Achalasia

Chitubu chomwe chimanyamula chakudya kuchokera pakamwa kupita kumimba ndi kholingo kapena chitoliro cha chakudya. Achalasia amalepheretsa kuti pamimba pakhale chakudya m'mimba.

Pali mphete yamphamvu pomwe pamimba pamimba pamakumana. Amatchedwa lower esophageal sphincter (LES). Nthawi zambiri, minofu imeneyi imamasuka ukameza kuti chakudya chilowe m'mimba. Mwa anthu omwe ali ndi achalasia, samapuma momwe ayenera. Kuphatikiza apo, minofu yabwinobwino yam'mero ​​(peristalsis) imachepetsedwa kapena kulibe.

Vutoli limayamba chifukwa cha kuwonongeka kwa mitsempha ya kum'mero.

Mavuto ena amatha kuyambitsa zofananazo, monga khansa ya kummero kapena kumtunda, komanso matenda opatsirana omwe amayambitsa matenda a Chagas.

Achalasia ndi osowa. Zitha kuchitika msinkhu uliwonse, koma ndizofala kwambiri kwa anthu azaka zapakati pa 25 mpaka 60. Kwa anthu ena, vutoli limatha kukhala lotengera.

Zizindikiro zake ndi izi:

• Kubwerera m'mbuyo (kubwezeretsanso) kwa chakudya
• Kupweteka pachifuwa, komwe kumatha kukulira mukatha kudya, kapena kumveka ngati kupweteka kumbuyo, khosi, ndi mikono
• Tsokomola
• Zovuta kumeza zakumwa ndi zolimba
• Kutentha pa chifuwa
• Kuchepetsa mwangozi

Kuyezetsa thupi kumatha kuwonetsa zizindikilo za kuchepa kwa magazi m'thupi kapena kuperewera kwa zakudya m'thupi.

Mayeso ndi awa:

• Manometry, kuyesa kuti muone ngati vuto lanu likugwira ntchito bwino.
• EGD kapena endoscopy wapamwamba, kuyesa kupenda m'mimba ndi m'mimba. Imagwiritsa ntchito chubu chosinthika ndi kamera.
• XI ray yakumtunda.

Cholinga cha chithandizo ndikuchepetsa kupsyinjika kwa minofu ya sphincter ndikulola chakudya ndi zakumwa kuti zidutse mosavuta m'mimba. Chithandizo chitha kukhala:

• Jekeseni wa poizoni wa botulinum (Botox) - Izi zitha kuthandiza kutulutsa minofu ya sphincter. Komabe, phindu limatha mkati mwa milungu ingapo kapena miyezi ingapo.
• Mankhwala, monga ma nitrate a nthawi yayitali kapena ma calcium blockers - Mankhwalawa atha kugwiritsidwa ntchito kupumula m'munsi pam'mero ​​sphincter. Koma palibe njira yanthawi yayitali yothana ndi achalasia.
• Opaleshoni (yotchedwa myotomy) - Mwa njirayi, minofu ya m'munsi ya sphincter imadulidwa.
• Kukulitsa (kutambasula) kwa kholingo - Izi zimachitika nthawi ya EGD potambasula LES ndi bulloon dilator.

Wothandizira zaumoyo wanu akhoza kukuthandizani kusankha mankhwala omwe angakuthandizeni.

Zotsatira za opaleshoni ndi mankhwala osachita opaleshoni ndi ofanana. Nthawi zambiri pamafunika chithandizo choposa chimodzi.

Zovuta zingaphatikizepo:

• Kubwerera m'mbuyo (kubwezeretsanso) kwa asidi kapena chakudya kuchokera m'mimba kupita kum'mero ​​(Reflux)
• Kupumira zakudya m'mapapu (aspiration), zomwe zimatha kuyambitsa chibayo
• Kukhadzula (kufinya) kwa kummero

Itanani omwe akukuthandizani ngati:

• Mumavutika kumeza kapena kumeza kowawa
• Zizindikiro zanu zimapitilira, ngakhale mutalandira chithandizo cha achalasia

Zambiri zomwe zimayambitsa achalasia sizingapewe. Komabe, chithandizo chitha kuthandiza kupewa zovuta.

Esophageal achalasia; Kumeza mavuto amadzimadzi ndi zolimba; Cardiospasm - kutsikira kwa esophageal sphincter spasm

• Dongosolo m'mimba
• M'mimba dongosolo
• Achalasia - mndandanda

Falk GW, Katzka DA. Matenda am'mimba. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 129.

Hamer PW, Mwanawankhosa PJ. Kuwongolera kwa achalasia ndi zovuta zina za motility za kum'mero. Mu: Griffin SM, Mwanawankhosa PJ, eds. Opaleshoni ya Oesophagogastric: Wothandizana Naye Kuchita Opaleshoni. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2019: mutu 16.

Pandolfino JE, Kahrilas PJ. Matenda a Esophageal neuromuscular and motility. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Matenda a Mimba ndi a Fordtran Amatenda a Chiwindi. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 43.