Gastroparesis chirwere chinoshanda chekudya, kazhinji chisingaperi, chinoratidzwa nekunonoka kwekubuda mudumbu, pasina chero chipingamupinyi chemuchina. Kazhinji chisingaperi, gastroparesis inogona kukonzera njodzi mhedzisiro, kunyanya muvanhu vane chirwere cheshuga. Nepo hutsanana hwekudya huchiwanzo kukwana kuderedza zviratidzo, zvimwe zviitiko zvinoda mishonga yenguva refu kana kuvhiyiwa.

Tsanangudzo ye gastroparesis

Gastroparesis chirwere chinoshanda chekudya, kazhinji chisingaperi, chinoratidzwa nekunonoka kwekubuda mudumbu, pasina chero chipingamupinyi chemuchina.

Gastroparesis idambudziko mukugadzirisa gastric tsandanyama basa. Zvinoitika kana vagus nerves ikasaita mabasa aya zvakanaka. Iyi tsinga mbiri dzinobatanidza, pakati pezvimwe zvinhu, huropi kune yakawanda yegumbo rekudya uye inotumira mameseji anodiwa pakushanda kwakanaka kwemhasuru dzemudumbu. Pane kudhonzwa mushure memaawa maviri mumashure megumbo rekudya, chikafu chinobva chamira mudumbu kwenguva refu.

Mhando dze gastroparesis

Gastroparesis inogona kuiswa muzvikamu zvinotevera:

• Idiopathic gastroparesis, kureva pasina chikonzero chakazivikanwa;
• Gastroparesis nekubatanidzwa kwetsinga;
• Gastroparesis nekukuvadza myogenic (chirwere chetsandanyama);
• Gastroparesis nekuda kweimwe etiology.

Zvikonzero zve gastroparesis

Muchikamu chinopfuura chetatu chezviitiko, gastroparesis idiopathic, kureva pasina chikonzero chakazivikanwa.

Kune zvimwe zvese zviitiko, zvinomuka kubva kune akawanda zvikonzero, zvakanyorwa pano kubva kune zvinowanzoitika kusvika kune zvishoma kazhinji:

• Type 1 kana 2 chirwere cheshuga;
• Kuvhiyiwa kwekudya: vagotomy (chikamu chekuvhiya chevagus nerves mudumbu) kana chikamu chegastrectomy (kubvisa chikamu chedumbu);
• Mishonga yemishonga: anticholinergics, opioid, antidepressants kusanganisira tricyclics, phenothiazines, L-Dopa, anticalcics, alumina hydroxide;
• Zvirwere (Epstein-Barr virus, varicella virus, zonatosis, trypanosoma cruzi);
• Neurological zvirwere: multiple sclerosis, sitiroko, chirwere cheParkinson;
• Systemic zvirwere: scleroderma, polymyositis, amyloidosis;
• Progressive muscular dystrophies;
• Zollinger-Ellison syndrome (chirwere chinoratidzwa nedumbu rakasimba uye duodenal ulcers);
• Maronda emudumbu anokonzerwa neradiation therapy;
• Digestive ischemia kana kuderera kweropa reropa kusvika mudumbu;
• Anorexia nervosa;
• Hypothyroidism kana mhedzisiro yekuderera kwekugadzirwa kwehomoni neiyo thyroid gland;
• Kukundikana kusingaperi kwemutsipa.

Kuongororwa kwegastroparesis

Kana gastroparesis ichifungidzirwa, iyo scintigraphy inoita kuti zvikwanise kuyera kukurumidza kwekudya kunogayiwa: chinhu chidiki cheradioactive, chine mwaranzi inogona kutariswa nemifananidzo yekurapa, inobva yapedzwa nekudya kwakareruka uye inoita kuti zvibvirire kutevera chiyero. apo kudya kunopfuura nepakati pekudya. Iyo octanoic acid breath test yakanyorwa ine yakagadzikana, isiri-radioactive isotope yekabhoni (13C) ndiyo imwe nzira kune scintigraphy.

Dzimwe nzira dzakakurudzirwa pakudzidza kwekubvisa gastric dzinosanganisira:

• Ultrasound iyo inoongorora shanduko pamusoro penzvimbo yedumbu remukati sebasa renguva mushure mekudya uye zvakare inobatsira kuona kana paine zvimwe zvisizvo zvemuviri zvinogona kutungamira kune zviratidzo zvinonzi gastroparesis;
• Iyo scanner kana magnetic resonance imaging (MRI) iyo inovakazve gastric volume nekufamba kwenguva.

Chiratidzo chekuongorora kwegastric emptying, inowanikwa chete munzvimbo dzakakosha, inongotarirwa kana pane zviratidzo zvakakomba zvinokanganisa hutano hwemurwere:

• Gastroscopy inonzi endoscopy - kuiswa kwechubhu diki inochinjika yakasungirirwa kamera uye mwenje - inobvumira kuona madziro emukati medumbu, gurokuro uye duodenum;
• Peptic manometry inosanganisira kuisa chubhu refu, nhete inoyera tsinga dzetsandanyama uye kudhonzwa kubva mudumbu kusvika mudumbu.

Iyo yakabatana capsule, iyo SmartPill ™ motility parizvino iri kuedzwa kurekodha mutsauko mukumanikidzwa, pH uye tembiricha mudumbu rekudya. Inogona kuita imwe nzira yekuongororwa kwevarwere kunze kwenzvimbo dzehunyanzvi.

Vanhu vane gastroparesis

Gastroparesis inokanganisa 4% yehuwandu uye inoita kunge inofumura vakadzi katatu kana kana kupfuura varume.

Vanhu vane chirwere cheshuga vanowanzoita gastroparesis.

Zvinhu zvinokurudzira gastroparesis

Kuvapo kwegastroparesis kunowanzoitika kune vane chirwere cheshuga vanouya:

• Nephropathy (dambudziko rinoitika muitsvo);
• Retinopathy (kukuvadza kwemidziyo yeropa mu retina);
• Neuropathy (kukuvadzwa kwemotokari uye tsinga dzekunzwa).

Kudya kwenguva refu

Gastroparesis inowanzoratidzwa nekunzwa kwedumbu rakazara kubva pakurumwa kwekutanga, kunobatanidza nekunzwa kwekudya kwenguva refu, kuguta kwekutanga uye kusvotwa.

Zvinorwadza mumimba

Kurwadziwa kwemudumbu kunobata zvinopfuura 90% zvevarwere vane gastroparesis. Marwadzo aya anowanzoitika zuva nezuva, dzimwe nguva zvachose, uye anoitika husiku munenge muzvikamu zviviri muzvitatu zvezviitiko.

Kuonda

Muchirwere cheshuga, kurutsa kunonyanya kupindirana kana kusavapo. Gastroparesis kazhinji inoguma nekuderera kusingatsananguriki mumamiriro ezvinhu emurwere, zvakadai sekurasikirwa nekurema uye kuoma mukuenzanisa chiyero cheglucose muropa - kana shuga yeropa - pasinei nekurapa.

Bezoar

Gastroparesis dzimwe nguva inogona kukonzera compact conglomerate yechikafu chisina kugayiwa kana zvishoma, inonzi bezoar, kuumba isingakwanise kubuda mudumbu.

Zvimwe zviratidzo

• Kushaya appetite;
• Bloating;
• Constipation ;
• Muscular weakness;
• Kudikitira usiku;
• Marwadzo emudumbu ;
• Kusvipa;
• Regurgitation;
• Kupera mvura mumuviri;
• Gastroesophageal reflux;
• Irritable bowel syndrome.

Iyo hygieno-dietetic kurudziro ndiyo yakasarudzika sarudzo mukurapa gastroparesis:

• Kupatsanurwa kwechikafu nekudyiwa kwezvikafu zvidiki asi kakawanda;
• Kuderedza lipids, fibers;
• Kubviswa kwemishonga inononoka kubuda mudumbu;
• Normalization yeshuga yeropa;
• Kurapa kwekuvhara.

Prokinetics, iyo inokurudzira gastrointestinal motility, inomiririra nzira huru yekurapa mune gastroparesis.

Muchiitiko chekuramba kukundikana kwekurapa, dzimwe mhinduro dzinogona kutariswa:

• Gastric magetsi stimulation (ESG): mudziyo wakasimwa uyu unogadzira magetsi akareruka anokurudzira tsinga dzevagus dzakatenderedza turakiti rekudya kuitira kuti rikurumidze kubuda kwegastric;
• Artificial feed techniques;
• Kuvhiya, muchimiro chechidimbu kana kuti subtotal gastrectomy, kunoramba kwakasiyana.

Kana zvichiita sekunge zvakaoma kudzivirira kutanga kwegastroparesis, mamwe matipi anogona kudzikamisa zviratidzo zvayo:

• Idya zvokudya zvishoma kakawanda;
• Kuda zvokudya zvinyoro kana mvura;
• Chew well;
• Sanganisa zvinovaka muviri zvinowedzera muchimiro chezvinwiwa nekudya.