Ukuthi iyini i-Achalasia? Izimpawu, Izimbangela, Nokwelashwa

I-Achalasia yisifo esingavamile lapho umgudu wakho wesophagus uhluleka ukuhambisa ukudla phansi esiswini sakho. Isophagus yakho yiyona ipayipi ehlanganisa umlomo wakho nesisu sakho, futhi ngokujwayelekile icindezela ukudla phansi ngenkathi umsipha ophakathi ukhululeka ukuvumela ukudla kudlule.

Ku-achalasia, le nqubo ehlelwe kahle iphuka. Isophagus ilahlekelwa amandla okuhambisa ukudla phansi ngokuphumelelayo, futhi umsipha ophakathi uhlala uqinile esikhundleni sokuphumula. Lokhu kudala ukubambeka kokudla nezinye izinto eziphuzwayo esophagus yakho, okuholela ekubeni kunzima ukugwinya kanye nezinye izimpawu ezingathandeki.

Ziyini izimpawu ze-achalasia?

Isimpawu esivame kakhulu oyibona yilokho okunzima ukugwinya, okuthi odokotela babize ngokuthi i-dysphagia. Lokhu ngokuvamile kuqala kancane kancane futhi kubi kakhulu ezinyangeni noma eminyakeni eminingi. Ungase uqale ubona ubunzima ngokudla okuqinile, bese kamuva ube nezingqinamba ekugwinyeni izinto eziphuzwayo.

Nazi izimpawu eziyinhloko abantu abane-achalasia abazibonayo:

• Ubunzima ekugwinyeni kokubili izinto eziqinile neziphuzwayo
• Ukudla noma izinto eziphuzwayo zibuyela phezulu (ukubuyela emuva), ikakhulukazi uma ulele
• Ubuhlungu noma ukucindezela esifubeni, ikakhulukazi ngemva kokudla
• Ukushisa esifubeni okungaphenduli kahle emithi evamile yokwelapha ukubuyela emuva kwesisu
• Ukwehla kobunzima obungalindelekile ngenxa yobunzima bokudla
• Ukuhlanza noma ukuhlwitha, ikakhulukazi ebusuku
• Umoya omubi ngenxa yokudla okuhlala esophagus

Lezi zimpawu zivame ukuvela kancane kancane, ngakho ungase uzilungiselele izindlela zakho zokudla ungaziboni.

Ziyini izinhlobo ze-achalasia?

Odokotela bahlukanisa i-achalasia zibe izinhlobo ezintathu eziyinhloko ngokusekelwe ekuziphatheni kwesophagus yakho ngesikhathi sezivivinyo ezikhethekile. Ukuqonda uhlobo lwakho kusiza ekutholeni indlela yokwelapha engcono kakhulu kuwe.

Uhlobo lwe-I achalasia lubonisa ukungabi khona noma ukuncane kokuhambisana kwemisipha esophagus yakho. Isophagus yakho ngokuyisisekelo iba yipayipi elingasebenzi kahle elisekelwe emandleni okudonsa ukudla phansi. Lolu hlobo ngokuvamile luphendula kahle ekwelapheni okuqina umsipha ophakathi kwesophagus yakho.

Uhlobo lwe-II achalasia luhilela ukuhambisana kwemisipha ethile, kodwa ayihlelwe kahle. Esikhundleni sokuhamba okufana nomzingeli okumele kuhambise ukudla phansi, isophagus yakho icindezela ngezigaba. Lolu hlobo ngokuvamile lube nemiphumela emihle yokwelashwa.

Uhlobo lwe-III achalasia lubonisa ukuhambisana okuqinile, okuqina okungasebenzi ngokumelene nokuhamba kokudla. Lokhu kuhambisana okuqinile kodwa okungahlelwe kahle kungabangela ubuhlungu obukhulu esifubeni. Lolu hlobo lungaba nzima ukulwelapha futhi lungadinga izindlela ezihlukile.

Yini ebangela i-achalasia?

Imbangela eqondile ye-achalasia ayiqondakali ngokuphelele, kodwa abacwaningi bakholelwa ukuthi ihilela ukulimala kwama-nerve aphethe isophagus yakho. La ma-nerve ngokujwayelekile ahlela ukuhambisana kwemisipha okuhambisa ukudla esiswini sakho.

Izimo eziningi zibhekwa njenge-achalasia eyinhloko, okusho ukuthi zithuthuka ngaphandle kwesizathu esicacile esisekelayo. Izazi zezesayensi zicabanga ukuthi lokhu kungase kuhilele inqubo ye-autoimmune lapho uhlelo lokulwa nezifo lomzimba wakho luhlasela ngephutha amaseli e-nerve esophagus yakho, nakuba le nkambo isacwaningwa.

I-achalasia yesibili ingase ibe khona ngenxa yezinye izimo ezilimaza ama-nerve esophagus. Lokhu kuhlanganisa ezinye izifo zekhanda, ukutheleleka njenge-Chagas disease (okuvamile eNingizimu Melika), noma ukuhlinzwa kwangaphambili endaweni yesifuba. Kodwa-ke, izimbangela zesibili azivamile njenge-achalasia eyinhloko.

Ucwaningo oluthile luphakamisa ukuthi izici zezofuzo zingase zidlale indima, njengoba ngokungavamile i-achalasia ingadluliselwa emindenini. Izici zemvelo nokutheleleka kwezifo ezihambisana ne-viral kuphinde kwaphakanyiswa njengokuthi kungaba yizimbangela, kodwa akukho sizathu esiqinisekisiwe esitholwe.

Nini kufanele ubheke udokotela ngenxa ye-achalasia?

Kufanele ubheke udokotela uma uhlushwa yinkinga yokugwinya, ikakhulukazi uma iba mbi ngokuhamba kwesikhathi. Ungalindi uma ubunzima bokugwinya buthinta ikhono lakho lokudla ngokujwayelekile noma uma ulahlekelwa isisindo ngaphandle kwesizathu.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlushwa ukubuyela emuva okuvamile, ikakhulukazi ebusuku, njengoba lokhu kungabangela i-aspiration pneumonia. Ubuhlungu besifuba obuvela njalo ngesikhathi sokudla buphinde bukhombise isidingo sokuhlolwa, ngisho noma ucabanga ukuthi kungase kube ukushisa esifubeni.

Xhumana nodokotela wakho ngokushesha uma ungakwazi ukugwinya izinto eziphuzwayo, uma uhlanza njalo, noma uma ubuhlungu besifuba obukhulu. Lezi zimpawu zingase zibonise ukuthi isimo sakho siqhubeka noma ukuthi uthuthukisa izinkinga ezidinga ukwelashwa okusheshayo.

Ziyini izici ezingase zikubeke engozini ye-achalasia?

Ubudala yiyona nto ebaluleke kakhulu ekubekeni engozini, ngoba i-achalasia ngokuvamile ithuthuka phakathi kweminyaka engama-30 nama-60. Kodwa-ke, ingase ibe khona kunoma yimuphi ubudala, kuhlanganise nezingane nabantu abadala, nakuba lokhu kungavamile.

Lesi simo sithinta amadoda nabesifazane ngokulinganayo, futhi sivela kuwo wonke amaqembu ezizwe emhlabeni jikelele. Indawo yomhlaba ingase ithonye ingozi kancane, njengoba ukutheleleka okuthile njenge-Chagas disease okungabangela i-achalasia yesibili kuvame kakhulu ezindaweni ezithile.

Ukuba nomlando womndeni we-achalasia kukhuphula kancane ingozi yakho, nakuba izimo zomndeni zingavamile kakhulu. Abantu abaningi abathuthukisa i-achalasia abanalo umlando womndeni wesimo.

Ziyini izinkinga ezingase zibe khona ze-achalasia?

Ngaphandle kokwelashwa, i-achalasia ingabangela izinkinga eziningi ezithinta kakhulu impilo yakho kanye nokuphumelela kwakho ekuphileni. Ukuqonda lezi zinkinga ezingase zibe khona kusiza ekuchazeni ukuthi kungani ukuxilongwa kwasekuqaleni nokwelashwa kubalulekile.

Ukwehla kobunzima nokondleka okungalungi kungase kuthuthuke njengoba ukudla kuqhubeka kunzima. Umzimba wakho ungase ungatholi ama-calories anele noma izondlo, okuholela ebuthakathakeni, ukudinwa, nezinye izinkinga zempilo. Lokhu ngokuvamile kuyinye yezinkinga ezinkulu zokuqala abantu abazibonayo.

I-Aspiration pneumonia yinkinga ebandakanyekayo eyenzeka lapho ukudla noma izinto eziphuzwayo ezivela esophagus yakho zingena emaphashini akho. Lokhu ngokuvamile kwenzeka ebusuku uma ulele futhi izinto ezibuyele emuva ziye endleleni engalungile. Izimo eziphindaphindayo zingabangela ukutheleleka okukhulu kwamaphaphu.

Isophagus yakho ingase ikhule ngokuhamba kwesikhathi njengoba ukudla nezinye izinto eziphuzwayo ziqoqana ngaphezulu komsipha oqinile. Lokhu kukhula, okuthiwa yi-megaesophagus, kungenza izimpawu zibe zimbi futhi kukhulise ingozi yokuthi izinto zingene emaphashini. Ezimweni ezinzima, isophagus ingase ibe yiyona eguqukile kakhulu.

Abantu abane-achalasia isikhathi eside banengozi encane yokuthuthukisa umdlavuza wesophagus, nakuba le ngozi ihlala iphansi. Ukuqapha njalo nodokotela wakho kusiza ekutholeni noma yiziphi izinguquko ezibalulekile ngokushesha. Ngokufanayo, ingozi yomdlavuza ibonakala ihlobene nokuvuvukala okuqhubekayo nokukhathazeka esophagus.

I-achalasia ixilongwa kanjani?

Ukuxilongwa kwe-achalasia ngokuvamile kuhilela ukuhlolwa okuthile okusisiza udokotela wakho ukubona ukuthi isophagus yakho isebenza kanjani. Inqubo ngokuvamile iqala ngokuxoxa ngezimpawu zakho kanye nomlando wakho wezokwelapha ngokuningiliziwe.

Ukugwinya i-barium ngokuvamile kuyivivinyo lokuqala udokotela wakho azoyala. Uzophuza ulwimi olukhulu oluqukethe i-barium, bese uthola izithombe ze-X-ray njengoba ulwimi luhamba ngesophagus yakho. Le nqubo ingabonisa uma ukudla noma izinto eziphuzwayo zibambeka futhi iveze ukubonakala okufana “ne-bird’s beak” kwesophagus ku-achalasia.

I-Upper endoscopy ihilela ukudlulisela ipayipi elincane, eliguquguqukayo elinamakhamera phansi komlomo wakho ukuhlola ngokuqondile isophagus yakho nesisu. Le nqubo ikusiza ukukhipha ezinye izimo futhi ingabonisa ukugcinwa kokudla esophagus. Udokotela wakho angase athathe amasampula ethishu uma kudingeka.

I-Esophageal manometry ibhekwa njengokuhlolwa okuyisisekelo ekuxilongweni kwe-achalasia. Ipayipi elincane elinamapheshini wokucindezela lidluliselwa ngaphansi kwesango lakho liye esophagus yakho ukuze lilinganise ukuhambisana kwemisipha nokucindezela. Le nqubo iqinisekisa ukuxilongwa kwe-achalasia futhi ibonise ukuthi yiluphi uhlobo olulokhu.

I-High-resolution manometry inikeza ulwazi olunemininingwane ngokwengeziwe ngokusebenza kwesophagus futhi iye yaba yindlela ekhethwayo ezindaweni eziningi zezokwelapha. I-CT scans ingase isetshenziswe ukuqeda ezinye izimo noma ukuhlola izinkinga.

Yini ukwelashwa kwe-achalasia?

Ukwelashwa kwe-achalasia kugxile ekunciphiseni ukucindezela ngaphansi kwesophagus yakho ukuze kusize ukudla kudlule kalula. Nakuba kungekho ukwelapha okubuyisela ukusebenza okujwayelekile kwesophagus, izindlela eziningi zokwelapha eziphumelelayo zingathuthukisa kakhulu izimpawu zakho kanye nokuphumelela kwakho ekuphileni.

I-Pneumatic dilation iyinqubo lapho udokotela wakho esebenzisa ibhaluni ukuqina umsipha oqinile ngaphansi kwesophagus yakho. Ibhaluni iphethwe ngokucindezela okulawulwayo ukuze iqhekeze ngokulinganayo imicu yemisipha, ivumela ukudla kudlule kalula. Lokhu kwelashwa kuphumelela kubantu abaningi, nakuba izimpawu zingase zibuyele ngokuhamba kwesikhathi.

I-Laparoscopic Heller myotomy ukwelashwa okuncane okuhilela ukusika imicu yemisipha engaphumuli kahle. Le nqubo ngokuvamile ihlanganiswe ne-fundoplication, lapho ingxenye yesisu sakho iphulwe ngaphezulu kwesophagus ukuvimbela ukubuyela emuva kwesisu. Ukwelashwa ngokuvamile kunikeza impumuzo isikhathi eside.

I-Peroral endoscopic myotomy (POEM) iyindlela entsha lapho udokotela efinyelela khona umsipha ngomlomo wakho usebenzisa i-endoscope. Le ndlela igwema ukusikwa kwangaphandle futhi ingasebenza kakhulu, nakuba idatha yesikhathi eside isacwaningwa. Ingase ibe yimbangela yokubuyela emuva kwesisu okukhulu kunokwelashwa okujwayelekile.

Ukugonywa kwe-Botulinum toxin kungaphumula isikhashana umsipha oqinile futhi kunikeze impumuzo yempawu izinyanga eziningana. Lokhu kwelashwa ngokuvamile kusetshenziswa kubantu abangafaneleki ukwelashwa noma ukuqina, noma njengendlela yesikhashana ngenkathi becabanga ngezinye izindlela zokwelapha.

Imithi efana ne-calcium channel blockers noma i-nitrates ingasiza ekuphumuleni umsipha wesophagus, nakuba ngokuvamile ingasebenzi kahle kunamanye ukwelashwa. Ingase isetshenziswe njengokwelashwa kokuqala noma ngokuhlanganiswa nezinye izindlela.

Ungayiphatha kanjani i-achalasia ekhaya?

Nakuba ukwelashwa kwezokwelapha kubalulekile, izindlela eziningana zingakusiza ukuphatha izimpawu zakho nokudla ngokunethezeka ekhaya. Lezi zindlela zisebenza kangcono uma zihlanganiswe nokukhathalelwa kwezokwelapha okuqondile eqenjini lakho lokukhathalela impilo.

Ukudla ukudla okuncane, okuvamile kungenza ukugwinya kube lula futhi kunciphisa imizwa yokudla okuhlala. Thatha isikhathi sakho uma uya kudla futhi uginye ukudla kahle. Ukupha izinto eziphuzwayo ezishisayo ngesikhathi sokudla kungasiza ukudla kudlule esophagus yakho kalula.

Ukulala ngekhanda eliphakeme kunganciphisa ukubuyela emuva ebusuku futhi kunciphisa ingozi yokuthi izinto zingene emaphashini. Sebenzisa amapilishi engeziwe noma uphakamise ikhanda lembhede yakho ngamasentimitha angu-15 kuya kwangu-20. Gwema ukudla ukudla okukhulu eduze nesikhathi sokulala, njengoba lokhu kukhuphula amathuba okubuyela emuva uma ulele.

Ukugcina umzimba uqinisile kubalulekile, ikakhulukazi njengoba ungase udle kancane ngenxa yobunzima bokugwinya. Izinto eziphuzwayo ezingama-room temperature noma ezishisayo ngokuvamile kulula ukugwinya kunokudla okubandayo kakhulu. Gwema iziphuzo ezikhiqizayo, njengoba zingase zikhulise ukucindezela esophagus yakho.

Gcina umbhalo wokudla okuyindlela elula noma okunzima kuwe ukugwinya, bese ulungisa ukudla kwakho ngokufanele. Abantu abaningi bathola ukuthi ukudla okuthambile nezinto eziphuzwayo kulula ukuphatha. Unganqikazi ukuguqula izakhiwo zokudla noma usebenzise i-blender uma kukusiza ukugcina ukondleka okuhle.

Kufanele uzilungiselele kanjani i-aphoyintimenti yakho nodokotela?

Ukulungiselela i-aphoyintimenti yakho kungasiza ekuqinisekiseni ukuthi uthola okuningi kakhulu ekuhambeleni kwakho futhi unike udokotela wakho ulwazi oludingekayo ekuxilongweni okuqondile nasekulungiseni ukwelashwa.

Gcina idayari enemininingwane yezimpawu zakho okungenani isonto ngaphambi kwe-aphoyintimenti yakho. Qaphela ukuthi izimpawu zivela nini, lokho okwakudla noma okwakupha, kanye nokuthi izimpawu zazinzima kangakanani. Faka ulwazi mayelana nanoma yikuphi ukwehla kobunzima, ukuthi izimpawu zakho zithinta kanjani imisebenzi yansuku zonke, nanoma yiziphi izindlela ozibonile.

Yenza uhlu lwayo yonke imithi, izithasiselo, namavithamini owaqaphela, kuhlanganise nezinga. Letha ulwazi mayelana nanoma yikuphi ukwelashwa okwakwenziwe ngaphambili ngezimpawu zakho, kuhlanganise ne-antacids noma ezinye izindlela zokwelapha.

Bhala imibuzo ofuna ukuyibuza udokotela wakho. Cabanga ukubuza ngezindlela zokwelapha, imiphumela elindelekile, ukuguqulwa kwesitayela sokuphila, kanye nokukhathalelwa okulandelayo. Unganqikazi ukucela incazelo uma amagama ezokwelapha noma imiqondo ayicaci kuwe.

Letha ilungu lomndeni noma umngani uma kungenzeka, njengoba bangakusiza ukukhumbula ulwazi olubalulekile oluxoxwe ngesikhathi se-aphoyintimenti. Ukuba nokwesekwa kungase futhi kusize uma uzizwa ukhathazekile ngezimpawu zakho noma ukwelashwa okungenzeka.

Iyini into ebaluleke kakhulu mayelana ne-achalasia?

I-Achalasia yisimo esilawuleka, nakuba ingase ithonye kakhulu impilo yakho yansuku zonke ekuqaleni. Okubalulekile ukuthola ukuxilongwa nokwelashwa okuqondile, okungathuthukisa kakhulu izimpawu zakho futhi kukusize ubuyele ekujabuleleni ukudla nemisebenzi evamile.

Nakuba i-achalasia iyisimo esiqhubekayo esidinga ukuphathwa okuqhubekayo, abantu abaningi bathola ukulawulwa okuhle kwezimpawu ngokwelashwa okuqondile. Izindlela ezihlukahlukene zokwelapha ezitholakalayo zisho ukuthi uma indlela ethile ingasebenzi kahle kuwe, kunezindlela eziphumelelayo ezingase zivivinywe.

Ukusebenzisana eduze neqembu lakho lokukhathalela impilo nokulandela iziphakamiso zabo kukunika ithuba elihle lokulawula izimpawu zakho ngempumelelo. Ngokwelashwa okuqondile, abantu abaningi abane-achalasia bangagcina impilo enhle futhi baqhubeke bejabulela ukudla, ngisho noma kukhona ukulungiswa kokudla okudingekayo.

Imibuzo evamile ebuzwayo mayelana ne-achalasia

Q1: Ingabe i-achalasia iyefa?

I-Achalasia ayivamile ukudluliselwa ezizukulwaneni. Nakuba kube khona izimo ezimbalwa ezibikwe ze-achalasia edluliselwa emindenini, iningi lezimo livela ngaphandle komlando womndeni. Uma une-achalasia, ingozi yezingane zakho yokuthuthukisa lesi simo iphakeme kancane kunengozi yabantu abavamile, okwamanje iphansi kakhulu.

Q2: Ingabe i-achalasia ingelashwa ngokuphelele?

Okwamanje, akukho ukwelapha okungabuyisela ukusebenza okujwayelekile kwesophagus ku-achalasia. Kodwa-ke, ukwelashwa kungasebenza kakhulu ekulawuleni izimpawu futhi kukuvumele ukudla ngokujwayelekile. Abantu abaningi bathola ukulawulwa okuhle kwezimpawu isikhathi eside ngokwelashwa okuqondile, nakuba abanye bangadinga izinqubo ezengeziwe ngokuhamba kwesikhathi njengoba izimpawu zingase zibuyele ngezinye izikhathi.

Q3: Ingabe ngizodinga ukulandela ukudla okukhethekile phakade?

Abantu abaningi bangabuyela ekudleni ngokujwayelekile ngemva kokwelashwa okuphumelelayo kwe-achalasia. Ungase udinga ukwenza ukulungiswa okuncane, njengokudla kancane noma ukugwema ukudla okukhulu, kodwa lezi zinguquko ngokuvamile zincane. Ngesikhathi sokwelashwa sokuqala, udokotela wakho angase aphakamise ukuguqulwa kokudla, kodwa lokhu ngokuvamile kuyisikhashana.

Q4: Izimpawu ziyathuthuka ngokushesha kangakanani ngemva kokwelashwa?

Ukuthuthuka kwezimpawu ngokuvamile kuqala ezinsukwini ezimbalwa kuya emavikeni ngemva kokwelashwa okuphumelelayo. I-Pneumatic dilation kanye nokwelashwa okuhlinzwayo ngokuvamile kunikeza impumuzo ngokushesha, nakuba kungase kudingeke amasonto ambalwa ukubona inzuzo ephelele. Abanye abantu baphawula ukuthuthuka ekugwinyeni ezinsukwini ezimbalwa zokuqala, ngenkathi abanye bengase bathathe isikhathi eside ukubona impumuzo enkulu.

Q5: Ingabe izimpawu ze-achalasia zingabuya ngemva kokwelashwa?

Yebo, izimpawu zingase zibuyele ngokuhamba kwesikhathi, ikakhulukazi ngemva kwe-pneumatic dilation, okungase kudingeke ukuphindwa. Ukwelashwa okuhlinzwayo kuvamise ukunikeza impumuzo isikhathi eside, kodwa abanye abantu bangase ekugcineni badinge izinqubo ezengeziwe. Ukuqapha njalo nodokotela wakho kusiza ekuqapheni isimo sakho nokubhekana nanoma yiziphi izimpawu ezibuyayo ngokushesha ngokulungiswa okuqondile kokwelashwa.