Achalasia
Incamake
Achalasia ni uburwayi bwo kugira ikibazo cyo kwishima, bugira ingaruka ku muyoboro uhuza akanwa n'igifu, witwa umuyoboro w'ibiryo. Ubumenyi bw'imitsi buwangirika bituma bimugora imitsi yo mu muyoboro w'ibiryo gukanda ibiryo n'ibinyobwa mu gifu. Ibiryo nyuma bihera mu muyoboro w'ibiryo, rimwe na rimwe bigatwika bikongera bisubira mu kanwa. Ibi biryo byatwitswe bishobora kugira uburyohe bubi.
Achalasia ni uburwayi buke cyane. Bamwe bayitiranya n'indwara y'umwuka mu gifu (GERD). Ariko rero, muri achalasia, ibiryo biva mu muyoboro w'ibiryo. Muri GERD, ibintu biva mu gifu.
Nta muti uwo ari wo wose wa achalasia. Iyo umuyoboro w'ibiryo wangiritse, imitsi ntishobora kongera gukora neza. Ariko ibimenyetso bishobora guhangana nabyo hakoreshejwe endoscopy, ubuvuzi buke cyangwa kubaga.
Ibimenyetso
Ibimenyetso bya Achalasia bigaragara buhoro buhoro kandi bikagenda birushaho kuba bibi uko igihe gihita. Ibimenyetso bishobora kuba birimo:
- Kugira ikibazo cyo kwishima, bita dysphagia, bishobora kumvikana nk'aho ibiryo cyangwa ibinyobwa biri mu muhogo.
- Ibiryo cyangwa amacandwe yanyoye asubira inyuma mu muhogo.
- Umuriro mu gituza.
- Kuvuza.
- Kubabara mu gituza bije bigenda.
- Kukohoma nijoro.
- Pneumonie iterwa no kwinjiza ibiryo mu mwijima.
- Kugabanuka k'uburemere.
- Kuvomitwa.
Impamvu
Impamvu nyakuri itera achalasia ntiyiyumvikana neza. Abashakashatsi bakeka ko ishobora guterwa no kubura uturemangingo tw'imiterere mu munwa. Hariho imitekerereze ku cyayitera, ariko kwandura virusi cyangwa imisubizo ya auto-immune ni bimwe mu bishoboka. Gake cyane, achalasia ishobora guterwa n'indwara y'umuzuko iherwa mu muryango cyangwa kwandura.
Ingaruka zishobora guteza
Ibintu byongera ibyago byo kurwara achalasia birimo:
- Imyaka. Nubwo achalasia ishobora kwibasira abantu b'imyaka yose, igaragara cyane mu bantu bari hagati y'imyaka 25 na 60.
- Indwara zimwe na zimwe. Ibyago byo kurwara achalasia biri hejuru mu bantu barwaye indwara z'uburwayi, kudakora neza kw'impyiko cyangwa Allgrove syndrome, indwara idasanzwe y'umuzuko iterwa n'impamvu z'umurage.
Kupima
Achalasia ishobora kwirengagizwa cyangwa ikavurwa nabi kuko ifite ibimenyetso bisa n’iby’izindi ndwara zifata uruvange. Kugira ngo bapime achalasia, umuhanga mu buvuzi ashobora kugutegurira: Ubupimo bw’imitsi yo mu nyuma y’umuyoboro w’ibiryo. Ubu bupimo bupima imikorere y’imitsi yo mu muyoboro w’ibiryo mu gihe cyo kunywa. Bupima kandi uko umusemburo wo hasi w’umuyoboro w’ibiryo ukinguka mu gihe cyo kunywa. Ubu bupimo ni bwo bufasha cyane mu gihe ushaka kumenya ubwoko bw’uburwayi bufata uburyo bwo kunywa ufite. Amafoto y’ama rayons X y’uruvange rw’ibiryo rwo hejuru. Amafoto ya rayons X afatwa nyuma yo kunywa amazi ameze nk’ifu yitwa baryum. Baryum ikingira imbere y’uruvange rw’ibiryo kandi yuzuza imyanya y’ibiryo. Iyo kingira ifasha umuhanga mu buvuzi kubona ishusho y’umuyoboro w’ibiryo, umwijima n’igice cyo hejuru cy’amara. Uretse kunywa amazi, gutwara igirabaryum bishobora gufasha kugaragaza ikibazo mu muyoboro w’ibiryo. Kwihera amaso imbere y’uruvange rw’ibiryo. Kwihera amaso imbere y’uruvange rw’ibiryo bikoresha camera ntoya iri ku mpera y’umuyoboro woroshye kugira ngo barebe uruvange rw’ibiryo rwo hejuru. Kwihera amaso imbere bishobora gukoreshwa mu gushaka ikibazo mu muyoboro w’ibiryo. Kwihera amaso imbere bishobora kandi gukoreshwa mu gufata igice cy’umubiri, cyitwa ubuvumu, kugira ngo harebwe ingaruka z’uburwayi bwo gusubira inyuma nk’uburwayi bwa Barrett. Ikoranabuhanga rya Functional luminal imaging probe (FLIP). FLIP ni uburyo bushya bushobora gufasha kwemeza uburwayi bwa achalasia niba ibindi bipimo bitahagije. Ubufasha muri Mayo Clinic Itsinda ryacu ry’abahanga muri Mayo Clinic barashobora kugufasha mu bibazo byawe by’ubuzima bifitanye isano na achalasia. Tangira hano
Uburyo bwo kuvura
Ubuvuzi bwa Achalasia bugamije kwerekana cyangwa gukuramo umusemburo wo hepfo w'umuyoboro w'ibiryo kugira ngo ibiryo n'ibinyobwa bishobore kunyura mu nzira y'igogorwa byoroshye.
Ubuvuzi bwabugenewe biterwa n'imyaka yawe, ubuzima bwawe n'uburemere bwa achalasia.
Amahitamo adakoresha ubuvuzi harimo:
- Kubumba umwuka. Muri ubu buryo bwo kuvura, umupira uterwa hagati mu musemburo w'umuyoboro w'ibiryo maze ugafukurwa kugira ngo ugurure umwanya. Kubumba umwuka bishobora gusubirwamo niba umusemburo w'umuyoboro w'ibiryo udasigaye ufunguye. Hafi kimwe cya gatatu cy'abantu bavuwe bakoresheje kubumba umupira bagomba gusubira kuvurwa mu myaka itanu. Ubu buryo bukeneye imiti ituma utaryama.
- OnabotulinumtoxinA (Botox). Iyi miti ituma imitsi idakora cyane ishobora guterwa muri musemburo w'umuyoboro w'ibiryo ikoresheje igikoresho cyo kubaga mu gihe cyo kubaga. Injuru zirakenewe gusubirwamo, kandi injuru zisubirwamo bishobora kugorana gukora ubuvuzi nyuma niba bikenewe.
Botox isanzwe igenewe abantu badashobora kubumba umwuka cyangwa kubagwa bitewe n'imyaka cyangwa ubuzima rusange. Injuru za Botox ntizikemara amezi arenga atandatu. Kugira iterambere rikomeye kuva ku gutera Botox bishobora gufasha kwemeza uburwayi bwa achalasia.
- Imiti. Muganga wawe ashobora kugutekereza imiti ituma imitsi idakora cyane nka nitroglycerin (Nitrostat) cyangwa nifedipine (Procardia) mbere yo kurya. Iyi miti ifite ingaruka nke kandi ingaruka mbi zikomeye. Imiti isanzwe itekerezwaho gusa niba utari umukandida wo kubumba umwuka cyangwa kubagwa kandi Botox itagufashije. Ubu bwoko bw'ubuvuzi buke cyane.
OnabotulinumtoxinA (Botox). Iyi miti ituma imitsi idakora cyane ishobora guterwa muri musemburo w'umuyoboro w'ibiryo ikoresheje igikoresho cyo kubaga mu gihe cyo kubaga. Injuru zirakenewe gusubirwamo, kandi injuru zisubirwamo bishobora kugorana gukora ubuvuzi nyuma niba bikenewe.
Botox isanzwe igenewe abantu badashobora kubumba umwuka cyangwa kubagwa bitewe n'imyaka cyangwa ubuzima rusange. Injuru za Botox ntizikemara amezi arenga atandatu. Kugira iterambere rikomeye kuva ku gutera Botox bishobora gufasha kwemeza uburwayi bwa achalasia.
Amahitamo yo kubaga yo kuvura achalasia harimo:
- Heller myotomy. Heller myotomy isobanura guca imitsi ku mpera y'umusemburo w'umuyoboro w'ibiryo. Ibi bituma ibiryo byinjira mu gifu byoroshye. Ubu buryo bushobora gukorwa hakoreshejwe uburyo buke cyane bwitwa laparoscopic Heller myotomy. Bamwe mu bantu bafite Heller myotomy bashobora kuza kwibasirwa n'indwara y'umusemburo w'igifu (GERD).
Kugira ngo birinde ibibazo bya GERD mu gihe kizaza, umuganga ashobora gukora uburyo bwitwa fundoplication icyarimwe na Heller myotomy. Muri fundoplication, umuganga apfunyika hejuru y'igifu ku muyoboro w'ibiryo wo hepfo kugira ngo akore umusemburo ubuza ibyo kurya gusubira mu muyoboro w'ibiryo. Fundoplication isanzwe ikorwa hakoreshejwe uburyo buke cyane, kandi bwitwa uburyo bwa laparoscopic.
- Peroral endoscopic myotomy (POEM). Muri POEM, umuganga akoresha endoscope ishyirwa mu kanwa maze ikazamuka mu muhogo kugira ngo ikore umwanya mu gice cy'imbere cy'umuyoboro w'ibiryo. Hanyuma, nk'uko biri muri Heller myotomy, umuganga aca imitsi ku mpera y'umusemburo w'umuyoboro w'ibiryo.
POEM ishobora kandi guhuzwa na fundoplication cyangwa kuyikurikira kugira ngo ifashe kwirinda GERD. Bamwe mu barwayi bafite POEM kandi bagira GERD nyuma y'ubuvuzi bavurwa hakoreshejwe imiti y'umunsi.
Heller myotomy. Heller myotomy isobanura guca imitsi ku mpera y'umusemburo w'umuyoboro w'ibiryo. Ibi bituma ibiryo byinjira mu gifu byoroshye. Ubu buryo bushobora gukorwa hakoreshejwe uburyo buke cyane bwitwa laparoscopic Heller myotomy. Bamwe mu bantu bafite Heller myotomy bashobora kuza kwibasirwa n'indwara y'umusemburo w'igifu (GERD).
Kugira ngo birinde ibibazo bya GERD mu gihe kizaza, umuganga ashobora gukora uburyo bwitwa fundoplication icyarimwe na Heller myotomy. Muri fundoplication, umuganga apfunyika hejuru y'igifu ku muyoboro w'ibiryo wo hepfo kugira ngo akore umusemburo ubuza ibyo kurya gusubira mu muyoboro w'ibiryo. Fundoplication isanzwe ikorwa hakoreshejwe uburyo buke cyane, kandi bwitwa uburyo bwa laparoscopic.
Peroral endoscopic myotomy (POEM). Muri POEM, umuganga akoresha endoscope ishyirwa mu kanwa maze ikazamuka mu muhogo kugira ngo ikore umwanya mu gice cy'imbere cy'umuyoboro w'ibiryo. Hanyuma, nk'uko biri muri Heller myotomy, umuganga aca imitsi ku mpera y'umusemburo w'umuyoboro w'ibiryo.
POEM ishobora kandi guhuzwa na fundoplication cyangwa kuyikurikira kugira ngo ifashe kwirinda GERD. Bamwe mu barwayi bafite POEM kandi bagira GERD nyuma y'ubuvuzi bavurwa hakoreshejwe imiti y'umunsi.
Umuhakana: Kanama ni urubuga rw'amakuru y'ubuzima kandi ibisubizo byayo ntibigize inama z'ubuvuzi. Jya ubona umuganga ufite uruhushya rwo gukorera hafi yawe mbere yo gukora impinduka izo ari zo zose.