Ukuginya ubunzima

Ubunzima ngokuginya kukuziva ukuba ukutya okanye ulwelo lunamathele emqaleni okanye nangaliphi na ixesha ngaphambi kokuba ukutya kungene esiswini. Le ngxaki ikwabizwa ngokuba yi-dysphagia.

Inkqubo yokuginya ibandakanya amanyathelo aliqela. Oku kubandakanya:

• Ukuhlafuna ukutya
• Ukuyihambisa emva komlomo
• Ukuyishenxisa ezophagus (ipayipi yokutya)

Zininzi imithambo-luvo ezinceda izihlunu zomlomo, zomqala, kunye nezomzimba zisebenza kunye. Ukuginya okuninzi kwenzeka ngaphandle kokuba uqaphele into oyenzayo.

Ukuginya sisenzo esimbaxa. Iimbilini ezininzi zisebenza ngokulinganayo ukulawula indlela izihlunu zomlomo, zomqala, kunye nezomqala ezisebenza ngayo kunye.

Ingqondo okanye ukuphazamiseka kwemithambo-luvo kunokuguqula oku kulungelelana okuhle kwiimisipha zomlomo nezomqala.

• Ukonakala kwengqondo kunokubangelwa kukuqina kwemithambo, isifo seParkinson, okanye ukubetha.
• Umonakalo wamathambo unokubangelwa kukulimala kwentambo yomqolo, i-amyotrophic lateral sclerosis (i-ALS okanye isifo seLou Gehrig), okanye i-myasthenia gravis.

Uxinzelelo okanye uxinzelelo kunokubangela abanye abantu ukuba bazive bexinekile emqaleni okanye bazive ngathi kukho into ebambekileyo emqaleni. Olu luvo lubizwa ngokuba yi-globus sensation kwaye aluhambelani nokutya. Nangona kunjalo, kunokubakho unobangela oyintloko.

Iingxaki ezibandakanya umqala zihlala zibangela iingxaki zokuginya. Oku kunokubandakanya:

• Isangqa esingaqhelekanga sethishyu esenza ukuba umqala nesisu zidibane (okubizwa ngokuba yiringi yeSchatzki).
• I-spasms engaqhelekanga yemisipha yomqala.
• Umhlaza womqala.
• Ukusilela kwesihlunu semisipha emazantsi esophagus yokuphumla (Achalasia).
• Ukuqhawulwa okunciphisa umqala. Oku kunokuba ngenxa yemitha, imichiza, amayeza, ukudumba okungapheliyo, izilonda, usulelo, okanye i-esophageal reflux.
• Into enamathele kwi-esophagus, efana neqhekeza lokutya.
• IScleroderma, ingxaki apho amajoni omzimba ahlasela ngempazamo i-esophagus.
• Amathumba esifubeni acofa kuwo umqala.
• Isifo sePlummer-Vinson, isifo esinqabileyo apho ii-webs ze-mucosal membrane zikhula ngapha kuvuleke umqala.

Intlungu yesifuba, imvakalelo yokutya okuncamathele emqaleni, okanye ubunzima okanye uxinzelelo entanyeni okanye ngaphezulu okanye esifubeni esisezantsi sinokubakho.

Ezinye iimpawu zingabandakanya:

• Ukukhohlela okanye ukuvutha kuya kusiba mandundu.
• Ukukhohlela ukutya okungagaywanga.
• Isitshisa.
• Isicaphucaphu.
• Umuncu omuncu emlonyeni.
• Ubunzima bokuginya kuphela iziqina (kunokubonisa ithumba okanye ukungqinisisa) icebisa ukuvalwa komzimba njengokuqina okanye ithumba.
• Ubunzima bokuginya ulwelo kodwa hayi iziqina (kunokubonisa ukonakala kwentliziyo okanye ispasm somqala).

Unokuba neengxaki zokugwinya nakuphi na ukutya okanye ukusela, okanye kuphela iintlobo ezithile zokutya okanye ulwelo. Iimpawu zokuqala zokugwinya zinokubandakanya ubunzima xa usitya:

• Ukutya okushushu kakhulu okanye okubandayo
• Abaqhekezi abomileyo okanye isonka
• Inyama okanye inkukhu

Umboneleli wakho wezempilo uya ku-odola uvavanyo ukuze ajonge:

• Into ethintela okanye inciphisa umqala
• Iingxaki ngezihlunu
• Utshintsho kuludwe lwe-esophagus

Uvavanyo olubizwa ngokuba yi-endoscopy ephezulu (i-EGD) luhlala lusenziwa.

• I-endoscope yityhubhu eguqukayo enesibane esiphelweni. Ingeniswa ngomlomo ize yehle ngomqala ukuya esiswini.
• Uya kunikwa umthomalalisi kwaye awuyi kuva zintlungu.

Olunye uvavanyo lunokubandakanya:

• Ukugwinya kweBarium kunye nolunye uvavanyo lokuginya
• I-x-ray yesifuba
• Ukubeka iliso kwi-pH ye-esophageal (amanyathelo e-asidi kwisopha)
• Esometgeal manometry (amanyathelo oxinzelelo kwi-esophagus)
• Intamo x-ray

Kuya kufuneka ukuba ube nokuvavanywa kwegazi ukukhangela ukuphazamiseka okunokubangela ukugwinya iingxaki.

Unyango lwengxaki yakho yokuginya luxhomekeke kwisizathu.

Kubalulekile ukuba ufunde indlela yokutya nokusela ngokukhuselekileyo. Ukuginya okungalunganga kunokukhokelela ekukrwitshweni okanye ekuphefumleni ukutya okanye kulwelo kwindlela yakho ephambili. Oku kunokukhokelela kwinyumoniya.

Ukulawula ukuginya iingxaki ekhaya:

• Umboneleli wakho unokucebisa utshintsho kwindlela otya ngayo. Unokufumana ukutya okhethekileyo kulwelo ukukunceda uhlale usempilweni.
• Kuya kufuneka ufunde iindlela ezintsha zokuhlafuna kunye nokuginya.
• Umboneleli wakho unokukuxelela ukuba usebenzise izinto ukondla amanzi kunye nolunye ulwelo ukuze ungazixhasi kwimiphunga yakho.

Amayeza anokusetyenziswa axhomekeke kwisizathu, kwaye anokubandakanya:

• Amayeza athile athoba izihlunu zomqala. Oku kubandakanya iitrate, nohlobo lonyango olusetyenziselwa ukunyanga uxinzelelo lwegazi, kunye nedicyclomine.
• Inaliti yetyhefu ye-botulinum.
• Amayeza anyanga isitshisa ngenxa ye-gastroesophageal reflux (GERD).
• Amayeza anyanga ingxaki yoxinzelelo, ukuba akhona.

Iinkqubo kunye notyando olunokusetyenziswa lubandakanya:

• I-endoscopy ephezulu: Umboneleli unokuyandisa okanye ayenze banzi indawo emxinwa yesophagus yakho usebenzisa le nkqubo. Abanye abantu, oku kufuneka kwenziwe kwakhona, kwaye ngamanye amaxesha ngaphezulu kwesinye.
• Imitha okanye utyando: Olu nyango lunokusetyenziswa ukuba umhlaza ubangela ingxaki yokuginya. I-Achalasia okanye i-spasms ye-esophagus nayo ingaphendula kutyando okanye inaliti ye-botulinum toxin.

Unokufuna ityhubhu yokondla ukuba:

• Iimpawu zakho zinzima kwaye awukwazi ukutya nokusela ngokwaneleyo.
• Unengxaki ngenxa yokukrwitshwa okanye inyumoniya.

Umbhobho wokutyisa ufakwa ngqo esiswini ngodonga lwesisu (G-tube).

Fowunela umboneleli wakho ukuba iingxaki eziginya aziphucuki emva kweentsuku ezimbalwa, okanye ziyafika zihambe.

Fowunela umboneleli wakho ngoko nangoko ukuba:

• Unomkhuhlane okanye umphefumlo omfutshane.
• Uphulukana nobunzima.
• Iingxaki zakho zokuginya ziya zisiba mbi.
• Ukhohlela okanye ugabhe igazi.
• Unesifo sombefu esiya sisiba mandundu.
• Uziva ngathi uyakrwitsha ngexesha okanye emva kokutya okanye ukusela.

IDysphagia; Ukugwinya okungalunganga; Ukukrwitshwa - ukutya; Imvakalelo yeglobus

• Umqala

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UMunter DW. Amaqumrhu angaphandle abethelelwa ngumoya. Ku: Roberts JR, Custalow CB, Thomsen TW, ii-eds. Iinkqubo zeKlinikhi zikaRoberts kunye neHedges kwiNyango kaXakeka kunye noKhathalelo oluQhelekileyo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2019: isahluko 39.

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.