So wunnye nea wudi no yiye? Momma yɛnka eyi ho asɛm (Malabsorption)!

So wotaa nya yafunu mu haw? So ɛtɔ mmere bi a wote nka sɛ woayɛ ma na gas ayɛ wo ma? Anaasɛ wotaa hu amane wɔ akisikuru ho? Ɛtɔ mmere bi a yesusuw sɛ eyinom yɛ nneɛma a ɛfata, biribi a ɛba bere a aduan yɛ nnuhwam kakra no. Nanso, sɛ saa sɛnkyerɛnne ahorow yi kɔ so a, ebetumi aba sɛ wo nipadua no nnye aduannuru a ehia mfi aduan a wudi no mu nti. Wɔ aduruyɛ mu no, yɛfrɛ saa tebea yi (Malabsorption).

Dɛn ne eyi (Malabsorption)?

Sɛ yɛbɛka no tiawa a, malabsorption yɛ asɛmfua a wɔde frɛ wo nipadua a entumi nnye aduannuru a ɛwɔ aduan a wudi no mu yiye. Eyi nyɛ yare biako pɛ, na mmom ɛyɛ tebea a nneɛma pii betumi de aba. Susuw ho hwɛ, sɛ yedi aduan a, sɛnea ɛbɛyɛ a ɛbɛma yɛn nipadua anya ahoɔden ne aduannuru no, ɛsɛ sɛ wɔyam no yiye na wɔtwe, ɛnte saa?

Yebetumi akyekyɛ ɔkwan a wɔfa so yam aduan no mu abiɛsa:

1. Ɔfã a Edi Kan: Aduan a wobɛtetew mu yiye na woakyekyɛ mu asinasin a wotumi di.

2. Ɔfã a ɛto so abien: Nnuannuru a nipadua no hia nyinaa a ɛbɛtwe afi aduan a wɔayam no mu.

3. Ɔfã a Ɛto so Abiɛsa: Nneɛma a ɛyɛ fĩ a ɛka bere a wɔatwe nneɛma pa nyinaa awie no a wobeyi afi mu.

Afei, sɛ wowɔ aduan mu haw ahorow a, ɔhaw no betumi aba wɔ saa mmere yi mu biara mu. Malabsorption yɛ ɔfã a ɛto so abien no fã . Eyi kyerɛ sɛ ɛwom sɛ wɔyam aduan de, nanso aduannuru no ntumi nkɔ nipadua no mu. Eyi betumi afi tebea horow te sɛ enzyme a enni nipadua no mu a ɛmma nipadua no ntumi nwe nnuan bi (sɛ nhwɛso no, nnipa binom ntumi nwe nufusu) ne dwensɔtwaa mu nyarewa ahorow a ɛka wo aduan mu nhyehyɛe no.

Dɛn na ɛba bere a malabsorption wɔ hɔ no?

Sɛ wowɔ malabsorption a, ebia wubehyia ɔhaw wɔ aduannuru nyinaa a wobɛtwe mu, anaasɛ wobɛhaw wo wɔ aduannuru pɔtee kakraa bi pɛ a wobɛtwe mu. Nneɛma a wuntumi nnye no kɔ wo nsu mu a ɛnyɛ nea wɔayam. Nnipa pii a wɔwɔ malabsorption nso wɔ tebea horow te sɛ atiridiinini, na ebetumi ama ɔhaw a ɛfa absorption yi asɛe kɛse. Eyi te saa efisɛ sɛ wo ho yɛ wo yaw a, aduan fa wo dwensɔtwaa mu ntɛmntɛm dodo, enti aduannuru nnya bere mfa nnye.

Wɔ bere tiaa bi mu no, sɛ obi ntumi nnom nsu yiye a, ebetumi ama ne yafunu ayɛ basaa na ne ho ayɛ no yaw efisɛ wontumi nnya nnuan bi. Nanso bere kɔ so no, wo nipadua no befi ase ada aduannuru a wuntumi nnye no mu sintɔ adi. Sɛ aduannuru akɛse nni wo mu – te sɛ protein, srade, ne carbohydrates a – wubefi ase ahu aduan pa a wonnya nni ho sɛnkyerɛnne, te sɛ ntini a wɔsɛe no ne nipadua mu ahoɔden a ɛko tia nyarewa a ayɛ mmerɛw . Saa ara nso na sɛ aduannuru nketenkete – te sɛ vitamin ne minerals nni wo mu a – w’ani, nnompe, honam ani, ne wo ti nhwi betumi aka wo.

Dɛn ne nneɛma atitiriw a ɛma obi ntumi nnom nsu yiye?

Dwotwaa mu nyarewa bi te sɛ Celiac Disease ne Inflammatory Bowel Disease (IBD) betumi de ɔhaw ahorow aba aduannuru ahorow nyinaa a wɔtwe no mu. Wɔ tebea afoforo mu no, ebia wubehyia ɔhaw wɔ aduannuru pɔtee bi nkutoo a wobɛtwe ho. Nneɛma ahorow no bi ni:

Carbohydrates ntumi nnye nipadua no yiye.

Nnipa binom ani gye carbohydrates (asikre) biako anaa nea ɛboro saa ho. Ebia wubehu eyi titiriw sɛ gas, wo yafunu a ɛyɛ wo yaw, ne ɛyaw a ɛba wo yafunu mu . Carbohydrates a ɛnkɔ wo dwensɔtwaa ketewa no mu yiye no, mmoawa a wɔwɔ wo dwensɔtwaa kɛse no mu na ɛma ɛyɛ hyew. Saa mmoawa yi dan wɔn mframa ne srade a ɛwɔ nkɔnsɔnkɔnsɔn tiaa mu. Saa mframa no ma mframa ba wo yafunu mu, na srade a ɛwɔ nkɔnsɔnkɔnsɔn tiawa no betumi ama wo nsu mu ayɛ srade.

Srade ntumi nkɔ nipadua no mu yiye

Eyi nso yɛ ade a ɛtaa ba a ɛma obi ntumi nnom nsu yiye. Ebetumi de nneɛma pii aba. Srade a ɛnkɔ dwensɔtwaa ketewa no mu no kɔ dwensɔtwaa kɛse no mu, na ɛde nsu a srade wom a ɛte sɛ akisikuru ba. Yɛsan frɛ eyi steatorrhea. Saa nsu a wɔde gu nsu mu yi yɛ nea srade wom, nsu wom, na ɛyɛ huam . Ebia ne kɔla yɛ hare na ɛsensɛn nsu mu. Esiane sɛ srade ntumi nkɔ nipadua no mu yiye nti, vitamin ahorow a ɛtumi nwura srade mu (vitamins A, D, E, ne K) nso sɛe.

Bile acid a ɛmma nipadua no ntumi nkɔ nipadua no mu

Ɛtɔ mmere bi a, srade ntumi nnye efisɛ akisikuru, ntini a ɛma mogya tu, anaa mmerɛbo no ntumi mma akisikuru a ɛdɔɔso. Nanso ɛtɔ mmere bi a nea ɛde ba no yɛ biribi foforo. Afei, bile acid a wɔannye no kɔ so tra dwensɔtwaa ketewa no mu na ɛkɔ dwensɔtwaa kɛse no mu. Wɔfrɛ saa ɔhaw bɔne yi Bile Acid Malabsorption. Nkyene a ɛwɔ mogya mu a ɛka saa kwan yi so no ma nsu a efi dwensɔtwaa kɛse no mu no yɛ kɛse, na ɛma obi nya akisikuru bere tenten .

Protein ntumi nnye nipadua no yiye

Mpɛn pii no, gye sɛ wunni protein pɔtee bi a wuntumi nnye ntom, kyerɛ sɛ, wuntumi nnyam, ɛntaa mma sɛ wubehyia ɔhaw wɔ protein nkutoo a wobɛtwe ho. Eyi ho nhwɛso ne sɛnea wontumi nnya protein a ɛwɔ nufusu mu no ne sɛnea wontumi nnya nnuan a gluten wom no.

Sɛ malabsorption wɔ hɔ a, dɛn ne sɛnkyerɛnne ahorow no?

Mfiase no, ebia ɛbɛyɛ te sɛ nea aduan a wɔmfa nni dwuma yiye no te sɛ aduan a wɔmfa nni dwuma yiye. Ebia sɛnkyerɛnne ahorow no bi ne:

• Yafunu mu yaw.
• Ɔhohoro, yafunu a ɛhyɛ ma.
• Mframa (gas) a ɛtaa fa mu.
• Akisikuru ne ɔfe.
• Ayamtuo.
• (Steatorrhea) - Srade, srade, ɛtɔ da bi a ne kɔla sesa, nsuo a ɛsensɛn nsuo mu.

Bere kɔ so no, aduan pa a wonnya nni ho sɛnkyerɛnne fi ase da adi.

Aduan pa a wonnya nni wɔ aduannuru atitiriw mu no betumi ayɛ te sɛ eyi:

• Mu duru a wɔtew so a wɔanhyɛ da .
• Ntini a wɔsɛe no, mu duru a ɛso tew.
• Nyarewa a ɛtaa nya (esiane nipadua no mu tumi a ɛko tia nyarewa a ɛba fam nti).
• Sɛ akuru ketewaa bi mpo a, honam ani yɛ bruu.
• Wora a ɛyɛ dry, honam ani akuru.
• Nwi a ayow, ti nhwi a ɛtɔ.
• Dehydration (nsu a enni nipadua no mu).
• (Edema) - Nipadua no mu ahohoro (esiane nsuo a ewo mu nti).
• Anemia - paleness, mmerɛwyɛ, adwenemhaw.
• Abufuw a ɛkɔ so daa, anigye a wonni, ɔbrɛ.
• Brayɛ a wogyae anaasɛ ɛnkɔ so daa wɔ mmea mu (Amenorrhea).
• Mmofra nkɔso a ɛkyɛ.

Aduan pa a wonnya nni wɔ aduannuru nketenkete mu betumi ayɛ te sɛ eyi:

• Anisoadehu a ɛso tew anadwo (Vitamin A a enni nipadua no mu).
• Nnompe a ɛyɛ mmerɛw, nnompe mu yaw (Vitamin D a enni nipadua mu).
• Mogya a ɛtɔ gu anom, hwene mu mogya (Vitamin K a enni nipadua mu).
• Tɛkrɛma kɔkɔɔ, tɛkrɛma mu akuru (Vitamin B12 a enni nipadua mu).
• Paleness, mmerɛwyɛ, adwenemhaw (vitamin a enni mogya mu).

Dɛn ne nneɛma atitiriw a ɛde malabsorption ba?

Malabsorption betumi ayɛ bere tiaa mu de, te sɛ bere a wowɔ yafunu mu mmoawa anaa yafunu mu atiridii no. Nanso aduruyɛ mu tebea bi a ɛda adi a woanya bere tenten na ɛde bere tenten a ɛma wotumi nnom nsu no ba. Nneɛma pii wɔ hɔ a ɛde malabsorption ba, nanso mpɛn pii no ɛhyɛ akuw kakraa bi mu.

Ɔsɛe a ɛba dwensɔtwaa ketewa no mu

Wo aduannuru dodow no ara kɔ dwensɔtwaa ketewa no mu (ebi nso kɔ dwensɔtwaa kɛse no mu). Wo dwensɔtwaa afasu mu ntini a ɛwɔ wo mogya mu no ka ho bi na ɛma aduan mu nneɛma a ɛma aduan mu yɛ hyew na ɛtwetwe aduan a ɛyɛ nsu kɔ wo mogya mu no nyinaa. Nanso, ɔfe (enteritis) ne opira betumi asɛe saa ntini a ɛwɔ nipadua no mu yi. Saa ɔsɛe yi betumi ayɛ bere tiaa mu (ɛyɛ den) anaa bere tenten (nea enni sabea). Nneɛma pii nti na ɛte saa:

• Nyarewa a ɛde ɔyare ba te sɛ Whipple’s Disease ne Tropical Sprue.
• Nyarewa a ɛma obi ho hyehye no (IBD) te sɛ Ulcerative Colitis ne Crohn Yare.
• Nyarewa a nipadua no tumi ko tia nyarewa te sɛ Celiac Disease.
• Nnuru bi a wɔde di dwuma dodo.
• Nsa a Wɔde Di Dwuma Ho Ɔhaw.
• Mframa a wɔde sa yare ne nnuru a wɔde sa yare.
• (Short Bowel Syndrome) - dwensɔtwaa ketewa no a ɛyɛ tiaa.
• (Small Intestinal Bacterial Overgrowth - SIBO) - Mmoawa a enyin dodo wɔ dwensɔtwaa ketewa no mu.
• Yafunu mu acid a wɔyɛ boro so wɔ tebea horow te sɛ Zollinger-Ellison Syndrome mu.

Pancreas, gallbladder, mmerɛbo mu nyarewa

Wo dwensɔtwaa, mmerɛbo, ne akisikuru ne wo dwensɔtwaa ketewaa no bom yɛ adwuma boa ma woyam aduan. Dwensɔtwaa no yɛ nneɛma a ɛho hia a ɛma aduan mu yɛ hyew. Mmɛn ne akisikuru no yɛ bile na ɛkora so. Saa bile yi ho hia na ama srade a wɔayam. Sɛ wodi aduan a, saa akwaa yi gyae wɔn nsuo kɔ dwensɔtwaa ketewa no mu. Nanso, sɛ saa akwaa ahorow yi ntumi nyɛ adwuma yiye esiane yare bi nti a, dwensɔtwaa ketewa no ntumi nwe aduan yiye na ɛntwe. Nhwɛso ahorow:

• Pancreatic a ɛnyɛ adwuma yiye.
• (Cystic Fibrosis) a ɛwɔ nipadua no mu.
• Bile Duct a Wɔde Siw Nneɛma Mu.
• Nyarewa a Ɛma Akisikuru.
• Mmɛn Yare.

Ntini a Ɛma Ntini Ho Nyarewa

Srade fi wo dwensɔtwaa ketewa no mu fa ntini a ɛma mogya tu mu kɔ wo mogya mu. Sɛ ntini ahorow yi siw esiane nyarewa a ɛwɔ ntini a ɛma mogya tu mu nti a, srade a wɔtwe no betumi asɛe. Intestinal Lymphangiectasia ne Lymphoma yɛ eyi ho nhwɛso abien.

Nnuan bi a wontumi nwe (Food Intolerances) .

Sɛ obi ntumi nnya carbohydrates anaa protein ahorow bi a, ebetumi ayɛ nea efi dwensɔtwaa mu nyarewa mu ba. (Nhwɛso bi ne sɛnea wontumi nnye fructose). Nanso ɛtɔ mmere bi a wɔwo nnipa a wonni enzymes a ehia na ama wɔatumi ayam aduannuru bi. (Eyi ho nhwɛso a eye sen biara ne sɛnea wontumi nnya lactose - Lactose Intolerance).

Wobɛyɛ dɛn ahu sɛ wowɔ malabsorption?

Te sɛ dwensɔtwaa mu nyarewa pii no, sɛ wobehu sɛ obi ntumi nnom nsu yiye a, ɛyɛ adeyɛ a ɛkɔ so nkakrankakra kakra. Wo duruyɛfo bedi kan ahwɛ wo na wasusuw w’ayaresa ho abakɔsɛm ne wo sɛnkyerɛnne ahorow ho. Ebia wobesusuw sɛ malabsorption sɛ wowɔ abakɔsɛm a ɛkyerɛ sɛ wowɔ dwensɔtwaa mu yare a enni sabea anaasɛ wɔayɛ wo oprehyɛn a.

Wobetumi asusuw denneennen sɛ obi ntumi nnom ne aduan pa a wonnya nni sɛ sɛnkyerɛnne ahorow bi te sɛ steatorrhea (nsu a srade wom) a yɛadi kan aka ho asɛm no ne akisikuru a ɛkɔ so daa, anaasɛ mogya a ɛtɔ kɔ nipadua mu a ɛda adi pefee ne ntini a wɔsɛe no wɔ hɔ a. Nanso, wɔ nsɛm bi mu no, eyi nna adi saa. Wo duruyɛfo bɛyɛ nhwehwɛmu a ɛfata de ahu nea ɛde wo yaw no ba ankasa.

Sɔhwɛ ahorow bɛn na wɔde hu sɛ obi ntumi nnom nsu yiye?

• Ɔhome mu Sɔhwɛ: Hydrogen home mu sɔhwɛ betumi aboa ma wɔahu tebea horow te sɛ lactose a wontumi nnye ntom, carbohydrate a wɔyam mu haw pɔtee bi, ne SIBO (dwotwaa nketenkete mu mmoawa a nyin boro so).
• Nsu mu Nhwehwɛmu: Nsu mu nhwehwɛmu betumi asusuw srade dodow a ɛwɔ wo nsu mu na ebetumi aboa ma woahu sɛ srade ntumi nkɔ nipadua no mu yiye. Etumi hu nneɛma te sɛ mmoawa a wɔsɛe nnɔbae ne dwensɔtwaa a entumi nyɛ adwuma yiye nso.
• Mogya mu Nhwehwɛmu: Eyinom betumi ada aduannuru pɔtee bi a enni nipadua mu ho sɛnkyerɛnne adi a ebetumi afi mogya a wɔmfa nni dwuma yiye ne aduruyɛ mu tebea pɔtee bi te sɛ Celiac Yare mu aba.
• Sweat Test: Eyi yɛ sɔhwɛ titiriw a wɔde hu tebea no (Cystic Fibrosis).
• Mfonini a Wɔde Hwɛ: Ebia wo duruyɛfo bɛpɛ sɛ ɔhwɛ wo aduan mu akwaa ahorow no mu hwɛ sɛ ebia sɛnkyerɛnne bi wɔ hɔ anaa. Ebia eyi bɛka GI X-ray Nhwehwɛmu, Endoscopic Ultrasound, anaa Video Capsule Endoscopy ho.
• Nkwammoaa nketewa mu nhwehwɛmu:Ebia oduruyɛfo no bɛpɛ sɛ ɔfa ntini bi fi wo dwensɔtwaa ketewaa mu de yɛ nhwehwɛmu wɔ aduruyɛdan mu. Saa biopsy yi betumi ahwehwɛ adanse a ɛkyerɛ sɛ wo dwensɔtwaa no mu nneɛma (mucosa) asɛe. Wobetumi afa saa nhwɛsode yi bere a wɔreyɛ endoscopy.

Ɔkwan bɛn so na wɔsa malabsorption?

Nneɛma pii wɔ hɔ a ebetumi ama obi ntumi nnom nsu yiye, na nkɛntɛnso ahorow a ebetumi de aba no dɔɔso. Wobegyina saa nneɛma yi so akyerɛ sɛnea wobɛsa wo yare.

Sɛnea ɛbɛyɛ na woasa nea efi nsu a wɔmfa nni dwuma yiye mu ba no, ebia wubehia aduannuru a wɔde ma . Wobetumi de ama sɛ nsu denam ano, afa nsukorabea (tube feeding), anaasɛ wɔde akɔ ntini mu (IV - intravenous). Ebia ɛho behia nso sɛ wofa nnuru titiriw bi a ɛma aduan mu yɛ hyew. Ebia eyi fi sɛ wuntumi nwe aduan pɔtee bi anaasɛ wo dwensɔtwaa no ntumi nyɛ adwuma yiye. Sɛ wowɔ bile acid malabsorption a, ebia wɔbɛma wo biribi a wɔfrɛ no bile acid sequestrant na aboa ma woasiw akisikuru ano.

Nea ɛde malabsorption ba no a wɔbɛsa no betumi ayɛ den kakra. Sɛ ɛyɛ aduan a wuntumi nnyina ano kɛkɛ a, ebia ɛho behia sɛ wosakra w’aduan ara kwa. Wobetumi de nnuru a ekum ɔyare mmoawa asa ɔyare mmoawa a ɛnyɛ den. Nanso tebea horow a ɛtra hɔ kyɛ hwehwɛ sɛ wɔsa yare titiriw. Ɛtɔ mmere bi a, wonni ayaresa biara ntɛm ara, nanso asetra mu nsakrae betumi aboa ma wɔadi yare no ho sɛnkyerɛnne ahorow so.

So wɔbɛsa malabsorption no yare?

Eyi gyina nea ɛde ba ankasa a wobehu na wɔasa no yiye so. Nneɛma bi a ɛde ba no yɛ mmerɛw sɛ wɔbɛsa sen afoforo. Sɛ wohu sɛ wo yare no wie a, wo duruyɛfo bɛkyerɛkyerɛ wo tebea no mu nsɛm mu. Mpɛn pii no, asetra mu nsakrae betumi aboa wo ma woasa tebea no (malabsorption) ne ne sɛnkyerɛnne ahorow.

Nnipa pii nya aduan a wontumi nwe, wɔn ho popo, mframa, ne akisikuru bere ne bere mu. Sɛ biribi a wudi no anyɛ adwuma mma wo a, ebia wubenya yare no ho sɛnkyerɛnne bere tiaa bi, nanso mpɛn pii no wɔn ankasa kɔ. Saa aduan a wɔmfa nni dwuma yiye yi nyɛ biribi a ɛsɛ sɛ ɛhaw adwene wɔ ho. Nanso sɛ wunya saa sɛnkyerɛnne ahorow yi daa a, ebetumi ayɛ biribi a anibere wom kɛse ho sɛnkyerɛnne. Atiridiinini a ɛkɔ so yɛ biribi a ɛsɛ sɛ wohaw wo ho bere nyinaa.

Nnuan a wɔmfa nni dwuma yiye betumi ayɛ ade a ahintaw a ɛde aduan pa a wonnya nni. Esiane sɛ aduan pa a wonnya nni kɔ so nkakrankakra nti, ebia worenhu kosi sɛ ɛbɛyɛ den paa, titiriw sɛ woyɛ obi a wunya aduan pa a. Eyi yɛ nea asiane wom titiriw ma mmofra. Wohia aduannuru pii na ama wɔanyin na wɔanyin, na ebia wɔrentumi nka wɔn yare no ho sɛnkyerɛnne nkyerɛ wo. Sɛ wo ba no reda sɛnkyerɛnne ahorow adi sɛ ne yafunu ayɛ no yaw mpɛn pii, titiriw ne nsu a ɛho ayɛ hare a, ɛho hia sɛ wokɔ oduruyɛfo nkyɛn kɔhwɛ sɛ onni tebea a ɛmma ne yafunu ntumi nkɔ nipadua no mu yiye.

Dɛn ne nkrasɛm a yɛpɛ sɛ yɛde fi asɛm yi mu kɔ fie?

Okay, enti seesei yɛnim sɛ malabsorption yɛ asɛmfua a wɔde di dwuma wɔ ɔkwan a ɛkɔ akyiri so na nipadua no ntumi nnye aduanenuru mfi aduane a yɛdi mu. Nneɛma pii betumi de eyi aba, na sɛnkyerɛnne ahorow no betumi ayɛ soronko wɔ onipa biara ho.

• Sɛ worehyia sɛnkyerɛnne ahorow te sɛ yafunu a ɛtaa yɛ wo yaw, akisikuru, wo ho a ɛyɛ wo yaw, ne wo mu duru a wɔanhyɛ da , mmu no sɛ ɛnyɛ wo yam a wontumi nnya kɛkɛ.
• Nnuan a wɔmfa nni dwuma yiye betumi ama obi anya aduan pa , na ebetumi anya nipadua no so nkɛntɛnso bɔne pii.
• Sɛ wo anaa wo ba kɔ so nya saa sɛnkyerɛnne ahorow yi a, hwɛ hu sɛ wobɛhwehwɛ aduruyɛfo afotu .
• Sɛ wohu yare no yiye na wɔsa no yiye a, mpɛn pii no wobetumi adi tebea yi so.

Kae sɛ ɛho hia sɛ wutie nea wo nipadua reka akyerɛ wo. Ɛwom mpo sɛ ebia ɛbɛyɛ te sɛ ade ketewaa bi de, nanso ɛtɔ mmere bi a ebetumi ayɛ biribi kɛse bi mfiase. Enti, w’akwahosan a wobɛhwɛ so no ne ade a ɛho hia sen biara.

` Malabsorption, aduannuru a enni nipadua mu, aduan a wɔyam, atiridiinini, aduan pa a wonnya nni, vitamin a enni nipadua mu, yafunu a ɛyɛ yaw