E aʻo kākou e pili ana i ka "bile retention" a i ʻole cholestasis.

Ua lohe paha ʻoe i ka "bile blockage" a i ʻole "gallstones"? Ua ʻike paha ʻoe i kekahi poʻe nona nā maka a me ka ʻili e melemele. Ua noʻonoʻo paha ʻoe i ke ʻano maoli o kēia mau mea a no ke aha lākou e hana ai? I kēia lā e kamaʻilio mākou e pili ana i ia ʻano maʻi. Ua kapa ʻia ʻo ia he cholestasis ma ke ʻano lapaʻau. Mai hopohopo, e wehewehe maʻalahi kākou.

He aha ka Kolestasis?

I ka ʻōlelo maʻalahi, ʻo ka cholestasis ka wā e lohi ai ke kahe ʻana o ka bile mai kou akepaʻa a i ʻole e oki loa. E noʻonoʻo iā ia e like me kahi hale hana liʻiliʻi i loko o ko mākou kino. Hoʻopuka ia i kahi mea i kapa ʻia ʻo bile . Kōkua kēia bile iā mākou e hoʻoheheʻe i ka meaʻai a mākou e ʻai ai, ʻoi aku hoʻi nā meaʻai momona.

Hoʻopuka ke akepaʻa i kēia bile a hoʻouna iā ia i kā mākou ʻōnaehana hoʻoheheʻe ma o kahi pūnaewele o nā ʻōmole liʻiliʻi i kapa ʻia ʻo nā ʻōmole bile . Aia kekahi o kēia mau ʻōmole bile i loko o ke ake (nā ʻōmole intrahepatic) a aia kekahi ma waho o ke ake (nā ʻōmole extrahepatic). Hoʻopili kēia ʻōnaehana o nā ʻōmole i ke ake, ka gallbladder, ka pancreas , a me ka ʻōpū liʻiliʻi. I ka hui pū ʻana, hana kēia mau mea i ka ʻōnaehana biliary .

I kēia manawa, e noʻonoʻo, he aha ka mea e hana ʻia inā he ālai ʻia a i ʻole he ālai ʻia ma kekahi wahi o kēia ʻōnaehana ʻauwai bile? Ua like ia me kahi paipu wai i ālai ʻia. ʻAʻole hiki i ka bile ke kahe pono. A laila hoʻomaka kēia bile e hōʻiliʻili i loko o nā ʻauwai bile a me nā ʻōpū pili e like me ke akepaʻa. Hiki i kēia ke hōʻino i kēlā mau ʻiʻo a hoʻopilikia i kā lākou hana. ʻAʻole wale ia, akā hoʻomaka mālie kēia bile i hōʻiliʻili ʻia e kahe i loko o ke koko. He mea ʻino kēia a he mea ʻawahia i ke kino. Hiki i kēia ke hana i nā hōʻailona ʻoluʻolu ʻole a, i ka hala ʻana o ka manawa, hiki ke alakaʻi i nā maʻi like ʻole. I kekahi manawa hiki i ka Cholestasis ke lilo i pilikia manawa pōkole, a i ʻole he pilikia e hoʻonui mālie a ke hoʻomau nei.

Pehea kēia e pili ai i kou kino?

Hiki i ka Cholestasis ke hoʻopilikia i kou kino ma nā ʻano like ʻole.

Nā hopena pōkole:

ʻO ka mea mua e hoʻopilikia ʻia, ʻo ia nā ʻōkana i loko o kāu ʻōnaehana biliary. Hiki i ka hōʻiliʻili ʻana o ka bile ke hoʻoulu i ke akepaʻa, ka gallbladder, ka pancreas, a i ʻole nā ​​​​​​auwai bile e pehu a lilo i mumū . Hiki i kēia ke hana i nā hōʻailona e like me ka ʻeha o ka ʻōpū a me ka nausea. Hoʻonui pū ia i ka pilikia o ka maʻi.

Eia kekahi, no ka mea, ʻaʻole lawa ka bile i loko o ka ʻōpū liʻiliʻi, ʻaʻole i hoʻoheheʻe pono ʻia nā momona i loko o ka meaʻai āu e ʻai ai. Hiki i kēia ke hana i ka pehu ʻana, ka indigestion, a me ka diarrhea.

Nā hopena lōʻihi:

Inā hoʻomau kēia kūlana, hiki ke kū mai nā pilikia hou aʻe.

• ʻO ka hōʻiliʻili ʻana o ka bile i loko o ke koko hiki ke hana i ka jaundice , ʻo ia hoʻi ka melemele o nā maka a me ka ʻili, a me ka mimi ʻeleʻele.
• Hiki i kekahi poʻe ke ʻike i ka maneʻo nui (pruritus) . ʻO kēia no ka mea ʻo nā paʻakai bile i loko o ke koko e hoʻoulu i nā aʻalolo.
• ʻO ka mumū lōʻihi o nā ʻōpū e like me ke akepaʻa hiki ke alakaʻi i ka ʻeha a me ka nalowale mau o ka hana. Ua kapa ʻia hoʻi kēia he cirrhosis .
• ʻAʻole komo pono ke kino i nā wikamina momona-hoʻoheheʻe ʻia, e like me nā wikamina A , D, E, a me K. Hiki i kēia ke alakaʻi i ka ʻai ʻole. Hiki i kēia ke lilo i kumu o ka ulu ʻole ʻana, ʻoiai hoʻi i nā keiki ʻōpio.

E hoʻomanaʻo nui!

Hoʻonui ka cholestasis obstetric i ka wā hāpai i ka pilikia o nā pilikia e hoʻoweliweli ana i ke ola no ka makuahine a me ka fetus. ʻO kēia mau mea e komo pū me ka preeclampsia, ka hānau mua ʻana, a me ka hānau make. No laila, he mea nui e ʻimi koke i ke kōkua lapaʻau inā ʻike ʻoe i kēia mau hōʻailona i ka wā hāpai.

He aha nā kumu nui no kēia?

Nui nā kumu o ka cholestasis. Ma keʻano laulā, aia ʻelua ʻano pilikia:

He aha nā hōʻailona o ka cholestasis?

Aia kekahi mau hōʻailona i ʻike pinepine ʻia ma kēia ʻano:

• ʻO ka Jaundice: ʻO ka melemele o kou ʻili a me nā keʻokeʻo o kou mau maka ka hōʻailona mua e hana pono ʻole ana kou ake. Hoʻokumu ʻia kēia e ka hōʻiliʻili ʻana o ka bile i loko o ke koko. ʻO ke kikoʻī, ʻo kahi pigment i kapa ʻia ʻo bilirubin i loko o ka bile ke kuleana no kēia kala melemele. I kekahi manawa, hoʻokuʻu ʻia ka bilirubin i loko o ka mimi, hiki ke hoʻololi i ka mimi i kala melemele/ʻeleʻele.
• ʻŌpū māmā: ʻO kēia no ka mea ʻaʻole e neʻe pono ka ʻōpū ma o nā ʻōpū, hiki ke hoʻololi i ka ʻōpala. Ke loaʻa ʻole ka ʻōpū e hoʻoheheʻe i nā momona, e hoʻopuka ʻia nā momona me ka ʻōpala. He keʻokeʻo kēia ʻano ʻōpala, he ʻano lepo. Eia kekahi, ʻo kēia kala māmā ma muli o ka nele o ka bilirubin (ʻo ka maʻamau, he ʻeleʻele ka ʻōpala ma muli o ka bilirubin). Hiki i kēia mau mea ke lana i ka wai a he ʻala ikaika.
• ʻŌhūhū: ʻO kēia kekahi hōʻailona maʻamau i ʻike ʻia ma ka cholestasis. Loaʻa ka maneʻo e pili ana i ka bile ke hōʻiliʻili nā paʻakai bile a i ʻole nā ​​​​waikawa bile i loko o ke koko a hoʻoulu i nā aʻalolo o ka ʻōnaehana nerve peripheral. ʻAʻole kēia maneʻo e hoʻoulu i kekahi ʻōhūhū. ʻOi aku ka maʻalahi o kekahi poʻe i kēia mau paʻakai bile. ʻOi aku ka liʻiliʻi o ka maneʻo o kekahi poʻe, aʻo kekahi poʻe he nui. Hiki ke ʻoi aku ka maneʻo ma nā poho lima, nā kapuwaʻi, a me nā lālā, a hiki i ke kino holoʻokoʻa ke maneʻo.

Ma waho aʻe o kēia mau hōʻailona nui, hiki ke kū mai nā hōʻailona ʻē aʻe ma muli o ke kumu o ka cholestasis.

• ʻEha ʻōpū
• Ka luaʻi a me ka luaʻi
• Luhi

Pehea ʻoe e ʻike ai i kēia?

Inā loaʻa iā ʻoe nā hōʻailona o ka cholestasis, ʻo ka mea mua a ke kauka e hana ai, ʻo ia ke hoʻāʻo i kahi hāpana o kou koko.

• Nā hoʻāʻo koko:Nānā kēia i nā pae bilirubin kiʻekiʻe a me nā paʻakai bile. Nānā pū ia i ka cholesterol kiʻekiʻe a me kekahi mau enzymes ate, e like me ka gamma-glutamyl transferase (GGT) a me ka alkaline phosphatase (ALP). Hiki i kēia mau mea ke hāʻawi i kahi manaʻo o ke kumu o ka maʻi.
• Nā hoʻāʻo kiʻi: Inā hōʻike nā hoʻokolohua koko i ka maʻi, ʻo ka hana aʻe ka loaʻa ʻana o nā hoʻokolohua kiʻi e nānā i kāu ʻōnaehana biliary. Hiki i kēia ke hoʻomaka me nā hoʻokolohua maʻalahi, ʻaʻole invasive e like me ka ultrasound ʻōpū a i ʻole ka scan CT ʻōpū. Hiki i kēia ke nānā i nā poloka kino i loko o nā ʻauwai bile a me ka pehu ʻana i loko o nā ʻōpū.
• Nā hoʻokolohua ʻimi: Pono kekahi mau kumu cholestasis i nā hoʻokolohua kūloko e ʻike a mālama i ke kumu. Pono paha ke kauka e nānā i nā ʻauwai bile a lawe paha i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ke akepaʻa (he biopsy akepaʻa) no ka hoʻāʻo ʻana ma kahi keʻena hoʻokolohua. I ka wā o ka ERCP (Endoscopic Retrograde Cholangiopancreatography) , hiki i nā kauka ke nānā a mālama i nā pilikia me nā ʻauwai bile.

Pehea e mālama ʻia ai?

ʻO ke ʻano o ka mālama ʻana i ka cholestasis e pili ana i ke kumu kumu.

• Nā kumu koʻikoʻi: Hiki ke mālama maʻalahi ʻia kekahi mau kumu. Hiki ke pani ʻia nā lāʻau lapaʻau e hoʻoulu ai i ka pilikia me nā lāʻau lapaʻau ʻē aʻe. Hiki ke hāʻawi ʻia nā antibiotics a i ʻole antivirals no nā maʻi. Hiki ke wehe ʻia nā mea keʻakeʻa o ka bile duct me nā kaʻina hana endoscopic e like me ERCP.
• Nā kumu mau: Hiki ke paʻakikī ke mālama i nā kumu mau o ka maʻi akepaʻa. ʻAʻohe lāʻau ola mau loa o kekahi mau maʻi, a ʻaʻole hiki ke hoʻohuli ʻia ke kaha o ke akepaʻa (cirrhosis). Eia nō naʻe, hiki i nā loli o ke ʻano o ka nohona e like me ka ʻai, ka hoʻoikaika kino, a me ka pale ʻana i ka waiʻona ke kōkua i ka kaohi ʻana i ka holomua o nā maʻi akepaʻa he nui. I kēia manawa, e kālele ana kāu kauka i ka mālama ʻana i nā hopena ʻaoʻao o kou maʻi.

Hiki i nā lāʻau lapaʻau ke komo pū me:

• ʻAi: Hiki i nā loli ʻai a me nā mea hoʻopihapiha meaʻai ke kōkua i ka pale ʻana i ka ʻai ʻole a me nā hemahema o ka huaora.
• ʻO ka waikawa Ursodeoxycholic:Hoʻohana pinepine ʻia kēia lāʻau lapaʻau e hoʻoheheʻe i nā gallstones, akā hiki iā ia ke kōkua i kekahi manawa me ka cholestasis ma ka hoʻonui ʻana i ka hana bile a me ka hoʻēmi ʻana i nā hopena o nā paʻakai bile keu i loko o ke koko.
• Naltrexone: Hoʻohana ʻia kēia mea hoʻokūkū opioid i kekahi manawa e mālama i ka maneʻo nui. Hana ia ma ke ālai ʻana i nā ala aʻalolo i hoʻoulu ʻia e nā waikawa bile i loko o ke koko.
• Cholestyramine: Hoʻopaʻa kēia lāʻau hoʻohaʻahaʻa cholesterol i ka cholesterol me nā paʻakai bile i loko o ka ʻōpū, e ʻae ana i ka nui o ia mea e hoʻokuʻu ʻia i loko o ka waihona.