He kanaka anei ʻoe i wehe ʻia kou kolona holoʻokoʻa a me kou rectum ma ke ʻoki ʻana ma muli o kahi maʻi a ua hana ʻia kahi 'ʻeke ileal' ma kona wahi? Inā pēlā, hiki iā ʻoe ke loaʻa i kekahi ʻeha e pili ana i kēia ʻeke i kekahi manawa. ʻO kekahi o nā pilikia maʻamau e kū mai ana, ʻo ia ka mea a mākou e kamaʻilio nei i kēia lā, ʻo 'Puchitis'. Mai makaʻu ke lohe ʻoe i kēia. E kamaʻilio kākou e pili ana i nā mea āpau me ka maopopo a me ka maʻalahi.
He aha ka Pouchitis? E hoʻomaopopo maʻalahi kākou.
ʻO ka mea mua, e nānā kākou i ke ʻano o kēia 'ʻeke ileal'. Ma hope o ka wehe loa ʻia ʻana o kou kolona a me kou rectum (total proctocolectomy), pono ʻoe i kahi ala hou e hoʻokuʻu ai i kou ʻōpala mai kou kino. ʻO kahi hopena no kēlā, ʻo ia ke ʻoki ʻeke ileal. ʻO ka mea e hana ʻia ma ʻaneʻi, hoʻohana nā kauka ʻoki i ka ʻāpana hope o kou ʻōpū liʻiliʻi (ileum) e hana i kahi ʻano ʻeke liʻiliʻi.
No laila, ʻo ka mea a kou ʻōpū nui i hana ai ma mua, ʻo ia ka hōʻiliʻili a mālama i ka ʻōpala no kekahi manawa ma mua o kona haʻalele ʻana, ua hana ʻia e kēlā ʻeke. I nā huaʻōlelo ʻē aʻe, hana kekahi hapa o kou ʻōpū liʻiliʻi e like me ka ʻōpū nui.
ʻO ka pouchitis ka wā e pehu ai ka ʻeke a pehu paha mai loko mai. He ʻano like ia me ka colitis (ka pehu ʻana o ke kolona) a i ʻole ka proctitis (ka pehu ʻana o ka rectum). He ʻano maʻamau kēia no kekahi kanaka me ka ʻeke.
No ka hapanui o nā kānaka, he manawa pōkole kēia (acute pouchitis), akā no kekahi poʻe hiki ke lilo i mea mau (chronic pouchitis) a i ʻole ke ʻano hou.
He aha nā hōʻailona o ka pouchitis?
Inā loaʻa iā ʻoe ka pouchitis, hiki iā ʻoe ke ʻike i hoʻokahi a ʻoi aku paha o kēia mau hōʻailona. He mea nui e makaʻala iā lākou.
| Hōʻailona | Wehewehena |
|---|---|
| ʻEha ʻōpū haʻahaʻa a me ka ʻōʻō ʻana | He ʻeha ʻē ma ka ʻōpū lalo a i ʻole he manaʻo e hopu ʻia a hoʻohuli ʻia. |
| Pono pinepine a koke e hele i ka lua | Pono ʻoe e hele i ka lua i nā manawa he nui ma mua o ka maʻamau, a laila manaʻo koke ʻoe i kahi pono hiki ʻole ke hoʻomanawanui e hele i ka lua. |
| Ke hele nei i ka lua i ka pō | Pono e ala a hele i ka lua. |
| Ka paʻakikī i ka hoʻokele ʻana i nā neʻe ʻana o ka ʻōpū (incontinence) | Ka hoʻolei ʻana i kahi ʻāpana liʻiliʻi o ka noho me ka ʻike ʻole. |
| Ka paʻakikī o ka hele ʻana i nā ʻū | Ke hoʻoikaika nei e hoʻokahe i ka ʻōpū i ka wā e hele ai i ka lua (dyschezia). |
| ʻO ka manaʻo o ka hiki ʻole ke hoʻokahe loa i ka lua ma hope o ka hele ʻana i ka lua | Manaʻo e like me ka neʻe ʻana o ka ʻōpū ma hope o ka hele ʻana i ka ʻōpū (tenesmus). |
| Ke koko iki i loko o ka ʻōpala | Ke ʻike nei i nā kaha koko i loko o ka ʻōpala. |
| Kuni a i ʻole ke anu | Ke kuni nei a i ʻole ke haʻalulu. |
No ke aha e kū mai ai ka pouchitis?
ʻAʻole i ʻike maopopo ʻia ke kumu maoli o kēia, akā ʻo ke kumumanaʻo nui, aia kahi kaulike ʻole i nā ʻano bacteria e noho ana i loko o ka ʻeke.
E noʻonoʻo, i ka wā e hana nei kekahi hapa o kou ʻōpū liʻiliʻi e like me ka ʻōpū nui, e komo mai nā ʻano bacteria hou. Aia kahi 'kaua' liʻiliʻi ma waena o kēia mau bacteria hou a me nā bacteria kahiko. Hiki i kēia hoʻololi ke hana i ka ʻōnaehana pale o ke kino e manaʻo he maʻi ma laila. No laila, ma muli o kēlā, hana ʻia ka mumū, ʻo ia hoʻi ka pehu ʻana o ka ʻeke.
I kekahi manawa, hiki i nā bacteria pathogenic ke ulu nui a hoʻoulu i kahi maʻi. Hoʻololi kēia kaulike bacteria ma hope o ke ʻoki ʻana, e hāʻawi ana i nā bacteria ʻino i kahi manawa kūpono e ulu ai.
He mea maʻamau ka loaʻa ʻana o ka pouchitis ma hope koke iho o ke ʻoki ʻana. Hiki ke mālama pinepine ʻia kēia me nā antibiotics. Eia nō naʻe, i kekahi poʻe, hiki ke hoʻi hou mai.
Nā kumu ʻē aʻe e kōkua ai i ka pouchitis mau loa
No kekahi poʻe, hoʻomau ka pouchitis a ʻaʻole pane maikaʻi i ka lāʻau. Hiki ke hana ʻia kēia ma muli o nā kumu ʻē aʻe.
- Nā kūlana olakino mua (IBD): Inā pono ʻoe e wehe i kou kolona ma muli o kahi maʻi ʻōpū mumū (IBD) e like me Ulcerative Colitis a i ʻole ka maʻi Crohn, ʻoi aku ka nui o kou pilikia o ka loaʻa ʻana o ka pouchitis. ʻO kēia no ka mea ʻo ke ʻano kumu like i hoʻokumu i kēlā maʻi hiki ke hoʻopilikia i ka ʻeke.
- Nā bacteria kū'ē i ka antibiotic: He paʻakikī ke kāohi i kekahi mau maʻi bacteria, e like me C. difficile, me nā antibiotics. Eia kekahi, me ka hoʻomau ʻana o ka hoʻohana ʻana i nā antibiotics, lilo kekahi mau bacteria i kū'ē iā lākou. Hiki i kēia ke hoʻonui i ke kaulike ʻole o ka bacteria i loko o ka ʻeke.
- Nā maʻi ʻē aʻe: I kekahi manawa, hiki ke hana ʻia ka mumū o ka ʻeke e nā maʻi viral (cytomegalovirus) a i ʻole fungal (candidiasis).
- Ka hoʻonāwaliwali ʻana o ka palekana: Inā hoʻonāwaliwali ʻia ka ʻōnaehana palekana o kou kino ma muli o nā kūlana olakino ʻē aʻe a i ʻole kekahi mau lāʻau lapaʻau, ua emi iho kou hiki ke hakakā i nā maʻi.
- Ka hoʻohana ʻana i nā lāʻau ʻeha (NSAID): ʻO ka hoʻohana lōʻihi a me ka hoʻohana nui ʻana i nā lāʻau ʻeha e like me ka ibuprofen a me ka aspirin (Nonsteroidal anti-inflammatory drugs - NSAIDs) hiki ke hōʻino i ka papa o loko o ka ʻeke.
- Hoʻemi ʻia ke koko (Ischemia): ʻOiai he mea kakaikahi loa, hiki ke hana ʻia ka mumū ma muli o ka pale ʻana o ke koko i ka ʻeke.
- ʻO ka maʻi PSC: ʻO ka `(Primary sclerosing cholangitis - PSC)` kahi maʻi e hoʻoulu ai i ka mumū o nā ʻauwai bile o ke akepaʻa. ʻO ka poʻe me kēia maʻi e piʻi aʻe ka pilikia o ka loaʻa ʻana o ka pouchitis.
He aha nā pilikia e hiki mai ana o ka pouchitis?
ʻAʻole pinepine ka pouchitis manawa pōkole i nā pilikia nui, akā inā hoʻomau ke kūlana a ʻaʻole pane paha i ka lāʻau lapaʻau, hiki iā ia ke hana i kekahi mau pilikia.
| Ka pilikia | Wehewehena |
|---|---|
| Hoʻololi i nā ʻano hana ʻōpū | Hiki i ka mumū ʻana o ka ʻeke ke hana i nā pilikia lōʻihi, e like me ka paʻakikī i ka paʻa ʻana i ka ʻōpala a i ʻole ka paʻakikī i ka hele ʻana i ka ʻōpala ma muli o ka pehu ʻana. |
| Ke emi nei ke kūlana o ka nohona | ʻO ka pilikia o ka hele pinepine ʻana i ka lua hiki ke alakaʻi i nā pilikia e like me ke kaumaha a me ka emi ʻana o nā pilina pili kanaka. |
| Ka hoʻohaiki ʻana o ka ʻeke (Stricture) | Hiki i ka mumū lōʻihi ke hana i ka ʻeha o ka ʻeke, e hoʻohaiki ana i kona puka. |
| Nā ʻōpū | Hiki i ka mumū ke hoʻonāukiuki i ka papa o loko o ka ʻeke a kahe ke koko. |
| Nā hemahema meaʻai | ʻO ka hōʻino ʻana i ka papa o loko o ka ʻeke hiki ke alakaʻi i ka emi ʻana o ka omo ʻana o nā meaola mai ka meaʻai (malabsorption), e alakaʻi ana i ka nele i ka ʻai. |
| Ka hemahema o ka ʻeke | ʻAʻole pinepine, hiki i nā pilikia mau ke hoʻolilo i ka ʻeke i mea hiki ʻole ke hoʻohana ʻia, e pono ai ke wehe ʻia a me nā kaʻina hana ʻē aʻe, e like me ka ileostomy. |
Pehea ʻoe e ʻike pono ai inā loaʻa iā ʻoe ka pouchitis?
Ma hope o ka hoʻolohe ʻana i kāu mau hōʻailona, e hana kāu kauka i kekahi mau hoʻokolohua e hōʻoia i ke kūlana. ʻO ka hoʻokolohua koʻikoʻi loa he pouchoscopy (endoscopy) .
ʻO kēia ke komo ʻana i kahi ʻōmole lahilahi loa me kahi kāmela i hoʻopili ʻia ma kou anus a me ka nānā ʻana i loko o ka ʻeke. A laila hiki i ke kauka ke nānā no kekahi mumū a i ʻole nā ʻeha i loko o ka ʻeke. I ka manawa like, hiki ke lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo (biopsy) no ka hoʻokolokolo ʻana.
Eia kekahi, hiki ke hana ʻia nā hoʻokolohua aʻe e nānā i ke kūlana o ka ʻeke a me nā hale a puni:
- Ka Pouchogram Hoʻohālikelike
- ʻO ke kiʻi CT
- ʻO ka MRI
He aha nā lāʻau lapaʻau no ka pouchitis?
Aia nā koho lapaʻau i ke ʻano o ka pouchitis āu e loaʻa ai.
Lapaʻau no ka Pouchitis ʻĀkiʻi
ʻO ka lāʻau lapaʻau mua he papa ʻelua pule o nā antibiotics. No nā kānaka he nui, e hoʻopau loa kēia i ko lākou mau hōʻailona. ʻOiai inā e hoʻomaikaʻi kāu mau hōʻailona, he mea nui e lawe i ka papa piha o ka lāʻau i kuhikuhi ʻia e kāu kauka.
Lapaʻau no ka Pouchitis Hoʻi Hou
Inā hoʻi hou ka pouchitis ma hope o ka mālama ʻana, e kuhikuhi paha ke kauka i nā antibiotics like. Eia nō naʻe, inā ʻoi aku ma mua o ʻekolu manawa i ka makahiki, ua manaʻo ʻia he maʻi mau loa ia a hiki ke hoʻomaka ʻia ka mālama mālama ʻana e pale aku i ka hoʻi hou ʻana. No kēia,
- Ke hāʻawi nei i nā antibiotics no ka manawa lōʻihi ma nā dosis haʻahaʻa.
- Ka Hoʻohana ʻana i nā Probiotics: Hiki i nā Probiotics, nona nā bacteria maikaʻi, ke kōkua i ka hoʻihoʻi ʻana i ke kaulike bacteria i loko o ka ʻeke.
ʻO ka mālama ʻana i ka pouchitis i pane ʻole i nā antibiotics (CARP)
Inā ʻaʻole kōkua nā lāʻau antibiotic, a inā paha ua kōkua lākou ma mua, ua kapa ʻia ke kūlana ʻo "Chronic antibiotic-resistant pouchitis (CARP)". Maanei, e ʻimi ke kauka i nā kumu ʻē aʻe a hoʻoholo i ka lāʻau e like me ia. Aia nā koho lapaʻau like ʻole no kēia.
- ʻEnema me nā lāʻau lapaʻau e like me 'Mesalamine' a i ʻole 'Bismuth'
- ʻO nā Corticosteroids, nā mea e hōʻemi ai i ka mumū
- ʻO nā immunosuppressants e kāohi ana i ka hana o ka ʻōnaehana pale
- Nā lāʻau lapaʻau hou e like me ka 'Biologics'
- Nā lāʻau lapaʻau kūikawā e like me ka `Fecal microbiota transplant (FMT)`
ʻO ka mea nui loa, ʻo ia ke hoʻoholo i kāu kauka i ka lāʻau lapaʻau kūpono loa iā ʻoe. No laila, inā loaʻa iā ʻoe nā hōʻailona, e ʻimi koke i ke kōkua lapaʻau.
Hiki ke mālama ʻia ka pouchitis me ka meaʻai a me ka mea inu?
ʻAe, i kekahi ʻano hiki. Hiki i kāu ʻai ke kōkua i ka pale ʻana i ka pouchitis mai ka ulu ʻana a kōkua pū i ka hoʻokele ʻana i nā hōʻailona ke kū mai lākou.
| Nā meaʻai e kōkua i ka pale ʻana i ka pouchitis (nā meaʻai waiwai i ka antioxidant) | Nā meaʻai e hoʻonui ai i nā hōʻailona pouchitis (e hoʻōki no kekahi manawa) |
|---|---|
E hoʻokomo i nā huaʻai a me nā mea kanu i waiwai i nā antioxidants e hōʻemi ana i ka mumū i kāu meaʻai.
| Ke ʻike ʻia nā hōʻailona, hiki ke loaʻa ka hōʻoluʻolu ma ka hōʻemi ʻana i kekahi mau meaʻai e hoʻoulu ai i ka bacteria ʻōpū a paʻakikī ke ʻeli (Low FODMAP Diet).
|
He mea nui: ʻAʻole pono ʻoe e hahai mau i ka ʻai haʻahaʻa FODMAP. He mea ia e pono ai ʻoe e hahai no kahi manawa pōkole, ke loaʻa iā ʻoe nā hōʻailona, ma lalo o ke alakaʻi a ke kauka a meaʻai meaʻai paha.
ʻOiai ua maʻalahi ke ola ma hope o ke ʻoki ʻana i ka ʻeke ileal, he mea maʻamau ke hopohopo i ka wā e kū mai ai nā pilikia e like me ka pouchitis. Akā e hoʻomanaʻo, he ʻano hiki ke mālama ʻia kēia e hoʻopilikia ana i nā poʻe he nui. Hiki iā ʻoe ke hana pū me kāu kauka e ʻimi i ka hopena maikaʻi loa nāu.
Leka Lawe-Home
- ʻO ka Pouchitis kahi mumū o ka ʻeke i maʻamau i waena o ka poʻe i hana ʻia i ke ʻoki ʻeke ileal.
- Inā ʻike ʻoe i nā hōʻailona e like me ka ʻeha o ka ʻōpū ma lalo, nā hele pinepine ʻana i ka lua, a i ʻole ke koko i loko o kou ʻōpala, e hoʻolohe iā lākou.
- Hiki ke mālama pono ʻia ka hapa nui o nā hihia o ka pouchitis me nā lāʻau antibiotic.
- Mai hoʻowahāwahā i nā hōʻailona. E ʻike i kāu kauka i ka hikiwawe loa no ka ʻōlelo aʻo.
- ʻO kahi papaʻai kaulike a me nā probiotics paha ke kōkua i ka mālama ʻana i ke olakino o ka ʻeke.
- Hiki i nā kūlana pouchitis mau loa (mau) ke koi aku i kahi lāʻau lapaʻau kūikawā, a na kāu kauka e hāʻawi iā ʻoe i ka hoʻolālā lapaʻau kūpono loa.
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