Wake wazizwa sengathi kukhona okubhajwe emphinjeni noma esifubeni sakho uma udla, uphuza amanzi amancane, noma ugwinya iphilisi? Uzizwa sengathi awukwazi ukugwinya ukudla kalula njengoba wawuvame ukwenza? Mhlawumbe ugwema ngokungazi ukudla okufana nokudla okuqinile nenyama. Uma nawe uzizwa kanje, ungakuthathi njengento evamile. Namuhla sizokhuluma ngesimo sezokwelapha esingaba imbangela yalokhu. Lokho kuwukuncipha komhubhe, ngokwezokwelapha okubizwa ngokuthi yi-Esophageal Stricture .
Kuyini Ukuqina Kwe-Esophageal?
Kulungile, ake sikuqonde kalula lokhu. Uyazi, sinengxenye efana nepayipi ethwala ukudla kusuka emlonyeni wethu kuya esiswini (esiswini). Lokhu sikubiza ngokuthi i-esophagus . Kufana nepayipi lamanzi. Igama elithi 'Stricture' lisho noma yiliphi ipayipi, indlela, noma ipayipi emzimbeni wethu elincipha noma elivalekile. Ngakho-ke, i-Esophageal Stricture yilapho lelo payipi lincipha ngendlela engavamile ngesizathu esithile.
Cabanga ngokungcola nokugqwala kwakheka ngaphakathi kwepayipi lamanzi, kunciphisa kancane kancane ipayipi. Kwenzeka into efanayo nasemqaleni wethu. Uma incipha, inciphisa isikhala sokudla neziphuzo ukuze kudlule kalula. Yingakho sinenkinga yokugwinya.
Lokhu kuvinjelwa kungenzeka ngaphakathi komphimbo noma ngaphandle. Ulwelwesi oluthambile lomphimbo (olubizwa ngokuthi 'i-mucosa') lungavuvukala noma lube nezibazi futhi lube lujiyile. Uma lokhu kwenzeka, ulwelwesi alunwebeki lapho sigwinya. Ngezinye izikhathi, into efana nesimila kwesinye isitho esizungeze umphimbo ingabangela ukuthi umphimbo uvinjwe ngale ndlela, noma ngabe kukhona ingcindezi evela ngaphandle. Esikhathini esiningi, le nqubo yenzeka kancane kakhulu, ngokuhamba kwesikhathi.
Ingabe lesi simo sibucayi?
Manje ungase uzibuze ukuthi lokhu kuyinto eyingozi yini. Empeleni, njengodokotela, asisithathi kalula lesi simo. Ngoba sithinta ngqo ikhono lakho lokugwinya ukudla, futhi uma singelashwa, singaba sibi kakhulu ngokuhamba kwesikhathi.
Into engcono kakhulu ukuthi ezimweni eziningi, lesi simo singalapheka ngokuphelele ngokungenelela kwezokwelapha okulula nokuncane. Kodwa-ke, ngephesenti elincane kakhulu, okungukuthi, akuvamile kakhulu, imbangela yalokhu kuvinjelwa kungaba umdlavuza. Leso yisimo esibi kakhulu. Yingakho sithi uma unenkinga yokugwinya, ungasinaki futhi ubone udokotela wakho ngokushesha okukhulu.
Ziyini izimpawu zalokhu? Uzizwa kanjani?
Uphawu lokuqala noluvame kakhulu ubunzima bokugwinya.. Ungakulawula lokhu ngokudla ukudla okuncane ekuqaleni, ukuhlafuna kahle, bese ukugwinya. Ungase futhi ugweme ukudla okubabayo nokuqinile (isibonelo, ilayisi elithosiwe, inyama). Kodwa njengoba umphimbo wakho uvaleka kakhulu, lezi zinto ngeke zisakusiza. Ungase uzizwe sengathi kukhona iqhubu emphinjeni wakho, noma sengathi imisipha yomphimbo wakho ayisebenzi kahle.
Cabanga nje, iqatha lenkukhu owawuthanda ukuyidla, manje lenza umphimbo wakho uzizwe uqinile. Ngakho-ke usunciphile ekudleni inkukhu. Ucabanga ukuthi kungenxa ye-"gastritis." Kodwa isizathu sangempela kungaba okunye.
Ngaphezu kwalesi sibonakaliso esiyinhloko, kungase kuvele ezinye izimpawu eziningana.
| Isibonakaliso | Kuchazwe kalula |
|---|---|
| Ubuhlungu besifuba obungeyona eyenhliziyo | Isifuba sami sibuhlungu, kodwa akungenxa yenkinga yenhliziyo. Kungenxa yenkinga emqaleni wami. |
| Ukukhwehlela noma ukuminyana lapho ugwinya ukudla | Ukhwehlela noma uminyaniswe ngokuzumayo lapho ugwinya ukudla. Lokhu kungenzeka ukuthi kungenxa yokuthi ukudla akwehli kahle. |
| Ukubuyela emtholampilo | Ukudla okugwinyiwe kubuyela emphinjeni. Akufani nokuhlanza, kuzwakala sengathi kuyaphuma. |
| Ukwehlisa isisindo ngokungenhloso | Ngenxa yokuthi udla kancane, isisindo somzimba wakho sizoqala ukwehla ngaphandle kokuthi uqaphele. |
Yiziphi izizathu eziyinhloko zalokhu?
Kunezizathu eziningana ezenza ukuthi umphimbo ube mncane. Ake siwahlukanise ngezigaba ezintathu eziyinhloko.
1. I-Esophagitis Engapheli
Lena yimbangela evame kakhulu . Kwenzeka lapho udonga lwangaphakathi lomphimbo luvuvukala isikhathi eside. Njengoba nje inxeba esikhumbeni sethu lishiya isibazi njengoba liphola, kanjalo futhi, lapho umphimbo ulimala njalo, kwakheka izicubu zesibazi (ezaziwa nangokuthi i-fibrosis). Lesi sibazi asinwebeki njengezicubu ezivamile, siyaqina. Yingakho umphimbo uncipha.
Imbangela eyinhloko yalokhu yi -acid reflux engapheli . Iningi lethu libiza lokhu ngokuthi "i-gastritis." Kalula nje, yilapho i-asidi esiswini ikhuphuka ingena emhubheni. Uma lokhu kwenzeka njalo, i-asidi iyashisa futhi ilimaze ulwelwesi oluthambile lomhubhe. Ngokuhamba kwesikhathi, lokhu kulimala kuba izibazi futhi kuvimbe umhubhe. Lena imbangela yamacala angaphezu kuka- 75% .
Ngaphezu kwalokho, kunezinye izizathu eziningana:
- I-Pill Esophagitis: Amanye ama-painkiller, ikakhulukazi ama-NSAID (imithi elwa nokuvuvukala engeyona i-steroidal) kanye ne-acetaminophen (i-paracetamol), angahlala emhubheni futhi alimaze udonga lwawo uma esetshenziswa njalo, ikakhulukazi uma egwinywa ngamanzi amancane.
- I-Esophagitis Ethelelanayo: Kubantu abanezivikeli mzimba ezibuthakathaka (njengeziguli ezine-HIV kanye neziguli ezinomdlavuza), amanye amagciwane (i-HPV, i-HSV-1) kanye ne-fungi (i-Candida albicans) angabangela ukuvuvukala komphimbo.
- I-Eosinophilic Esophagitis: Lesi yisimo esingavamile esibangelwa inkinga ngesimiso somzimba sokuzivikela. Umzimba usabela ngokweqile ezintweni ezithile ezibangela ukungezwani komzimba, okubangela ukuvuvukala okungapheli komphimbo. Lokhu kungaqala ebuntwaneni.
2. Ukulimala noma Ukulimala emphinjeni
Izibazi kanye nokuvaleka kungavela ngenxa yanoma yikuphi ukulimala odongeni lwangaphakathi lomphimbo. Lokhu kungavela futhi njengomphumela ongemuhle wezingozi noma ukwelashwa kwezokwelapha.
- Ukungena Okubangela Ubuhlungu: Ukuphuza uketshezi olubangela ukuvuvukala njenge-asidi, kungaba ngephutha noma ngenhloso yokuzibulala, kungabangela ukusha okukhulu kanye nezibazi emqaleni.
- Ukulimala Okushisayo: Ukugwinya into eshisayo kakhulu (isib. itiye elishisayo, iphalishi elishisayo) kungazelelwe kungashisa umphimbo.
- Ukwelashwa komdlavuza:Lapho kutholwa ukwelashwa ngemisebe yomdlavuza endaweni yentamo noma esifubeni, ukuvuvukala komhubhe (mucositis) kanye nokuvinjelwa okulandelayo (RIES) kungenzeka njengomphumela ongemuhle.
- Imithi: Ngesikhathi umphimbo uvulekile, ukufaka ama-steroid endaweni evinjiwe kunganciphisa ukuvuvukala futhi kuvimbele ukuphinda kwenzeke.
- I-Endoscopic Strituroplasty: Kulokhu, ithuluzi elikhethekile elifana nommese lidluliselwa nge-endoscope, esika izicubu zesilonda ezibangela ukuvaleka ezindaweni eziningana, okwenza indawo yande.
- Ukubopha: Ipayipi elincane, elifana ne-mesh (i-`stent`) lifakwa endaweni evalekile ukuze lihlale livulekile. Lokhu kufana ne-stent yomthambo ovalekile.
- Ukuhlinzwa: Lokhu kwenziwa kaningi kakhulu. Ezimweni zomdlavuza kanye nokuvaleka okukhulu okungaphenduli kwezinye izindlela zokwelapha, ukuhlinzwa kokususa ingxenye eyonakele yomhubhe (`Esophagectomy`) kungadingeka.
- Uma uzizwa unenkinga yokugwinya ukudla.
- Uma uvame ukuzwa isilungulela noma umuzwa we-asidi ukhuphuka emphinjeni wakho.
- Uma wehlisa isisindo ngaphandle kwesizathu esibonakalayo.
- Uma ucezu lokudla lubhajwa ngokuphelele emphinjeni.
- Uma ungakwazi nhlobo ukugwinya ukudla okuqinile.
- Uma ukudla kungena ku-trachea uma kugwinyiwe futhi kubangela ubunzima bokuphefumula.
- Uma uzwa ubuhlungu obukhulu esifubeni.
- Ubunzima bokugwinya akuvamile . Kuwuphawu. Ngakho ungalushayi indiva.
- Imbangela eyinhloko yesilungulela yisifo sohudo esihlala isikhathi eside noma i-acid reflux . Uma unesilungulela esihlala sikhona, thola ukwelashwa.
- Ukuxilongwa kusenesikhathi kanye nokwelashwa kwalesi simo kungaholela ekululameni okuhle kakhulu. Ngakho-ke uma unezimpawu, ungesabi ukubona udokotela.
- Ukuvaleka okuningi kungalapheka ngenqubo elula ebizwa ngokuthi i-dilation.
- Uma uzwa ukuminyana okungazelelwe noma ubuhlungu obukhulu besifuba, iya eMnyangweni Wezimo Eziphuthumayo (ETU) ngokushesha.
Kubaluleke kakhulu: Uma umuntu edla into enobuthi enjalo, shayela ngokushesha i-National Poisons Information Centre e-Colombo National Hospital . Futhi, thatha isiguli usiyise esibhedlela i-Emergency Treatment Unit (ETU) ngokushesha okukhulu.
3. Umdlavuza
Lokhu kungase kuzwakale kusabisa, kodwa kubalulekile ukwazi. Umdlavuza womqala ungabangela lolu hlobo lokuminyana. Kodwa-ke, ngokungafani nezinye izimbangela, izimpawu zokuminyana ngenxa yomdlavuza zivela ngokushesha kakhulu . Uma umuntu obedla kahle amasonto ambalwa eba nobunzima bokugwinya, kubaluleke kakhulu ukukhathazeka. Kunezinhlobo eziningana zomdlavuza womqala (i-Adenocarcinoma, i-Squamous cell carcinoma).
Kwenziwa kanjani ukuxilongwa?
Uma unalezi zimpawu, udokotela wakho cishe uzokudlulisela kudokotela wezifo zamathumbu. Uzolalela ngokucophelela izimpawu zakho futhi ancome ukuhlolwa okuningana ukuqinisekisa isimo.
| Ukuhlolwa | Kwenzekani? |
|---|---|
| Ukuhlolwa kwe-Barium Swallow | Lokhu ukuhlolwa kwe-X-ray. Unikwa uketshezi olumhlophe olufana ne-chalk olubizwa ngokuthi i-barium ukuze uluphuze. Njengoba ulugwinya, kuthathwa ividiyo ye-X-ray ukuze ubone ukuthi uketshezi luhamba kanjani emhubheni wakho. Lokhu kungabona ngokucacile ukuthi kukhona yini ukuvaleka noma ukuncishiswa noma yikuphi. |
| Ukuhlolwa kwe-Upper Endoscopy / EGD | Lolu uhlobo lokuhlola oluvame kakhulu nolunembe kakhulu lokuxilonga lesi sifo. Unikwa umuthi wokudambisa, bese kufakwa ipayipi elincane, eliguquguqukayo (i-'endoscope') elinekhamera encane enamathiselwe ngomlomo wakho ukuze kuhlolwe umphimbo wakho, isisu, kanye nengxenye yokuqala yamathumbu akho amancane. Lokhu kuvumela udokotela ukuthi abone ingaphakathi lomphimbo wakho esikrinini. Indawo yokuvaleka, imbangela yako, kanye nohlobo lokuvuvukala kungabonakala. Uma kudingeka, ucezu oluncane lwezicubu oluvela endaweni esolisayo lungathathwa luthunyelwe elabhorethri ukuze luhlolwe ('i-biopsy'). |
Iphathwa kanjani?
Umgomo oyinhloko wokwelapha lokhu ukwandisa umphimbo ovalekile futhi ukuze ukwazi ukugwinya ukudla ngaphandle kobunzima.
Ukwelashwa Okuyinhloko: Ukwanda Komqala
Lokhu ukwelashwa okuvamile kakhulu. Kalula nje, kuhilela ukwandisa kancane kancane ukuvaleka. Njengokuhlolwa kwe-endoscopy, ithuluzi elikhethekile (njenge-scope noma i-cylinder) lifakwa emhubheni ukuze kwandiswe kancane kancane ukuvaleka. Lokhu akwenziwa konke ngesikhathi esisodwa, kodwa izikhathi eziningana ngesonto. Njengoba ukuvaleka kuyanda kancane kancane, ubunzima bakho bokugwinya buzoncipha kancane kancane. Lokhu kwelashwa kusebenza kahle kakhulu ekuvinjweni okulula.
Ezinye izindlela zokwelapha
Kwezinye izimo eziyinkimbinkimbi zokuvinjelwa, noma ezimweni ezingaphenduli ekwelashweni kokwandiswa, ezinye izindlela zokwelapha kungadingeka zisetshenziswe.
Kufanele ubonane nini nodokotela?
Kubaluleke kakhulu ukuqaphela lezi zimpawu, ngoba uma zisheshe zibonakale, kuba lula ukuzelapha.
| Nini lapho kufanele uthole iseluleko sezokwelapha | |
|---|---|
| Izimo ezivamile lapho kufanele ubonane nodokotela: | |
| Yiya e-Emergency Treatment Unit (ETU) yesibhedlela ngokushesha! | |
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