Loaʻa pinepine iā ʻoe ka ʻeha puʻuwai? Me he mea lā e ʻā ana kou umauma. I kekahi manawa ma hope o ka ʻai ʻana, ʻoiai i ka pō ke moe ʻoe ma hope o ka ʻai ʻana, manaʻo ʻoe e puka mai ana kahi mea ʻawaʻawa a ʻawaʻawa mai kou waha? Manaʻo ka hapa nui o mākou he "gastritis" kēia a lawe i kahi lāʻau lapaʻau mai kahi hale kūʻai lāʻau a inu wale. Akā ua ʻike anei ʻoe inā hoʻomau kēia ʻano no ka manawa lōʻihi, hiki iā ia ke hōʻino i ko mākou esophagus? He ʻano koʻikoʻi kēia e hiki ke hana ma muli o kēlā hōʻino, i kapa ʻia ʻo 'Barrett's Esophagus'. Mai makaʻu, e kamaʻilio maʻalahi kākou e pili ana i kēia.
I ka ʻōlelo maʻalahi, he aha ka Barrett's Esophagus?
E noʻonoʻo i ko kākou esophagus e like me ka paipu wai. ʻO kēia ka paipu e lawe ana i ka meaʻai a kākou e ʻai ai mai ko kākou waha a i ko kākou ʻōpū. E like me nā wahi ʻē aʻe o ko kākou kino, aia i loko o kēia paipu kahi papa lahilahi a pale o nā cell (lining). ʻO kāna hana ka pale ʻana i ka esophagus.
I kēia manawa, e noʻonoʻo ʻoe e piʻi mau ana nā waikawa ʻino i loko o ko kākou ʻōpū a paʻi i nā paia o kēia esophagus. E like me ka wā e hāʻule mau ai kahi mea ʻino ma ka papahele, e puhi ʻia kēlā papahele, hōʻino kēia mau ala waikawa i ka papa cell palupalu o ka esophagus.
I ka hoʻomau ʻana o kēia pōʻino i nā makahiki, hoʻāʻo ko mākou kino e ʻimi i kahi hopena. Manaʻo ke kino, "ʻAʻole hiki i nā pūnaewele i loko o kēia esophagus ke hoʻomanawanui i kēia hoʻouka ʻakika. E aho wau e hana i kahi ʻano pūnaewele ikaika a kūʻē i ka ʻakika ma aneʻi."
No laila, ʻo ka mea a ke kino e hana ai, ʻo ia ke pani i nā ʻāpana i hōʻino ʻia i loko o ka esophagus me kahi ʻano ʻāpana i ʻoi aku ka pale ʻana i ka waikawa ma mua o ke ʻano i loaʻa i loko o ko kākou mau ʻōpū. I ka ʻōlelo maʻalahi, ma kahi o ke ʻano o ke ʻāpana e pono ai i loko o ka esophagus, hoʻomaka kahi ʻano ʻāpana i loaʻa i loko o ka ʻōpū e ulu i loko o ka esophagus. I ka lāʻau lapaʻau, kapa mākou i kēia metaplasia ʻōpū . ʻO ia ka mea a mākou e kapa ai ʻo 'Barrett's Esophagus'.
ʻO kēia ka hoʻāʻo ʻana o ke kino e pale iā ia iho. Akā ʻo ka pilikia, ʻoi aku ka nui o ka lilo ʻana o kēia mau ʻano cell hou i ka maʻi kanesa ma mua o nā cell maʻamau.
Pehea ke koʻikoʻi o kēia kūlana? Pono anei kākou e makaʻu?
E hoʻoweliweli paha kēia iā ʻoe. Makaʻu mākou a pau ke lohe mākou i ka huaʻōlelo "pilikia maʻi kanesa." Akā, ʻo ka mea nui e hoʻomaopopo ma ʻaneʻi, ʻaʻole e loaʻa i nā kānaka a pau me ka Barrett's Esophagus ka maʻi kanesa.
ʻO ka ʻoiaʻiʻo, haʻahaʻa loa ka pilikia o ka loaʻa ʻana o ka maʻi kanesa. Ua ʻike ʻia e ka noiʻi he 0.5% ka pilikia i kēlā me kēia makahiki, ʻo ia hoʻi ka emi ma mua o 1%. ʻO ke ʻano kēia, hoʻokahi wale nō i loko o 200 mau kānaka me ka Barrett's Esophagus e loaʻa i ka maʻi kanesa i loko o hoʻokahi makahiki.
Eia kekahi, ʻaʻole lilo kēia loli o ke kelepona i ka maʻi kanesa i ka pō hoʻokahi. He hana mālie loa ia. Ma mua o kona hele ʻana mai ke kūlana o ka 'metaplasia' a i ka 'maʻi kanesa', hele ia ma kekahi pae waena. Kāhea mākou iā ia he 'dysplasia'. Ma kēia pae o ka 'dysplasia', hiki i nā kauka ke ʻike iā ia. Inā hiki iā lākou ke ʻike iā ia, hiki iā lākou ke wehe i kēlā ʻāpana kelepona i hoʻololi ʻia a kāohi iā ia mai ka holomua ʻana i ka maʻi kanesa.
ʻO ia ke kumu e nānā mau ai nā kauka a nānā i nā poʻe me ka Barrett's Esophagus.
He aha nā hōʻailona o ka Barrett's Esophagus?
ʻO ka mea kupanaha ma ʻaneʻi, ʻaʻohe hōʻailona kikoʻī no ka Barrett's Esophagus. ʻO ia hoʻi, ʻaʻole ʻoe e manaʻo ua loli nā pūnaewele i loko o kou esophagus.
No laila pehea ʻoe e ʻike ai i kēia?
ʻO ka maʻamau, ʻo ka pilikia kumu e hoʻoulu ai i kēia kūlana ke kumu o kou ʻike ʻana i nā hōʻailona. No ka hapa nui o ka poʻe, ua hoʻokumu ʻia kēia e kahi kūlana i kapa ʻia ʻo ka maʻi reflux gastroesophageal . E like me kā mākou e ʻike nei, ʻo ia ka mea i kapa ʻia ʻo GERD (Gastroesophageal Reflux Disease). ʻO kēia ka manawa e piʻi ai ka waikawa o ka ʻōpū a komo i loko o ka esophagus.
No laila, ke ʻike nei ʻoe i kēia mau hōʻailona o GERD:
- ʻĀʻī: He ʻano wela e puka mai ana mai waenakonu o ka umauma.
- ʻĀʻī ʻawaʻawa: ʻO ke ʻano o nā mea o loko o ka ʻōpū, i.e. ka waikawa a me ka meaʻai i ʻeli ʻole ʻia, e piʻi ana i luna i loko o ka waha.
- Paʻakikī i ka moni ʻana: He manaʻo o ka ʻū ʻana i ka wā e moni ai i ka meaʻai a mea inu paha.
- ʻEha mau ka ʻāʻī a i ʻole ke kuni.
- ʻEha ka umauma.
ʻO ka mea nui loa, ʻoiai inā ua loaʻa iā ʻoe kēia mau hōʻailona no ka manawa lōʻihi, ʻoiai no nā makahiki, malia paha me ka hoʻāla ʻana i kekahi manawa, mai hoʻowahāwahā iā lākou. E ʻike pono i ke kauka a loaʻa ka ʻōlelo aʻo.
He aha nā kumu pilikia e kōkua ai i kēia kūlana?
ʻOiai ʻo ke kumu nui o ka Barrett's Esophagus ka hōʻino lōʻihi i ka esophagus, ʻaʻole i loaʻa i nā kānaka a pau. Eia nō naʻe, ʻoi aku ka nui o ka pilikia o kekahi poʻe. E nānā kākou iā lākou.
| Kumu pilikia | Wehewehena |
|---|---|
| Loaʻa iā GERD | ʻO kēia ke kumu pilikia nui. ʻOi aku ka nui o ka pilikia o ka poʻe i loaʻa iā GERD no nā makahiki he 10 a ʻoi. Ma kahi o 10%-15% o ka poʻe me GERD e loaʻa paha kēia maʻi. |
| Kāne/Wahine | ʻOi aku ka nui o nā kāne i ka loaʻa ʻana o ka Barrett's Esophagus ma mua o nā wahine. |
| Makahiki | ʻIke pinepine ʻia kēia ʻano i nā poʻe ma luna o 55 mau makahiki. ʻO kēia no ka mea he manawa ka lōʻihi e hana ai kēia mau loli cell. |
| Puhipaka | ʻO ka puhipaka kekahi kumu nui e hoʻopilikia nei i kēia. |
Pehea e ʻike ai inā loaʻa iā ʻoe ka Barrett's Esophagus?
Inā loaʻa iā ʻoe nā hōʻailona GERD no ka manawa lōʻihi, e kuhikuhi kāu kauka iā ʻoe i kahi gastroenterologist. E hana ʻo ia i kahi hoʻāʻo e hōʻoia inā loaʻa iā ʻoe kēia maʻi. Ua kapa ʻia kēia he endoscopy .
He aha ka hoʻāʻo endoscopy?
ʻO kēia ka hāʻawi ʻana iā ʻoe i kahi hoʻomaha iki, a laila e hoʻokomo i kahi ʻōmole lahilahi a palupalu me kahi kāmela ma ka hopena ma kou waha a i lalo i kou esophagus i loko o kou ʻōpū. ʻAʻole ʻoe e ʻeha i ka wā o kēia kaʻina hana.
Me kēia kāmela, hiki i ke kauka ke ʻike maopopo i ka paia o loko o ka esophagus.
- He ʻulaʻula māmā ke kala o ka paia o loko o ka esophagus maʻamau a he laumania kona ʻili.
- ʻIke ʻia ka Barrett's Esophagus he ʻulaʻula-ʻalani (ke kala o ka iʻa sālemona) a he ʻāpāpā.
Inā ʻike ʻia kahi loli i ke ʻano ma kēia ʻano, e lawe ke kauka i kahi ʻāpana liʻiliʻi loa o ka ʻiʻo mai kahi kānalua no ka hoʻokolokolo ʻana. Kāhea mākou i kēia he biopsy . Nānā ʻia kēia ʻāpana ʻiʻo ma lalo o kahi microscope e hōʻoia i ka 100% inā ua loli maoli nā cell, ʻo ia hoʻi inā he Barrett's Esophagus kāu.
Ka Hoʻokaʻawale ʻana a me nā Pae o ka Barrett's Esophagus
Ke hiki mai kāu hōʻike biopsy, e wehewehe kāu kauka i ke kūlana iā ʻoe. Hoʻokaʻawale pinepine ʻia i ʻelua ʻano a me kekahi mau pae.
| Hoʻokaʻawale ʻana | Wehewehena |
|---|---|
| ʻĀpana pōkole | ʻO ka ʻāpana o ka esophagus kahi i loli ai nā cell he emi ma mua o 3 kenimika ka lōʻihi. |
| ʻĀpana lōʻihi | ʻOi aku ka lōʻihi o ka ʻāpana kahi i loli ai nā cell ma mua o 3 kenimika. |
| Nā Pae e like me ka pilikia o ka maʻi kanesa (Nā Pae Dysplasia) | |
| ʻO ka Metaplasia me ka ʻole o ka dysplasia | Ua loli nā pūnaewele, akā, ʻaʻole i hoʻomaka nā loli ma mua o ke kanesa (dysplasia). He haʻahaʻa loa ka pilikia o ka maʻi kanesa. |
| Dysplasia haʻahaʻa | Ke hoʻomaka nei nā loli o nā cell precancerous e ʻike ʻia. Ua kiʻekiʻe iki aʻe ka pilikia o ka maʻi kanesa. |
| Dysplasia kiʻekiʻe | Aia nā loli koʻikoʻi ma mua o ke kanesa i loko o nā pūnaewele. Kiʻekiʻe ka pilikia o ka maʻi kanesa. |
| ʻO ke kanesa | Ua lilo ʻo Dysplasia i maʻi ʻaʻai. |
He aha nā lāʻau lapaʻau no ka Barrett's Esophagus?
Hiki ke hoʻokaʻawale ʻia nā ʻano lapaʻau i ʻekolu mau ʻāpana nui.
1. Ke mālama ʻana i ke kumu kumu
ʻO kēia ka mea nui loa. Pono mākou e ho'ōki i ka hōʻino ʻana i ka esophagus. ʻO ka hapa nui o nā hihia i hana ʻia e GERD, kahi i mālama ʻia.
- Nā Hoʻololi o ke ʻAno Noho: E hōʻemi i nā mea ʻala, nā mea ʻaila, ke kofe, a pēlā aku. Mai moe i lalo no 2-3 mau hola ma hope o ka ʻai ʻana i ka pō.
- Nā lāʻau lapaʻau: Hāʻawi ʻia nā lāʻau lapaʻau e kāohi ana i ka hana ʻana o ka waikawa i loko o ka ʻōpū. He kūpono loa nā Proton Pump Inhibitors (PPIs) e like me `Omeprazole` a me `Esomeprazole` no kēia. Hoʻōki kēia i ka hōʻino ʻana i ka esophagus a kōkua iā ia e ho'ōla.
2. Nānā ʻana
Inā ʻaʻohe dysplasia i kou kūlana, ʻo ia hoʻi, he haʻahaʻa kou pilikia o ka maʻi ʻaʻai, e ʻōlelo paha kāu kauka e hana ʻoe i kahi endoscopy i kēlā me kēia mau makahiki e nānā i kou kūlana. Inā loaʻa iā ʻoe ka dysplasia, pono ʻoe e hana i kahi endoscopy ma ka liʻiliʻi hoʻokahi manawa i ka makahiki.
3. Ka wehe ʻana i nā pūnaewele pre-cancerous (Dysplasia)
Inā ʻōlelo kāu hōʻike he "dysplasia kiʻekiʻe" kou, ʻo ia hoʻi he kiʻekiʻe kou pilikia o ka maʻi kanesa, e ʻōlelo aku kāu kauka e wehe i nā pūnaewele ʻē. Aia kekahi mau ala e hana ai i kēia.
- Lapaʻau Ablation: Ma kēia, ua hoʻokomo ʻia kahi hāmeʻa ma o ka ʻōmole endoscopy a ua luku ʻia nā ʻāpana ʻino me ka hoʻohana ʻana i ka radiofrequency a i ʻole cryotherapy.
- Endoscopic Mucosal Resection (EMR): He hana ʻoki liʻiliʻi kēia i hana ʻia ma o ka 'endoscopy'. Ma kēia, ʻoki ʻia a wehe ʻia nā ʻiʻo ʻē.
- ʻO ke ʻoki kino (Esophagectomy): Inā koʻikoʻi ka dysplasia a ua holomua paha i ka maʻi kanesa, pono paha ke ʻoki kino e wehe i ka ʻāpana i hōʻino ʻia o ka esophagus.
Hiki ke ho'ōla loa ʻia kēia maʻi?
ʻAʻole e nalowale ka metaplasia, a i ʻole ka loli ʻana o nā cell, ma kāna iho. Eia nō naʻe, hiki i nā lāʻau lapaʻau i ʻōlelo ʻia ma luna ke kōkua i ka wehe ʻana i nā ʻiʻo i hōʻino ʻia. Eia kekahi, inā mālama maikaʻi ʻia ʻo GERD, hiki ke pale ʻia ka hōʻino hou aʻe.
Akā ma hope o ka mālama ʻana, aia kahi manawa liʻiliʻi e hiki ai ke hoʻi hou mai kēia maʻi, no laila he mea nui loa e hoʻomau i ka hele ʻana i nā hoʻokolohua a kāu kauka e ʻōlelo ai.
Hiki i ke kanaka me ka Barrett's Esophagus ke ola i kahi ola maʻamau. ʻO ka mea nui loa, ʻo ia ka ʻike mua ʻana i ke kūlana, a me ka hahai ʻana i ka lāʻau lapaʻau kūpono a me nā ʻōlelo aʻoaʻo lapaʻau ma mua o ka lilo ʻana i mea ʻino. Inā ʻoe e hana pēlā, hiki iā ʻoe ke pale aku i nā kūlana koʻikoʻi e like me ke kanesa a ola i kahi ola olakino.
Leka Lawe-Home
- Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha mau o ka umauma a i ʻole ka ʻono ʻawaʻawa i kou puʻu, mai hoʻowahāwahā iā ia. E ʻike pono i ke kauka.
- ʻAʻole ka maʻi kanesa ka Barrett's Esophagus, akā he kūlana ia e hoʻonui iki ai i ka pilikia o ka loaʻa ʻana o ka maʻi kanesa esophageal.
- He haʻahaʻa loa ka pilikia o kēia maʻi ʻaʻai a hiki ke pale ʻia ma ke kau ʻana ma lalo o ka mākaʻikaʻi lapaʻau kūpono.
- Hoʻopau ʻia kēia ma o ka biopsy a me ka endoscopy.
- ʻO nā pahuhopu nui o ka mālama ʻana, ʻo ia ke kāohi i ke kumu kumu (GERD), nānā mau i ke kūlana, a wehe i nā cell pre-cancerous inā pono.
- Ma ka hahai pono ʻana i nā ʻōlelo a kāu kauka, hiki iā ʻoe ke ola i kahi ola olakino a maʻamau.
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