I-Gastroparesis, ebizwa nangokuthi ukulibaleka kwe-gastric ephuzile, kuyisifo lapho isisu esithatha isikhathi eside ukuze singenalutho okuqukethwe. Kuvame ukuvela kubantu abanesifo sikashukela sohlobo 1 noma uhlobo lwesifo sikashukela sohlobo lwesibili.
Sibutsetelo
I-Gastroparesis yenzeke lapho izinzwa zesisu zisengozini noma ziyeka ukusebenza. I-vagus nererve ilawula ukuhamba kokudla nge-tract digestive.
Uma i-vagus nerve ilimazekile, imisipha yesisu nezinambuzane azisebenzi ngendlela evamile futhi ukunyakaza kokudla kuncipha noma kumile.
Isifo sikashukela singalimaza i-vagus nerve uma amazinga e-glucose egazi ehlala phezulu esikhathini eside. Igazi eliphakeme eliphezulu lidala ukushintsha kwamakhemikhali emithanjeni bese kulimaza imithwalo yegazi ethwala oksijeni kanye nezakhi ezithombeni.
Izimbangela
I-Gastroparesis ivame ukubangelwa yi:
- Isifo sikashukela
- Ama-syndromes we-postviral
- Anorexia nervosa
- Ukwelashwa esiswini noma nge- vagus nerve
- Imithi, ikakhulukazi i-anticholinergics nama-narcotics (izidakamizwa eziphuza ukuchotshozwa emathunjini)
- Isifo se-reflux se-gastroesophageal (okuvamile)
- Izinkinga ezibuhlungu ze-muscle, njenge-amyloidosis ne- scleroderma
- Izifo zesimiso sezinzwa, kuhlanganise nesisu esiswini nesifo sikaParkinson
- Izinkinga zemetabolic, kuhlanganise ne- hypothyroidism
Izimpawu Nezibonakaliso
Lezi zimpawu zingaba mnene noma ezinzima, kuye ngokuthi umuntu:
- Ukuguquka kwenhliziyo
- I-nausea
- Ukuvuthwa kokudla okungaxhunyiwe
- Ukuzwa kwangempela kokugcwele lapho udla
- Ukulahlekelwa kwesisindo
- Ukuvimbela kwesisu
- Amazinga we-glucose wegazi
- Ukungabi nesifiso
- Reflux ye-gstroesophageal (GERD)
- I-spasms nodonga lwesisu
Izivivinyo zokuxilonga
Ukuxilongwa kwe-gastroparesis kuqinisekiswa ngokusebenzisa eyodwa noma ngaphezulu kokuhlolwa okulandelayo:
- I-Barium x-ray. Ngemuva kokuzila ukudla amahora angu-12, uzophuza uketshezi olubi olubizwa nge-barium, olugqoke ngaphakathi kwesisu, okwenza luvezwe kwi-ray ray. Ngokujwayelekile, isisu ngeke sibe nalutho kukho konke ukudla emva kwamahora angu-12 wokuzila. Uma i-x-ray ibonisa ukudla esiswini, kungenzeka ukuthi i-gastroparesis. Uma i-x-ray ikhombisa isisu esingenalutho kepha udokotela usalokhu esola ukuthi usephuzile ukuthulisa, kungase kudingeke uphinde uhlole olunye usuku. Ngolunye usuku olulodwa, umuntu one-gastroparesis angadla ukudla ngokujwayelekile, anikeze umphumela wokuhlola ongajwayelekile. Uma unesifo sikashukela, udokotela wakho angase abe nemiyalelo ekhethekile mayelana nokuzila ukudla.
- Barium beefsteak ukudla. Uyodla ukudla okuqukethe i-barium, ngaleyo ndlela uvumela i-radiologist ukuba ibukele isisu sakho njengoba igcina ukudla. Isikhathi esithathayo sokudla kwesibindi sokugaya futhi sishiye isisu sinika udokotela umbono wokuthi isisu sisasebenza kangakanani. Lokhu kuhlolwa kungasiza ukuthola izinkinga zokuthutha ezingabonakali kwi-ray ye-barium x ray. Eqinisweni, abantu abane-gastroparesis ehlobene nesifo sikashukela bavame ukugaya amanzi ngokujwayelekile, ngakho-ke ukudla kwe-barium beefsteak kungasiza kakhulu.
- I-radioisotope yokuskena kwe-gastric-ekuphumuleni. Uyodla ukudla okuqukethe i-radioisotope, imithi encane emisakazweni eyobonakala ku-scan. Umthamo wemisindo evela kwi-radioisotope incane futhi ayingozi. Emva kokudla, uzolala phansi komshini othola i-radioisotope futhi ubonisa isithombe sokudla esiswini nokuthi kushiya masinyane isisu. I-Gastroparesis ithola ukuthi uma ngaphezu kwengxenye yokudla ihlala esiswini ngemva kwamahora amabili.
- I-manometry ye-gastric. Lokhu kuhlola kulungisa umsebenzi wegesi nesisisu esiswini. Udokotela udlula ithini elincane elingaphansi komphimbo ukuya esiswini. Ithebhulethi iqukethe ucingo oluthatha isilinganiso sezenzo zikagesi nezomzimba njengesisu njengoba kugoba uketshezi nokudla okuqinile. Izilinganiso zibonisa ukuthi isisu sisasebenza nokuthi ngabe kukhona ukulibaziseka kokugaya.
- Ukuhlolwa kwegazi. Udokotela angase futhi ahlele ukuhlolwa kwe-laboratory ukuhlola ukubala kwegazi nokukala amazinga amakhemikhali ne-electrolyte.
Ukulawula izimbangela ze-gastroparesis ngaphandle kwesifo sikashukela, udokotela angenza i- endoscopy engenhla noma i-ultrasound.
- Endoscopy ephezulu. Ngemva kokunika isidumbu, udokotela udlula ithini elide, elincanyana, elibizwa ngokuthi i-endoscope, ngomlomo futhi ngokuyinhloko liqondisa phansi isisu ngaphakathi esiswini. Nge-endoscope, udokotela angabheka ubhedu besisu ukuze ahlole noma yikuphi okungajwayelekile.
- I-Ultrasound. Ukulawula isifo se-gallbladder noma i-pancreatitis njengomthombo wenkinga, ungaba nokuhlolwa kwe-ultrasound, okusebenzisa amagagasi omsindo ongenangqondo ukuchaza nokuchaza isimo se-gallbladder ne-pancreas.
Izinkinga
Uma ukudla kuhlala isikhathi eside kakhulu esiswini, kungabangela izinkinga ezinjenge-bacterial overgrowth kusukela kokuvuthwa kokudla. Futhi, ukudla kungaba nzima ukuza emasimini aqinile, abizwa ngokuthi ama-bezoars, angabangela isicanucanu, ukuhlanza nokuvimbela esiswini. Izinyosi zingaba yingozi uma zivimbela ukudla okuphakathi kwamathumbu amancane.
I-Gastroparesis ingenza isifo sikashukela sibi nakakhulu ngokungeza ubunzima bokulawula i-glucose yegazi. Uma ukudla okwephuzile esiswini sekugcineni kungena emathunjini amancane futhi kungenele, amazinga egazi le-glucose aphakama.
Njengoba i-gastroparesis yenza isisu singenakulinganiswa, amazinga egazi lomuntu wegazi angasifaka futhi azinzima ukulawula.
Ukwelapha
Umgomo oyinhloko wokwelashwa we-gastroparesis ohlobene nesifo sikashukela ukuphinde uphinde ulawule amazinga egazi le-glucose. Ukwelapha kufaka i-insulin, imithi yomlomo, izinguquko kulokho nesikhathi odlayo, futhi, ezimweni ezimbi, amashubhu okudla kanye nokudla okudliwayo.
Kubalulekile ukuqaphela ukuthi ezimweni eziningi ukwelashwa akuphili i-gastroparesis-ngokuvamile kuvamile.
Ukwelashwa kukusiza ukuba uphathe isimo ukuze ube nempilo enhle futhi ukhululekile ngangokunokwenzeka.
I-insulini ye-Blood Glucose Control
Uma une-gastroparesis, ukudla kwakho kuthatha kancane kancane futhi ngezikhathi ezingalindelekile. Ukulawula i-glucose yegazi, kungase kudingeke ukuthi:
- Thatha i-insulin kaningi
- Thatha i-insulin yakho ngemuva kokuthi udle esikhundleni salokho ngaphambili
- Hlola amazinga akho wegazi glucose njalo emva kokudla futhi uhlinzeke i-insulin uma kunesidingo
Udokotela wakho uzokunikeza imiyalelo ethize ngokusekelwe ezidingo zakho ezithile.
Imithi
Izidakamizwa eziningana zisetshenziselwa ukwelapha i-gastroparesis. Udokotela wakho angase azame izidakamizwa ezahlukene noma ukuhlanganiswa kwezidakamizwa ukuze uthole ukwelashwa okuphumelela kakhulu, kuhlanganise:
- I-Metoclopramide (Reglan). Lesi sidakamizwa sishukumisa iziphambano zomzimba zesisu ukusiza ukudla okungenalutho. Futhi kusiza ukunciphisa izinambuzane nokuhlanza. I-Metoclopramide ithathwa amaminithi angu-20 kuya kwangu-30 ngaphambi kokudla nangesikhathi sokulala. Imiphumela emibi yalesi sidakamizwa ihlanganisa ukukhathala, ukulala, futhi ngezinye izikhathi ukucindezeleka, ukukhathazeka, nezinkinga zokunyakaza ngokomzimba.
- I-Erythromycin. Le mithi elwa namagciwane iphinde ithuthukise ukukhipha isisu. Isebenza ngokwandisa izithintelo ezihambisa ukudla ngesisu. Imithelela emibi ihlanganisa ukunxanxathela, ukuhlanza, nezikhwama zesisu.
- I-Domperidone. I-US Yokudla Nezidakamizwa Zokulawulwa Kwezidakamizwa ibukeza i-domperidone, eye isetshenziswe kwenye indawo emhlabeni ukuphatha i-gastroparesis. Kuyinto ejenti yokukhuphula efana ne-metoclopramide. Kubuye kusize nge-nausea.
- Ezinye imithi. Ezinye imithi ingasetshenziswa ukuphatha izimpawu nezinkinga ezihlobene ne-gastroparesis. Isibonelo, i-antiemetic ingasiza nge-nausea nokuhlanza. Ama-antibiotics azosula ukutheleleka kwebhaktheriya. Uma une-bezoar, udokotela angasebenzisa i-endoscope ukujova imithi ezoyiqeda.
Izinguquko Zezinkukhu
Ukushintsha imikhuba yakho yokudla kungasiza ukulawula i-gastroparesis. Udokotela wakho noma u-dietitian uzokunikeza iziyalezo eziqondile, kodwa ungase ucelwe ukuba udle ukudla okuyisithupha okuncane ngosuku kunamakhulu amathathu amakhulu. Uma ukudla okuncane kungena esiswini ngaso sonke isikhathi uma udla, kungase kungagcwaliseki ngokweqile.
Futhi, udokotela wakho noma u-dietitian angase asikisele ukuthi uzame ukudla okwezinye izikhathi ngosuku kuze kube yilapho amazinga egazi legazi lakho ezinzile futhi i-gastroparesis ilungiswa.
Ukudla okunomsoco kunika zonke izakhi ezitholakala ekudleni okuqinile, kodwa kungadlula esiswini kalula futhi ngokushesha.
Ngaphezu kwalokho, udokotela wakho angancoma ukuthi ugweme ukudla okunamafutha aphezulu kanye ne-high fiber. Amafutha ngokwehlisa ngokwehlisa ukugaya-inkinga awudingi uma une-gastroparesis-ne-fibre kunzima ukugaya. Ezinye ukudla okuphezulu-fiber, njenge-oranges ne-broccoli, aqukethe izinto ezingenakugaya. Gwema lokhu kudla ngoba ingxenye ye-indigestible izohlala isisu sakho eside futhi mhlawumbe ifomu.
Isitembu sokudla
Uma ezinye izindlela zingasebenzi, ungadinga ukuhlinzwa ukuze ufake ithubhu yokudla. I-tube, ebizwa ngokuthi i-jejunostomy tube, ifakwa ngesikhumba esikhumulweni sakho emathunjini amancane. I-tube yokudla ikuvumela ukuba ufake izakhi ngendlela efanele ngqo emathunjini amancane, ngokudlula isisu ngokuphelele. Uzothola ukudla okhethekile ketshezi okumele usebenzise ne-tube.
Ijjunostomy iwusizo ngokukhethekile lapho i-gastroparesis ivimbela izakhi nemithi edingekayo ukulawula amazinga weglucose egazi ekufinyeleleni kwegazi.
Ngokugwema umthombo wenkinga-isisu-nokubeka izakhi nemithi ngqo emathunjini amancane, uqinisekisa ukuthi le mikhiqizo iguzwa futhi ihanjiswe egazini lakho ngokushesha. I-tube yejjunostomy ingaba yesikhashana futhi isetshenziswa kuphela uma kunesidingo lapho i-gastroparesis inzima.
Ukudla okunamazinyo
Ukudla kokubeletha kusho ukuletha izakhi zomzimba ngokuqondile emzimbeni wegazi, ngokweqile uhlelo lokugaya. Udokotela wakho uzobeka ithubhu elincanyana, elibizwa ngokuthi i-catheter, esifubeni se-chest, eshiya ukuvula kuso ngaphandle kwesikhumba.
Ukuze ukondle, unamathisela isikhwama esinamakhilogremu noma imithi ekhethini. Umswakama ungena emzimbeni wakho ngegazi. Udokotela wakho uzokutshela ukuthi hlobo luni lokudla okunomsoco oluzosetshenziswa.
Le ndlela iyindlela ehlukile ye-tube yejjunostomy futhi ngokuvamile yindlela yesikhashana yokuthola isikhala esinzima se-gastroparesis. Ukudla kokubeletha kusetshenziselwa kuphela lapho i-gastroparesis inzima futhi ingasizwa ezinye izindlela.
Izinketho ezintsha
- I-neurostimulator ye-gastric ("pacemaker") ithuthukiswe ukusiza abantu abane-gastroparesis. I-pacemaker ibhethri-eqhutshwa, idivayisi ye-elekthronikhi eyenziwa ngokuhlinzwa. It uletha amapulisi kagesi amancane avuselela ukuvimbela isisu ukuze ukudla kuguqulwe futhi kususwe kusuka esiswini kuya emathunjini. Ukugqugquzela kagesi kubuye kusize ukulawula ukunxanxathela nokuhlanza okuhambisana ne-gastroparesis.
- Ukusetshenziswa kwe-toxin ye-botulinum kuye kwaboniswa ukuthuthukisa ukuthutha kwesisu kanye nezimpawu ze-gastroparesis ngokunciphisa izinhlangothi ezithatha isikhathi eside emisipha phakathi kwesisu nesisu esincane (pyloric sphincter). I-toxin ifakwe ku-sphincter ye-pyloric.
Izwi elivela
Lolu lwazi oluningi lokubamba, ngakho-ke nansi amaphuzu ayisithupha abalulekile okufanele uwakhumbule:
- I-Gastroparesis ingenzeka kubantu abane-type 1 yesifo sikashukela noma uhlobo lwesifo sikashukela sesi-2.
- I-Gastroparesis ingumphumela wokulimala kwenzalo ye-vagus, elawula ukuhamba kokudla ngokusebenzisa uhlelo lokugaya ukudla. Esikhundleni sokudla okuhamba ngendlela ye-digestive ngokuvamile, kugcinwa esiswini.
- I-vagus nerve ibhidliza emva kweminyaka yokulawulwa kwe-glucose yegazi, okuholela ekutheni i-gastroparesis. Kanti, i-gastroparesis inengxenye yokulawula ukulawulwa kwegazi kwegazi.
- Izimpawu ze-gastroparesis zihlanganisa ukugcwaliswa kokuqala, isicanucanu, ukuhlanza nokulahlekelwa isisindo.
- I-Gastroparesis itholakale ngezivivinyo ezifana ne-x-ray, i-manometry, ne-scanning.
- Ukwelashwa kufaka izinguquko lapho udla khona nalokho okudlayo, ukuguqula uhlobo lwe-insulin kanye nesikhathi sokujova, imithi yomlomo, ijjunostomy, ukondleka kokubeletha, i-pacemaker ye-gastric, noma i-botulinum toxin.
Ukuze uthole olunye ulwazi, bheka i-NIDDK's Division of Digestive Diseases and Nutrition. Besekela ucwaningo oluyisisekelo nolomtholampilo ezinkingeni zomzimba zamathumbu, kubandakanya i-gastroparesis. Phakathi kwezinye izindawo, abacwaningi bacwaninga ukuthi imithi yokuhlola inganciphisa noma iyanciphisa izimpawu ze-gastroparesis, njengokubhuqa, ubuhlungu besisu, isicashu, nokuhlanza, noma unciphise isikhathi esidinga isisu sokungena okuqukethwe okulandela ukudla okujwayelekile.