I-Achalasia

Ishubhu elithwala ukudla lisuke emlonyeni liye esiswini yilona umphimbo noma ipayipi lokudla. I-Achalasia yenza kube nzima ngesifo ukuhambisa ukudla esiswini.

Kukhona indandatho yemisipha lapho kuhlangana khona isisu nesisu. Ibizwa nge-esophageal sphincter (LES) engezansi. Imvamisa, le misipha iyakhululeka lapho ugwinya ukuvumela ukudla kudlulele esiswini. Kubantu abane-achalasia, ayiphumuli njengoba kufanele. Ngaphezu kwalokho, umsebenzi wemisipha ojwayelekile we-esophagus (peristalsis) uyancipha noma awukho.

Le nkinga idalwa ukulimala kwezinzwa ze-esophagus.

Ezinye izinkinga zingadala izimpawu ezifanayo, njengomdlavuza we-esophagus noma isisu esingaphezulu, kanye nokutheleleka ngama-parasite okubangela isifo se-Chagas.

I-Achalasia ayivamile. Kungenzeka noma ngabe ibuphi ubudala, kepha kuvame kakhulu kubantu abaneminyaka engama-25 kuya kwengama-60. Kwabanye abantu, inkinga ingahle izuzwe njengefa.

Izimpawu zifaka:

• Ukubuyela emuva (ukuphinda wenze kabusha) kokudla
• Ubuhlungu besifuba, obungakhuphuka ngemuva kokudla, noma bungazwakala njengobuhlungu emuva, entanyeni, nasezingalweni
• Khwehlela
• Kunzima ukugwinya uketshezi nokuqina
• Isilungulela
• Ukwehla kwesisindo ngokungenhloso

Ukuhlolwa komzimba kungakhombisa izimpawu zokushoda kwegazi noma ukungondleki.

Izivivinyo zifaka:

• I-Manometry, isivivinyo sokukala ukuthi ngabe isisu sakho sisebenza kahle yini.
• I-EGD noma i-endoscopy ephezulu, isivivinyo sokuhlola ulwelwesi lwesisu kanye nomphimbo. Isebenzisa ithubhu nezimo zekhamera.
• I-x-ray ephezulu ye-GI.

Umgomo wokwelashwa ukunciphisa ingcindezi emisipha ye-sphincter futhi uvumele ukudla neziphuzo kudlule kalula esiswini. Ukwelashwa kungafaka:

• Ukujova nge-botulinum toxin (Botox) - Lokhu kungasiza ukukhulula imisipha ye-sphincter. Kodwa-ke, inzuzo iyaphela kungakapheli amasonto noma izinyanga ezimbalwa.
• Imithi, efana nama-nitrate asebenza isikhathi eside noma ama-block block wesiteshi se-calcium - Le mithi ingasetshenziselwa ukukhulula i-esophagus sphincter engezansi. Kepha asitholakali isixazululo sesikhathi eside sokwelapha i-achalasia.
• Ukuhlinzwa (okubizwa nge-myotomy) - Kule nqubo, imisipha engezansi ye-sphincter iyasikwa.
• Ukunwebeka (ukunwebeka) kwesisu - Lokhu kwenziwa ngesikhathi se-EGD ngokwelula i-LES nge-dilloon dilator.

Umhlinzeki wakho wezokunakekelwa kwempilo angakusiza unqume ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe.

Imiphumela yokuhlinzwa kanye nokwelashwa okungahlinzeki kuyafana. Ngezinye izikhathi kudingeka ukwelashwa okungaphezu koyedwa.

Izinkinga zingafaka:

• Ukubuyela emuva (ukuphinda wenze kabusha) i-asidi noma ukudla okuvela esiswini kuya ku-esophagus (reflux)
• Ukuphefumulela okuqukethwe kokudla emaphashini (aspiration), okungadala inyumoniya
• Ukudwengula (ukugcotshwa) komphimbo

Shayela umhlinzeki wakho uma:

• Unenkinga yokugwinya noma ukugwinya okubuhlungu
• Izimpawu zakho ziyaqhubeka, noma ngabe ulashwa i-achalasia

Izimbangela eziningi ze-achalasia azikwazi ukuvinjelwa. Noma kunjalo, ukwelashwa kungasiza ukuvimbela izinkinga.

I-esophageal achalasia; Ukugwinya izinkinga zoketshezi nokuqina; I-Cardiospasm - i-sphincter spasm ephansi

• Uhlelo lokugaya ukudla
• Isistimu ephezulu yamathumbu
• Achalasia - uchungechunge

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IHamer PW, iWundlu PJ. Ukuphathwa kwe-achalasia nokunye ukuphazamiseka kwe-motility kwesopha. Ku: Griffin SM, iWundlu PJ, ama-eds. Ukuhlinzwa Kwe-Oesophagogastric: Umngane Wokuzijwayeza Kokuhlinzwa Okukhethekile. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2019: isahluko 16.

UPandolfino JE, uKahrilas PJ. Umsebenzi we-Esophageal neuromuscular and disorders. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 43.