Ngaba wakha waziva ngathi ukutya kwakho kunamathele esifubeni sakho endaweni yokuba kungene esiswini sakho? Okanye mhlawumbi uziva ngathi kuqhubeka kubuyela emphinjeni wakho emva kokusela amanzi amancinci? Kuqhelekile ukuba oku kwenzeke ngamanye amaxesha. Kodwa ukuba kuyaqhubeka, asinto esinokuyityeshela. Namhlanje, siza kuthetha ngemeko ebangela ukungakhululeki okunjalo, kodwa engaziwa kakuhle. YiAchalasia leyo.
Ngamafutshane, yintoni iAchalasia?
I-Achalasia yimeko engaqhelekanga echaphazela ummizo wethu. Ukuze sikuqonde oku ngokulula, masiqale sijonge indlela ummizo wethu oqhelekileyo osebenza ngayo.
Khawuthelekelele ukuba umphimbo wethu yityhubhu eyenziwe ngezihlunu ezisuka emlonyeni wethu ziye esiswini (esiswini). Xa siginya ukutya, izihlunu ezikule tyhubhu ziyancintisana ukusuka phezulu ukuya ezantsi ngentshukumo efana namaza (oku kubizwa ngokuba yi -peristalsis ngokwezonyango), zityhala ibhola yokutya phantsi.
Emazantsi alo mphunga, apho udibana khona nesisu, kukho isangqa semisipha esisebenza njengevalvu. Siyibiza ngokuba yiLower Esophageal Sphincter (LES) . Ifana nocango. Olu cango (LES) luvuleka ngexesha elifanelekileyo xa ibhola yokutya yehla, kwaye emva kokuba ukutya kungene esiswini, luvala kwakhona. Ngenxa yolu valo, iiasidi zesisu azibuyeli kwi-esophagus.
Ngoku, umntu one-Achalasia ufumana iingxaki ezimbini kule nkqubo.
1. Izihlunu ezikumphimbo azisebenzi kakuhle: Inkqubo efana namaza etyhala ukutya phantsi (i-peristalsis) endikhankanyileyo ayenzeki kakuhle. Nokuba ayenzeki kwaphela, okanye yenzeka kancinci kakhulu.
2. I-sphincter esezantsi ye-esophageal (LES) ayivuli: Nangona ukutya kuyehla, inxalenye efana nevalvu ekufanele ingene esiswini (LES) ayivuli njengoko kufanele. Ihlala iqinile.
Khawucinge nje, ukutya akunyuswa phezulu, kwaye ucango aluvuleki ezantsi. Kwenzeka ntoni ke ngoko? Konke ukutya kunye nesiselo esisiginyayo sinamathela ngaphakathi komphimbo. Akungeni esiswini. Yiloo nto kanye eyenzekayo kwiAchalasia.
Le meko ichaphazela umntu omnye kuphela kwabayi-100,000 kumazwe afana ne-United States. Oko kuthetha ukuba ayiqhelekanga kakhulu. Idla ngokuchaphazela abantu abadala abaneminyaka ephakathi kwama-25 nama-60, kodwa ngamanye amaxesha inokuchaphazela abantu abangaphantsi koko.
Zithini iimpawu zomntu one-Achalasia?
Iimpawu ze-achalasia azibonakali ngaxeshanye. Zivela kancinci kancinci. Usenokuba nale meko kangangeenyanga okanye iminyaka, kodwa usenokungawuboni umahluko omkhulu. Iimpawu ziya zisiba mandundu ngokuhamba kwexesha.
Makhe sibone ukuba zeziphi ezi mpawu kwitheyibhile engezantsi.
| Uphawu | Ingcaciso elula |
|---|---|
| Ubunzima bokuginya (i-Dysphagia) | Olu lolona phawu luphambili noluqhelekileyo. Kuvakala ngathi kukho ukuvaleka komqala okanye esifubeni xa usitya. Ekuqaleni, kuchaphazela kuphela ukutya okuqinileyo, kodwa kamva, oku kungakhululeki kunokwenzeka xa usela ulwelo. |
| Ukubuyela embilinini (ukutya okubuyela emqaleni) | Ukutya okungaginywanga okuginyiweyo, okubuyela emlonyeni. Oku akufani nokuhlanza. Akunambitheki kuba akuxutywanga nee-asidi zesisu. Oku kunokwenzeka ingakumbi xa ulele. |
| Iintlungu zesifuba | Iintlungu zesifuba ezifika zidlule zinokubakho. Abanye abantu banokude bacinge ukuba oku kukuhlaselwa yintliziyo. |
| Ukuhla ukusinda | Ngenxa yokuba ukutya akungeni kakuhle esiswini kwaye ngenxa yobunzima bokutya, umzimba uqala ukwehla ubunzima ngaphandle kwesizathu. |
| Ezinye iimpawu | Ubunzima bokuginya, isitshiso sentliziyo, kunye nokuqhwanyaza rhoqo nako kunokwenzeka. |
Kutheni oku kusenzeka? Yintoni unobangela?
Enyanisweni, oogqirha abakaqiniseki ngokupheleleyo ukuba yintoni ebangela i-Achalasia. Kodwa enye yeengcamango eziphambili kukuba sisifo esibangelwa kukuzikhusela komzimba .
Ngamafutshane, kuthetha ukuba inkqubo yokuzikhusela yomzimba wethu (inkqubo yokuzikhusela komzimba) ihlasela iiseli zethu ezilungileyo ngempazamo. Nantsi into ekukholelwa ukuba yenzeka kwiAchalasia:
- Inkqubo yethu yokuzikhusela komzimba ivuselelwa yinto efana nosulelo lwentsholongwane.
- Emva koko le nkqubo yomzimba yokuzikhusela iqala ngempazamo ukuhlasela iiseli zemithambo-luvo ezilawula ukusebenza kwemisipha kwi-esophagus yethu.
- Ngenxa yolu hlaselo, ezo seli zemithambo-luvo ziyatshatyalaliswa kancinci kancinci.
- Xa ezo seli zemithambo-luvo zilahlekile, izihlunu ezikwi-esophagus azifumani zimpawu zokufinyela ngokufanelekileyo. Kwaye i-sphincter esezantsi ye-esophageal (LES) ayifumani zimpawu zokuphumza. Yiyo loo nto ibangela le ngxaki.
Eyona nto ibalulekileyo kukuba esi ayisosifo esidluliselwa ngelifa okanye esosulelayo. Ngoko ke akukho mfuneko yokukhathazeka ngaso.
Ziziphi iingxaki ezinokwenzeka ngenxa yale meko?
Ukuba i-achalasia ayinyangwa kakuhle, inokukhokelela kwiingxaki ezinkulu. Ukutya neziselo eziqokelelana kumqala zinokubuyela emqaleni zize ngengozi zihambe ngombhobho womoya ziye emiphungeni. Ukuba oko kuyenzeka, iingxaki ezinje ngezi zinokwenzeka.
- I-Aspiration pneumonia: I-pneumonia enzima ebangelwa kukutya okanye isiselo esingena emiphungeni.
- Usulelo lwemiphunga kunye ne-bronchiectasis: Ukuphefumla ukutya rhoqo emiphungeni kunokubangela umonakalo ongunaphakade emiphungeni.
- Umngcipheko okhulayo womhlaza womqala: Xa i-achalasia ikhona ixesha elide, utshintsho luyenzeka kwiiseli zomqala, kwaye umngcipheko wokuba nomhlaza womqala uyanda kancinci kunomntu oqhelekileyo.
- Ukungondleki: Ngenxa yokuba ukutya kungafunxwa kakuhle ngumzimba, umzimba unokuba mncane kwaye ungafumani izondlo ezifunekayo.
Yiyo loo nto sisithi ukuba unengxaki yokuginya, kufuneka ungayinaki loo nto uze ubone ugqirha wakho ngokukhawuleza.
Ugqirha uxilonga njani esi sifo?
Xa usiya kugqirha, uza kukubuza ngeempawu zakho aze akuhlole umzimba. Emva koko uza kukucebisa ukuba wenze iimvavanyo ezininzi ukuqinisekisa ukuba unayo na i-Achalasia. Ezona vavanyo ziqhelekileyo zintathu zezi:
1. Uvavanyo lwe-Esophagram (Barium Swallow): Kolu vavanyo, unikwa ulwelo olukhethekileyo olubizwa ngokuba yi-barium ukuze ulusele. Olu lwelo lubonakala lumhlophe kwi-X-ray. Njengoko uluginya, kuthathwa uthotho lwemifanekiso ye-X-ray. Oku kukuvumela ukuba ubone ngokucacileyo indlela olu lwelo luhamba ngayo kwi-esophagus, nokuba luvalekile naphi na, nokuba i-esophagus ibanzi, okanye nokuba inxalenye esezantsi inciphile (oku kukwabizwa ngokuba luphawu 'lomlomo wentaka').
2. I-Esophageal Manometry: Olu lolona vavanyo lubalaseleyo noluchanekileyo lokufumanisa i-Achalasia. Kule meko, kufakwa ityhubhu encinci kakhulu, eguquguqukayo ngempumlo yakho kwi-esophagus yakho. Ngelixa ucelwa ukuba uginye amanzi amancinci, ii-sensors ezikwityhubhu zinokulinganisa ngokuchanekileyo uxinzelelo lwemisipha kwi-esophagus yakho, nokuba intshukumo efana neyamaza (i-peristalsis) iyenzeka, kwaye nokuba i-sphincter esezantsi ye-esophageal (LES) iphumla ngokufanelekileyo.
3. I-Upper Endoscopy: Kolu vavanyo , ityhubhu eguquguqukayo (i-endoscope) enekhamera eqhotyoshelweyo ifakwa ngomlomo iye kwi-esophagus kwaye ingaphakathi lijongwa ngqo kwiscreen. Oku kunokuqinisekisa ukuba i-esophagus ivaliwe, nokuba ukutya kubambekile, okanye kukho ezinye iimeko ezifana nomhlaza.
Ziziphi iindlela zonyango lwe-Achalasia?
Injongo ephambili yokunyanga i-achalasia kukukhulula i-sphincter esezantsi esophageal (LES), ukuvumela ukutya kudlule lula esiswini.
Into ebalulekileyo kukuba olu nyango alunakuyinyanga ngokupheleleyo i-Achalasia, njengoko iiseli zemithambo-luvo ezilahlekileyo zingenakuphinda zivuselelwe. Nangona kunjalo, olu nyango lunokukunceda ukulawula iimpawu zakho kwaye uphile ubomi obuqhelekileyo .
Iindlela zonyango zinokwahlulwa zibe ziindidi ezimbini: ezingasebenzisi utyando kunye nezotyando. Ugqirha wakho uza kuxoxa nawe ngonyango olufanelekileyo ngokusekelwe kwimeko yakho, ubudala, kunye nezinto ozithandayo.
| Uhlobo lonyango | Indlela yokwenza kunye nenkcazo |
|---|---|
| Unyango olungelulo utyando | |
| Ukwanda kweBhaluni | Ngexesha le-endoscopy, ibhaluni ifakwa ngetyhubhu kwindawo encinci ye-esophagus ize ivuthe. Izihlunu ezinciphileyo ziyakhululeka, okwenza umngxuma ube mkhulu kancinci. Oku kwenziwa phantsi kwe-anesthesia elula. Kusenokufuneka wenze olu nyango izihlandlo ezininzi. |
| Amayeza | Amayeza angasetyenziswa ukuthomalalisa izihlunu ze-LES. Enye indlela kukufaka iBotox® (ityhefu ye-botulinum) kwisihlunu. Kukwakho neepilisi ezifana ne-nifedipine kunye ne-isosorbide. Nangona kunjalo, iziphumo zezi zezexeshana. |
| Unyango lotyando | |
| I-Laparoscopic Heller Myotomy | Olu lolona tyando luqhelekileyo noluphumeleleyo. Kwenziwa imingxunya embalwa emincinci esiswini, kufakwa ikhamera kunye nezixhobo ezithambileyo, kwaye imicu yemisipha eqinileyo ezantsi kwe-esophagus iyasikwa kancinci kwaye yahlulwe ngaphandle. Ukuqina kuyakhululwa kwaye ucango luyakhululeka. |
| I-Peroscopic Endoscopic Myotomy (IMBONGO) | Le yindlela entsha. Ngaphandle kokwenza naluphi na utyando ngaphandle komzimba, kufakwa i-endoscope ngomlomo kwaye umsipha oqinileyo unqunyulwa ngaphakathi kwi-esophagus. |
Kunqabile kakhulu, ukuba iimpawu zinzima kakhulu kwaye ezinye iindlela zonyango aziphumeleli, utyando lokususa yonke i -esophagectomy lunokufuneka.
Yintoni endifanele ndiyilumkele emva konyango?
Iimpawu ze-Achalasia zinokuphinda zibuye emva konyango. Ke ngoko, kuya kufuneka uhlale unxibelelana nogqirha wakho ixesha elide. Uza kujonga rhoqo oku kulandelayo:
- Ngaba uyakwazi ukuhambisa ukutya okwaneleyo kunye nesiselo esiswini sakho nge-esophagus yakho?
- Ngenxa yokuba ucango olusezantsi lukhululekile, imeko apho iiasidi zesisu zibuyela kwi-esophagus (GERD) iye yavela.
- Ngaba kukho umngcipheko wokuba nomhlaza womqala?
Esi sifo asiyi kuchaphazela ubomi bakho, kodwa ngokuqinisekileyo sifuna unyango olufanelekileyo kunye nokulandelelana .
Ndingenza ntoni xa ndihlala ne-Achalasia?
Kunye nonyango, ukwenza utshintsho oluncinci kwindlela ophila ngayo kunye nendlela otya ngayo kunokunciphisa kakhulu oku kungakhululeki.
- Tshintsha indlela otya ngayo: Xa usitya, yaphula ukutya kwakho kube ziinxalenye ezincinci, ukuhlafune kakuhle, uze ukuginye. Sela amanzi amaninzi xa usitya. Oku kuya kunceda ukutya kuhlale kumanzi kwaye kunciphe lula.
- Yitya uhleli ngqo: Hlala ngqo ngelixa usitya. Musa ukulala phantsi iyure okanye ezimbini emva kokutya. Oku kuya kunceda amandla adonsela phantsi ekushukumiseni ukutya.
- Musa ukutya ngaphambi kokuba ulale: Yeka ukutya ukutya okuqinileyo ubuncinane iiyure ezi-3-4 ngaphambi kokuba ulale. Oku kuya kunika isisu sakho ixesha lokugaya ukutya ngaphambi kokuba ulale.
- Lala intloko yakho iphakanyisiwe: Gcina intloko yakho iphakanyisiwe kancinci ngokusebenzisa umqamelo owongezelelweyo ngelixa ulele. Oku kuya kunciphisa umngcipheko wokutya okusemqaleni kungena kumphimbo womoya.
Zeziphi izinto endingafanele ndizitye?
Umntu one-achalasia unokuba nobunzima bokuginya ukutya okuthile. Lumka ngakumbi ngezi ntlobo zokutya.
- Ukutya okunokunamathela emqaleni: ii-apile ezingaxotyulwanga, iidiliya, imifuno eluhlaza, inyama ethambileyo okanye eyomileyo.
- Ukutya okunokuqina kwi-esophagus: Izinto ezifana nesonka, irayisi, iitapile, iitships, kunye nepasta zinokunamathelana kwi-esophagus zize ziqine.
- Izinto ezicaphukisa umphimbo: ukutya okuneziqholo, iziselo ezine-carbonated (ezifana ne-soda), utywala.
Akunyanzelekanga ukuba uyeke ngokupheleleyo ukutya oku kutya, kodwa ukuba uziva ungakhululekanga, kungcono uhlale kude nako.
Umyalezo Wokuya Ekhaya
- I-Achalasia yimeko engaqhelekanga ebangelwa zizihlunu ze-esophagus kunye ne-sphincter esezantsi ye-esophageal (LES) engasebenzi kakuhle.
- Ubunzima bokuginya, ukugabha, kunye nentlungu yesifuba zezona mpawu ziphambili.
- Ezi mpawu ziyenzeka ngamaxesha athile, ngoko ke musa ukuzityeshela nokuba kunzima kangakanani ukuginya.
- Nangona ingenakunyangwa ngokupheleleyo, utyando kunye nezinye iindlela zonyango zinokulawula ngempumelelo iimpawu kwaye zivumele abantu ukuba baphile ubomi obuqhelekileyo.
- Ukuba unale mpawu, kubaluleke kakhulu ukubona ugqirha wosapho lwakho ngokukhawuleza ukuze akunike ingcebiso.
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