Tonsefe takhala tikukumana ndi izi nthawi ina. Tikadya kapena kumwa chinthu mwachangu, pakhosi pathu mwadzidzidzi timamva kutsekeka, timamva mawu opweteka, ndipo timamva ngati tikutsamwitsidwa. Timati, "Tapita njira yolakwika." Nthawi zambiri, zimatha titamwa madzi. Ngati izi zimachitika nthawi zina, palibe chodetsa nkhawa nacho. Koma ngati mukuvutika kumeza chakudya ndi chakumwa nthawi zonse, zikutanthauza kuti pali china chake chomwe chikulepheretsa njira yoyendera chakudya kuchokera pakamwa panu kupita m'mimba mwanu. Mu zamankhwala, timatcha vutoli kukhala dysphagia .
Izi si vuto lokha. Nthawi zina zimatha kukhala chizindikiro cha matenda oopsa. Mwachitsanzo, vutoli limapezeka kwambiri mwa anthu omwe adadwala sitiroko. Ngati salandira chithandizo, chakudya kapena chakumwa chingalowe m'mapapo mwanu, kutanthauza m'mapapo mwanu. Mu zamankhwala, timatcha izi aspiration . Izi zingayambitse matenda aakulu monga matenda a m'mapapo ndi chibayo. Chifukwa chake, ndikofunikira kwambiri kudziwa izi.
Kodi pali mitundu ya dysphagia?
Mwachidule, inde. Mavuto omeza awa akhoza kugawidwa m'magulu atatu akuluakulu kutengera komwe amachitika. Taganizirani ngati ulendo wochokera pakamwa kupita m'mimba. Pali malo atatu akuluakulu paulendowu: pakamwa (mkamwa), pakhosi (pharynx), ndi chubu chomwe chimanyamula chakudya kupita m'mimba, m'mero. Ngati pali vuto pa malo aliwonse omayima awa, ulendowu umakhala waufupi, zomwe zikutanthauza kuti kumeza kumakhala kovuta.
| Mtundu wa dysphagia | Mwachidule... |
|---|---|
| Kulephera Kulankhula Pakamwa | Vuto lili mkamwa mwanu. Izi zitha kuchitika pamene minofu yomwe imagwiritsa ntchito kutafuna chakudya, kupanga mipira ya chakudya ndi lilime lanu, ndikusakaniza ndi malovu ikhala yofooka. |
| Kuvutika kwa M'mero (Kuvutika kokhudzana ndi pakhosi) | Vuto limachitika pamene chotupa cha chakudya chomwe chimapangika mkamwa chimakankhira pakhosi. Pali zinthu zambiri zomwe zimachitika zokha apa. Mwachitsanzo, kholingo (bokosi la mawu) limatseka kuti chakudya chisalowe m'mphuno. Vutoli likhoza kuchitika chifukwa cha vuto lomwe limachitika pankhaniyi. |
| Kusokonezeka kwa Misozi | Vuto limachitika pamene chakudya chikuyenda pakhosi, pansi pa m'mero, ndi m'mimba. Chakudyacho chimakankhidwira pansi ndi kutsekeka kwa m'mero kofanana ndi mafunde (peristalsis). Kusasangalala kumeneku kumachitika ngati izi zasokonezedwa kapena ngati m'mero mwatsekedwa. |
Kodi ndi zifukwa ziti za dysphagia?
Vuto lililonse lomwe limakhudza mitsempha kapena minofu yomwe imathandiza kumeza lingayambitse izi.
Matenda a mitsempha ndi ubongo
Kuyenda kwa thupi lathu kumayendetsedwa ndi ubongo ndi mitsempha. Matenda omwe amakhudza dongosololi angayambitse mavuto pomeza.
- Kutsekeka kwa magazi kupita ku ubongo kungawononge ziwalo zomwe zimalamulira kumeza.
- Matenda a Parkinson: Kufooka pang'onopang'ono kwa ziwalo za ubongo zomwe zimakhudza kayendetsedwe ka thupi.
- Multiple Sclerosis (MS): Matenda a autoimmune omwe amawononga mitsempha yamagazi.
- Amyotrophic Lateral Sclerosis (ALS): Matenda omwe amafooketsa mitsempha yomwe imalamulira minofu.
- Matenda amisala: Matenda omwe amakhudza kukumbukira ndi kugwirizana kwa mayendedwe.
- Zotupa za muubongo: Izi zitha kukhala khansa kapena zosavulaza. Zingasokoneze zizindikiro za mitsempha.
- Cerebral palsy: Matenda omwe amachitika munthu akangobadwa ndipo amakhudza kugwirizana kwa minofu.
Matenda a minofu
Dysphagia ingayambitsidwenso ndi matenda omwe amakhudza minofu ya pakhosi ndi m'mero omwe amathandiza kumeza.
- Achalasia: Matenda osowa kwambiri omwe minofu yomwe ili kumapeto kwa m'mero siimamasuka, zomwe zimalepheretsa chakudya kulowa m'mimba.
- Scleroderma: Matenda a autoimmune omwe amachititsa kuti minofu ya m'mero ikhale yolimba, zomwe zimapangitsa kuti minofu ikhale yovuta kukankhira chakudya pansi.
- Kufooka kwa minofu: Gulu la matenda obadwa nawo omwe amayambitsa kufooka kwa minofu pang'onopang'ono.
- Myasthenia gravis: Matenda a autoimmune omwe amasokoneza zizindikiro kuchokera ku mitsempha kupita ku minofu.
Kutsekeka kwa m'mimba, kutsekeka, ndi mavuto a kapangidwe kake
- Khansa: Zotupa za khansa m'mutu, pakhosi, kapena m'mero zimatha kutseka njira yodutsa chakudya.
- GERD (Kubwerera m'mimba kwa asidi): Kubwerera m'mimba kwa asidi nthawi zonse kumatha kuwononga minofu ya m'mero, zomwe zimapangitsa kuti zipsera ndi kucheperachepera. Izi zimatchedwa esophageal strictures .
- Eosinophilic esophagitis: Mtundu wa maselo oyera a m'magazi (eosinophils) umasonkhana m'mero, zomwe zimapangitsa kuti ukhale wovuta komanso wovuta kumeza.
- Kutupa kwa m'mero:Malo ang'onoang'ono ngati thumba amapangika pamalo ofooka pakhoma la mmero. Tinthu ta chakudya tingamamatire pamalo amenewa, zomwe zimapangitsa kuti munthu azimva ngati pali chinachake chomwe chamatirira pakhosi.
Chofunika kwambiri n’chakuti, ngakhale kuti ukalamba si chifukwa cha dysphagia mwachindunji, ndi chinthu chachikulu chomwe chimayambitsa vutoli. Matendawa amapezeka kwambiri pakati pa okalamba chifukwa cha chiopsezo chowonjezeka cha kufooka kwa minofu ndi matenda ambiri amitsempha omwe atchulidwa pamwambapa.
Kodi mungazindikire bwanji vutoli?
Mukapita kwa dokotala, adzamvetsera mosamala zizindikiro zanu ndikukupimirani thupi. Kenako, angakulimbikitseni mayeso apadera kuti adziwe chomwe chikuyambitsa vutoli.
- Kumeza kwa Barium (Esophagram kapena Barium swallow test): Mu mayeso awa, mumamwa madzi otchedwa barium. Madzi awa amaoneka oyera pa X-ray, kotero mutha kuonera m'mero mukugwira ntchito ngati kanema pamene mukumeza.
- Upper endoscopy (EGD): Mu njirayi, dokotala wanu amaika chubu chaching'ono chokhala ndi kamera pakhosi panu kuti aone pakhosi panu, m'mero, ndi m'mimba. Izi zingathandize kuwona ngati pali zotupa ndi zotsekeka.
- ZOLIPIRA (Kuyesa kwa Fiberoptic Endoscopic of Melt): Kuyesa komwe kumachitika ndi Katswiri wa Matenda a Chilankhulo Cholankhulidwa (SLP). Kamera yaying'ono imayikidwa kudzera mu mphuno kuti ione ngati chakudya kapena chakumwa chamtundu wina chimalowa m'mapapo mwanu mukameza.
- Kuyeza kwa Esophageal Manometry: Chubu chimayikidwa kudzera mu mphuno yanu kupita m'mimba mwanu ndipo chimayesa kupanikizika, kapena kupindika, kwa minofu ya m'mero mwanu mukamwa madzi.
Kodi chimachiritsidwa bwanji?
Chithandizo chimadalira chifukwa cha dysphagia yanu ndi kuopsa kwake.
- Mankhwala: Mankhwala opha tizilombo toyambitsa matenda angapatsidwe matenda, ndipo mankhwala oletsa asidi angapatsidwe matenda monga GERD.
- Kusintha kwa moyo: Dokotala wanu kapena katswiri wolankhula angakuuzeni kuti musinthe zakudya. Angakulimbikitseni kudya zakudya zofewa, zophwanyika bwino, kutafuna chakudya chanu bwino, ndikumwa pang'ono.
- Mankhwala ena: Ngati m'mero wachepa, pali njira zokulitsa. Jakisoni wa Botox® amagwiritsidwanso ntchito pochiza mavuto ena a minofu.
- Njira yodyetsera: Pa milandu yovuta kwambiri, ndiko kuti, pamene kudya ndi kumwa sikungatheke ndipo pali chiopsezo chowonjezeka cha kutsamwa, njira iyi imagwiritsidwa ntchito popereka zakudya.
- Masewero olimbitsa thupi: Katswiri wolankhula ndi kulankhula (SLP) angakuphunzitseni maseŵero olimbitsa thupi kuti alimbitse minofu yanu yomeza. Angakuphunzitseninso momwe mungadyere mosamala, momwe mungagwirire mutu wanu, komanso njira yoyenera yochotsera chakudya ngati chatsekeka.
Ndi mavuto otani omwe angachitike ngati sanachiritsidwe?
Ngati vutoli silichiritsidwa, lingayambitse mavuto aakulu azaumoyo, ngakhale imfa. Chifukwa chake, ndikofunikira kwambiri kudziwa izi.
Zoopsa zazikulu ndi izi:
- Kusowa madzi m'thupi: Kusowa madzi m'thupi chifukwa chosatha kumwa madzi okwanira.
- Kusadya bwino: Kusowa zakudya zokwanira.
- Kutsamwa: Kungakhalenso koopsa.
- Chibayo cha mpweya woipa: Chibayo chachikulu chomwe chimayamba chifukwa cha chakudya kapena chakumwa chomwe chimalowetsedwa m'mapapo. Nthawi zina, makamaka kwa anthu omwe adadwala sitiroko, chakudya chimalowetsedwa m'mapapo popanda kutsokomola (silent aspiration). Izi ndi zoopsa kwambiri.
Kodi muyenera kupita kwa dokotala liti?
Ngati mukuona kuti mukuvutika kumeza mobwerezabwereza kuposa kamodzi kapena kawiri, pitani kwa dokotala nthawi yomweyo. Ndikofunikira kupeza ndikuchiza chomwe chimayambitsa vutoli.
| Zadzidzidzi! Pitani ku ETU (Emergency Treatment Unit) nthawi yomweyo. | |
|---|---|
| Udindo | Ngati mukumva ngati chinachake chatsekeredwa pakhosi panu ndipo mukuvutika kupuma . |
| Udindo | Kufooka kwa minofu mwadzidzidzi, kulephera kugwira ntchito kwa gawo lina la thupi (kufooka), kapena kulephera kumeza kwathunthu . |
Ngakhale zinthu monga kutsokomola ndi kupuma movutikira zingakhale zovuta, ndi chenjezo lochokera m'thupi lanu. Choncho musanyalanyaze zizindikiro zimenezo.
Uthenga Wopita Nawo Kunyumba
- Ngati mukuvutika kumeza chakudya, ndipo nthawi zambiri zimachitika, musaganize kuti "chapita molakwika."
- Dysphagia si vuto lokha, koma ikhoza kukhala chizindikiro cha matenda aakulu monga sitiroko, khansa, kapena matenda amitsempha.
- Musanyalanyaze vuto la kumeza, pitani kwa dokotala nthawi yomweyo kuti mudziwe ngati pali vuto lililonse.
- Akatswiri olankhula ndi kulankhula (SLPs) angathandize kwambiri pophunzitsa masewera olimbitsa minofu komanso njira zodzitetezera kudya.
- Ngati mwadzidzidzi mukuvutika kupuma kapena kumeza, ndi vuto ladzidzidzi. Pitani ku ETU ya chipatala nthawi yomweyo.
👩🏽⚕️ Mafunso ena (Mafunso Ofunsidwa Kawirikawiri)
💬 Mapiritsi a Gemfibrozil (Lopid) ndi mankhwala omwe amagwiritsidwa ntchito pochiza matenda ati?
Iyi si piritsi la cholesterol (Statin) lokhazikika! Iyi ndi mankhwala othandiza kwambiri (Fibrate) omwe amatha kuchepetsa nthawi yomweyo kuchuluka kwa mafuta oopsa otchedwa 'Very High Triglycerides' ndi pafupifupi 50% kwa odwala omwe ali ndi triglycerides yokwera kwambiri/yosazolowereka! Madokotala amapereka piritsili nthawi yomweyo chifukwa ngati triglycerides ikwera kwambiri, kapamba amatha kuphulika (Pancreatitis) ndikuyambitsa imfa.
💬 Kodi piritsi lamphamvu la mafuta (Gemfibrozil) limasungunula bwanji triglycerides ikalowa m'thupi lathu?
Iyi si makina a cholesterol omwe amatseka chiwindi! Piritsi iyi imapita ku chiwindi ndi maselo athu amafuta (PPAR-alpha activation), ndipo imayambitsa/kuyambitsa kwathunthu 'enzyme yophwanya mafuta (Lipoprotein lipase)' m'thupi! Kenako, ma enzyme amenewo amaswa mafuta (VLDL/Triglycerides) m'magazi ngati mtsinje kukhala zidutswa ndikuwononga (ndipo izi zimawonjezera kwambiri cholesterol/HDL yabwino).
💬 N’chifukwa chiyani akunenedwa kuti musamwe mankhwalawa (Gemfibrozil) pamodzi ndi mapiritsi a cholesterol wamba (Statins)? Kodi zoopsa zake ndi ziti?
Imeneyo ndiye ngozi yaikulu komanso yoopsa kwambiri ya izi! Ngati mumwa piritsi ili mukumwa piritsi la cholesterol (Atorvastatin/Simvastatin), mkati mwa sabata yoyamba, 100% ya minofu yanu idzasungunuka (Severe Rhabdomyolysis) ndipo impso zanu zidzawola kwathunthu ndipo mudzafa. Izi ndi zoopsa kwambiri moti zitha kupha! Komanso, chiopsezo chotenga 'Gallstones / Cholelithiasis' n'chokwera kwambiri.











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