka e toru ki te whā hāora i mua i te moe. Mā tēnei ka whai wā tō puku ki te nakunaku i te kai i mua i tō moe.
• Puritia he urunga tāpiri i raro i tōu mahunga ina moe koe. Mā te pupuri i tōu mahunga kia teitei ake ka āwhina i te whakaiti i te tūponotanga o te kai mai i te korokoro ki roto i te puku o te ihu.

He aha ngā kai me karo mēnā kei a koe te 'Akalasia'?

Nā te mea he uaua te haere o te kai mā te korokoro nā te achalasia, ka taea e ētahi kai te whakararu i ngā tohu. Kia tino tupato ki ngā kai pēnei i ēnei:

• Ngā kai ka ārai i te korokoro: Hei tauira, ngā aporo kāore anō kia tihorea te kiri, ngā karepe, ngā huawhenua mata, ngā mīti muka, ngā mīti maroke rānei.
• Ngā kai ka matotoru, ka kohia hoki i roto i te korokoro: Hei tauira, te taro (ina koa ko te taro mā), te raihi mā, te rīwai, te parai paraoa, me te rimurapa.
• Ngā kai ka whakapataritari i te korokoro: Hei tauira, ngā kai raukikī, ngā inu warowaihā, me ngā inu waipiro.

Kāore ēnei kai e pā ana ki te katoa i te ōrite. Me kimi e koe māu ake he aha ngā kai e uaua ana ki a koe.

Āhea ahau me toro atu ki te tākuta?

Ki te kite koe i ētahi huringa hou i roto i tō tinana, inā koa ngā tohu hou o te Achalasia, pērā i te uaua ki te horomi , me toro atu ki te tākuta tonu.

He mate onge te Achalasia, ka puta haere ngā tohu i roto i te wā. Ka rerekē ngā tohu mai i te ngaungau o te puku ki te whāwhā, ki te uaua ki te horomi. Nō reira, kāore pea koe e whakaaro tonu he mate kotahi ēnei tohu katoa.

Heoi, he mea nui kia kōrero ki te tākuta mō ngā tohu e mau tonu ana, ahakoa te āhua kāore e pā ana. He maha ngā maimoatanga mō te achalasia. Ka taea e tō tākuta te whakamārama i ia maimoatanga ki a koe, me te āwhina i a koe ki te whiriwhiri i te mea e pai ana mōu. Kaua e manukanuka, ki te kitea tō mate me te rongoā wawe, ka taea e koe te whakahaere pai i te mate.

Whakarāpopototanga (Karere hei tango ki te kāinga)

Ko te `Akalasia` he mate e kore ai e mahi tika ngā uaua o te pito o raro o te korokoro, e ārai ana i te kai kia uru ki roto i te puku. Ko ngā tohu ko te uaua ki te horomi, te mamae o te uma, me te urunga o te kai ki roto i te korokoro. He whakamātautau motuhake hei tautuhi i tēnei. Ko ngā maimoatanga ko te whakawhānui i ngā uaua ki te poihau, ngā rongoā, me te pokanga. Ahakoa kāore he rongoā katoa, ka taea te whakahaere pai i ngā tohu, ā, ka taea e koe te noho noa. Mena kei a koe ēnei tohu, kaua e mangere ki te rapu tohutohu hauora. Kei roto i ō ringaringa tō hauora!

Ākarahia , Ngākau Pōrearea, Uaua ki te horomi, Te korokoro, LES, Te korenga o te manawa, Te tirotiro i te korokoro