Ingabe nawe unenkinga yokugwinya ukudla? Ake sifunde nge-Plummer-Vinson syndrome?

Ingabe ukuthola kunzima ukugwinya ukudla? Noma uzizwa ukhathele ngaso sonke isikhathi, uzizwa uvilapha? Ngezinye izikhathi lezi zinto zibonakala zivamile, kodwa kungase kube nesinye isizathu ngemuva kwazo. Namuhla sizokhuluma ngesimo sezokwelapha esingavamile kodwa esibalulekile. Leso yi-Plummer-Vinson syndrome.

Iyini i-Plummer-Vinson syndrome?

Kalula nje, i-Plummer-Vinson syndrome (PVS) yisimo lapho izimpawu ezintathu ezihlobene zenzeka khona ndawonye. Odokotela ngezinye izikhathi babiza lokhu ngokuthi "unxantathu," okusho "inhlanganisela yezinto ezintathu." Ake sibheke ukuthi ziyini lezi zimo ezintathu:

1. I-anemia yokuntuleka kwensimbi: Lokhu kwenzeka lapho umzimba wakho ungenayo insimbi eyanele yokwenza iphrotheni ebizwa ngokuthi i-hemoglobin emaseli akho abomvu egazi. Uyazi, i-hemoglobin yiyo ethwala umoya-mpilo kuwo wonke amaseli emzimbeni wakho. Ngakho-ke, uma ungenayo insimbi eyanele, i-hemoglobin ayikhiqizwa kahle, futhi umzimba wakho awutholi umoya-mpilo owudingayo. Yilokhu okubangela izimpawu ezifana nokukhathala nokuphaphatheka.

2. Ama-esophageal webs: Lokhu kwenzeka lapho kwakheka izicubu ezincane, ezingavamile ngaphakathi komphimbo wakho, noma ipayipi lokudla. Cabanga ngakho njengomphimbo wesicabucabu owakheka kuwo wonke umphimbo wakho. Lokhu kubangela ukuthi umphimbo ube mncane futhi uvaleke. Lokhu kwenza kube nzima ukuthi ukudla kudlule.

3. Ubunzima bokugwinya (i-Dysphagia): Leli igama odokotela abalibiza ngobunzima bokugwinya ukudla neziphuzo ngenxa yolwelwesi lomphimbo okukhulunywe ngalo ngenhla. Abanye abantu bangase babe nobunzima bokugwinya hhayi ukudla okuqinile kuphela kodwa noketshezi.

Lokhu kubizwa ngamanye amagama. Elinye yi-sideropenic dysphagia. Futhi e-United Kingdom, okungukuthi, eNgilandi, kubizwa ngokuthi i-Paterson-Brown Kelly syndrome.

Manje, nansi into okungafanele uyesabe. Abantu abane-Plummer-Vinson syndrome (PVS) kuthiwa basengozini enkulu yokuba nomdlavuza womphimbo noma umdlavuza we-hypopharyngeal kamuva ekuphileni. Kodwa-ke, lokhu kumane kuyingozi . Udokotela wakho uzokuhlola njalo futhi akuqaphe njengoba kudingeka ukuze athole noma yiziphi izimo ezinjalo kusenesikhathi.

Ziyini izimpawu zalokhu?

Kulungile, manje ake sibone ukuthi yiziphi izimpawu eziboniswa umuntu one-Plummer-Vinson syndrome (PVS). Lezi zimpawu azibonakali kubo bonke ngendlela efanayo, futhi abanye abantu bangase babe nezinye zezimpawu kuphela.

• Ukuzizwa ukhathele futhi ukhathele ngaso sonke isikhathi: Lokhu kuyisibonakaliso esikhulu sokuntuleka kwe-iron. Uzizwa ukhathele ngisho nangemva kokwenza imisebenzi emincane futhi uzizwe ulele usuku lonke.
• Ubunzima bokuphefumula (ukuphelelwa umoya): Ungase uzizwe uphelelwa umoya, hhayi nje kuphela uma uhamba kancane, ukhuphuka izitebhisi, kodwa ngezinye izikhathi ngisho nalapho umi nje.
• Ubunzima bokugwinya ukudla:Lesi yisibonakaliso esiphawuleka kakhulu salesi sifo. Ikakhulukazi uma ugwinya ukudla okuqinile, njengelayisi, isinkwa, inyama nenhlanzi, kuba nomuzwa wokuqina emphinjeni nasesifubeni. Abanye abantu kufanele baphuze amanzi amancane ukuze bagwinye ukudla. Nakuba ukudla okuqinile kunzima ekuqaleni, kamuva kungaba nzima nokugwinya uketshezi.
• Ulimi luyavuvukala, luvuvuke, lube bomvu (glossitis): Ulimi luba bushelelezi, lube bomvu, futhi ngezinye izikhathi lungase luzwakale sengathi luyasha.
• Umlomo owomile (xerostomia): Ingaphakathi lomlomo lizwakala lomile ngaso sonke isikhathi, futhi kunomuzwa wokuntuleka kwamathe.
• I-Angular cheilitis: Amakhona omlomo ayaqhekeka, abe bomvu, futhi abe buhlungu.
• Izinzipho ziyaqina futhi zibe ziyisicaba njengezipuni: Izinzipho zibuthakathaka kakhulu futhi ziyaphuka kalula. Ngezinye izikhathi izinzipho ziyacwila phakathi, njengesipuni (koilonychia).
• Ukuvuvukala kwendlala yegilo kanye namaqhubu (amaqhubu egilo): Indlala yegilo, etholakala ngaphambili entanyeni, ingakhula futhi izwakale njengeqhubu.
• I-Splenomegaly: I-spleen iyisitho esitholakala ohlangothini olungaphezulu kwesobunxele lwesisu sethu. Singavuvukala futhi kulesi simo, kodwa ngokuvamile asibangeli zimpawu ezinkulu.

Iyini imbangela yalokhu?

Eqinisweni, abacwaningi abakaqiniseki ngokuphelele ukuthi yini ebangela i-Plummer-Vinson syndrome (PVS). Kodwa kunezinto ezimbalwa abazicabangayo nabazisolayo:

• Ukuntuleka kwensimbi kuyinto esolwa kakhulu: Abantu abaningi bacabanga ukuthi ukuntuleka kwensimbi isikhathi eside kubangela ukuthi imisipha esemgogodleni ibe buthaka futhi yakhe ama-web. Insimbi iyadingeka kuma-enzyme amaningi emzimbeni wethu.
• Ukushoda kokudla okunempilo: Kukhona inkolelo yokuthi akuyona nje i-iron, kodwa namanye amavithamini namaminerali angathinta lokhu.
• Izifo ezithinta amasosha omzimba: Kungenzeka ukuthi uke wezwa ngezifo ezifana ne-rheumatoid arthritis kanye nesifo se-celiac. Lezi yizifo ezithinta amasosha omzimba ezenzeka lapho amasosha omzimba ethu ehlasela amangqamuzana ethu. Ngakho-ke, njengoba abanye abantu abane-PVS nabo benalezi zifo, odokotela bacabanga ukuthi kungenzeka ukuthi kuhlobene nesistimu yomzimba.
• Ithonya lezakhi zofuzo: Abanye bakholelwa ukuthi lesi yisimo sezakhi zofuzo, okusho ukuthi uma othile emndenini enaso, nabanye banamathuba amaningi okuba naso.

Kodwa lokhu kuseyimibono nje. Kudingeka ucwaningo olwengeziwe ukuze kutholakale imbangela eqondile.

Ubani osengozini enkulu yokuthuthukisa lokhu?

I-Plummer-Vinson syndrome (PVS) iyisimo esingavamile kakhulu . Ayithinti wonke umuntu. Kodwa-ke, ngokwezibalo, ivame kakhulu kwabesifazane abamhlophe. Ngokuvamile ithinta abesifazane abaseminyakeni ephakathi, abaneminyaka ephakathi kuka-40 no-70.Lena yimbangela evame kakhulu. Kodwa-ke, akuvamile kakhulu, okungukuthi, akuvamile kakhulu, ukuthi kubikwe ukuthi kwenzeka kubantu abasebasha ngisho nasezinganeni ezincane.

Esikhathini esidlule, okungukuthi, ekuqaleni kwawo-1900, lesi sifo sasivame kakhulu emazweni aseScandinavia (isib., eSweden, eNorway). Kodwa-ke, ngasekupheleni kwawo-1900, okungukuthi, emashumini ambalwa eminyaka edlule, asisavamile kakhulu kulawo mazwe. Isizathu esiyinhloko salokhu kucatshangwa ukuthi ukuthuthuka kwesimo sokudla kwabantu kulawo mazwe ngaleso sikhathi, ikakhulukazi ukutholakala kalula kokudla okucebile ngensimbi.

Yiziphi izinkinga ezingaba khona ze-PVS?

Njengoba sesikhulume kancane ngaphambili, abantu abane-Plummer-Vinson syndrome (PVS) batholakale benengozi enkulu kancane yokuba nomdlavuza womphimbo kanye nomdlavuza we-hypopharyngeal, umdlavuza engxenyeni engezansi yomphimbo, obizwa ngokuthi i-hypopharynx, kunabantu abangenayo i-PVS.

Kodwa ungakhathazeki ngalokhu. Akuwona wonke umuntu one-PVS ozoba nomdlavuza. Lokhu kumane kuyisici esiyingozi.

Ngenxa yokuthi lesi sifo asivamile, asikho idatha eyanele yocwaningo yokusho ukuthi bangaki abantu abane-PVS abathola umdlavuza.

Kodwa uma unalesi simo, udokotela wakho uzozama ukuthola noma yini efana nomdlavuza kusenesikhathi , ngoba kunethuba elikhulu lokwelashwa nokwelashwa. Yingakho kubalulekile ukuya kohlolwa njalo, njengoba udokotela wakho esho.

Itholakala kanjani i-Plummer-Vinson syndrome (PVS)?

Uma unezimpawu ezishiwo ngenhla, uma uya kudokotela, uzokubuza imibuzo futhi akuhlole. Ngemuva kwalokho, bazoyala ukuhlolwa kwegazi kanye nezinqubo ezikhethekile zokuthatha izithombe ukuqinisekisa ukuthi une-PVS.

• Ukuhlolwa kwegazi: Lokhu kuhlola ikakhulukazi i-anemia yokuntuleka kwensimbi.
• Ukubalwa Kwegazi Okuphelele (i-CBC): Lokhu kungahlola izinto eziningi njengeseli lakho elibomvu legazi, iseli elimhlophe legazi, kanye namazinga e-hemoglobin.
• Ukuskena Kwegazi Okuseduze (i-PBS): Lokhu kuhilela ukubuka isampula yegazi ngaphansi kwe-microscope ukuhlola ukuma nobukhulu bamaseli abomvu egazi. Uma ukuntuleka kwensimbi, amaseli abomvu egazi angaba mancane futhi acwebezele (ama-microcytic, hypochromic).
• Ukuhlolwa kwezinga lensimbi: Ukuhlolwa okufana ne-serum ferritin, i-serum iron, kanye ne-TIBC (Total Iron Binding Capacity) kunganikeza umbono wenani lensimbi emzimbeni.

• Ukuhlolwa kwezithombe: Lokhu kubheka izintambo zomqala kanye nembangela ye-dysphagia.
• I-endoscopy Ephezulu (OGD - I-Oesophago-Gastro-Duodenoscopy):Kulokhu, kufakwa ipayipi elinekhamera encane enamathiselwe ngomlomo bese kuhlolwa umphimbo, isisu, bese kuhlolwa ingxenye yokuqala yamathumbu amancane. Lokhu kukuvumela ukuthi ubone ngqo ukuthi kukhona yini ama-webs. Uma kudingeka, kungathathwa ingcezu encane yezicubu (i-biopsy) ukuze ihlolwe.
• I-Barium swallow / Esophagram: Kulolu vivinyo, uphuza into ebizwa ngokuthi i-barium bese uthwetshulwa izithombe ze-X-ray. I-barium yenza i-esophagus ibonakale ku-X-ray, okukuvumela ukuthi ubone noma yiziphi izindawo ezivalekile noma ezijiyile.
• I-Videofluoroscopy: Lokhu futhi ukuhlolwa kwe-X-ray. Kuqopha ividiyo yakho ugwinya izinhlobo ezahlukene zokudla. Lokhu kungakusiza ukuthi ubone kahle ukuthi ugwinya kanjani nokuthi inkinga ikuphi.

Ngezinye izikhathi udokotela kungadingeka enze izivivinyo ezengeziwe ukuze athole imbangela yangempela yokuntuleka kwensimbi. Isibonelo, bangase babheke izilonda esiswini noma ukopha emathunjini.

Kuphathwa kanjani lokhu?

Kunemigomo emibili eyinhloko lapho welapha i-Plummer-Vinson syndrome (PVS). Eyokuqala ukulungisa ukuntuleka kwensimbi , kanti enye ukubhekana nobunzima bokugwinya ukudla .

• Ukwelashwa kokuntuleka kwensimbi:
• Into eyinhloko ukunikeza umzimba wakho insimbi oyidingayo. Ungathatha izithasiselo zensimbi kulokhu. Kufanele uzithathe njengoba nje udokotela wakho ekutshelile, isikhathi akutshela sona.
• Kwabanye abantu, uma amaphilisi ensimbi aphuzwa ngomlomo engamuncwa kahle, noma uma ukuntuleka kwensimbi kukhulu kakhulu, insimbi ingase inikezwe ngemithambo yegazi ngezinye izikhathi (IV - Iron Intravenous).
• Uma unesinye isimo sezokwelapha esibangela ukuntuleka kwensimbi (isib. ukopha okukhulu kokuya esikhathini, ama-hemorrhoids, izilonda zesisu), kufanele nakanjani ulaphe naso.

• Ukwelashwa kobunzima bokugwinya (i-Dysphagia):
• Ezimweni eziningi, uma lokhu kuntuleka kwensimbi kwelashwa, futhi umzimba uthola insimbi, ama-esophagus ayanyamalala cishe ngokuzenzakalelayo, futhi ubunzima bokugwinya ukudla buyancipha kakhulu.
• Ake sithi ukwelashwa ngensimbi kukodwa akukuqedi ngokuphelele ubunzima bakho bokugwinya. Uma kunjalo, kunenqubo yokwandisa, noma yokwelula, umphimbo wakho. Kubizwa ngokuthi ukunwebeka komphimbo . Lokhu kwenziwa ngesikhathi se-endoscopy. Idivayisi encane efana nebhaluni ifakwa engxenyeni encane yomphimbo bese ivuvukala noma inwetshwe ukuze inwebe umphimbo. Lokhu akuyona inqubo enkulu yokuhlinzwa, kodwa inqubo elula, evame ukungabi buhlungu ehilela ukungasikeki umphimbo. Abanye abantu bangadinga ukwenza lokhu izikhathi ezingaphezu kwesisodwa.

Iyini ikusasa lalesi simo?

Eqinisweni, umuntu one-Plummer-Vinson syndrome (PVS) angalindela imiphumela emihle kanye nokululama .

Kwabaningi, uma ukuntuleka kwensimbi sekulungisiwe, izimpawu ze-anemia (njengokukhathala nokuphelelwa umoya) ziyancipha kakhulu. Futhi, ubunzima bokugwinya ukudla buthuthuka kakhulu.

Uma ubunzima bokugwinya bungaxazululwa ngokwelashwa ngensimbi kuphela, ukwelashwa kokukhulisa umphimbo okukhulunywe ngakho ngaphambili kuvame ukuthuthukisa ubunzima bokugwinya. Abanye abantu bangadinga ukwenza lokhu kwelashwa kokukhulisa umphimbo izikhathi ezingaphezu kwesisodwa. Kodwa kuyinqubo elula kakhulu futhi enobungozi obuphansi.

Udokotela wakho angase afune ukwenza i-endoscopy yokuqapha ukuze ahlole izimo ezifana nomdlavuza emqaleni wakho noma emphinjeni. Kodwa khumbula, ukuba ne-PVS kumane kuyisici esiyingozi somdlavuza. Ukuba ne-PVS akusho ukuthi uzothola umdlavuza nakanjani.

Khuluma nodokotela wakho ngokuthi ukuba ne-PVS kuyithinta kanjani ingozi yakho yomdlavuza, ukuthi ungayinakekela kanjani esikhathini esizayo, nokuthi kufanele uhlolwe kangaki.

Ingabe i-Plummer-Vinson Syndrome (PVS) ingavinjelwa?

Odokotela abasazi kahle ukuthi yini ebangela i-Plummer-Vinson syndrome (PVS), ngakho-ke akunakwenzeka ukusho ngokuqinisekile ukuthi ikhona yini indlela ethile yokuyivimbela.

Kodwa-ke, ukuvimbela ukuntuleka kwensimbi nokuyelapha ngokushesha okukhulu uma unesifo esibangela ukuntuleka kwensimbi kunganciphisa ingozi yakho yokuthola i-PVS.

Ngakho-ke, kuwumqondo omuhle ukuqinisekisa ukuthi uthola insimbi eyanele kulokho okudlayo nokuphuzayo. Faka ukudla okune-iron eningi (isib. inyama ebomvu, uphizi, isipinashi, udali, i-soy) ekudleni kwakho.

Kufanele ngimbone nini udokotela?

Uma unezimpawu ze-anemia (isibonelo, ukukhathala okungabekezeleleki, ukuphefumula okungapheli, isikhumba esimpunga), futhi uma lezo zimpawu zingathuthuki ngemva kwamasonto amabili, qiniseka ukuthi ubona udokotela.

Futhi, uma uzizwa sengathi unenkinga yokugwinya ukudla, ikakhulukazi uma uzizwa sengathi ubambeke ekudleni okuqinile , futhi isimo singathuthuki, kungcono ukubona udokotela ukuze akunike iseluleko kunokungakunaki.

Yini okufanele ngiyibuze udokotela?

Uma uya kudokotela, mbuze ngezinto ezikukhathazayo kanye nokwesaba kwakho. Isibonelo, ungase ubuze imibuzo efana nale:

• Yini engabangela i-anemia yami?
• Yiziphi izivivinyo okudingeka ngizenze ukuze ngazi ngokuqinisekile ukuthi ngine-Plummer-Vinson syndrome (PVS)?
• Hlobo luni lokwelashwa olungincomayo?
• Ingabe kuzodingeka ngihlinzwe ukuze kulungiswe i-dysphagia yami? Kukangaki ngidinga ukuhlinzwa?
• Ingabe kufanele ngikhathazeke ngengozi yami yokuba nomdlavuza esikhathini esizayo? Yini okufanele ngiyenze ngakho?

Uma ucabanga ukuthi unezimpawu ze-Plummer-Vinson syndrome (PVS), bona udokotela ngokushesha. Akudingeki uphile nokukhathala okungapheli okubangelwa yi-anemia. Akudingeki futhi uphile nobuhlungu bokugwinya (i-dysphagia) okwenza ukudla kube umsebenzi onzima. Ngezinye izikhathi ikhambi lilula njengamaphilisi ambalwa ensimbi. Uma kungenjalo, ungathola impumuzo ngokukhulisa umphimbo wakho. Kodwa-ke, kunezindlela zokwelapha ezingakusiza uzizwe ungcono .

Okokugcina, izinto ezibaluleke kakhulu okufanele uzikhumbule

I-Plummer-Vinson syndrome (PVS) iyisimo esingavamile. Kodwa-ke, izici zayo eziyinhloko i-anemia yokuntuleka kwensimbi, ubunzima bokugwinya (i-dysphagia), kanye ne-esophageal webs . Uma uhlala ubhekene nokukhathala, ubunzima bokugwinya, noma ulimi olubuhlungu, kubalulekile ukubona udokotela kunokukubheka njengento evamile.

Kunezindlela zokwelapha ezinhle ze-PVS. Ezimweni eziningi, izimpawu eziningi ziyathuthuka uma ukuntuleka kwensimbi sekulungisiwe futhi umphimbo uvulwa uma kudingeka.

Ngisho noma sikhuluma ngengozi yomdlavuza, khumbula ukuthi kuyisici esiyingozi kuphela. Uma ukhuluma nodokotela wakho, uthola izivivinyo ezidingekayo, futhi uthola ukwelashwa okufanele, ungahlala uphilile. Ngakho-ke ungesabi lutho, futhi uma unenkinga, funa iseluleko sezokwelapha ngokushesha. Impilo yakho ibaluleke kakhulu kuwe!

I- Plummer-Vinson syndrome, i-PVS, ukuntuleka kwensimbi, i-dysphagia, ubunzima bokugwinya, ukuvaleka kwemithambo yomphimbo, i-anemia