Gastroparesis, yomwe imatchedwanso kuchepetsedwa kwa mimba, ndiyo matenda omwe amatenga nthawi yaitali kuti asawononge zomwe zili mkati mwake. Nthawi zambiri imapezeka mwa anthu omwe ali ndi matenda a shuga kapena mtundu wa shuga.
Mwachidule
Gastroparesis imachitika pamene mitsempha ya m'mimba yawonongeka kapena imasiya kugwira ntchito. Mitsempha ya vagus imayendetsa kayendetsedwe ka chakudya kupyolera m'thupi.
Ngati nthenda ya vagus yowonongeka, minofu m'mimba ndi m'matumbo sizigwira ntchito bwino ndipo kuyenda kwa chakudya kumachepa kapena kuimitsa.
Matenda a shuga angathe kuwononga nthenda ya vagus ngati m'magazi a m'magazi amakhalabe okwera kwa nthawi yaitali. Magazi a m'magazi amachititsa kuti thupi lisinthe mitsempha ndi kuwononga mitsempha ya magazi yomwe imanyamula mpweya ndi zakudya ku mitsempha.
Zimayambitsa
Gastroparesis nthawi zambiri amayamba chifukwa:
- Matenda a shuga
- Mavitamini a postviral
- Anorexia nervosa
- Kuchita opaleshoni m'mimba kapena mitsempha ya vagus
- Mankhwala, makamaka anticholinergics ndi mankhwala osokoneza bongo (mankhwala osokoneza bongo m'mimba)
- Matenda a reflux a m'mimba (kawirikawiri)
- Matenda osokonezeka, monga amyloidosis ndi scleroderma
- Matenda a mitsempha , kuphatikizapo mimba migraine ndi matenda a Parkinson
- Matenda amadzimadzi, kuphatikizapo hypothyroidism
Zizindikiro ndi Zizindikiro
Zizindikirozi zingakhale zofewa kapena zovuta, malingana ndi munthuyo:
- Kuthamangitsani
- Nausea
- Kuthamanga kwa chakudya choposa
- Kumverera koyamba kwa kukhuta pamene mukudya
- Kutaya thupi
- Mimba yamimba
- Magulu olakwika a shuga wa magazi
- Kupanda njala
- Reflux ya Gstroesophageal (GERD)
- Mphuno ya khoma la mmimba
Mayesero Opatsirana
Kutsimikiziridwa kwa gastroparesis kumatsimikiziridwa ndi mayesero amodzi kapena angapo awa:
- Barium x-ray. Mukatha kudya maola 12, mudzamwa madzi akuda otchedwa Barium, omwe amavala mkati mwa mimba, kuti awawonetsere pa x-ray. Kawirikawiri, mimba idzakhala yopanda chakudya chonse pambuyo pa kusala kwa maola 12. Ngati x-ray ikuwonetsa chakudya mmimba, gastroparesis n'zotheka. Ngati x-ray ikuwonetsa mimba yopanda kanthu koma adokotala akukayikira kuti mwachedwa kuchepetsa, mungafunike kubwereza mayeso tsiku lina. Pa tsiku limodzi, munthu amene ali ndi gastroparesis akhoza kudya chakudya mwachizolowezi, kupereka zotsatira zowonongeka. Ngati muli ndi shuga, dokotala wanu akhoza kukhala ndi malangizo apadera okhudza kudya.
- Barium beefsteak chakudya. Mudya chakudya chomwe chiri ndi barium, motero amalola radiologist kuyang'ana mimba yanu pamene ikudya chakudya. Nthawi yochuluka yoti chakudya cha Barium chifidwe ndikuchoka m'mimba chimapereka dokotala lingaliro la momwe mimba ikugwirira ntchito. Mayesowa angathe kuthandizira kupeza mavuto omwe sakuwoneka pa radiyo ya Barium. Ndipotu, anthu omwe ali ndi gastroparesis okhudzana ndi shuga amayamba kukumba madzimadzi kawirikawiri, choncho barium beefsteak chakudya angakhale othandiza kwambiri.
- Ma radioisotope-kutaya kuyesa. Mudzadya chakudya chomwe chimakhala ndi radioisotope, mankhwala othandizira mavitamini omwe angayambe kuwonekera. Kuchuluka kwa ma radio kuchokera ku radioisotope ndi kochepa ndipo si koopsa. Mutatha kudya, mumagona pansi pa makina omwe amatha kuona radioisotope ndipo amasonyeza chithunzi cha chakudya m'mimba ndipo chimachokera mimba mwamsanga. Gastroparesis amapezeka ngati zoposa theka la chakudya zimakhala m'mimba pambuyo pa maola awiri.
- Gastric manometry. Mayesowa amachititsa ntchito zamagetsi ndi zam'mimba m'mimba. Dokotala amapereka chubu lochepa kwambiri pammero mpaka m'mimba. Phukusi lili ndi waya umene umatengera kuchuluka kwa ntchito ya magetsi ndi minofu monga momwe imayambira zakumwa ndi zakudya zolimba. Kuyeza kumasonyeza mmene mimba ikugwirira ntchito komanso ngati pali kuchedwa kwa chimbudzi.
- Mayeso a magazi. Dokotala akhoza kuitananso mayeso a laboratory kuti awonetse kuwerengera kwa magazi ndi kuyerekezera mayendedwe a mankhwala ndi electrolyte.
Pofuna kuthetsa zifukwa za gastroparesis osati matenda a shuga, dokotala angakhale ndi aposcopy kapena ultrasound.
- Kutsekemera kochepa kwambiri. Atakupatsani mankhwala osokoneza bongo, adokotala amatha kutengera kachilombo kautali kakang'ono kwambiri, kamene kamatchedwa endoscope, kudzera pakamwa ndikumatsogolera mokondweretsa m'mimba. Kupyolera mu endoscope, dokotala akhoza kuyang'ana pa chida cha m'mimba kuti aone ngati pali vuto lililonse.
- Ultrasound. Pofuna kuthetsa matenda a chifuwa kapena kuperewera kwa matenda monga vuto la vutoli, mukhoza kukhala ndi mayeso a ultrasound, omwe amagwiritsa ntchito mafunde osalongosoka kuti afotokoze ndi kufotokoza mawonekedwe a ndulu ndi zoperekera.
Mavuto
Ngati chakudya chimakhala chotalika m'mimba, chikhoza kuyambitsa mavuto monga kupitirira kwa bakiteriya kuchokera ku kuthirira chakudya. Komanso, chakudyacho chikhoza kuumitsa mizati yamphamvu, yotchedwa bezoars, yomwe ingayambitse chifuwa, kusanza, ndi kupsinjika mmimba. Njoka zimakhala zoopsa ngati zimaletsa chakudya kumatumbo aang'ono.
Gastroparesis imathandizanso kuti matenda a shuga akhale ovuta kwambiri powonjezera kuvuta kwa kuchepetsa magazi m'magazi. Pamene chakudya chimene chatsekedwa mmimba chimatha kulowa m'mimba mwachinyamatayo ndipo chimathamanga, magulu a m'magazi amayamba.
Popeza gastroparesis imatulutsa mimba mosadziŵika, mazira a magazi amagazi amatha kukhala ovuta komanso ovuta kuwongolera.
Chithandizo
Cholinga chachikulu cha chithandizo cha gastroparesis chokhudzana ndi shuga ndi kubwezeretsanso magazi m'magulu a shuga. Mankhwalawa akuphatikizapo insulini, mankhwala am'kamwa, kusintha pa zomwe mumadya, komanso podwala kwambiri, kudyetsa makapu ndi kudyetsa mwachangu.
Ndikofunika kudziwa kuti nthawi zambiri mankhwala samachiza gastroparesis-kawirikawiri ndi matenda aakulu.
Chithandizo chimakuthandizani kuthetsa vutoli kuti muthe kukhala wathanzi komanso omasuka momwe mungathere.
Insulini ya Kupewa Magazi a Magazi
Ngati muli ndi gastroparesis, chakudya chanu chimakwera pang'onopang'ono komanso nthawi yosadziŵika. Kuti muchepetse magazi a shuga, mungafunike ku:
- Katemera kambirimbiri
- Tengani insulini yanu mutadya m'malo mmbuyomu
- Yang'anani m'magazi anu a shuga nthawi zambiri mukadya ndikupereka insulini nthawi zonse
Dokotala wanu adzakupatsani malangizo enieni malinga ndi zosowa zanu.
Mankhwala
Mankhwala angapo amagwiritsidwa ntchito pochiza gastroparesis. Dokotala wanu akhoza kuyesa mankhwala osiyanasiyana kapena mankhwala osokoneza bongo kuti apeze mankhwala ogwira mtima, kuphatikizapo:
- Metoclopramide (Reglan). Mankhwalawa amachititsa kuti thupi likhale lopweteka m'mimba kuti liwathandize chakudya chopanda kanthu. Zimathandizanso kuchepetsa kunyowa ndi kusanza. Metoclopramide imatengedwa mphindi 20 mpaka 30 musanadye komanso nthawi yogona. Zotsatira za mankhwalawa zimaphatikizapo kutopa, kugona, ndi nthawi zina kupsinjika maganizo, nkhawa, ndi mavuto ndi kuthamanga kwa thupi.
- Erythromycin. Mankhwalawa amathandizanso kuchepetsa mimba. Zimagwira ntchito poonjezera zovuta zomwe zimasunthira chakudya kudzera mmimba. Zotsatirapo zimaphatikizapo kunyoza, kusanza, ndi kupweteka m'mimba.
- Domperidone. Boma la US Food and Drug Administration likuyang'ana domperidone, yomwe yagwiritsidwa ntchito kwina kulikonse padziko lapansi kuti ichitire gastroparesis. Ndi wothandizira otetezera ofanana ndi metoclopramide. Zimathandizanso ndi mseru.
- Mankhwala ena. Mankhwala ena angagwiritsidwe ntchito pochiza zizindikiro ndi mavuto okhudzana ndi gastroparesis. Mwachitsanzo, antiemetic ikhoza kuthandizira kusuta ndi kusanza. Maantibayotiki adzathetsa kachilombo ka bakiteriya. Ngati muli ndi bezoar, dokotala akhoza kugwiritsa ntchito endoscope kuti ayambe kumwa mankhwala omwe amatha kupasuka.
Kusintha kwa Zakudya
Kusintha chizolowezi chanu cha kudya kumathandiza kuchepetsa gastroparesis. Dokotala wanu kapena odyetserako zakudya amakupatsani malangizo apadera, koma mukhoza kupemphedwa kuti mudye chakudya chazing'ono zisanu ndi chimodzi pa tsiku m'malo mwa zitatu zazikulu. Ngati chakudya chochepa chikafika m'mimba nthawi iliyonse mukadya, sichidzadzaza kwambiri.
Komanso, dokotala wanu kapena odyetserako zakudya angapangire kuti mumayesa zakudya zingapo tsiku limodzi mpaka mayendedwe a shuga a magazi asakhazikika ndipo gastroparesis yatsutsidwa.
Zakudya zamadzimadzi zimapereka zakudya zonse zomwe zimapezeka mu zakudya zolimba, koma zimatha kudutsa m'mimba mosavuta komanso mofulumira.
Kuwonjezera apo, dokotala wanu angakulimbikitseni kuti musapewe zakudya zamtengo wapatali komanso zam'mwamba. Mafuta mwachibadwa amachepetsa kuyamwa-vuto limene simukusowa ngati muli ndi gastroparesis-ndipo fiber ndi yovuta kukumba. Zakudya zina zapamwamba kwambiri, monga malalanje ndi broccoli, zili ndi zinthu zomwe sizingatheke. Pewani zakudya izi chifukwa gawo losatayika lidzakhalabe m'mimba mwanu motalika kwambiri komanso mwinamwake kupanga mawonekedwe.
Kudyetsa Tube
Ngati njira zina sizikugwira ntchito, mungafunikire opaleshoni kuti muyike chubu. Thumba, yotchedwa jejunostomy chubu, imayikidwa kudzera pakhungu pamimba mwathu mumatumbo aang'ono. Tizilombo toyambitsa matenda amakupatsani zakudya zam'mimba mwachindunji, kudutsa m'mimba mwathunthu. Mudzalandira chakudya chamadzimadzi chapadera kuti mugwiritse ntchito ndi chubu.
Ijjunostomy imathandiza kwambiri pamene gastroparesis imaletsa zakudya ndi mankhwala oyenera kuti muyambe kuika magazi m'magazi.
Popewera gwero la vuto-m'mimba-ndi kuika zakudya ndi mankhwala mwapang'onopang'ono m'mimba, mumatsimikizira kuti mankhwalawa akugwedezeka ndikuperekedwa ku magazi mwamsanga. Thupi la jejunostomy lingakhale laling'ono ndipo limagwiritsidwa ntchito ngati kuli koyenera pamene gastroparesis ndi yaikulu.
Nthenda ya Parenteral
Chakudya chogonana chimatanthawuza kupereka mchere mwachindunji m'magazi, kupyolera m'thupi. Dokotala wanu adzaika chubu chochepa, chotchedwa catheter, mu mitsempha ya chifuwa, n'kusiya kutsegula kunja kwa khungu.
Pofuna kudyetsa, mumakhudza thumba lokhala ndi zakudya zamadzimadzi kapena mankhwala kwa catheter. Mankhwalawa amalowa m'magazi anu kudzera mu mitsempha. Dokotala wanu adzakuuzani mtundu wa zakudya zamadzi zomwe mungagwiritse ntchito.
Njira imeneyi ndi njira yotsalira ya chubu lajjunostomy ndipo kawirikawiri ndi njira yamakono kuti mukhale ndi vuto lovuta la gastroparesis. Chakudya chogonana chimagwiritsidwa ntchito pokhapokha ngati gastroparesis ndi yaikulu ndipo sathandizidwa ndi njira zina.
Zosankha Zatsopano
- Gastric neurostimulator ("pacemaker") yakhazikitsidwa kuthandiza anthu okhala ndi gastroparesis. Pulogalamu ya pacemaker imagwiritsa ntchito betri, chipangizo chamagetsi chomwe chimayikidwa opaleshoni. Amatulutsa mpweya wochepa wa magetsi omwe amachititsa kuti mimba ikhale yosiyana kotero kuti chakudya chimadulidwa ndikuchoka m'mimba mpaka m'mimba. Kutsitsimutsa kwa magetsi kumathandizanso kuchepetsa kunyowa ndi kusanza komwe kumagwirizanitsidwa ndi gastroparesis.
- Kugwiritsidwa ntchito kwa poizoni ya botulinum kwawonetsedwa kuti zipititse patsogolo kutaya mimba ndi zizindikiro za gastroparesis mwa kuchepetsa kusamvana kwa nthawi yaitali pakati pa mimba pakati pa m'mimba ndi m'mimba mwachinyama (pyloric sphincter). Thexin imayikidwa mu pyloric sphincter.
Mawu Ochokera
Izi ndizo zambiri zomwe mungadziwe, kotero apa pali mfundo zisanu ndi chimodzi zofunika kuzikumbukira:
- Gastroparesis ikhoza kuchitika mwa anthu omwe ali ndi matenda a shuga 1 kapena mtundu wa shuga.
- Gastroparesis ndi zotsatira za kuwonongeka kwa mitsempha ya vagus, yomwe imayendetsa kayendetsedwe ka chakudya kudzera m'thupi. Mmalo mwa chakudya chomwe chimayenda kudzera mu kapangidwe kakang'ono ka zakudya, nthawi zambiri chimasungidwa mmimba.
- Mitsempha ya vagus imatha kuwonongeka pambuyo pa zaka zochepa zowonongeka kwa shuga, zomwe zimachititsa gastroparesis. Komanso, gastroparesis amathandiza osauka magazi shuga kulamulira.
- Zizindikiro za gastroparesis zikuphatikizapo kudzala msanga, kunyozetsa, kusanza, ndi kutaya thupi.
- Gastroparesis amapezeka kudzera mu mayesero monga x-ray, manometry, ndi scanning.
- Mankhwala amaphatikizapo kusintha nthawi ndi zomwe mumadya, kusintha kwa mtundu wa insulin ndi nthawi ya jekeseni, mankhwala a pamlomo, jejunostomy, zakudya za parenteral, gastric pacemakers, kapena botulinum poizoni.
Kuti mudziwe zambiri, onani NIDDK's Division of Digestive Diseases and Nutrition. Iwo amathandizira kafukufuku wamakono ndi zamakono ku matenda a mimba motility, kuphatikizapo gastroparesis. Pakati pazinthu zina, ofufuza akuphunzira ngati mankhwala akuyesera angathe kuchepetsa kapena kuchepetsa zizindikiro za gastroparesis, monga kupweteka, kupweteka m'mimba, kunyozetsa, ndi kusanza, kapena kuchepetsanso nthawi yomwe m'mimba imataya zomwe zili mkati mwa chakudya.