Achalasia inonzi motility disorder ye- sophagus inokonzera kuoma kumedza uye mamwe matambudziko. Achalasia chirwere chisingawanzoitiki chinowanzoitika apo masero emironda ari mudumbu inowedzera.
Izvo hazvizivikanwi nei masero emasero akatanga kuoma asi kurasikirwa kwemasero aya kunotungamirira kusakanganiswa kwemisungo muhuputi uye kusakwanisa kwechepasi esophageal sphincter (LES) kuvhara zvakanaka.
I-LES inowanzobvumirana kuti izarure, ichibvumira kudya kupinda mudumbu kubva kune chekudenga uye kunodzokorora zvakavharwa kuchengetedza zvinyorwa zvekudya kubva pakudzoka kweeophagus.
Muna 1929 apo vanachiremba vakaona kuti chikonzero cheAchalasia chakanga chisisakwanisi cheLES kuti chivhare zvakanaka ivo vakadana chirwere achalasia, izvo zvinoreva kusakwanisa kupora.
Achalasia inogona kupiwa nhaka mune vamwe vanhu asi kazhinji, inowanikwa pakati pemakore maviri evanhu vakuru nevarume vakuru. Iyo nharaunda inofungidzirwa kuva inenge 1 mu100 000 vanhu pagore. Utachiona hunonzi Chagas hunogona kukonzera achalasia.
Zvakakoshawo kuziva kuti achalasia dzimwe nguva isingazivikanwi se gastroesophageal reflux disorder ( GERD ). Kutanga kufungidzirwa kweAchalasia kunokosha zvikuru, sezvo achalasia inogona kuwedzera mukana wako wekuve nekenza yemasophagus .
Zviratidzo
Kana iwe uchitambura kubva kune achalasia unogona kuwana imwe kana zvimwe zvezviratidzo zvinotevera:
- Acid reflux kana kuora mwoyo
- Kudzorera zvemukati zviri mukati
- Kuramba uchikanganiswa
- Dambudziko kukumedza
- Choking
- Kunzwa sekudya kunowanikwa mubhokisi
- Kunzwa sokuti pane nguva dzose bundu muhuro mako
- Unintentional kurasikirwa nekurema uye / kana kusakondwa
Kuziva
Chiremba wako angakonzera achalasia zvichienderana nezviratidzo zvako uye kuongorora muviri.
Achalasia inofanira kufungidzirwa kana iwe uchinetseka kumedza zvose zvakasikwa uye zvinodhaka uye une regurgitation iyo isina kugadziriswa pasinei nekurapwa neproton pump inhibitors. Proton pump inhibitors ikirasi yemishonga inowanzoshandiswa kurapa asidi reflux uye inosanganisira Prilosec , Nexium , uye Dexilant .
Miedzo inotevera inobatsirawo kuziva chirwere ichi:
Kurapa
Iye zvino mazano ekurapa kweAchalasia anosanganisira kubhadhara pneumatic dilation kana chirurgical myotomy nekodzero yekubhadhara mari. Aya maitiro ekufungidzira ave akaratidzwa kuti ndiwo maitiro ekurapa anonyatsoshanda (mamwe mashoko pamusoro pezvinotevera zvinotevera).
Kune avo vasingakwanisi kuvhiyiwa kana kusarudza kusazviita, botox injections inotevera kutevedzwa nemishonga inokurudzirwa.
Iko parizvino hapana hurapi hunowanika hunogona kudzorera hutachiona hunoita basa (peristalsis) kusvika panopa. Saka, mishonga yose inotarirwa kuderedza kushungurudzwa muLes.
- Kuvhiya myotomy ndiyo nzira inopesana inoshandiswa nemasikisi emisumbu yeLES. Inogona kuitwa laparoscopically iyo inoderedza nguva yekudzikinura. Zvidzidzo zvakaratidza kushandiswa kwemaotomy kuti ibudirire pakuderedza zviratidzo zveAchalasia asi kusimbiswa kweGERD mushure mekunge nzira iyi inowanzoitika. Nokuda kwechikonzero ichi, zvinokurudzirwa kuti chirwere chemaotomy chiri kuitwa pamwe chete nedzimwe nzira inonzi partial fundoplication kudzivirira GERD.
- Kuwedzera kwepineumatic (PD) inzira isiri yekuvhiya iyo inoshandisa kushandiswa kwemhepo kunoparadza mishonga yevasumbu muLes. Nzira yacho inoshandiswa uchishandisa chiedza chinonzi sedation. Pane mungozi yekuvhiringidza hutachiona (zvichikuvadza kuputika, kana kuisa gomba mairi) uye mushure mekugadzirisa, unofanira kuva nebhaumus esophagram kuti uone kuti dumbu racho harina kuputirwa. Zvidzidzo zvinoratidza kuti kana yakagadzirwa zvakanaka PD inopa zvakanaka kununurwa kukuru kwezviratidzo zve achalasia. Migumisiro haisi yekusingaperi asi inogona kugara kwemakore.
- Esophageal Dilation yakafanana nekumhanya kwepineumatic asi panguva yekunyatsopera , chiremba anotambanudza LES ne dilator. Vamwe varwere vanogona kutanga GERD mushure mekuita izvi.
- Botox injections dzakaratidzwa kuderedza kushandiswa muLI asi haisi yakakosha sePP kana kuti chirwere. Majojo aya anoguma endoscopically uye kukwidza kukuru kwegadziriro ndeyekuti pane zvishoma migumisiro, pangozi yakakomba yezvinetso, nekugadzirisa inowanzokurumidza uye isina kuoma. Zviratidzo zvinowanzoitika zvakare majekiseni anotevera anodiwa kune vanhu vakawanda vanosarudza kurapwa uku.
- Esophagectomy , kana kubviswa kushandiswa kwemasimba (kana zvikamu zvehuputi), yakachengeterwa maitiro akaoma umo mamwe marapirwo akakundikana.
- Mishonga yekugadzirisa achalasia inofungidzirwa kuti ndiyo nzira inonyanya kushandisa yekudzivirira zviratidzo. Zvisinei, kune avo vasingakwanisi kuvhiyiwa uye avo vane botox mishonga vasina kubudirira mishonga inogona kushandiswa. Mishonga inonzi calcium channel blockers, iyo inowanzonzi yakanyorerwa kuwedzerwa kweropa, inowanzoshandiswa kuAchalasia nekuda kwekugona kwavo kurega kufara kwemisumbu. Iyi yekuzorora inoderedza kushungurudzwa muLAT. Imwe mishonga inonzi sildenafil (Viagra) yakaratidzwa zvakare kuderedza kushandiswa muLes. Mimwe mishonga inogona kushandiswa zvichienderana nemamiriro ezvinhu nekuchenjera kwechiremba wako.
Nemhaka yehuwandu hwehuwandu hwekuita kenza yemajoka, varwere vose vane achalasia vanofanira kugara vachifambidzana nechiremba wavo, kunyange kana kurapwa kuchibudirira. Chiremba wako achacherechedza uye kuongorora (sezvazvakakodzera) chekushaya chirwere chekenza.
Sources:
American College of Gastroenterology. ACG Clinical Guideline: Kuziva uye Kutonga kweAkaya. http://d2j7fjepcxuj0a.cloudfront.net/wp-content/uploads/2013/07/ACG_Guideline_Achalasia_July_2013.pdf
Medline Plus. Achalasia. http://www.nlm.nih.gov/medlineplus/ency/article/000267.htm
Medscape. Achalasia. https://reference.medscape.com/article/169974-overview#aw2aab6b2b4aa
Kusvika pari zvino. Information Patient: Achalasia (Beyond the Basics). http://www.uptodate.com/contents/achalasia-beyond-the-basics