Achalasia

ʻO ka paipu e lawe ana i ka meaʻai mai ka waha a i ka ʻōpū ʻo ka esophagus a i ʻole ka paipu meaʻai. Hana ʻo Achalasia i mea paʻakikī i ka esophagus e hoʻoneʻe i ka meaʻai i loko o ka ʻōpū.

Aia kekahi apo muscular ma kahi e hui ai ka esophagus a me ka ʻōpū. Kāhea ʻia ʻo ia ka sphincter esophageal haʻahaʻa (LES). ʻO ka maʻamau, hoʻomaha kēia mākala ke ale ʻoe e ʻae i nā meaʻai e hele i loko o ka ʻōpū. I ka poʻe me ka achalasia, ʻaʻole ia e hoʻomaha e like me ka mea e pono ai. Hoʻohui ʻia, hoʻoliʻiliʻi a hele ʻole paha ka hana muscle maʻamau o ka esophagus (peristalsis).

Hoʻokumu ʻia kēia pilikia e ka hōʻino ʻana i nā aʻalolo o ka esophagus.

Hiki i nā pilikia ʻē aʻe ke kumu i nā ʻōuli like, e like me ka maʻi ʻaʻai o ka esophagus a i ʻole luna o ka ʻōpū, a me kahi maʻi parasite e kumu ai ka maʻi Chagas.

Kākaʻikahi ʻo Achalasia. Hiki paha i kēlā me kēia makahiki, akā ʻike pinepine ʻia i ka poʻe 25 a 60 mau makahiki. I kekahi poʻe, hoʻoilina paha ka pilikia.

ʻO nā hōʻailona me:

• Backflow (regurgitation) o ka meaʻai
• ʻO ka ʻeha o ka umauma, i hoʻonui ʻia ma hope o ka ʻai ʻana, a i ʻole manaʻo ʻia he ʻeha ma ka hope, ka ʻāʻī, a me nā lima
• Cough
• Pilikia i ka ale ʻana i nā wai a me nā paʻa
• Puʻuwai puʻuwai
• Ka hoʻohaʻahaʻa kaumaha ʻole

Hōʻike paha ka loiloi kino i nā hōʻailona o ka anemia a i ʻole kaʻai pono ʻole.

Loaʻa i nā hoʻāʻo:

• Manometry, kahi hoʻāʻo e ana ai inā e hana pono ana kāu esophagus.
• ʻO EGD a i ʻole endoscopy luna, kahi hōʻike e nānā ai i ka uhi ʻana o ka ʻōpū a me ka esophagus. Hoʻohana ia i kahi paipu maʻalahi a me kāmela.
• Kaha ʻāpana GI luna.

ʻO ka pahuhopu o ka mālama ʻana e hōʻemi i ke kaomi ma ka mākala sphincter a ʻae i ka ʻai a me nā wai e hele maʻalahi i loko o ka ʻōpū. Pili paha ka Therapy:

• Ka pahu kui me ka botulinum toxin (Botox) - Hiki i kēia ke kōkua i ka hoʻomaha ʻana i nā mākala sphincter. Eia naʻe, pau ka pōmaikaʻi i loko o kekahi mau pule a i ʻole mau mahina.
• ʻO nā lāʻau lapaʻau, e like me nā nitrates hana lōʻihi a i ʻole nā ​​poloka aʻa calcium - Hiki ke hoʻohana ʻia i kēia mau lāʻau e hoʻomaha ai i ka sphincter esophagus haʻahaʻa. Akā ʻaʻole kakaʻikahi kahi hopena lōʻihi e mālama ai i ka achalasia.
• ʻOki kino (i kapa ʻia he myotomy) - I kēia kaʻina hana, ʻokiʻoki ʻia ka mākala sphincter lalo.
• ʻO ka laulā (dilation) o ka esophagus - Hana ʻia kēia i ka wā o EGD ma ke kau ʻana i ka LES me kahi mea hoʻomake balloon.

Hiki i kāu kauka olakino ke kōkua iā ʻoe e hoʻoholo i ka lāʻau e pono ai nāu.

ʻO nā hopena o ke kaha ʻana a me nā hana ʻoki lāʻau ʻole. ʻOi aku ka pono ma mua o hoʻokahi lapaʻau i kekahi manawa.

Komo pū nā pilikia:

• Backflow (regurgitation) o ka waikawa a meaʻai paha mai ka ʻōpū i ka esophagus (reflux)
• ʻO ka hanu ʻana i nā meaʻai i loko o nā akemāmā (aspiration), kahi e hiki ai ke hōʻeha i ka maʻi pneumonia
• Haehae (perforation) o ka esophagus

Kāhea i kāu mea hāʻawi inā:

• Loaʻa iā ʻoe ka pilikia e ale a me ka ale ʻeha
• Ke hoʻomau nei kāu mau ʻōuli, ʻoiai me ka mālama ʻana no achalasia

ʻAʻole hiki ke pale ʻia nā kumu he nui o ka achalasia. Eia nō naʻe, kōkua ke kōkua i ka pale ʻana i nā pilikia.

ʻAʻa ʻaʻa Esophageal; ʻO ka ale ʻana i nā pilikia no nā wai a me nā mea paʻa; Cardiospasm - spasm puna sphincter haʻahaʻa

• ʻŌnaehana Digestive
• ʻŌnaehana gastrointestinal luna
• Achalasia - moʻo

ʻO Falk GW, Katzka DA. Nā maʻi o ka esophagus. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 129.

Hamer PW, Keikihipa PJ. Ka mālama ʻana i ka achalasia a me nā maʻi motility ʻē aʻe o ka esophagus. I: Griffin SM, Lamb PJ, eds. ʻO ke kahakaha ʻOesophagogastric: kahi hoa hele i ka hana ʻoki kino hoʻomalu. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2019: chap 16.

Pandolfino JE, Kahrilas PJ. ʻO ka hana neuromuscular Esophageal a me nā maʻi motility. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 43.