Loaʻa iā ʻoe kekahi mau ʻeha ʻōpū pinepine? Hiki paha he malabsorption bile acid!

Ke ʻeha nei hoʻi ʻoe i ka neʻe pinepine ʻana o ka ʻōpū, ʻo ia hoʻi, ka maʻi diarrhea? Ke ʻeha nei hoʻi ʻoe i ka maʻi diarrhea paʻakikī ke hoʻōki, i kekahi manawa wai, i nā manawa he nui i ka lā? A laila he mea nui paha kēia iā ʻoe. I kēia lā, e kamaʻilio mākou e pili ana i kahi kūlana i kapa ʻia ʻo Bile Acid Malabsorption (BAM) . ʻOiai paha he paʻakikī iki ka inoa, e wehewehe maʻalahi kākou.

He aha ka Bile Acid Malabsorption?

I ka ʻōlelo maʻalahi, he maʻi kēia o kā mākou ʻōnaehana hoʻoheheʻe . ʻOi aku hoʻi, hiki iā ia ke lilo i kumu nui o ka maʻi diarrhea mau loa , ʻo ia hoʻi, ka maʻi diarrhea mau. Ke komo pono ʻole ke kino i nā waikawa bile i loko o ko mākou ʻōpū, hōʻiliʻili lākou i loko o nā ʻōpū. A laila hoʻopilikia ʻia ke kaulike kemika i loko. Ma muli o kēia mau waikawa bile keu, hoʻouna ʻia kā mākou colon i kahi leka e hoʻokuʻu i ka wai hou aku. ʻO ia ke kumu e loaʻa ai ka maʻi diarrhea wai. E noʻonoʻo e like me ka wai e iho ana i lalo o kahi paipu, akā ʻo kēia ka mea e hana ʻia ke pau ka wai i ka mana.

He aha nā waikawa bile?

I kēia manawa, ke noʻonoʻo nei paha ʻoe, "He aha kēia mau waikawa bile?" ʻO ka bile kahi mea i hana ʻia e ko kākou akepaʻa . Ke hoʻomaʻemaʻe ke akepaʻa i ko kākou koko, hoʻokaʻawale ia i nā huahana ʻōpala e like me nā mea ʻawahia, nā hunaola koko make, a me ka cholesterol keu a hana i ka bile. Hoʻohui pū nā ʻano waikawa like ʻole i loko o kēia bile e hana i nā waikawa bile . Kōkua kēia mau waikawa i ka mālama ʻana i nā lipids i loko o ka wai bile.

Hoʻouna ʻia kēia bile mai ke akepaʻa ma o nā ʻauwai bile i ko kākou ʻōpū liʻiliʻi e kōkua i ka ʻeli ʻana i ka meaʻai. I loko o ka ʻōpū liʻiliʻi, kōkua kēia mau waikawa bile i ke kino e ʻeli i nā momona i loko o ka meaʻai a kākou e ʻai ai a omo iā lākou. Ke pau kēlā hana, hoʻopili hou ʻia kēia mau waikawa bile i loko o ko kākou kino, hele ma ke kahe koko i ke akepaʻa, a hoʻohana hou ʻia e hana i ka bile. Ua like kēia me ke kaʻina hana hou .

He aha ke ʻano o ka "Malabsorption"?

ʻO ke ʻano o "Malabsorption" ʻaʻole hiki i ko kākou mau ʻōpū ke omo pono i nā kemika e pono ai kākou e omo. Hiki ke kumu kēia ma muli o kahi pilikia me nā ʻōpū ponoʻī, a i ʻole ma muli o kahi kaulike ʻole o nā kemika. No ka laʻana, i ka wā e nui loa ai a liʻiliʻi paha o kekahi kemika, ʻaʻole hiki i nā ʻōpū ke omo pono iā ia.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia kūlana?

I ka wā ma mua, ʻaʻole i ʻike ʻia ka malabsorption bile acid (BAM) i nā poʻe he nui no ka mea ʻaʻohe ala e ʻike pololei ai. Eia nō naʻe, ua hōʻike ʻia nā noiʻi hou e hiki i nā maʻi diarrhea hana (FDD) ke hoʻopilikia i ka hana o ka maʻi.Ua manaʻo ʻia aia ma ka liʻiliʻi he 30% o ka poʻe me BAM e loaʻa iā ia. ʻO nā maʻi hana he mau kūlana i loaʻa ʻole kahi kumu maopopo a ʻaʻole hiki ke ʻike maʻalahi ʻia e kahi hoʻokolokolo lapaʻau. No ka laʻana, kahi kūlana i kapa ʻia ʻo (Irritable Bowel Syndrome - IBS) .

Hiki ke ʻike ʻia ka BAM i nā poʻe me nā kūlana olakino e hiki mai ana:

• ʻO ka colitis microscopic
• ka maʻi o Crohn
• ʻO ka maʻi ʻōpū e pili ana i ka maʻi HIV
• ʻO ka maʻi diarrhea mau loa ma hope o ka maʻi bacteria
• ʻO ka lawa ʻole o ka pancreatic exocrine

Eia kekahi, hiki ke loaʻa kēia ʻano i nā poʻe e loaʻa ana i kekahi mau lāʻau lapaʻau:

• Ka wehe ʻana a i ʻole ka hoʻololi ʻana o ka ileum, ka ʻāpana hope loa o ka ʻōpū liʻiliʻi.
• ʻO ke ʻoki ʻana i ka ʻōpū gall (cholecystectomy) .
• ʻO ka radiation therapy , ʻoi aku hoʻi i ka ʻōpū a me ke pelvis.
• Kemoterapia .
• Ka hoʻohana ʻana i ka Metformin no ka maʻi diabetes type 2, kahi lāʻau lapaʻau i hoʻohana ʻia.

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He aha nā hōʻailona o kēia?

ʻO nā hōʻailona i ʻike pinepine ʻia:

• Ka maʻi kahe wai
• Pono pinepine e hele i ka lua
• ʻEhaʻeha i loko o ka ʻōpū
• Pono koke e hele i ka lua a me ka paʻakikī e paʻa i loko o ka ʻōpala

Hiki i kekahi poʻe ke loaʻa nā hōʻailona penei:

• Pehu ʻōpū
• ʻO ke kinoea a me ka ʻeha e hoʻoulu ai
• Nā ʻōpala momona (Steatorrhea)
• ʻAʻai ʻole

Hiki i nā hopena lōʻihi ke komo pū me:

• Ka maloʻo ʻana
• Luhi nui ʻoiai ua lawa ka hoʻomaha
• ʻEha poʻo
• Pōʻino
• Ka luaʻi
• Piʻi ke kaumaha o kekahi poʻe, emi ke kaumaha o kekahi.

ʻO ka hapa nui o ka manawa, ma kahi o ka hapalua o ka poʻe e ʻeha nei i kēia mau hōʻailona e loaʻa mau iā lākou . ʻO ka hapalua ʻē aʻe e ʻike wale i nā hōʻailona i kekahi manawa .

No ke aha e hana ai ka maʻi diarrhea bile acid?

ʻO ka hōʻailona nui o ka malabsorption o ka bile acid diarrhea (BAD) . Hoʻokumu ʻia kēia e nā waikawa bile e hōʻiliʻili ana i loko o ko kākou ʻōpū nui (colon) , kahi e hoʻololi ʻia ai ka ʻōpala meaʻai i loko o ka ʻōpala. ʻO ka maʻamau, 95% o nā waikawa bile i loko o ko kākou ʻōpū liʻiliʻi e hoʻopili hou ʻia ma ka ʻāpana hope o ka ʻōpū liʻiliʻi, ka ileum, ma mua o ko lākou hiki ʻana i ka ʻōpū nui.

Eia nō naʻe, inā ʻaʻole i komo ʻia nā waikawa bile keu ma kēia ʻano, hele pū lākou me nā huahana ʻōpala ʻē aʻe i loko o ka ʻōpū nui. I loko o ka ʻōpū nui, hoʻonāukiuki kēia mau waikawa bile i ka uhi o ka ʻōpū. ʻO kēia ke kumu e hoʻokuʻu ai i ka wai hou aku, a ʻoi aku ka ikaika o nā ʻiʻo e hoʻokuke ana i ka ʻōpala i mua. ʻO ia ke kumu e pinepine ai a koke ka maʻi diarrhea, a loaʻa nā ʻeha o ka ʻōpū.

He aha nā kumu o ka emi ʻana o ka absorption o ka bile acid?

ʻO ka nīnau i kēia manawa, no ke aha e hōʻiliʻili ai kēia mau waikawa bile i loko o nā ʻōpū? Ua hoʻokaʻawale nā ​​​​​​mea noiʻi i ka BAM i ʻehā mau kumu hiki. I kekahi manawa ua hoʻokaʻawale ʻia kēia mau mea he mua a me ka lua .

• BAM Mua: Hoʻokumu ʻia kēia e ko mākou akepaʻa e hana ana i ka nui o nā waikawa bile (ʻano 2 a me 4).
• BAM Lua: Hana ʻia kēia ke hōʻino ʻia ko kākou ʻōpū liʻiliʻi ma muli o kahi maʻi, ʻoki kino, a i ʻole ka radiation therapy (ʻano 1 a me 3).

ʻAno 1 BAM: Hoʻokumu ʻia kēia e kahi pilikia ma ka ileum, ka ʻāpana hope loa o ka ʻōpū liʻiliʻi. Ua kapa ʻia kēia he malabsorption maoli no ka mea hoʻomaka ka pilikia ma ke kahua omo o ka pōʻaiapuni bile acid. Loaʻa paha iā ʻoe ke ʻano 1 BAM inā ua wehe ʻia ka ʻāpana hope loa o ka ʻōpū liʻiliʻi, hoʻololi ʻia, a i ʻole i kāpae ʻia ma ke ʻano he ʻāpana o kekahi maʻi olakino ʻē aʻe. Hiki ke hōʻino ʻia ka ileum e nā kūlana e like me ka maʻi Crohn a me ka radiation therapy. Inā he pōʻino nui, ua pilikia ka omo ʻana.

ʻAno 2 BAM: Ua kapa ʻia kēia i kekahi manawa he "idiopathic." ʻO ia hoʻi, hiki koke mai ia, me ke kumu ʻole. Eia nō naʻe, hōʻike ka noiʻi o kēia manawa ua hoʻokumu ʻia ia e kahi pilikia me ka ʻōnaehana hōʻailona kemika ma waena o ko mākou ʻōpū a me ke ake. ʻO kēia ʻōnaehana hōʻailona ka mea maʻamau e kāohi i ke kahe ʻana o ka enterohepatic. Hōʻike kēia mau hōʻailona i ke ake i ka wā e hana ai a hoʻouna aku i nā waikawa bile hou aku, a i ka wā e hoʻōki ai, hoʻopili hou, a hana hou iā lākou. Akā i ka ʻAno 2 BAM, ʻaʻole i hele pono ka leka e "hoʻōki". No laila, hoʻomau ke ake i ka hoʻouna ʻana i nā waikawa bile - ʻoi aku ka nui ma mua o ka hiki i ka ileum ke omo.

ʻAno 3 BAM: Hoʻokumu ʻia kēia e nā maʻi e hoʻopilikia ana i ka ileum me nā ʻāpana ʻē aʻe o kā mākou ʻōnaehana hoʻoheheʻe. No ka laʻana, nā kūlana e like me ka maʻi celiac , ka pancreatitis mau , a me ka Small Intestinal Bacterial Overgrowth (SIBO) .

ʻAno 4 BAM: Hana ʻia kēia ma ke ʻano he hopena ʻaoʻao o ka lawe ʻana i ka lāʻau maʻi diabetes metformin , ka mea e hoʻoulu ai i ka hana nui ʻana o ka bile acid.

He aha nā hopena lōʻihi o kēia maʻi?

Inā loaʻa ka malabsorption bile acid koʻikoʻi, hiki ke ulu aʻe ka hemahema o ka bile acid i ka hala ʻana o ka manawa.Hiki ke hana ʻia kēia. ʻO ia hoʻi, ke hoʻokuʻu ʻia ka nui o ka waikawa bile i loko o ka ʻōpala a ʻaʻole hoʻi e hana hou ʻia i ke akepaʻa, ʻaʻole lawa ka nui o nā waikawa bile o ke akepaʻa e hana i ka bile. Inā emi ka bile i loko o ka ʻōpū liʻiliʻi, hoʻopilikia ia i kāu ʻai ʻana a me ka meaʻai.

ʻO ka nele o nā waikawa bile i loko o ka ʻōpū liʻiliʻi e hōʻemi ana i ka omo ʻana o nā momona a me nā huaora momona-soluble (A, D, E, a me K). Hiki i kēia ke alakaʻi i ka ʻai ʻole a me nā pilikia kikoʻī e pili ana me nā hemahema o nā huaora momona-soluble. No ka laʻana, hoʻopilikia ka hemahema o ka huaora D i nā iwi, a hoʻopilikia ka hemahema o ka huaora A i ka ʻike.

ʻO ka poʻe me ka Type 1 BAM, ma ke ʻano kūikawā, hiki ke loaʻa i ka nele o ka wikamina B12 . ʻO kēia no ka mea ua komo ka wikamina B12 ma o ka ileum. I kēia hihia, ʻaʻole i hoʻokumu ʻia ka hemahema e BAM ponoʻī, akā na ke kūlana e hoʻoulu ai i ka Type 1 BAM - ʻo ia hoʻi, ka hana pono ʻole o ka ileum. Hiki i nā hōʻailona e like me ka nausea, ka dizziness, a me ka luhi ke hele pū me kēia.

Inā loaʻa iā ʻoe ka hemahema o ka waikawa bile, kahi e hōʻemi ai i ka omo ʻana o ka momona a pale iā ʻoe mai ka puhi ʻana i nā calorie lawa, hiki iā ʻoe ke lilo i ke kaumaha. Eia nō naʻe, i kekahi mau hihia, hiki i ka omo ʻana o ka waikawa bile maikaʻi ʻole ke alakaʻi i ka piʻi ʻana o ke kaumaha. Me he mea lā e pili ana kēia i ka metabolism. ʻO BAM, a i ʻole nā ​​​​kūlana e hoʻokumu ai, hiki ke hoʻopilikia i ke ʻano o ka hoʻohana ʻana o kou kino i nā calorie a mālama iā lākou ma ke ʻano he momona.

Pehea e ʻike ʻia ai kēia maʻi?

Manaʻo nā kulekele lapaʻau o kēia manawa e hoʻāʻo ʻia kekahi me ka maʻi diarrhea mau me ke kumu ʻole o ka bile acid malabsorption. Akā, ʻaʻole loaʻa kēia mau hoʻokolohua ma nā wahi āpau. E nānā kekahi mau kauka no kēia a kuhikuhi i nā lāʻau lapaʻau i kapa ʻia ʻo bile acid sequestrants e ʻike inā hāʻawi lākou i ka hōʻoluʻolu.

Aia kekahi mau hoʻokolohua e hiki ke hoʻohana ʻia e ʻike i ka malabsorption bile acid:

• Hoʻāʻo SeHCAT: Ua manaʻo ʻia kēia ʻo ia ka hoʻāʻo maikaʻi loa e ʻike ai i ka BAM, akā naʻe, ʻaʻohe pono o nā ʻāina he nui, me Sri Lanka, e hana i kēia. He hoʻāʻo kiʻi lāʻau lapaʻau nukelea kēia. ʻO ia hoʻi, ua hoʻokomo ʻia kahi mea radioactive haʻahaʻa i loko o ke kino, a nānā ke kamepiula i kona neʻe ʻana ma ke kino a lawe i nā kiʻi. Ma kēia hoʻāʻo, ale ʻoe i kahi capsule i loaʻa kahi waikawa bile synthetic i kapa ʻia ʻo SeHCAT me kēia mea radioactive. Hele kēia capsule i ka ʻōpū liʻiliʻi a komo koke ʻia e nā waikawa bile i loko o kou kino. Ana ke kāmela gamma i ka pae o SeHCAT i loko o kou kino i ka lā mua a ma hope o ʻehiku lā. Inā emi ma lalo o 85% o SeHCAT i koe ma hope o ʻehiku lā, hiki ke ʻike ʻia he BAM.

• Hoʻāʻo serum C4:He hoʻāʻo koko kēia. Ua manaʻo ʻia ʻo ia ke koho maikaʻi loa ma hope o ka hoʻāʻo SeHCAT. Ana ia i ka pae o kahi enzyme i kapa ʻia ʻo C4 i loko o ke koko. Pili nā pae C4 i ka nui o nā waikawa bile i hana ʻia e kou ake. Inā kiʻekiʻe kou mau pae C4, he hōʻailona maikaʻi ia he BAM mua kou (ʻano 2 a me 4). I ka poʻe me ka BAM lua (ʻano 1 a me 3), hiki ke kiʻekiʻe nā pae C4 inā hoʻomaka ke ake e hana i nā waikawa bile hou aʻe e uku no ka emi ʻana o ka omo ʻana. No laila, he mea pono kēia hoʻāʻo no nā poʻe he nui. Eia nō naʻe, hiki iā ia ke hāʻawi i nā hopena wahaheʻe i ka poʻe me kekahi mau kūlana, e like me ke cholesterol kiʻekiʻe a me ka maʻi momona momona metabolic non-alcoholic .

• Hoʻāʻo ʻAkika Bile Fecal (hoʻāʻo Fecal BA): Ke ana kēia i ka nui o nā waikawa bile i loko o kou ʻōpala. ʻO kēia ke ala pololei loa e ana i ka malabsorption o ka waikawa bile. Eia nō naʻe, ʻoi aku ka paʻakikī o ke ʻano a hiki ke hana ʻia ma nā kikowaena olakino i koho ʻia. Pono kēia hoʻāʻo i ka hoʻomākaukau kūikawā. Pono ʻoe e hahai i kahi papaʻai kūikawā no kekahi mau lā ma mua, a laila e hōʻiliʻili i nā laʻana ʻōpala no 48 mau hola. E hoʻāʻo nā loea i kāu ʻōpala no nā waikawa bile i loko o kahi lab. Inā kiʻekiʻe kou pae waikawa bile, ʻo ia hoʻi, nui ka waikawa bile e omo ʻia ana i loko o ka ʻōpū liʻiliʻi a ke hele ʻia nei i loko o ka ʻōpū nui, e hoʻoulu ai i ka maʻi diarrhea waikawa bile.

He aha nā lāʻau lapaʻau maikaʻi loa?

ʻO ka lāʻau lapaʻau laina mua no ka malabsorption bile acid he papa o nā lāʻau i kapa ʻia ʻo bile acid sequestrants a i ʻole bile acid binders . ʻO Cholestyramine lāua ʻo colestipol nā mea i kuhikuhi pinepine ʻia. He koho laikini ʻole ʻia ʻo Colesevelam , akā ʻike kekahi poʻe he maʻalahi ka hoʻohana ʻana.

ʻO kēia mau mea hoʻopaʻa waikawa bile he mau ʻāpana i hoʻopiʻi maikaʻi ʻia e hoʻopaʻa i nā waikawa bile i hoʻopiʻi maikaʻi ʻole ʻia i loko o nā ʻōpū, e pale ana iā lākou mai ka wāwahi ʻia i mau ʻāpana liʻiliʻi e hiki ke omo ʻia. ʻO kēia nakinaki ʻana e pale aku i nā waikawa bile mai ka hana ʻana ma ka ʻōpū nui a me ke kumu o ka maʻi diarrhea. Kōkua kēia i ka hōʻemi ʻana i nā hōʻailona o BAM.

Aia kekahi mau hopena ʻaoʻao o ka lāʻau lapaʻau?

ʻO ka maʻamau, loaʻa kēia mau lāʻau lapaʻau i ke ʻano pauka. Pono lākou e hui pū ʻia me kahi wai a lawe ʻia. He mea paʻakikī i kekahi poʻe ke ale i ka ʻono a me ke ʻano. Loaʻa i kekahi poʻe nā hōʻailona BAM a me nā hopena ʻino ʻole. ʻO kēia ka paʻa ʻana o ka ʻōpū , ka nausea, ka pehu ʻana, a me ke kinoea.

Eia kekahi, hiki i nā bile acid sequestrants ke hoʻopaʻa i nā huaora momona-soluble i loko o ka ʻōpū liʻiliʻi. Hiki i kēia ke pale i ka ʻōpū liʻiliʻi mai ka omo ʻana iā lākou. Pono paha kekahi poʻe e lawe ana i nā bile acid sequestrants e lawe i nā mea hoʻohui huaora. Pono paha e lawe ʻia ma ke ʻano e pale aku ai i ka ʻōnaehana hoʻoheheʻe, e like me ka injection .

Hiki ke ho'ōla loa ʻia kēia maʻi?

Inā hiki ke ho'ōla ʻia ka malabsorption o ka bile acid, aia ia ma muli o ke kumu. Hiki ke ho'ōla ʻia kekahi mau kumu, a ʻaʻole hiki i kekahi. Inā mālama pololei ʻia ke kumu kumu, i kekahi manawa hiki ke hoʻomaikaʻi ʻia ke kūlana BAM. I nā hihia ʻē aʻe, ʻoiai inā ʻaʻole hiki ke hoʻōla ʻia ke kumu, aia kahi manawa kūpono e hiki ke mālama pono ʻia nā hōʻailona.

Mea nui: Mai hopohopo! Hiki ke mālama ʻia ka BAM. ʻO ka mea nui loa, ʻo ia ka hahai ʻana i nā ʻōlelo a kāu kauka.

He aha ka mea e ʻoi aku ai ka ʻino o nā hōʻailona?

Hoʻāla ʻia ke kaʻina hana o ka bile acid e ka nui o ka momona i kāu meaʻai. Inā nui loa ka momona i loko o ka ʻōpū liʻiliʻi, loaʻa i ke akepaʻa kahi hōʻailona kemika e haʻi ana iā ia e "hoʻouna i ka bile hou aku." ʻO ka nui o ka bile ʻo ia hoʻi ka nui o nā waikawa bile e hele ana i loko o ka ʻōpū nui. ʻO ia ke kumu e paipai ai nā kauka i kahi meaʻai haʻahaʻa momona e kōkua i ka mālama ʻana i ka BAM.

Āhea ʻoe e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe ka maʻi diarrhea mau loa me ke kumu ʻole, e nīnau i kāu kauka e pili ana i ka malabsorption bile acid. He ʻano maʻi maopopo ʻole kēia a ʻaʻole i ʻike ʻia, no laila ʻaʻole e noʻonoʻo koke nā kauka āpau e pili ana i ia mea. No laila e noi i kāu kauka e hoʻāʻo iā ʻoe no ia mea, a i ʻole e kuhikuhi iā ʻoe i kahi loea i ʻike e pili ana i ia mea.

Hoʻolilo ka poʻe he nui i nā makahiki e hoʻāʻo nei e ʻimi i kahi hōʻailona kūpono a me ka lāʻau lapaʻau kūpono no kā lākou maʻi diarrhea i wehewehe ʻole ʻia. No ka poʻe me ka malabsorption bile acid, aia ka manaʻolana e pau kēlā mau lā. Me ka ʻike nui ʻana i ke kūlana a me nā ʻano ʻike maʻalahi, e hoʻomaikaʻi ka hōʻailona.

ʻOiai he nui nā kumu o ka malabsorption bile acid, like nō ka lāʻau lapaʻau i nā hihia āpau. Hiki i ke kauka e kānalua nei iā BAM ke kuhikuhi i ka lāʻau lapaʻau, malia paha ma ke ʻano he ala e hōʻoia ai. Hiki i ka poʻe he nui me BAM ke hoʻokele pono i kā lākou mau hōʻailona me nā bile acid sequestrants a me nā hoʻololi ʻai.

Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

ʻAe, e hōʻuluʻulu kākou i nā mea a mākou i kamaʻilio ai i kēia lā:

• ʻO ka Bile acid malabsorption (BAM) kahi kūlana i hiki ke lilo i kumu nui o ka maʻi diarrhea mau loa.
• ʻO kēia ka mea no ka mea ʻaʻole i hoʻopili pono ʻia nā waikawa bile e nā ʻōpū, akā hōʻiliʻili i loko o ka ʻōpū nui, e hana ana i ka maʻi diarrhea wai.
• Hiki i nā ʻano maʻi like ʻole, nā ʻoki kino, a me kekahi mau lāʻau lapaʻau ke hana i kēia.
• Hiki i nā hōʻailona ke komo pū me ka maʻi pākī pinepine, ka ʻeha o ka ʻōpū, a me ka pehu ʻana.
• Hiki ke ʻike ʻia ka maʻi ma o nā hoʻokolohua e like me ka hoʻāʻo SeHCAT, ka hoʻāʻo serum C4, a me ka hoʻāʻo fecal bile acid .
• ʻO nā lāʻau lapaʻau nui, ʻo ia nā lāʻau lapaʻau i kapa ʻia ʻo bile acid sequestrants a me ka ʻai haʻahaʻa momona .
• Ma muli o ke kumu, hiki ke ho'ōla loa ʻia a ʻaʻole paha, akā hiki ke kaohi maikaʻi ʻia nā hōʻailona.
• Inā loaʻa iā ʻoe ka maʻi diarrhea mau loa, ʻaʻole i wehewehe ʻia, e ʻimi pono i ka ʻōlelo aʻoaʻo lapaʻau.A e nīnau pū e pili ana iā BAM.

Mai hopohopo, inā maopopo iā ʻoe kēia kūlana a mālama pono iā ia, hiki iā ʻoe ke loaʻa ka hōʻoluʻolu. E olakino!

Nā waikawa bile, ka maʻi pākī, nā ʻōpū, ka omo ʻana, ke akepaʻa, nā hōʻailona, ​​ka lāʻau lapaʻau