So wo ba no wɔ Short Bowel Syndrome (SBS)? Momma yɛnka eyi ho asɛm tiawa!

So wo ba taa nya yafunu mu haw te sɛ akisikuru? Ɛmfa ho aduan dodow a wode bɛma wɔn no, ɛte sɛ nea wonnidi sɛnea ɛsɛ, na wɔn mu duru nso nkɔ soro? Anaasɛ saa sɛnkyerɛnne ahorow yi ada adi wɔ dwensɔtwaa mu oprehyɛn bi akyi? Sɛ́ ɛna anaa agya no, ɛyɛ ade a ɛfata sɛ wuhu nneɛma a ɛte sɛɛ a, wobɛte ehu ne dadwen kɛse nka. Ɛnnɛ yɛrebɛka Short Bowel Syndrome (SBS) ho asɛm, tebea bi a ebetumi de saa sɛnkyerɛnne ahorow yi aba, nanso wɔnka ho asɛm pii.

Sɛ yɛbɛka no tiawa a, dɛn ne Short Bowel Syndrome (SBS)?

Short Bowel Syndrome (SBS) yɛ tebea a ɛma wo ba nipadua ntumi nnye aduannuru ne nsu a ɛdɔɔso. Nea enti a ɛte saa ne sɛ abofra no dwensɔtwaa ketewa no fã bi nni hɔ anaasɛ entumi nyɛ adwuma yiye.

Saa tebea yi betumi aba fi awo mu. Afei nso, ɛtɔ mmere bi a SBS betumi aba bere a wɔayɛ oprehyɛn ayi dwensɔtwaa ketewaa no fã kɛse esiane aduruyɛ tebea foforo nti akyi. Wɔsan frɛ eyi "Short gut syndrome".

Enti, dwuma bɛn na dwensɔtwaa ketewa yi di?

Sɛ yɛbɛte eyi ase yiye a, momma yenni kan nsua dwensɔtwaa ketewaa, yɛn aduan mu ɔbran no ho ade kakra. Susuw dwensɔtwaa ketewa no ho sɛ ade tenten bi a wɔde fa nneɛma so wɔ adwumayɛbea bi. Aduan a yedi no dan nsu wɔ yafunu no mu na afei ɛnam saa abɔso yi so. Wɔ kwan so no, dwensɔtwaa no afasu a ɛyɛ adwuma te sɛ adwumayɛbea adwumayɛfo no tetew nneɛma pa a ɛwɔ saa aduan no mu nyinaa mu — kyerɛ sɛ, aduannuru a ɛho hia te sɛ protein, carbohydrates, srade, vitamin, dade, calcium, ne nsu — na ɛde ka mogya no ho. Nea aka a ɛho nni mfaso mma nipadua no kɔ dwensɔtwaa kɛse no mu na wɔayi afi mu sɛ nsu a ɛyɛ fĩ.

Dwonku ketewa no wɔ afã atitiriw abiɛsa:

• Duodenum: Eyi ne fã a ɛyɛ tiaa sen biara wɔ yafunu no akyi.
• Jejunum: Eyi ne mfinimfini fã no.
• Ileum: Eyi ne ɔfã a ɛware sen biara. Ɛba awiei wɔ dwensɔtwaa kɛse no mu.

Ɔkwan bɛn so na SBS ka dwensɔtwaa ketewaa no?

Afei susuw ho hwɛ, sɛ yeyi ade kɛse bi fi conveyor belt no mu wɔ saa adwumayɛbea a yɛkaa ho asɛm no mu a, dɛn na ɛbɛba? Ná nneɛma (i.e. aduan) no bɛsa afi conveyor belt no mu ntɛmntɛm dodo. Adwumayɛfo no (dwensɔtwaa afasu) no rennya bere a ɛdɔɔso mfa ntetew nneɛma pa (aduannuru) no mfi nneɛma no mu. Saa ara na ɛkɔ so wɔ SBS mu.

Mpɛn pii no, wɔwo akokoaa a ne dwensɔtwaa ware kakra sen sɛnea ɛte daa. Ɛte sɛ ɔfã bi a ɛboro so. Sɛ woyi duodenum ne jejunum no fã ketewaa bi mpo bere a wɔreyɛ oprehyɛn no a, ileum no betumi agye afã abien no nyinaa adwuma na akari pɛ wɔ aduannuru a wɔtwe no mu.

Sɛ wɔannya saa tebea yi a, abofra no betumi anya tebea horow a emu yɛ den te sɛ aduan pa a onnya nni na ɛde ne nkwa mpo to asiane mu.

Wobɛyɛ dɛn ahu sɛ abofra bi wɔ SBS? Dɛn ne sɛnkyerɛnne ahorow no?

Sɛ wususuw sɛ wo ba no wɔ saa tebea yi a, ma w’ani nna hɔ wɔ saa sɛnkyerɛnne ahorow yi ho. Sɛ wowɔ saa sɛnkyerɛnne yi mu biako anaa nea ɛboro saa nnidiso nnidiso a, kɔ oduruyɛfo nkyɛn ntɛm ara.

Dɛn nti na mmofra wɔ saa tebea yi?

Sɛnea edin no kyerɛ no, nea ɛde eyi ba titiriw ne dwensɔtwaa a ɛsiw. Nneɛma atitiriw abien na ɛde ba:

1. Ɔhaw ahorow a wonya fi awo mu: Wɔwo mmofra binom a wɔwɔ dwensɔtwaa mu nneɛma bi a ɛnteɛ.

• Awosu mu dwensɔtwaa no tenten a ɛso tew.
• Sɛ wɔwo obi a dwensɔtwaa no fã biara nni mu.
• Intestinal atresia yɛ aduruyɛ mu asɛmfua a ɛkyerɛ sɛ dwensɔtwaa no ntumi nnyin koraa wɔ awotwaa no mu.

2. Sɛ́ oprehyɛn mu nsunsuanso bɔne: Aduruyɛ mu tebea horow bi a emu yɛ den hwehwɛ sɛ wɔyɛ oprehyɛn yi abofra dwensɔtwaa ketewaa no fã bi. SBS nso betumi aba.

Tebea horow bɛn na ɛhwehwɛ sɛ wɔyɛ oprehyɛn yi dwensɔtwaa no fã bi?

• Necrotizing enterocolitis: Eyi ba bere a mogya a ɛkɔ dwensɔtwaa no afasu mu no so tew, na ɛma dwensɔtwaa no afã horow wuwu no. Saa tebea yi abu so wɔ nkokoaa a wɔawo wɔn ntɛm mu.
• Gastroschisis: Eyi ne bere a dwensɔtwaa no puepue wɔ nipadua no akyi bere a akokoaa no renyin wɔ awotwaa no mu no.
• Volvulus: Ɛyɛ dwensɔtwaa a ɛkyinkyini. Eyi betumi atwa mogya a ɛsen no na asɛe saa beae no.
• Crohn yare: Tebea a ɛma aduan mu yɛ hyew a enni sabea.
• Intussusception: Dwensɔtwaa no fã biako kɔhyɛ ɔfã foforo mu.

Dɛn ne nsɛnnennen a ebetumi afi SBS mu aba?

Sɛ wɔansa SBS yiye a, abofra no betumi anya nsɛnnennen ahorow, na emu bi betumi ayɛ nea emu yɛ den yiye.

• Nsu a ɛtɔ: Nsu a ɛkɔ nipadua no mu bere nyinaa efisɛ nipadua no ntumi nnye nsu dodow a ɛho hia no.
• Aduan pa a wonnya nni: Ne mu duru a ɛso tew ne sɛnea wontumi nnya mu duru esiane aduannuru a wɔmfa nkɔ nipadua no mu yiye nti.
• Vitamin ne mineral a enni nipadua no mu: Vitamin a ɛho hia (A, D, E, K, B12) ne minerals (calcium, magnesium, zinc) a enni nipadua no mu.
• Diaper rash a emu yɛ den: Honam ani yare a emu yɛ den a efi dwensɔtwaa a ɛtaa kɔ ne nsu mu acid a ɛdɔɔso mu ba.
• Mmerɛbo mu yare: Mmerɛbo a ɛsɛe esiane aduan a wɔde IV a wɔde ma bere tenten ne nneɛma afoforo a ɛde ba nti.
• Asaabo mu abo: Esiane sɛ calcium ne oxalate a wɔtwe no nkari pɛ nti.
• Mmoawa a nyin boro so: Mmoawa a wopira a ɛdɔɔso dodo wɔ dwensɔtwaa ketewa no mu.
• Aduan a wontumi nnyina ano: Sɛ nhwɛso no, sɛnea wontumi nwe nufusu mu nneɛma a lactose wom.

Ɔkwan bɛn so na nnuruyɛfo hu yare yi?

Sɛ wode wo ba no kɔ oduruyɛfo nkyɛn a, obedi kan abisa abofra no yare no ho sɛnkyerɛnne ne n’abusua aduruyɛ ho abakɔsɛm. Afei, wɔbɛhwehwɛ abofra no mu. Wobetumi ayɛ nhwehwɛmu pii de asi nea wɔahu no so dua na wɔahu nea ɛde ba ankasa:

• Mogya mu nhwehwɛmu: Hwɛ abofra no mogya mu hwɛ sɛ nneɛma te sɛ vitamin ne mineral dodow, ne mogya a ɛtɔ kɔ nipadua mu.
• Fecal fat test: Ɛhwɛ sɛnea srade a wɔannye no dodow te wɔ nsu mu.
• X-ray: Sɛnea ɛbɛyɛ a wobɛhwɛ sɛnea dwensɔtwaa no te. Ebia wɔbɛma wo nsu titiriw bi te sɛ barium, na wobetumi ayɛ X-ray.
• CT scan: Nya dwensɔtwaa ne yafunu mu akwaa afoforo ho mfonini a emu da hɔ.

Dɛn ne ayaresa ahorow a wɔde sa SBS?

Botae atitiriw abien na ɛwɔ abofra a ɔwɔ SBS a wɔbɛsa no mu. Biako ne sɛ wɔbɛfa ɔkwan bi so ama abofra no anya aduannuru a ohia na ama wanyin. Ɔfoforo no ne sɛ wobedi sɛnkyerɛnne ahorow te sɛ akisikuru so. Wɔde akwan pii a wɔfa so sa yare bom di dwuma na ama wɔatumi ayɛ eyi.

1. Nsakrae a ɛba aduannuru mu

Eyi ne ɔfã a ɛho hia sen biara. Ɛdenam abofra no tebea so no, nnuruyɛfo ne aduannuru ho abenfo bom yɛ aduan ho nhyehyɛe a ɛfata sen biara ma abofra no.

• Nsakrae wɔ aduan mu: Sɛ wo ba no tumi di n’ano a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ ɔmma no aduan nketenkete mpɛn pii da biara . Ebia wɔbɛkamfo akyerɛ sɛ wɔbɛtew nnuan a srade pii wom, asikre a ɛnyɛ den, ne fiber so na mmom wɔde aduan a ahoɔdennuru pii wom a carbohydrates ne protein wom bɛma.
• Total Parenteral Nutrition (TPN): Nea ɛka eyi ho ne sɛ wɔde aduannuru no nyinaa (nsu, asikre, protein, srade, vitamin) bɛkɔ ntini bi mu tẽẽ sɛ nsu, na wɔatwa abofra no aduan mu nhyehyɛe no ho ahyia koraa. Wɔtaa de saa kwan yi di dwuma wɔ dwensɔtwaa mu oprehyɛn akyi anaa bere a abofra no ntumi mfa n’ano nnom aduan no.
• Aduandi a Ɛwɔ Awotwaa Mu: Wɔ eyi mu no, wɔde afiri a ɛyɛ mmerɛw fa hwene no mu anaasɛ wɔde hyɛ yafunu anaa dwensɔtwaa ketewa no mu tẽẽ, na wɔfa mu de nsu mu aduan ma. Saa kwan yi boa ma wonya aduannuru pii de ka aduan dodow a wɔde ano di ho.

2. Nnuru a wɔde di dwuma

Wɔde nnuru ahorow di dwuma de siw yare no ho sɛnkyerɛnne ahorow so na ɛma aduannuru a wɔde di dwuma no tu mpɔn.

• Nnuru a ekum ɔyare mmoawa: Siw mmoawa a enyin dodo wɔ dwensɔtwaa no mu ano.
• Nnuru a ɛtew yafunu mu acid so (proton pump inhibitors, H2 blockers): Tew ɔhaw ahorow a yafunu mu acid de ba no so.
• Nnuru a wɔde ko tia akisikuru: Tew sɛnea aduan fa dwensɔtwaa no mu no brɛoo, na ɛma wonya bere pii ma aduannuru no twetwe.
• Nnuru a ɛma obi nyin: Ɛma aduannuru a dwensɔtwaa no twetwe no tu mpɔn.

3. Oprehyɛn a wɔyɛ

Ebia ɛho behia sɛ wɔyɛ mmofra binom oprehyɛn foforo na ama wɔn dwensɔtwaa ayɛ adwuma yiye. Eyinom bi ne:

• Dwensɔtwaa no tenten a wɔbɛma akɔ soro (denam oprehyɛn akwan titiriw so).
• Ahoɔhare a aduan de tu ntɛmntɛm a wɔbɛma ayɛ brɛoo.
• Nneɛma a ɛsiw dwensɔtwaa mu no a wobeyi afi hɔ.

Wɔ tebea horow a emu yɛ den yiye mu no, ebia ɛho behia sɛ wɔde abofra no dwensɔtwaa/mmerɛbo foforo ma.

Anidaso a anidaso wom a ɛne sɛ dwensɔtwaa bɛsakra

Eyi ne anidaso kɛse ma awofo a wɔwɔ mmofra a wɔwɔ SBS. Intestinal adaptation yɛ adeyɛ a dwensɔtwaa no fã a aka no ma ne dwumadi tu mpɔn bere tenten bere a wɔayi dwensɔtwaa no fã bi afi hɔ akyi.

Wɔ eyi mu no, dwensɔtwaa a aka no mu ɔfasu no yɛ den, na nneɛma a ɛte sɛ nsateaa a wɔfrɛ no villi a ɛtwe aduannuru no yɛ tenten na ɛyɛ den. Eyi ma dwensɔtwaa ketewaa a aka no tumi twetwe aduannuru yiye sen kan no. Saa kwan a wɔfa so yɛ nsakrae yi betumi adi nkonim titiriw, efisɛ mmofra nkumaa dwensɔtwaa kɔ so nyin wɔ awosu mu kosi sɛ wobedu wɔn mmofraase.

Nnansa yi nnuru a wɔde bɔ nkurɔfo ho ban te sɛ teduglutide rema saa nsakrae nhyehyɛe yi ayɛ ntɛmntɛm na ɛreboa ma wɔatwe mmofra nufu afi aduannuru a wɔde fa ntini mu te sɛ TPN ho.

Dɛn na wubetumi ayɛ sɛ ɔwofo?

Ɛwom sɛ akwantu yi yɛ den de, nanso ɛnyɛ wo nkutoo. Kuw kɛse bi wɔ hɔ a wɔbɛboa wo ma woadi wo ba no akwahosan ho dwuma.

• Mmofra oduruyɛfo
• Mmofra yafunu mu yafunu ho ɔbenfo
• Mmofra aduan ho ɔbenfo
• Mmofra oprehyɛn ho ɔbenfo

W’adwuma titiriw ne sɛ wubedi akwankyerɛ a nnuruyɛfo kuw yi de ama no akyi pɛpɛɛpɛ. Ɛho hia sɛ wohwɛ yiye kɛse wɔ abofra no aduan a wode ma no mu, nnuru a wode bɛma no bere ano, na sɛ wode ayaresa te sɛ TPN redi dwuma a, ɛho hia sɛ wohwɛ yiye kɛse wɔ ne ho a wobɛma ho atew mu.

SBS betumi ayɛ mmofra binom nkwa nna nyinaa tebea. Nanso, wɔ mmofra binom fam no, bere kɔ so no, tebea no tu mpɔn kɛse. Sɛ wonya ayaresa a ɛfata, wodi aduan pa, na wofi ɔdɔ mu hwɛ wɔn a, mmofra yi mu pii betumi atra ase sɛnea ɛsɛ, na anigye wom.