Achalasia ndi matenda a motility omwe amachititsa kuti vuto likhale lovuta komanso mavuto ena. Achalasia ndi matenda omwe amapezeka pamene mitsempha ya mitsempha ya m'mimba imawonongeka.
Sidziwika chifukwa chake mitsempha ya mitsempha imayamba kuchepa koma kutayika kwa maselowa kumabweretsa kusokonekera kwa minofu yomwe ili pamtunda komanso kusowa kwa m'mimba otsika kwambiri (lesophageal sphincter (LES) kutseka bwino.
The LES normally amavomereza kuti atsegule, kulola chakudya kulowa m'mimba kuchokera odwala ndipo kenaka amatsekedwa kuti kusunga chakudya kuti abwerere mmwamba.
Mu 1929 pamene madokotala anapeza kuti chifukwa cha achalasia chinali chosatheka kuti LES atseka bwino iwo amatcha chikhalidwe achalasia, kutanthauza kulephera kupuma.
Achalasia akhoza kulandira cholowa mwa anthu ena koma kawirikawiri, amapezeka pakati pa amuna ndi akazi akuluakulu akuluakulu. Chiwerengerochi chikhoza kukhala pafupifupi 1 pa 100,000 anthu pachaka. Matenda otchedwa Chagas angayambitsenso achalasia.
Ndikofunika kudziwa kuti achalasia nthawi zina amadziwika ngati matenda a reflux disorder ( GERD ). Matenda oyambirira a achalasia ndi ofunika kwambiri, monga achalasia akhoza kuwonjezera chiopsezo chanu chokhala ndi khansa ya m'mimba .
Zizindikiro
Ngati mukudwala achalasia mukhoza kukhala ndi zizindikiro zotsatirazi:
- Acid x acid kapena kupweteka kwa mtima
- Kubwezeretsanso m'mimba zomwe zili m'mimba
- Kuthamanga kwafupipafupi
- Zovuta kumeza
- Kusankha
- Kumva ngati chakudya chimakanizika mu chifuwa
- Kukumverera ngati kuti nthawizonse pamakhala pakhosi pamtima pako
- Kuwonongeka kosayembekezereka ndi / kapena kusowa kwa zakudya
Kudziwa
Dokotala wanu angakayikire achalasia pogwiritsa ntchito zizindikiro zanu ndi kuunika kwanu.
Achalasia ayenera kukayikira ngati muli ndi vuto lomeza zowonjezera zonse ndi zakumwa ndipo muli ndi regurgitation zomwe simunathetse ngakhale mukuchiritsidwa ndi proton pump inhibitors. Proton pump inhibitors ndi kalasi ya mankhwala omwe amagwiritsidwa ntchito popanga acid reflux ndipo amaphatikizapo Prilosec , Nexium , ndi Dexilant .
Mayesero otsatirawa amathandizanso kuti mudziwe vutoli:
Chithandizo
Zovomerezeka zamakono za chithandizo cha achalasia zimaphatikiziranso kuthamanga kwa chibayo kapena kuchitidwa opaleshoni yophatikizapo ndalama. Ndondomeko izi zimagwiritsidwa ntchito ngati mankhwala othandiza kwambiri (zambiri zokhudzana ndi izi m'munsimu).
Kwa iwo omwe sangakhoze kuchitidwa opaleshoni kapena kusankha, ma jekeseni a botox amatsatiridwa ndi mankhwala ndi mankhwala akulimbikitsidwa.
Pakalipano palibe mankhwala omwe angathe kubwezeretsa minofu yowonongeka (peristalsis) ku malo ozungulira. Choncho, mankhwala onse akuthandizira kuchepetsa mavuto ku LES.
- Kutsegula myotomy ndi njira yowopsya yomwe minofu ya a LES imagawanika. Ikhoza kuchitidwa mwachisawawa chomwe chimachepetsa nthawi yochira. Kafukufuku wasonyeza kuti opaleshoni ya myotomy imathandiza kwambiri kuchepetsa zizindikiro za achalasia koma kukula kwa GERD potsatira njirayi nthawi zambiri. Pachifukwa ichi, ndikulimbikitsidwa kuti opaleshoni ya myotomy imayendetsedwa pamodzi ndi njira ina yotchedwa partial fundoplication kuti tipewe GERD.
- Kutentha kwapweya (PD) ndi njira yopanda opaleshoni yomwe imagwiritsa ntchito mpweya wa mpweya kusokoneza minofu ya LES. Ndondomekoyi imagwiritsidwa ntchito pogwiritsa ntchito kuwala. Pali chiopsezo cha kupopera phokoso (kutulutsa mwala mwangozi, kapena kubisa dzenje) ndipo mutatha njirayi muyenera kukhala ndi barium esophagram kuti muwonetsetse kuti mimbayo siinapangidwe. Kafukufuku akusonyeza kuti pamene ntchito yoyenera PD imapereka ubwino wabwino kwambiri wa zizindikiro za achalasia. Zotsatira sizikhala zamuyaya koma zingakhale zaka.
- Kusokonezeka kwapadera kumakhala kofanana ndi kupuma kwa chibayo koma pamene nthawi yayitali , dokotala amatambasula LES ndi dilator. Odwala ena akhoza kukhala ndi GERD pambuyo pa njirayi.
- Majekesiti a Botox awonetsedwa kuti achepetse kupanikizika mu LES koma sali othandiza ngati PD kapena opaleshoni. Majekeseniwa amachitika nthawi zonse ndipo chikoka chachikulu cha ndondomekoyi ndi chakuti pali zotsatira zochepa chabe, chiopsezo chochepa cha mavuto, ndi kupuma kumakhala kofulumira komanso kosavuta. Zizindikiro kawirikawiri zimayambiranso ndi jekeseni wotsatira ndizofunika kwa anthu ambiri omwe amasankha mankhwalawa.
- Esophagectomy , kapena kuchotsa opaleshoni ya mthempha (kapena magawo a m'mimba), imasungiratu milandu yambiri yomwe mankhwala ena alephera.
- Kusamalira mankhwala a achalasia kumatengedwa njira yabwino kwambiri yothetsera zizindikiro. Komabe, kwa iwo omwe sangathe kuchitidwa opaleshoni komanso omwe mankhwala a botox akhala opanda ntchito mankhwala angagwiritsidwe ntchito. Mankhwala otchedwa calcium channel blockers, omwe kawirikawiri amaperekedwa chifukwa cha kuthamanga kwambiri kwa magazi, amagwiritsidwa ntchito nthawi zambiri kwa achalasia chifukwa chakuti amatha kumasula minofu yosalala. Chisangalalo ichi chimachepetsa kukakamizidwa ku LES. Mankhwala ena otchedwa sildenafil (Viagra) awonetsedwanso kuchepetsa kupanikizika mu LES. Mankhwala ena angagwiritsidwe ntchito malingana ndi mkhalidwe ndi luntha la dokotala wanu.
Chifukwa cha chiopsezo chowonjezeka cha khansa ya umoyo wodwalayo, odwala onse omwe ali ndi achalasia ayenera kukhala ndi maulendo obwereza nthawi zonse ndi dokotala wawo, ngakhale mankhwala atakhala othandiza. Dokotala wanu adzayang'ana ndi kuyang'ana (ngati n'koyenera) kwa khansara yotopetsa.
Zotsatira:
American College of Gastroenterology. Malangizo Othandizira a ACG: Kuzindikira ndi Kulamulira kwa Achalasia. 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
Kusaka. Achalasia. https://reference.medscape.com/article/169974-overview#aw2aab6b2b4aa
Zaposachedwa. Information Patient: Achalasia (Beyond the Basics). http://www.uptodate.com/contents/achalasia-beyond-the-basics