Ukugwinya ubunzima

Ubunzima ngokugwinya umuzwa wokuthi ukudla noma uketshezi kubhajwe emphinjeni noma nganoma yisiphi isikhathi ngaphambi kokuba ukudla kungene esiswini. Le nkinga ibizwa nangokuthi i-dysphagia.

Inqubo yokugwinya ibandakanya izinyathelo eziningana. Lokhu kufaka phakathi:

• Ukuhlafuna ukudla
• Ukuyihambisa ngemuva komlomo
• Ukuyihambisa phansi i-esophagus (ipayipi lokudla)

Kunemizwa eminingi esiza imisipha yomlomo, yomphimbo, neyomzimba ukusebenza ndawonye. Ukugwinya okuningi kwenzeka ngaphandle kwakho ukwazi okwenzayo.

Ukugwinya yisenzo esiyinkimbinkimbi. Izinzwa eziningi zisebenza ngokulingana okuhle ukulawula ukuthi imisipha yomlomo, yomphimbo neyomzimba isebenza kanjani ngokubambisana.

Ukuphazamiseka kobuchopho noma kwemizwa kungashintsha lokhu kulinganisa okuhle emisipheni yomlomo nomphimbo.

• Ukulimala kwengqondo kungadalwa yi-multiple sclerosis, isifo se-Parkinson, noma isifo sohlangothi.
• Ukulimala kwemithambo kungabangelwa ukulimala komgogodla, i-amyotrophic lateral sclerosis (i-ALS noma isifo seLou Gehrig), noma i-myasthenia gravis.

Ingcindezi noma ukukhathazeka kungadala ukuthi abanye abantu bezwe ukuqina emphinjeni noma bazizwe sengathi kukhona okubhajwe emphinjeni. Lo muzwa ubizwa ngokuthi yi-globus sensation futhi awuhlobene nokudla. Noma kunjalo, kungaba khona imbangela ethile.

Izinkinga ezibandakanya i-esophagus zivame ukudala izinkinga zokugwinya. Lokhu kungafaka:

• Indandatho engajwayelekile yezicubu ezakha lapho kuhlangana khona umqala nesisu (okubizwa ngokuthi yiSchatzki ring).
• Ukuphazamiseka okungavamile kwemisipha yomphimbo.
• Umdlavuza womphimbo.
• Ukwehluleka kwesixha semisipha ezansi kwesikhala ukuze uphumule (Achalasia).
• Ukugqashuka okunciphisa umqala. Lokhu kungabangelwa yimisebe, amakhemikhali, imithi, ukuvuvukala okungamahlalakhona, izilonda, ukutheleleka, noma i-reflux esophageal.
• Okuthile kunamathele emphinjeni, njengocezu lokudla.
• I-Scleroderma, okuyisifo lapho amasosha omzimba ahlasela khona ngephutha umphimbo.
• Amathumba esifubeni acindezela uqhoqhoqho.
• I-Plummer-Vinson syndrome, isifo esingajwayelekile lapho ama-webs of mucosal membrane ekhula ngaphesheya kokuvuleka komqala.

Ubuhlungu besifuba, umuzwa wokudla obhajwe emphinjeni, noma isisindo noma ingcindezi entanyeni noma esifubeni esingenhla noma esingezansi kungenzeka kube khona.

Ezinye izimpawu zingafaka:

• Ukukhwehlela noma ukuphefumula okuba kubi kakhulu.
• Ukukhwehlela ukudla okungakagayeki.
• Isilungulela.
• Isicanucanu.
• Ukunambitheka okumuncu emlonyeni.
• Ubunzima bokugwinya kuphela okuqinile (kungakhombisa isimila noma ukuqina) kuphakamisa ukuvinjelwa komzimba okufana nokuqina noma isimila.
• Kunzima ukugwinya uketshezi kepha hhayi okuqinile (kungakhombisa ukulimala kwezinzwa noma ukuqhuma kwesisu).

Ungaba nezinkinga zokugwinya nganoma yikuphi ukudla noma ukuphuza, noma ngezinhlobo ezithile zokudla noma iziphuzo. Izimpawu zokuqala zezinkinga zokugwinya zingafaka ubunzima lapho udla:

• Ukudla okushisa kakhulu noma okubandayo
• Abaqhekezi abomile noma isinkwa
• Inyama noma inkukhu

Umhlinzeki wakho wezokunakekelwa kwempilo uzo-oda izivivinyo azobheka:

• Okuthile okuvimba noma okunciphisa umqala
• Izinkinga ngemisipha
• Izinguquko kulwelwesi lwe-esophagus

Ukuhlolwa okubizwa nge-endoscopy ephezulu (EGD) kuvame ukwenziwa.

• I-endoscope yishubhu eliguquguqukayo elinokukhanya ekugcineni. Ifakwa ngomlomo yehle ngomlomo iye esiswini.
• Uzonikezwa isiduli futhi ngeke uzwe buhlungu.

Ezinye izivivinyo zingafaka:

• Ukugwinya kwe-Barium nokunye ukuhlolwa kokugwinya
• I-x-ray yesifuba
• Ukuqapha kwe-pH ye-esophageal (kukala i-acid esophagus)
• I-Esophageal manometry (ilinganisa ingcindezi endaweni)
• Intamo x-ray

Ungadinga futhi ukuhlolwa kwegazi ukuze ubheke ukuphazamiseka okungadala izinkinga zokugwinya.

Ukwelashwa kwenkinga yakho yokugwinya kuya ngesizathu.

Kubalulekile ukufunda ukuthi ungadla futhi uphuze kanjani ngokuphepha. Ukugwinya okungalungile kungaholela ekuminyaneni noma ekuphefumuleni ukudla noma ketshezi ezindleleni zakho ezinkulu. Lokhu kungaholela ku-pneumonia.

Ukuphatha izinkinga zokugwinya ekhaya:

• Umhlinzeki wakho angaphakamisa ushintsho ekudleni kwakho. Ungathola nokudla oketshezi okukhethekile ukuze kukusize uhlale uphilile.
• Ungadinga ukuthi ufunde izindlela ezintsha zokuhlafuna nokugwinya.
• Umhlinzeki wakho angakutshela ukuthi usebenzise izinto ukukhulisa amanzi nezinye iziphuzo ukuze ungazifaki emaphashini akho.

Imithi engasetshenziswa incike embangela, futhi ingafaka:

• Imithi ethile ekhulula izicubu zomzimba. Lokhu kufaka phakathi ama-nitrate, okuwuhlobo lomuthi osetshenziselwa ukwelapha umfutho wegazi, kanye ne-dicyclomine.
• Ukujova ubuthi be-botulinum.
• Imithi yokwelapha isilungulela ngenxa ye-reflux ye-gastroesophageal (GERD).
• Imithi yokwelapha ukuphazamiseka kokukhathazeka, uma ikhona.

Izinqubo nokuhlinzwa okungasetshenziswa kufaka:

• I-endoscopy ephezulu: Umhlinzeki angakhulisa noma anwebe indawo encishisiwe yesifo sakho esebenzisa le nqubo. Kwabanye abantu, lokhu kudinga ukwenziwa futhi, futhi kwesinye isikhathi kube ngaphezulu kokukodwa.
• Imisebe noma ukuhlinzwa: Lezi zindlela zokwelapha zingasetshenziswa uma umdlavuza ubangela inkinga yokugwinya. I-Achalasia noma i-spasms ye-esophagus nayo ingaphendula ekuhlinzweni noma emijoweni ye-toxin ye-botulinum.

Ungadinga ithubhu yokudla uma:

• Izimpawu zakho zinzima futhi awukwazi ukudla nokuphuza ngokwanele.
• Unezinkinga ngenxa yokuminyaniswa noma inyumoniya.

Ishubhu yokondla ifakwa ngqo esiswini ngodonga lwesisu (i-G-tube).

Shayela umhlinzeki wakho uma izinkinga zokugwinya zingathuthuki ngemuva kwezinsuku ezimbalwa, noma zifike zidlule.

Shayela umhlinzeki wakho ngokushesha uma:

• Unomkhuhlane noma ukuphefumula okuncane.
• Ulahlekelwa isisindo.
• Izinkinga zakho zokugwinya ziya ngokuya ziba zimbi.
• Ukhwehlela noma uhlanza igazi.
• Unesifuba somoya esiba sibi kakhulu.
• Uzizwa sengathi uyaklinya ngesikhathi noma ngemuva kokudla noma ukuphuza.

IDysphagia; Ukugwinya okungakhubazekile; Ukuchofoza - ukudla; Ukuzwa kweGlobus

• Isisu

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UMunter DW. Izindikimba zamazwe angaphandle ezi-Esophageal. Ku: Roberts JR, Custalow CB, Thomsen TW, ama-eds. Izinqubo Zomtholampilo zikaRoberts noHedges ku-Emergency Medicine kanye ne-Acute Care. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2019: isahluko 39.

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.