Uzizwa sengathi kukhona okubambeke emphinjeni wakho noma iqhubu emphinjeni wakho uma ugwinya? Ngezinye izikhathi, ngemva kwesikhathi esithile, ikakhulukazi uma ugoba noma usonta, uzizwa sengathi ukudla okudlile kubuyela emphinjeni wakho? Imbangela yalokhu kungaba isikhwama esincane esakheka emhubheni wakho, ipayipi esigwinya ngalo ukudla. Ngokwezokwelapha, lokhu sikubiza ngokuthi i- Esophageal Diverticulum . Ungesabi uma uzwa leli gama, ake sixoxe ngalo kalula.
Kalula nje, iyini le Esophageal Diverticulum?
Cabanga ngomqala wakho, ipayipi lemisipha elithwala ukudla kusuka emlonyeni wakho liye esiswini sakho, njengethayi emotweni. Ngezinye izikhathi, uma kukhona indawo ebuthakathaka ethayini, umfutho womoya ngaphakathi ubangela ukuba igwebu elincane liphume kuleyo ndawo ebuthakathaka, akunjalo? Kunjalo nangalena.
Uma kukhona indawo ebuthakathaka olwelwesini lwe-mucosa yomphimbo wethu, ingcindezi edalwa lapho sigwinya ukudla ibangela ukuba kwakheke isikhwama esincane, noma umgodi, ngaphandle kwaleyo ndawo ebuthakathaka. Yilokho esikubiza ngokuthi i-Esophageal Diverticulum . Okunye kokudla noketshezi okugwinyayo kungabanjwa ngaphakathi kwalesi sikhwama.
Yiziphi izinhlobo eziyinhloko zalesi simo?
Odokotela bahlukanisa lezi zikhwama (diverticula) zibe izinhlobo eziningana ngokusekelwe endleleni ezakheka ngayo nokuthi zitholakala kuphi. Ake sibheke izinhlobo eziyinhloko.
Okokuqala, kunezinhlobo ezimbili zalezi: "iqiniso" kanye "namanga".
- I-True Diverticulum: Kulesi simo, isikhwama sakhiwa ngokuvela ngaphandle kuzo zonke izingqimba zodonga lomphimbo, kufaka phakathi imisipha.
- I-False Diverticulum: Kulokhu, zimbalwa kuphela izingqimba zangaphakathi zodonga ezivuvukala ngaphandle.
Manje ake sibone ukuthi lezi zihlukaniswa kanjani ngokwendawo ezikuyo emhubheni.
| Uhlobo lwe-Diverticulum | Indawo kanye nencazelo elula |
|---|---|
| I-Zenker Diverticulum | Lolu uhlobo oluvame kakhulu . Luvela engxenyeni engenhla yomphimbo, eduze kwasekuqaleni komphimbo. Ngokuvamile, lokhu kuyi-diverticula "yamanga". Imbangela eyinhloko ukucindezeleka okubangelwa ubunzima bokugwinya ukudla. |
| Killian-Jamieson Diverticulum | Lokhu kuncane kancane kune-Zenker Diverticulum. Kwenzeka endaweni yentamo. Ngokuvamile kubonakala njengesikhwama esincane, esisodwa. Kungase kubangelwe ubuthakathaka bokuzalwa ezicutshini ezikuleyo ndawo. |
| I-Midesophageal Diverticulum | Lokhu kuvela phakathi komphimbo, okuyingxenye engaphakathi komgodi wesifuba. Lokhu kuvame ukubizwa ngokuthi i-diverticula "yeqiniso". Kubangelwa ukudonswa kwangaphandle. Ukutheleleka esifubeni kungabangela ukuthi lokhu kwakheke lapho izicubu zivuvukala futhi zinamathela kumphimbo, ziwudonsele ngaphandle. |
| I-Epiphrenic Diverticulum | Lokhu kuvela engxenyeni engezansi yomhubhe, eduze nalapho kuhlangana khona nesisu. Lokhu kubizwa nangokuthi i-diverticula "yamanga", okubangelwa ukucindezeleka kwangaphakathi. Isibonelo, uma ingxenye engezansi yomhubhe ivaliwe, ingakheka njengoba ukudla kuzama ukungena esiswini. |
Ingabe lesi yisimo esivame kakhulu?
Cha, empeleni lesi yisimo esingavamile kakhulu . Sithinta cishe u-1% wabantu. Sivame kakhulu kubantu abangaphezu kweminyaka engu-50, ikakhulukazi ngemva kweminyaka engu-70. Sivame kakhulu futhi kwabesilisa kunabesifazane.
Ingabe nawe unalezi zimpawu?
Abantu abaningi banale diverticulum kodwa ababi nazo izimpawu. Ungase ungazi nokuthi unale diverticulum impilo yakho yonke. Kodwa uma unazo, kungenzeka ukuthi yi-Zenker diverticulum. Bheka ukuthi ubhekene nanoma yiziphi zalezi zimpawu:
- Kuzwakala sengathi kuyakhahlela emphinjeni yingakho ukhwehlela .
- Ukuzwa sengathi kukhona iqhubu emphinjeni wakho uma ugwinya ukudla.
- Ukuzwa sengathi ukudla kunamathele emphinjeni .
- Ukubuyela emuva kokudla kuwukubuyela kokudla emphinjeni uma ugoba noma uthambekele.
- Umoya omubi ngaphandle kwesizathu esithile.
- Ngezinye izikhathi umsindo wokukhala uvela esifubeni.
Kungani kwenzeka into efana nale? Yiziphi izizathu?
Kunezinhlobo ezimbili eziyinhloko zezimbangela zalokhu. Eyokuqala ukushukuma kwangaphakathi, kanti enye ukudonswa kwangaphandle.
1. Ngenxa yengcindezi (Pulsion Diverticula)
Iningi le-esophagus diverticula likhula ngale ndlela. Lokhu kwenzeka lapho kuba nokucindezeleka okuqhubekayo endaweni efanayo ngaphakathi kwe-esophagus. Esikhathini esiningi, lokhu kucindezeleka kwenzeka lapho sigwinya. Lokhu kucindezeleka okungavamile kungabangelwa nezinye izimo zezokwelapha ezenza kube nzima ukugwinya.
Ezinye zezimo ezinjalo yilezi:
- I-Achalasia: Ukungakwazi ukukhulula imisipha engxenyeni engezansi ye-esophagus.
- Ukuqaqamba komphimbo: Ukufinyela okungajwayelekile kwemisipha emqaleni.
- Ukuqina komlomo wesibeletho: Ukuncipha noma ukuncishiswa komphimbo.
- I-Eosinophilic esophagitis: Ukuvuvukala komphimbo ngenxa yokungezwani komzimba.
2. Ngenxa yokubambelela (i-Traction Diverticula)
Lokhu kwenzeka lapho into engaphandle komphimbo isunduza udonga ngaphandle. Lokhu kudala i-diverticula "yeqiniso", okusho ukuthi lonke ugqinsi lodonga lusunduzwa ngaphakathi. Lokhu kuvame ukwakheka phakathi komphimbo. Lokhu kubangelwa izicubu ezivela ngaphakathi komgodi wesifuba ezivuvukalayo, zinamathele kumphimbo, bese ziwudonsela ngaphandle.
Izifo ezingabangela ukuthi izicubu zesifuba zivuvuke ngale ndlela zifaka:
- Isifo sofuba
- I-Histoplasmosis (ukutheleleka kwesikhunta)
Into ebalulekile ukuthi lesi simo sivame ukwenzeka ngenxa yesinye isimo sezokwelapha esiyisisekelo. Akuvamile kakhulu ukuthi i-diverticulum ivele yodwa.
Yiziphi izinkinga ezingabangelwa yilokhu?
Ngokuhamba kwesikhathi, lesi sikhwama (i-diverticulum) singakhula kancane kancane. Lokhu kwandisa ingozi yokudla okubhajwe ngaphakathi kuso. Uma ukudla kubhajwe kanje, ungase uzizwe sengathi kuneqhubu emphinjeni wakho. Futhi, ukudla okubhajwe kungabangela ukutheleleka, ubuhlungu, nokuvuvukala .
Ukudla okubambekile kungabangela umoya omubi, ukunambitheka okubi emlonyeni, futhi ezimweni ezimbi kakhulu, kungazwakala sengathi yiqhubu entanyeni.
Enye into ukuthi ukudla okubhajwe kungabuyela emphinjeni uma ushintsha izikhundla, isibonelo uma ugoba. Lokhu kungabangela ukukhwehlela nokuphelelwa umoya. Into eyingozi kakhulu ukuthi uma lokhu kwenzeka ebusuku ngenkathi ulele , izinhlayiya zokudla zingangena emaphashini akho ngaphandle kokuthi uqaphele. Kwezokwelapha, lokhu sikubiza ngokuthi i-buthule aspiration . Lokhu kungabangela ukutheleleka emaphashini, okubizwa ngokuthi i-Aspiration Pneumonia .
Ingabe lo mdlavuza? Ingabe kukhona ingozi?
Lo mbuzo kungenzeka ukuthi ufike nakuwe. Lesi simo asisona ngempela umdlavuza. Kodwa akuvamile kakhulu , okungukuthi, kubantu abanale diverticulum.Kutholakale ukuthi iphesenti elincane kakhulu, cishe u-0.05%, liba ne- squamous cell carcinoma ngaphakathi kwalesi sikhwama. Akukacaci ukuthi ukucasuka okungapheli okuvela ekugcinweni kokudla isikhathi eside kulesi sikhwama kungaba yimbangela yini. Kodwa khumbula, le ngozi iphansi kakhulu .
Uyibona kanjani le nkinga?
Esikhathini esiningi, lokhu kutholakala ngengozi. Lesi sikhwama sitholakala kuphela uma umphimbo wakho uhlolwa esinye isimo. Kodwa-ke, uma unezimpawu, udokotela wakho uzoyala ukuhlolwa komphimbo wakho. Kunezindlela ezimbili eziyinhloko zalokhu. Lezi yi-radiology kanye ne-endoscopy.
Nazi ezinye izinhlobo zokuhlolwa ongazenza:
- I-Esophagram (Ukuhlolwa Kokugwinya Kwe-Barium): Lokhu kufana ne-X-ray. Unikwa uketshezi olufana ne-chalk olubizwa ngokuthi i-barium ukuze uluphuze. Uma lugwinywa, ingaphakathi lomphimbo lingabonakala kahle. Ngemuva kwalokho, njengoba ulugwinya, kuthathwa ividiyo ye-X-ray (fluoroscopy). Lokhu kuzokukhombisa ukuthi kukhona yini isikhwama.
- I-Upper Endoscopy (Ukuhlolwa kwe-EGD): Lokhu kuhilela ukufaka ithubhu elincane elifakwe ikhamera ngomlomo wakho ukuze kuhlolwe umphimbo wakho nesisu. Uzonikezwa i-anesthesia ukuqinisekisa ukuthi awuzizwa ungakhululekile phakathi nale nqubo. Izithombe ezivela kukhamera zingabukwa esikrinini sekhompyutha, okuvumela udokotela ukuthi abone ukuthi i-diverticulum ikuphi nokuthi inkulu kangakanani.
- Ukuhlolwa kwe-Esophageal Manometry: Lokhu kuhlolwa kungenziwa uma usola ukuthi i-diverticulum ibangela ubunzima bokugwinya. Lokhu kuhlolwa kuhlola ukuthi imisipha yakho iqine kangakanani nokuthi isebenza kahle kangakanani.
Yiziphi izindlela zokwelapha lokhu?
Izindaba ezinhle ukuthi iningi le-esophagus diverticula alidingi ukwelashwa . Uma ungenazo izimpawu noma izinkinga, ungavele ukhohlwe.
Kodwa-ke, uma izimpawu zakho ziphazamisa impilo yakho yansuku zonke noma uma kuvela izinkinga, isikhwama singase sidingeke sisuswe noma sivalwe. Kunezindlela eziningana zokwenza lokhu. Kungase kudingeke futhi welaphe isimo esiyisisekelo esibangele lokhu.
Izindlela zokwelapha
- Ukulungiswa Kokuhlinzwa: Udokotela ohlinzayo angasika futhi asuse isikhwama ngokuphelele (i-diverticulectomy). Noma, angasithunga asibuyisele odongeni lwe-esophagus (i-diverticulopexy). Ngezinye izikhathi, uma imbangela iwukuqina kwemisipha, inqubo ebizwa ngokuthi i-myotomy (ukusika nokukhulula imisipha) ingenziwa ngesikhathi esifanayo nalokhu kuhlinzwa.
- Ukwelashwa nge-endoscope (i-Endoscopic Diverticulotomy):Lena inqubo elula kunokuhlinzwa. I-endoscope ifakwa ngomlomo bese i-septum inqunywa phakathi kwesikhwama nodonga lomphimbo. Lokhu kwenziwa kusetshenziswa i-laser, i-electrocautery, noma idivayisi ye-stapler. Lawa madivayisi asika futhi avale inxeba ngesikhathi esifanayo.
Udokotela wakho uzoxoxa nawe ngendlela yokwelapha efaneleka kakhulu esimweni sakho.
Kuthatha isikhathi esingakanani ukululama ngemva kokwelashwa?
Ngemva kokwelashwa, kuzodingeka uhlale esibhedlela cishe usuku lonke. Ngemuva kwalokho kuzodingeka uye ekhaya uyophumula amasonto ambalwa. Ezinsukwini ezimbalwa zokuqala, umphimbo wakho ungase ube buhlungu futhi uvuvukele. Lokhu kungenza kube nzima ukugwinya.
Udokotela wakho uzokunikeza imithi yokubulala izinhlungu. Uzokunikeza nemiyalelo yokuthi ungaqala kanjani ngokudla okumanzi, kancane kancane ushintshele ekudleni okuthambile, bese udla ukudla okuvamile. Ukulandela le miyalelo kubaluleke kakhulu ukuze ululame ngokushesha.
Ekuphetheni, iningi labantu abanalesi simo alibi nezinkinga. Noma ngabe zikhona, kunezindlela zokwelapha ezisebenzayo. Izinga lempumelelo lokwelashwa lingaphezu kuka-90%.
Ngakho-ke uma unalezi zimpawu, ungesabi ukubona udokotela bese uthola iseluleko. Uzokwenzela izivivinyo ezidingekayo, akuchazele ngokucacile ukuthi unalesi simo, futhi uma kunjalo, ukuthi yini okufanele uyenze ngokulandelayo.
Umlayezo Wokuya Nawe Ekhaya
- I-esophageal diverticulum yisikhwama esincane esivela endaweni ebuthakathaka odongeni lwepayipi lapho sigwinya khona ukudla.
- Abantu abaningi banalokhu kodwa abanazo izimpawu.
- Izimpawu zingase zihlanganise ubunzima bokugwinya, ukudla okubhajwe emphinjeni, umoya onukayo, kanye nomuzwa wokuthi kukhona okubhajwe emphinjeni.
- Lokhu akuwona umdlavuza, futhi ingozi yokuba umdlavuza iphansi kakhulu.
- Uma unezimpawu, lesi simo singatholakala kalula nge-Barium Swallow Test noma i-Endoscopy.
- Ngokuvamile, akukho ukwelashwa okudingekayo. Kodwa-ke, uma izimpawu zinzima, ukuhlinzwa noma ukwelashwa nge-endoscopic kungelashwa ngempumelelo.
- Uma unokungabaza ngalokhu, khuluma nodokotela wakho nakanjani.
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