概述

失弛缓症是一种罕见的疾病,使食物和液体很难通过连接嘴和胃的吞咽管道(食管)进入胃中。

当食管中的神经受损时,会发生失弛缓症。这会导致患者食管渐渐麻痹并扩张,最终失去将食物挤入胃中的能力。然后食物会积聚在食管中,有时会发酵并冲回嘴里,尝起来可能有苦味。有人把这误认为是胃食管反流病(GERD)。但是,失弛缓症的反流食物来自食管,而胃食管反流病中的反流食物则来自胃。

失弛缓症尚无治愈方法。一旦食管麻痹,相关肌肉将再也不能正常工作。不过,通常可以通过内镜检查、微创治疗或手术来控制症状。

症状

失弛缓症症状通常会逐渐显现出来,并随着时间而恶化。体征和症状可能包括:

  • 无法吞咽(吞咽困难),感觉就像食物或饮料卡在喉咙中
  • 食物或唾液反流
  • 胃灼热
  • 打嗝
  • 时有时无的胸部疼痛
  • 夜间咳嗽
  • 感染性肺炎(因食物吸入肺部所致)
  • 体重减轻
  • 呕吐

病因

失弛缓症的准确病因还不太清楚。研究人员怀疑可能是食管的神经细胞丧失导致的。关于病因众说纷纭,但可能是病毒感染或自免疫反应的问题。极其罕见的情况下,遗传病或感染可能导致失弛缓症。

风险因素

Risk factors for achalasia include:

  • Age. Although achalasia can people of affect all ages, it's more common in people between 25 and 60 years of age.
  • Certain medical conditions. The risk of achalasia is higher in people with allergic disorders, adrenal insufficiency or Allgrove syndrome, a rare autosomal recessive genetic condition.

在 Mayo Clinic 治疗

May 11, 2023
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  3. Achalasia. Canadian Society of Intestinal Research. https://badgut.org/information-centre/a-z-digestive-topics/achalasia/. Accessed April 6, 2020.
  4. Swanstrom LL. Achalasia: Treatment, current status and future advances. Korean Journal of Internal Medicine. 2019; doi:10.3904/kjim.2018.439.
  5. Jung HK, et al. 2019 Seoul consensus on esophageal achalasia guidelines. Neurogastroenterology and Motility. 2020; doi:10.5056/jnm20014.
  6. Achalasia. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/achalasia. Accessed April 6, 2020.
  7. Ahmed Y, et al. Peroral endoscopic myotomy (POEM) for achalasia. Journal of Thoracic Disease. 2019; doi:10.21037/jtd.2019.07.84.
  8. Brown AY. Allscripts EPSi. Mayo Clinic. March 12, 2020.
  9. Blackmon SH (expert opinion). Mayo Clinic. April 8, 2020

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