Ke ʻeha nui nei paha ʻoe ma muli o kahi maʻi lōʻihi i loko o kou ʻōpū. Malia paha, ʻoiai me ka lāʻau lapaʻau, he paʻakikī ke kaohi i ke ʻano. I loko o ia kūlana, hiki i ke kauka ke kuhikuhi i kahi hopena no ʻoe e wehe ai i ka ʻōpū nui maʻi a hana i kahi ʻeke kūikawā i loko o ke kino e hiki ke hōʻiliʻili i nā ʻōpala. ʻO ia ka mea a mākou e kapa nei he ʻeke ileal. E kamaʻilio kākou e pili ana i nā mea āpau ma nā ʻōlelo maʻalahi.
I ka ʻōlelo maʻalahi, he aha ka ʻeke ileal?
E noʻonoʻo ʻoe ua wehe ʻia kou ʻōpū nui holoʻokoʻa (colon) a me ka rectum ma ke ʻoki ʻana ma muli o kahi maʻi. Ua kapa ʻia kēia ʻoki ʻana he "Total Proctocolectomy". No laila, ma hope o ka wehe ʻia ʻana, pono ʻoe i kahi e hōʻiliʻili a mālama ai i nā huahana ʻōpala (stool) i hana ʻia ma hope o ka ʻeli ʻana i ka meaʻai ma mua o ko lākou haʻalele ʻana i ke kino.
ʻO ia ka manawa e hoʻohana ai nā kauka ʻoki i ka hopena o kou ʻōpū liʻiliʻi ponoʻī (ka ileum) e hana i kahi ʻeke liʻiliʻi i loko o kou kino. Ua kapa ʻia kēia he ʻeke ileal .
ʻO ka pōmaikaʻi nui o kēia, ʻaʻole pono ʻoe e ʻaʻahu i kahi ʻeke/ʻeke waho e hōʻiliʻili i nā ʻōpala ma waho o kou ʻōpū. Hiki iā ʻoe ke mālama i ka kaohi ʻana o ka ʻōpū e like me ka maʻamau.
I loko o nā ʻano kūlana olakino hea e pono ai ke hana ʻia kēia ʻoki kino?
ʻAʻole i loaʻa i nā kānaka a pau kēia ʻoki kino. Noʻonoʻo nā kauka i kēia koho ke hiki ʻole ke hoʻomalu ʻia kekahi mau kūlana olakino me ka lāʻau lapaʻau. ʻO kēia ʻoki kino, i kapa ʻia ʻo `(Ileal Pouch-Anal Anastomosis - IPAA)`, hoʻohana pinepine ʻia i nā kūlana aʻe:
- Ulcerative Colitis: He kūlana kēia e hoʻoulu ai i ka mumū a me ka pehu ʻana i loko o ka ʻōpū nui no ka manawa lōʻihi. ʻO kēia ke koho maikaʻi loa ke hana ʻole nā lāʻau lapaʻau.
- ʻO Familial Adenomatous Polyposis (FAP): He maʻi hoʻoilina kēia e hoʻoulu ai i nā haneli o nā ulu liʻiliʻi (polyps) i loko o ka ʻōpū nui e hiki ai ke lilo i maʻi kanesa.
- Ka maʻi ʻaʻai Colorectal/Colon: I kekahi mau hihia o ka maʻi ʻaʻai.
- Ka Maʻi ʻAʻai Rectal: No kekahi mau maʻi ʻaʻai e kū ana ma ka ʻaoʻao o luna o ka rectum, ma mua o ka ʻaoʻao o lalo.
Ehia mau ʻano o kēia mau ʻeke?
ʻAe, ʻekolu mau ʻano nui o kēia mau ʻeke kūloko a nā kauka ʻoki i hana ai.
| ʻAno ʻeke | Ka wehewehe maʻalahi |
|---|---|
| ʻEke-J | ʻO kēia ke ʻano i hoʻohana nui ʻia . Hana ʻia ka ʻeke ma ka pelu ʻana i ka ʻōpū liʻiliʻi i ke ʻano o ka leka 'J'. Hoʻopili pololei ʻia ia i ka anus, no laila hiki iā ʻoe ke kahe maʻamau. |
| ʻEke-S | Hana ʻia kēia ma ke ʻano o ka leka 'S'. Ua like loa ia me ka ʻeke-J. Hoʻopili pū ʻia ia i ka anus. |
| ʻEke Kock / ʻeke K | He ʻano laha ʻole kēia. Hana ʻia ia no ka poʻe ʻaʻole hiki ke loaʻa nā ʻano ʻelua ʻē aʻe. Maanei, ua hoʻopili ʻia ka ʻeke i kahi puka (stoma) i hana ʻia ma ka ʻili o ka ʻōpū. |
No laila, no wai kēia ʻoki kino kūpono a no wai ʻaʻole?
I mea e holomua ai kēia ʻoki kino, pono e hana pono kekahi mau ʻāpana o kou kino. Eia kekahi, ʻaʻole paha ia e kūpono no ka poʻe me kekahi mau maʻi.
| Nā Moho Maikaʻi no kēia ʻoki kino | ʻO ka poʻe i ʻōlelo ʻole ʻia no ke ʻoki kino (ʻAʻole paha e kūpono) |
|---|---|
| ʻO ka poʻe nona nā ʻāpana i koe o ka ʻōnaehana hoʻoheheʻe e hana maikaʻi ana. | ʻO nā kānaka me ka maʻi o Crohn (ʻoiai hiki i kēia maʻi ke hoʻopili i ka ʻeke i hana hou ʻia). |
| ʻO nā kānaka me nā ʻiʻo anal sphincter e hana maikaʻi ana a me ka hiki ke hoʻomalu i ko lākou neʻe ʻana o ka ʻōpū. | ʻO ka poʻe i loaʻa mua i ka incontinence fecal . |
| ʻO nā poʻe i loaʻa ʻole ka hōʻino ʻana i nā aʻalolo pelvic. | ʻO nā kānaka me ka momona nui (Class III momona) . |
| He holomua loa nā hopena no ka poʻe ma waena o 20 a me 50 mau makahiki. Akā hiki i ka poʻe olakino ma luna o 50 ke hana i kēia. | Nā kānaka me ka maʻi ʻaʻai rectal haʻahaʻa . |
He aha ka mea e manaʻo ai ma hope o ke ʻoki kino?
ʻAʻole kēia he ʻoki kino hoʻokahi manawa. Hana pinepine ʻia ia i ʻelua a ʻekolu paha mau pae . Ma hope o ke ʻoki kino, pono ʻoe e noho ma ka haukapila no hoʻokahi pule.
I ka wā mua, e kau ʻia kahi ʻeke manawa pōkole ma waho o kou ʻōpū i ka wā e ho'ōla ai ka ʻeke hou i hana ʻia. Hiki i kēia ke mau mai ʻekolu a ʻeono mahina. A laila, e hana ʻia kahi hana liʻiliʻi e wehe iā ia a ʻae i ka ʻeke o loko e hoʻomaka e hana. I loko o kēia manawa, e mālama pono loa ke kime lapaʻau iā ʻoe. Mai makaʻu e kamaʻilio me lākou inā he mau nīnau kāu.
Pehea ka holomua o kēia? Aia kekahi mau pilikia?
He ʻoki kino holomua loa kēia. ʻO ka nui o ka holomua ma kahi o 95% . I ka hala ʻana o ka manawa, e hoʻomaikaʻi nui ʻia kou ʻano ola. No ka laʻana, ʻo ka mea i loaʻa i ka `(Ulcerative Colitis)` ʻaʻole ia e makemake koke e hele i ka lua e like me ka wā ma mua.
Ma ka awelika, pono ʻoe e kahe i loko o kahi ʻehiku mau manawa i ka lā. Akā ʻo ka mea nui loa, ʻo ia ka hiki ke kāohi iā ia me ka ʻole o ka wikiwiki i ka wā e pono ai.
Eia nō naʻe, e like me nā ʻoki kino nui a pau, aia nā pilikia a me nā pilikia.
- Pouchitis: ʻO kēia ka pilikia maʻamau. He mumū a maʻi paha ia o ka ʻeke i hana hou ʻia.
- Nā pilikia ʻē aʻe:
- Ka leaka ʻana mai loko mai o ka ʻeke ma hope o ke ʻoki ʻana.
- Ka pale ʻana o ka ʻōpū liʻiliʻi.
- Nā ʻūpā koko a i ʻole ke kahe ʻana o ke koko.
- ʻO ke kūkulu ʻia ʻana o kahi pilina kūpono ʻole (fistula) ma waena o ka ʻeke a me kekahi ʻano kino ʻē aʻe.
- ʻO ka ʻeha ma ka ʻili a puni ka anus ma muli o ka neʻe pinepine ʻana o ka ʻōpū.
ʻO ka pilikia o kēia mau pilikia ma waena o 5% a me 10%. Inā hana ʻia kēia, pono paha ʻoe e hana i kahi ʻoki ʻē aʻe a i ʻole he stoma mau loa. No laila, he mea nui e kūkākūkā i kēia mau mea āpau me kāu kauka.
Āhea ʻoe e ʻike koke ai i ke kauka?
He mea nui loa e ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe kekahi mau hōʻailona hou a ʻano ʻē paha ma hope o ke ʻoki ʻana. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, e haʻi koke aku i kāu kauka.
| Nā hōʻailona e makaʻala ai |
|---|
| ʻO ka pehu ʻana o ka ʻōpū a i ʻole nā ʻūmiʻi e mau ana ma mua o ʻelua a ʻekolu mau hola. |
| Ke kahe ʻana o ke koko. |
| (Inā he ʻeke manawa pōkole) kahi loli a ʻeha paha i ka stoma. |
| Ka paʻakikī i ka hoʻokahe ʻana. |
| Ka nui o ka liki ʻana. |
| ʻEha nui. |
| Ka nausea nui, ka luaʻi ʻana, a i ʻole ka diarrhea. |
Pehea ka lōʻihi e hoʻi ai i ke ola maʻamau? Pehea e pili ana i ka meaʻai a me ka mea inu?
Hiki iā ʻoe ke hoʻi i ka hana a me nā hana i loko o ʻehā a ʻewalu pule . Ma hope o kou ho'ōla ʻana, e hana kāu kauka i kahi pouchoscopy (kahi kāmela liʻiliʻi e nānā i loko o ka ʻeke) i kēlā me kēia makahiki a ʻelua paha e hōʻoia i ka maikaʻi o nā mea āpau.
I ka wā e pili ana i ka meaʻai , pono paha ʻoe e hana i kekahi mau hoʻololi i kāu papaʻai e hoʻokipa i kāu ʻōnaehana hoʻoheheʻe hou i ka wā mua. ʻOi aku ka maikaʻi o ke kūkākūkā ʻana me kahi meaʻai no ka ʻōlelo aʻoaʻo. Akā, i ka hopena, hiki i ka hapa nui o ka poʻe ke ʻai i nā mea a lākou e makemake ai.
No ka hāpai ʻana , ʻaʻole pinepine kēia ʻoki kino e hoʻopilikia i kou hiki ke loaʻa nā keiki. Eia nō naʻe, i mea e pale aku ai i ka hōʻino ʻana i nā ʻiʻo o ka rectum i ka wā hānau keiki, hiki i kāu kauka ke ʻōlelo aku i kahi ʻoki cesarean .
Leka Lawe-Home
- ʻO ke ʻoki ʻana i ka ʻeke ʻo Ileal kahi manawa kūpono loa no ka poʻe e ʻeha nei i nā maʻi colon e ola i kahi ola maʻamau me ka ʻole o kahi ʻeke i loko o ko lākou ʻōpū.
- He hana ʻoki kino kēia i loaʻa ka nui o ka holomua kiʻekiʻe loa (95%) a hoʻomaikaʻi nui i ka maikaʻi o ke ola.
- Eia nō naʻe, he hana ʻoki kino nui kēia ʻaʻole me ka ʻole o nā pilikia a me nā pilikia. ʻO ka pilikia maʻamau ka maʻi i kapa ʻia ʻo pouchitis.
- He manawa iki ka manawa e ho'ōla ai ma hope o ke ʻoki ʻana, a he mea nui nā nānā mau ʻana me kāu kauka no ke olakino lōʻihi.
- Inā he mau nīnau kāu e pili ana i kēia, mai makaʻu e nīnau i kāu kauka.
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