Ukuhlupheka Kokugwinya (Dysphagia): Izimpawu, Izimbangela, Nokwelapha

I-Dysphagia yigama lezokwelapha elithi ukukhuluphuka kokugwinya ukudla, izinto eziphuzwayo, noma ngisho ne-saliva yakho. Lesi simo sihlupha izigidi zabantu futhi singaba lutho kusuka ekuhluphekeni okuncane lapho kudliwa ukudla okuthile kuya ekungakwazi nhlobo ukugwinya ngokuphephile.

Nakuba ukungakwazi ukugwinya okungathí sina kungase kwenzeke kunoma ubani, izinkinga zokugwinya ezihlala njalo kufanele ziqaphelwe. Inqubo yakho yokugwinya ihilela imisipha nezinzwa ezingaphezu kuka-50 ezisebenza ndawonye, ngakho-ke uma kukhona okuthinta le nhlangano, kungathinta kakhulu impilo yakho yansuku zonke nokudla kwakho.

Ziyini izimpawu ze-dysphagia?

Isilwane esibonakalayo kakhulu ukuzizwa sengathi ukudla noma isiphuzo kunamathele entanyeni yakho noma esifubeni lapho uzama ukugwinya. Noma kunjalo, izimpawu ze-dysphagia zingaba zahlukene kakhulu futhi ngezinye izikhathi zibe buthakathaka.

Nazi izimpawu ezivamile ongazihlangabezana nazo:

• Ukudla noma isiphuzo sizizwa sinamathele entanyeni yakho, esifubeni, noma ngemuva kwesifuba sakho
• Ubuhlungu lapho ugwinya (okubizwa ngokuthi i-odynophagia)
• Ukuhlwitha noma ukukhokha ngesikhathi noma ngemva kokudla noma ukuphuza
• Ukukhipha ukudla (ukubuyisela)
• Ukukhishwa kwesaliva noma ukukhuluphuka kokulawula isaliva
• Izwi elihlwithayo noma eli-gurgly ngemva kokudla
• I-heartburn evamile noma i-acid reflux
• Ukulahlekelwa isisindo okungalindelekile ngokugwema ukudla
• Ukuthatha isikhathi eside kunokujwayelekile ukukoma noma ukugwinya
• Ukudinga ukugwinya izikhathi eziningi ngokuma okulodwa

Abanye abantu nabo bahlangabezana nezibonakaliso ezingabonakali kangako njengokugwema ukudla kwempilo, ukusika ukudla izingcezu ezincane kakhulu, noma ukuzizwa bexakekile ngokudla. Lezi zinguquko zokuziphatha zivame ukuthuthuka kancane njengoba umzimba wakho uzama ukuzivumelanisa nobunzima bokugwinya.

Ezimweni ezinzima kakhulu, ungase uqaphele i-pneumonia ephindaphindayo noma ukutheleleka kwesifuba, okungase kwenzeke lapho ukudla noma isiphuzo kungena ngephutha emaphashini akho esikhundleni sesisu sakho.

Ziyini izinhlobo ze-dysphagia?

Odokotela ngokuvamile bahlukanisa i-dysphagia zibe izinhlobo ezimbili eziyinhloko ngokusekelwe lapho inkinga ivela khona enkambweni yakho yokugwinya. Ukuqonda lezi zinhlobo kusiza ekutholeni imbangela yangempela nendlela yokwelapha engcono kakhulu.

I-oropharyngeal dysphagia ihlupha indawo yomlomo nomlomo. Lo mbono wenza kube nzima ukususa ukudla emlonyeni wakho uye entanyeni yakho bese uya phansi e-esophagus yakho. Ungase uzizwe sengathi awukwazi ukuqala ukugwinya, noma ukudla kunamathele ngemuva kwentanyeni yakho.

I-Esophageal dysphagia ivela lapho ukudla kunamathele e-esophagus yakho, umbozo othatha ukudla entanyeni yakho uye esiswini sakho. Ngale ndlela, ngokuvamile ungaqala ukugwinya ngokujwayelekile, kodwa-ke ukudla kuzizwa kunamathele endaweni yesifuba sakho.

Uhlobo ngalunye lunezimbangela nezibonakaliso ezahlukene, kungakho udokotela wakho azokubuza imibuzo eminingana mayelana nokuthi uhlupheka kuphi nokuthi nini lapho uzwa ubunzima bokugwinya.

Yini ebangela i-dysphagia?

I-Dysphagia ingase ibe yimphumela yezimo ezahlukene ezihlupha izingxenye ezahlukene zesimiso sakho sokugwinya. Izimbangela zincike kakhulu ekutheni uhlobo luni lwe-dysphagia olukhona.

Izimbangela ezivamile ze-oropharyngeal dysphagia zihlanganisa:

• Isifo sohlangothi noma ezinye izimo zezinzwa njenge-Parkinson's disease
• Ukuhlinzwa komlomo nobuso noma ukwelashwa kwabo
• Ubuthakathaka bemisipha njenge-myasthenia gravis
• Ukuwohloka kwengqondo noma ukuwohloka kokucinga
• Ukutholakala komlomo noma ukuvuvukala
• Izinkinga zamahlombe noma ama-dentures angafanele kahle
• Imithi ebangela umlomo owomile noma ubuthakathaka bemisipha

I-Esophageal dysphagia ngokuvamile ivela ku:

• Isifo se-Gastroesophageal reflux (GERD) esibangela ama-scar
• Ukuqina kwemisipha e-esophagus
• Ukuncipha kwe-esophagus ngenxa yokuqina noma ama-scar
• Iziphumu e-esophagus noma ecindezela kuyo
• I-Hiatal hernia
• Izifo ze-connective tissue njenge-scleroderma
• I-Eosinophilic esophagitis (ukuvuvukala okungokwe-allergic)

Ngezinye izikhathi, i-dysphagia ithuthuka njengomphumela wecala wemithi, ikakhulukazi leyo eithinta umsebenzi wemisipha noma ebangela umlomo owomile. Izinguquko ezihlobene nobudala zingase futhi zinikeze, njengoba imisipha ehilelekile ekugwinyeni ingase ibuthakathaka ngokuhamba kwesikhathi.

Ezimweni ezingavamile, i-dysphagia ingase ibe yimphumela wezimo ezinjenge-achalasia, lapho i-lower esophageal sphincter ingakhululi kahle, noma ezinye izifo ze-autoimmune ezihlupha imisipha yokugwinya.

Nini okumele ubona udokotela nge-dysphagia?

Kufanele uxhumane nodokotela wakho uma ubunzima bokugwinya buhlala isikhathi esingaphezu kwamalanga ambalwa noma buthinta ukudla kwakho nokuphuza kwakho. Ungalindi uma inkinga iba mbi noma ithonya ukudla kwakho.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nokuthi:

• Ukungaqondi nhlobo ukugwinya izinto eziphuzwayo noma eziqinile
• Izehlakalo zokukhokha okunzima
• Izibonakaliso zokulahleka kwamanzi emzimbeni noma ukulahleka kwesisindo esikhulu
• Ukuqina kanye nezinhlungu zokugwinya
• Ubuhlungu besifuba obukhulu lapho ugwinya
• Ukukhahlela igazi noma into ebukeka njenge-coffee grounds

Ngisho nezibonakaliso ezilula kufanele ziqaphelwe uma zihlala njalo. Ukuxilongwa kwasekuqaleni kungasiza ekutholeni izimbangela ezilashwayo nokuvimbela izinkinga ezinjengokulahleka kokudla noma i-aspiration pneumonia.

Udokotela wakho anganquma ukuthi izimpawu zakho zidinga ukungenelela ngokushesha noma zingaphathwa ngokushintsha indlela yokuphila nokwelashwa.

Ziyini izinto ezingase zikwenze ube sengozini ye-dysphagia?

Izinto eziningi zingase zikwenze ube nethuba elikhulu lokuthola ubunzima bokugwinya. Ukuqonda lezi zinto ezingase zikwenze ube sengozini kungakusiza uhlale uqaphile ngezinkinga ezingase zenzeke futhi ucele usizo lapho kudingeka.

Ubudala ingenye yezinto ezibaluleke kakhulu ezingase zikwenze ube sengozini, njengoba imisipha nezinzwa ezihilelekile ekugwinyeni zibuthakathaka ngokwemvelo ngokuhamba kwesikhathi. Abantu abadala abangaphezu kweminyaka engama-65 banesihloko esikhethekile, ikakhulukazi uma benesinye isimo sempilo.

Izimo zezokwelapha ezivame ukwandisa ingozi ye-dysphagia zihlanganisa:

• Izifo zezinzwa (isiphumu, i-Parkinson's disease, i-multiple sclerosis)
• Ukuhlinzwa komlomo nobuso
• Isifo se-Gastroesophageal reflux (GERD)
• Izifo ze-connective tissue
• Ukuwohloka kwengqondo noma ukuwohloka kokucinga
• Ukuphathwa ngaphambili kwe-radiation therapy ekhanda noma entanyeni
• Isifo sikidini esiqhubekayo
• Izimo ze-autoimmune

Imithi ethile ingase futhi ikwandisa ingozi yakho, ikakhulukazi leyo ebangela umlomo owomile, ukuphumula kwemisipha, noma ukulala. Uma uthatha imithi eminingi, imiphumela ehlangene ingase ithonye umsebenzi wakho wokugwinya.

Izinto zokuphila ezinjengokubhema nokusebenzisa utshwala ngokweqile kungathukuthelisa intanyeni yakho ne-esophagus, okungase kube yimbangela yobunzima bokugwinya ngokuhamba kwesikhathi.

Ziyini izinkinga ezingase zenzeke ngenxa ye-dysphagia?

Uma ingaphathwa, i-dysphagia ingase iholele ezinkingeni zezempilo ezinzima ezihlupha inhlalakahle yakho yonke. Izindaba ezinhle ukuthi izinhlupheko eziningi zingavikeleka ngokuphathwa kahle nokwelashwa.

Izinhlupheko ezivamile zihlanganisa:

• Ukungaqondi kahle kokudla nokulahleka kwamanzi emzimbeni ngokugwema ukudla neziphuzo
• Ukulahleka kwesisindo okungalindelekile
• I-Aspiration pneumonia (lapho ukudla noma isiphuzo kungena emaphashini)
• Ukutholakala okuphindaphindayo kokuphefumula
• Ukuzihlukanisa nabanye ngokugwema ukudla nabo
• Ukukhathazeka noma ukucindezeleka okuhlobene nobunzima bokudla
• Izehlakalo zokukhokha

I-Aspiration pneumonia kufanele iqaphelwe ngokukhethekile ngoba ingase ibe yingozi eyingozi, ikakhulukazi kubantu abadala noma labo abanesimiso somzimba esibuthakathaka. Lokhu kwenzeka lapho ukudla, isiphuzo, noma isaliva kungena ngephutha emaphashini akho esikhundleni sesisu sakho.

Izinhlupheko ezingavamile kodwa ezinzima zingase zihlanganise ukungabi namanzi emzimbeni okudinga ukungena esibhedlela, noma ukuvimbela okuphelele kwe-esophagus okudinga ukungenelela okusheshayo.

Umphumela wobuhlungu awufanele ukhunjulwe. Abantu abaningi abane-dysphagia bathuthukisa ukukhathazeka ngokudla, okungase kukhuluphuke inkinga futhi kuthinte ikhwalithi yempilo yabo kakhulu.

I-Dysphagia ingavikeleka kanjani?

Nakuba ungakwazi ukuvimbela zonke izimbangela ze-dysphagia, ikakhulukazi lezo ezihlobene nezimo zezinzwa noma umdlavuza, kunezinyathelo ongazithatha ukuze unciphise ingozi yakho futhi uvikele umsebenzi wakho wokugwinya.

Ukuphatha izimo zezempilo eziyinhloko kubalulekile. Gcina izimo ezinjenge-GERD, isifo sikashukela, kanye nokucindezeleka kwegazi kuqondiswe kahle ngosizo luka-dokotela wakho. Lezi zimo zingase zinikeze izinkinga zokugwinya uma zingaphathwa.

Izinyathelo zokuphila ezingasiza zihlanganisa:

• Ukugwema ukubhema nokusebenzisa utshwala ngokweqile
• Ukuhlala unamanzi emzimbeni
• Ukugcina ukuhlanzeka komlomo omuhle nokunakekelwa kwamazinyo okujwayelekile
• Ukudla kancane nokukoma kahle
• Ukugwema ukukhuluma ngesikhathi sodla
• Ukuhlala uqonde ngesikhathi samasidla nangemva kwawo
• Ukuphatha ukucindezeleka, okungase kuthinte ukubambisana kwemisipha

Uma ukhuluphuke ingozi ngenxa yobudala noma izimo zezokwelapha, ukuhlola okujwayelekile nodokotela wakho kungasiza ekutholeni izinkinga kwasekuqaleni. Bangase bancoma ukuzivocavoca kokugwinya noma bakuthumele ku-speech-language pathologist ukuze uthole amasu okuvimbela.

Kubantu abaphila kabusha ngemva kwesifo sohlangothi noma ezinye izehlakalo zezinzwa, ukusebenza nochwepheshe bokuvuselela kwasekuqaleni kungasiza ekuqondiseni noma ekuthuthukiseni umsebenzi wokugwinya.

I-Dysphagia ixilongwa kanjani?

Udokotela wakho uzoqala ngengxoxo eningiliziwe mayelana nezibonakaliso zakho, umlando wezokwelapha, kanye nemithi. Uzothanda ukwazi ukuthi nini nokuthi kuphi lapho uzwa ubunzima bokugwinya, yikuphi ukudla noma izinto eziphuzwayo ebangela izinkinga, nokuthi izimpawu ziya mbi yini.

Ukuhlolwa komzimba ngokuvamile kuhlanganisa ukuhlola umlomo wakho, umlomo, nentanyeni, kanye nokulalela ikhwalithi yezwi lakho nokukubuka ugwinya amanzi amancane.

Ngokuya ngezimpawu zakho, udokotela wakho angase a-ode amaviki amaningana:

• Isifundo sokugwinya i-barium (i-modified barium swallow noma i-videofluoroscopic swallow study)
• I-Upper endoscopy ukubuka ngaphakathi kwe-esophagus yakho nesisu
• I-Esophageal manometry ukulinganisa ukucindezela kwemisipha nokubambisana
• I-CT scan noma i-MRI uma kukhona izinkinga zesakhiwo ezithathwa njengokungabaza
• Ukuqapha i-pH ukuhlola i-acid reflux

I-Barium swallow ngokuvamile iyona viki yokuqala eyenziwayo. Uzophuza isiphuzo esinamandla esinezinto ze-barium ngenkathi kuthathwa ama-X-rays ukubona ukuthi isiphuzo sihamba kanjani esimisweni sakho sokugwinya. Le viki ingabonisa ukuthi inkinga ivela kuphi.

Ezimweni ezithile, ungase uthunyelwe kubachwepheshe abanjengogastroenterologist, neurologist, noma i-speech-language pathologist ukuze uthole ukuxilongwa okuningiliziwe nohlelo lokwelapha.

Yikuphi ukwelashwa kwe-dysphagia?

Ukwelashwa kwe-dysphagia kuncike embangelweni yangempela nohlobo lwenkinga yokugwinya olukhona. Umgomo ukukusiza ugwinye ngokuphephile ngenkathi ugcina ukudla okuhle nokuvimbela izinkinga.

Nge-oropharyngeal dysphagia, ukwelashwa ngokuvamile kuhlanganisa:

• Ukwelashwa kokugwinya nge-speech-language pathologist
• Ukufunda amasu akhethekile okugwinya nokuzivocavoca
• Ukushintsha izakhiwo zokudla nokuhlanganiswa kwezinto eziphuzwayo
• Ukushintsha izikhundla zokudla noma amasu
• Ukwelapha izimo eziyinhloko ezinjenge-GERD noma ukutholakala

Ukwelashwa kwe-Esophageal dysphagia kungase kuhlanganise:

• Imithi yokunciphisa i-acid reflux noma ukuphumula imisipha ye-esophagus
• Izindlela zokwandisa ukuze kuqiniswe izindawo ezinciphile
• Ukuhlinzwa ukususa izithiyo noma ukulungisa izinkinga zesakhiwo
• I-Botox injections ngezimo zokukhahlela kwemisipha
• Ukwelashwa kwezimo eziyinhloko ezinjenge-eosinophilic esophagitis

Abantu abaningi bazuza ekusebenzeni nodokotela wokudla ukuqinisekisa ukuthi bathola ukudla okuhle ngenkathi baphatha ubunzima bokugwinya. Bangakusiza ukukhetha izakhiwo zokudla ezifanele nokuhlanganiswa kokushintsha.

Ezimweni ezinzima lapho ukudla komlomo kungaphephile, imibhobho yokudla yesikhashana noma ehlala njalo ingase idingeke ukuqinisekisa ukudla okuhle nokuvimbela ukukhokha.

Indlela yokuphatha i-dysphagia ekhaya

Nakuba ukwelashwa kwezokwelapha kubalulekile, kunezindlela eziningi ongazisebenzisa ekhaya ukwenza ukugwinya kube ngokuphephile futhi kube lula. Lezi zindlela zisebenza kangcono uma zihlanganiswa nokuqondiswa yiqembu lakho lezempilo.

Amasu okudla avame ukusiza ahlanganisa:

• Ukuhlala uqonde ngesikhathi samasidla nokuhlala uqonde imizuzu engama-30 ngemva kwalokho
• Ukuthatha izingcezu ezincane nezicucu
• Ukucoma kahle ngaphambi kokugwinya
• Ukugwinya kabili ngokuma ngakunye uma kudingeka
• Ukugwema ukukhuluma ngesikhathi sodla
• Ukususa izinto ezikuphazamisayo ngesikhathi samasidla
• Ukudla lapho uqaphile futhi awukhathali

Ukushintsha kokudla nokusetshenziswa kwezinto eziphuzwayo kungase kuhlanganise ukwenza izinto eziphuzwayo zibe zinzima, ukukhetha ukudla okulula, noma ukugwema ukudla okuvame ukubangela izinkinga ezinjenge-nuts, imbewu, noma inyama eqinile. I-speech-language pathologist yakho ingakunikeza izincomo ezithile ngokusekelwe emiphumeleni yesifundo sakho sokugwinya.

Ukudala indawo yokudla ethulile, engaphuthumiyo kungasiza futhi. Ukucindezeleka nokukhathazeka kungase kukhuluphuke ubunzima bokugwinya, ngakho-ke ukuthatha isikhathi sokuphumula ngaphambi kwamasisidla kungase kuthuthukise izimpawu zakho.

Gcina ulwazi loxhumana nabo oluphuthumayo lusebenza, futhi uqinisekise ukuthi amalungu omndeni wakho ayazi ukuthi yini okumele ayenze uma uhlangabezana nesigameko sokukhokha.

Kufanele uzilungiselele kanjani i-aphoyintimenti yakho nodokotela?

Ukuza ulungile e-aphoyintimenti yakho kuzosiza udokotela wakho ukuqonda izimpawu zakho kangcono futhi akhe uhlelo lokwelapha oluphumelelayo. Qala ngokugcina idayari yezimpawu izinsuku ezimbalwa ngaphambi kokuya kwakho.

Bhala phansi ukuthi izinkinga zokugwinya zenzeka nini, ukuthi wawudla noma uphuza ini, nokuthi uzizwa kuphi ngempela ubunzima. Qaphela ukuthi ukudla okuthile noma izikhundla kwenza izimpawu zibe ngcono noma zibe mbi.

Letha ulwazi olulandelayo e-aphoyintimenti yakho:

• Uhlu oluphelele lwemithi yamanje kanye nezinhlanganisela
• Umlando wezokwelapha, kuhlanganise izifo zakamuva noma izinqubo
• Umlando womndeni wezinkinga zokugwinya noma izimo ezihlobene
• Imibuzo mayelana nezibonakaliso zakho nezinketho zokwelapha
• Uhlu lokudla noma izinto eziphuzwayo ebangela ubunzima obukhulu

Lungela ukuchaza izimpawu zakho ngokuningiliziwe. Udokotela wakho uzothanda ukwazi ukuthi inkinga ingaphi lapho uqala ukugwinya, noma uma ukudla kunamathele ngaphansi. Bazobabuza futhi ngezimpawu ezihambisana nazo ezinjenge-heartburn, ukulahleka kwesisindo, noma ukushintsha kwezwi.

Uma uke wahlinzwa noma waphathwa ngaphambili ngezinkinga zokugwinya, letha lezo zirekhodi nawe. Lolu lwazi lungasiza ekuqedeni ukuphindaphinda kokuhlolwa okungadingeki.

Iyini into ebaluleke kakhulu nge-dysphagia?

I-Dysphagia yisimo esilashwayo esithinta izigidi zabantu, futhi awudingi ukuphila nobunzima bokugwinya. Nakuba kungase kuzwakale kuyesabekayo noma kuyadumaza, ukuqonda izimpawu zakho nokusebenza nochwepheshe bezempilo kungathuthukisa kakhulu ikhwalithi yempilo yakho.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi izinkinga zokugwinya ezihlala njalo kufanele ziqaphelwe. Ukuxilongwa kwasekuqaleni nokuphathwa kungavimbela izinhlupheko ezinzima futhi kukusize ugcine ukudla okuhle nokuhlangana komphakathi ngokudla.

Abantu abaningi abane-dysphagia bangafunda amasu okugwinya ngokuphephile nangokuthula. Kungaba ngokwelashwa kokugwinya, ukushintsha kokudla, ukwelashwa kwezokwelapha, noma ukuhlanganiswa kwezindlela, kunezindlela ezisebenzayo zokuphatha lesi simo.

Hlala uxhumene neqembu lakho lezempilo, landela izincomo zabo, futhi ungangabazi ukubuza imibuzo mayelana nehlolo lakho lokwelapha. Ngokuphathwa okuhle, ungaqhubeka ujabulela ukudla ngokuphephile ngenkathi uvikela impilo yakho yonke.

Imibuzo evamile ebuzwayo mayelana ne-dysphagia

Ingabe i-dysphagia ingaphela yodwa?

Ezinye izimo ze-dysphagia zingase zibe ngcono yodwa, ikakhulukazi uma zibangelwa izimo zesikhashana ezinjengokutholakala komlomo noma imiphumela yecala yemithi. Noma kunjalo, izinkinga zokugwinya ezihlala njalo ngokuvamile zidinga ukwelashwa ukuvimbela izinkinga nokuthuthukisa izimpawu. Kubalulekile ukubona udokotela kunokulinda ukubona ukuthi inkinga iyaphela yini.

Ingabe i-dysphagia ihlala iyingozi?

Nakuba i-dysphagia ingaba lutho kusuka ekuthambile kuya ekuqineni, zonke izinkinga zokugwinya ezihlala njalo kufanele zithathwe njengokubalulekile ngenxa yengozi yezinhlupheko ezinjengokulahleka kokudla noma i-aspiration pneumonia. Ngisho ne-dysphagia elula ingase ithonye kakhulu ikhwalithi yempilo yakho futhi ingase ibe mbi ngokuhamba kwesikhathi uma izimbangela eziyinhloko zingaphathwa.

Yikuphi ukudla okumele ngikugweme nge-dysphagia?

Ukudla okuvame ukubangela izinkinga kuhlanganisa i-nuts, imbewu, i-popcorn, inyama eqinile, ukudla okunamathelayo njenge-peanut butter, kanye nokudla okunezakhiwo ezihlangene njenge-cereal eno-milk. Noma kunjalo, izincomo zokudla ezithile zincike endleleni yakho yokugwinya futhi kufanele zitholakale ngokuhlolwa nge-speech-language pathologist noma udokotela wakho.

Ingabe ukucindezeleka kwenza i-dysphagia ibe mbi?

Yebo, ukucindezeleka nokukhathazeka kungase kukhuluphuke ubunzima bokugwinya ngokuthinta ukubambisana kwemisipha nokukwenza ube nomzimba ngesikhathi samasidla. Abantu abaningi bathola ukuthi ukudala indawo yokudla ethulile nokusebenzisa amasu okuphumula kungasiza ekuthuthukiseni izimpawu zabo zokugwinya. Ukuphatha ukukhathazeka okuyinhloko ngokudla kuvame ukuba yingxenye ebalulekile yokwelapha.

Kuthatha isikhathi esingakanani ukubona ukuthuthuka ngokwelashwa kwe-dysphagia?

Isikhathi sokuthuthuka sihluka kakhulu kuye ngembangela yangempela nohlobo lokwelashwa. Abanye abantu baqaphela ukuthuthuka phakathi namasonto okuqala kokwelashwa kokugwinya noma imithi, ngenkathi abanye bangase badinge izinyanga eziningi zokwelashwa okuqhubekayo. Iqembu lakho lezempilo lingakunikeza umbono omuhle wokulindela ngokusekelwe esimweni sakho esithile.