Ke ʻai maikaʻi nei ʻoe, akā ke manaʻo nei ʻoe ʻaʻole i loaʻa i kou kino nā meaʻai kūpono? Ke ʻeha mau nei kou ʻōpū, piha kou manaʻo, a emi paha ke kaumaha me ke kumu ʻole? I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi olakino ma hope o kēia mau mea āpau, akā ʻaʻole ʻike ka poʻe he nui. Ua kapa ʻia kēia ʻo EPI, ʻo ia hoʻi ka Exocrine Pancreatic Insufficiency. ʻOiai paha he paʻakikī ke kani ʻana o ka inoa, e mālama kākou i ka maʻalahi.
I ka ʻōlelo maʻalahi, he aha ka EPI?
E noʻonoʻo i loko o kou ʻōpū, ma hope o kou ʻōpū, aia kahi ʻōkana liʻiliʻi i kapa ʻia ʻo ka pancreas . Ua like ia me kahi hale hana liʻiliʻi i loko o ko mākou kino. Hana kēia hale hana i nā kemika kūikawā, i kapa ʻia ʻo nā enzymes digestive, e kōkua iā mākou e hoʻoheheʻe i ka meaʻai a mākou e ʻai ai.
Ua like nā ʻenzymes me nā limahana liʻiliʻi e wāwahi i ka meaʻai. ʻO kā lākou hana ka wāwahi ʻana i nā meaolaola i loko o ka meaʻai a mākou e ʻai ai i mau ʻāpana liʻiliʻi e omo ai ko mākou kino.
Eia ka mea e hana ʻia i kahi kanaka me EPI:
ʻAʻole hana pono kāu pancreas, kēlā hale hana enzyme. ʻO ia hoʻi, ʻaʻole ia e hana i nā enzymes lawa (kēlā mau limahana) e hoʻoheheʻe i ka meaʻai. A i ʻole, ʻaʻole hana pono nā enzymes āna e hana ai. He aha ka mea e hana ʻia? ʻAʻole i hoʻoheheʻe pono ʻia ka meaʻai a mākou e ʻai ai, ʻaʻole i omo ʻia e ke kino nā meaola waiwai i loko, a haʻalele wale ia i ke kino.
I ka ʻōlelo maʻalahi, ʻo EPI kahi kūlana kahi i hana ʻole ai kāu pancreas i nā enzymes lawa e hoʻokaʻawale pono i ka meaʻai āu e ʻai ai, ʻo ia hoʻi, ʻaʻole i loaʻa i kou kino nā meaʻai e pono ai.
ʻEkolu mau ʻano nui o nā enzymes i hana ʻia e kā mākou pancreas:
- Amylase: ʻO kēia ka mea e hoʻoheheʻe i nā kalapona a mākou e ʻai ai (e like me ka berena a me ka laiki).
- Lipase: ʻO kēia ka mea e hoʻoheheʻe i nā momona (nā ʻaila, ka pata, a me nā mea ʻē aʻe) a mākou e ʻai ai.
- Protease a me Elastase: Hoʻohana ʻia kēia mau mea no ka hoʻoheheʻe ʻana i nā protein a mākou e ʻai ai (e like me ka ʻiʻo, iʻa, hua manu).
I loko o EPI, ua hoʻemi nui ʻia ka enzyme lipase, ka mea e hoʻoheheʻe i ka momona.
No ke aha e hana ʻia ai ka EPI? E nānā kākou i nā kumu
Hiki ke ʻokoʻa nā kumu o EPI no nā pākeke a me nā keiki.
Nā kumu o ka EPI i nā pākeke
ʻO ke kumu nui o ka EPI i nā pākeke, ʻo ia ka pancreatitis mau loa . I ka ʻōlelo maʻalahi, ʻo ia ka wā e pehu ai ka pancreas a pehu no ka manawa lōʻihi. E noʻonoʻo iā ia e like me kahi ʻeha e hoʻomau nei i ka pehu. I ka hala ʻana o ka manawa, ua luku mālie ʻia nā pūnaewele i loko o ka pancreas e hana ana i nā enzymes. Ma kahi o ʻewalu o nā pākeke he ʻumi me kēia maʻi e loaʻa iā EPI.
Eia kekahi, aia kekahi mau kumu ʻē aʻe.
| Kumu | He wehewehe maʻalahi |
|---|---|
| Maʻi Celiac | ʻO ka pane a ke kino i ka gluten i loko o ka palaoa. |
| Maʻi diabetes | ʻOi aku ka maʻi diabetes lōʻihi a kāohi ʻole ʻia hiki ke hōʻino i ka pancreas. |
| ʻO ka maʻi ʻōpū mumū (IBD) | Nā kūlana mumū lōʻihi o nā ʻōpū, e like me ka maʻi o Crohn. |
| Ka maʻi ʻaʻai pancreatic | Ka hana ʻino ʻana o ka pancreas ma muli o nā hunaola kanesa. |
| ʻO ke ʻoki kino ʻōpū | ʻO ke ʻoki ʻōpū a i ʻole ka naʻau, me ke ʻoki ʻana i ka pohō kaumaha. |
Nā kumu o ka EPI i nā keiki
ʻO ke kumu nui o ka EPI i nā kamaliʻi ʻōpio a me nā pēpē he maʻi i kapa ʻia ʻo cystic fibrosis . He maʻi genetic kēia i hoʻoili ʻia mai nā mākua a i nā keiki. Hoʻoulu kēia maʻi i ke kino e hana i ka nui o ka mucus mānoanoa a pipili. Hiki i kēia mucus ke hōʻiliʻili i loko o nā māmā, e paʻakikī ai ka hanu ʻana, a hiki nō hoʻi iā ia ke ālai i nā ducts o ka pancreas, e ālai ana i ke ala o nā enzymes i hana ʻia e ka pancreas i nā ʻōpū.
ʻO kekahi ʻano genetic i kapa ʻia ʻo Shwachman-Diamond Syndrome (SDS) kekahi kumu o EPI i nā keiki.
He aha nā hōʻailona o ka EPI?
ʻO ka momona i kā lākou meaʻai ka mea nui e hoʻopilikia ʻia e ka momona o ka meaʻai a ke kanaka me EPI.ʻAʻole hoʻoheheʻe pono. Hoʻopilikia kēia i nā pilikia he nui o ka ʻōnaehana hoʻoheheʻe ʻoluʻolu ʻole a hoʻopilikia.
| Nā hōʻailona maʻamau | |
|---|---|
| ʻEha ka ʻōpū, ka pehu ʻana, a me ka flatulence | Hoʻokumu ʻia kēia mau ʻehaʻeha e ka meaʻai i ʻeli ʻole ʻia e hoʻoulu ana i loko o nā ʻōpū. |
| Ka paʻa ʻana o ka ʻōpū | Hiki i kekahi poʻe ke loaʻa i ka paʻa ʻana o ka ʻōpū. |
| Ka maʻi pākī | He nui ka poʻe e ʻike i ka maʻi diarrhea. |
| Nā noho momona | He hōʻailona kikoʻī loa kēia o ka EPI. He keʻokeʻo ka ʻōpala, he ʻaila, lana i ka wai, a he ʻala ʻino loa . |
| ʻO ka pohō kaumaha me ke kumu ʻole | Hiki ke emi ke kaumaha ma muli o ke komo ʻole ʻana o ke kino i nā meaʻai. Hiki i nā keiki ʻōpio ke ulu iki. |
Pehea e ʻike ai ke kauka i ka EPI?
Ma muli o ke ʻano like o kēia mau hōʻailona me nā pilikia ʻōpū ʻē aʻe, hiki i kāu kauka ke haʻi maopopo inā loaʻa iā ʻoe ka EPI. Inā loaʻa iā ʻoe kekahi ʻano ʻē aʻe e hoʻopilikia ai i ka pancreas (e like me ka maʻi diabetes), kānalua paha kāu kauka i ka EPI.
Hiki ke hana ʻia hoʻokahi a ʻoi aku paha o nā hoʻokolohua aʻe e hana ai i kahi hōʻoia:
- Hoʻāʻo Elastase Fecal (FE-1): Hoʻāʻo kēia i kahi hāpana o kou ʻōpala e ʻike inā he enzyme kou i kapa ʻia ʻo elastase, e kōkua ana i ka hoʻoheheʻe ʻana i nā protein. Inā haʻahaʻa, loaʻa paha iā ʻoe ka EPI.
- Hoʻāʻo Momona Fecal:Ana kēia i ka nui o ka momona i loko o ka ʻōpala. ʻO ka nui loa o ka momona, ʻo ia hoʻi, ʻaʻole ke omo nei ke kino iā ia.
- Hoʻāʻo Hana Pancreatic Secretin: He hoʻāʻo paʻakikī iki kēia. Ma kēia hoʻāʻo, hāʻawi ʻia kahi hormone i kapa ʻia ʻo 'secretin' i loko o ke kino ma o kahi aʻa koko ma ka lima. Hōʻailona kēia hormone i ka pancreas e hana i nā enzymes. A laila, hōʻiliʻili ke kauka i ka wai mai ka pancreas me ka hoʻohana ʻana i kahi ʻano e like me ka endoscopy a nānā i ke alo o nā enzymes.
Eia kekahi, hiki ke hana ʻia nā hoʻokolohua e like me ka CT scan a i ʻole ka ultrasound scan e nānā i kekahi pilikia me ka pancreas.
He aha nā pilikia o ka EPI?
ʻO ka pilikia nui o EPI ka malabsorption meaʻai . ʻO ia hoʻi, ʻaʻole hiki i ke kino ke omo i nā mea waiwai i ka meaʻai, e like me nā momona, nā protein, a me nā kalapona. He mea nui kēia mau meaola no ko mākou kino e hoʻolako i ka ikehu a no nā ʻōkana e hana pono.
Ke hoʻomau ʻoe i ka ʻai ʻole i ka meaʻai e like me kēia, e nāwaliwali kou kino. Kāhea mākou i kēlā he malnutrition .
| Nā hōʻailona o ka ʻai ʻole | |
|---|---|
| ʻIli maloʻo, nā kui palupalu, a me ka nalowale o ka lauoho | |
| Kaumaha | |
| Ka pehu ʻana o nā ʻiʻo o ke kino (Edema) | |
| Luhi nui a i ʻole ka poniuniu | |
| Ke anu nei i nā manawa a pau | |
| Hoʻomaha ʻole, huhū wikiwiki | |
| Ka paʻakikī i ka hoʻomanaʻo a me ka noʻonoʻo ʻana | |
| Ka hoʻopau ʻana i nā ʻiʻo | |
He aha nā lāʻau lapaʻau no EPI?
He maʻi ola ka EPI. ʻO ia hoʻi, ʻaʻole hiki ke ho'ōla piha ʻia. Eia nō naʻe, me ka mālama kūpono, hiki ke hoʻomalu maikaʻi ʻia a hiki iā ʻoe ke ola i kahi ola maʻamau. ʻO ka pahuhopu nui o ka mālama ʻana, ʻo ia ka hāʻawi ʻana i kou kino i nā meaʻai e pono ai.
- ʻO ka Pancreatic Enzyme Replacement Therapy (PERT): ʻO kēia ka lāʻau lapaʻau nui. I ka ʻōlelo maʻalahi, he pila (capsule) ia e hāʻawi iā ʻoe i nā enzymes a kou kino ʻaʻole e hana nei. Lawe ʻoe i kēia pila me kēlā me kēia ʻai a me ka meaʻai māmā . Kōkua nā enzymes i loko o ka pila iā ʻoe e hoʻoheheʻe i ka meaʻai āu e ʻai ai.
- ʻAi momona kiʻekiʻe i ka calorie: He mea nui e loaʻa nā calorie a me ka momona lawa mai ka meaʻai. He mea pono kēia no ka mea kōkua ka momona i ke kino e omo i nā meaola. Hiki ke kōkua ke ʻimi i ka ʻōlelo aʻo mai kahi meaʻai loea no kēia.
- Nā wikamina: ʻAʻole hiki i ka poʻe me EPI ke omo i nā wikamina momona-soluble, e like me nā wikamina A, D, E, a me K. No laila, inā makemake ʻoe i kēia mau wikamina, e kuhikuhi kāu kauka iā lākou ma ke ʻano he lāʻau lapaʻau.
ʻO ka mea nui loa, ʻo ia ka mālama pono ʻana i ke kūlana olakino maʻamau (e like me, Chronic Pancreatitis) i hoʻokumu ai i ka EPI.
Aia kekahi ala e pale aku ai i kēia kūlana?
ʻAʻole hiki ke pale ʻia nā maʻi genetic e hoʻoulu ai i ka EPI (e like me Cystic Fibrosis). Eia nō naʻe, hiki ke hoʻemi ʻia ka pilikia o ka Chronic Pancreatitis, ke kumu maʻamau i waena o nā pākeke.
He mea hoʻoluhi nui ka puhipaka a me ka inu ʻona no ka pancreas. Hoʻonui kēia mau mea i ka pilikia o ka mumū o ka pancreas (pancreatitis) a me ka hoʻomohala ʻana i ka EPI. No laila, he mea nui loa ka pale ʻana i ka puhipaka a me ka inu ʻona no ke olakino o ka pancreas.
I ka manawa hea e ʻike ai i kāu kauka
Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o nā hōʻailona ma lalo nei, e ʻike koke i kāu kauka.
| E ʻimi koke i ke kōkua lapaʻau: | |
|---|---|
| • Inā manaʻo ʻoe ua luhi loa a poniuniu paha | |
| • Inā he ʻaila a pilau ka ʻōpala | |
| • Inā loaʻa iā ʻoe nā hōʻailona o ka nele i ka ʻai (e like me ka ʻili maloʻo, ka hāʻule ʻana o ka lauoho) | |
| • Inā ʻoe e emi ana ke kaumaha me ke kumu ʻike ʻole ʻia | |
He mea kōkua nui iā ʻoe ke nīnau i kēia mau nīnau i kou wā e kipa aku ai i kāu kauka:
- He aha ke kumu e hoʻomohala ai iaʻu i ka EPI?
- He aha ka lāʻau lapaʻau maikaʻi loa noʻu?
- He aha nā hoʻololi e pono iaʻu e hana i kaʻu papaʻai?
- Pono anei au e lawe i nā wikamina?
- He aha nā pilikia e pono iaʻu e hopohopo?
Hiki ke paʻakikī ka noho ʻana me EPI, akā e hoʻomanaʻo me ka mālama kūpono a me nā hoʻololi ʻana i ke ʻano o ka nohona, hiki iā ʻoe ke ola i kahi ola olakino piha.
Leka Lawe-Home
- ʻO ka EPI kahi kūlana i hana ʻole ai ka pancreas i nā enzyme digestive lawa, kahi e hoʻopilikia ai i ka hiki o ke kino ke omo i nā meaʻai.
- ʻO ka hōʻailona nui a kikoʻī hoʻi, ʻo ia ke hele ʻana o nā ʻōpala wai, ʻaila, pilau.
- ʻO ka lāʻau lapaʻau nui ʻo PERT (Pancreatic Enzyme Replacement Therapy). Pono e lawe ʻia kēia me kēlā me kēia ʻai.
- Mai hoʻowahāwahā i nā hōʻailona e like me ka pohō kaumaha i wehewehe ʻole ʻia a i ʻole ka pehu ʻana. E ʻike koke i kāu kauka.
- No ka mālama ʻana i ke olakino o ka pancreas, e hōʻole loa i ka puhipaka a me ka inu ʻona.
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