Ukuthungatha into esiyithatha kalula. Kodwa kubantu abaphila ne- multiple sclerosis (MS) (MS), lesi senzo esilula singabangela ukucindezeleka okukhulu lapho bezithola bengenakukwazi ukugqoka, ukudla noma ukuphuza.
Odokotela babhekisela kulezi zibonakaliso njenge-dysphagia (ezitholakala ezigameni zesiGreki ezisho ukuthi "ubunzima" kanye ne- phagein lisho "ukudla"). Isimo esidabukisayo nesinye isikhathi esibi esingathinta noma yikuphi ukusuka kwesithathu kuya kwengxenye yabantu abahlala ne-MS ngesikhathi esithile esifundweni sabo sesifo.
Izimbangela
Ukugxila kuyinkimbinkimbi eyinkimbinkimbi ehilela kokubili izenzo zokuzikhethela kanye nezingqondo ezizimele. I-MS ingalimaza le nqubo ngokulimaza ezinye izinzwa nemigwaqo ye-neural engxenyeni yesistimu yezinzwa eziphakathi, eyaziwa njenge- stem yobuchopho , elawula le nqubo.
I-MS ingagcini nje ukubuthakathaka imisipha yokugwinya, ingaphazamisa isikhathi lapho i-windpipe (ebizwa ngokuthi i-trachea) ihloswe ukuba isondele uma ukudla kungena emgqeni wokudla (obizwa ngokuthi i-esophagus). Uma lokhu kuvalwa kungeke kwenzeke, umuntu angaphetha ukukhwehlela, ukuchofoza, noma ukuthola iziphuzo noma ukudla ngqo emaphashini abo.
Nakuba i-dysphagia ivame ukuthinta abantu abanezifo ezithuthukisiwe, ingenzeka ngempela kunoma yisiphi isigaba (ngisho nangaphambi kwesikhathi) ngezimpawu kusuka ekucashile kuya ezinzima.
I-Dysphagia ingaqhubeka ibuhlungu kakhulu ngenxa yokuntuleka kwamathambo okungapheli (okubizwa ngokuthi umlomo owomile ), nomlomo owomile ngumphumela ovamile wemijoqo ethile esetshenziselwa ukuphatha izimpawu ezihlukahlukene ze-MS njengezidakamizwa zokulwa nokucindezeleka kanye ne- anticholinergics esetshenziselwa ukuphatha izinkinga zokulawula isisu.
Izimpawu
I-Dysphagia ingaqala cishe ngokungabonakali kubantu abane-MS. Uma lokhu kwenzeka, umuntu angase aqale ukuthuma kancane emva kokuphuza noma ukuphuza ngengozi ukudla (ngokuvamile ukudla okudliwayo) ngendlela engavamile ngokuphelele.
Kuyinto kuphela uma inkinga iqhubeka njalo ukuthi abantu baqale ukuqaphela ukuthi inkinga yabo yokugwinya ingaphezu kokungavamile.
Ngalesi sikhathi, isenzo sokudla singabangela ukukhathazeka futhi nokwesaba, okuholela abanye ukuba badle kancane kancane ngenxa yokwesaba ukuchithwa.
Kuzo zonke, izimpawu ze-dysphagia zihlobene nesigaba esithile senqubo yokugwinya ephazamiseke yi-MS. Njengoba kunikezwa ukuthi le nqubo ingathatha imisipha ehlukene engama-30, izinhlobo nezinkinga zezimpawu zingashintsha ngokuphawulekayo kumuntu nomuntu futhi zingabandakanya:
- Kunzima ukuhlafuna
- Ukubola ngesikhathi noma emva kokugwinya ukudla
- Umatha owedlulele noma ukuwayeka
- Ukudla okunamathela emphinjeni
- Ukukhetha ukudla noma ukuphuza
- Ukuba nezwi elibuthakathaka, elithambile
- Ukungakwazi ukugwinya noma ukuhambisa ukudla emlonyeni
- Ukuhlunga noma ukuhlanza ukudla
- Ukuthola (ukufisa) ukudla noma uketshezi emaphashini
Ngenxa yobunzima bokugwinya, akuyona into engavamile ukuthi abantu abane-MS-bahlobanise i-dysphagia ukuzwa ukulahlekelwa isisindo, ukuphelelwa amandla kwamanzi nokuntuleka kokudla okunempilo njengoba isimo siqhubeka noma siba nzima.
Okubi nakakhulu, uma i-dysphagia ibangela ukudla noma uketshezi ukuthi kungene emaphashini, umuntu angathuthukisa i-abscesses noma i- aspiration pneumonia (uhlobo lwe-pneumonia okuyinto amabhaktheriya ekudleni okubangelwa ukutheleleka). Zombili ziyizimo eziyingozi futhi ziphakathi kwezimbangela eziyinhloko zokufa kubantu abane-MS ephakeme.
Ukuxilongwa
I-Dysphagia ingase ingabi yinkinga enkulu ezinkathini zokuqala futhi, eqinisweni, ingeke iqhubekele ekubeni yinto engaphezu kokucasula.
Noma kunjalo, kubalulekile ukweluleka udokotela wakho uma unenkinga yokugwinya-uma nje uhlola ukuthi kwenzekani nokuthi ubheke kangcono izimpawu ezihamba phambili.
Ukuxilongwa ngokuvamile kuhilela ukuhlolwa kwesinye noma ngaphezulu:
- Izivivinyo zezimoto zomlomo zenziwa ngumuntu wezinkinga zokukhuluma ukuze ubone ukuthi imisipha yakho ihamba kanjani emqaleni wakho futhi ulalele ukuthi izwi lakho lizwakala kanjani.
- I-videofluoroscopy uhlobo lwe-X ray oluqopha inqubo yokugwinya.
- I-endoscopy ye-Fiberoptic ihilela ukusebenzisa ikhamera encane efakwe ekhaleni lakho noma emphinjeni ukuze ubuke inqubo yokugwinya.
Ukuphathwa
Ngokuya ngobukhulu bezimpawu, ukwelashwa ngokuvamile kuzohilela ukuguqula indlela odla ngayo kunokusebenzisa noma yikuphi ukungenelela okuqondile kwezokwelapha.
Phakathi kokukhethwa okusemandleni:
- Ukuguqulwa kokudla kuyisisekelo sokugcina ukudla okunomsoco kanye nokuhlunga kahle. Lokhu kungabandakanya ukunciphisa ukudla okunzima ngamanzi noma ukukhetha ukudla nge-softer, ukulingana okuncane. Ukubamba amancane nokuhlafuna isikhathi eside kuyasiza. Ngokuvamile kungcono ukusebenza nomhlengikazi ukuqinisekisa ukuthi uhlangabezana nezidingo zakho zokudla okunomsoco.
- Ukulungisa isimo sekhanda nentamo yakho ngezinye izikhathi kunganciphisa ukugwinya ubunzima. Lena inqubo yesilingo nesiphambeko okungase ihilele ukucubungula i-chin yakho, ukuguqula ikhanda lakho, noma ukuhlezi phezulu ukuze uqinisekise kangcono ukuthi ukudla kuhla ngendlela efanele.
- Ukwenza ukuvivinya umzimba kwemisipha kuyinto into yokukhulumisana ngayo ingakwazi ukukufundisa futhi ingasiza ekuthuthukiseni ezinye zezinkinga zokugwinya okungenzeka uzizwe.
Ezimweni ezimbi kakhulu, kungadingeka ithubhu yokudla (ukudla okunomsoco) ukuletha ukudla kanye nezikhukhula ngqo esiswini.
Izwi elivela
Njengezimpawu eziningi ze-MS, ukwelapha i-dysphagia kudinga ukuhlanganiswa kwemithi yokwenza ngcono ukudla okunomsoco, ukunciphisa ukukhathazeka kwakho, ukuvimbela ukutheleleka nokulahlekelwa isisindo, futhi uphathe imiphumela engokwengqondo nokunye komzimba we-dysphagia yakho (isibonelo, ukulahlekelwa injabulo ngesikhathi sokudla noma ukuzwa ukhathele ngesikhathi sokudla).
Qinisekisa ukuthi uhlala uxhumane nodokotela wakho kanye nomuntu okhuluma ulimi lwezolimi ngokuphathelene nokugwinya kwakho, njengoba kungase kuphele futhi kudlule isikhathi, futhi kudinga ushintsho ohlelweni lwakho lwezokwelapha.
> Imithombo
> Miller, R. noBrithton, D. (2011) "Ukudambisa izifo zohlelo lwe-Central Nervous System (CNS)." I-Dysphagia e-Neuromuscular Disease. I-San Diego, California: I-Plural Publishing, iphe 161-183.
> National MS Society. Dysphagia.