Gastroparesis ndi matenda omwe amagwira ntchito m'mimba, omwe nthawi zambiri amakhala osatha, omwe amadziwika ndi kuchedwetsa kutulutsa m'mimba, popanda chopinga chilichonse. Nthawi zambiri, gastroparesis imatha kuyambitsa zovuta zina, makamaka mwa anthu odwala matenda ashuga. Ngakhale kuti ukhondo pazakudya nthawi zambiri umakhala wokwanira kuchepetsa zizindikiro, zina zimafuna mankhwala anthawi yayitali kapena opaleshoni.

Tanthauzo la gastroparesis

Gastroparesis ndi matenda omwe amagwira ntchito m'mimba, omwe nthawi zambiri amakhala osatha, omwe amadziwika ndi kuchedwetsa kutulutsa m'mimba, popanda chopinga chilichonse.

Gastroparesis ndi vuto pakuwongolera magwiridwe antchito am'mimba. Zimachitika pamene mitsempha ya vagus sikugwira ntchito bwino. Mitsempha iwiriyi imagwirizanitsa, mwa zina, ubongo kumagulu ambiri am'mimba ndikutumiza mauthenga ofunikira kuti minofu ya m'mimba igwire bwino ntchito. M’malo mokokedwa pambuyo pa maola aŵiri pambuyo pa kugaya chakudya, chakudyacho chimaima m’mimba kwa nthaŵi yaitali.

Mitundu ya gastroparesis

Gastroparesis ikhoza kugawidwa m'magulu otsatirawa:

• Idiopathic gastroparesis, ndiko kunena popanda chifukwa chodziwika;
• Gastroparesis ndi kukhudzidwa kwa mitsempha;
• Gastroparesis ndi kuwonongeka kwa myogenic (matenda a minofu);
• Gastroparesis chifukwa cha etiology ina.

Zifukwa za gastroparesis

Nthawi zambiri, gastroparesis ndi idiopathic, ndiye kuti popanda chifukwa chodziwika.

Pazochitika zina zonse, zimachokera pazifukwa zingapo, zomwe zalembedwa apa kuchokera pafupipafupi mpaka zochepa:

• Type 1 kapena 2 shuga mellitus;
• Opaleshoni ya m'mimba: vagotomy (gawo la opaleshoni ya mitsempha ya vagus m'mimba) kapena gastrectomy pang'ono (kuchotsa m'mimba pang'ono);
• Kumwa mankhwala: anticholinergics, opioids, antidepressants kuphatikizapo tricyclics, phenothiazines, L-Dopa, anticalcics, alumina hydroxide;
• Matenda (Epstein-Barr virus, varicella virus, zonatosis, trypanosoma cruzi);
• Matenda a ubongo: multiple sclerosis, sitiroko, matenda a Parkinson;
• Systemic matenda: scleroderma, polymyositis, amyloidosis;
• Progressive muscular dystrophies;
• Zollinger-Ellison syndrome (matenda omwe amadziwika ndi zilonda zam'mimba ndi duodenum);
• Zilonda zam'mimba zomwe zimayambitsidwa ndi ma radiation;
• M'mimba ischemia kapena kuchepa kwa magazi m'mimba;
• Anorexia nervosa;
• Hypothyroidism kapena zotsatira za kuchepa kwa mahomoni opangidwa ndi chithokomiro;
• Aakulu aimpso kulephera.

Kuzindikira kwa gastroparesis

Pamene gastroparesis ikukayikiridwa, scintigraphy imapangitsa kuti athe kuyeza liwiro lomwe chakudya chimagayidwa: kachidutswa kakang'ono ka radioactive, kamene ma radiation ake amatha kuyang'aniridwa ndi kujambula kwachipatala, ndiyeno amadyedwa ndi chakudya chopepuka ndikupangitsa kuti zitheke kutsatira mlingo. pomwe chakudya chimadutsa m'mimba. Mayeso a mpweya wa octanoic acid olembedwa ndi isotopu yokhazikika, yopanda ma radiation ya carbon (13C) ndi m'malo mwa scintigraphy.

Njira zina zomwe zaperekedwa pophunzira kutulutsa m'mimba ndi monga:

• Ultrasound yomwe imayesa kusintha kwa gawo la m'mimba ngati nthawi yayitali mutatha kudya komanso imathandizira kudziwa ngati pali zovuta zina zomwe zingayambitse matenda a gastroparesis;
• Scanner kapena imaging resonance imaging (MRI) yomwe imapanganso kuchuluka kwa m'mimba pakapita nthawi.

Chizindikiro cha kufufuza kwa m'mimba kutulutsa m'mimba, komwe kumapezeka m'malo apadera, kumangotchulidwa ngati zizindikiro zazikulu zomwe zimakhudza thanzi la wodwalayo:

• Gastroscopy ndi endoscopy - kuyika kachubu kakang'ono kosinthika kokhala ndi kamera ndi kuwala - kulola kuwona khoma lamkati la m'mimba, mmero ndi duodenum;
• Peptic manometry imaphatikizapo kulowetsa chubu lalitali, lopyapyala lomwe limayesa kuthamanga kwa minofu ndi kutsika kuchokera m'mimba kupita m'mimba.

Kapisozi wolumikizidwa, SmartPill ™ motility pano ikuyesedwa kuti ijambule kusiyanasiyana kwa kuthamanga, pH ndi kutentha m'matumbo am'mimba. Itha kukhala njira ina yofufuza odwala kunja kwa malo apadera.

Anthu omwe ali ndi gastroparesis

Gastroparesis imakhudza pafupifupi 4% ya anthu ndipo ikuwoneka kuti imawulula akazi katatu kapena kanayi kuposa amuna.

Anthu omwe ali ndi matenda a shuga amatha kuyambitsa gastroparesis.

Zomwe zimayambitsa gastroparesis

Kupezeka kwa gastroparesis kumakhala kofala kwambiri mwa odwala omwe ali ndi matenda ashuga: +

• Nephropathy (zovuta zomwe zimachitika mu impso);
• Retinopathy (kuwonongeka kwa mitsempha yamagazi mu retina);
• Neuropathy (kuwonongeka kwa mitsempha yamagalimoto ndi zomverera).

Kutalika kwa chimbudzi

Gastroparesis nthawi zambiri imawonetsedwa ndi kumva kukhuta m'mimba kuyambira kulumidwa koyamba, komwe kumayenderana ndi kumverera kwachimbudzi kwa nthawi yayitali, kukhuta koyambirira komanso nseru.

ululu m'mimba

Kupweteka kwa m'mimba kumakhudza odwala oposa 90% omwe ali ndi gastroparesis. Zowawa izi nthawi zambiri zimachitika tsiku lililonse, nthawi zina kosatha, ndipo zimachitika usiku pafupifupi magawo awiri mwa atatu a milandu.

kuwonda

Mwa odwala matenda ashuga, kusanza kumakhala kwapakatikati kapena kulibe. Gastroparesis nthawi zambiri imabweretsa kuwonongeka kosadziwika bwino kwa mkhalidwe wa wodwalayo, monga kuchepa thupi komanso kuvutikira kusanja kuchuluka kwa shuga m'magazi - kapena shuga - ngakhale atalandira chithandizo.

Bezoar

Gastroparesis nthawi zina imatha kupangitsa kuti chakudya chisagayidwe kapena kugayidwa pang'ono, chotchedwa bezoar, kupanga chomwe sichingatuluke m'mimba.

Zizindikiro zina

• Kusowa chilakolako;
• Kutupa;
• Kudzimbidwa ;
• Kufooka kwa minofu;
• Thukuta usiku;
• Kupweteka kwa m'mimba ;
• Kusanza;
• Regurgitation;
• Kutaya madzi m'thupi;
• Reflux ya gastroesophageal;
• Matenda owopsa a m'mimba.

Malangizo a hygieno-dietetic ndi njira yabwino kwambiri pochiza gastroparesis:

• Kugawikana kwa zakudya ndi kumwa zakudya zing'onozing'ono koma nthawi zambiri;
• Kuchepetsa lipids, ulusi;
• Kuchotsa mankhwala omwe amachepetsa kutuluka kwa m'mimba;
• Kukhazikika kwa shuga m'magazi;
• Chithandizo cha kudzimbidwa.

Prokinetics, yomwe imathandizira m'mimba motility, imayimira njira yayikulu yochizira gastroparesis.

Ngati chithandizo chikulephereka, njira zina zitha kuganiziridwa:

• Kukondoweza kwamagetsi a m'mimba (ESG): chipangizo chokhazikitsidwa ichi chimapanga mphamvu zamagetsi zopepuka zomwe zimakoka mitsempha ya vagus kuzungulira chigawo cham'mimba kuti ifulumizitse kutuluka kwa m'mimba;
• Njira zodyetsera zopangira;
• Opaleshoni, mwa mawonekedwe a gawo kapena subtotal gastrectomy, imakhalabe yachilendo.

Ngati zikuwoneka zovuta kupewa kuyambika kwa gastroparesis, malangizo angapo amatha kuchepetsa zizindikiro zake:

• Idyani zakudya zopepuka nthawi zambiri;
• Kondani zakudya zofewa kapena zamadzimadzi;
• Tafunani bwino;
• Phatikizani zowonjezera zakudya mu mawonekedwe a zakumwa ndi zakudya.