USally wayenenkinga yokudla. Wayevame ukuzwa ukuthi ukudla kwakunamathela lapho edla, okwakwenza angakhululekile. U-Adamu oneminyaka engu-4 wayekhula kabi, evame ukucasuka etafuleni lokudla, futhi wayevame ukula ukudla. Kuvela ukuthi bobabili uSally no-Adamu babe nesimo esifanayo: i-eosinophilic esophagitis (EoE).
Yini Eosinophilic Esophagitis (EoE)?
I-eosinophilic isophagitis iyingxenye yokudla kokungezwani, okuyingxenye yokugwinya kwesifo.
I-EoE isimiso se-immune system esingapheli, esanda kutholakala umphakathi wezokwelapha. Amanani okuxilongwa ayelokhu ekhula eminyakeni eyishumi edlule, efana nezinga elikhulayo lokuxilongwa kwezifo ezibangelwa ukungezwani komzimba kanye nokuxilongwa kwe-asthma.
Ama-eosinophils amangqamuzana egazi amhlophe avame ukutholakala endleleni yakho yokugaya ukudla, kepha e-EoE, akha ngaphakathi kwesishubhu (i-tube ehlanganisela umphimbo kuya esiswini; futhi ibizwa ngokuthi i-tube yokudla noma i-gullet). Ama-eosinophils akhiqiza amaprotheni, okubangela ukuvuvukala noma ukuvuvukala. Lokhu kungaholela ekunqandeni nasekunciphiseni isikhuphuka phezu kwesikhathi kanye nokubunjwa kwezicubu ezifubeni emgodini wesifo sakho.
Ama-eosinophils akha endaweni yokuthi umzimba ulalele i-allergen yokudla, ezinye izifo ezifana ne-pollen, noma ihlobene ne-reflux ye-acid. Abantu abangaba ngu-50% abane-EoE nabo banomzimba we-season or asthma. Umonakalo we-esophagus wenza kube nzima ukugwinya noma kungaholela ekuzweni kokudla okunamathela.
Izimpawu
Izingane nabantu abadala bangase babone izimpawu ezihlobene ne-EoE ngokuhlukile.
Abantu abadala bangaba nezimpawu ezihlukahlukene, kubandakanya :
- Kunzima ukugwinya, okubizwa nangokuthi i-dysphagia
- Ukudla kokudla (ukudla kufakwa emva kokugwinya)
- Ubuhlungu be-chest bufana nokukhwabanisa, okungaxazululwa ngama-antacids
- Ubuhlungu besisu obuphezulu
- Izimpawu ezingaxazululwa nemithi yokwelapha ye-reflux (GERD) ye-gastroesophageal (GERD)
- Ukuphindaphinda (ukugeleza emuva kokudla okungaxhunyiwe)
Izimpawu zezingane zingabandakanya lokhu okulandelayo:
- Ukuthukuthela
- Izinkinga ngokudla
- Ukuvota
- Ubuhlungu besisu
- Inkinga igwinya
- Umqondo wokudla ufakwa
- Ukunciphisa umzimba kanye nokukhula (isib. Ukwehluleka ukukhula, ukungondleki, ukungapheli komzimba)
- Akuphenduli imithi ye-GERD
Izingozi Zezingozi
Kunezici ezimbalwa ezenza ukuba i-EoE ithuthuke kakhulu, kodwa ubufakazi obuxhumanisa ukuthi, nini futhi uma i-EoE izokwenzeka namanje kuvela. Kodwa-ke, kunezici ezimbalwa eziyingozi eziye zabonwa:
- Ubulili : I-EOE ivame kakhulu kubesilisa kunabesifazane.
- Izakhi zofuzo : I-EoE ibonakala ihlobene nezakhi zofuzo; uma ilungu lomndeni linama-EoE, ingozi iphezulu ekuthuthukiseni i-EoE.
- Ukuphefumula nokuphefumula : Labo bantu abanezifo zokudla, ezinye izifo, kanye ne-asthma zisengozini enkulu yokuthuthukisa i-EoE.
- Lapho uhlala khona : Ukuhlala endaweni ebandayo noma eyomile kwandisa ingozi yakho ye-EoE.
- Isikhathi sonyaka : Abantu bangase bahlolwe phakathi kwentwasahlobo nokuwa lapho izilonda zendawo zemvelo ziphakeme futhi abantu bangaphandle kakhulu.
Ukuxilongwa
Kuhlolwa okuningana ukuze kuhlolwe i-EoE futhi kufaka phakathi i-endoscopy engenayo ne-biopsy.
I-endoscopy ephezulu isebenzisa ithubhu elide elincane nekhamera ekugcineni efakwe emlonyeni bese phansi phansi. Le nqubo ivumela udokotela ukuba abuke isifo sakho futhi abuke ukuvuvukala nokuvuvukala, noma yikuphi okungajwayelekile okuhlobene ne-EoE. I-biopsy ihilela ukuthatha isampula yezicubu zakho zokuxilonga ezivela ezindaweni eziningana (ngokuvamile ezimbili kuya kwezine).
Uma ucatshangwa ukuthi une-EoE, udokotela wakho angenza izivivinyo ezengeziwe ezifana nokuhlolwa kwegazi, ukuhlolwa kwemithi, ukuhlolwa kwe-patch yokudla, nokuguqulwa kokudla.
Ukwelapha
Uma uthola ukuthi une-EoE, uzodinga ukwelashwa okuqhubekayo njengoba i-EoE isifo esingapheli, sokubuyela emuva.
Lezi zindlela ezijwayelekile kakhulu zokwelashwa; zingase zisetshenziswe ngokuhlanganiswa ngenjongo yokwelapha ephumelela kakhulu:
Ukudla
Kunokudla okuvamile okuphakathi kuka-10-15 okubangelwa i-EoE, kodwa umzimba ungasabela kunoma yikuphi ukudla. Ukudla kwe-Trigger kufanele kususwe ekudleni isikhathi eside ukuze izimpawu zixazululwe. Ukucabangela kwe-EoE ukuthi umzimba wakho ungase usabele ekudleni odla nsuku zonke-okungaveli ukuthi kuyinkinga kuwe. Ezinye zezifo ezivame kakhulu zokudla ezibangelwa i-EoE yizobisi, ukolweni , iqanda kanye ne- soy .
Uma ukudla noma ukudla okungaphezu kwesisodwa kubangela izimpawu zakho, lezo zokudla zizoqedwa ekudleni kwakho. Ezinye izimo ze-EoE zidinga ukuguqulwa okuningi kokudla. Ukudla kokuqeda kungase kuyingxenye yelungiselelo lokwelapha. Kwezinye izimo, amafomu akhethekile abizwa ngokuthi ukudla okuyisisekelo asetshenziselwa ukuqeda yonke imithombo yokudla yamaprotheni ngenkathi ehlanganisa isidingo somuntu siqu, ikakhulukazi uma ukudla okuningi kudingeka kususwe ekudleni.
Imithi
Imithi eminingi ingasetshenziswa ekwelapheni i-EoE. Ngokujwayelekile, i-blocker ye-acid iyalingwa kuqala, kodwa abanye abantu bangase bangabonisi ukuthuthukiswa kwesibonakaliso. I-steroid ye-topical eyanikezwa njenge-puff noma ixubene ne-slurry ingasetshenziswa. Lokhu kungasiza ukukhulisa ukuvuvukala kwabanye abantu ngaphandle kwemiphumela emibi ehambisana ne-steroids ngoba engangeni emzimbeni wegazi. Uma le mithi ingasebenzi, i-steroids, njenge-prednisone, ingahle ibekiwe. I-steroids inganciphisa ukwakhiwa kwama-eosinophils futhi uvumele umphimbo wakho uphulukise. Abanye abantu bangase babe nge-steroids njalo.
Ukuxuba
Kulabo abahlangabezana nesimiso esincane (esibizwa ngokuthi yi-strictures), inqubo ebizwa ngokuthi i-dilation inganconywa. Le nqubo ivula isisindo futhi yenza ukugwinya kube lula. Kodwa-ke, kunezingozi zokuqothulwa kwe-esophagusal and perforation. I-Dilation ayibhekisi ukuvuvukala okuyisisekelo.
> Izinsiza:
> Furuta et al. I-Eosinophilic Esophagitis Ezinganeni Nabantu Abadala: Ukubuyekezwa Okuhlelekile Nezincomo Zokuqapha Nokunakekelwa. I-Gastroenterology. 2007. 133: 1342-1363.
> Liacouras CA. I-Eosinophilic esophagitis: Izincomo zokubuyekezwa kokubuyekezwa kwezingane kanye nabantu abadala. I-Journal ye -ergy and Immunology Clinic. 2011; 128: 3-20.
> I-American Academy Yezokwelapha, i-Asthma, ne-Immunology: http://www.aaaai.org/conditions-and-treatments/related-conditions/eosinophilic-esophagitis.aspx