Achalasia

Phala e isang lijo ho tloha molomong ho ea ka mpeng ke 'metso kapa phala ea lijo. Achalasia e thatafalletsa 'metso ho tsamaisa lijo ka mpeng.

Ho na le selikalikoe sa mesifa moo 'metso le mpa li kopanang. E bitsoa low esophageal sphincter (LES). Ka tloaelo, mesifa ena ea phomola ha u koenya e le hore lijo li fete ka mpeng. Ho batho ba nang le achalasia, ha e phomole kamoo e lokelang. Ntle le moo, ts'ebetso e tloaelehileng ea mesifa ea 'metso (peristalsis) ea fokotseha kapa ha e eo.

Bothata bona bo bakoa ke tšenyo ea methapo ea 'metso.

Mathata a mang a ka baka matšoao a ts'oanang, joalo ka mofetše oa 'metso kapa mala a kaholimo, le tšoaetso ea likokoana-hloko e bakang lefu la Chagas.

Achalasia ha e fumanehe hangata. E kanna ea etsahala ka nako efe kapa efe, empa e atile haholo bathong ba lilemo tse 25 ho isa ho tse 60. Ho batho ba bang, bothata e ka ba bo futsitsoeng.

Matšoao a kenyelletsa:

• Ho khutlela morao (ho pheta-pheta) lijo
• Bohloko ba sefuba, bo ka nyolohang kamora ho ja, kapa bo ka utloahala e le bohloko mokokotlong, molaleng le matsohong
• Khohlela
• Ho thata ho metsa mokelikeli le metsoako
• Ho heletsa
• Ho theola boima ba 'mele ka boomo

Tlhahlobo ea 'mele e ka bontša matšoao a khaello ea mali kapa khaello ea phepo e nepahetseng.

Liteko li kenyelletsa:

• Manometry, teko ea ho lekanya hore na 'metso oa hau o sebetsa hantle.
• EGD kapa endoscopy e kaholimo, teko ea ho lekola lesela la mpa le 'metso. E sebelisa tube e tenyetsehang le kh'amera.
• X-ray e holimo ea GI.

Morero oa kalafo ke ho fokotsa khatello ea mesifa ea sphincter le ho lumella lijo le maro ho feta habonolo ka mpeng. Phekolo e ka kenyelletsa:

• Ho entoa ka chefo ea botulinum (Botox) - Sena se ka thusa ho theola mesifa ea sphincter. Leha ho le joalo, molemo o fela ka mor'a libeke kapa likhoeli tse 'maloa.
• Meriana, joalo ka li-nitrate tse sebetsang nako e telele kapa li-block channel tsa calcium - Meriana ena e ka sebelisoa ho phomotsa 'metso o ka tlase oa' metso. Empa ha ho na tharollo ea nako e telele ea ho phekola achalasia.
• Phekolo (e bitsoang myotomy) - Ts'ebetsong ena, mesifa e tlase ea sphincter e khaola.
• Ho atolosa (ho atoloha) ha setopo - Sena se etsoa nakong ea EGD ka ho otlolla LES ka sesebelisoa sa balune.

Mofani oa hao oa tlhokomelo ea bophelo a ka u thusa ho etsa qeto ea hore na ke kalafo efe e u loketseng.

Liphetho tsa ho buuoa le kalafo e sa sebetseng lia tšoana. Ka linako tse ling ho hlokahala kalafo e fetang e le 'ngoe.

Mathata a ka kenyelletsa:

• Backflow (regurgitation) ea asiti kapa lijo tse tsoang ka mpeng ho kena ka mpeng (reflux)
• Ho hema lijo tse kenang matšoafong (aspiration), tse ka bakang pneumonia
• Ho taboha (pherekano) ea 'metso

Bitsa mofani oa hau haeba:

• O na le bothata ba ho kwenya kapa ho kwenya ho bohloko
• Matšoao a hau a ntse a tsoela pele, le kalafo ea achalasia

Lisosa tse ngata tsa achalasia li ke ke tsa qojoa. Leha ho le joalo, kalafo e ka thusa ho thibela mathata.

Esophageal achalasia; Ho metsa mathata a metsi le metso; Cardiospasm - sekhahla se tlase sa 'mele sa sphincter

• Tsamaiso ea ho sila lijo
• Tsamaiso e kaholimo ea mala
• Achalasia - letoto la lihlooho tse

Falk GW, Katzka DA. Maloetse a 'metso. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 129.

Hamer PW, Konyana PJ. Tsamaiso ea achalasia le mathata a mang a motility ea 'metso. Ka: Griffin SM, Konyana PJ, eds. Ho Buuoa ka Oesophagogastric: Motsoalle ho Tloaelo ea Phekolo ea Ngaka. La 6th. Philadelphia, PA: Elsevier; 2019: khaolo ea 16.

Pandolfino JE, Kahrilas PJ. Ts'ebetso ea Esophageal neuromuscular le mathata a motility. Ka: Feldman M, Friedman LS, Brandt LJ, bahlophisi. Sleisenger le Fordtran's Mpeng le Mafu a Sebete. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 43.