E aʻo kākou e pili ana i ke Kanesa ʻŌpū ma nā ʻōlelo maʻalahi!

I kēia lā, e kamaʻilio mākou e pili ana i kahi kumuhana koʻikoʻi iki, akā he mea nui i nā poʻe he nui. ʻO ia ka maʻi ʻōpū, kapa ʻia kekahi he '(Gastric Cancer)' . E noʻonoʻo, he aha ka mea e hana ʻia inā hoʻomaka koke nā ʻāpana i loko o ko kākou ʻōpū, ʻo ia hoʻi ka ʻōpū, e māhelehele me ka ʻole o ke kāohi ʻia, e like me ka pupule? ʻO ia ka mea e hana ʻia me ka maʻi ʻōpū. Hiki i kēia mau ʻāpana kanesa ke hana ʻia ma nā wahi āpau o ka ʻōpū. ʻO ka hapa nui o ka manawa, ʻoi aku hoʻi ma nā ʻāina e like me ʻAmelika, hana ʻia kēia kanesa ma kahi e hui ai ka ʻōpū a me ko kākou esophagus (ʻo ia hoʻi, ka paipu e iho ana mai ka ʻāʻī), a mākou e kapa nei he '(gastroesophageal junction)' . Akā ma kekahi mau ʻāina e like me Sri Lanka, kahi i maʻamau ai ka maʻi ʻōpū, hana pinepine ʻia ia ma ka ʻāpana nui o ka ʻōpū.

ʻO ka mea nui, ma kahi o 95% o nā maʻi ʻaʻai ʻōpū e hoʻomaka ana ma ka uhi o ka ʻōpū, ka papa luna o ka paia. Akā ulu koke lākou. Inā ʻaʻole mālama pono ʻia, hiki i kēia mau cell ke ulu pū e hana i kahi puʻupuʻu a ulu i loko o ka paia o ka ʻōpū. I kekahi manawa, hiki i kēia puʻupuʻu ke laha (metastasize) i nā ʻōpū kokoke ʻē aʻe, e like me ke akepaʻa a me ka pancreas.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o ka maʻi ʻōpū?

ʻO ka ʻoiaʻiʻo, hiki i kekahi ke loaʻa i ka maʻi ʻōpū. Eia nō naʻe, aia kekahi mau mea e hoʻonui ai i ka pilikia. Eia kekahi laʻana:

• Inā he 65 ou mau makahiki a ʻoi paha .
• Inā he kāne ʻoe (ʻoi aku ka nui o ka pilikia o nā kāne ma mua o nā wahine).
• He mea maʻamau kēia i waena o kekahi mau hui lāhui ma ka honua (no ka laʻana, ʻAmelika Hema a Waena paha, ʻEulopa Hikina, a pēlā aku).

Pehea ka maʻamau o ka maʻi ʻaʻai ʻōpū?

ʻO ke kanesa ʻōpū kekahi o nā ʻano kanesa maʻamau ma ka honua holoʻokoʻa. Eia nō naʻe, ʻaʻole ia he mea maʻamau ma kekahi mau ʻāina Komohana, e like me ʻAmelika Hui Pū ʻIa. ʻO ka ʻoiaʻiʻo, ʻo ke kanesa ʻōpū he 1.5% wale nō o nā kanesa i ʻike hou ʻia ma ʻAmelika Hui Pū ʻIa. A ua emi mau ka nui o nā hihia ma laila i nā makahiki he 10 i hala.

He aha nā hōʻailona o ka maʻi ʻaʻai ʻōpū?

ʻO kēia ka pilikia i loaʻa i nā kānaka he nui. I nā pae mua o ka maʻi ʻaʻai ʻōpū , ʻaʻohe mau hōʻailona . ʻO ia ka ʻāpana weliweli loa o ia mea. ʻOiai nā hōʻailona mua maʻamau, e like me ka ʻeha ʻōpū a me ka pohō kaumaha i wehewehe ʻole ʻia, ʻike ʻia ma hope o ka holomua iki ʻana o ke kanesa.

Eia kekahi o nā hōʻailona e hiki ke loaʻa i ka maʻi ʻaʻai ʻōpū:

• ʻAnorexia , ka manaʻo o ka pōloli ʻole.
• Paʻakikī ke ale ʻana (me he mea lā ua paʻa kekahi mea i loko o ka puʻu).
• Ka luhi a nāwaliwali mau.
• Ka luaʻi a me ka luaʻi .
• Ka pohō kaumaha me ke kumu ʻole.
• ʻEha ka ʻōpū a me ka indigestion (e like me ke kinoea).
• Nā ʻōpala ʻeleʻele a i ʻole ka luaʻi ʻana i ke koko .
• Manaʻo o ka piha ʻana o ka ʻōpū, me he mea lā ua piha ka ʻōpū i ka ea ma hope o ka ʻai ʻana.
• ʻEha ʻōpū , ʻoi aku hoʻi ma luna o ka pihi ʻōpū.
• Manaʻo piha ʻoiai ma hope o ka ʻai ʻana i kahi meaʻai liʻiliʻi.

Mea nui: Hiki ke ʻike pinepine ʻia kēia mau hōʻailona i nā kūlana olakino ʻē aʻe, no laila inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​he mea nui e ʻike i ke kauka e hoʻoholo ai inā he maʻi ʻōpū a i ʻole kekahi mea ʻē aʻe.

Hiki iā ʻoe ke loaʻa i kahi maʻi ʻaʻai ʻōpū?

Ma muli o ka mamao o ka laha ʻana o ke kanesa, hiki paha i ke kauka ke ʻike i kahi puʻupuʻu i loko o kou ʻōpū ke nānā ʻia ʻoe. Akā ʻo ka hapa nui, ʻo nā hōʻailona he mau manaʻo i loko o kou ʻōpū. Hiki i kou ʻōpū ke pehu, piha, a ʻeha paha. Hiki i kēia ʻeha ke hoʻomaka mālie i ka wā mua a lilo i mea ʻoi aku ka koʻikoʻi i ka holomua ʻana o ka maʻi.

He aha ke kumu o ka maʻi ʻaʻai ʻōpū?

I ka ʻōlelo maʻalahi, ua hoʻokumu ʻia ka maʻi ʻōpū e kahi hoʻololi genetic i loko o ka DNA o ko kākou mau cell ʻōpū. Ua ʻike ʻoe, ua like kēia DNA me kahi code e haʻi ana i kā kākou mau cell i ka wā e ulu ai a me ka wā e make ai. Ma muli o kēlā hoʻololi genetic, ma kahi o ka make ʻana, ulu koke nā cell a hana i kahi puʻupuʻu . Hiki i kēia mau cell cancer ke lanakila ma luna o nā cell olakino a laha i nā ʻāpana ʻē aʻe o ke kino.

ʻAʻole maopopo i nā kānaka noiʻi ke kumu o kēia loli hoʻoilina. Eia nō naʻe, ua ʻike lākou i kekahi mau mea e hoʻonui ai i ka pilikia o ka loaʻa ʻana o ka maʻi ʻōpū. ʻO lākou kekahi:

• Inā ua loaʻa i kekahi o ka ʻohana ka maʻi ʻōpū (ka loulou hoʻoilina).
• ʻO ka maʻi bacteria (Helicobacter pylori - H. pylori) . He mea nui loa kēia.
• ʻO ka maʻi reflux Gastroesophageal (GERD) (piʻi ka waikawa o ka ʻōpū i loko o ka puʻu).
• ʻO Gastritis (ka mumū o ka ʻōpū).
• ʻO ka maʻi Epstein-Barr .
• Inā ua loaʻa iā ʻoe nā ʻōpū ʻōpū a i ʻole polyps ma mua.
• Ka ʻai nui ʻana i nā meaʻai ʻaila, paʻakai, uahi ʻia a i ʻōhinu ʻia paha .
• ʻAi ʻana i kahi papaʻai haʻahaʻa i nā huaʻai a me nā mea kanu .
• Hoʻopili pinepine ʻia i nā mea e like me ke kalapona, ka metala, a me ka laholio.
• Ka puhi paka, ka vaping, a i ʻole ka nau ʻana i ka paka .
• Ka inu nui ʻana i ka waiʻona .
• Ka momona nui .
• `(Autoimmune atrophic gastritis)` (kahi kūlana e hoʻouka ai ka ʻōnaehana pale i nā hunaola ʻōpū).

Eia kekahi, aia kekahi mau kūlana genetic e hoʻonui ai i ka pilikia o ka maʻi ʻōpū:

• `(Lynch syndrome)`
• ʻO ka maʻi Peutz-Jeghers
• ʻO ka maʻi Li-Fraumeni
• `(ʻO ka polyposis adenomatous ʻohana)`
• ``(Ka maʻi ʻōpū hoʻolaha hoʻoilina)``
• `(Ka hemahema pale ʻōnaehana maʻamau - CVID)`

ʻOiai ʻaʻole hiki i nā kānaka noiʻi ke kuhikuhi pono i ke kumu, ua ʻike ʻia he ʻano koʻikoʻi ko ka poʻe me ke ʻano koko 'A' e loaʻa i ka maʻi ʻōpū.

Pehea e ʻike ʻia ai ka maʻi ʻaʻai ʻōpū?

Ke ʻike ʻoe i ke kauka, e nīnau lākou e pili ana i kou mōʻaukala olakino, e nīnau e pili ana i kāu mau hōʻailona, ​​a e hana i kahi hoʻokolokolo kino e nānā i nā puʻupuʻu i loko o kou ʻōpū. A laila e hana paha lākou i kekahi mau hoʻokolohua e ʻike ai i ka maʻi ʻaʻai ʻōpū a hoʻoholo i ka mamao o kona laha ʻana (ke kahua).

He mea nui loa ka ʻike ʻana i ke kahua o ke kanesa . ʻO kēia ka mea e kōkua ai i ke kauka e hoʻomaopopo i ka mamao o ka laha ʻana o ke kanesa. I ke kanesa ʻōpū, aia kēia mau pae mai 0 (ʻole) a i IV (ʻehā). ʻO ke kahua 0 ke ʻano ʻaʻole i laha ke kanesa ma waho o ka uhi o ka ʻōpū. ʻO ke kahua IV ke ʻano ua laha i nā ʻōpū ʻē aʻe.

Eia nā hoʻokolohua i hana pinepine ʻia:

• ʻO ka endoscopy luna: ʻO kēia ke ala maʻamau e ʻike ai i ka maʻi ʻaʻai ʻōpū. Ma kēia kaʻina hana, hoʻokomo ke kauka i kahi ʻōmole lahilahi (i kapa ʻia he endoscope) me kahi kāmela liʻiliʻi ma ka hopena ma kou waha a i lalo i loko o kou ʻōpū. Hoʻokomo ʻia nā mea hana ʻoki liʻiliʻi ma o ka endoscope e lawe i kahi ʻāpana liʻiliʻi o ka ʻiʻo (he biopsy) mai ka paia o ka ʻōpū. A laila hoʻouna ʻia ka ʻiʻo i kahi lab e hoʻāʻo ʻia no nā cell kanesa.
• ʻO ka ultrasound Endoscopic: He ʻano kūikawā kēia o ka endoscopy. Kōkua ia i ka hoʻoholo ʻana i ke kahua o ke kanesa. Ua lako ka endoscope i hoʻohana ʻia i loko o kēia me kahi probe ultrasound, hiki ke kiʻi i nā kiʻi o ka ʻōpū. Hiki ke hoʻohana ʻia kēia e ʻike inā ua pālahalaha ke kanesa mai ka uhi o ka ʻōpū a i ka paia o ka ʻōpū.
• Nā hoʻāʻo Radiological: ʻO kēia mau mea nā scan CT , nā ale barium ( kahi āu e inu ai i kahi wai kūikawā e ʻike ʻia ai ka uhi o kou ʻōpū ma kahi X-ray), a me nā MRI . Hiki i kēia mau mea ke kōkua i ka ʻike ʻana i nā puʻupuʻu kanesa a me nā mea ʻē aʻe e pili ana i ka maʻi kanesa. Hiki ke hoʻohana ʻia kahi scan PET e ʻike inā ua laha ka maʻi kanesa ma kou kino.
• Nā hoʻāʻo koko: Hiki i kēia ke hāʻawi i ka ʻike e pili ana i ke ʻano o ka hana ʻana o kāu mau kino. Inā ʻaʻole hana pono kahi kino, hiki iā ia ke hōʻike ua laha paha ke kanesa i kēlā kino.
• Laparoscopy: He ʻano hana ʻoki kino kēia. Hana ʻia ia ke hāʻawi ʻole nā ​​ʻano hana ʻoi aku ka liʻiliʻi o ka invasive e like me ke kiʻi ʻana i ka ʻike lawa e pili ana i ka nui o ke kanesa. Ma kēia, hana ke kauka i kekahi mau ʻoki liʻiliʻi i loko o kou ʻōpū a hoʻokomo i kahi kāmela liʻiliʻi ma o lākou e nānā pololei i nā ʻōpū.

No ka mea, he mea kakaikahi ka maʻi ʻaʻai ʻōpū ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa, ʻaʻole ia he hoʻāʻo nānā maʻamau no nā mea āpau. Eia nō naʻe, inā he maʻi kou e hoʻonui ai i kou pilikia o ka loaʻa ʻana o ka maʻi ʻaʻai ʻōpū, hiki i kāu kauka ke ʻōlelo aku e loaʻa iā ʻoe nā hoʻokolohua maʻamau, e like me ka endoscopy luna, e nānā i nā loli kanesa. E nīnau i kāu kauka i kāu mea e hana ai ma muli o kou pilikia.

Pehea e mālama ʻia ai ka maʻi ʻaʻai ʻōpū?

Aia nā koho lapaʻau i ka mamao o ka laha ʻana o kou maʻi ʻaʻai, kou olakino holoʻokoʻa, a me kāu mau makemake lapaʻau. ʻO ka maʻamau, pili kēia i kahi hui o nā kauka, me kāu kauka ʻohana, kahi oncologist, a me kahi gastroenterologist . E aʻo lākou iā ʻoe i nā koho lapaʻau maikaʻi loa nāu.

ʻoki kino

Ma muli o ka nui o ke kanesa, hiki i kāu kauka ke ʻōlelo i ke ʻoki ʻana e wehe i nā hunaola kanesa, ka puʻupuʻu, a i ʻole kekahi hapa a i ʻole ka ʻōpū holoʻokoʻa.

• Ka wehe ʻana ma o ka endoscopy luna: I nā pae mua, i ka wā e kaupalena ʻia ai ke kanesa i nā papa superficial o ka ʻōpū, hiki ke wehe ʻia ke kanesa ma o ka endoscopy luna. Ua kapa ʻia kēia kaʻina hana ʻo endoscopic submucosal dissection a i ʻole endoscopic mucosal resection . Ma kēia, ʻoki ka gastroenterologist i ka puʻupuʻu kanesa mai ka paia o ka ʻōpū a wehe iā ia ma o kou waha.
• ʻO ke ʻoki ʻana i ka ʻōpū: Ke pālahalaha ka maʻi kanesa ma ʻō aku o nā papa o ka ʻōpū, pono paha ke ʻoki ʻana e wehe i kahi hapa a i ʻole ka ʻōpū holoʻokoʻa. ʻO ke ʻoki ʻana i ka ʻōpū ma lalo o ka ʻōpū e wehe wale i ka ʻāpana o ka ʻōpū i hoʻopilikia ʻia e ka maʻi kanesa. ʻO ke ʻoki ʻana i ka ʻōpū holoʻokoʻa e wehe i ka ʻōpū holoʻokoʻa. Ma hope o ka wehe ʻia ʻana o ka ʻōpū holoʻokoʻa, e hoʻopili ke kauka i kou esophagus a me ka ʻōpū liʻiliʻi i hiki iā ʻoe ke hoʻomau i ka ʻai ʻana.

Nā lāʻau lapaʻau ʻē aʻe

Hoʻouka pololei kēia mau lāʻau i nā hunaola kanesa.

• `(Chemotherapy - chemo)` (lāʻau lapaʻau kemika): Hoʻohana kēia i nā lāʻau lapaʻau e hoʻēmi i nā hunaola kanesa. ʻOi aku ka maʻalahi o ka wehe ʻana iā lākou ma mua o ke ʻoki ʻana. Hoʻohana pū ʻia ka `(Chemotherapy)` e pepehi i nā hunaola kanesa i koe ma hope o ke ʻoki ʻana. Hāʻawi pinepine ʻia me ka lāʻau lapaʻau radiation. Hiki ke hāʻawi pū ʻia ka `(Lapaʻau lāʻau i kuhikuhi ʻia)` me ka `(chemo)`.
• Lapaʻau radiation: Hoʻohana kēia i nā kukuna ikehu i kuhikuhi ʻia, e like me nā kukuna X, e pepehi i nā hunaola kanesa. ʻAʻole maikaʻi loa ka lapaʻau radiation wale nō no ka maʻi kanesa ʻōpū. Eia nō naʻe, hiki ke hāʻawi pū ʻia me ka chemotherapy ma mua a ma hope o ke ʻoki ʻana. Hiki i ka lapaʻau radiation ke kōkua i ka hōʻoluʻolu ʻana i nā hōʻailona.
• Lapaʻau lāʻau i kuhikuhi ʻia:Kuhi kēia i nā nāwaliwali o nā hunaola kanesa a make lākou. Hāʻawi pinepine ʻia me ka chemo no nā kanesa i hoʻi hou mai a holomua paha.
• Immunotherapy: Kōkua kēia i kāu ʻōnaehana pale ponoʻī e ʻike a luku i nā hunaola kanesa paʻakikī ke ʻike. Hoʻohana pinepine ʻia kēia no nā kanesa e hana hou ana a i ʻole nā ​​​​​​maʻi ʻeha.
• Mālama Palliative: Kōkua kēia i ka hoʻomaikaʻi ʻana i kou ʻano ola ma ke ʻano he kanaka e noho nei me ka maʻi kanesa. He lawelawe lapaʻau kūikawā ka mālama palliative. Hiki ke komo pū me nā kauka, nā kahu maʻi, a me nā loea ʻē aʻe e hiki ke kōkua i ka hōʻoluʻolu ʻana i nā hōʻailona. Hiki iā ʻoe ke loaʻa i kēia kākoʻo ma waho aʻe o nā lawelawe āu e loaʻa ai mai kāu mau kauka maʻamau. Hiki iā ʻoe ke loaʻa i kēia mālama palliative me nā lāʻau lapaʻau ʻē aʻe.

Hiki ke pale ʻia ka maʻi ʻaʻai ʻōpū?

ʻOiai ʻaʻole hiki ke pale loa ʻia ka maʻi ʻōpū, hiki iā ʻoe ke hōʻemi i kou pilikia ma ka hana ʻana i kēia mau mea:

• Inā ua hoʻāʻo ʻia ʻoe no ka maʻi H. pylori , e kiʻi i ka lāʻau lapaʻau . ʻO ka maʻi H. pylori kahi kumu nui o ka maʻi ʻōpū.
• E kiʻi koke i ka lāʻau no nā ʻōpū ʻeha, ka gastritis, a me nā maʻi ʻōpū ʻē aʻe. ʻO nā maʻi ʻōpū i mālama ʻole ʻia, ʻoiai nā mea i hoʻokumu ʻia e ka bacteria H. pylori, e hoʻonui i ka pilikia o ka maʻi ʻōpū.
• E ʻai i ka meaʻai olakino. ʻO ka ʻai ʻana i ka meaʻai olakino e kiʻekiʻe ana i nā huaʻai a me nā mea kanu a haʻahaʻa i ka paʻakai a me ka ʻiʻo ʻulaʻula e hiki ke hōʻemi i kou pilikia o ka maʻi ʻōpū. ʻO nā meaʻai waiwai i ka huaora C, beta-carotene, a me nā carotenoids (e.g., nā hua citrus, nā mea kanu ʻōmaʻomaʻo, kāloti) he mau kumu maikaʻi ia o kēia mau meaola koʻikoʻi.
• E pale i ka puhipaka a me ka hoʻohana ʻana i nā huahana paka. Hoʻonui ka hoʻohana ʻana i ka paka i ka pilikia o ka maʻi ʻōpū ʻaʻole wale nō, akā, i nā ʻano maʻi ʻē aʻe he nui.
• E mālama i ke kaumaha olakino. ʻOkoʻa ke ʻano o ke kaumaha olakino mai kēlā kanaka a kēia kanaka. E nīnau i kāu kauka i ke ʻano o ke kaumaha olakino nou.

Hiki ke ho'ōla ʻia ke kanesa ʻōpū?

Hiki ke ho'ōla ʻia ke kanesa ʻōpū inā ʻike mua ʻia. Eia nō naʻe, i ka hapa nui o ka manawa, ʻike ʻia nā hōʻailona i ka wā lohi i ka wā e ʻike ʻia ai ka maʻi, ʻo ia hoʻi, aia paha ke kanesa i kahi pae holomua. E kamaʻilio me kāu kauka e pili ana i nā mea e hiki ke hoʻopilikia i ka hopena o kāu lāʻau.

He aha ka wānana no ka poʻe me ka maʻi ʻōpū?

ʻO ka wānana no ka maʻi ʻaʻai ʻōpū e pili ana i ke kahua o ke kanesa. ʻOi aku ka maikaʻi o ka wānana o ka poʻe i ʻike ʻia i nā pae mua ma mua o ka poʻe i ʻike ʻia i nā pae holomua. Hiki i ka helu ola 5 makahiki no ka maʻi ʻaʻai ʻōpū ke piʻi aʻe mai ka 70% (inā ua laha maikaʻi ʻole ke kanesa) a hiki i ka 6% (inā ua laha holomua), ma muli o ka mamao o ka laha ʻana o ke kanesa.

E kamaʻilio me kāu kauka no ka loiloi pololei o kou kūlana. ʻO ke ʻano o ka maʻi kanesa āu, pehea ka mamao o kona laha ʻana, kou olakino holoʻokoʻa, a pehea ka pane ʻana o kāu maʻi kanesa i ka lāʻau lapaʻau e pili ana i kāu prognosis.

Āhea wau e ʻike ai i ke kauka?

Inā he kiʻekiʻe kou pilikia no ka maʻi ʻōpū, e kamaʻilio me kāu kauka e pili ana i nā pono a me nā pōʻino o ka loaʻa ʻana o nā hoʻokolohua maʻamau. A i ʻole, e makaʻala i kāu mau hōʻailona. Hiki i nā hōʻailona he nui e pili ana i ka maʻi ʻōpū ke lilo i mau hōʻailona o nā kūlana ʻē aʻe. ʻO ke kauka wale nō ke hana i kahi hōʻoia paʻa.

E ʻike i ke kauka inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha o ka ʻōpū a me ka pohō kaumaha i wehewehe ʻole ʻia, me a i ʻole me ka ʻole o kēia mau hōʻailona:

• Paʻakikī i ka ʻai ʻana.
• Ka maʻi pākī.
• Ka luaʻi.
• Nā ʻōpala koko a ʻeleʻele paha.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Hiki iā ʻoe ke nīnau i nā nīnau e like me kēia:

• Aia i hea ke kanesa?
• He aha ke kahua o ka maʻi kanesa i loaʻa iaʻu?
• Pehea ka hopena o kēia i kaʻu wānana?
• He aha nā lāʻau lapaʻau e hiki iaʻu ke loaʻa?
• He aha nā pono o kēia lāʻau lapaʻau? He aha nā pilikia e hiki mai ana?
• Aia kekahi mau koho lapaʻau ʻē aʻe?
• Pehea e pili ai kaʻu ʻike a me ka mālama ʻana i ka maʻi kanesa i koʻu ola o kēlā me kēia lā?
• Pono anei au e kiʻi i kahi manaʻo ʻelua?

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

ʻAʻole paha hiki ke pale ʻia ka maʻi ʻōpū i nā manawa a pau. Akā inā ʻike mua ʻia, ʻoi aku ka nui o ka mālama ʻia a me ka hoʻōla ʻia. Ma muli o kāu hōʻailona maʻi ʻaʻai, hiki i kāu kauka ke ʻōlelo aku i ke ʻoki kino e wehe i nā hunaola maʻi ʻaʻai a i ʻole nā ​​puʻupuʻu. A i ʻole e ʻōlelo aku paha lākou i ka hui pū ʻana o nā lāʻau lapaʻau e hiki ai ke pepehi a hoʻēmi paha i nā hunaola maʻi ʻaʻai.

ʻO ka mea nui loa, e hilinaʻi kou manaʻo i kekahi mau mea hiki iā ʻoe ke kūkākūkā me kāu kauka. Mai kānalua e nīnau e pili ana i nā koho lapaʻau, ko lākou mau pono, a me nā pilikia. E ʻimi i ke alakaʻi mai kāu mau kauka e pili ana i ke ʻano o ka hopena o kāu hōʻailona maʻi kanesa iā ʻoe. ʻO kou kuleana ia e lohe ʻia a hoʻomaopopo ʻia me ka makaʻu ʻole a kānalua ʻole. E noho olakino!

ʻO ke kanesa ʻōpū, ke kanesa ʻōpū, nā hōʻailona kanesa, ke kanesa ʻōpū, H. pylori, endoscopy, mālama ʻana i ke kanesa, pilikia kanesa