Uma udla, uke uzizwe sengathi amanzi owaphuzayo awangeni emphinjeni wakho? Kuzwakala sengathi kukhona okubhajwe emphinjeni wakho... Mhlawumbe ukudla kubuyela emphinjeni wakho. Lokhu akuyona nje into, kungaba uphawu lwesifo esibizwa ngokuthi i-Achalasia . Nakuba abantu abaningi becabanga ukuthi lokhu kuyinto evamile, kubaluleke kakhulu ukuqaphela lokhu. Ngakho ake sixoxe ngakho namuhla.

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Kalula nje, iyini i-Achalasia?

Cabanga ngakho, uma sidla, ukudla kudingeka kusuke emlonyeni wethu kuye esiswini, akunjalo? Lolu hambo lwenzeka ngepayipi elibizwa ngokuthi i-esophagus. Ukuze le nqubo yenzeke kahle, kunezinto ezimbili okudingeka zenzeke.

1. Umphimbo udinga ukufinyela futhi ucindezele ukudla phansi, njengokuciphiza ipayipi lomuthi wokuxubha amazinyo.

2. I-valve encane (i-muscle flap) ekugcineni komphimbo, lapho ukudla kungena khona esiswini, idinga ukuvulwa.

Manje, uma une-achalasia, zombili lezi zinqubo azisebenzi kahle. I-esophagus ayikwazi ukusunduza ukudla phansi, futhi leyo valve ayivuli kahle. Kwenzekani-ke? Ukudla kubhajwa engxenyeni engezansi ye-esophagus. Kufana nomsele ovalekile esinkini. Ekugcineni, lokhu kudla okubhajwe kuqala ukubuyela phezulu emphinjeni.

Lesi yisimo esingavamile kakhulu. Sithinta cishe umuntu oyedwa kwabayisigidi. Kodwa asiveli ngokuzumayo, sikhula kancane kancane eminyakeni edlule. Abanye abantu baphila iminyaka eminingi bengenazo izimpawu. Nakuba singelapheki ngokuphelele, ngokwelashwa okufanele , ungaphila impilo evamile.

Yiziphi izimbangela ze-Achalasia?

Imbangela yangempela yalokhu ayikatholakali okwamanje, kodwa kunezinto ezimbalwa odokotela abacabanga ukuthi zingenzeka.

Izimbangela zofuzo: Lokhu kusho ukuthi zingazuzwa njengefa.
Izinkinga zokuzivikela komzimba: Yilapho isimiso somzimba sokuzivikela somzimba, esivikela umzimba wethu, sihlasela amangqamuzana ethu ezinzwa.
Ukutheleleka ngegciwane: Ezinye izifo ezibangelwa amagciwane kucatshangwa ukuthi zonakalisa imizwa esemgogodleni.
Ukuwohloka kwemizwa: Ukubhujiswa kancane kancane kwemizwa elawula imisipha yomphimbo.

Lesi simo singathinta noma ubani. Sithinta kokubili abesilisa nabesifazane ngokulinganayo. Kodwa sivame kakhulu kubantu abaneminyaka ephakathi kuka-25 no-60. Singathinta nezingane. Sibonakala nakubantu abane-Down syndrome.

Ingabe kukhona izinhlobo ze-Achalasia?

Yebo, i-Achalasia ihlukaniswe ngezinhlobo ezintathu eziyinhloko. Kuye ngokuthi unaluphi uhlobo, izimpawu kanye nokwelashwa kungahluka.

Uhlobo lwe-Achalasia	Incazelo elula
Uhlobo 1 (Uhlobo 1 - I-Achalasia Yakudala)	Lolu uhlobo olujwayelekile. Lapha, imisipha esemgogodleni ibonakala ingasebenzi lutho. Ukudla kwehlela phansi ngenxa yamandla adonsela phansi kuphela.
Uhlobo 2	Lolu uhlobo oluvame kakhulu. Lapha, ingcindezi iyanqwabelana ngaphakathi komphimbo, okwenza wonke umphimbo ucindezelwe. Izimpawu zinzima kakhulu kunohlobo lokuqala.
Uhlobo 3 (Uhlobo 3 - I-Spastic Achalasia)	Lolu uhlobo olunzima kakhulu. Imisipha engxenyeni engezansi ye-esophagus iyafinyela ngokuzumayo (i-spasm). Ngezinye izikhathi, ngisho nalapho ulele ebusuku, ungavuka unezinhlungu zesifuba ezinzima, njengokuhlaselwa yinhliziyo .

Yiziphi izimpawu eziyinhloko zalokhu?

Uphawu oluyinhloko noluvame kakhulu lwe-achalasia ubunzima bokugwinya uketshezi nezinto eziqinile . Ukudla kungabhajwa emphinjeni, okubangela ukuthi umphimbo uvuvuke noma ukhule.

Ngaphezu kwalokho, lezi zici zingabonakala futhi:

Ubuhlungu esifubeni ngemva kokudla.
Ukudla kubuyela emphinjeni.
Isilungulela kanye nokungagayeki kahle kokudla.
Ukwehlisa isisindo ngaphandle kwesizathu.
Ukukhwehlela ebusuku.
Ukuhlanza.
Ukudla noma uketshezi olungena emaphashini kungabangela i-pneumonia.
Ukuminyana.
Ukuqunjelwa noma ubunzima bokuphuma kwendle.

Lezi zimpawu zingaba zimbi kakhulu, ikakhulukazi uma udla ukudla okuqinile ngaphambi kokulala. Abanye abantu baphinde bazizwe bengakhululekile lapho bedla izinto ezifana nenyama nesinkwa.

Ukuthola kanjani lokhu, Dokotela?

Ngenxa yokuthi izimpawu ze-achalasia zifana kakhulu nezinye izimo zesisu, njenge-GERD (Gastroesophageal Reflux Disease), udokotela wakho angase akwelaphe lokho kuqala. Kodwa-ke, uma lokhu kungathuthuki, lezi zivivinyo zingenziwa ukuhlola i-achalasia.

I-Manometry: Lesi isivivinyo esingcono kakhulu sokuqinisekisa isimo. Lapha, kufakwa ipayipi elincane ngekhala lakho esiswini sakho bese udokotela elinganisa amandla emisipha emphinjeni wakho kanye nomsebenzi we-valve engezansi uma ugwinya uketshezi.
I-Upper Endoscopy: Ipayipi elinekhamera, elibizwa ngokuthi i-endoscope, lifakwa ngomlomo wakho bese kuhlolwa ingaphakathi lomphimbo wakho nesisu. Lisetshenziselwa ukuhlola ukukhubazeka kanye nokuncipha, futhi kungase kuthathwe i-biopsy uma kudingeka.
Ukugwinya kweBarium: Lokhu kubizwa nangokuthi i-Esophagogram. Lapha, unikezwa uketshezi olukhethekile olubizwa ngokuthi i-barium ukuze uluphuze bese kuthathwa i-X-ray. Lolu ketshezi lwenza umphimbo ubonakale ngokucacile ku-X-ray. Lokhu kwenza kube lula ukubona ukuthi kukhona yini ukuncishiswa kuwo.
Ukuhlolwa kwe-pH: Lokhu kulinganisa ubumuncu emqaleni wakho. Lokhu kungasiza ekunqumeni ukuthi unezinye izifo, njenge-GERD.

Yiziphi izindlela zokwelapha?

Umgomo oyinhloko wokwelashwa ukukhulula nokwandisa imisipha eqinile engxenyeni engezansi yomphimbo, okuvumela ukudla noketshezi ukuthi kudlule kalula esiswini. Udokotela wakho uzonquma ukwelashwa okungcono kakhulu kuwe ngokusekelwe eminyakeni yakho, izimpawu, kanye nezinye izimo zempilo.

Ukuhlinzwa

Ukwelashwa okuphumelelayo kakhulu kwe-achalasia ukuhlinzwa. Iningi labantu lithola ukululama isikhathi eside ngemva kokuhlinzwa.

Ukuhlinzwa kwe-Heller Myotomy: Lokhu kuyindlela yokuhlinzwa evame kakhulu. Ngokuvamile kwenziwa nge-laparoscopically, okusho ukuthi kwenziwa ngokusika okuncane esiswini nangosizo lwekhamera. Lapha, udokotela usika futhi akhulule ungqimba lwemisipha oluqinile phansi komphimbo.
I-Peroral Endoscopic Myotomy (POEM): Lena inqubo entsha yokuhlinzwa. Akukho ukusikwa okwenziwe ngaphandle. I-endoscope ifakwa ngomlomo, kusikwe okuncane olwelwesini lwe-esophagus, bese kusikwa imisipha eqinile.

Zombili lezi zindlela zokuhlinzwa ziyaphumelela, kodwa abanye abantu bangase babe ne-acid reflux ngemva kwalokho.

Ukwelashwa okungekona ukuhlinzwa

Akuwona wonke umuntu odinga ukuhlinzwa. Lezi zindlela zingasiza, kodwa aziyona ikhambi elihlala njalo njengokuhlinzwa. Kungase kudingeke ukwenze izikhathi eziningana.

Imijovo ye-Botox: Ngesikhathi sokuhlolwa kwe-endoscopy, kufakwa umjovo we-Botox (i-botulinum toxin) emisipheni eqinile. Lokhu kukhulula imisipha okwesikhashana.
Ukwanda Komoya:Kusetshenziswa i-endoscope, ibhaluni lifakwa endaweni encishisiwe ye-esophagus bese livuthelwa umoya ukuze lelule futhi likhulise imisipha.
Imithi: Imithi efana nama-nitrate kanye nama-calcium channel blockers ingasiza ekuphumuzeni imisipha eqinile. Kodwa-ke, lokhu kungabangela imiphumela emibi, ngakho-ke kufanele kusetshenziswe kuphela njengoba kuqondiswe udokotela wakho.

Lezi zinto zingasiza uma uhlala ne-Achalasia

Akukho ukudla okuqondile kwalesi simo. Kodwa uzoqonda ukuthi yikuphi ukudla okulula ukudla nokuthi yikuphi okunzima. Kungumqondo omuhle futhi ukubhala ngakho encwadini. Kubaluleke kakhulu ukuqaphela ukuthi udla kanjani futhi nini.

Hlafuna ukudla kahle bese ukudle kube yizicucu ezincane .
Yidla uhleli uqonde . Lokhu kuzosiza ukudla ukuthi kwehle kalula ngosizo lwamandla adonsela phansi.
Ungadli ukudla okuqinile ngaphambi kokulala .
Ukudla neziphuzo ezishisa kakhulu noma ezibandayo kakhulu kungabangela ukuqaqamba kwemisipha kwabanye abantu.
Phuza amanzi amaningi ngenkathi udla.
Abanye abantu bathi ukuphuza iziphuzo ezine-carbonated kusiza ekunciphiseni ukudla.

Uma isimo sakho sibi kakhulu, kungaba ngumqondo omuhle ukushintshela ekudleni okumanzi okwesikhashana. Kodwa uma kunjalo, khuluma nodokotela wakho ukuze uqiniseke ukuthi uthola ukudla okunomsoco okudingayo. Uma wehlisa isisindo esiningi, tshela nodokotela wakho, ngoba kungaba uphawu lokungondleki kahle.

Okubaluleke kakhulu, abanye abantu abane-Achalasia basengozini yokuthola umdlavuza womphimbo esikhathini esizayo. Ngakho-ke, kubalulekile ukubona udokotela ukuze ahlolwe njalo.

Umlayezo Wokuya Nawe Ekhaya

I-Achalasia yisimo lapho imizimba yethu ingakwazi ukuhambisa ukudla ngendlela efanele emphinjeni iye esiswini.
Izimpawu eziyinhloko zifaka phakathi ubunzima bokugwinya, ubuhlungu besifuba, kanye nokudla okubhajwe emphinjeni.
Lesi yisimo esingavamile. Nakuba singelapheki ngokuphelele, ngokwelashwa kanye nokushintsha kwendlela yokuphila, izimpawu zingalawulwa kahle futhi impilo evamile ingaphilwa.
Uma unezimpawu ezinjengalezi, ungazinaki futhi nakanjani ubone udokotela.