I-Dysphagia: Izimbangela, Izimpawu kanye Nokwelashwa

I-Dysphagia yisimo sezokwelapha esingaphazamisa inqubo eyinkimbinkimbi, yezigaba eziningi ezibalulekile zokugwinya okuphephile, okuphumelelayo. Lesi sihloko solwazi sinikeza ukubuka konke kwe-dysphagia, okuhlanganisa izimpawu nezimpawu ezivamile abantu abangase babe nazo.

Iyini i-Dysphagia?

I-Dysphagia isho ubunzima noma ubuhlungu lapho uzama ukugwinya ukudla, uketshezi noma amathe. Kubonisa inqubo ephazamisekile, eyinkimbinkimbi, edidiyelwe edinga izicubu nezinzwa ukuhambisa impahla isuka emlonyeni iye emlonyeni. isisu. Izimo ze-Dysphagia zisukela ebunzimeni obuncane bokuqalisa ukugwinya kuye emandleni okonakala ngokwedlulele okuthutha zonke izinto eziqinile noketshezi.

• I-Dysphagia ivimbela ukuthuthwa okushelelayo kwe-bolus yokudla kusuka emgodini womlomo wehle ngepharynx (emphinjeni) kanye nomminzo ukuya esiswini. 
• Lokhu kungase kubangele izimpawu zokungasebenzi kahle kokugwinya.
• Ubunzima obuncane bezikhathi ezithile bokugwinya ngokuvamile abubonisi isifo esibucayi ngokwaso, ikakhulukazi uma kukhona ezinye izici ezifana nesivinini sokudla noma ukuthungwa kokudla. 
• Nokho, okungapheliyo ikhono elikhubazekile lokugwinya ngokuphepha phakathi namasonto kuya eminyakeni kungase kubonise isimo sezempilo esidinga ukuhlolwa nokwelashwa okulungiselelwe okuvela kodokotela be-gastroenterologist.

Izinhlobo ze-Dysphagia

Kunezigaba ezimbili eziyinhloko ezisetshenziselwa ukuhlukaniswa kwe-dysphagia:

1. I-Oropharyngeal Dysphagia: Lolu hlobo oluncane lubhekisela ebunzimeni bokuqalisa ukulandelana kokugwinya nokuhambisa imbobo yokudla isuka emlonyeni ibuyele emphinjeni (emphinjeni). Izici ezinomthelela zihlanganisa:

• Izimo zezinzwa ezifana nesifo sika-Parkinson noma unhlangothi zithinta amasignali okulawula
• Ukulimala kwezinzwa zomzimba ngenxa yokulimala, ukuhlinzwa noma imisebe
• Ubuthakathaka bemisipha buvimbela ukukhiqizwa kwamandla okwanele
• Imiphumela emibi ye umdlavuza zokwelapha

2. I-Esophageal Dysphagia: Lolu hlobo lubonisa izinkinga eziphakamayo lapho umzamo wokugwinya ufinyelela esigabeni sokuhamba kommizo. Izimpawu zihlanganisa ukudla kubambeke ngasemqaleni noma ezindaweni ezisesifubeni. Izinkinga kungaba:

• Ukulimala noma ukuncishiswa kwezicubu zephaseji (imigqa)
• Isifo se-reflux se-gastroesophageal eroding ulwelwesi
• Amathumba avimba ukugeleza
• Izinto zangaphandle ezifakwe emhubheni womminzo

Ukuhlukaniswa okufanele kuqondise ukuhlolwa kwe-dysphagia nokuhlelwa kokuphatha ngokuvumela odokotela ukuthi baqondise i(izigaba) ezisengozini yokulandelana kokugwinya.

Izinkinga ze-Dysphagia

Kunezizathu eziningana ezingenzeka zokungasebenzi kahle kokugwinya, okuhlanganisa:

1. Izimo Zemizwa: Izifo zemizwa njenge-stroke, isifo sika-Parkinson, i-multiple sclerosis noma i-muscular dystrophy zingathinta imizwa elawula umphimbo nemisipha yomphimbo. Lokhu kuholela ebunzimeni bokuxhumanisa ekulawuleni ukudla ngendlela efanele kanye nokukhiqiza ingcindezi eyanele yokukuhambisa.

2. Izinguquko Ze-anatomical/Isakhiwo: Ukungajwayelekile kwesakhiwo kungavimba noma kuvimbe umphimbo noma umminzo wesisulu se-dysphagia, okuhlanganisa:

• Izicubu ezibomvu ezinciphisa indlela yokudlula (ebizwa ngokuthi ama-strictures noma ama-webs)
• I-hiatal hernia isusa isisu
• I-Diverticula, okusho ukuphuma ephaketheni okuphumela ezindongeni
• Umdlavuza we-Esophageal 

Izici ezengeziwe:

• Ezinye izici eziningi zingase zibe nomthelela ekugwinyeni ukungasebenzi, njenge:
• Umdlavuza wekhanda nentamo noma imiphumela yemisebe/ukuhlinzwa okuhlobene
• Izinto zangaphandle ezifakwe emphinjeni noma emphinjeni
• Isifo esibi kakhulu se-acid reflux siqinisa kancane umminzo
• Izimo ze-autoimmune njenge-scleroderma
• Imithi ethile efana nemisipha eyenza buthaka njengama-sedative,
• Amagciwane afana ne-oral thrush noma amathumba

Ukuhlonza imbangela eyingqayizivele kuvumela ukuphathwa okwenziwe ngezifiso ukukhulula izimpawu nokuthuthukisa umsebenzi.

Izimpawu ze-Dysphagia

Izimpawu zokugwinya kwezinkinga zingahluka kuye ngokuthi hlobo luni kanye nembangela ye-dysphagia kodwa zingabandakanya:

• Kunzima ukuqala inkonjane
• Ubuhlungu lapho ugwinya - i-odynophagia
• Ukuzwa kokuthile okunamathele esifubeni sakho noma emphinjeni
• Ukuconsa ukudla/uketshezi oluphuma emlonyeni
• Izwi eliphuthumayo 
• Ukubuyisela ukudla ukuze ukuphinde ukuhlafune noma ukugwinye kabusha
• Ukukhwehlela noma ukuvala umlomo lapho ugwinya

Uyombona Nini Udokotela?

Bonana nodokotela wakho uma unenkinga yokugwinya njalo noma uma ubunzima bokugwinya buhambisana nezimpawu ezifana nalezi:

• Ukuncipha kwesisindo okungachazeki nge-dysphoria
• Ukuhlanza ngemva kokudla
• Imizwa yokuklinywa
• ubuhlungu besifuba

Thola usizo oluphuthumayo ngokushesha uma:

• Ukuvaleka kwenza kube nzima kakhulu ukuphefumula
• Awukwazi ukugwinya noma yini, kuhlanganise namathe akho

Ukwelashwa kwe-Dysphagia

• Ukushintsha Ukudla
  • Ukushintsha ukwakheka kokudla kanye nokujiya koketshezi kungenza ukugwinya kuphephe. 
  • Izibonelo ukudla okuthambile noma okuhlanzekile okudinga amandla amancane okuhlafuna.
• Imithi: Imithi ingasiza ekwelapheni izinto ezinomthelela, okuhlanganisa ama-antacid, iziphumuza imisipha noma izidambisi zinhlungu.
• Izinketho Zokuhlinza: Ukuhlinza ukususa okuvalekile, ukunweba izigaba eziwumngcingo noma ukushintsha ukukhubazeka kwe-anatomical kuvame ukuthuthukisa ngempumelelo iphasishi.
• Inqubo Yokunwebeka: Odokotela be-Gastroenterologists bangakwazi ukunweba ngobumnene izindawo eziqinile besebenzisa amashubhu e-dilator adlula phakathi ne-endoscopy.
• Usizo Lokusuthisa Olwengeziwe: Lapho ukuphuza ngomlomo kuhlala kungaphephile, uketshezi umsoco amafomula angalethwa ngeshubhu yokudla yesikhashana.

Kanye nezinketho zokwelashwa ezingenhla, ukwelashwa kokubuyisela kubalulekile ukuze kube lula ukuthuthuka kwesikhathi eside.

I-Rehabilitation Therapy ye-Dysphagia

I-Speech-Language Pathologist (SLP) ngokuvamile iyingxenye ebalulekile yokwelashwa kwe-dysphagia. I-SLP ingahlola ubunzima bakho bokugwinya ngokuhlolwa okubizwa ngokuthi “I-Modified Barium Swallow Study”.

Ngokusekelwe kuleyo miphumela, i-SLP izosebenza nawe kuhlelo lokulungisa kabusha oluhambisana nawe oluhlanganisa amasu okugwinya aphephile nokuzivocavoca okukhethekile, okufana nalokhu:

• I-Oral Motor Exercises: Ukusebenzisa izindebe, ulimi, nomhlathi ukuthuthukisa amandla nokuxhumana kwemisipha yokugwinya.
• Ukuzivocavoca Kwe-Pharyngeal: Ukugwinya okuzikhandlayo, i-Mendelsohn iqondisa ukuqinisa nokuvikela indlela yomoya.
• Ukuphakama Kwe-Laryngeal: Ukuphakamisa ikhanda ukuze kuthuthukiswe ukunyakaza kwe-larynx.
• I-Chin Tucks: Ukwehlisa isilevu ngesikhathi sokugwinya.
• Izindlela Zokunxeshezelwa: Ukushintsha ukuma kwekhanda, ukuhamba kancane, ukugwinya phakathi kokuphefumula.

Ngokuzijwayeza okungaguquki kwalezi zindlela nokuzivocavoca okuqondisiwe, abantu abaningi bangakwazi ukuzuza intuthuko enkulu noma ukuxazululwa kwezimpawu zabo ze-dysphagia.

Isiphetho

Kafushane, i-dysphagia ibonakala ngobunzima lapho izama ukugwinya ukudla, uketshezi noma amathe. Lokhu kuba nomthelela omkhulu ekondlekeni komuntu kanye nekhono lokudla ngokunethezeka. I-Dysphagia inezimbangela eziningi ezingaba khona, kusukela esifweni sezinzwa kuya kokungavamile kwe-anatomical okubangela ukuvinjelwa.

Ngenkathi ikhwalithi yempilo ene-dysphagia iba sebucayini, isimo singathuthukiswa noma sinqotshwe ngenhlanganisela yokwelashwa okulungiselelwe, yokudla ukuguqulwa, kanye nokuvuselelwa kokugwinya nodokotela wezifo zolimi lokukhuluma. Ukuhlonza i-dysphagia kusenesikhathi nokuthola inkinga ewumsuka kuyizinyathelo zokuqala ezibalulekile. 

Imibuzo Evame Ukubuzwa

1. Ingabe umuntu angalulama ngokugcwele ku-dysphagia?

Abantu abaningi bathola ukuthuthuka okukhulu noma ukuxazulula okucishe kuphele kwe-dysphagia engapheli ngokwelashwa okungaguquki. Ngisho nabathile abanokulimala kwezinzwa unomphela baphinde bathole amandla okugwinya asebenzayo ngokuhamba kwesikhathi.

2. Imaphi amakhambi emvelo asiza i-dysphagia?

Ezinye izithasiselo ezifana ne-elm eshelelayo zingase zigqoke futhi zidambise izicubu ezicasuliwe. Iziphuzo ezifana nejinja noma ijusi yephayinaphu zinganciphisa izimpawu zezinkinga ezihlobene ne-GERD/reflux. Nokho, i-dysphagia idinga ukunakekelwa okufanele kwezokwelapha.

3. Yiziphi izinhlobo eziyinhloko ze-dysphagia?

Izigaba ezinkulu yilezi:

• I-Oropharyngeal (phezulu) i-dysphagia
• I-Esophageal (low) dysphagia
• I-dysphagia esebenzayo/neurogenic
• I-anatomical/mechanical dysphagia

4. Ingabe ukuphila ne-dysphagia kuyalawuleka?

Yebo, ngesiqondiso sezokwelapha nesokugwinya amasu okubhekana nesimo esivumelanayo - njengezinguquko zokudla, amasu akhethekile nokuzivocavoca - abantu abaningi baphatha kahle i-dysphagia engapheli futhi balondoloze izinga elihle lokuphila isikhathi eside.

5. Ubani othambekele kakhulu ekubeni ne-dysphagia?

Labo abasengozini enkulu bahlanganisa abantu abangaphezu kweminyaka engama-50, iziguli zohlangothi, abantu abanezimo ezifana nezimo zemizwa, iziguli ezilashelwa umdlavuza wekhanda/intamo odinga ukuhlinzwa/ukukhishwa kwemisebe, kanye nalabo abazalwa benokukhubazeka kwe-anatomical okuthinta umgudu wokudla ongaphezulu.