Ua ʻeha a ʻeha paha kou ʻōpū no nā lā? Ua haʻi aku paha kāu kauka iā ʻoe he maʻi ʻōpū mumū (IBD) kou e like me ka maʻi Crohn. Ke loaʻa iā ʻoe kēia maʻi no ka manawa lōʻihi, hoʻomaka mālie kekahi mau wahi i loko o kou ʻōpū e haiki. Ua like ia me kahi paipu wai e paʻa ana i waenakonu. No laila, kapa mākou i kēia ʻoki kūikawā e hoʻonui i kēia mau wahi haiki ʻo 'Strictureplasty'. I kēia lā, e kamaʻilio mākou e pili ana i nā mea āpau ma nā ʻōlelo maʻalahi.
He aha maoli ka Strictureplasty?
I ka ʻōlelo maʻalahi, he hana ʻoki kino ka strictureplasty e hoʻonui ai i kahi ʻāpana i haiki a paʻa paha i loko o kou ʻōpū (i kapa ʻia he stricture). Hoʻokumu pinepine ʻia kēia e ka mumū mau, i hoʻokumu ʻia e nā maʻi ʻōpū mumū (IBD) e like me ka maʻi Crohn a me Ulcerative Colitis. Hoʻoulu kēia mumū i ka ʻeha o nā paia ʻōpū, kahi e hoʻomānoanoa a hoʻohāiki ai.
ʻO kēia ʻano strictures e loaʻa pinepine ʻia ma:
- ʻO ka ʻāpana haʻahaʻa o ka ʻōpū liʻiliʻi (ileum)
- E pili ana i ka valve e hoʻopili ai i ka ʻōpū liʻiliʻi a me ka ʻōpū nui (ka `ileocecal valve`).
Eia nō naʻe, hiki ke loaʻa kēia ʻano ma ka kolona, ka rectum, a me ka anus. ʻO ka pahuhopu nui o kēia ʻoki kino, ʻo ia ka hoʻonui ʻana i ka ʻāpana i haiki ʻia o ka ʻōpū a hoʻihoʻi i ka neʻe ʻana o ka meaʻai maʻamau, me ka ʻole o ka wehe ʻana i kekahi ʻāpana o ka ʻōpū.
No ke aha ʻoe e pono ai i kēia ʻoki kino?
Ke hāiki kahi ʻāpana o kou ʻōpū e like me kēia, ʻaʻole hiki i ka meaʻai ke neʻe pono i lalo. Hiki i kēia ke hana i kekahi mau hōʻailona ʻoluʻolu ʻole a ʻeha hoʻi.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| ʻEha nui o ka ʻōpū a me ka ʻōʻō ʻana | Hiki mai kēia ʻeha ma muli o ka ʻūmiʻi ʻana o nā ʻōpū i ko lākou hoʻāʻo ʻana e hoʻolei i ka meaʻai ma o ka mea i ālai ʻia. |
| ʻŌpū pehu a me ka flatulence | Pehu ka ʻōpū no ka mea ʻaʻole hiki i ka meaʻai a me ka ea ke iho pono i lalo a paʻa i kahi hoʻokahi. |
| Ka luaʻi a me ka luaʻi | Inā koʻikoʻi ka paʻa ʻana, ʻaʻole paha e hiki i ka meaʻai ke iho i lalo a piʻi hou mai i luna. |
| Ka paʻa ʻana o ka ʻōpū | Lilo ka paʻakikī o ka hoʻokahe koko ma muli o ke kaʻina hana hoʻoheheʻe lohi. |
| Ka nalowale o ka makemake a me ka pohō kaumaha | Ma muli o ka ʻeha a me ka ʻoluʻolu ʻole, ua nalowale ka makemake e ʻai, a ʻaʻole hiki i ke kino ke omo pono i nā meaʻai. |
| Luhi a me ka Anemia | I ka manawa pinepine, hoʻokumu ʻia nā ʻeha ma kēia mau wahi i haiki ʻia. Ke kahe mālie nei ke koko o kēia mau ʻeha, e alakaʻi ana i ka anemia i ka hala ʻana o ka manawa. Hoʻopau ʻia kēia kūlana ma hope o ke ʻoki ʻana. |
ʻO ka mea nui loa: Inā hoʻomau kēia ʻūlū ʻana i ka hoʻonui ʻia, hiki ke pani loa ʻia ka ʻōpū (pale ʻōpū). He kūlana weliweli loa kēia a hiki ke hoʻoweliweli i ke ola. No laila, inā loaʻa iā ʻoe nā hōʻailona, he mea nui e ʻike koke i ke kauka.
No wai kēia ʻoki kino kūpono loa a kūpono ʻole hoʻi?
ʻAʻole no nā kānaka āpau ke ʻoki ʻana o ka strictureplasty. Na kāu kauka e hoʻoholo i ka hoʻoholo maikaʻi loa e pili ana i kou kūlana.
| ʻO ka poʻe kūpono no ke ʻoki kino | Nā hihia i ʻōlelo ʻole ʻia ai ke ʻoki kino |
|---|---|
| Inā he nui nā haiki ma nā wahi ma kahi ʻāpana lōʻihi o ka ʻōpū. | Inā he nui nā ʻokiʻoki ma kahi ʻāpana pōkole o ka ʻōpū, e hoʻokokoke pū kekahi. |
| Inā ua hana mua ʻoe i kahi ʻoki ʻōpū. | Inā he ʻeha, mumū, fistula, a i ʻole ka ulu ʻana ma kahi i hāiki ʻia. |
| Inā loaʻa iā ʻoe ka maʻi ʻōpū pōkole. | Aia ka hāiki kokoke i kahi hana ʻoki mua (anastomosis). |
| Inā he haiki wale nō, me ka ʻole o ka mumū a i ʻole ka ʻeha ma ka wahi i haiki. | Inā he ʻōpū puka kou. |
| Inā loaʻa iā ʻoe nā hōʻailona pinepine o ka maʻi o Crohn. | Inā ʻoe e ʻeha nei i ka ʻai ʻole nui. |
Pehea ʻoe e hoʻomākaukau ai ma mua o ke ʻoki kino?
No ka mea he hana hoʻolālā kēia, e hana kāu kauka i kekahi mau hoʻokolohua ma mua.
- Nā Hoʻāʻo Kiʻi: E hana ʻia kahi hoʻāʻo e like me ka CT scan a i ʻole Magnetic Resonance Enterography (MRE) e ʻike pono i kahi o nā ʻūlū i loko o kou ʻōpū a me ka lōʻihi o lākou.
- Nā Hoʻāʻo Koko: E hana ʻia nā hoʻāʻo koko e nānā i kou kūlana meaʻai. Inā ʻaʻole ʻoe i lawa ka meaʻai, hiki ke hāʻawi ʻia iā ʻoe nā mea hoʻohui meaʻai ma o kahi aʻa (`IV`) no kekahi mau lā ma mua o ke ʻoki ʻana. E kōkua kēia iā ʻoe e hoʻōla wikiwiki ma hope o ke ʻoki ʻana.
- ʻEke Stoma (ʻeke Ostomy): I kekahi mau hihia, ma hope o ke ʻoki ʻana, pono paha e hana ʻia kahi puka manawa pōkole (`stoma`) ma ka ʻili o ka ʻōpū e ʻae ai i ka ʻōpala e hele ma waena, a pono paha e hoʻopili ʻia kahi ʻeke (`ʻeke ostomy`) iā ia a hiki i ka ho'ōla ʻana o ka ʻōpū. Mai hopohopo no kēia. Inā pono kēia, e wehewehe pono kāu kauka iā ʻoe ma mua o ke ʻoki ʻana.
Pehea e hana ʻia ai ke ʻoki kino?
He hana ʻoki kino nui ka Strictureplasty i hana ʻia ma lalo o ka anesthesia laulā. Pono ʻoe e noho i ka haukapila no kekahi mau lā. Ma mua o ka hoʻomaka ʻana o ke ʻoki kino, e hāʻawi ʻia ʻoe i ka anesthesia laulā, no laila ʻaʻole ʻoe e ʻeha a hoʻomanaʻo paha i ke ʻoki kino.
I ka wā o ke ʻoki ʻana, hana ke kauka ʻoki i kahi ʻoki ma ka ʻaoʻao haiki o ka ʻōpū a humuhumu iā ia. E noʻonoʻo iā ia e like me ka ʻoki ʻana i kahi paipu i paʻa i ka lōʻihi, e hoʻokaʻawale ana i nā wēlau ʻelua o ka ʻoki ʻana, a e humuhumu ana iā lākou. Ke ākea ka ʻōpū, hiki i ka meaʻai ke neʻe maʻalahi hou ma waena. Inā he nui kou mau strictures, hiki iā ʻoe ke mālama pinepine iā lākou āpau i hoʻokahi hana.
Aia kekahi mau ʻano Strictureplasty ma muli o ka lōʻihi o ka ʻūlū ʻana:
Heineke-Mikulicz Strictureplasty
ʻO kēia ke ʻano hana i hoʻohana pinepine ʻia. Hana ʻia ia no nā ʻoki ʻana i ʻoi aku ka pōkole ma mua o 10 kenimika (ma kahi o 4 ʻīniha).
ʻO Finney a i ʻole Jaboulay Strictureplasty
Hoʻohana ʻia kēia mau mea no ka hoʻohaiki ʻana ma waena o 10-20 kenimika (ma kahi o 8 ʻīniha) ka lōʻihi. Ma kēia ʻoki kino, ua pelu ʻia ka ʻōpū i ke ʻano 'U'.
ʻO ke kālai ʻana o Michelassi Strictureplasty
He hana kūikawā kēia no nā ʻoki ʻoi aku ka lōʻihi ma mua o 20 kenimika. Ma kēia hana, ua pelu ʻia ka ʻāpana haiki o ka ʻōpū i ʻelua, ua hoʻohui ʻia nā ʻaoʻao ʻelua, ua hana ʻia kahi ʻoki lōʻihi, a ua humuhumu ʻia nā mea ʻelua.
ʻEhia ka lōʻihi e hoʻōla ai ma hope o ke ʻoki kino?
He ʻoki kino nui kēia, no laila e lōʻihi ka manawa e hoʻōla ai. Pono paha ʻoe e noho ma ka haukapila no hoʻokahi pule . Inā he mau pilikia, pono paha ʻoe e noho lōʻihi.
- ʻEha: Hiki paha iā ʻoe ke ʻeha iki i ka ʻōpū i nā lā mua ma hope o ke ʻoki ʻana. E hāʻawi ke kauka iā ʻoe i nā lāʻau ʻeha no kēia.
- Nā Palena: ʻAʻole hiki iā ʻoe ke hana i nā mea e like me ka hāpai ʻana i nā kaumaha a i ʻole ka hoʻokele ʻana no kekahi mau pule.
- E makaʻala i nā maʻi: Pono ʻoe e makaʻala loa i ka loaʻa ʻana o kahi maʻi ma hope o ke ʻoki ʻana. Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha nui, ke kuni, ka ʻulaʻula a i ʻole ka pehu ʻana ma kahi ʻoki ʻana, a i ʻole ka hoʻokahe ʻokoʻa mai ka ʻeha, pono ʻoe e hoʻomaopopo koke i kāu kauka .
- ʻAi: Ma muli o kou kūlana, hiki i kāu kauka a meaʻai meaʻai paha ke ʻōlelo aku i kahi ʻai kūikawā ('GI soft diet').
- Lapaʻau IBD: ʻO ka mea nui e hoʻomanaʻo ai, ʻo kēia ʻoki kino e hoʻonui wale i ka ʻūmiʻi. ʻAʻole ia e ho'ōla i ka IBD kumu (e like me Crohn's). No laila, pono ʻoe e hoʻomau i ka lawe ʻana i nā lāʻau lapaʻau ʻē aʻe no kou kūlana.
He aha ka ʻokoʻa ma waena o ka 'Strictureplasty' a me ka 'Bowel Resection'?
He nīnau kēia a nā poʻe he nui e nīnau ai. He ʻokoʻa nui ma waena o kēia mau ʻoki kino ʻelua.
| ʻAno | Strictureplasty (hoʻonui ʻana) | ʻOki ʻana o ka ʻōpū |
|---|---|---|
| He aha e hana ai | Ua hoʻonui ʻia ka ʻāpana haiki o ka ʻōpū. | Ua ʻoki ʻia ka ʻāpana haiki o ka ʻōpū a ua hoʻohui ʻia nā ʻāpana ʻelua i koe. |
| Pōmaikaʻi nui | Mālama ʻia ka lōʻihi holoʻokoʻa o ka ʻōpū, e hōʻemi ana i ka pilikia o ka 'Short Bowel Syndrome' (nā pilikia o ka omo ʻana i ka meaʻai) . | Hiki ke hoʻemi iki ʻia ka pilikia o ka hanana hou ʻana mai o kahi pilikia ma kahi hoʻokahi. |
| Ka pilikia o ka wā e hiki mai ana | Aia kahi manawa kūpono e pono hou ai ke ʻoki kino i ka wā e hiki mai ana. | He haʻahaʻa ka manawa kūpono e pono ai ke ʻoki hou ʻana i ka wā e hiki mai ana. |
Hoʻāʻo pinepine nā kauka i kahi strictureplasty mua, no ka mea, ʻo ka mālama ʻana i ka lōʻihi o ka ʻōpū he mea nui ia no ka meaʻai.
Leka Lawe-Home
- He ʻoki kino ʻo Strictureplasty e hoʻonui i nā wahi i haiki o ka ʻōpū ma muli o nā maʻi e like me Crohn's. ʻAʻole ia e pili ana i ka ʻoki ʻana i nā ʻāpana o ka ʻōpū.
- Hiki i kēia ʻoki kino ke hoʻopau i nā hōʻailona e like me ka ʻeha o ka ʻōpū a me ka pehu ʻana, a hoʻemi i ka pilikia weliweli o ka pani piha ʻana o ka ʻōpū.
- ʻAʻole kūpono kēia ʻoki kino no nā kānaka a pau. Na kāu kauka e hoʻoholo i ka lāʻau kūpono loa ma muli o kou kūlana.
- He ʻoki kino nui kēia, no laila he manawa ka manawa e ho'ōla ai. Aia kekahi mau pilikia e like me ka maʻi a me ke kahe ʻana o ke koko.
- E ho'ōla wale kēia ʻoki kino i ka ʻūmiʻi. Pono e mālama ʻia ka maʻi kumu (IBD).
- Inā he mau nīnau kāu e pili ana i kēia, mai makaʻu e kamaʻilio me kāu kauka a e hoʻomaopopo i nā mea āpau.
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