Unenkinga yokugwinya? Ingabe kungaba yi-'Achalasia'? Ake sixoxe ngalokhu!

Wake wazizwa sengathi ukudla noma isiphuzo sakho sibhajwe emqaleni wakho? Noma wake wazizwa ubuhlungu besifuba nokudla kubuyela emphinjeni wakho? Lokhu kungaba yinto ecasulayo kakhulu empilweni yakho yansuku zonke. Namuhla sizokhuluma ngesimo esingadala izimpawu ezifanayo, kodwa esingavamile kakhulu. Leso yisimo esibizwa ngokuthi 'i-Achalasia' (eyaziwa nangokuthi 'i-Cardiospasm').

Kuyini i-'Achalasia'? Masiyiqonde kalula!

Kalula nje, i-'Achalasia' yisimo esingavamile lapho umphimbo wethu, ipayipi elithwala ukudla kusuka emlonyeni wethu liye esiswini sethu, lingasebenzi kahle. Ubuwazi ukuthi umphimbo wethu awusiwo nje umphimbo? Uyipayipi elenziwe ngemisipha. Uma sigwinya okuthile, le misipha iyafinyela (njengegagasi) bese icindezela ukudla phansi. Sibiza le nqubo ngokuthi `(Peristalsis)`.

Manje ake ucabange ukuthi phansi kwe-esophagus, lapho ukudla kungena khona esiswini, kukhona indandatho yemisipha ebukeka njengesango. Lokhu kubizwa ngokuthi "i-Lower Esophageal Sphincter" noma "i-LES." Ngokuvamile, lapho ukudla kusondela kule "LES", kuyavuleka (kuyakhululeka) futhi kuvumele ukudla kudlulele esiswini. Bese kuvala futhi, kuvimbe okuqukethwe yisisu ukuthi kungabuyeli phezulu ku-esophagus.

Kodwa-ke, kumuntu one-'Achalasia', le nqubo iyaphazamiseka.

1. Ukunyakaza okufana ne-peristalsis endleleni yokugaya ukudla akwenzeki kahle, noma kubuthakathaka kakhulu.

2. Lowo mnyango obizwa ngokuthi `LES` awuvuli kahle lapho ukudla kufika. Ubhajwe.

Kwenzekani-ke? Izinto ozidlayo noziphuzayo zibhajwa emqaleni wakho, zingangeni esiswini sakho. Lokhu kubangela ubunzima bokugwinya, ubuhlungu besifuba, nokudla kubuyele emphinjeni wakho. Ngokuhamba kwesikhathi, umzimba ungancipha isisindo futhi ube nokuntuleka kokudla okunempilo ngoba awutholi ukudla okwanele.

I-'Achalasia' ayisona isifo esivame kakhulu. Ezweni elifana neMelika, ithinta cishe umuntu oyedwa kwabayizinkulungwane eziyikhulu. Ivame ukuthinta abantu asebekhulile, abaneminyaka ephakathi kuka-25 no-60. Kodwa-ke, ngezinye izikhathi izingane ezincane zingaba nalesi simo.

Ziyini izimpawu ze-'Achalasia'? Itholakala kanjani?

Izimpawu ze-'Achalasia' azibonakali ngokuzumayo. Esikhathini esiningi, zikhula kancane. Ungase ungawuboni umehluko izinyanga noma iminyaka. Izimpawu eziyinhloko ezingabonakala yilezi:

• Ubunzima bokugwinya (i-Dysphagia): Lolu uphawu oluyinhloko. Kungaba nzima ukugwinya ukudla okuqinile kuqala, bese kuba uketshezi.
• Ukuphinda udle: Lokhu akufani nokuhlanza, kodwa ukudla okungagayiwe kubuyela emphinjeni. Lokhu kungenzeka ikakhulukazi ebusuku ngesikhathi ulele.
• Ubuhlungu besifuba: Ubuhlungu obungazelelwe, ngezinye izikhathi obukhulu, esifubeni bungaba bukhulu kangangokuthi bungacatshangwa njengokuhlaselwa yinhliziyo.
• Ubunzima bokuchama.
• Isilungulela: Kodwa lokhu kungase kuhluke ekuvuvukeni kwe-gastritis evamile.
• Ukuquleka.
• Ukwehla kwesisindo okungachazeki: Ukwehla kwesisindo kwenzeka ngokuhamba kwesikhathi ngoba ukudla akumuncwa kahle ngumzimba.

Khumbula, lezi zimpawu ziya ziba zimbi kakhulu ngokuhamba kwesikhathi, ngakho-ke kubalulekile ukufuna iseluleko sezokwelapha uma ubona ngisho noshintsho oluncane kakhulu.

Yini ebangela i-'Achalasia'?

Eqinisweni, ochwepheshe abakayazi imbangela eqondile ye-achalasia. Kodwa-ke, kunenkolelo eyodwa eyinhloko. Okusho ukuthi, yisifo esibangelwa ukuzivikela komzimba, okusho ukuthi amasosha omzimba ethu ahlasela amangqamuzana omzimba wethu. Ngokwale nkolelo, kwenzeka into efana nale:

1. Amasosha ethu omzimba asebenza ngento efana negciwane.

2. Kodwa-ke, ngephutha, lesi simiso sokuzivikela komzimba siqala ukuhlasela amangqamuzana ezinzwa alawula ukusebenza kwemisipha yesisu sethu.

3. Lawa maseli ezinzwa ayabhujiswa kancane kancane.

4. Khona-ke ukunyakaza (i-peristalsis) okusunduza ukudla phansi emhubheni kanye nokuvulwa kwe-LES akwenzeki kahle.

Lona umbono owamukelwayo njengamanje, kodwa ucwaningo olwengeziwe luyaqhubeka.

Yiziphi izinkinga ezingaba khona ze-'Achalasia'?

Nge-achalasia, ukudla kubhajwa emqaleni, okungabangela ukuthi kubuyele emphinjeni futhi ngezinye izikhathi kungene emqaleni womoya. Uma lokhu kwenzeka, kungabangela izinkinga ezahlukahlukene. Isibonelo:

• I-Aspiration pneumonia: Isimo se-pneumonia esibangelwa ukudla okungena emaphashini.
• I-Bronchiectasis: Ukulimala kwemigudu yomoya emaphashini.
• Ukutheleleka kwamaphaphu.
• Ingozi ekhulayo yomdlavuza womphimbo: Le ngozi iyanda ngenxa yokudla okubhajwa emmphinjeni isikhathi eside kanye nokuvuvukala.
• Ukungondleki kahle: Lokhu kungenxa yokuntuleka kokudla emzimbeni.

Yingakho kubalulekile ukuxilonga nokwelapha i-Achalasia ngokushesha.

Odokotela bakuthola kanjani i-'Achalasia'?

Uma unezimpawu ezishiwo ngenhla, uma ubona udokotela, uzokubuza ngezimpawu zakho, ukuthi sezinesikhathi esingakanani zikhona, njll. Bazobe sebekwenza ukuhlolwa ngokomzimba. Kusetshenziswa izivivinyo ezintathu eziyinhloko ukuqinisekisa ukutholakala kwe-achalasia:

1. I-Esophagram (i-Barium Swallow): Kulesi sivivinyo, unikezwa uketshezi olubizwa ngokuthi i-barium ukuze uluphuze. Kuthathwa i-X-ray ukuze kubonwe ukuthi ukudla kuhamba kanjani emhubheni. Uma une-achalasia, umhubhe uyavuvukala futhi i-LES ayivuli kahle.

2. Ukuhlolwa kwe-Esophageal manometry:Kulokhu, kufakwa ipayipi elincane ngekhala lingene emhubheni kanye nendlela imisipha yomhubhe oncipha ngayo kanye nokucindezela kwe-'LES' kulinganiswa ngayo. Ku-'Achalasia', ukucindezela kwe-'LES' kuphezulu, futhi kungatholakala ukuthi akukho ukunyakaza komhubhe (i-peristalsis). Lesi isivivinyo esingcono kakhulu sokuxilonga i-'Achalasia'.

3. I-endoscopy Ephezulu: Ipayipi elincane, eliguquguqukayo elinekhamera enamathiselwe lifakwa ngomlomo liye emhubheni nasesiswini ukuze kubhekwe ngaphakathi. Lokhu kungasiza futhi ekuhloleni ezinye izinkinga emhubheni (njengomdlavuza). Ngezinye izikhathi i-biopsy, okuyingcezu encane yezicubu, ingase ithathwe ukuze ihlolwe.

Yiziphi izindlela zokwelapha i-'Achalasia'?

Umgomo oyinhloko wokwelashwa kwe-achalasia ukukhulula imisipha ye-LES phansi komphimbo, okuvumela ukudla ukuthi kudlulele esiswini. Lokhu kwelashwa akukwazi ukwelapha i-achalasia ngokuphelele , kodwa kungalawula izimpawu futhi kwenze impilo ibe lula. Udokotela wakho uzocabangela izimpawu zakho, ubudala, kanye nezintandokazi zakho ukuze anqume inketho yokwelashwa engcono kakhulu.

Ukwelashwa ngaphandle kokuhlinzwa

• Ukwandiswa kwebhaluni: Kulokhu, ibhaluni elikhethekile lidlula emhubheni, ngendlela efana ne-endoscopy, endaweni lapho i-LES ikhona, bese ibhaluni livuvukala. Bese kuthi indandatho yemisipha eqinile ikhululeke kancane. Lokhu kudala indlela yokudla okuzodlula ngayo. Lokhu kwenziwa ngaphansi kwe-anesthesia elula. Lokhu kwelashwa kungadinga ukuphindaphindiwe izikhathi eziningana.
• Imithi: Kunemithi ethile engaphumuza i-LES.
• Umjovo we-Botox® (botulinum toxin): I-Botox ifakwa ku-LES nge-endoscopy. Lokhu kuyakhubaza okwesikhashana futhi kuphumuze imisipha. Kodwa-ke, umphumela uhlala izinyanga ezimbalwa kuphela futhi kumele uphindwe.
• Amaphilisi afana ne-`Nifedipine` (`Procardia XL®`, `Adalat CC®`) noma i-`Isosorbide` (`Imdur®`, `Monoket®`). Lawa kufanele athathwe ngaphambi kokudla futhi aphumuze i-`LES`. Kodwa-ke, lawa awasebenzi kuwo wonke umuntu futhi angaba nemiphumela emibi.

Ukwelashwa ngokuhlinzwa

Kunezinqubo eziningana zokuhlinzwa ezingenziwa ukuze kuphumule i-LES. Lezi zivame ukwenziwa ngaphandle kokusikwa okukhulu, ngokusebenzisa ukusikwa okuncane (`Laparoscopic` / `Minimally invasive`).

• I-Laparoscopic Heller myotomy: Lokhu kuyindlela yokuhlinzwa evame kakhulu. Kulokhu, kufakwa ithuluzi, elifana ne-endoscope, ngokusikwa okuncane esiswini bese kusikwa imicu yemisipha ye-LES (i-myotomy isho ukusika imisipha). Lokhu kukhulula i-LES. Ngokuvamile, kwenziwa inqubo ebizwa ngokuthi i-fundoplication, ehilela ukugoqa ingxenye engenhla yesisu eduze komphimbo ukuze kuncishiswe i-reflux ye-acid esiswini iye kumphimbo (GERD).
• I-Peral endoscopic myotomy (POEM): Lena inqubo entsha. Kulokhu, kufakwa i-endoscope ngomlomo, ingena ngaphansi kolwelwesi lwe-esophagus, bese isika imisipha ye-LES. Lokhu akudingi ukusikwa kwangaphandle.

Akuvamile kakhulu, uma izimpawu zinzima kakhulu futhi ezinye izindlela zokwelapha zingasebenzi, udokotela wakho angase akuncome ukuhlinzwa ukuze kususwe wonke umphimbo (i-esophagectomy).

Izinkinga zokwelashwa

Ukuhlinzwa kwe-Laparoscopic Heller myotomy kanye ne-POEM kuphumelele kakhulu. Kodwa-ke, ezinye izinkinga zingavela:

• Ukuvela kabusha kwezimpawu ze-'Achalasia'.
• I-GERD (isifo se-gastroesophageal reflux) (ikakhulukazi uma i-fundoplication ingenziwa ngemva kwe-Heller myotomy).
• Akuvamile kakhulu, ukubhoboka komphimbo ngesikhathi sokuhlinzwa.

Yini ongayilindela uma une-'Achalasia'?

Izimpawu ze-achalasia ngezinye izikhathi zingaphinde zibuye ngisho nangemva kokwelashwa. Ngakho-ke, ukuqapha isikhathi eside kwezokwelapha (`ukulandelwa`) kubaluleke kakhulu. Udokotela wakho uzokukuhlola njalo:

• Ukuhlolwa kwenziwa ukuqinisekisa ukuthi ukudla noketshezi kudlula kahle emphinjeni kuya esiswini.
• Hlola izimpawu ze-GERD.
• Hlola izimpawu zokuqala zomdlavuza womphimbo (le ngozi iphezulu kancane nge-achalasia).

Uma ingelashwa, i-achalasia ingaholela ekuntuleni ukudla okunempilo futhi ingaba yingozi empilweni. Kodwa-ke, ngokwelashwa okufanele, umuntu ongenayo i-achalasia angaphila isikhathi esijwayelekile sokuphila.

Ngizinakekela kanjani?

Uma uphila nesifo esibizwa ngokuthi 'i-Achalasia', kunezinto eziningana ongazenza ukusiza ukudlulisa ukudla nokuphuza emhubheni kalula futhi ulawule izimpawu:

• Sika ukudla kube yizicucu ezincane bese ukuhlafuna kahle.
• Phuza amanzi amaningi ngesikhathi udla. Lokhu kuzokwenza ukudla kumanzi futhi kusize ukuthi kwehle kalula.
• Yidla uhleli uqonde. Lokhu kuzosiza amandla adonsela phansi ukuthi ahambise ukudla phansi.
• Gwema ukudla ukudla okuqinile emahoreni amathathu kuya kwamane ngaphambi kokulala. Lokhu kuzonikeza isisu sakho isikhathi sokugaya ukudla ngaphambi kokuba ulale.
• Gcina umcamelo owengeziwe ngaphansi kwekhanda lakho uma ulele. Ukugcina ikhanda lakho liphakeme kuzosiza ekunciphiseni amathuba okudla okuvela emhubheni womoya.

Yikuphi ukudla okufanele kugwenywe uma une-'Achalasia'?

Ngenxa yokuthi i-achalasia yenza kube nzima ukuthi ukudla kudlule emhubheni, ukudla okuthile kungenza izimpawu zibe zimbi kakhulu. Qaphela kakhulu ngokudla okufana nalokhu:

• Ukudla okungavimba umphimbo: Isibonelo, ama-apula angahlutshiwe, amagilebhisi, imifino eluhlaza, inyama ene-fiber noma eyomisiwe.
• Ukudla okungajiya futhi kuqongelelane emqaleni: Isibonelo, isinkwa (ikakhulukazi isinkwa esimhlophe), ilayisi elimhlophe, amazambane, ama-chips, kanye ne-pasta.
• Ukudla okungacasula umphimbo: Isibonelo, ukudla okunongwe, iziphuzo ezine-carbonated, kanye neziphuzo ezidakayo.

Lokhu kudla akuthinti wonke umuntu ngendlela efanayo. Kufanele uzitholele ngokwakho ngokuzibonela ukuthi yikuphi ukudla okunzima kuwe.

Kufanele ngimbone nini udokotela?

Uma ubona noma yiziphi izinguquko ezintsha emzimbeni wakho, ikakhulukazi izimpawu ezintsha ze-Achalasia, njengobunzima bokugwinya , bona udokotela ngokushesha.

I-Achalasia yisimo esingavamile lapho izimpawu zikhula kancane kancane ngokuhamba kwesikhathi. Izimpawu zingasukela ekushiseni kwenhliziyo kuya ekuguleni kuya ekubunzimeni kokugwinya. Ngakho-ke ungase ungacabangi ngokushesha ukuthi zonke lezi zimpawu zihlobene nesifo esisodwa.

Kodwa-ke, kubalulekile ukukhuluma nodokotela nganoma yiziphi izimpawu eziqhubekayo, noma ngabe zibonakala zingahlobene. Kunezindlela eziningana zokwelapha i-achalasia. Udokotela wakho angakuchazela ukwelashwa ngakunye futhi akusize ukhethe okulungele wena. Ungakhathazeki, uma uxilongwa futhi welashwa kusenesikhathi, ungasiphatha kahle lesi simo.

Isifinyezo (Umyalezo Wokuya Nawe Ekhaya)

I-'Achalasia' yisimo lapho imisipha engxenyeni engezansi yomhubhe ingasebenzi kahle, okuvimbela ukudla ukuthi kungadluleli esiswini. Izimpawu zifaka phakathi ubunzima bokugwinya, ubuhlungu besifuba, nokudla ukungena emphinjeni. Kunezivivinyo ezikhethekile zokuxilonga lokhu. Ukwelashwa kuhlanganisa ukwandiswa kwemisipha ngebhaluni, imithi, kanye nokuhlinzwa. Nakuba kungekho ukwelashwa okuphelele, izimpawu zingalawulwa kahle futhi ungaphila impilo evamile. Uma unalezi zimpawu, ungangabazi ukufuna iseluleko sezokwelapha. Impilo yakho isezandleni zakho!

I- Achalasia, I-Cardiospasm, Ubunzima bokugwinya, i-Esophagus, i-LES, i-Dysphagia, i-Esophageal Manometry