Ke manaʻo nei anei kou ʻōpū e paʻa ana? E kamaʻilio kākou e pili ana i ka Gastric Outlet Obstruction (GOO)!

Ke manaʻo nei ʻoe i kekahi ʻeha a ʻoluʻolu ʻole paha i loko o kou ʻōpū ma hope o ka ʻai ʻana? Malia paha ua piha ʻoe ma hope o ka ʻai iki ʻana? A i ʻole e luaʻi ʻoe ma hope o ka ʻai ʻana? ʻAʻole wale kēia mau mea he mau mea maʻamau. ʻO ke kumu lapaʻau paha ma hope o kēia, ʻo ia ke kūlana a mākou e kamaʻilio ai i kēia lā, i kapa ʻia ʻo Gastric Outlet Obstruction, a i ʻole GOO (Gastric Outlet Obstruction) . Mai hopohopo, e kamaʻilio mākou e pili ana i kēia me nā kikoʻī a me ka maʻalahi.

Ua ʻike anei ʻoe i ke ʻano o ka Gastric Outlet Obstruction (GOO)?

I ka ʻōlelo maʻalahi, ʻo Gastric Outlet Obstruction (GOO) ka wā e ālai ʻia ai ke ala ma waena o kou ʻōpū a me kou ʻōpū liʻiliʻi no kekahi kumu. ʻO kēia ala a mākou e kapa nei he pylorus . E noʻonoʻo penei: ʻo ko mākou ʻōpū he ʻeke i hana ʻia me nā ʻiʻo e kōkua iā mākou e ʻeli i ka meaʻai. Ma lalo o kēia ʻeke ʻo ka pylorus, ka mea e hana ana e like me ka valve. ʻO ia ka mea e kāohi ana i ke ala o ka meaʻai i ʻeli ʻia i loko o ka ʻōpū liʻiliʻi. No laila, ma GOO, ua hewa kekahi mea me kēia pylorus a i ʻole kona wahi e puni ana, a ʻaʻole hiki i ka meaʻai ke haʻalele i ka ʻōpū. Ua like ia me kahi pōpō lauoho e ālai ana i kahi kahawai.

Loaʻa iā ʻoe kēia mau hōʻailona?

I ke ʻano o GOO, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Ka luaʻi: ​​He manaʻo mau o ka maʻi.
• Luaʻi ma hope o ka ʻai ʻana: Loaʻa ka luaʻi, ʻoiai ma hope koke iho o ka ʻai ʻana. I kekahi manawa, hiki i nā mea i ʻai ʻia i kekahi mau lā i hala aku nei ke puka pū me ka luaʻi.
• ʻEha ʻōpū: Loaʻa paha iā ʻoe kahi ʻeha iki ma ka ʻōpū o luna.
• Māʻona mua: Manaʻo piha ma mua o ka pau ʻana o ka ʻai ʻana.
• Pohō kaumaha: Hiki ke hōʻemi kaumaha ma muli o ka ʻai maikaʻi ʻole ʻana o ka meaʻai a me ka luaʻi ʻana.

E noʻonoʻo, ua ʻai ʻoe i kāu meaʻai punahele, akā ua piha kou ʻōpū ma mua o kou pau ʻana i ka hapalua o ka pā. A i ʻole, e luaʻi ʻoe me kahi mea ʻē i loko o kou ʻōpū ma hope koke iho o ka ʻai ʻana. Inā hoʻomau kēia, pono ʻoe e hopohopo.

No ke aha e hana ʻia ai kēia? He aha nā kumu o GOO?

Nui nā kumu like ʻole o GOO. Kāhea nā kauka i kēia mau "mea pale mechanical." ʻO ke ʻano kēia he mea pale kino i ke ala o ka meaʻai mai ka ʻōpū mai. Hiki i kēia mau mea pale ke maikaʻi a i ʻole ka maikaʻi ʻole .

Nā kumu maikaʻi

ʻO ke ʻano kēia, ʻaʻole kēia keʻakeʻa ma muli o ke kanesa.

• ʻO nā ʻeha peptic: He mau ʻeha kēia e kū mai ana i loko o ka ʻōpū a i ʻole ka hoʻomaka ʻana o ka ʻōpū liʻiliʻi (duodenum). ʻO ka ʻōpala e kū mai ana ma hope o ka ho'ōla ʻana o kēia mau ʻeha hiki ke hoʻohāiki i ka pylorus.
• Nā Bezoars:ʻO kēia nā mea e like me ka lauoho, nā ʻāpana meaʻai i hoʻoheheʻe ʻole ʻia, a i ʻole nā ​​mea ʻē aʻe e hōʻiliʻili ana i loko o ka ʻōpū a hana i nā puʻupuʻu. Hiki i kēia ke ālai i ka pylorus. I kekahi manawa, hiki ke hana ʻia kēia inā ʻoe e ale hewa i nā mea e like me ka lauoho me kāu meaʻai.
• ʻO ka stenosis pyloric: He kūlana kēia e kū mai ana i kekahi mau pēpē ʻōpio. Lilo ko lākou ʻiʻo pyloric i mea haiki, e paʻakikī ai iā lākou ke hana i nā mea e like me ka omo waiū pono ʻana. He mea maikaʻi ke makaʻala i kēia no ka mea hiki ke hiki i kā mākou poʻe liʻiliʻi pū kekahi.
• ʻO ka gastroenteritis Eosinophilic: He ʻano maʻi mumū kakaikahi loa kēia o ke ala ʻai (me ka ʻōpū a me ka ʻōpū liʻiliʻi). Hiki i kēia ke hoʻomānoanoa a hoʻohāiki i ka pylorus.
• ʻO ka maʻi Crohn: He ʻano mumū hoʻi kēia o nā ʻōpū. Inā pili ia i ka ʻōpū a me ka ʻōpū liʻiliʻi, hiki i nā strictures ke hana a ālai i ka pylorus.
• ʻO ka hernia hiatal: Hiki i kahi hernia hiatal nui ke hoʻoulu i kahi ʻāpana o ka ʻōpū e paʻi ma o ka diaphragm i loko o ka lua umauma. I kekahi manawa hiki i kēia ke kumu i ka ʻōpū e wili a pelu paha, e hana ana i ka GERD.
• Pancreatitis: ʻO ka mumū o ka pancreas hiki ke hoʻoulu i ka ʻāpana mua o ka ʻōpū liʻiliʻi (duodenum), e ālai ana i ke hele ʻana o ka meaʻai mai ka ʻōpū.

Nā kumu ʻino

I kekahi manawa hiki ke hana ʻia kēia ālai ʻia e ka maʻi kanesa.

• ʻO ke kanesa ʻōpū: ʻO nā ʻōpū kanesa e hana ʻia i loko o ka ʻōpū e hiki ke hoʻoulu i ka pylorus a i ʻole nā ​​​​ʻiʻo a puni e pehu a ālai ʻia.
• ʻO ke kanesa pancreatic: ʻO nā puʻupuʻu e ulu ana i loko o ka pancreas hiki ke hana i ka ʻāpana mua o ka ʻōpū liʻiliʻi e pehu, e ālai ana i ke hele ʻana o ka meaʻai mai ka ʻōpū.
• Nā puʻupuʻu stromal Gastrointestinal (GISTs): He ʻano puʻupuʻu laha ʻole kēia e hana ʻia ana i loko o nā paia o ka ʻōpū a i ʻole nā ​​​​​​naʻau. Hiki iā lākou ke hana i nā mea keakea i kekahi manawa.
• Lymphoma: He maʻi ʻaʻai kēia o ka ʻōnaehana lymphatic. Inā hoʻopilikia ia i nā lymph nodes a puni ka ʻōpū a me ka ʻōpū liʻiliʻi, hiki iā lākou ke pehu a hoʻoulu i ka GOO.
• Ka maʻi ʻaʻai Metastatic: Inā ulu ka maʻi ʻaʻai ma kahi ʻē aʻe o ke kino a pālahalaha i ka ʻōpū a i ʻole nā ​​​​ʻiʻo a puni, hiki iā ia ke hana i kahi ālai.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o kēia GOO?

ʻOi aku ka nui o ka loaʻa ʻana o ka GOO i kekahi poʻe ma mua o kekahi. Eia kekahi mau kumu e hiki ke kōkua i kēia:

• ʻO ka maʻi H. pylori: Hoʻonāwaliwali kēia bacteria i ka uhi o ka ʻōpū, e ʻoi aku ka maʻalahi o ka loaʻa ʻana o nā ʻōpū peptic. Hiki i kēia mau ʻōpū ke hōʻeha a hoʻohaiki i ka pylorus ma hope.
• Ka hoʻohana ʻana i nā lāʻau lapaʻau NSAID no ka manawa lōʻihi:ʻO ka hoʻohana mau ʻana i kekahi mau lāʻau ʻeha ʻeha ma luna o ke kauka (Nonsteroidal anti-inflammatory drugs - NSAIDs) hiki ke hōʻino i ka ʻili o ka ʻōpū a hoʻonui i ka pilikia o ka loaʻa ʻana o nā ʻeha.
• Inā ua loaʻa iā ʻoe ke ʻoki ʻōpū ma mua: Hiki i ka pylorus ke lilo i ʻano haiki ma muli o nā ʻeha mai nā ʻoki ʻōpū ma mua.
• ʻO ka maʻi reflux Gastroesophageal (GERD): Hiki i ka reflux acid mau ke hōʻino i ka uhi o ka ʻōpū, e hana ana i ka ʻili ʻeha a me ke keakea ʻana.

He aha nā pilikia e hiki ke hana inā lilo ke kūlana GOO i mea koʻikoʻi?

Inā ʻaʻole mālama pono ʻia ʻo GOO, hiki i ka hala ʻana o ka manawa ke alakaʻi i nā pilikia koʻikoʻi e like me:

• Ka maloʻo ʻana: ʻO ka luaʻi mau ʻana e hiki ke alakaʻi i ka maloʻo ʻana, hiki ke alakaʻi i ka nalowale o ka wai a me nā paʻakai i loko o ke kino.
• ʻO ke kaulike ʻole o ke electrolyte: ʻO ka luaʻi ʻana ke kumu o ka nalowale ʻana o ke kino i nā electrolytes koʻikoʻi, e like me ka sodium a me ka potassium, hiki ke hoʻopilikia i ka hana o nā mākala a me nā ʻōnaehana nerve.
• ʻAi ʻole: Ma muli o ka komo pono ʻole ʻana o ka meaʻai, ʻaʻole i loaʻa i ke kino nā meaola e pono ai, hiki ke alakaʻi i ka ʻai ʻole a me ka nawaliwali o nā ʻiʻo.
• ʻO ka niumonia aspiration: Ke luaʻi ʻoe, hiki i nā mea i luaʻi ʻia ke komo i loko o kou mau māmā. Hiki i kēia ke hana i ka niumonia. He kūlana weliweli kēia.

Mea nui: Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​he mea nui loa ia e ʻike koke i ke kauka no ka ʻōlelo aʻo. Hiki i kēia ke kōkua i ka pale ʻana i nā pilikia e like me kēia.

Pehea e ʻike pololei ai ke kauka i kēia maʻi GOO?

Aia kekahi mau hoʻokolohua e hiki ke hana ʻia e hōʻoia i ka hōʻoia o GOO. E nānā mua kāu kauka iā ʻoe a nīnau e pili ana i kāu mau hōʻailona. A laila, hiki iā lākou ke hana i kēia mau hoʻokolohua:

• Nā kukuna X-ray: Hiki i nā kiʻi kukuna X-ray o ka ʻōpū ke hāʻawi i kekahi manaʻo inā he mau mea keakea.
• Endoscopy: Ma kēia hoʻāʻo, ua hoʻokomo ʻia kahi ʻōmole lahilahi a palupalu me kahi kāmela i hoʻopili ʻia ma o ka waha e nānā pololei i loko o ka ʻōpū a me ka pylorus. Hiki i kēia ke kōkua i ka hoʻoholo ʻana i ke kumu o ka paʻa ʻana.
• ʻO ka moʻo GI kiʻekiʻe: Ma kēia, inu ʻoe i kahi wai kūikawā (hoʻonā hoʻohālikelike) a lawe ʻia kekahi mau kiʻi X-ray i kona hele ʻana ma kāu ʻōnaehana hoʻoheheʻe.
• Ke nānā ʻana i ka hoʻokahe ʻana o ka ʻōpū: Ke ana kēia hoʻāʻo i ka wikiwiki o ka hemo ʻana o ka meaʻai mai loko mai o ka ʻōpū.
• CT scan: Hiki i kēia ke kiʻi i nā kiʻi kikoʻī o ka ʻōpū, ka ʻāpana mua o ka ʻōpū liʻiliʻi, a me nā ʻōpū e pili ana. He mea kōkua nui kēia i ka loaʻa ʻana o ke kumu o ka paʻa ʻana.

He aha nā lāʻau lapaʻau no kēia? Hiki ke ho'ōla ʻia?

ʻO ka nūhou maikaʻi, aia nā lāʻau lapaʻau no GOO. Aia ka lāʻau lapaʻau i ke kumu o ka paʻa ʻana a me ke koʻikoʻi o ke kūlana.

• Nā lāʻau lapaʻau:Inā hoʻokumu ʻia ʻo GOO e kahi ʻōpū peptic, hiki ke kuhikuhi ʻia nā lāʻau lapaʻau e hoʻemi i ka waikawa o ka ʻōpū (e like me nā mea hoʻopaʻa proton pump (PPIs) ). Hiki i kēia ke kōkua i ka ho'ōla ʻana o nā ʻōpū a hoʻēmi i ka paʻa ʻana.
• ʻO ke ʻoki endoscopic: I kekahi mau hihia, hiki ke hana ʻia kahi ʻoki e like me ka pyloroplasty i ka manawa like me ka endoscopy e hoʻonui i ka wahi i hāiki ʻia.
• ʻO ke ʻoki kino Laparoscopic a hāmama paha: Ma muli o ke kumu a me ke kūlana o GOO, pono paha ke ʻoki kino. Hiki i kēia ke pili i ka wehe ʻana i nā ʻiʻo ʻeha, nā bezoars, a i ʻole, i nā hihia koʻikoʻi, ka wehe ʻana i kahi ʻāpana o ka ʻōpū a i ʻole ka ʻōpū liʻiliʻi.
• ʻEnteroscopy Balloon: Ma kēia ʻano hana, hoʻohana ʻia kahi catheter kūikawā me ka piko balloon e hoʻonui i ka pylorus me ka ʻole o ke ʻoki ʻana.

He aha ke kūlana ola o kekahi me GOO?

ʻO ka wānana a me ke ola o kekahi me GOO e pili ana i ke kumu o ka paʻa ʻana a me ke koʻikoʻi o ke kūlana. ʻO ka ʻike mua a me ka mālama ʻana e hopena pinepine i nā hopena maikaʻi. Eia nō naʻe, inā ʻaʻole mālama ʻia, hiki i ke kūlana ke ʻoi aku ka ʻino, e hoʻoulu ai i nā pilikia a hoʻopilikia i ke ola.

He aha kā mākou e hana ai e pale aku i ka hoʻokumu ʻia ʻana o GOO?

ʻOiai he hiki ʻole ke pale loa i ka hoʻokumu ʻia ʻana o GOO, aia kekahi mau mea hiki iā mākou ke hana e hōʻemi i ka pilikia.

Pono anei kākou e hana i kēia mau hoʻololi i ke ʻano o ka nohona?

• E haʻalele i ka puhipaka: Hiki i ka puhipaka ke hoʻonui i ka maʻi ʻōpū peptic a hoʻonui i ka pilikia o nā pilikia e like me ka ʻeha. He mea maikaʻi ka haʻalele ʻana i ka puhipaka no kou olakino holoʻokoʻa a me ka ʻōnaehana hoʻoheheʻe.
• E hoʻokele i ke kaumaha: Hiki i ke kaumaha mau ke hoʻonui i nā pilikia o ka ʻōpū. No laila e hoʻāʻo e hoʻokele i ke kaumaha ma o nā mea e like me ka hoʻoikaika kino, nā hana hoʻomaha, a me ka noʻonoʻo ʻana.

E mālama pono i nā kūlana olakino ma lalo

• Lapaʻau no ka maʻi H. pylori: Inā ua ʻike ʻia ʻoe me ka maʻi H. pylori, hiki i ka mālama ʻana me nā antibiotics ke hōʻemi nui i ka pilikia o ka loaʻa ʻana o nā ʻōpū a me nā pilikia GOO. Ma hope o ka mālama ʻana, e nānā kāu kauka e ʻike inā ua pau loa ka maʻi.
• Hoʻokele GERD: Loaʻa i ka poʻe me ka maʻi reflux gastroesophageal (GERD) ka reflux acid mau. Hiki i kēia ke hōʻino i ka uhi o ka ʻōpū a alakaʻi i nā ʻōpū. No laila, he mea nui e lawe i nā lāʻau lapaʻau GERD a hana i nā hoʻololi i ke ʻano o ka nohona e hoʻokele ai.

E hoʻomaka kākou e hoihoi iki, ʻeā?

• Nā nānā lapaʻau maʻamau: Ma ka ʻike pinepine ʻana i ke kauka, hiki ke ʻike ʻia a mālama ʻia i ka wā mua nā pilikia o ka ʻōnaehana hoʻoheheʻe e hiki ke alakaʻi i nā kūlana e like me GOO.
• Ke hoʻohana pono nei i nā lāʻau lapaʻau:ʻO kekahi mau lāʻau lapaʻau, ʻoiai nā NSAID (Nonsteroidal anti-inflammatory drugs) nā mea hoʻopau ʻeha, hiki ke hōʻino i ka ʻili o ka ʻōpū a hoʻonui i ka pilikia o nā ʻōpū. No laila e makaʻala i ka hoʻohana ʻana iā lākou. Inā pono, e kamaʻilio me kāu kauka e pili ana i nā koho ʻē aʻe.

Pehea e mālama ai iaʻu iho? (Ma hope o ka mālama ʻana)

Ma hope o ka mālama ʻana no GOO, pono ʻoe e hana i kekahi mau hoʻololi i kou nohona:

• Nā Hoʻololi i nā manawa ʻai: Ma kahi o ka ʻai ʻana i kahi meaʻai nui i ka manawa hoʻokahi, e ʻai i nā meaʻai liʻiliʻi i nā manawa he nui i ka lā. E hōʻemi kēia i ke kaumaha ma kou ʻōpū.
• Ka hoʻokele koʻikoʻi: Hiki ke hoʻonui ʻia kekahi mau hōʻailona ʻōpū e ke koʻikoʻi, no laila hiki i ka hoʻohana ʻana i nā ʻano hana hōʻoluʻolu ke kōkua.

He aha nā meaʻai maikaʻi ʻole ke ʻai ʻia ke loaʻa iā ʻoe ka GOO?

Inā loaʻa iā ʻoe ka GOO, pono ʻoe e pale i ka ʻai ʻana i nā huaʻai maka, nā mea kanu, a me nā palaoa piha, no ka mea, he paʻakikī ke hele ma waena o ka mea paʻa. He manaʻo maikaʻi nō hoʻi e kaupalena i nā meaʻai ʻala, ʻaila, a me nā mea ʻakika, no ka mea, hiki iā lākou ke hoʻonāukiuki i ka uhi o ka ʻōpū.

Āhea wau e ʻike ai i ke kauka?

Inā hoʻomau ʻoe i nā hōʻailona e like me ka nausea, ka luaʻi ʻana, a me ka ʻeha o ka ʻōpū, he mea nui loa ia e ʻike i ke kauka e ʻike i ke kumu a pale i nā pilikia.

E hoʻomanaʻo, ʻo ka mālama ʻana i nā maʻi kumu i ka wā mua hiki ke hōʻemi nui i ka pilikia o GOO a mālama i kou olakino holoʻokoʻa.

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

Inā loaʻa iā ʻoe ʻo GOO, hiki iā ʻoe ke nīnau i kāu kauka i nā nīnau e like me kēia:

• He aha ke kumu kūpono loa o koʻu kūlana GOO?
• Pehea ka ʻino o ke ālai ʻana?
• He aha nā koho lapaʻau e loaʻa iaʻu?
• He aha nā pōmaikaʻi a me nā pōʻino o kēlā mau koho lapaʻau?
• He aha ka nānā ʻana no koʻu kūlana?
• Pono anei au e hoʻololi i kaʻu meaʻai ma hope o ka mālama ʻana?

He aha ka ʻokoʻa ma waena o ka Gastric Outlet Obstruction (GOO) a me ka Gastroparesis?

Hiki i ke ālai ʻana o ka puka ʻōpū (GOO) a me ka gastroparesis ke hana i nā pilikia me ka hele ʻana o ka meaʻai mai ka ʻōpū. Eia nō naʻe, ʻokoʻa nā kumu a me nā ʻano hana o nā mea ʻelua.

E noʻonoʻo iā GOO me he ʻauwai paʻa. ʻO kēia mea paʻa kino e pale aku i ka meaʻai mai ka haʻalele ʻana i ka ʻōpū a hoʻomau i ke koena o ke kaʻina hana ʻai.

ʻAʻole ʻo Gastroparesis he ālai kino e like me GOO. He kūlana ia kahi e nāwaliwali ai a hana ʻole paha nā ʻiʻo i loko o ka paia o ka ʻōpū e kōkua mau ana i ka hoʻokuke ʻana i ka meaʻai i waho o ka ʻōpū, e hoʻopaneʻe ana i ka hele ʻana o ka meaʻai mai ka ʻōpū.

ʻO ka mea hope loa, ʻo ka mea nui e hoʻomanaʻo (Leka Lawe-Home)

He mea maʻamau ke makaʻu a me ka hopohopo ke ʻike ʻia ʻoe me ka Gastric Outlet Obstruction (GOO). Akā ʻo ka mea nui loa, ʻo ia ka hoʻomanaʻo ʻana he maʻi hiki ke mālama ʻia kēia.He nui ka ʻike o nā kauka i ka mālama ʻana i kēia maʻi. Eia kekahi, aia nā koho lapaʻau kūpono ma muli o ke kumu. Nui ka poʻe e kū nei i kēia maʻi. Inā loaʻa iā ʻoe ka lāʻau kūpono, hiki iā ʻoe ke hoʻōla koke. E noho maikaʻi, e kālele i ka loaʻa ʻana o ka lāʻau lapaʻau maikaʻi loa, a e hoʻomanaʻo ʻaʻole ʻoe hoʻokahi i kēia. E kōkua kāu hui lapaʻau iā ʻoe i kēlā me kēia ʻanuʻu o ke ala.

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