Yini Engadala Ukuba Umuntu Akhohlwe Indlela Yokugwinya?

-Delile

• Ukukhohlwa ukuthi ungagwinya kanjani izimbangela
• Ukungasebenzi kobuchopho
• Ukungasebenzi kahle komlomo noma komlomo
• Ukulahleka kokuphumula kwemisipha ye-sphincter (achalasia)
• Ukuncipha kwe-Esophageal
• Ukukhathazeka
• Izimpawu zenkinga yokugwinya
• Ukuhlonza izinkinga zokugwinya
• I-endoscopy ephezulu, noma i-EGD
• I-Manometry
• Ukuhlolwa kwe-impedance ne-pH
• Ukuhlolwa kokugwinya kwe-barium okushintshiwe
• I-Esophagram
• Ukuhlolwa kwegazi
• Ukukhohlwa ukuthi ungakugwinya kanjani ukwelashwa
• Imithi
• Ukuhlinzwa
• Izinguquko zendlela yokuphila
• Ukudla okudlela endlini

Ukubuka konke

Ukugwinya kungabonakala njengokuhamba okulula, kodwa empeleni kuhilela ukuhlangana ngokucophelela kwamabhangqa angama-50 emisipha, izinzwa eziningi, umphimbo (ibhokisi lezwi), nomhosha wakho.

Bonke kumele basebenze ngokubambisana ukuqoqa nokulungisa ukudla emlonyeni, bese bekuhambisa kusuka emphinjeni, kudlule ngasesimweni somlomo, kuya esiswini. Lokhu kufanele kwenzeke ngenkathi ngasikhathi sinye kuvalwa umgwaqo womoya ukugcina ukudla kungangeni kupayipi lakho lomoya. Ngenxa yalokho, kunamathuba amaningi okuthi okuthile kungahambi kahle.

Izinkinga ngesikhathi sokugwinya zingaqala ngokukhwehlela noma ukuminca ngoba ukudla noma uketshezi kungena ku-windpipe ukuqedela ukungakwazi ukugwinya noma yini.

Ukuphazamiseka kobuchopho noma uhlelo lwezinzwa, njengokushaywa unhlangothi, noma ukwenza buthakathaka imisipha esemphinjeni noma emlonyeni kungenza umuntu akhohlwe ukuthi angagwinya kanjani. Ngezinye izikhathi, ubunzima bokugwinya kungumphumela wokuvaleka komphimbo, ipharynx, noma i-esophagus, noma ukuncipha komphimbo kusuka kwesinye isimo.

Ukukhohlwa ukuthi ungagwinya kanjani izimbangela

Igama lezokwelapha lobunzima ngokugwinya yi-dysphagia.

Noma yiluphi udaba olwenza buthakathaka imisipha noma izinzwa ezahlukahlukene ezibandakanyeka ekugwinyweni noma ekuvimbeleni ukudla noketshezi ukuba kungagobhozi ngokukhululeka kumhosha kungadala i-dysphagia. I-Dysphagia ivame kakhulu kubantu abadala asebekhulile.

Ukungasebenzi kobuchopho

Ukulimala kobuchopho nomgogodla kungaphazamisa izinzwa ezidingekayo zokugwinya. Izimbangela zifaka:

• unhlangothi: ukuvinjelwa ekunikezelweni kwegazi ebuchosheni okungaholela ekukhubazekeni kwesikhathi eside
• ukulimala okubuhlungu kwengqondo
• izimo zezinzwa ezilimaza ubuchopho ngokuhamba kwesikhathi, njengesifo sikaParkinson's, multiple sclerosis, isifo sikaHuntington, kanye ne-amyotrophic lateral sclerosis (ALS)
• isimila sobuchopho

Ukulahleka kwenkumbulo kanye nokwehla kokuqonda okubangelwa ukuwohloka komqondo noma isifo i-Alzheimer nakho kungenza kube nzima ukuhlafuna nokugwinya.

Ukungasebenzi kahle komlomo noma komlomo

Ukuphazamiseka kwemizwa nemisipha esemphinjeni kungenza izicubu zibe buthakathaka futhi kwenze umuntu aqumbe noma avuze lapho egwinya. Izibonelo zifaka:

• cerebral palsy: ukuphazamiseka okuthinta ukunyakaza kwemisipha nokuxhumanisa
• ukukhubazeka kokuzalwa, njenge-cleft palate (igebe ophahleni lomlomo)
• i-myasthenia gravis: isifo se-neuromuscular esibangela ubuthakathaka emisipheni esetshenziselwa ukunyakaza; izimpawu zifaka phakathi inkinga yokukhuluma, ukukhubazeka ebusweni, nobunzima bokugwinya
• ukulimala ekhanda okulimaza izinzwa noma imisipha emphinjeni

Ukulahleka kokuphumula kwemisipha ye-sphincter (achalasia)

Lapho kuhlangana khona i-esophagus nesisu kunomsipha obizwa nge-lower esophageal sphincter (LES). Lo msipha uyakhululeka lapho ugwinya ukuvumela ukudla kudlule. Kubantu abane-achalasia, i-LES ayiphumuli.

I-Achalasia kucatshangwa ukuthi ingumphumela wesimo sokuzivikela komzimba, lapho amasosha akho omzimba ehlasela ngephutha amangqamuzana ezinzwa emqaleni wakho. Ezinye izimpawu zifaka phakathi ubuhlungu ngemuva kokudla nesilungulela.

Ukuncipha kwe-Esophageal

Ukulimala komphimbo kungaholela ekwakhekeni kwezicubu ezibomvu. Izicubu ezibomvu zinganciphisa i-esophagus futhi ziholele enkingeni yokugwinya.

Izimo ezingadala izicubu ezibomvu zifaka:

• i-acid reflux: lapho isisu esiswini sigeleza sibuyele emuva siphume, sidale izimpawu ezifana nesilungulela, ubuhlungu besisu, nenkinga yokugwinya
• isifo se-reflux se-gastroesophageal (GERD): uhlobo olubi kakhulu nolungapheli lwe-acid reflux; ngokuhamba kwesikhathi kungadala izicubu ezibomvu ukwakheka noma ukuvuvukala komphimbo (esophagitis)
• izifo ezinjenge-herpes esophagitis, i-herpes simplex labialis ephindaphindwayo, noma i-mononucleosis
• ukwelashwa ngemisebe esifubeni noma entanyeni
• ukulimala okuvela ku-endoscope (ithubhu enamathiselwe kukhamera esetshenziselwa ukubheka ngaphakathi komzimba) noma ishubhu le-nasogastric (ithubhu ethwala ukudla nemithi iye esiswini ngamakhala)
• scleroderma: ukuphazamiseka lapho izivikeli mzimba zihlasela ngephutha isisu

I-esophagus nayo ingancishiswa ukuvinjelwa noma ukukhula okungavamile. Izimbangela zalokhu zibandakanya:

• izimila kulesisiga
• i-goiter: ukukhuliswa kwendlala yegilo; i-goiter enkulu ingafaka ingcindezi ku-esophagus futhi iholele ebunzimeni bokugwinya noma ukuphefumula, kanye nokukhwehlela nokuhhahazela
• ukudla okubhajwe emphinjeni noma emphinjeni okungagezwa ngamanzi. Lesi yisimo esiphuthumayo sezokwelapha.

Ukukhathazeka

Ukukhathazeka noma ukwethuka kungadala umuzwa wokuqina noma isigaxa emphinjeni noma umuzwa wokuminyaniswa. Lokhu kungenza ukugwinya kube nzima okwesikhashana. Ezinye izimpawu zokukhathazeka zifaka:

• uvalo
• imizwa yengozi, ukwethuka, noma ukwesaba
• ukujuluka
• ukuphefumula okusheshayo

Izimpawu zenkinga yokugwinya

Uma ucabanga ukuthi unenkinga yokugwinya, kunezimpawu ezithile okufanele uzibheke. Ungaba nobunzima bokugwinya ngokuphelele noma ubunzima bokugwinya okuqinile, uketshezi, noma amathe.

Ezinye izimpawu zenkinga yokugwinya zifaka:

• ukumunca amathe
• ukuzwa sengathi kukhona okufakwe emphinjeni
• ingcindezi entanyeni noma esifubeni
• ukuvuselela kaningi ngesikhathi sokudla
• isicanucanu
• isilungulela
• ukukhwehlela noma ukuklinya lapho ugwinya
• ubuhlungu lapho ugwinya (odynophagia)
• ukuhlafuna ubunzima
• ukuncipha kwesisindo ngokungenhloso
• Umphimbo obuhlungu
• ukuduma kwezwi lakho
• kufanele usike ukudla kube yizicucu ezincane ukuze ukuhlafune nokukugwinya

Ukuhlonza izinkinga zokugwinya

Ngemuva kokuthatha umlando wezokwelapha nowomndeni, udokotela wakho uzoku-oda izivivinyo ukuthola ukuthi ngabe kukhona yini okuvimba i-esophagus noma uma unezinkinga zemizwa noma izinkinga ngemisipha esemphinjeni wakho.

Ezinye izivivinyo udokotela wakho angaku-oda zifaka:

I-endoscopy ephezulu, noma i-EGD

I-endoscope yishubhu eliguquguqukayo elinekhamera ekugcineni efakwa emlonyeni nangaphakathi kwesisu esiswini. Ngesikhathi se-endoscopy, udokotela uyakwazi ukubona ngeso lengqondo izinguquko ku-esophagus, njengezicubu ezibomvu, noma ukuvinjelwa ngaphakathi komphimbo nomphimbo.

I-Manometry

Ukuhlolwa kwe-manometry kubheka ingcindezi yemisipha esemphinjeni wakho lapho ugwinya usebenzisa ithubhu ekhethekile exhunywe kwirekhoda yengcindezi.

Ukuhlolwa kwe-impedance ne-pH

Isivivinyo se-pH / impedance silinganisa inani le-asidi esiswini isikhathi esithile (imvamisa amahora angama-24). Kungasiza ukuxilonga izimo ezifana ne-GERD.

Ukuhlolwa kokugwinya kwe-barium okushintshiwe

Ngesikhathi sale nqubo, uzodla ukudla okwehlukile neziphuzo ezigcotshwe ku-barium ngenkathi izithombe ze-X-ray zithathwa nge-oropharynx. Udokotela wezifo zolimi uzoxilonga noma yibuphi ubunzima bokugwinya.

I-Esophagram

Ngesikhathi sale nqubo, uzogwinya uketshezi noma iphilisi eliqukethe i-barium, ekhombisa i-X-ray. Udokotela uzobheka izithombe ze-X-ray njengoba ugwinya ukuze ubone ukuthi isisu sisebenza kanjani.

Ukuhlolwa kwegazi

Udokotela wakho angalawula ukuhlolwa kwegazi ukuze afune ezinye iziphazamiso ezingaphansi ezingadala izinkinga zokugwinya noma aqiniseke ukuthi awunakho ukushoda kokudla okunempilo.

Ukukhohlwa ukuthi ungakugwinya kanjani ukwelashwa

Ukwelashwa kwezinkinga zokugwinya kuncike embangela. Izinkinga eziningi zingalawulwa ngokubona udokotela wezifo zokukhuluma, udokotela wezinzwa, isazi sokudla, i-gastroenterologist, kwesinye isikhathi nodokotela ohlinzayo.

Imithi

I-Acid reflux ne-GERD zivame ukuphathwa ngemithi efana neproton-pump inhibitors (PPI). Izinkinga zokugwinya ezibangelwa ukukhathazeka zingaphathwa ngemithi yokulwa nokukhathazeka.

I-Achalasia kwesinye isikhathi ingalashwa ngomjovo we-botulinum toxin (Botox) ukukhulula imisipha ye-sphincter. Eminye imithi, efana ne-nitrate ne-calcium block blockers, nayo ingasiza ukukhulula i-LES.

Ukuhlinzwa

Udokotela angasiza ukukhulisa indawo encishisiwe yesifo ngenqubo ebizwa ngokuthi i-esophageal dilation. Ibhaluni elincane lifuthwe ngaphakathi komphimbo ukulikhulisa. Ibhaluni bese liyasuswa.

Ukuhlinzwa kungenziwa futhi ukuze kususwe isimila noma izicubu ezibomvu ezivimbela noma zinciphise i-esophagus.

Izinguquko zendlela yokuphila

Uma izingqinamba zakho zokugwinya zibangelwa ukuphazamiseka kwemithambo, njengesifo sikaParkinson, kungadingeka ukuthi ufunde izindlela ezintsha zokuhlafuna nokugwinya. Udokotela wezifo zolimi angancoma ushintsho ekudleni, izivivinyo zokugwinya, kanye nokulungiswa kwangemuva kokulandela ngenkathi udla.

Uma izimpawu zinzima futhi ungakwazi ukudla noma ukuphuza ngokwanele, ungahle udinge ithubhu yokudla. Ishubhu le-PEG lifakwa ngqo esiswini ngodonga lwesisu.

Ukudla okudlela endlini

Isizathu esivame kakhulu sezinkinga zokugwinya yisifo sohlangothi, kepha kunezinye izimo eziningi ezingenza ukugwinya kube nzima. Uma unenkinga yokugwinya, noma uvame ukuphinda uvuselele, uminyanise, noma uhlanze ngemuva kokugwinya, kubalulekile ukubona udokotela ukuze athole imbangela eyimbangela nokuthola ukwelashwa.

Izinkinga ngokugwinya zingaholela ekuchameni. Uma ukudla noma uketshezi kungena ezindleleni zakho zomoya, kungadala isimo esisongela impilo esibizwa nge-aspiration pneumonia. Izinkinga zokugwinya nazo zingaholela ekungondlekeni nasekuphelelweni amanzi emzimbeni.

Uma ungakwazi ukugwinya ngoba kuzwakala sengathi ukudla kubhajwe emphinjeni noma esifubeni, noma uma unenkinga yokuphefumula, iya emnyangweni ophuthumayo oseduze.