Chirongwa cheGastroparesis

Gastroparesis, iyo inonziwo yakanonoka gastric kubudisa, chirwere umo mudumbu inotora nguva yakareba kuti isakure zviri mukati. Inowanzoitika kuvanhu vane chirwere cheshuga 1 kana chirwere cheshuga chechipiri.

Overview

Gastroparesis inosvika apo nhubu dzinoenda kumudumbu dzakakanganiswa kana kuti dzamira kushanda. Iyo vagus nerve inodzora kufamba kwezvokudya kuburikidza nehupenyu hwekudya.

Kana iyo vagus nerve iri kukuvadza, masumbu emudumbu uye matumbu haashande zvakajeka uye kufamba kwezvokudya kunonoka kana kumira.

Chirwere cheshuga chinogona kukuvadza vagus nerve kana ropa regihusi yezinga richikwirira kumusoro kwenguva refu. Iropa rakasvibiswa neropa rinokonzera kemikemikari kuchinja mumisungo uye kunokanganisa midzi yeropa inotakura oksijeni nemuviri kune maronda.

Zvinokonzera

Gastroparesis inowanzokonzerwa ne:

• Chirwere cheshuga
• Postviral syndromes
• Anorexia nervosa
• Kuvhiya mudumbu kana musimba wenzara
• Mishonga, kunyanya anticholinergics uye narcotics (zvinodhaka zvinononoka kupesana mumatumbo)
• Gastroesophageal reflux chirwere (kazhinji)
• Smooth muscle disorders, zvakadai seamyloidosis uye scleroderma
• Nervous system zvirwere, kusanganisira mimba migraine uye chirwere chePalinson
• Matambudziko emagetsi, kusanganisira hypothyroidism

Zviratidzo nezviratidzo

Zviratidzo izvi zvingave zvinyoro kana zvakakomba, zvichienderana nemunhu:

• Kushungurudza
• Nausea
• Kuputika kwezvokudya zvisingaverengeki
• Kutanga kwekutanga kwekuzara kana uchidya
• Kuonda
• Abdominal bloating
• Nhamba dzisina kukodzera yehuga yega
• Kusava nenzara
• Gstroesophageal reflux (GERD)
• Zvirwere zvemukati mudumbu

Miedzo yekuongorora

Kuongororwa kwegastroparesis kunosimbiswa kuburikidza nechimwe kana zvinopfuura zvezviedzo zvinotevera:

• Barium x-ray. Mushure mokutsanya kwemaawa gumi nemaviri, muchanwa mvura yakasviba inonzi bhanum, iyo inopfeka mukati memudumbu, ichiita kuti iratidze pa x-ray. Kazhinji, dumbu richava risina chinhu chekudya zvose mushure memaawa gumi okutsanya. Kana x-ray inoratidza zvokudya mudumbu, gastroparesis inogoneka. Kana i-x-ray ichiratidza dumbu risina chinhu asi chiremba achiri kukanganisa kuti wakanonoka kubudisa, iwe unogona kudzokorora kuedza rimwe zuva. Pazuva rimwe chete, munhu ane gastroparesis anogona kudya kudya kazhinji, achipa mhedzisiro yechiratidzo chenhema. Kana iwe une chirwere cheshuga, chiremba wako angave ane mirayiridzo inokosha pamusoro pokutsanya.

• Barium beefsteak kudya. Iwe uchadya kudya ine bhayoum, nokudaro uchibvumira radiologist kutarisa dumbu rako sezvainochera kudya. Nguva yakawanda iyo inotora kuti bharium kudya igocherwa uye inobva mudumbu inopa chiremba pfungwa yekuti dumbu rinoshanda zvakadini. Uyu muedzo unogona kubatsira kuona matambudziko ekudzinga asingaratidziki pamvura ye-barium x-ray. Kutaura zvazviri, vanhu vane chirwere cheshuga che gadroparesis vanowanzochera mvura mvura, saka bhayoum beefsteak kudya inogona kubatsira.
• Radioisotope gastric-kubudisa kupenya. Iwe uchadya zvokudya zvine radiyoisotopu, chinhu chisinganyanyi kushandiswa kwemhepo chinenge chichiratidzwa pane scan. Mukana wemazuva ano kubva mumusasatiyotiyo muduku uye hauna ngozi. Mushure mekudya, iwe ucharara pasi pemushini unoona radioisotope uye unoratidza mufananidzo wezvokudya mumudumbu uye kuti unokurumidza sei kubva mudumbu. Gastroparesis inoratidzwa kuti kana hafu yezvokudya inoramba iri mudumbu mushure meawa maviri.

• Gastric manometry. Ichi chiyero chinodisa basa remagetsi uye muscular mukati mudumbu. Chiremba anopfuura chidiki chidiki pasi pasi pamutsipa kusvika mudumbu. Iyo tubhu ine tambo inotora zviyero zvemuviri wemagetsi uye musumbu sezvainochera mvura uye mvura yakasimba. Izvo zviyero zvinoratidza kuti dumbu riri kushanda sei uye kana kune imwe nguva kunonoka mukudya.

• Kuyera ropa. Chiremba anogonawo kuraira maitiro e laboratory kuti aongorore kuverenga ropa nekuyera mazinga emakemikari uye electrolyte.

Kuti atonge zvinokonzera gastroparesis imwe kunze kwechirwere cheshuga, chiremba angaita endoscopy kumusoro kana ultrasound.

• Endoscopy yapamusoro. Mushure mekunge vakupai chirwere, chiremba anopfuura tambo refu, yakaonda, inonzi endoscope, kuburikidza nemuromo uye inonyatsoritungamirira iyo inophagus mudumbu. Kuburikidza ne endoscope, chiremba anokwanisa kutarisa kubatanidzwa kwemudumbu kuti aongorore chero zvisiri izvo.
• Ultrasound. Kuti utonge chirwere chenduru kana kuti kuputika sechinhu chinokonzera dambudziko, iwe unogona kunge uine test ultrasound, iyo inoshandisa marwadzo asinganzwisisiki kutarisa uye kutsanangura chimiro cheguruvladder uye pancreas.

Matambudziko

Kana chikafu chikarara kwenguva refu mudumbu, chinogona kukonzera matambudziko akadai seakterter overflow from the fermentation of food. Uyezve, zvokudya zvinogona kuoma mumasimba akasimba, anonzi mazai, ayo anogona kukonzera kushungurudza, kurutsa, uye kuvhiringidzika mudumbu. Bezoresi inogona kuva nengozi kana ichivhara chikamu chezvokudya mumukati muduku.

Gastroparesis inogonawo kuita kuti chirwere cheshuga chiwedzere kuburikidza nekuwedzera kuoma kwekutarisa ropa glucose. Apo zvokudya izvo zvakanonoka mukati mudumbu zvinopinda kupinda mudumbu ruduku uye zvinowanikwa, mazinga eropa glucose anomuka.

Sezvo gastroparesis inokonzera kusununguka kwemudumbu kusingafanozivikanwi, manzwi eropa glucose mazinga anogona kunge akanganisa uye akaoma kuzvidzora.

Kurapa

Icho chinonyanya kukosha chinangwa che gastroparesis chakabatana nechirwere cheshuga ndechokudzidzirazve kutarisa kwemashuga eropa. Mishonga inosanganisira insulin, kunwa mishonga, kuchinja mune izvo uye paunenge uchidya, uye, mumatambudziko akaoma, kudya mabhesi uye kudya kwechingwa.

Zvakakosha kucherechedza kuti mumatambudziko akawanda kurapwa hakupore gastroparesis-inowanzova chirwere chisingaperi.

Chirwere chinokubatsira kuti uchengetedze chirwere kuitira kuti iwe uwane sehutano uye uchinetseka sezvaunokwanisa.

Insulin yeRopa Glucose Control

Kana iwe une gastroparesis, zvokudya zvako zviri kuwedzera zvishoma nezvishoma uye panguva dzisingatarisirwi. Kuti udzidzise glucose yeropa, ungada ku:

• Tora insulin kakawanda
• Tora insulini yako mushure mokudya iwe panzvimbo yekare
• Chengetedza mazinga ako eropa mushure mekunge wadya uye upe insulin chero pazvinodiwa

Chiremba wako achakupa mirayiridzo yakananga kubva pane zvaunoda.

Mishonga

Mishonga yakawanda inoshandiswa kurapa gastroparesis. Chiremba wako anogona kuedza zvakasiyana-siyana zvinodhaka kana kusanganisa kwemishonga kuti awane mushonga unoshanda, kusanganisira:

• Metoclopramide (Reglan). Ichi chinodhaka chinokurudzira musimba mutsara kunobatsira zvokudya zvisina chinhu. Inobatsirawo kuderedza kushushikana uye kurutsa. Metoclopramide inotorwa 20 kusvika kumaminitsi makumi matatu vasati vadya uye panguva yokurara. Zvimwe zvinokonzerwa nemishonga iyi zvinosanganisira kuneta, kurara, uye dzimwe nguva kuora mwoyo, kuzvidya mwoyo, uye zvinetso zvine muviri.

• Erythromycin. Iyi antibiotic inoitawo kuti zvirambe zviri mukati. Inoshanda kuburikidza nekuwedzera zvipembenene zvinoendesa zvokudya kuburikidza nedumbu. Zvimwe zvinokonzera zvinosanganisira kuora mwoyo, kurutsira, uye mimba dzomumakumbo.
• Domperidone. IU.S. Food and Drug Administration iri kugadzirisa domperidone, iyo yakashandiswa kune imwe nzvimbo munyika kuti igare gastroparesis. Icho chiremba chekusimudzira chakafanana nemetoclopramide. Inobatsirawo nekunyunyuta.

• Mamwe mishonga. Mamwe mishonga inogona kushandiswa kuporesa zviratidzo nezvinetso zvakabatana ne gastroparesis. Semuenzaniso, antiemetic inogona kubatsira nekutsvaira nekutuka. Mishonga inorwisa mabhakitiriya ichabvisa utachiona hwehutachiona. Kana uine bhero, chiremba angashandisa endoscope kupinza mishonga iyo ichaiparadza.

Kudya Kwezvokudya

Kuchinja kudya kwako kunogona kubatsira kudzora gastroparesis. Chiremba wako kana kuti dietitian achakupa mirayiridzo yakananga, asi unogona kubvunzwa kudya zviduku zvitanhatu pazuva pane matatu makuru. Kana zviduku zvishoma zvichisvika mudumbu nguva dzose paunodya, zvingasava zvakanyanya kuzadza.

Uyewo, chiremba wako kana kuti dietitian angakurudzira kuti iwe uedze kudya kwemanheru kwemazuva zuva kusvikira ropa rako rejlucose rikasimba uye gastroparesis inoruramiswa.

Zvokudya zvinodhaka zvinopa mishonga yose inowanikwa muzvokudya zvakasimba, asi inogona kudarika mudumbu nyore nyore uye nokukurumidza.

Mukuwedzera, chiremba wako anogona kukurudzira kuti urege kudzivirira mafuta-e-high-fiber foods. Mafuta anononoka kuderedza kudya-dambudziko rausingadi kana iwe une gastroparesis-uye fiber zvakaoma kugora. Zvimwe zvepamusoro-fiber, zvakadai semarangi uye broccoli, zvine zvinhu zvisingagoni kudyiwa. Dzivisa zvikafu izvi nokuti chikamu chinosvibiswa chicharamba chiri mudumbu mako kwenguva yakareba uye zvichida chimiro chekuita.

Feeding Tube

Kana dzimwe nzira dzisingashande, ungada kuvhiyiwa kuti uise chigadzirwa chekudya. Iyo tube, inonzi jejunostomy tube, inoiswa kuburikidza neganda pamuviri wako mudumbu duku. Iyo yekudya tube inokubvumira kuisa mishonga zvakananga mumukati muduku, kupfurikidza nedumbu zvachose. Iwe uchagamuchira zvokudya zvakasvibirira zvinoshandiswa kushandiswa ne tube.

Ijjunostomy inonyanya kubatsira apo gastroparesis inodzivirira mishonga uye mishonga inofanirwa kuronga masero eropa neropa kusvika pakuwedzerwa ropa.

Nokudzivisa chinokonzera dambudziko-mudumbu-uye kuisa mishonga nemishonga zvakananga mumukati muduku, unova nechokwadi chokuti zvinhu izvi zvinogadzirwa uye zvinowanikwa kuropa rako nokukurumidza. Ijjunostomy tube inogona kuva kwenguva pfupi uye inoshandiswa chete kana zvichidikanwa apo gastroparesis yakaoma.

Parenteral Nutrition

Parenteral chikafu chinoreva kuendesa mishonga zvakananga muropa, nekudarika chirwere chekudya. Chiremba wako achaisa chidimbu chiduku, chinonzi catheter, muchipfuva chechipfuva, achisiya mukova kune iyo kunze kweganda.

Kana uchida kudya, iwe unobata bhegi ine midzi yemvura kana mishonga kune catheter. Iyo inonaya inopinda muropa rako mumvura. Chiremba wako achakuudza kuti ndeupi rudzi rwekudya kwemhepo kunoshandisa.

Iyi nzira ndiyo imwe nzira yejjunostomy tube uye inowanzoita nzira pfupi yekukuendesa kuburikidza nedambudziko rakaoma re gastroparesis. Parenteral nutrition inoshandiswa chete apo gastroparesis yakaoma uye haibatsirwe nedzimwe nzira.

Zvitsva Zvitsva

• A gastric neurostimulator ("pacemaker") yakagadzirirwa kubatsira vanhu vane gastroparesis. Iyo pacemaker ibhati-inoshandiswa, chigadzirwa chemagetsi chinoshandiswa pakuvhiyiwa. Iyo inotora magetsi emagetsi anokonzera izvo zvinokurudzira kuzvirwisana kwemudumbu kuitira kuti zvokudya zvipwe uye zvinobva kubva mudumbu kusvika mumatumbo. Ikusimudzira magetsi kunobatsirawo kudzora kunyorera uye kurutsa kunobatanidza ne gastroparesis.
• Kushandiswa kweshuini ye botulinum kwakaratidzwa kunatsiridza kubuda kwemudumbu uye zviratidzo zvegastroparesis nekuderedza kuputika kwenguva refu kwemuviri pakati pemudumbu uye musikana muduku (pyloric sphincter). Iyo inxin inopindwa mu pyloric sphincter.

Shoko Rinobva

Iyi yakawanda yeruzivo kuti uwane, saka apa pane mamwe mashomanana matanhatu anokosha okuyeuka:

1. Gastroparesis inogona kuitika kuvanhu vane chirwere cheshuga 1 kana chirwere cheshuga chechipiri.
2. Gastroparesis inokonzera kukanganisa kune vagus nerve, iyo inodzora kufamba kwezvokudya kuburikidza nekugadzirisa chirongwa chekudya. Panzvimbo yezvokudya zvinofamba nepakati pemugwagwa wezvokudya, kazhinji, inochengetwa mudumbu.

1. Iyo vagus nerve inokuvara pashure pemakore ekutambura kweglucose ropa, zvichiita gastroparesis. Nekudaro, gastroparesis inobatsira kushayikwa kweropa glucose control.
2. Zviratidzo zve gastroparesis zvinosanganisira kuzadza kwokutanga, kusuruvara, kurutsa, uye kuora muviri.
3. Gastroparesis inowanikwa kuburikidza nemiedzo yakadai se-x-rays, manometry, uye scanning.
4. Mishonga inosanganisira kuchinja panguva uye nezvamunodya, kuchinja mu insulin mararamiro uye nguva yejojo, mishonga yemishonga, jejunostomy, parenteral kudya, gastric pacemakers, kana botulinum toxin.

Kuti uwane mamwe mashoko, ona NIDDK's Division of Digestive Diseases and Nutrition. Vanotsigira tsvakurudzo yekutanga uye yezvechiremba mune zvepabonde zvinokonzera mhuka, kusanganisira gastroparesis. Pakati peimwe nzvimbo, vatsvakurudzi vari kudzidza kana mishonga yekuedza inogona kuderedza kana kuderedza zviratidzo zvegastroparesis, zvakadai sokubvisa, kurwadziwa kwepamuviri, kushungurudza, uye kurutsa, kana kuderedza nguva inoshayiwa nedumbu kuti ibvise zvayo mukati mekudya.