Akalasia

Ko te Achalasia he āhuatanga o te horomi e pā ana ki te pūkaha e hono ana i te waha me te kopu, e kiia nei ko te esophagus. Ma te kino o ngā pūtau nerve ka uaua ai te whakauru o ngā uaua o te esophagus i te kai me te wai ki te kopu. Ka kohikohi te kai ki te esophagus, ka whakakōkō pea, ka horomia ki te waha. Ka kawa te kai kōkō. He āhuatanga onge te Achalasia. Ka whakapohehetia e ētahi ki te mate reflux gastroesophageal (GERD). Heoi, i te achalasia, ka puta mai te kai i te esophagus. I te GERD, ka puta mai te mea mai i te kopu. Kāo te rongoā mō te achalasia. Kia pā te esophagus, kāore e taea e ngā uaua te mahi tika. Engari ka taea te whakahaere i ngā tohu mā te endoscopy, te rongoā iti rānei, te pokanga rānei.

Ko ngā tohu o te mate achalasia e puta ana te nuinga i te wā roa, ā, ka kaha ake i te wā. Ko ētahi o ngā tohu pea:

• Te raruraru ki te horomi, e kiia nei ko te dysphagia, ā, ka rite pea te āhua ki te kōpū kai rānei, inu rānei e mau ana ki te korokoro.
• Te hoki mai o te kai kua horomia, inu rānei ki te korokoro.
• Te ngakau wera.
• Te pupuhi.
• Te mamae o te uma e puta ana, ka mutu.
• Te tae i te pō.
• Te mate huango nā te kai e tomo ana ki roto i ngā pūkahukahu.
• Te ngaro o te taumaha.
• Te ruaki.

Kaore he uauatanga

Ko te take tino tika o te achalasia kaore i te tino mohiotia. E whakaaro ana nga kairangahau pea na te ngaro o nga pūtau io i roto i te esophagus. He ngā whakaaro mō te take o tēnei, engari ko te mate huaketo, te mate pāwera ranei he wāhi pea. Ko te tino onge, ka puta pea te achalasia i te mate pārongo i nā roto i te whakapaparitanga, i te mate rānei.

Ngā take morearea mō te achalasia e whai ake nei:

• Tau. Ahakoa ka pā te achalasia ki te tangata o ngā tau katoa, he maha ake te kitea i roto i te hunga kei waenganui i te 25 me te 60 tau te pakeke.
• Ētahi āhuatanga hauora. He nui ake te morearea o te achalasia ki te hunga he mate pāwera, he korenga o te adrenal, he mate Allgrove rānei, he āhuatanga tuku iho onge e kawe ana i te recessive autosomal.

Kaore he uauatanga

Kaore he uauatanga

Ka taea te tirotiro hapa, te whakatau he ranei te Achalasia, na te mea he rite tonu ōna tohu ki ētahi atu mate pūnaha kai. Hei whakamātautau i te achalasia, ka tūtohutia pea e te kaimahi hauora: Te manometry esophageal. Ka ine tenei whakamātautau i ngā whakawhāiti uaua i roto i te esophagus i te wā e horomia ana. Ka ine hoki te pai o te whakatuwhera o te sphincter esophageal raro i te wā e horomia ana. Ko te whakamātautau tenei te mea tino whai hua i te whakatau i te momo āhuatanga horomi ka pa pea ki a koe. Ngā X-rays o te pūnaha kai o runga. Ka tangohia ngā X-rays i muri i te inu i te wai māwhero e kiia nei ko te barium. Ka hipoki te barium i te taha o roto o te pūnaha kai, ka whakakiia ngā kōpū kai. Ka taea e tēnei hipoki te kite atu i te ahua o te esophagus, te kopu me te whekau o runga. I tua atu i te inu i te wai, ka taea te awhina i te horomi i te pūnaha barium ki te whakaatu i te aukati i roto i te esophagus. Te endoscopy o runga. Ka whakamahi te endoscopy o runga i te kamera iti kei te pito o te pūtau kōpiko hei tirotiro i te pūnaha kai o runga. Ka taea te whakamahi i te endoscopy ki te kimi i te aukati wāhanga o te esophagus. Ka taea hoki te whakamahi i te endoscopy ki te kohikohi i te tauira o te kiko, e kiia nei ko te biopsy, hei whakamātautau mo ngā raruraru o te reflux penei i te Barrett esophagus. Te hangarau tirotiro whakaahua luminal mahi (FLIP). Ko te FLIP he hangarau hou ka taea te awhina i te whakau i te tautuhi achalasia ki te kore e ranea ētahi atu whakamātautau. Te tiaki i te Kaupapa Hauora Mayo Ka taea e ta mātou rōpū manaaki o ngā tohunga Kaupapa Hauora Mayo te awhina i a koe ki ō kaupapa hauora e pā ana ki te achalasia Tīmata Mai I konei

Ko te ātete achalasia e āta whakaaro ana ki te whakahaumaru, ki te whakamātauria rānei te sphincter esophageal raro kia taea ai te neke atu o te kai me te wai i roto i te pūnaha whakahaere kai.

Ko te ātete motuhake e whakaaro ana ki tō tau, āhua hauora me te kaha o te achalasia.

Ko ētahi atu whiringa kore pokanga e whai ake nei:

• Te whakamātauria hau. I roto i tēnei mahi tākuta, ka whakauruhia he poroporo ki waenganui o te sphincter esophageal, ā, ka pupuhi kia nui ake te tuwhera. Me whakahoki pea te whakamātauria hau mēnā ka kore te sphincter esophageal e tuwhera tonu. Tata ki te toru o ngā tāngata i whakamahia ki te whakamātauria poroporo e hiahia ana ki te whakaora i roto i ngā rima tau. E hiahiatia ana tēnei mahi te whakaora.
• OnabotulinumtoxinA (Botox). Ka taea te whakauru tika ki te sphincter esophageal tēnei whakahaumaru uaua ki te ngira i te wa o te endoscopy. Me whakahoki pea ngā whakaurunga, ā, ko ngā whakaurunga whakahoki ka uaua ake pea te mahi pokanga i muri mai mēnā e hiahiatia ana.

Ko te Botox te tikanga ka tūtohutia anake mō ngā tāngata kaore e taea te whakamātauria hau, te pokanga rānei, nā te pakeke, te hauora whānui rānei. Ko ngā whakaurunga Botox te tikanga kaore e roa atu i te ono marama. Ko te whakapai ake kaha mai i te whakaurunga o Botox ka āhei pea te whakau i te whakatau o te achalasia.

• Rongoā. Ka tūtohu pea tō tākuta i ngā whakahaumaru uaua pēnei i te nitroglycerin (Nitrostat) te nifedipine rānei (Procardia) i mua i te kai. He iti te pānga ātete o ēnei rongoā, ā, he nui ngā pānga kino. Ko ngā rongoā te tikanga ka whakaarohia anake mēnā kaore koe e te kānaretī mō te whakamātauria hau, te pokanga rānei, ā, kāore i āwhina te Botox. Ko tēnei momo rongoā te tikanga kaore e tohua.

OnabotulinumtoxinA (Botox). Ka taea te whakauru tika ki te sphincter esophageal tēnei whakahaumaru uaua ki te ngira i te wa o te endoscopy. Me whakahoki pea ngā whakaurunga, ā, ko ngā whakaurunga whakahoki ka uaua ake pea te mahi pokanga i muri mai mēnā e hiahiatia ana.

Ko te Botox te tikanga ka tūtohutia anake mō ngā tāngata kaore e taea te whakamātauria hau, te pokanga rānei, nā te pakeke, te hauora whānui rānei. Ko ngā whakaurunga Botox te tikanga kaore e roa atu i te ono marama. Ko te whakapai ake kaha mai i te whakaurunga o Botox ka āhei pea te whakau i te whakatau o te achalasia.

Ko ētahi atu whiringa pokanga mō te ātete achalasia e whai ake nei:

• Heller myotomy. Ko te Heller myotomy e whakauru ana ki te tapahi i te uaua i te pito raro o te sphincter esophageal. Ka taea ai e te kai te neke atu ki te kopu. Ka taea te mahi i te mahi mā te tikanga iti-whakauru e kiia nei ko te laparoscopic Heller myotomy. Ko ētahi o ngā tāngata he Heller myotomy kei a rātou ka whanake pea i te mate reflux gastroesophageal (GERD) i muri mai.

Kia kore ai e puta mai ngā raruraru i muri mai ki te GERD, ka mahi pea te taote i te mahi e kiia nei ko te fundoplication i te wā anō o te Heller myotomy. I roto i te fundoplication, ka takai te taote i te pito o te kopu ki te esophageal raro kia waiho ai he waiti anti-reflux, kia kore ai te waikawa e hoki mai ki te esophagus. Ko te fundoplication te tikanga ka mahihia mā te mahi iti-whakauru, e kiia ana hoki ko te mahi laparoscopic.

• Peroral endoscopic myotomy (POEM). I roto i te mahi POEM, ka whakamahi te taote i te endoscope i whakauruhia i roto i te waha, ki raro i te korokoro kia waiho ai he tapahi i roto i te papanga o roto o te esophagus. Katahi, pēnei i te Heller myotomy, ka tapahia e te taote te uaua i te pito raro o te sphincter esophageal.

Ka taea hoki te whakakotahi i te POEM me te whai muri rānei i te fundoplication i muri mai kia āhei ai te ārai i te GERD. Ko ētahi o ngā turoro he POEM, ā, ka whanake i te GERD i muri i te mahi ka whakamahia ki te rongoā i ia rā e tangohia ana mā te waha.

Heller myotomy. Ko te Heller myotomy e whakauru ana ki te tapahi i te uaua i te pito raro o te sphincter esophageal. Ka taea ai e te kai te neke atu ki te kopu. Ka taea te mahi i te mahi mā te tikanga iti-whakauru e kiia nei ko te laparoscopic Heller myotomy. Ko ētahi o ngā tāngata he Heller myotomy kei a rātou ka whanake pea i te mate reflux gastroesophageal (GERD) i muri mai.

Kia kore ai e puta mai ngā raruraru i muri mai ki te GERD, ka mahi pea te taote i te mahi e kiia nei ko te fundoplication i te wā anō o te Heller myotomy. I roto i te fundoplication, ka takai te taote i te pito o te kopu ki te esophageal raro kia waiho ai he waiti anti-reflux, kia kore ai te waikawa e hoki mai ki te esophagus. Ko te fundoplication te tikanga ka mahihia mā te mahi iti-whakauru, e kiia ana hoki ko te mahi laparoscopic.

Peroral endoscopic myotomy (POEM). I roto i te mahi POEM, ka whakamahi te taote i te endoscope i whakauruhia i roto i te waha, ki raro i te korokoro kia waiho ai he tapahi i roto i te papanga o roto o te esophagus. Katahi, pēnei i te Heller myotomy, ka tapahia e te taote te uaua i te pito raro o te sphincter esophageal.

Ka taea hoki te whakakotahi i te POEM me te whai muri rānei i te fundoplication i muri mai kia āhei ai te ārai i te GERD. Ko ētahi o ngā turoro he POEM, ā, ka whanake i te GERD i muri i te mahi ka whakamahia ki te rongoā i ia rā e tangohia ana mā te waha.

Kaore he uauatanga