Abantu abaningi abaphila nezifo ze-neurological, noma abaphila ngesifo sohlangothi, abanenkinga yokugwinya. Abantu abahlala ne- dysphagia banenkinga yokudla, ukuphuza nokuthatha imithi. Uma kungatholakali futhi kulawulwa ngokwanele, i-dysphagia ingaholela ekutheni okunomsoco omfutho , i- aspiration pneumonia nokukhubazeka okuqhubekayo.
Izimpawu zeDysphagia
I-Dysphagia ibhekene nobunzima bokugwinya.
Izimo eziningana ze-neurological, njenge-stroke, ukuwohloka komqondo, ukukhubazeka kwesibindi kanye ne-multiple sclerosis kungabangela i-dysphagia uma imisipha yokugwinya iba buthakathaka noma ilahlekelwe ukusebenzisana. Abantu abahlala ne-dysphagia bangathola izimpawu ezilandelayo uma bezama ukugwinya :
- Ukuchofoza
- Ukushaya noma ukugwedla
- I-liquid ephuma ekhaleni
- Ukudla okubanjwa emaphashini
- Izwi eliphansi
- Kudonsa
- Ukungabi nokukhuluma kolimi
- Ukulahlekelwa kwe-gag reflex
Ukuvotela okujwayelekile nokugaya ukudla
Isinyathelo sokuqala sokugwinya ukubunjwa kwe-bolus yokudla. Lesi sinyathelo singakwazi ukukhubazeka kakhulu uma une-dysphagia.
I-bolus yokudla iyinqwaba yokudla okwakhiwa emlonyeni ngesikhathi sokuqala kokugaya. Ukwakhiwa kwe-bolus yokudla kwenza inqubo yokugwinya ilula futhi iphephile futhi ibuye iqale inqubo yokudla kokudla (ukuphuka) ukuze uketshezi lwezakhi kungenzeke esiswini nasezintweni ezincane.
I-bolus yokudla yakhiwa njengokudla okuhlanjululwayo, okugcoba ngamathe, okuxutshwe nama-enzyme futhi kwakha ubukhulu obumbene obumbene. I-bolus ihlala emlonyeni womlomo (umlomo) kuze kufike inqubo yokugwinya .
Ukwakhiwa kokuqala kwe-bolus kuncike ezinyathelweni ezine zokucubungula ngomlomo okungaphazanyiswa uma une-dysphagia.
Lezi zinyathelo zifaka:
- Ukuhambisa ukudla okuvela emlonyeni kuya emazinyo
- Ukuthutha ukudla ngemuva komlomo ukwakha i-bolus
- Ukuhambisa i-bolus ngemuva kolimi ukugwinya
- Ukufaka i-bolus
Uma imisipha yomlomo neyomphimbo iqala inqubo yokugwinya, i-bolus yokudla ihlehlisa phansi isisindo ngokushesha, isekelwe ukunyakaza okungenakuzikhethela (hhayi ngokuzibophezela) ukunyakaza kwemisipha ye-esophagus. I-bolus isuke idlula emisipha ehlukanisa isisu esiswini, okuthiwa i-sphincter esophageal. Le misipha ivala emva kokungena kwesisu, ukuze ukudla kuhlale esiswini lapho kuqhutshelwa khona lapho kuqhutshwa inqubo yokugaya esiswini .
Njengoba i-bolus ingena esiswini, ingena ekuvuneni kwesisu. Phakathi nenqubo yokugaya esiswini, i-bolus isukhemikhali esetshenziselwa ama-acids nama-enzyme akhiqizwa esiswini. Ekugcineni, njengoba i-bolus iqhubeka ephukile, ezinye izakhi ezitholakala ku-bolus yokudla ziyangena esiswini. Iningi lezinto ezihambayo ziyahamba emathunjini amancane ukuze kuqhutshekwe ukuwohloka nokubamba.
Ukwakhiwa kweBolus nokuhlukaniswa yizinyathelo ezibalulekile ohlelweni lokugaya ngezizathu eziningana.
Okokuqala, ukubunjwa kwe-bolus yokudla okunethezekile nokunezinyosi kuvumela ukudla ukuthi kuhambe kalula ezindaweni ezihlukahlukene ngaphakathi kwesistimu yokugaya ukudla. Futhi, ukuguqulwa kokugqoka nokubunjwa kokudla kuqala inqubo yokugaya amakhemikhali, okuyinto inqubo lapho ukudla esikudlayo kwehlelwa khona zibe yizinhlayiya ezincane ngokwanele ukuze umzimba ungenele izingxenye zokudla okunomsoco egazini. Lezi zici zokukhiqizwa kokudla kwe-bolus ekugcineni zilawula izinga lapho ukudla nokudla okunomsoco kungena khona futhi kukhishwe emzimbeni.
Ngokuvamile, i-bolus yokudla ikhiwa ngendlela engaguquki bese ihamba ngendlela yokugaya kahle ngokuqhubekayo nokudilizwa esiswini nasemathunjini amancane.
Kodwa-ke, i-dysphagia ingalimaza ukubunjwa okuphumelelayo kwe-bolus yokudla.
Izwi elivela
Uma uhlangabezane ne-dysphagia, izinkinga zakho zokugwinya zingase zithuthuke ngokwabo ngokuhamba kwesikhathi. Noma kunjalo, ayikho isiqinisekiso sokuthi uzokwenza ngaphandle kokungenelela. Kunezindlela eziningana ongazuza ngamakhono angcono okugwinya uma une-dysphagia.
Abaphathi be-dysphagia bahlanganisa ukulungiswa kwendlela yokuphila, ukuvivinya umzimba kanye nokwelashwa.
- Ukuguqula indlela yokuphila: Izinguquko zokuhamba, kokubili kokumi nokuhlala, kanye nokudla kancane zizindlela ezilula ezinganciphisa inqubo yokugwinya. Uketshezi oluncibilikisayo, njengamanzi, kunzima ukugwinya uma une-dysphagia. Ukushintsha ukwanda kwamanzi nokudla ukudla okulula kungasiza.
- Ukuzivocavoca: Ukwelashwa kwe-dysphagia kuhilela ukwelashwa ngosizo lwezinkulumo, ulimi, abahlinzeki bokusebenza noma abagulayo. Ukuzivocavoca kolwimi , izindebe , umphimbo, nomlomo kuzokhululeka futhi kuqinise imisipha elawula ukugwinya nokwandisa ukuguquguquka kwendawo.
- Ukwelashwa kwezokwelapha: Kukhona imithi yokwelashwa engasiza ukuvula imisipha yomphimbo ukuze kugwinyeke lula. Ezinye izinhlobo zokwelapha zingabandakanya izinqubo ezifana nokuvuselela kagesi nge-neuromuscular (NMES).
> Ukufunda okuqhubekayo:
> I-anatomy ne-physiology yokugwinya okungavamile ku-oropharyngeal dysphagia, i-Sasegbon A, i-Hamdy S, i-Neurogastroenterol Motil. 2017 Nov; 29 (11). i-doi: 10.1111 / nmo.13100. Epub 2017 Meyi 25.