Loaʻa i kāu keiki ka Short Bowel Syndrome (SBS)? E kamaʻilio maʻalahi kākou e pili ana i kēia!

Loaʻa pinepine anei i kāu keiki nā pilikia ʻōpū e like me ka maʻi diarrhea? ʻAʻohe mea nui ka nui o ka meaʻai āu e hāʻawi ai iā lākou, ʻaʻole lākou e ʻai lawa, a ʻaʻole lākou e piʻi i ke kaumaha? A i ʻole ua ʻike ʻia kēia mau hōʻailona ma hope o kekahi ʻoki ʻōpū? Ma ke ʻano he makuahine a makua kāne paha, he mea maʻamau iā ʻoe ke makaʻu nui a hopohopo ke ʻike ʻoe i nā mea e like me kēia. I kēia lā e kamaʻilio mākou e pili ana i ka Short Bowel Syndrome (SBS), kahi maʻi e hiki ai ke hoʻoulu i kēia mau hōʻailona, ​​​​akā ʻaʻole i kamaʻilio nui ʻia.

I ka ʻōlelo maʻalahi, he aha ka Short Bowel Syndrome (SBS)?

ʻO ka Short Bowel Syndrome (SBS) kahi kūlana i hiki ʻole ai i ke kino o kāu keiki ke omo i nā meaʻai a me nā wai kūpono. ʻO kēia no ka mea ua nalowale kekahi hapa o ka ʻōpū liʻiliʻi o ke keiki a ʻaʻole paha e hana pono.

Hiki ke loaʻa kēia ʻano mai ka wā hānau mai. Eia kekahi, i kekahi manawa hiki ke loaʻa ka SBS ma hope o ka wehe ʻia ʻana o kahi ʻāpana nui o ka ʻōpū liʻiliʻi ma muli o kekahi ʻano maʻi ʻē aʻe. Ua kapa ʻia kēia ʻo "Short gut syndrome".

No laila, he aha ke kuleana o kēia ʻōpū liʻiliʻi?

I mea e hoʻomaopopo maikaʻi ai i kēia, e aʻo mua kākou e pili ana i ka ʻōpū liʻiliʻi, ke koa o kā kākou ʻōnaehana hoʻoheheʻe. E noʻonoʻo i ka ʻōpū liʻiliʻi e like me ke kāʻei lawe lōʻihi ma kahi hale hana. ʻO ka meaʻai a kākou e ʻai ai e lilo i wai i loko o ka ʻōpū a laila hele ma kēia kāʻei. Ma ke ala, ʻo nā paia o ka ʻōpū, e hana ana e like me nā limahana hale hana, e hoʻokaʻawale i nā mea maikaʻi a pau i loko o kēlā meaʻai - ʻo ia hoʻi, nā meaʻai koʻikoʻi e like me nā protein, nā carbohydrates, nā momona, nā wikamina, ka hao, ka calcium, a me nā wai - a hoʻohui iā lākou i ke koko. ʻO ke koena, ʻaʻole pono i ke kino, hele i ka ʻōpū nui a hoʻokuʻu ʻia ma ke ʻano he feces.

ʻEkolu mau ʻāpana nui o ka ʻōpū liʻiliʻi:

• Duodenum: ʻO kēia ka ʻāpana pōkole loa ma hope o ka ʻōpū.
• ʻO Jejunum: ʻO kēia ka ʻāpana waena.
• ʻIleum: ʻO kēia ka ʻāpana lōʻihi loa. Hoʻopau ia ma ka ʻōpū nui.

Pehea ka hopena o SBS i ka ʻōpū liʻiliʻi?

E noʻonoʻo, he aha ka mea e hana ʻia inā e wehe mākou i kahi ʻāpana nui mai ke kāʻei conveyor ma kēlā hale hana a mākou i ʻōlelo ai? E holo wikiwiki loa nā waiwai (ʻo ia hoʻi ka meaʻai) mai loko mai o ke kāʻei conveyor. ʻAʻole lawa ka manawa o nā limahana (nā paia o nā ʻōpū) e hoʻokaʻawale i nā mea maikaʻi (meaʻai) mai nā waiwai. Hana like ka mea ma SBS.

ʻO ka maʻamau, hānau ʻia kahi pēpē me kahi ʻōpū lōʻihi iki ma mua o ka maʻamau. Ua like ia me kahi ʻāpana keu. ʻOiai inā e wehe ʻia kahi ʻāpana liʻiliʻi o ka duodenum a me ka jejunum i ka wā o ke ʻoki ʻana, hiki i ka ileum ke lawe i ka hana o nā ʻāpana ʻelua a kaulike i ka omo ʻana o nā meaola.

Inā waiho ʻole ʻia kēia maʻi i ka mālama ʻole ʻia, hiki i ke keiki ke loaʻa i nā maʻi koʻikoʻi e like me ka ʻai ʻole a hiki ke hoʻoweliweli i ke ola.

Pehea ʻoe e ʻike ai inā loaʻa i kahi keiki ʻo SBS? He aha nā hōʻailona?

Inā kānalua ʻoe ua loaʻa i kāu keiki kēia maʻi, e makaʻala i kēia mau hōʻailona. Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona ma ka lālani, e ʻike koke i ke kauka.

No ke aha i loaʻa ai kēia maʻi i nā keiki?

E like me ka inoa e hōʻike nei, ʻo ke kumu nui o kēia, ʻo ia ka pale ʻana o ka ʻōpū. ʻElua mau ʻano nui o nā kumu e kōkua ai i ia mea:

1. Nā pilikia hānau ʻia: Hānau ʻia kekahi mau keiki me kekahi mau ʻano ʻē o ka ʻōpū.

• Ka emi ʻana o ka lōʻihi o ka ʻōpū mai ka hānau ʻana.
• ʻO ka hānau ʻia ʻana me ka ʻole o kahi ʻāpana o ka ʻōpū.
• ʻO ka atresia ʻōpū ka huaʻōlelo lapaʻau no ka hiki ʻole o ka ʻōpū ke ulu piha i loko o ka ʻōpū.

2. Ma ke ʻano he hopena ʻaoʻao o ke ʻoki kino: Pono kekahi mau maʻi koʻikoʻi e wehe ʻia kahi ʻāpana o ka ʻōpū liʻiliʻi o ke keiki i ke ʻoki kino. Hiki nō hoʻi ke hana ʻia ʻo SBS.

He aha nā kūlana e pono ai ke wehe ʻoki ʻana i kahi ʻāpana o ka ʻōpū?

• ʻO ka necrotizing enterocolitis: Hana ʻia kēia ke emi ke kahe o ke koko i nā paia o ka ʻōpū, e make ai nā ʻāpana o ka ʻōpū. He mea maʻamau kēia ʻano i nā pēpē hānau mua ʻole.
• Gastroschisis: ʻO kēia ka wā e puka mai ai nā ʻōpū ma waho o ke kino i ka wā e ulu ana ke pēpē i loko o ka ʻōpū.
• Volvulus: He wili ʻana o ka ʻōpū. Hiki i kēia ke ʻoki i ke kahe koko a hōʻino i kēlā wahi.
• ʻO ka maʻi o Crohn: He maʻi mumū mau loa o ka ʻōnaehana hoʻoheheʻe.
• Intussusception: Hoʻopaʻa ʻia kekahi ʻāpana o ka ʻōpū i loko o kekahi ʻāpana ʻē aʻe.

He aha nā pilikia e hiki ke loaʻa mai ka SBS?

Inā ʻaʻole mālama pono ʻia ʻo SBS, hiki i ke keiki ke loaʻa i nā pilikia like ʻole, a hiki i kekahi o ia mau mea ke koʻikoʻi loa.

• Maloʻo wai: Paʻa mau ka wai i loko o ke kino no ka mea ʻaʻole hiki i ke kino ke omo i ka nui o ka wai e pono ai.
• ʻAʻole pono ka meaʻai: Ka pohō kaumaha a me ka hiki ʻole ke piʻi i ke kaumaha ma muli o ka omo maikaʻi ʻole ʻana o nā meaola.
• Ka nele o nā wikamina a me nā minelala: Ka nele o nā wikamina koʻikoʻi (A, D, E, K, B12) a me nā minelala (calcium, magnesium, zinc) no ke kino.
• ʻŌhūhū diaper nui: ʻO ka huhū nui o ka ʻili i hoʻokumu ʻia e ka neʻe pinepine ʻana o ka ʻōpū a me ke kiʻekiʻe o ka waikawa o nā ʻōpala.
• Maʻi akepaʻa: Ka hōʻino ʻia o ke akepaʻa ma muli o ka hānai IV lōʻihi a me nā kumu ʻē aʻe.
• Nā pōhaku puʻupaʻa: Ma muli o ke kaulike ʻole o ka omo ʻana o ka calcium a me ka oxalate.
• Ka ulu nui ʻana o ka bacteria: ʻO ka ulu nui ʻana o nā bacteria ʻino i loko o ka ʻōpū liʻiliʻi.
• Nā maʻi ʻaʻai ʻole: No ka laʻana, ka hiki ʻole ke hoʻoheheʻe i nā huahana waiū i loaʻa ka lactose.

Pehea e ʻike ai nā kauka i kēia maʻi?

Ke lawe ʻoe i kāu keiki i ke kauka, e nīnau mua ʻo ia e pili ana i nā hōʻailona o ke keiki a me ka mōʻaukala olakino ʻohana. A laila, e nānā ʻia ke keiki. Hiki ke hana ʻia kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona a loaʻa ke kumu pololei:

• Nā hoʻāʻo koko: E nānā i ke koko o ke keiki no nā mea e like me nā pae wikamina a me nā minelala, a me ka anemia.
• Hoʻāʻo momona fecal: Nānā i ka nui o ka momona i ʻeli ʻole ʻia i loko o ka ʻōpala.
• Nā kukuna X-ray: No ka nānā ʻana i ke kūlana o nā ʻōpū. Hiki ke hāʻawi ʻia iā ʻoe kahi wai kūikawā, e like me ka barium, a hiki ke lawe ʻia kahi kukuna X-ray.
• CT scan: E kiʻi i kahi kiʻi maopopo o nā ʻōpū a me nā ʻōpū ʻē aʻe.

He aha nā lāʻau lapaʻau no SBS?

ʻElua mau pahuhopu nui i ka mālama ʻana i kahi keiki me SBS. ʻO kekahi, ʻo ia ke hāʻawi ʻana i ke keiki i ka meaʻai e pono ai lākou e ulu. ʻO kekahi, ʻo ia ke kāohi i nā hōʻailona e like me ka maʻi diarrhea. Hoʻohana pū ʻia kekahi mau ʻano lapaʻau e hoʻokō ai i kēia.

1. Nā loli meaʻai

ʻO kēia ka ʻāpana koʻikoʻi loa. Ma muli o ke kūlana o ke keiki, hana pū nā kauka a me nā mea lapaʻau meaʻai e hana i ka hoʻolālā meaʻai kūpono loa no ke keiki.

• Nā hoʻololi ʻana i ka ʻai: Inā hiki i kāu keiki ke ʻai ma ka waha, hiki i kāu kauka ke ʻōlelo aku e hānai iā lākou i kahi meaʻai liʻiliʻi i nā manawa he nui i ka lā . Hiki iā lākou ke ʻōlelo aku e hōʻemi i nā meaʻai kiʻekiʻe i ka momona, nā kō maʻalahi, a me ka fiber a ma kahi o ka hāʻawi ʻana i kahi meaʻai calorie kiʻekiʻe i waiwai i nā kalapona a me ka protein.
• ʻO ka ʻAi Parenteral Holoʻokoʻa (TPN): ʻO kēia ka hāʻawi ʻana i nā meaolaola āpau (wai, kō, protein, momona, wikamina) pololei i loko o kahi aa koko ma ke ʻano he wai, e kāpae ana i ka ʻōnaehana hoʻoheheʻe o ke keiki. Hoʻohana pinepine ʻia kēia ʻano hana ma hope o ke ʻoki ʻana i ka ʻōpū a i ʻole ke hiki ʻole i ke keiki ke lawe i ka meaʻai ma ka waha.
• ʻAi ʻai ʻōpū: Ma kēia, hoʻokomo ʻia kahi ʻōmole palupalu ma o ka ihu a i ʻole pololei i loko o ka ʻōpū a i ʻole ka ʻōpū liʻiliʻi, a hāʻawi ʻia ka meaʻai wai ma o ia mea. Kōkua kēia ʻano hana i ka hāʻawi ʻana i nā meaʻai hou aʻe ma waho aʻe o ka nui o ka meaʻai i ʻai ʻia e ka waha.

2. Nā lāʻau lapaʻau

Hoʻohana ʻia nā lāʻau lapaʻau like ʻole e kāohi i nā hōʻailona a hoʻomaikaʻi i ka hoʻopili ʻana i ka meaʻai.

• Nā lāʻau lapaʻau antibiotic: Kāohi i ka ulu nui ʻana o ka bacteria i loko o ka ʻōpū.
• Nā lāʻau hoʻemi waikawa o ka ʻōpū (nā mea hoʻopaʻa proton pump, nā mea pale H2): E hōʻemi i nā pilikia i hoʻokumu ʻia e ka waikawa o ka ʻōpū.
• Nā lāʻau lapaʻau antidiarrheal: E hoʻolohi i ka wikiwiki o ka neʻe ʻana o ka meaʻai ma o nā ʻōpū, e ʻae ana i ka manawa hou aʻe no ka omo ʻana o nā meaola.
• Nā hormones ulu: Hoʻomaikaʻi i ka omo ʻana o nā meaola e ka ʻōpū.

3. ʻoki kino

Pono paha kekahi mau keiki i ke ʻoki kino hou e hoʻomaikaʻi i ka hana ʻōpū. ʻO kēia mau mea:

• Ka hoʻonui ʻana i ka lōʻihi o ka ʻōpū (ma o nā ʻano hana ʻoki kūikawā).
• Ke hoʻolohi nei i ka wikiwiki o ka neʻe ʻana o ka meaʻai.
• Ke wehe ʻana i nā mea pale ʻōpū.

I nā hihia koʻikoʻi loa, pono paha i ke keiki ke hana i kahi hoʻoili ʻōpū/akepaʻa.

ʻO ka manaʻolana maikaʻi o ka hoʻololi ʻana o ka ʻōpū

ʻO kēia ka manaʻolana nui loa no nā mākua o nā keiki me SBS. ʻO ka hoʻololi ʻana o ka ʻōpū ke kaʻina hana e hoʻomaikaʻi ai ke koena o ka ʻōpū i kāna hana i ka hala ʻana o ka manawa ma hope o ka wehe ʻia ʻana o kahi ʻāpana o ka ʻōpū.

Ma kēia, mānoanoa ka paia o loko o ka ʻōpū i koe, a ʻoi aku ka lōʻihi a me ka mānoanoa o nā ʻano hana e like me ka manamana lima i kapa ʻia ʻo villi e omo ana i nā meaʻai. ʻAe kēia i ka ʻōpū liʻiliʻi i koe e omo i nā meaʻai me ka ʻoi aku ka maikaʻi ma mua o ka wā ma mua. Hiki i kēia kaʻina hana hoʻololi ke holomua loa, ʻoiai e hoʻomau ka ulu ʻana o nā ʻōpū o nā keiki liʻiliʻi a hiki i ko lākou wā ʻōpiopio.

ʻO nā lāʻau pale i hoʻolauna ʻia nei e like me teduglutide ke hoʻolalelale nei i kēia kaʻina hana hoʻololi a ke kōkua nei i ka hoʻokaʻawale ʻana i nā keiki mai ka meaʻai intravenous e like me TPN.

He aha kāu e hiki ai ke hana ma ke ʻano he makua?

ʻOiai he mea paʻakikī kēia huakaʻi, ʻaʻole ʻoe hoʻokahi. Aia kahi hui maikaʻi e kōkua iā ʻoe e mālama i ke kūlana olakino o kāu keiki.

• Kauka keiki
• Kauka lapaʻau gastroenterologist keiki
• Meaʻai meaʻai keiki
• Kauka lapaʻau keiki

ʻO kāu hana nui, ʻo ia ke hahai pono i nā kuhikuhi i hāʻawi ʻia e kēia hui lapaʻau. He mea nui e mālama pono i ka hānai ʻana i ke keiki, e hāʻawi i nā lāʻau lapaʻau i ka manawa kūpono, a inā ʻoe e hoʻohana ana i nā lāʻau lapaʻau e like me TPN, he mea nui e mālama pono i ka mālama ʻana iā lākou i ka maʻemaʻe.

Hiki i ka SBS ke lilo i maʻi no ke ola holoʻokoʻa no kekahi mau keiki. Eia nō naʻe, no kekahi mau keiki, hoʻomaikaʻi nui ke ʻano i ka hala ʻana o ka manawa. Me ka mālama lapaʻau kūpono, ka meaʻai maikaʻi, a me ka mālama aloha, hiki i ka nui o kēia mau keiki ke ola maʻamau a hauʻoli.