Ngaba unengxaki yokuginya? Ngaba yi-'Achalasia'? Makhe sithethe ngale nto!

Ngaba wakha waziva ngathi ukutya okanye isiselo sakho sibambeke emqaleni wakho? Okanye ngaba wakha waziva iintlungu zesifuba kunye nokutya kubuyela emqaleni wakho? Ezi zinokuba yinto ecaphukisayo kakhulu kubomi bakho bemihla ngemihla. Namhlanje siza kuthetha ngemeko enokubangela iimpawu ezifanayo, kodwa ayiqhelekanga kangako. Leyo yimeko ebizwa ngokuba yi-'Achalasia' (eyaziwa nangokuthi yi-'Cardiospasm').

Yintoni i-'Achalasia'? Masiyiqonde ngokulula!

Ngamafutshane, i-'Achalasia' yimeko engaqhelekanga apho i-esophagus yethu, ityhubhu ethwala ukutya emlonyeni wethu ukuya esiswini, ingasebenzi kakuhle. Ubusazi na ukuba i-esophagus yethu ayisiyo ityhubhu nje? Yityhubhu eyenziwe ngezihlunu. Xa siginya into ethile, ezi zihlunu ziyafinyela (njengegagasi) kwaye zityhale ukutya phantsi. Le nkqubo siyibiza ngokuba yi-'(Peristalsis)'.

Ngoku khawucinge nje ukuba emazantsi e-esophagus, apho ukutya kungena khona esiswini, kukho isandi semisipha esifana nesango. Oku kubizwa ngokuba yi-"Lower Esophageal Sphincter" okanye "LES." Ngokwesiqhelo, xa ukutya kusondela kule "LES", kuyavuleka (kuyaphumla) kwaye kuvumele ukutya ukuba kudlulele esiswini. Emva koko kuyavalwa kwakhona, kuthintele ukuba okungaphakathi kwesisu kungabuyeli kwi-esophagus.

Nangona kunjalo, kumntu one-'Achalasia', le nkqubo iyaphazamiseka.

1. Intshukumo efana ne-peristalsis kwindlela yokugaya ukutya ayenzeki kakuhle, okanye ibuthathaka kakhulu.

2. Loo mnyango ubizwa ngokuba yi-'LES' awuvuli kakuhle xa ukutya kufika. Ubambekile.

Kwenzeka ntoni ke ngoko? Izinto ozityayo noziselayo ziyanamathela emqaleni wakho, zingangeni esiswini sakho. Oku kubangela ubunzima bokuginya, iintlungu zesifuba, nokutya kubuyele emqaleni wakho. Ekuhambeni kwexesha, umzimba unokunciphisa umzimba kwaye ube nokungabikho kokutya okunesondlo kuba awufumani kutya kwaneleyo.

I-'Achalasia' ayisiyonto ixhaphakileyo. Kwilizwe elifana neMelika, ichaphazela malunga nomntu omnye kwikhulu lamawaka. Idla ngokuchaphazela abantu abadala, abaphakathi kweminyaka engama-25 ukuya kwengama-60. Nangona kunjalo, ngamanye amaxesha abantwana abancinci banokuba nale meko.

Zithini iimpawu ze-'Achalasia'? Ifunyaniswa njani?

Iimpawu ze-'Achalasia' azibonakali ngequbuliso. Uninzi lwexesha, zikhula kancinci. Usenokungawuboni umahluko kangangeenyanga okanye iminyaka. Iimpawu eziphambili ezinokubonwa zezi:

• Ubunzima bokuginya (iDysphagia): Olu luphawu oluphambili. Kunokuba nzima ukuginya ukutya okuqinileyo kuqala, uze emva koko uginye ulwelo.
• Ukuphinda utye: Oku akufani nokuhlanza, kodwa ukutya okungagayiwanga kubuyela emqaleni. Oku kunokwenzeka ingakumbi ebusuku xa ulele.
• Intlungu yesifuba: Intlungu yesifuba ngequbuliso, ngamanye amaxesha enzima, inokuba qatha kangangokuba inokucingelwa njengokuhlaselwa yintliziyo.
• Ubunzima bokuya kwigumbi lokuhlambela.
• Isitshiso sentliziyo: Kodwa oku kunokwahluka ekuvuvukeni kwe-gastritis eqhelekileyo.
• Iingxaki.
• Ukwehla kobunzima ngendlela engachazekiyo: Ukwehla kobunzima kwenzeka ngokuhamba kwexesha kuba ukutya akufunxwa kakuhle ngumzimba.

Khumbula, ezi mpawu ziya ziba mandundu ngokuhamba kwexesha, ngoko ke kubalulekile ukufuna ingcebiso kagqirha ukuba ubona notshintsho oluncinci.

Yintoni ebangela i-'Achalasia'?

Enyanisweni, iingcali azikayazi eyona nto ibangela i-achalasia. Nangona kunjalo, kukho ingcamango enye ephambili. Oko kukuthi, sisifo esibangelwa kukuzikhusela komzimba, oko kuthetha ukuba inkqubo yethu yokuzikhusela komzimba ihlasela iiseli zomzimba wethu. Ngokwale ngcamango, into efana nale iyenzeka:

1. Inkqubo yethu yokuzikhusela yomzimba isebenza yinto efana nentsholongwane.

2. Nangona kunjalo, ngempazamo, le nkqubo yokuzikhusela komzimba iqala ukuhlasela iiseli zemithambo-luvo ezilawula ukusebenza kwemisipha ye-esophagus yethu.

3. Ezi seli zemithambo-luvo ziyatshatyalaliswa kancinci kancinci.

4. Emva koko intshukumo (i-peristalsis) etyhala ukutya kwi-esophagus kunye nokuvulwa kwe-LES ayenzeki kakuhle.

Olu luluvo olwamkelweyo okwangoku, kodwa uphando olongezelelekileyo luyaqhubeka.

Ziziphi iingxaki ezinokubakho ze-'Achalasia'?

Xa kukho i-achalasia, ukutya kunamathela kwi-esophagus, nto leyo enokubangela ukuba kubuyele phezulu emqaleni kwaye ngamanye amaxesha kungene kwi-windpipe. Ukuba oku kuyenzeka, kunokubangela iingxaki ezahlukeneyo. Umzekelo:

• I-Aspiration pneumonia: Imeko ye-pneumonia ebangelwa kukutya okungena emiphungeni.
• I-Bronchiectasis: Ukonakala kwendlela yomoya emiphungeni.
• Usulelo lwemiphunga.
• Umngcipheko okhulayo womhlaza womqala: Lo mngcipheko uyanda ngenxa yokutya okunamathelayo kumqala ixesha elide kunye nokudumba.
• Ukungondleki: Oku kungenxa yokunqongophala kokutya emzimbeni.

Yingakho kubalulekile ukuxilonga nokunyanga i-Achalasia ngokukhawuleza.

Oogqirha bayixilonga njani i-'Achalasia'?

Ukuba uneempawu ezikhankanyiweyo apha ngasentla, xa ubona ugqirha, uza kukubuza ngeempawu zakho, ukuba zikho ixesha elingakanani, njl. Baza kuhlola umzimba. Kusetyenziswa iimvavanyo ezintathu eziphambili ukuqinisekisa ukuxilongwa kwe-achalasia:

1. I-Esophagram (iBarium Swallow): Kolu vavanyo, unikwa ulwelo olubizwa ngokuba yi-barium ukuba ulusele. Emva koko kuthathwa i-X-ray ukuze kubonwe ukuba ukutya kuhamba njani kwi-esophagus. Ukuba une-achalasia, i-esophagus idumbile kwaye i-LES ayivuli kakuhle.

2. Uvavanyo lwe-Esophageal manometry:Kule nto, kufakwa umbhobho omncinci ngempumlo ungene kwi-esophagus kunye nendlela ezincipha ngayo izihlunu ze-esophagus kunye noxinzelelo lwe-`LES`. Kwi-`Achalasia`, uxinzelelo lwe-`LES` luphezulu, kwaye kunokufunyanwa ukuba akukho ntshukumo ye-esophagus (peristalsis). Olu lolona vavanyo lubalaseleyo lokuxilonga i-`Achalasia`.

3. I-endoscopy ephezulu: Ityhubhu encinci, eguquguqukayo enekhamera eqhotyoshelweyo ifakwa ngomlomo iye kwi-esophagus nakwisisu ukuze ijonge ngaphakathi. Oku kunokunceda ukujonga ezinye iingxaki kwi-esophagus (ezifana nomhlaza). Ngamanye amaxesha i-biopsy, eyingcezu encinci yethishu, inokuthathwa ukuze ihlolwe.

Ziziphi iindlela zonyango lwe-'Achalasia'?

Injongo ephambili yonyango lwe-achalasia kukukhulula izihlunu ze-LES ezantsi kwe-esophagus, ukuvumela ukutya ukuba kudlulele esiswini. Olu nyango alunakunyanga ngokupheleleyo i-achalasia , kodwa lunokulawula iimpawu kwaye lwenze ubomi bube lula. Ugqirha wakho uya kuqwalasela iimpawu zakho, ubudala, kunye nezinto ozithandayo ukuze akhethe olona khetho lufanelekileyo lonyango.

Unyango olungelulo utyando

• Ukwandiswa kwebhaluni: Kule nto, ibhaluni ekhethekileyo idluliselwa kwi-esophagus, efana ne-endoscopy, kwindawo apho i-LES ikhoyo, kwaye ibhaluni iyavuthelwa. Emva koko, iringi yemisipha eqinileyo iyolula kwaye iphumle kancinci. Oku kudala indlela yokutya edlula kuyo. Oku kwenziwa phantsi kwe-anesthesia elula. Olu nyango lunokufuna ukuphinda-phindwa amaxesha amaninzi.
• Amayeza: Kukho amayeza anokuthomalalisa i-LES.
• Inaliti yeBotox® (botulinum toxin): IBotox ifakwa kwi-LES nge-endoscopy. Oku kuyayikhubaza okwethutyana kwaye kuphumze izihlunu. Nangona kunjalo, isiphumo sihlala iinyanga ezimbalwa kuphela kwaye kufuneka siphindwe.
• Iipilisi ezifana ne-`Nifedipine` (`Procardia XL®`, `Adalat CC®`) okanye `Isosorbide` (`Imdur®`, `Monoket®`). Ezi kufuneka zithathwe ngaphambi kokutya kwaye ziphumze i-`LES`. Nangona kunjalo, ezi azisebenzi kuye wonke umntu kwaye zinokuba nemiphumo emibi.

Unyango lotyando

Kukho iinkqubo ezahlukeneyo zotyando ezinokwenziwa ukuze kuphumzwe i-LES. Ezi zihlala zenziwa ngaphandle kokusikwa okukhulu, ngokusikwa okuncinci (`Laparoscopic` / `Minimally invasive`).

• I-Laparoscopic Heller myotomy: Olu lolona tyando luqhelekileyo. Kule meko, kufakwa isixhobo, esifana ne-endoscope, ngokusebenzisa imingxunya emincinci esiswini kwaye imicu yemisipha ye-LES iyasikwa (i-myotomy ithetha ukusika umsipha). Oku kuyayikhulula i-LES. Rhoqo, kwenziwa inkqubo ebizwa ngokuba yi-fundoplication, equka ukusonga inxalenye ephezulu yesisu ijikeleze i-esophagus ukunciphisa i-reflux ye-acid yesisu kwi-esophagus (GERD).
• I-Peroral endoscopic myotomy (POEM): Le yinkqubo entsha. Kule nkqubo, kufakwa i-endoscope ngomlomo, ingena ngaphantsi kolwelo lwe-esophagus, ize inqumle izihlunu ze-LES. Oku akudingi kususwa kwangaphandle.

Kunqabile kakhulu, ukuba iimpawu zinzima kakhulu kwaye ezinye iindlela zonyango azisebenzanga, ugqirha wakho unokucebisa utyando lokususa yonke i-esophagectomy.

Iingxaki zonyango

Utyando lwe-Laparoscopic Heller myotomy kunye ne-POEM luphumelele kakhulu. Nangona kunjalo, ezinye iingxaki zinokwenzeka:

• Ukuphinda kuvele iimpawu ze-'Achalasia'.
• I-GERD (isifo se-gastroesophageal reflux) (ingakumbi ukuba i-fundoplication ayenziwanga emva kwe-Heller myotomy).
• Kunqabile kakhulu, ukugqobhoka kwe-esophagus ngexesha lotyando.

Yintoni onokuyilindela ukuba une-'Achalasia'?

Iimpawu ze-achalasia ngamanye amaxesha zinokuphinda zibuye nasemva konyango. Ngoko ke, ukujonga ugqirha ixesha elide (`ukulandelela`) kubaluleke kakhulu. Ugqirha wakho uza kukujonga rhoqo:

• Uvavanyo lwenziwa ukuqinisekisa ukuba ukutya kunye nolwelo kudlula kakuhle kwi-esophagus ukuya esiswini.
• Jonga iimpawu ze-GERD.
• Jonga iimpawu zokuqala zomhlaza womqala (le ngozi iphezulu kancinci xa une-achalasia).

Ukuba ayinyangwa, i-achalasia inokukhokelela ekusweleni kokutya kwaye inokuba yingozi ebomini. Nangona kunjalo, ngonyango olufanelekileyo, umntu ongena-achalasia unokuphila ubomi obuqhelekileyo.

Ndingazinyamekela njani?

Xa uphila nesifo esibizwa ngokuba yi-'Achalasia', kukho izinto ezininzi onokuzenza ukunceda ukudlulisa ukutya nokusela kwi-esophagus ngokulula kwaye ulawule iimpawu:

• Sika ukutya kube ziingceba ezincinci uze ukuhlafune kakuhle.
• Sela amanzi amaninzi ngelixa usitya. Oku kuya kumanzisa ukutya kwaye kuncede ukuba kunciphe lula.
• Yitya uhleli ngqo. Oku kuya kunceda amandla adonsela phantsi ekushukumiseni ukutya.
• Kuphephe ukutya ukutya okuqinileyo iiyure ezintathu ukuya kwezine ngaphambi kokuba ulale. Oku kuya kunika isisu sakho ixesha lokugaya ukutya ngaphambi kokuba ulale.
• Gcina umqamelo owongezelelweyo phantsi kwentloko yakho xa ulele. Ukugcina intloko yakho iphakanyisiwe kuya kunceda ukunciphisa amathuba okuba ukutya okuvela kumqala kungene kumphimbo womoya.

Zeziphi ukutya ekufuneka uziphephe ukuba une-'Achalasia'?

Ngenxa yokuba i-achalasia yenza kube nzima ukuba ukutya kudlule kwi-esophagus, ukutya okuthile kunokwenza iimpawu zibe zimbi ngakumbi. Lumka ngakumbi ngokutya okufana noku:

• Ukutya okunokuvala umphimbo: Umzekelo, ii-apile ezingaxotyulwanga, iidiliya, imifuno eluhlaza, inyama ene-fibrous okanye eyomileyo.
• Ukutya okunokuqina nokuqokeleleka emqaleni: Umzekelo, isonka (ingakumbi isonka esimhlophe), irayisi emhlophe, iitapile, iitships, kunye nepasta.
• Ukutya okunokucaphukisa umqala: Umzekelo, ukutya okuneziqholo, iziselo ezine-carbonated, kunye neziselo ezinxilisayo.

Oku kutya akuchaphazeli wonke umntu ngendlela efanayo. Kuya kufuneka uzibonele ngokwakho ngamava ukuba zeziphi ukutya ezinzima kuwe.

Ndifanele ndimbone nini ugqirha?

Ukuba ubona naluphi na utshintsho olutsha emzimbeni wakho, ingakumbi iimpawu ezintsha ze-Achalasia, ezinje ngobunzima bokuginya , bonana nogqirha ngokukhawuleza.

I-Achalasia yimeko engaqhelekanga apho iimpawu zikhula kancinci kancinci ngokuhamba kwexesha. Iimpawu zinokuqala kwisitshiso sentliziyo ukuya kwi-hiccups ukuya kubunzima bokuginya. Ngoko ke usenokungacingi kwangoko ukuba zonke ezi mpawu zinxulumene nesifo esinye.

Nangona kunjalo, kubalulekile ukuthetha nogqirha malunga nazo naziphi na iimpawu eziqhubekayo, nokuba zibonakala zinganxulumananga. Kukho iindlela ezahlukeneyo zonyango lwe-achalasia. Ugqirha wakho unokukuchazela unyango ngalunye aze akuncede ukhethe olulungele wena. Ungakhathazeki, ukuba uxilongiwe kwaye unyangwe kwangethuba, ungayilawula kakuhle imeko.

Isishwankathelo (Umyalezo Wokuya Ekhaya)

I-'Achalasia' yimeko apho izihlunu ezikwinxalenye esezantsi yomqala zingasebenzi kakuhle, nto leyo ethintela ukutya ukuba kungangeni esiswini. Iimpawu ziquka ubunzima bokuginya, iintlungu zesifuba, kunye nokutya okungena emqaleni. Kukho iimvavanyo ezikhethekileyo zokuxilonga oku. Unyango luquka ukwandiswa kwemisipha ngebhaluni, amayeza, kunye notyando. Nangona kungekho nyango lupheleleyo, iimpawu zinokulawulwa kakuhle kwaye ungaphila ubomi obuqhelekileyo. Ukuba unale mpawu, ungathandabuzi ukufuna ingcebiso kagqirha. Impilo yakho isezandleni zakho!

I- Achalasia, i-Cardiospasm, ubunzima bokuginya, i-Esophagus, i-LES, i-Dysphagia, i-Esophageal Manometry