So woasusuw nea enti a, bere a woadi biribi te sɛ paanoo, roti, anaa noodles akyi no, ɛtɔ mmere bi a wote nka sɛ ɛyɛ nwonwa, ɛyɛ yaw, anaasɛ ɛyɛ ma wɔ wo yafunu mu no ho pɛn? Wɔ nnipa binom fam no, eyi si bere nyinaa. Yɛdwene wɔ yɛn tirim sɛ, "Oh... Mintumi nni saa." Nanso wɔ saa ɔhaw a ɛba bere a yɛadi esiam yi akyi no, ebia asɛm bi a anibere wom wɔ hɔ a yennim. Saa asɛm no yɛ celiac yare, anaa sɛnea yɛka wɔ Borɔfo kasa mu no, `(Celiac Disease)`. Ɛnnɛ, yɛbɛka eyi ho asɛm tiawa koraa, wɔ ɔkwan a wubetumi ate ase so.
Sɛ yɛbɛka no tiawa a, dɛn ne Celiac Yare?
Fa no sɛ wowɔ asraafo dɔm a wɔbɔ wɔn ho ban a wɔn ani da hɔ na wɔn ho yɛ den yiye wɔ wo nipadua mu. Yɛfrɛ eyi sɛ nipadua no mu tumi a ɛko tia nyarewa. Asraafo yi adwuma ne sɛ wɔbɛhwehwɛ, atow ahyɛ wɔn so, na wɔasɛe atamfo te sɛ mmoawa ne mmoawa a wɔhyɛn wo nipadua mu, abɔ wo ho ban afi nyarewa ho.
Nanso wɔ obi a ɔwɔ celiac yare mu no, saa ahobammɔ nhyehyɛe yi di mfomso ketewaa bi. Ɛdi mfomso sɛ biribi a asiane biara nni ho na ɛyɛ ade a ɛfata sɛ ɔtamfo. Wɔ eyi mu no, saa "ɔtamfo" no yɛ protein bi a wɔfrɛ no gluten .
Enti, sɛ obi a ɔwɔ celiac yare di aduan a gluten wom a, nipadua no mu tumi a ɛko tia nyarewa no nya sɛnkyerɛnne bi a ɛka sɛ, "Ɔtamfo bi reba ha!" Afei nipadua no mu tumi a ɛko tia nyarewa no kɔ na efi ase ko tia gluten no. Nanso saa ɔko yi kɔ so wɔ wo dwensɔtwaa ketewa no mu . Wɔ ɔko yi mu no, awerɛhosɛm ne sɛ ɛnyɛ gluten no nko na ɛsɛe, na mmom wo dwensɔtwaa ketewa no afasu nso sɛe.
Sɛ yɛbɛka no tiawa a, celiac yɛ tebea a wo nipadua mu tumi a ɛko tia nyarewa no di mfomso tow hyɛ protein bi a wɔfrɛ no gluten so. Ɛnyɛ akisikuru a ɛyɛ mmerɛw, na mmom ɛyɛ yare a emu dɔ a nipadua no tumi ko tia nyarewa.
Okay, enti dɛn ne saa gluten a obiara reka ho asɛm yi?
Gluten yɛ protein a ɛwɔ aburow te sɛ awi, atoko, ne rye mu. Ɛno na ɛma paanoo mmɔre yɛ nea ɛtrɛw, anaasɛ ɛyɛ den bere a wɔafra no. Eyi ne nea ɛboa paanoo ne keeki ma ɛsɔre na ɛsɔre fɛfɛɛfɛ.
Wɔ Sri Lanka no, nnuan a yedi no pii wɔ gluten. Susuw ho hwɛ...
- Anɔpaduan: Atoko esiam, a wɔde ka curries bi a wɔde paanoo, buns, toast, ne nufusu aburow di ho.
- Awia aduan: Ɛtɔ mmere bi a midi noodles ne pasta.
- Awia tii bere: keeki, bisket, patties, rolls, mpataa keeki.
- Sɛ wopɛ anwummere aduan a: roti, paratha, kottu.
Nea ɛka eyi ho no, wobetumi de gluten asie nneɛma pii a yensusuw ho. Sɛ nhwɛso no, wɔde gluten ka sauce, soup packets, nam bi a wɔayɛ, ne ice cream mpo ho ma ɛyɛ den. Enti, ɛsɛ sɛ obi a ɔwɔ celiac yare no hwɛ yiye paa.
So yare yi betumi ayɛ nea asiane wom?
Yiw, sɛ wɔansa eyi a, ebetumi ayɛ aniberesɛm. Sɛnea yɛadi kan aka ho asɛm no, bere biara a yebedi gluten no, dwensɔtwaa ketewa no sɛe. Yɛn dwensɔtwaa ketewa no mu ɔfasu no wɔ nneɛma nketenkete ɔpepem pii a ɛte sɛ nsateaa. Yɛfrɛ eyinom `(villi)`. Eyinom adwuma titiriw ne sɛ ɛbɛtwe aduannuru (vitamins, minerals, proteins) afi aduan a yedi mu.
Wɔ celiac yare mu no, sɛ nipadua no mu tumi a ɛko tia nyarewa no tow hyɛ so a, saa villi yi yɛ petee na ɛsɛe. Ɛte sɛ obi a ɔretiatia sare fɛfɛ bi so. Dɛn na ɛba saa bere no? Nipadua no nnye aduannuru a ɛwɔ aduan mu no yiye. Yɛfrɛ tebea yi malabsorption.
Sɛ eyi kɔ so a, aduan pa a wonnya nni bɛba. Eyi ne ade a asiane wom sen biara. Eyi ka mmofra nkumaa titiriw.
- Ebia mmofra nyini ayɛ basaa (wɔnnyin, wɔnyɛ akɛse).
- Ebetumi aka mmofra adwene ne nipadua mu nkɔso .
Enti, ɛnyɛ adwene pa sɛ yɛbɛpow eyi sɛ "yafunu mu yaw a ɛfata ara kwa."
Dɛn ne celiac yare ho sɛnkyerɛnne ahorow?
Ɔhaw biako a ɛwɔ saa yare yi ho ne sɛ, ɛsono sɛnea yare no ho sɛnkyerɛnne no yɛ soronko koraa wɔ nnipa biara mu. Ebia nnipa binom renkyerɛ yare no ho sɛnkyerɛnne biara koraa. Nanso ɔsɛe no rekɔ so wɔ nipadua no mu. Mpɛn pii no, mfe abien na yare yi ba.
1. Wɔ mmofraase: Bɛyɛ afe biako, kyerɛ sɛ, bere a wufi ase ma mmofra nkumaa nnuan a gluten wom te sɛ bisket ne aburow.
2. Mfinimfini mfe: Mfe 40 kosi 60 ntam.
Momma yɛnhwɛ pon a ɛwɔ ase ha no na yɛnhwɛ nea ɛyɛ sɛnkyerɛnne ahorow atitiriw no.
| Nsɛnkyerɛnne no fã | Nneɛma a ɛsɛ sɛ wohu |
|---|---|
| Su ahorow a ɛfa aduan mu nhyehyɛe ho |
|
| Nsɛnkyerɛnne a ɛkyerɛ sɛ obi nni iron (nemia mogya) . | |
| Aduan pa a wonnya nni ho sɛnkyerɛnne afoforo | |
| Honam ani sɛnkyerɛnne ahorow |
Dɛn nti na saa yare yi ba? Dɛn ne nneɛma a ɛde asiane ba?
Celiac yare yɛ tebea a wonya fi awo mu . Eyi kyerɛ sɛ ɛwɔ awosu mu abusuabɔ bi. Ɛkame ayɛ sɛ obiara a ɔwɔ celiac yare no wɔ awosu mu nkwaadɔm mu nsakrae a wɔfrɛ no `(HLA-DQ2)` anaa `(HLA-DQ8)` no biako. Nanso, ɛnyɛ obiara a ɔwɔ saa awosu yi na obenya yare no.
Nnuruyɛfo gye di sɛ awosu mu nneɛma akyi no, nneɛma afoforo betumi adi dwuma wɔ yare yi mu. Nanso wonnya nhuu nea wɔyɛ ankasa. Ebinom ka sɛ saa yare yi betumi ada adi mpofirim esiane biribi te sɛ oprehyɛn kɛse, yare a emu yɛ den, anaa nyinsɛn nti.
Saa nkurɔfo yi wɔ asiane kɛse mu:
- Sɛ obi a ɔwɔ abusua no mu (ɛna, agya, onua) wɔ celiac yare a.
- Sɛ wowɔ yare foforo a nipadua no tumi ko tia nyarewa (e.g., asikreyare a ɛto so 1, thyroid yare).
- Sɛ nkwaboaa mu nneɛma a ɛnteɛ te sɛ Turner syndrome anaa Down syndrome wɔ hɔ a.
- Mmea taa nya saa yare yi.
Sɛ wɔansa a, dɛn ne nkɛntɛnso a ɛtra hɔ kyɛ?
Eyi nso ho hia paa. Sɛ wɔanhu yare no anaa wɔammu wɔn ani agu so a, bere kɔ so no, nsɛnnennen a emu yɛ den betumi aba.
| Nsɛnnennen a ɛba | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Aduan pa a wonnya nni | Vitamin ne mineral a enni nipadua mu no betumi ama nneɛma te sɛ nnompe a ɛyɛ mmerɛw (nnompe mu yare) ne ntini ahorow a ɛsɛe. Eyi nya mmofra nkɔso so nkɛntɛnso kɛse. |
| Nnuan afoforo a wontumi nnyina ano | Sɛ wosɛe dwensɔtwaa ketewa no a, ebetumi ama tebea bi a wɔfrɛ no `Lactose Intolerance` aba, a wuntumi nwe nneɛma te sɛ nufusu (lactose) a kan no na wonom a ɔhaw biara nni ho. |
| Nkwammoaa a ɛko tia nyarewa a ayɛ mmerɛw | Sɛ wowɔ yare biako a nipadua no tumi ko tia nyarewa a, ɛma asiane a ɛwɔ hɔ sɛ wubenya foforo no yɛ kɛse. Saa asiane yi kɔ soro bere tenten a wonnyaw no yare no. |
| Mmɛn mu yare | Ebia ayarefo binom benya mmerɛbo mu enzyme dodow a ɛkɔ soro, na ebetumi ama wɔanya mmerɛbo mu yare a enni sabea bere a bere kɔ so no. |
| Kokoram ho asiane | Celiac yare a wɔansa no wɔ asiane a ɛkɔ soro sɛ wobenya kokoram wɔ dwensɔtwaa mu no sua koraa (bɛyɛ 7%). Eyi betumi agye mfe du du pii ansa na ayɛ yiye. Enti mma wo ho nnyɛ wo hu, ayaresa a wubenya no ne ade a ɛho hia sen biara. |
Wobɛyɛ dɛn ahu sɛ wowɔ saa yare yi?
Sɛ wowɔ sɛnkyerɛnne ahorow a yɛaka ho asɛm wɔ atifi hɔ no a, ade a edi kan ne nea ɛho hia sen biara a ɛsɛ sɛ woyɛ ne sɛ wobɛkɔ wo duruyɛfo nkyɛn. Mma nnsi gyinae kɛkɛ sɛ, "Me ntumi nnye gluten ntom," na nnyae gluten a wodi. Saa a wɔbɛyɛ no betumi ama wɔanya nhwehwɛmu a wɔde hu yare no mu aba a ɛnyɛ nokware.
Oduruyɛfo no de akwan abien a wɔfa so yɛ nhwehwɛmu di dwuma titiriw de si yare no so dua.
1. Mogya mu Nhwehwɛmu: Eyi hwɛ sɛ ebia nnuru titiriw bi a ɛko tia nyarewa a nipadua no mu tumi a ɛko tia nyarewa no yɛ de ko tia gluten wɔ wo mogya mu anaa.
2. Endoscopy a wɔde hwɛ nipadua no mu:Sɛ mogya mu nhwehwɛmu no aba yɛ ``ayɛ papa a,`` afei yafunu mu ɔyaresafo bɛyɛ saa nhwehwɛmu yi. Wɔ eyi mu no, wɔde afiri teateaa bi a mfoninitwa afiri abata ho fa ano no mu na wɔhwehwɛ dwensɔtwaa ketewa no mu. Bere koro no ara mu no, woyi ntini ketewaa bi ``biopsy`` fi dwensɔtwaa ketewa no fasu mu na wɔde kɔ aduruyɛdan mu. Ɛhɔ no, wɔde microscope hwehwɛ ``villi`` a yɛaka ho asɛm no mu de kyerɛ sɛ ebia asɛe anaa.
Nea ɛho hia yiye: Enkosi sɛ wobɛkɔ wo duruyɛfo nkyɛn na wɔayɛ nhwehwɛmu yi nyinaa no, ɛho hia sɛ wokɔ so di nnuan a gluten wom sɛnea wotaa di. Sɛ ɛnte saa a, ebia wo dwensɔtwaa ketewa no bɛsa kakra na nhwehwɛmu no renkyerɛ yare no.
Dɛn ne ayaresa ahorow no? So ɛsɛ sɛ menom nnuru wɔ me nkwa nna nyinaa mu?
Asɛmpa no ni. Aduru biako pɛ a etu mpɔn sen biara a wɔde sa celiac yare ne nkwa nna nyinaa mu aduan a gluten nnim 100%. Yiw, enhia sɛ wonom nnuru a wɔde sa yare akuwakuw. Nea ɛsɛ sɛ woyɛ ara ne sɛ wobɛsesa w’aduan.
Sɛ wugyae gluten a wudi koraa a, sɛnea wo dwensɔtwaa ketewaa no sɛe no gyae. Afei ɛde nkakrankakra fi ase nya ahoɔden, anaasɛ ɛsa. Asram kakraa bi mu no, aduannuru a wɔtwe no fi ase san kɔ sɛnea na ɛte kan no.
Nea ɛka eyi ho no, ebia wo duruyɛfo bɛkamfo nea edidi so yi akyerɛ wo:
- Sɛ aduannuru a wonnya nni no mu yɛ den a, susuw vitamin ne mineral a wɔde ma (e.g. iron tablets) ho.
- Nnuru a wɔde sa honam ani akisikuru (dermatitis herpetiformis).
- Sɛ ɔfe a ɛwɔ dwensɔtwaa no mu no mu yɛ den dodo a, wobetumi de bere tiaa mu corticosteroids adi dwuma de asiw ano.
Wobɛyɛ dɛn ayɛ nsakrae wɔ asetra a gluten nnim mu?
Ebia eyi bɛyɛ te sɛ nea ɛyɛ den kakra mfiase no, efisɛ ɛsɛ sɛ yegyae nnuan a yɛasua no pii. Nanso eyi yɛ sika a wode bɛto w’akwahosan mu. Bere kɔ so no, eyi bɛyɛ w’asetra fã a ɛfata.
Afotu kakraa bi a ebetumi aboa wo ni:
- Fa wo su sɛ wobɛkenkan nkyerɛwde a wɔakyerɛw so: Kenkan ``nneɛma a wɔde yɛ aduan'' a ɛwɔ ade biara a wobɛtɔ afi sotɔɔ mu no so. Hwɛ sɛ ɛka sɛ ``Ɛwɔ awi, atoko, rye.''
- Hu nneɛma a efi awosu mu a gluten nnim: Aburow, nhabannuru, nnuaba, nam, mpataa, nkesua, ne nufusu a wɔde yɛ nneɛma no fi awosu mu nni gluten.
- Yɛn mpɔtam hɔ nneɛma a yɛde si ananmu: Sɛ́ anka wubedi paanoo esiam no, wubetumi adi nnuan a wɔde aburow esiam, semolina esiam, chickpea esiam, ne gram esiam a ɛyɛ ahabammono (indiappa, pittu, roti, ɛnonom) ayɛ.
- Hwɛ yiye bere a woredidi wɔ abɔnten no:Sɛ woredidi wɔ adidibea a, bisa wɔn sɛ wɔwɔ nneɛma a gluten nnim anaa. Wɔ mmeae a wɔyɛ nneɛma te sɛ kottu ne paratha no, sɛ wonoa nnuan a gluten nnim wɔ kyɛnsee koro mu a, gluten betumi aka ho (cross-contamination). Hwɛ yiye wɔ ɛno nso ho.
- Yɛ ofie aduan: Susuw nnuan kakraa bi a ɛnyɛ den sɛ wubesiesie a wubetumi adi ho, na fa nneɛma a wode bɛyɛ aduan no sie fie. Afei ɛho renhia sɛ wohaw wo ho sɛ ɔkɔm bɛde wo.
Sɛ wohu sɛ wowɔ celiac yare a, ɛyɛ nsakrae kɛse wɔ w’asetra mu. Nanso ɛyɛ nsakrae pa. Seesei wunim nea ɛde wo ho a ɛyɛ wo yaw bere tenten no ba. Ano aduru no wɔ wo nsam. Sɛ wudi aduan pa a, wubetumi abɔ bra a ɛyɛ dɛ, apɔwmuden, na anigye wom.
Nkrasɛm a Wɔde Kɔ Fie
- Celiac yare yɛ nipadua no mu tumi a ɛko tia nyarewa no mmuae a ɛnteɛ wɔ protein gluten ho. Ɛnyɛ ade a ɛtaa ba a ɛma obi ho yɛ no yaw.
- Saa yare yi sɛe dwensɔtwaa ketewa no na ɛmma aduannuru a ɛwɔ aduan mu no ntumi nkɔ. Eyi betumi ama obi anya aduan pa a wonnya nni.
- Yafunu mu yaw, akisikuru, akisikuru, ɔbrɛ, ne mu duru a ɛso tew yɛ sɛnkyerɛnne a ɛtaa ba, nanso ebia nnipa binom rennya yare no ho sɛnkyerɛnne biara.
- Sɛ wowɔ sɛnkyerɛnne bi a, kɔ wo duruyɛfo nkyɛn ntɛm ara. Kwati sɛ wubegyae nnuan a gluten wom a wunnya nnuruyɛfo afotu.
- Wobetumi de mogya mu nhwehwɛmu ne endoscopy ahu yare no pɛpɛɛpɛ.
- Aduan a gluten nnim 100% akyi a wubedi akyi nkwa nna nkutoo ne ayaresa a edi mu sen biara.
- Sɛ wudi aduan pa akyi a, wubetumi atra ase a ahoɔden wom koraa na ɛyɛ nnam.
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