Wake wazizwa sengathi ukudla kwakho kubhajwe esifubeni sakho esikhundleni sokuthi kwehle esiswini sakho? Noma mhlawumbe uzizwa sengathi kuqhubeka kubuyela emphinjeni wakho ngemva kokuphuza amanzi amancane? Kuvamile ukuthi lokhu kwenzeke ngezikhathi ezithile. Kodwa uma kuqhubeka, akuyona into esingayinaki. Namuhla, sizokhuluma ngesimo esibangela ukungakhululeki okunjalo, kodwa esingaziwa kahle. Leso yi-Achalasia.
Kalula nje, iyini i-Achalasia?
I-Achalasia yisimo esingavamile esithinta umphimbo wethu. Ukuze sikuqonde kalula lokhu, ake siqale sibheke ukuthi umphimbo wethu usebenza kanjani ngokuvamile.
Cabanga ukuthi umphimbo wethu uyipayipi elenziwe ngemisipha egeleza emlonyeni wethu iye esiswini (esiswini). Uma sigwinya ukudla, imisipha ekuleli payipi iyafinyela kusukela phezulu kuya phansi ngokunyakaza okufana namagagasi (lokhu kubizwa ngokuthi i-peristalsis ngokwezokwelapha), isunduza ibhola lokudla phansi.
Ngaphansi kwalomhubhe, lapho uxhumeka khona esiswini, kukhona indandatho yemisipha esebenza njenge-valve. Lokhu sikubiza ngokuthi i-Lower Esophageal Sphincter (LES) . Kufana nomnyango. Lo mnyango (LES) uvula ngesikhathi esifanele lapho ibhola lokudla lehla, futhi ngemva kokuba ukudla kungene esiswini, uvala kahle futhi. Ngenxa yalokhu kuvalwa, ama-asidi esiswini awabuyeli emhubheni.
Manje, umuntu one-Achalasia uhlangabezana nokuphazamiseka okubili kule nqubo.
1. Imisipha emphinjeni ayisebenzi kahle: Inqubo efana namagagasi ecindezela ukudla phansi (i-peristalsis) engikhulume ngayo ayenzeki kahle. Kungakhathaliseki ukuthi ayenzeki nhlobo, noma yenzeka kancane kakhulu.
2. I-sphincter engezansi yomphimbo (LES) ayivuli: Ngisho noma ukudla kwehla, ingxenye efana ne-valve okufanele ingene esiswini (LES) ayivuli ngendlela efanele. Ihlala iqinile.
Ngakho-ke cabanga, ukudla akucindezelwa phezulu, futhi umnyango awuvuli phansi. Kwenzekani-ke? Konke ukudla neziphuzo esizigwinyayo kubhajwa ngaphakathi komphimbo. Akungeni esiswini. Yilokho okwenzekayo e-Achalasia.
Lesi simo sithinta cishe umuntu oyedwa kwabayi-100,000 emazweni afana ne-United States. Lokho kusho ukuthi asivamile kakhulu. Sivame ukuthinta abantu abadala abaneminyaka ephakathi kuka-25 no-60, kodwa ngezinye izikhathi singathinta abantu abangaphansi kwalokho.
Yiziphi izimpawu zomuntu one-Achalasia?
Izimpawu ze-achalasia azibonakali zonke ngesikhathi esisodwa. Zivela kancane kancane. Ungase ube nalesi simo izinyanga noma ngisho neminyaka, kodwa ungase ungaboni umehluko omkhulu. Izimpawu ziya ziba zimbi kakhulu ngokuhamba kwesikhathi.
Ake sibone ukuthi lezi zimpawu ziyini kuthebula elingezansi.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ubunzima bokugwinya (i-Dysphagia) | Lolu uphawu oluyinhloko noluvame kakhulu. Kuzwakala sengathi kukhona ukuvaleka komphimbo noma esifubeni lapho udla. Ekuqaleni, kuthinta ukudla okuqinile kuphela, kodwa kamuva, lokhu kungakhululeki kungenzeka nalapho uphuza uketshezi. |
| Ukubuyela emuva (ukudla okubuyela emphinjeni) | Ukudla okungagwinywanga okugwinyiwe, okubuyela emlonyeni. Lokhu akufani nokuhlanza. Akunambitheki kubamuncu ngoba akuxutshwanga nama-asidi esiswini. Lokhu kungenzeka ikakhulukazi ngesikhathi ulele. |
| Ubuhlungu besifuba | Ubuhlungu besifuba obufika budlule bungaba khona. Abanye abantu bangase bacabange ukuthi lokhu kuwukuhlaselwa yinhliziyo. |
| Ukwehlisa isisindo | Ngenxa yokuthi ukudla akungeni kahle esiswini futhi ngenxa yobunzima bokudla, umzimba uqala ukwehlisa isisindo ngaphandle kwesizathu. |
| Ezinye izici | Ubunzima bokugwinya, isilungulela, kanye nokuqunjelwa njalo nakho kungase kube khona. |
Kungani lokhu kwenzeka? Iyini imbangela?
Eqinisweni, odokotela abakaqiniseki ngokuphelele ukuthi yini ebangela i-Achalasia. Kodwa enye yezinkolelo-mbono eziyinhloko ukuthi iyisifo esibangelwa ukuzivikela komzimba .
Kalula nje, kusho ukuthi uhlelo lokuzivikela lomzimba wethu (amasosha omzimba) luhlasela ngephutha amangqamuzana ethu amahle. Nakhu okukholelwa ukuthi kwenzeka e-Achalasia:
- Amasosha ethu omzimba avuselelwa yinto efana nokutheleleka ngegciwane.
- Ngemuva kwalokho lesi simiso somzimba sokuzivikela siqala ngephutha ukuhlasela amangqamuzana ezinzwa alawula ukusebenza kwemisipha emhubheni wethu.
- Ngenxa yalokhu kuhlasela, lawo maseli ezinzwa ayabhujiswa kancane kancane.
- Uma lawo maseli ezinzwa elahlekile, imisipha esemlonyeni ayitholi izimpawu zokufinyela kahle. Futhi i-sphincter engezansi ye-esophageal (LES) ayitholi izimpawu zokuthi iphumule. Yilokho okubangela le nkinga.
Into ebaluleke kakhulu ukuthi lesi akusona isifo esidluliselwa ngofuzo noma esithathelwanayo. Ngakho-ke asikho isidingo sokukhathazeka ngaso.
Yiziphi izinkinga ezingaba khona ngenxa yalesi simo?
Uma i-achalasia ingelashwa kahle, ingaholela ezinkingeni ezinkulu. Ukudla neziphuzo eziqoqana emqaleni kungabuyela emphinjeni bese ngengozi kukhuphuke ngombhobho womoya kuye emaphashini. Uma lokho kwenzeka, kungavela izinkinga ezinjengalezi.
- I-Aspiration pneumonia: I-pneumonia enzima ebangelwa ukudla noma isiphuzo okungena emaphashini.
- Ukutheleleka kwamaphaphu kanye ne-bronchiectasis: Ukuhogela ukudla njalo emaphashini kungabangela ngisho nomonakalo ongapheli emaphashini.
- Ingozi ekhulayo yomdlavuza womphimbo: Uma i-achalasia ikhona isikhathi eside, kwenzeka izinguquko emaseli omphimbo, futhi ingozi yokuba nomdlavuza womphimbo iyanda kancane kunomuntu ojwayelekile.
- Ukungondleki: Ngenxa yokuthi ukudla akumuncwa kahle ngumzimba, umzimba ungase ube mncane futhi ungatholi ukudla okunomsoco okudingekayo.
Yingakho sithi uma unenkinga yokugwinya, kufanele ungayinaki bese ubona udokotela wakho ngokushesha okukhulu.
Udokotela usithola kanjani lesi sifo?
Uma uya kudokotela, uzokubuza ngezimpawu zakho bese ekwenza ukuhlolwa ngokomzimba. Uzobe esencoma ukuhlolwa okuningana ukuqinisekisa ukuthi une-Achalasia. Ukuhlolwa okuvame kakhulu yilokhu:
1. Ukuhlolwa kwe-Esophagram (Barium Swallow): Kulesi sivivinyo, unikezwa uketshezi olukhethekile olubizwa ngokuthi i-barium ukuze uluphuze. Lolu ketshezi lubonakala lumhlophe kuma-X-ray. Njengoba ulugwinya, kuthathwa uchungechunge lwezithombe ze-X-ray. Lokhu kukuvumela ukuthi ubone ngokucacile ukuthi uketshezi luhamba kanjani emhubheni, ukuthi luvinjiwe noma kuphi, ukuthi umhubhe ubanzi, noma ukuthi ingxenye engezansi inciphile (lokhu kubizwa nangokuthi uphawu 'lomlomo wenyoni').
2. I-Esophageal Manometry: Lolu vivinyo olungcono kakhulu nolunembe kakhulu lokuxilonga i-Achalasia. Kulokhu, kufakwa ipayipi elincane kakhulu, eliguquguqukayo ngekhala lakho liye emhubheni wakho. Ngenkathi ucelwa ukuba ugwinye inani elincane lamanzi, izinzwa ezisemhubheni zingalinganisa ngokunembile ukucindezela kokufinyela kwemisipha emhubheni wakho, ukuthi ngabe ukunyakaza okufana namagagasi (i-peristalsis) kuyenzeka, nokuthi ngabe i-sphincter engezansi ye-esophageal (LES) iphumula kahle yini.
3. I-Upper Endoscopy: Kulolu vivinyo , ithubhu eguquguqukayo (i-endoscope) enekhamera enamathiselwe ifakwa ngomlomo iye emhubheni bese ingaphakathi libukwa ngqo esikrinini. Lokhu kungaqinisekisa ukuthi umhubhe uvaliwe, ukuthi ukudla kubambekile, noma ngabe kunezinye izimo ezifana nomdlavuza.
Yiziphi izindlela zokwelapha i-Achalasia?
Umgomo oyinhloko wokwelapha i-achalasia ukukhulula i-sphincter engezansi esophageal (LES) eqinile, okuvumela ukudla ukuthi kudlule kalula esiswini.
Into ebalulekile ukuthi lezi zindlela zokwelapha azikwazi ukwelapha i-Achalasia ngokuphelele, njengoba amangqamuzana ezinzwa alahlekile engakwazi ukuvuselelwa. Kodwa-ke, lezi zindlela zokwelapha zingakusiza ukulawula izimpawu zakho futhi uphile impilo evamile .
Izinketho zokwelapha zingahlukaniswa ngezigaba ezimbili: okungezona ezokuhlinzwa kanye nokuhlinzwa. Udokotela wakho uzoxoxa nawe ngokwelashwa okufanele kakhulu ngokusekelwe esimweni sakho, ubudala, kanye nezintandokazi zakho.
| Uhlobo lokwelashwa | Indlela yokukwenza kanye nencazelo |
|---|---|
| Ukwelashwa Okungahlinzwa | |
| Ukwanda Kwebhaluni | Ngesikhathi sokuhlolwa kwe-endoscopy, ibhaluni lifakwa ngepayipi engxenyeni encane yomphimbo bese livuvukala. Imisipha emincane iyakhululeka, okwenza imbobo ibe nkulu kancane. Lokhu kwenziwa ngaphansi kwe-anesthesia elula. Kungadingeka wenze lokhu kwelashwa izikhathi eziningana. |
| Imithi | Imithi ingasetshenziswa ukukhulula imisipha ye-LES. Enye indlela ukufaka i-Botox® (i-botulinum toxin) emisipheni. Kukhona namaphilisi afana ne-nifedipine kanye ne-isosorbide. Kodwa-ke, imiphumela yalokhu ingeyesikhashana. |
| Ukwelashwa Kokuhlinzwa | |
| I-Laparoscopic Heller Myotomy | Lokhu ukuhlinzwa okuvamile nokuphumelela kakhulu. Kwenziwa izimbobo ezimbalwa ezincane kakhulu esiswini, kufakwa ikhamera kanye nezinto ezithambile, bese imicu yemisipha eqinile phansi komphimbo inqunywa kancane bese ihlukaniswa nengaphandle. Ukuqina kuyakhululwa bese umnyango ukhululeka. |
| I-Peroscopic Endoscopic Myotomy (INKONDLO) | Lena inqubo entsha. Ngaphandle kokwenza noma yikuphi ukusikwa ngaphandle komzimba, kufakwa i-endoscope ngomlomo bese imisipha eqinile inqunywa ngaphakathi komphimbo. |
Akuvamile kakhulu, uma izimpawu zinzima kakhulu futhi ezinye izindlela zokwelapha zingaphumeleli, ukuhlinzwa kokususa wonke umphimbo (i-esophagectomy) kungadingeka.
Yini okufanele ngikhathazeke ngayo ngemva kokwelashwa?
Izimpawu ze-Achalasia zingase zibuye ngemva kokwelashwa. Ngakho-ke, kuzodingeka uhlale uthintana nodokotela wakho isikhathi eside. Uzohlola njalo okulandelayo:
- Ungakwazi yini ukudlulisa ukudla okwanele nokuphuza ngomqala wakho kuya esiswini sakho?
- Ngenxa yokuthi umnyango ongezansi ukhululekile, isimo lapho ama-acid esiswini ebuyela khona e-esophagus (GERD) sesivele sikhona.
- Ingabe ikhona ingozi yokuba nomdlavuza womphimbo?
Lesi sifo ngeke sithinte impilo yakho yonke, kodwa sidinga ukwelashwa okufanele kanye nokulandelela .
Yini okufanele ngiyenze ngenkathi ngihlala ne-Achalasia?
Kanye nokwelashwa, ukwenza izinguquko ezincane endleleni yakho yokuphila kanye nemikhuba yokudla kunganciphisa kakhulu lokhu kungakhululeki.
- Shintsha imikhuba yakho yokudla: Uma udla, phula ukudla kwakho kube yizicucu ezincane, ukuhlafune kahle, bese ukugwinya. Phuza amanzi amaningi ekudleni kwakho. Lokhu kuzosiza ukudla ukuthi kuhlale kumanzi futhi kwehle kalula.
- Yidla uhleli uqonde: Hlala uqonde ngenkathi udla. Ungalali ihora noma amabili ngemva kokudla. Lokhu kuzosiza amandla adonsela phansi ukuthi ahambise ukudla phansi.
- Ungadli ngaphambi kokulala: Yeka ukudla ukudla okuqinile okungenani amahora angu-3-4 ngaphambi kokulala. Lokhu kuzonikeza isisu sakho isikhathi sokugaya ukudla ngaphambi kokulala.
- Lala ikhanda lakho liphakeme: Gcina ikhanda lakho liphakeme kancane ngokusebenzisa umcamelo owengeziwe ngenkathi ulele. Lokhu kuzonciphisa ingozi yokudla okusemlonyeni kungena emphinjeni.
Yikuphi ukudla okungafanele ngikudle?
Umuntu one-achalasia angase abe nobunzima bokugwinya ukudla okuthile. Qaphela kakhulu ngalezi zinhlobo zokudla.
- Ukudla okungabhajwa emphinjeni: ama-apula angahlutshiwe, amagilebhisi, imifino eluhlaza, inyama enamathelayo noma eyomisiwe.
- Ukudla okungaqina emhubheni: Izinto ezifana nesinkwa, ilayisi, amazambane, ama-chips, kanye ne-pasta zinganamathelana emhubheni bese ziqina.
- Izinto ezicasula umphimbo: ukudla okubabayo, iziphuzo ezine-carbonated (njenge-soda), utshwala.
Akudingeki uyeke ngokuphelele ukudla lokhu kudla, kodwa uma uzizwa ungakhululekile, kungcono ukungazinaki.
Umlayezo Wokuya Nawe Ekhaya
- I-Achalasia yisimo esingavamile esibangelwa imisipha ye-esophagus kanye ne-sphincter engezansi ye-esophageal (LES) engasebenzi kahle.
- Ubunzima bokugwinya, ukugabha, kanye nobuhlungu besifuba yizimpawu eziyinhloko.
- Lezi zimpawu zenzeka ngezikhathi ezithile, ngakho-ke ungakunaki ngisho nobunzima obuncane bokugwinya.
- Nakuba kungelapheki ngokuphelele, ukuhlinzwa kanye nezinye izindlela zokwelapha kungalawula ngempumelelo izimpawu futhi kuvumele abantu ukuba baphile impilo evamile.
- Uma unalezi zimpawu, kubaluleke kakhulu ukubona udokotela womndeni wakho ngokushesha okukhulu ukuze uthole iseluleko.
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