I-Achalasia

Umbhobho ohambisa ukutya usuke emlonyeni uye esiswini sisisu okanye umbhobho wokutya. I-Achalasia yenza kube nzima ukuba isisu sihambise ukutya kwisisu.

Kukho iringi yemisipha kwindawo apho ukudibana kunye nesisu kuhlangana khona. Ibizwa ngokuba yi-sphincter esezantsi esophageal (LES). Ngokwesiqhelo, esi sihlunu siyakhululeka xa uginya ukuvumela ukutya kudlule kwisisu. Kubantu abane-achalasia, ayiphumli njengoko kufanelekile. Ukongeza, umsebenzi wesihlunu oqhelekileyo we-esophagus (peristalsis) uyancitshiswa okanye awukho.

Le ngxaki ibangelwa ngumonakalo kwimithambo-luvo yomqala.

Ezinye iingxaki zinokubangela iimpawu ezifanayo, ezinjengomhlaza womqala okanye isisu esingaphezulu, kunye nosulelo lwe-parasite olwenza isifo seChagas.

I-Achalasia inqabile. Inokwenzeka nokuba yeyiphi na iminyaka, kodwa ixhaphake kakhulu kubantu abaneminyaka engama-25 ukuya kuma-60.

Iimpawu zibandakanya:

• Ukubuyela umva (ukuphinda ubuye) kokutya
• Intlungu yesifuba, enokuthi inyuke emva kokutya, okanye ive njengentlungu yomqolo, intamo kunye neengalo
• Khohlela
• Kunzima ukugwinya ulwelo kunye nokuqina
• Isitshisa
• Ukuphulukana nobunzima ngabom

Uvavanyo lomzimba lunokubonisa iimpawu zokuphazamiseka kwegazi emzimbeni okanye ukungondleki.

Uvavanyo lubandakanya:

• IManometry, uvavanyo lokulinganisa ukuba ingaba umqala wakho usebenza kakuhle na.
• I-EGD okanye i-endoscopy ephezulu, uvavanyo lokuvavanya ulusu lwesisu kunye nomqala. Isebenzisa ityhubhu eguqukayo kunye nekhamera.
• I-x-ray ephezulu ye-GI.

Injongo yonyango ukunciphisa uxinzelelo kwimisipha ye-sphincter kunye nokuvumela ukutya kunye nolwelo ukuba kudlule ngokulula esiswini. Unyango lunokubandakanya:

• Inaliti nge-botulinum toxin (Botox) -Oku kunokunceda ukukhulula izihlunu ze-sphincter. Nangona kunjalo, isibonelelo siphela kwiiveki okanye iinyanga ezimbalwa.
• Amayeza, anjengee-nitrate ezisebenza ixesha elide okanye i-calcium channel blockers- La machiza anokusetyenziselwa ukukhulula isopha esophagus sphincter. Kodwa kunqabile ukuba kubekho isisombululo sexesha elide sokunyanga i-achalasia.
• Utyando (olubizwa ngokuba yi-myotomy) - Kule nkqubo, umsipha osezantsi we-sphincter uyanqunyulwa.
• Ukwandiswa (ukuxutywa) kwe-esophagus - Oku kwenziwa ngexesha le-EGD ngokunweba i-LES nge-balloon dilator.

Umboneleli wakho wezempilo unokukunceda uthathe isigqibo sokuba loluphi unyango olulungele wena.

Iziphumo zoqhaqho kunye nonyango olunganyangiyo ziyafana. Ngamanye amaxesha unyango olungaphezulu kolunye luyimfuneko.

Iingxaki zinokubandakanya:

• Ukubuyela umva (ukuphinda ubuye) kwe-asidi okanye ukutya okusuka esiswini kungena kwi-esophagus (reflux)
• Ukuphefumla imixholo yokutya kwimiphunga (aspiration), enokubangela inyumoniya
• Ukukrazula (ukugqobhoza) komqala

Fowunela umnikezeli wakho ukuba:

• Unengxaki yokuginya okanye yokuginya okubuhlungu
• Iimpawu zakho ziyaqhubeka, nditsho nonyango lwe-achalasia

Uninzi lwezizathu ze-achalasia azinakuthintelwa. Nangona kunjalo, unyango lunokunceda ukuthintela iingxaki.

I-esophageal achalasia; Ukuginya iingxaki kulwelo kunye nokuqina; I-Cardiospasm -i-sphincter spasm esezantsi

• Inkqubo yokwetyisa
• Inkqubo ephezulu yesisu
• Achalasia - uthotho

IFalk GW, Katzka DA. Izifo zomqala. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 129.

IHamer PW, iMvana PJ. Ulawulo lwe-achalasia kunye nokunye ukuphazamiseka kwemotopu. Ku: Griffin SM, iMvana PJ, ii-eds. Utyando lwe-Oesophagogastric: Umlingani kuQeqesho lweeNgcali. Umhla wesi-6. IPhiladelphia, PA: Elsevier; I-2019: isahluko 16.

IPandolfino JE, iKahrilas PJ. Umsebenzi we-Esophageal neuromuscular kunye nokuphazamiseka kwemotility. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 43.