Achalasia

Chubhu inotakura chikafu kubva pamuromo kuenda mudumbu ndiyo yegurokuro kana pombi yechikafu. Achalasia inoita kuti zviome kuti esophagus ifambise chikafu mudumbu.

Kune mhete yetsandanyama panosangana dumbu nedumbu. Iyo inonzi yepasi esophageal sphincter (LES). Kazhinji, mhasuru iyi inozorora kana iwe uchimedza kubvumira chikafu kupfuura mudumbu. Mune vanhu vane achalasia, haizorodze sezvazvinofanira kuita. Uye zvakare, iyo yakajairwa mhasuru yekuita yegurokuro (peristalsis) yakaderedzwa kana isipo.

Dambudziko iri rinokonzerwa nekukuvara kwemitsipa yegurokuro.

Mamwe matambudziko anogona kukonzera zviratidzo zvakafanana, senge kenza yegurokuro kana yepamusoro mudumbu, uye hutachiona hwehutachiona hunokonzera Chagas chirwere.

Achalasia ishoma. Zvinogona kuitika chero zera, asi zvakajairika muvanhu vane makore makumi maviri kusvika makumi matanhatu. Mune vamwe vanhu, dambudziko rinogona kugarwa nhaka.

Zviratidzo zvinosanganisira:

• Kudzoka (kudzokazve) kwechikafu
• Kurwadziwa pachifuva, uko kunogona kuwedzera mushure mekudya, kana kunganzwika sekurwadziwa kumusana, mutsipa nemaoko
• Kukosora
• Zvakaoma kumedza zvinwiwa uye zvakasviba
• Kushungurudza
• Kurasikirwa kwekurema kwemaune

Kuongorora kwepanyama kunogona kuratidza zviratidzo zvekushaya ropa kana kushaya zvinovaka muviri.

Miedzo inosanganisira:

• Manometry, bvunzo yekuyera kana yako esophagus iri kushanda nemazvo.
• EGD kana yekumusoro endoscopy, muyedzo wekutarisa kumucheto kwedumbu uye esophagus. Iyo inoshandisa inochinja chubhu uye kamera.
• Kumusoro GI x-ray.

Chinangwa chekurapa ndechekuderedza kumanikidza kune sphincter mhasuru uye kubvumira chikafu nezvinwiwa kupfuura nyore mudumbu. Therapy inogona kusanganisira:

• Jekiseni ne botulinum toxin (Botox) - Izvi zvinogona kubatsira kusunungura mhasuru dze sphincter. Nekudaro, iyo bhenefiti inopera mukati memavhiki mashoma kana mwedzi.
• Mishonga, senge yakareba-inoshanda nitrate kana calcium chiteshi blockers - Iyi mishonga inogona kushandiswa kuzorodza yepazasi esophagus sphincter. Asi pane isingawanzo mhinduro yenguva refu yekurapa achalasia.
• Kuvhiya (kunonzi myotomy) - Mune ino maitiro, yepasi sphincter mhasuru inodimburwa.
• Kuwedzera (kuwedzera) kwesophagus - Izvi zvinoitwa panguva yeEGD nekutambanudza iyo LES nebhaluni dilator.

Mubatsiri wako wehutano anogona kukubatsira kuti usarudze kuti ndeupi kurapwa kwakanakira iwe.

Mhedzisiro yekuvhiya uye isiri-yekuvhiya kurapwa yakafanana. Zvinopfuura kurapwa kumwe dzimwe nguva zvinodikanwa.

Zvinetso zvinogona kusanganisira:

• Kudzoka (kudzokazve) kweacid kana chikafu kubva mudumbu kuenda kune yeguroku (reflux)
• Kufema chikafu chirimo mumapapu (aspiration), izvo zvinogona kukonzera mabayo
• Kubvarura (kupera) yegurokuro

Fonera mupiki wako kana:

• Unonetseka kumedza kana kumedza kunorwadza
• Zviratidzo zvako zvinopfuurira, kunyangwe nekurapwa kweachalasia

Zvakawanda zvezvikonzero zveachalasia hazvigone kudzivirirwa. Zvisinei, kurapwa kunogona kubatsira kudzivirira matambudziko.

Esophageal achalasia; Kumedza matambudziko ezvinwiwa uye zvinwiwa; Cardiospasm - yakaderera esophageal sphincter spasm

• Kugaya chirongwa
• Kumusoro mudumbu system
• Achalasia - akateedzana

Falk GW, Katzka DA. Zvirwere zvegurokuro. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 129.

Hamer PW, Gwayana PJ. Iwo manejimendi eachalasia uye zvimwe zvinokanganisa motility yesophagus. Mune: Griffin SM, Gwayana PJ, eds. Oesophagogastric Kuvhiya: A Companion to Specialist Nzira Yokuvhiya. 6th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 16.

Pandolfino JE, Kahrilas PJ. Esophageal neuromuscular basa uye motility kusagadzikana. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chiropa. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chits. 43.