Pahu i ka paʻakikī

ʻO ka paʻakikī me ka ale ʻana ka manaʻo e paʻa ka meaʻai a wai paha i ka puʻu a i ʻole i kēlā me kēia manawa ma mua o ka komo ʻana o ka meaʻai i loko o ka ʻōpū. Kāhea ʻia kēia pilikia ʻo Disphagia.

ʻO ke kaʻina hana o ka moni ʻana e komo i nā ʻanuʻu he nui. Pākuʻi ʻia kēia mau mea:

• ʻAi meaʻai
• Ke hoʻoneʻe nei i ka hope o ka waha
• Ke hoʻoneʻe nei i lalo i ka esophagus (paipu meaʻai)

Nui nā aʻa e kōkua i nā mākala o ka waha, ka puʻu, a me ka esophagus e hana pū. Hana ʻia ka hapa nui o ka ale ʻana me ka ʻole o ʻoe e ʻike i kāu mea e hana nei.

ʻO ka ale ʻana he hana paʻakikī. Hana nā aʻa he nui i ke kaulike maikaʻi e kāohi ai i ka hana pū ʻana o nā mākala o ka waha, ka puʻu, a me ka esophagus.

Hiki i kahi lolo a me nā ʻāʻoki nerve ke hoʻololi i kēia kaulike maikaʻi i nā mākala o ka waha a me ka puʻu.

• ʻO ke kumu o ka hōʻino ʻana i ka lolo e sclerosis maha, maʻi ʻo Parkinson, a i ʻole hōʻeha.
• Ma muli o ka ʻeha o ke kuamoʻo i hōʻeha ʻia, amyotrophic lateral sclerosis (ALS a i ʻole maʻi Lou Gehrig), a i ʻole myasthenia gravis.

ʻO ke koʻikoʻi a hopohopo paha e hoʻonā i kekahi poʻe i ka ʻāʻī o ka ʻāʻī a i ʻole me he mea lā ua paʻa kekahi i ka ʻāʻī. Kapa ʻia kēia ʻano manaʻo he globus sensation a pili ʻole i ka ʻai ʻana. Eia nō naʻe, aia paha kekahi kumu kumu.

ʻO nā pilikia e pili ana i ka esophagus ke kumu i nā pilikia ale. Pākuʻi ʻia kēia mau mea:

• ʻO kahi apo o nā mea kiko ʻole e hana ai kahi e hui ai ka esophagus a me ka ʻōpū (i kapa ʻia ʻo Schatzki ring).
• Nā spasms kūpono ʻole o nā mākala esophagus.
• Ka maʻi ʻaʻai o ka esophagus.
• Ka holo pono ʻole ʻana o ka pūʻolo puʻupuʻu ma ka lalo o ka esophagus e hoʻomaha ai (Achalasia).
• Scarring e hoʻopili i ka esophagus. Pili paha kēia i ka pāhawewe, nā kemika, nā lāʻau, ka huʻihu mau ʻana, ka maʻi ʻeha, ka maʻi, a me ka reflux esophageal.
• ʻO kekahi mea i paʻa i ka esophagus, e like me kahi ʻāpana o ka meaʻai.
• ʻO Scleroderma, kahi maʻi kahi e kuhi hewa ai ka ʻōnaehana pale i ka esophagus.
• Nā tumors i ka umauma e kaomi ma luna o ka esophagus.
• ʻO Plummer-Vinson Syndrome, kahi maʻi laha ʻole kahi e ulu ai nā pūnaewele o ka membrane mucosal i ka wehe ʻana o ka esophagus.

ʻO ka ʻeha o ka umauma, ka manaʻo o ka meaʻai i paʻa i ka ʻāʻī, a i ʻole ke kaumaha a i ʻole kaomi i ka ʻāʻī a i luna a i ʻole lalo o ka umauma.

Hiki i nā ʻōuli ʻē aʻe ke:

• Cough a i ʻole wheezing e lilo i ʻino.
• ʻO ka hoʻomake ʻana i ka ʻai i hoʻomo ʻole ʻole ʻia.
• Puʻuwai puʻuwai.
• Nusea.
• ʻOno ono i ka waha.
• ʻO ka paʻakikī ʻana e ale wale i nā mea paʻa (hiki ke kuhikuhi i kahi tumo a i ʻole ke koʻikoʻi) hōʻike i kahi blockage kino e like me ke kaohi a me kahi tumo.
• Pilikia i ka ale ʻana i nā wai akā ʻaʻole ka paʻa (e kuhikuhi paha i ka hōʻino o ke aʻa a i ʻole ka spasm o ka esophagus).

Hiki paha iā ʻoe ke pilikia i ka ale ʻana me ka ʻai ʻana a me ka inu ʻana, a i ʻole me kekahi ʻano o nā meaʻai a wai paha. Pākuʻi ʻia paha nā ʻōuli o ka moni ʻana i nā pilikia me ka paʻakikī ke ʻai:

• Mea ʻai wela loa a anuanu hoʻi
• Pāpelu maloʻo a palaoa paha
• ʻIʻo a moa paha

E kauoha kāu mea mālama ola i nā hoʻokolohua e nānā:

• Kekahi mea e ālai ana a i ʻole ka hoʻopili ʻana i ka esophagus
• Nā pilikia me nā mākala
• Nā loli i ka uhi o ka esophagus

Hana pinepine ʻia kahi hōʻike i kapa ʻia ʻo endoscopy luna (EGD).

• ʻO kahi endoscope kahi paipu maʻalahi me ke kukui ma ka hopena. Hoʻokomo ʻia ma o ka waha a i lalo ma o ka esophagus i ka ʻōpū.
• E hāʻawi ʻia ʻoe i kahi mea hōʻoluʻolu a ʻaʻole ʻoe e ʻeha.

Hiki i nā hoʻokolohua ʻē aʻe ke:

• E ale ʻo Barium a me nā hoʻowalewale ʻē aʻe
• Pākuʻi x-ray
• Nānā PH Esophageal (ana i ka acid i ka esophagus)
• ʻO ka manometry esophageal (ana i ke kaomi i ka esophagus)
• Kālā x-ray

Pono paha ʻoe e hōʻoia i ke koko e nānā i nā maʻi e hiki ai ke hoʻopau i nā pilikia.

ʻO ka mālama ʻana i kāu pilikia e ale i ka kumu.

He mea nui e aʻo pehea e ʻai ai a inu ai hoʻi me ka palekana. ʻO ke ale ʻana i ka hewa ʻole e alakaʻi ʻia ai i ka ʻānai ʻana a i ka hanu ʻana i ka meaʻai a wai paha i loko o kāu ala nui. Hiki i kēia ke alakaʻi i ka niumonia.

E mālama i ka hoʻopulana ʻana i nā pilikia ma ka home:

• Kuhi paha kāu mea hāʻawi i nā loli i kāu papaʻai. Loaʻa paha iā ʻoe kahi papaʻai wai kūikawā e kōkua iā ʻoe e noho olakino.
• Pono paha ʻoe e aʻo i nā loea hou a me ka ale ʻana.
• E haʻi paha kāu mea lawelawe iā ʻoe e hoʻohana i nā mea e mānoanoa ai ka wai a me nā wai ʻē aʻe i mea e makemake ʻole ai lākou iā lākou i loko o kou mau māmā.

Pili nā lāʻau i hiki ke hoʻohana ʻia i ke kumu, a hiki ke hoʻopili ʻia:

• ʻO kekahi mau lāʻau e hoʻomaha ai i nā mākala i ka esophagus. Hoʻopili kēia i nā nitrates, kahi ʻano lāʻau i hoʻohana ʻia e mālama i ke koko, a me ka dicyclomine.
• Ka pahu kui o botulinum toxin.
• ʻO nā lāʻau e mālama ai i ka puʻuwai ma muli o ka reflux gastroesophageal (GERD).
• Nā lāʻau lapaʻau e mālama ai i kahi maʻi pīhoihoi, inā loaʻa.

ʻO nā kaʻina hana a me nā ʻoki ʻana i hiki ke hoʻohana ʻia me:

• Endoscopy o luna: Hiki i ka mea hoʻolako ke hoʻonui a hoʻonui i kahi ākea o kāu esophagus e hoʻohana nei i kēia kaʻina hana. No kekahi poʻe, pono e hana hou i kēia, ai kekahi manawa ʻoi aku i hoʻokahi manawa.
• ʻO ka uila a i ʻole ke ʻoki ʻana: Hiki ke hoʻohana ʻia kēia mau hana inā loaʻa ka maʻi ʻaʻai i ka pilikia o ka ale. Hiki paha i ka Achalasia a i ʻole nā ​​spasms o ka esophagus ke pane i ka ʻoki ʻana a i ʻole nā ​​injection o botulinum toxin.

Pono ʻoe i kahi paipu hānai inā:

• Kūpilikiʻi kāu mau ʻōuli a ʻaʻole hiki iā ʻoe ke ʻai a inu lawa.
• Loaʻa iā ʻoe nā pilikia ma muli o ke kuke a me ka maʻi pulmononia.

Hoʻokomo pololei ʻia kahi pūʻai hānai i loko o ka ʻōpū ma o ka paia ʻōpū (G-tube).

Kāhea i kāu mea hāʻawi inā ʻaʻole maikaʻi ka ale ʻana i nā pilikia ma hope o kekahi mau lā, a i ʻole hele mai lākou a hoʻi.

Kāhea koke i kāu mea hāʻawi inā:

• He kuni a hanu paha kou.
• Ke emi nei kou kaumaha.
• Ke hele a māhuahua nei kou mau pilikia ale.
• Kaha ʻoe a luaʻi paha i ke koko.
• Loaʻa iā ʻoe ka hānō e lilo i ʻino.
• ʻIke ʻoe me he mea lā e haʻalulu ana i ka wā a ma hope paha o ka ʻai ʻana a inu paha.

ʻO Dysphagia; Ale ʻinoʻino; Kāpena - ʻai; ʻIke Globus

• ʻEsopago

Brown DJ, Lefton-Greif MA, Ishman SL. Nā manaʻo aspiration a me nā ale. I: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Ke poʻo poʻo a me ka ʻāʻī. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2015: chap 209.

ʻO Munter DW. Nā kino haole esophageal. I: Roberts JR, Custalow CB, Thomsen TW, eds. ʻO Roberts a me Hedges 'Nā Kauka Lapaʻau i ka Medicine Emergency a me ka Care Acute. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 39.

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.