Gastroparesis
Uhlolojikelele
Isisu yisikhwama samatha. Lingalingana nobukhulu bemelon encane elikhula uma udle noma uphuza. Lingagcina okuningi njengalitha ezine (cishe amamitha angu-4) yokudla noma ulwetshe. Uma isisu selihlume okudla, ukucindezela kwamandla emisipha okuthiwa amaza e-peristaltic kucindezela ukudla ukuya evalini le-pyloric. I-valve ye-pyloric iholela engxenyeni engaphezulu yesisu esincane, okuthiwa yi-duodenum.
I-Gastroparesis yisimo lapho imisipha esiswini ingaluthuthukisi khona ukudla njengoba kufanele ukuze luhlanzwe.
Ngokuvamile, imisipha icindezela ukuthumela ukudla endleleni yokugaya. Kodwa nge-gastroparesis, ukuhamba kwesisu, okuthiwa yi-motility, kuhamba kancane noma akusebenzi nhlobo. Lokhu kwenza isisu lingakwazi ukuhlanza kahle.
Ngokuvamile, imbangela ye-gastroparesis ayaziwa. Ngezinye izikhathi ixhunyaniswe nesifo sikashukela. Futhi abanye abantu bathola i-gastroparesis ngemva kokuhlinzwa noma ngemva kokugula okuyisifo.
I-Gastroparesis ithonya ukugaya. Ingabangela ukuphefumula, ukugabha nobuhlungu besisu. Ingabangela nezinkinga amazinga okusanhlamvu negazi nokondliwa. Ayikho indlela yokwelapha i-gastroparesis. Kepha imithi nokushintsha kokudla kungakhipha ukukhululeka okwengeziwe.
Izimpawu
Izimpawu ze-gastroparesis zifaka: Ukuhlanza. Ukupukeka. Ukukhukhula kwesisu. Ubuhlungu besisu. Ukuzizwa ugcwele ngemuva kokudla ukudla okuncane kakhulu nangemuva kokudla isikhathi eside. Ukuhlanza ukudla okungagayiwe okudliwe amahora ambalwa ngaphambili. Ukubuyela emuva kwesisu. Ukushintsha amazinga e-shuga egazini. Ukungafuni ukudla. Ukwehliswa kwesisindo nokungatholi izondlo ezanele, okuthiwa ukungondliwe kahle. Abantu abaningi abane-gastroparesis ababonisi zimpawu. Yenza i-aphoyintimenti nodokotela wakho uma unezimpawu ezikukhathazayo.
Isikhathi sokubona udokotela
Yenza i-aphoyintimenti nodokotela wakho uma unezimpawu ezikukhathazayo.
Izimbangela
Akuvamile ukuthi kucace ukuthi yini eholela ekuqaleni kwesisu. Kodwa ngezinye izikhathi ukulimala komthambo olulawula imisipha yesisu kungabangela lokhu. Lo mthambo ubizwa ngokuthi umthambo we-vagus.
Umthambo we-vagus uqondisa lokho okwenzekayo emgqeni wokugaya. Lokhu kuhlanganisa ukutshela imisipha esiswini ukuthi iqiniswe bese isusa ukudla esibindini esincane. Umthambo we-vagus olimale ngeke uthumele izimpawu eziya emisipha yesisu njengoba kufanele. Lokhu kungabangela ukudla ukuhlala esiswini isikhathi eside.
Izimo ezinjengesihlalo noma ukuhlinzwa esiswini noma esibindini esincane zingalimaza umthambo we-vagus namagatsha awo.
Izici eziyingozi
Izimbangela ezingandisa ingozi ye-gastroparesis zifaka phakathi:
- Ukushwabana kweswekile.
- Ukuhlinzwa endaweni yesisu noma empumphini ehlanganisa umlomo nomphi, okuthiwa yi-esophagus.
- Ukutheleleka nge-virus.
- Ezinye izifo zomdlavuza kanye nokwelashwa komdlavuza, njengokwelashwa ngomgqomo esifubeni noma esiswini.
- Imithi ethile ehambisa ukukhululwa kwesisu, njengomuthi wokunciphisa ubuhlungu be-opioid.
- Isimo esenza ukuba isikhumba siqine futhi siqine, okuthiwa yi-scleroderma.
- Izifo zesimiso sezinzwa, njengemigraine, isifo se-Parkinson noma i-multiple sclerosis.
- I-thyroid ehambayo, okuthiwa yi-hypothyroidism.
Abantu ababekwa njengabesifazane ekuzalweni banesihloko esikhulu sokuthola i-gastroparesis kunabantu ababekwa njengabesilisa ekuzalweni.
Izingqinamba
I-Gastroparesis ingabangela izinkinga eziningi, ezifana nalezi:
- Ukwehluleka kwamanzi emzimbeni, okubizwa ngokuthi ukuphelelwa amanzi emzimbeni. Ukugabha okuphindaphindayo kungabangela ukuphelelwa amanzi emzimbeni.
- Ukondleka okungalungile. Ukungafuni ukudla kungasho ukuthi awuthathi ama-calories anele. Noma umzimba wakho ungase ungakwazi ukuthatha ama-nutrients anele ngenxa yokugabha.
- Ukudla okungagayi okunqaba futhi kuhlale esiswini. Lokhu kudla kungaqina lube yisigaxa esiqinile esibizwa ngokuthi i-bezoar. Ama-Bezoars angabangela isicanucanu nokugabha. Angaba yingozi eyingozi uma avikelwa ukudla ukudlula esibindini esincane.
- Ukushintsha kweswekile legazi. I-Gastroparesis ayibangeli isifo sikashukela. Kodwa ukushintsha kwesivinini namani ukudla okudlula esibindini esincane kungabangela ukushintsha okungazelelwe amazinga eswekile legazi. Lokhu kushintsha kweswekile legazi kungenza isifo sikashukela sibe sibi kakhulu. Ngalokhu, ukungalawuli kahle amazinga eswekile legazi kwenza i-gastroparesis ibe sibi kakhulu.
- Izinga lokuphila eliphansi. Izimpawu zingenza kube nzima ukusebenza nokugcina imisebenzi yansuku zonke.
Ukuxilongwa
Izivivinyo eziningi zisiza ekutholakala kokungasebenzi kahle kwesisu nokususa ezinye izimo ezingabangela izimpawu ezifana nalezo zokungasebenzi kahle kwesisu. Izivivinyo zingafaka: Ukuze ubone ukuthi isisu sakho siyaphuma kangcono kangakanani, ungase ube nokuhlolwa okukodwa noma ngaphezulu kwalokhu: - Ukuhlolwa komoya. Ngokuhlolwa komoya, uya kudla ukudla okuqinile noma oketshezi okunezinto ezithile ezithathwa yomzimba wakho. Ngemuva kwesikhathi, leyo nto ivela emoyeni wakho. Iqembu lakho lokunakekelwa kwezempilo liqoqa amasampula emoyeni wakho amahora ambalwa ukuze lilinganise inani laleyo nto emoyeni wakho. Inani lale nto emoyeni wakho libonisa ukuthi isisu sakho siyaphuma kangcono kangakanani. I-Scintigraphy. Lolu uhlolo oluyinhloko olusetshenziswa ekutholeni ukungasebenzi kahle kwesisu. Lufaka ukudla ukudla okulula, njengeqanda ne-toast, okunezingxenye ezincane zezinto ezinobuthi. I-scanner ilandela ukuhamba kwezinto ezinobuthi. I-scanner iya phezu kwesisu ukuze ibonise izinga lokudla eliphuma esiswini. Lo mkhuba uthatha amahora angaba amane. Kuzodingeka uyeke ukuthatha noma iyiphi imithi engase ihambise ukukhishwa kwesisu. Buza udokotela wakho ukuthi yini okungafanele uyithathe. Ukuhlolwa komoya. Ngokuhlolwa komoya, uya kudla ukudla okuqinile noma oketshezi okunezinto ezithile ezithathwa yomzimba wakho. Ngemuva kwesikhathi, leyo nto ivela emoyeni wakho. Iqembu lakho lokunakekelwa kwezempilo liqoqa amasampula emoyeni wakho amahora ambalwa ukuze lilinganise inani laleyo nto emoyeni wakho. Inani lale nto emoyeni wakho libonisa ukuthi isisu sakho siyaphuma kangcono kangakanani. Le nqubo isetshenziswa ukubona umgudu ohlanganisa umlomo nesisu, obizwa ngokuthi i-esophagus, isisu nokuqala kwesisu esincane, obizwa ngokuthi i-duodenum. Isebenzisa ikhamera encane ekugcineni komgudu omde, onobuningi. Lo mkhuba ubuye uthola ezinye izimo ezingaba nezimpawu ezifana nalezo zokungasebenzi kahle kwesisu. Izibonelo yisifo se-peptic ulcer kanye ne-pyloric stenosis. Lo mkhuba usebenzisa amaza omsindo aphezulu ukuze wenze izithombe zezakhiwo ezikhathini zomzimba. I-Ultrasound ingasiza ekutholeni ukuthi izinkinga zesibindi noma izinso zingabangela izimpawu.
Ukwelashwa
Ukwelapha i-gastroparesis kuqala ngokuthola nokwelapha isimo esiyibangela. Uma isifo sikashukela sibangela i-gastroparesis yakho, ochwepheshe bakho bezempilo bangasebenza nawe ukuze bakusize ukulawula amazinga akho kashukela egazini.
Ukuthola ama-calories anele nokudla ngenkathi uthuthukisa izimpawu yiyona njongo ephambili ekwelapheni i-gastroparesis. Abantu abaningi bangaphatha i-gastroparesis ngokushintsha ukudla. Ochwepheshe bakho bezempilo bangase bakubhekisele kucwebe, okuthiwa yi-dietitian.
Dietitian angasebenza nawe ukuze uthole ukudla okulula ukulihlanza. Lokhu kungakusiza ukuthola ukudla okwanele ekudleni okukudlayo.
Dietitian angase akuqondise ukuzama okulandelayo:
- Dlala ukudla okuncane kaningi.
- Gwayiza ukudla kahle.
- Dlala izithelo nemifino ebilisiwe kunokudla izithelo nemifino eluhlaza.
- Ungadli izithelo nemifino enenhlanzi eningi, njenge-orenji ne-broccoli. Lezi zingaba nzima zibe yingxube enkulu ehlala esiswini, okuthiwa yi-bezoar.
- Khetha ukudla okunefutha eliphansi. Uma ukudla amafutha akukukhathazi, engeza izikweletu ezincane zokudla okunefutha ekudleni kwakho.
- Dlala usoso nokudla okuhlanganisiwe uma izinto eziphuzwayo kulula kuwe ukuziluma.
- Phuza amanzi angama-34 kuya kwama-51 ounces (ama-1 kuya ku-1.5 amamitha) ngosuku.
- Zivocavoca kancane, njengokuhamba, ngemuva kokudla.
- Ungaphuzi izithelo eziqhumayo, okuthiwa yi-carbonated drinks, noma utshwala.
- Ungabhemi.
- Ungalali amahora amabili ngemuva kokudla.
- Thatha i-multivitamin nsuku zonke.
- Ungadli uphuze ngesikhathi esifanayo. Bahlukanise ngehora elilodwa.
Buza i-dietitian yakho uhlu lokudla oluphakanyiswe kubantu abane-gastroparesis.
Amakhambi okuwelapha i-gastroparesis angafaka:
- Amakhambi okusiza imisipha yesisu ukusebenza. I-Metoclopramide yiyona kuphela imithi i-U.S. Food & Drug Administration (FDA) evumile ukwelapha i-gastroparesis. Iphilisi le-metoclopramide (Reglan) inengozi yemiphumela emibi emibi.
Kodwa i-FDA yamukele muva nje i-metoclopramide nasal spray (Gimoti) yokwelapha i-diabetic gastroparesis. I-nasal spray inemiphumela emibi emincane kunepilisi.
Enye imithi esiza imisipha yesisu ukusebenza yi-erythromycin. Ingasebenzi kahle ngokuhamba kwesikhathi. Futhi ingabangela imiphumela emibi efana nokukhipha.
Kukhona imithi entsha, i-domperidone, ehlisa izimpawu ze-gastroparesis. Kodwa i-FDA ayivumi imithi ngaphandle uma ezinye izindlela zokwelapha sezihlulekile. Ukuqaphela imithi, ochwepheshe bezempilo kumele basebenzele kwi-FDA.
- Amakhambi okulawula isicanucanu nokugabha. Imithi esiza ukuhlisa isicanucanu nokugabha ihlanganisa i-diphenhydramine (Benadryl) ne-ondansetron. I-Prochlorperazine (Compro) ingenzelwe isicanucanu nokugabha okungapheli ngeminye imithi.
Amakhambi okusiza imisipha yesisu ukusebenza. I-Metoclopramide yiyona kuphela imithi i-U.S. Food & Drug Administration (FDA) evumile ukwelapha i-gastroparesis. Iphilisi le-metoclopramide (Reglan) inengozi yemiphumela emibi emibi.
Kodwa i-FDA yamukele muva nje i-metoclopramide nasal spray (Gimoti) yokwelapha i-diabetic gastroparesis. I-nasal spray inemiphumela emibi emincane kunepilisi.
Enye imithi esiza imisipha yesisu ukusebenza yi-erythromycin. Ingasebenzi kahle ngokuhamba kwesikhathi. Futhi ingabangela imiphumela emibi efana nokukhipha.
Kukhona imithi entsha, i-domperidone, ehlisa izimpawu ze-gastroparesis. Kodwa i-FDA ayivumi imithi ngaphandle uma ezinye izindlela zokwelapha sezihlulekile. Ukuqaphela imithi, ochwepheshe bezempilo kumele basebenzele kwi-FDA.
Amathebula okudla angadluliselwa ngenxeba noma emlonyeni noma ngqo esibindini esincane ngesikhumba. Ngokuvamile, i-tube ibekwa isikhathi esifushane. I-tube yokudla ingenzelwe kuphela i-gastroparesis ebuhlungu noma uma akukho enye indlela elawula amazinga kashukela egazini. Abanye abantu bangadinga i-tube yokudla eya esithanjeni esifubeni, okuthiwa yi-intravenous (IV) feeding tube.
Abalimi baqhubeka bebuka imithi nemikhuba emisha yokwelapha i-gastroparesis.
Enye imithi emisha ekuthuthukisweni ibizwa nge-relamorelin. Imiphumela yokuhlola isigaba 2 yathola ukuthi leli dwalu lingasheshisa ukukhishwa kwesisu nokunciphisa ukugabha. I-FDA ayikavumi imithi, kodwa ucwaningo lwayo luyaqhubeka.
Abalimi futhi bahlola izindlela zokwelapha ezintsha ezihilela i-tube encane, okuthiwa yi-endoscope. I-endoscope iya esibindini.
Enye inqubo, eyaziwa ngokuthi yi-endoscopic pyloromyotomy, ihilela ukwenza isiqu ecingweni lemisipha phakathi kwesisu nesibindini esincane. Leli cingwe lemisipha libizwa nge-pylorus. Ivula umzila osuka esiswini uye esibindini esincane. Le nqubo ibizwa nangokuthi yi-gastric peroral endoscopic myotomy (G-POEM). Le nqubo ibonisa ithemba le-gastroparesis. Kufanele kwenziwe ucwaningo olwengeziwe.
Ekukhuthazeni kwamandla kagesi, idivayisi ebekwe emzimbeni ngokuhlinzwa inika ukukhuthazwa kwamandla emisipha yesisu ukuhambisa ukudla kangcono. Imiphumela yocwaningo ihlangene. Kodwa idivayisi ibonakala isizakala kakhulu kubantu abanesifo sikashukela ne-gastroparesis.
I-FDA ivumela idivayisi ukuba isebenziswe kulabo abangakwazi ukulawula izimpawu ze-gastroparesis ngokushintsha ukudla noma imithi. Kufanele kwenziwe ucwaningo olukhulu.
Umshwana wokuzihlangula: I-August iyinkundla yolwazi lwezempilo futhi izimpendulo zayo azihlanganisi iseluleko sezokwelapha. Njalo thintana nochwepheshe bezokwelapha onelayisensi eduze nawe ngaphambi kokwenza noma yiluphi ushintsho.