Kodi munayamba mwamvapo ngati chakudya chanu chakhala m'chifuwa mwanu m'malo mopita m'mimba mwanu? Kapena mwina mumamva ngati chikubwerera m'khosi mwanu mutamwa madzi pang'ono? Ndizachilendo kuti izi zichitike nthawi zina. Koma ngati zipitirira, si chinthu chomwe tingachinyalanyaze. Lero, tikambirana za vuto lomwe limayambitsa kusasangalala kotere, koma silikudziwika bwino. Ndi Achalasia imeneyo.
Mwachidule, kodi Achalasia ndi chiyani?
Achalasia ndi vuto losowa lomwe limakhudza mmero mwathu. Kuti timvetse izi mosavuta, choyamba tiyeni tiwone momwe mmero mwathu umagwirira ntchito nthawi zambiri.
Tangoganizani kuti mmero wathu ndi chubu chopangidwa ndi minofu yomwe imayenda kuchokera pakamwa pathu kupita m'mimba mwathu (m'mimba). Tikamameza chakudya, minofu yomwe ili mu chubuchi imagwedezeka kuchokera pamwamba mpaka pansi mozungulira ngati mafunde (izi zimatchedwa peristalsis m'mawu azachipatala), ndikukankhira mpira wa chakudya pansi.
Pansi penipeni pa mmero uwu, pomwe umalumikizana ndi mimba, pali mphete ya minofu yomwe imagwira ntchito ngati valavu. Timatcha izi kuti Lower Esophageal Sphincter (LES) . Zili ngati chitseko. Chitseko ichi (LES) chimatseguka panthawi yoyenera pamene mpira wa chakudya umatsika, ndipo chakudya chikalowa m'mimba, chimatsekanso mwamphamvu. Chifukwa cha kutseka kumeneku, asidi am'mimba sabwerera m'mimba.
Tsopano, munthu amene ali ndi Achalasia amakumana ndi mavuto awiri mu njirayi.
1. Minofu ya m'mero sikugwira ntchito bwino: Njira yofanana ndi mafunde yomwe imakankhira chakudya pansi (peristalsis) yomwe ndatchulayi sikuchitika bwino. Mwina sizichitika konse, kapena zimachitika mofooka kwambiri.
2. Mphuno ya m'munsi mwa mmero (LES) siitseguka: Ngakhale chakudya chikutsika, gawo lofanana ndi valavu lomwe liyenera kulowa m'mimba (LES) silikutseguka momwe liyenera kukhalira. Limakhalabe lolimba.
Tangoganizirani, chakudya sichikukankhidwira mmwamba, ndipo chitseko sichikutsegulidwa pansi. Ndiye chimachitika ndi chiyani? Chakudya ndi zakumwa zonse zomwe timameza zimalowa m'mimba. Sizilowa m'mimba. Ndicho chimene chimachitika ku Achalasia.
Matendawa amakhudza munthu m'modzi mwa anthu 100,000 m'maiko ngati United States. Izi zikutanthauza kuti ndi osowa kwambiri. Nthawi zambiri amakhudza akuluakulu azaka zapakati pa 25 ndi 60, koma nthawi zina amatha kukhudza anthu azaka zocheperapo.
Kodi zizindikiro za munthu amene ali ndi Achalasia ndi ziti?
Zizindikiro za achalasia sizimawonekera nthawi imodzi. Zimabwera pang'onopang'ono. Mutha kukhala ndi vutoli kwa miyezi kapena zaka, koma simungazindikire kusiyana kwakukulu. Zizindikiro zimangokulirakulira pakapita nthawi.
Tiyeni tiwone zizindikiro izi mu tebulo ili m'munsimu.
| Chizindikiro | Kufotokozera kosavuta |
|---|---|
| Kuvuta kumeza (Dysphagia) | Ichi ndiye chizindikiro chachikulu komanso chofala kwambiri. Zimakhala ngati pali kutsekeka pakhosi kapena pachifuwa mukamadya. Poyamba, zimakhudza zakudya zolimba zokha, koma pambuyo pake, kusasangalala kumeneku kumatha kuchitika mukamwa zakumwa. |
| Kubwezeretsa chakudya m'mimba (chakudya chomwe chimabwerera m'khosi) | Chakudya chosameza chomwe chameza, chomwe sichinalowe mkamwa. Izi sizili ngati kusanza. Sichimakoma ngati chowawasa chifukwa sichinasakanizidwe ndi asidi m'mimba. Izi zitha kuchitika makamaka munthu akagona. |
| Kupweteka pachifuwa | Kupweteka pachifuwa komwe kumabwera ndi kutha kumatha. Anthu ena angaganize kuti izi ndi matenda a mtima. |
| Kuchepetsa thupi | Chifukwa chakudya sichilowa bwino m'mimba ndipo chifukwa cha kuvutika kudya, thupi limayamba kuchepa thupi popanda chifukwa. |
| Zina mwazinthu | Kuvuta kumeza, kutentha pamtima, komanso kuvutika ndi kugunda kwa mtima pafupipafupi kungachitikenso. |
Chifukwa chiyani izi zikuchitika? Chifukwa chake ndi chiyani?
Ndipotu, madokotala sakudziwabe 100% chomwe chimayambitsa Achalasia. Koma chimodzi mwa ziphunzitso zazikulu ndichakuti ndi matenda omwe amayambitsa chitetezo chamthupi .
Mwachidule, zikutanthauza kuti chitetezo cha mthupi lathu (chitetezo cha mthupi) chimaukira maselo athu abwino molakwika. Izi ndi zomwe amakhulupirira kuti zimachitika ku Achalasia:
- Chitetezo chathu cha mthupi chimalimbikitsidwa ndi chinthu chonga kachilombo ka HIV.
- Kenako chitetezo chamthupi ichi molakwika chimayamba kuukira maselo amitsempha omwe amalamulira ntchito ya minofu m'khosi mwathu.
- Chifukwa cha kuukira kumeneku, maselo amitsempha amenewo amawonongeka pang'onopang'ono.
- Maselo amitsempha akatayika, minofu ya m'mero siilandira zizindikiro kuti zikoke bwino. Ndipo m'mero wa m'munsi (LES) sulandira zizindikiro kuti zipumule. Ndicho chimene chimayambitsa vutoli.
Chofunika kwambiri ndichakuti iyi si matenda obadwa nawo kapena opatsirana. Choncho palibe chifukwa chodera nkhawa.
Ndi mavuto ati omwe angachitike chifukwa cha vutoli?
Ngati achalasia sichitha kuchiritsidwa bwino, ingayambitse mavuto aakulu. Chakudya ndi zakumwa zomwe zimasonkhana m'mero zimatha kubwerera m'khosi ndikukwera mwangozi m'mapapo. Ngati zitatero, mavuto ngati awa angachitike.
- Chibayo choyambitsa kupuma: Chibayo choopsa chomwe chimayamba chifukwa cha chakudya kapena chakumwa cholowa m'mapapo.
- Matenda a m'mapapo ndi bronchiectasis: Kupumira chakudya m'mapapo pafupipafupi kungayambitse kuwonongeka kosatha kwa mapapo.
- Kuwonjezeka kwa chiopsezo cha khansa ya m'mero: Akalasia ikapezeka kwa nthawi yayitali, kusintha kumachitika m'maselo a m'mero, ndipo chiopsezo chotenga khansa ya m'mero chimawonjezeka pang'ono kuposa munthu wamba.
- Kusadya bwino: Popeza chakudya sichimayamwa bwino ndi thupi, thupi limatha kuonda ndipo silingalandire zakudya zofunikira.
Ichi ndichifukwa chake timanena kuti ngati mukuvutika kumeza, muyenera kunyalanyaza ndikuonana ndi dokotala mwamsanga.
Kodi dokotala amazindikira bwanji matendawa?
Mukapita kwa dokotala, adzakufunsani za zizindikiro zanu ndikukuyesani thupi. Kenako adzakulangizani mayeso angapo kuti atsimikizire ngati muli ndi Achalasia. Mayeso atatu odziwika kwambiri ndi awa:
1. Kuyesa kwa Esophagram (Barium Swallow): Mu mayesowa, mumapatsidwa madzi apadera otchedwa barium kuti mumwe. Madzi awa amaoneka oyera pa X-ray. Mukameza, zithunzi zingapo za X-ray zimatengedwa. Izi zimakupatsani mwayi wowona bwino momwe madziwo amayendera kudzera mu m'mero, kaya atsekeka kulikonse, kaya m'mero ndi waukulu, kapena ngati gawo la pansi ndi lopapatiza (izi zimatchedwanso chizindikiro cha 'mlomo wa mbalame').
2. Esophageal Manometry: Iyi ndi njira yabwino komanso yolondola kwambiri yodziwira Achalasia. Mu izi, chubu chopyapyala kwambiri, chosinthasintha chimayikidwa kudzera mu mphuno mwanu kupita mu mkodzo wanu. Pamene mukupemphedwa kuti mumeze madzi pang'ono, masensa pa chubu amatha kuyeza molondola kupanikizika kwa minofu mu mkodzo wanu, kaya kuyenda kofanana ndi mafunde (peristalsis) kukuchitika, komanso ngati m'munsi mwa esophageal sphincter (LES) mukupumula bwino.
3. Upper Endoscopy: Mu mayesowa , chubu chosinthasintha (endoscope) chokhala ndi kamera yolumikizidwa chimayikidwa kudzera pakamwa kupita ku m'mero ndipo mkati mwake mumawonekera mwachindunji pa sikirini. Izi zitha kutsimikizira ngati m'mero mwatsekedwa, ngati chakudya chatsekedwa, kapena ngati pali matenda ena monga khansa.
Kodi mankhwala a Achalasia ndi ati?
Cholinga chachikulu chochiza achalasia ndikuchepetsa vuto la sphincter yolimba ya m'munsi mwa esophageal (LES), zomwe zimathandiza kuti chakudya chilowe m'mimba mosavuta.
Chofunika kwambiri ndichakuti mankhwala awa sangachiritse Achalasia kwathunthu, chifukwa maselo amitsempha omwe atayika sangabwezeretsedwenso. Komabe, mankhwala awa angakuthandizeni kuwongolera zizindikiro zanu ndikukhala ndi moyo wabwinobwino .
Njira zochiritsira zitha kugawidwa m'magulu awiri: osachita opaleshoni ndi opaleshoni. Dokotala wanu adzakambirana nanu chithandizo choyenera kwambiri kutengera matenda anu, zaka zanu, komanso zomwe mumakonda.
| Mtundu wa chithandizo | Momwe mungachitire ndi kufotokozera |
|---|---|
| Mankhwala Opanda Opaleshoni | |
| Kutambasuka kwa Baluni | Pa nthawi ya endoscopy, baluni imayikidwa kudzera mu chubu kupita ku gawo lopapatiza la m'mero ndipo imatuluka mpweya. Minofu yopapatiza imamasuka, zomwe zimapangitsa kuti khomo likhale lalikulu pang'ono. Izi zimachitika pansi pa mankhwala oletsa ululu pang'ono. Mungafunike kuchita chithandizochi kangapo. |
| Mankhwala | Mankhwala angagwiritsidwe ntchito kupumula minofu ya LES. Njira imodzi ndi kubaya Botox® (botulinum toxin) mu minofu. Palinso mapiritsi monga nifedipine ndi isosorbide. Komabe, zotsatira zake ndi zakanthawi kochepa. |
| Mankhwala Opaleshoni | |
| Laparoscopic Heller Myotomy | Iyi ndi opaleshoni yodziwika bwino komanso yopambana kwambiri. Mabala ochepa kwambiri amapangidwa m'mimba, kamera ndi zida zofewa zimayikidwa, ndipo ulusi wa minofu womwe uli pansi pa mmero umadulidwa pang'onopang'ono ndikulekanitsidwa ndi kunja. Kulimba kwake kumatulutsidwa ndipo chitseko chimamasulidwa. |
| Myotomy ya Endoscopic ya M'kamwa (NDANDANDA) | Iyi ndi njira yatsopano. Popanda kudula ziwalo zakunja kwa thupi, endoscope imayikidwa kudzera pakamwa ndipo minofu yolimba imadulidwa kuchokera mkati mwa mmero. |
Kawirikawiri, ngati zizindikiro zili zoopsa kwambiri ndipo mankhwala ena sakuyenda bwino, opaleshoni yochotsa m'mero wonse (esophagectomy) ingafunike.
Ndiyenera kusamala ndi chiyani ndikalandira chithandizo?
Zizindikiro za Achalasia zimatha kubwereranso mukalandira chithandizo. Chifukwa chake, muyenera kulumikizana ndi dokotala kwa nthawi yayitali. Iye nthawi zonse azifufuza zotsatirazi:
- Kodi mumatha kupereka chakudya ndi zakumwa zokwanira kudzera mu mmero mwanu kupita m'mimba mwanu?
- Chifukwa chakuti chitseko chapansi chimamasuka, vuto lomwe asidi am'mimba amabwerera ku esophagus (GERD) layamba.
- Kodi pali chiopsezo chotenga khansa ya m'mero?
Matendawa sadzakhudza moyo wanu wonse, koma amafunikira chithandizo choyenera komanso kutsatira malangizo .
Kodi ndiyenera kuchita chiyani ndikakhala ndi Achalasia?
Pamodzi ndi chithandizo, kusintha pang'ono moyo wanu ndi zakudya zanu kungachepetse kwambiri mavuto amenewa.
- Sinthani kadyedwe kanu: Mukadya, dulani chakudya chanu m'zidutswa tating'onoting'ono, chitafuneni bwino, kenako muchimeze. Imwani madzi ambiri pa chakudya chanu. Izi zithandiza kuti chakudyacho chikhale chonyowa komanso chikhale chosavuta kuchidya.
- Idyani mutakhala molunjika: Khalani molunjika mukudya. Musagone kwa ola limodzi kapena awiri mutadya. Izi zithandiza mphamvu yokoka kusuntha chakudya pansi.
- Musadye musanagone: Siyani kudya zakudya zolimba maola osachepera atatu kapena anayi musanagone. Izi zipatsa m'mimba mwanu nthawi yoti mugaye chakudyacho musanagone.
- Gonani mutu wanu utakwezedwa: Sungani mutu wanu utakwezedwa pang'ono pogwiritsa ntchito pilo yowonjezera pamene mukugona. Izi zichepetsa chiopsezo cha chakudya chomwe chili mu mmero kulowa mu mphuno.
Ndi zakudya ziti zomwe sindiyenera kudya?
Munthu amene ali ndi achalasia angavutike kumeza zakudya zina. Samalani kwambiri ndi zakudya zamtunduwu.
- Zakudya zomwe zingatsekere m'mero: maapulo osadulidwa, mphesa, ndiwo zamasamba zosaphika, nyama yopyapyala kapena youma.
- Zakudya zomwe zimatha kukhala zolimba mu mmero: Zinthu monga buledi, mpunga, mbatata, tchipisi, ndi pasitala zimatha kumamatirana mu mmero ndikukhala zolimba.
- Zinthu zomwe zimakwiyitsa mmero: zakudya zokometsera, zakumwa zokhala ndi carbonated (monga soda), mowa.
Simuyenera kusiya kudya zakudya zimenezi kotheratu, koma ngati simukumva bwino, ndi bwino kuzipewa.
Uthenga Wopita Nawo Kunyumba
- Achalasia ndi vuto losowa lomwe limayamba chifukwa cha minofu ya m'mero ndi m'munsi mwa esophageal sphincter (LES) yomwe siigwira ntchito bwino.
- Kuvuta kumeza, kubweza m'mimba, ndi kupweteka pachifuwa ndi zizindikiro zazikulu.
- Zizindikiro zimenezi zimachitika pang'onopang'ono, choncho musanyalanyaze ngakhale vuto laling'ono lomeza.
- Ngakhale kuti sichingathe kuchiritsidwa kwathunthu, opaleshoni ndi njira zina zothandizira zimatha kuletsa zizindikirozo ndikulola anthu kukhala ndi moyo wabwinobwino.
- Ngati muli ndi zizindikiro izi, ndikofunikira kwambiri kupita kwa dokotala wa banja lanu mwamsanga kuti akupatseni upangiri.
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