I-Gastroparesis ukuphazamiseka kokugaya ukudla okusebenzayo, ngokuvamile okungamahlalakhona, okubonakala ngokuncipha kokuphuma kwesisu, lapho kungekho khona isithiyo semishini. Imvamisa okungalapheki, i-gastroparesis ingadala imiphumela emibi eyingozi, ikakhulukazi kubantu abanesifo sikashukela. Ngenkathi inhlanzeko ekudleni ivame ukwanela ukunciphisa izimpawu, amanye amacala azodinga imithi yesikhathi eside noma ngisho nokuhlinzwa.

Incazelo ye-gastroparesis

I-Gastroparesis ukuphazamiseka kokugaya ukudla okusebenzayo, ngokuvamile okungamahlalakhona, okubonakala ngokuncipha kokuphuma kwesisu, lapho kungekho khona isithiyo semishini.

I-Gastroparesis iyinkinga ekulawuleni umsebenzi wesisu esiswini. Kwenzeka lapho izinzwa ze-vagus zingenzi kahle le misebenzi. Lezi zinzwa zixhuma, phakathi kwezinye izinto, ubuchopho engxenyeni enkulu yokugaya bese zithumela imiyalezo edingekayo ukuze kusebenze kahle imisipha yesisu. Esikhundleni sokuhudulwa ngemuva kwamahora angaba mabili ngemuva kwendlela yokugaya ukudla, ukudla bese kuyama esiswini isikhathi eside.

Izinhlobo ze-gastroparesis

I-Gastroparesis ingahlukaniswa ngezigaba ezilandelayo:

• Idiopathic gastroparesis, okungukuthi ngaphandle kwesizathu esikhonjisiwe;
• I-Gastroparesis ngokubandakanyeka kwemizwa;
• I-Gastroparesis ngomonakalo we-myogenic (isifo semisipha);
• I-Gastroparesis ngenxa yenye i-etiology.

Izimbangela ze-gastroparesis

Ezimweni ezingaphezu kwengxenye yesithathu, i-gastroparesis iyi-idiopathic, okusho ukuthi ngaphandle kwesizathu esikhonjisiwe.

Kuwo wonke amanye amacala, kuvela ezimbangela eziningi, ezibalwe lapha kusuka kokuvame kakhulu kuya kokuvame kakhulu:

• Thayipha 1 noma 2 sikashukela;
• Ukuhlinzwa kokugaya: i-vagotomy (isigaba sokuhlinzwa semizwa yezitho zangasese esiswini) noma i-gastrectomy engaphelele (ukukhishwa kwesisu okuyingxenye);
• Ukufakwa kwemithi: i-anticholinergics, i-opioid, imishanguzo yokulwa nokudangala okubandakanya ama-tricyclics, ama-phenothiazines, i-L-Dopa, i-anticalcics, i-alumina hydroxide;
• Ukutheleleka (igciwane le-Epstein-Barr, igciwane le-varicella, i-zonatosis, i-trypanosoma cruzi);
• Izifo zemizwa: multiple sclerosis, stroke, isifo sikaParkinson;
• Izifo zesistimu: i-scleroderma, i-polymyositis, i-amyloidosis;
• Ama-dystrophies aqhubekayo emisipha;
• I-Zollinger-Ellison syndrome (isifo esibonakala ngezilonda ezinzima zesisu kanye nezilonda ze-duodenal);
• Izilonda emathunjini ezibangelwa ukwelashwa ngemisebe;
• I-ischemia yokugaya noma ukuncipha kokunikezwa kwegazi esiswini;
• I-anorexia nervosa;
• I-Hypothyroidism noma umphumela wokukhiqizwa okuphansi kwamahomoni ngendlala yegilo;
• Ukwehluleka kwezinso okungamahlalakhona.

Ukuxilongwa kwe-gastroparesis

Lapho kusolwa i-gastroparesis, i-scintigraphy yenza sikwazi ukukala ijubane lapho ukudla kugaywa khona: into encane enemisebe, enemisebe yayo engabhekwa ngemifanekiso yezokwelapha, bese idliwa ngokudla okulula futhi ikwazi ukulandela isilinganiso lapho isidlo sidlula khona ohlelweni lokugaya ukudla. Ukuhlolwa kokuphefumula kwe-octanoic acid okubhalwe nge-isotope engazinzile, engasebenzisi imisebe yekhabhoni (13C) kungenye indlela yokwenza i-scintigraphy.

Ezinye izindlela ezihlongozwayo zocwaningo lokukhipha isisu zifaka:

• I-Ultrasound ehlola izinguquko engxenyeni engaphezulu yolwelwesi lwesisu njengomsebenzi wesikhathi ngemuva kokudla futhi isiza nokuthola ukuthi ngabe kukhona yini okunye ukukhubazeka ngokomzimba okungaholela ezimpawu ezibangelwa yi-gastroparesis;
• Isithwebuli noma i-magnetic resonance imaging (i-MRI) eyakha kabusha ivolumu yesisu ngokuhamba kwesikhathi.

Inkomba yokuhlolwa kokukhishwa kwesisu, etholakala kuphela ezikhungweni ezikhethekile, inqunywa kuphela uma kunezimpawu ezinzima ezithinta isimo sokudla kwesiguli:

• I-Gastroscopy iyi-endoscopy - ukufaka ithubhu encane eguquguqukayo efakwe ikhamera nokukhanya - okuvumela ukubona ngeso lengqondo udonga lwangaphakathi lwesisu, i-esophagus ne-duodenum;
• I-Peptic manometry ifaka ukufaka ithubhu ende, ezacile elinganisa ukucindezela kwemisipha nezingcindezi ezisuka emgudwini wokugaya ukudla ziye esiswini.

I-capsule exhunyiwe, i-motility ye-SmartPill ™ okwamanje iyahlolwa ukurekhoda ukuhluka kwengcindezi, i-pH kanye nokushisa endaweni yokugaya ukudla. Kungaba enye indlela yokuhlola iziguli ezingaphandle kwezikhungo ezikhethekile.

Abantu abathintekayo yi-gastroparesis

I-Gastroparesis ithinta cishe u-4% wabantu futhi ibonakala iveza abesifazane izikhathi eziphindwe kathathu noma kane kunabesilisa.

Abantu abanesifo sikashukela banamathuba amaningi okuqala i-gastroparesis.

Izici ezithandayo i-gastroparesis

Ukuba khona kwe-gastroparesis kuvame kakhulu kubantu abanesifo sikashukela abethula:

• I-nephropathy (inkinga eyenzeka ezinso);
• I-retinopathy (ukulimala kwemithambo yegazi ku-retina);
• I-Neuropathy (ukulimala kwezimoto nezinzwa zezinzwa).

Ukugaya isikhathi eside

I-Gastroparesis ivame ukuvezwa ngomuzwa wesisu esigcwele kusukela ekulunyweni kokuqala, okuhambisana nokuzizwa kokugaya isikhathi eside, ukusutha kwasekuqaleni kanye nesicanucanu.

Ubuhlungu besisu

Ubuhlungu besisu buhlasela ngaphezu kweziguli ezingama-90% ezine-gastroparesis. Lezi zinhlungu zivame ukwenziwa nsuku zonke, kwesinye isikhathi zibe unomphela, futhi zenzeka ebusuku cishe kwamacala amabili kwamathathu.

Weight Loss

Kubantu abanesifo sikashukela, ukuhlanza kungesikhathi esithile noma akukho. I-Gastroparesis ivame ukuholela ekuwohlokeni okungachazeki esimweni esijwayelekile sesiguli, njengokuncipha kwesisindo nobunzima bokulinganisa izinga le-glucose egazini - noma ushukela wegazi - yize welashwa.

IBézoard

I-Gastroparesis kwesinye isikhathi ingadala i-compact conglomerate yokudla okungagayeki noma okugayiwe kancane, okubizwa ngokuthi yi-bezoar, ukwakheka okungaphumi esiswini.

Ezinye izimpawu

• Ukuntula ukudla;
• Ukuqhakaza;
• Ukuqunjelwa;
• Ubuthakathaka bemisipha;
• Ukujuluka ebusuku;
• Izinhlungu zesisu;
• Ukuhlanza;
• Ukuvuselelwa kabusha;
• Ukwehla kwamanzi emzimbeni;
• I-reflux ye-gastroesophageal;
• Isifo samathumbu esicasulayo.

Izincomo ze-hygieno-dietetic ziyindlela ekhethwayo ekwelapheni i-gastroparesis:

• Ukuhlukaniswa kokudla nokusetshenziswa kokudla okuncane kepha kaningi;
• Ukunciphisa i-lipids, imicu;
• Ukususwa kwezidakamizwa ezehlisa ukukhipha isisu;
• Ukujwayelekile kukashukela wegazi;
• Ukwelashwa kokuqunjelwa.

I-Prokinetics, evuselela ukuhamba kwamathumbu emathunjini, imelela inketho eyinhloko yokwelapha ku-gastroparesis.

Uma kwenzeka ukwehluleka kokwelashwa okuqhubekayo, ezinye izixazululo zingabhekwa:

• Ukugqugquzela ugesi (i-ESG): le divayisi efakiwe yakha imizwa elula kagesi evuselela imizwa yezitho zangasese ezungeze umgudu wokugaya ukudla ukusheshisa ukukhipha isisu;
• Amasu okudla okufakelwayo;
• Ukuhlinzwa, ngesimo se-gastrectomy engaphelele noma engaphansi, kuhlala kuyinto ehlukile.

Uma kubonakala kunzima ukuvimbela ukuqala kwe-gastroparesis, amathiphu ambalwa angakhawulela izimpawu zawo:

• Yidla ukudla okulula kaningi;
• Uncamela ukudla okuthambile noma okungamanzi;
• Uhlafune kahle;
• Hlanganisa izithako zokudla okunempilo ngendlela yeziphuzo nokudla.