Loaʻa pinepine iā ʻoe nā ʻōpū ʻeha a i ʻole gastritis? Ke ʻeha nei ʻoe i nā ʻōpū ʻeha mau ʻaʻole i hoʻomaikaʻi ʻia me ka mālama ʻia? Loaʻa pū kekahi iā ʻoe ka maʻi diarrhea? I kekahi manawa manaʻo mākou he mau mea maʻamau kēia, akā i kēia lā e kamaʻilio mākou e pili ana i kahi maʻi laha ʻole i hūnā ʻia ma hope o kēia mau mea, akā hiki ke lilo i mea koʻikoʻi iki. Ua kapa ʻia kēia ʻo Zollinger-Ellison Syndrome.
I ka ʻōlelo maʻalahi, he aha ka Zollinger-Ellison Syndrome (ZES)?
E noʻonoʻo ʻoe aia kekahi kuapo i loko o ko kākou ʻōpū e kāohi ana i ka hana ʻana o ka waikawa. Hana like ka hormone i kapa ʻia ʻo gastrin me kēlā kuapo. ʻO ka maʻamau, ke ʻai kākou, hoʻokuʻu ʻia kēia hormone, e hana ana i ka ʻōpū e hana i ka waikawa e kōkua i ka hoʻoheheʻe ʻana i ka meaʻai. Ke pau ka hana, ua kāohi ʻia ka hana ʻana o ka waikawa.
Eia nō naʻe, i loko o ka poʻe me Zollinger-Ellison Syndrome (ZES), ulu aʻe kahi ʻano puʻupuʻu i kapa ʻia he gastrinoma i loko o ke kino. Hoʻoulu pinepine kēia mau puʻupuʻu i loko o ka pancreas a i ʻole ka ʻaoʻao o luna o ka ʻōpū liʻiliʻi (duodenum). ʻO ka mea a kēia mau puʻupuʻu e hana ai, ʻo ia ka hana ʻana i ka nui o ka hormone gastrin me ka ʻole o ka mana. Me he mea lā ua 'on' mau ke kuapo.
Ke nui loa ka gastrin iā kākou, hoʻomaka ko kākou ʻōpū e hana i ka nui o ka waikawa. ʻO kēia waikawa keu ke kumu o nā ʻōpū ʻeha nui (nā ʻōpū peptic) a me ka maʻi diarrhea mau loa.
Ma kahi o 60% o kēia mau gastrinomas hiki ke lilo i maʻi kanesa , no laila he mea nui loa ka ʻike ʻana a me ka mālama ʻana iā lākou i ka wā mua.
He aha nā hōʻailona o kēia maʻi? Pehea mākou e ʻike ai?
I kekahi manawa, ʻaʻole paha e hōʻike ʻo ZES i kekahi mau hōʻailona i nā pae mua. Akā i ka wā e ʻike ʻia ai nā hōʻailona, hiki iā lākou ke ʻoi aku ka koʻikoʻi ma mua o ka gastritis maʻamau. ʻOkoʻa ka koʻikoʻi o nā hōʻailona ma muli o ka nui a me ka helu o nā puʻupuʻu i loko o kou kino.
E wehewehe hou aku kākou i kēia ma ka papa ma lalo nei.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| ʻEha nui o ka ʻōpū a i ʻole ka pehu ʻana | Hiki mai kēia ʻeha ke hōʻino ʻia nā paia o ka ʻōpū a me nā naʻau e ka nui o ka waikawa o ka ʻōpū. |
| Ka maʻi pākī mau | Ke komo ka waikawa keu i loko o nā ʻōpū, hoʻopilikia ia i ka hana o nā enzymes ma laila, e hoʻoulu ai i ka maʻi pākī a me ka ʻeli pono ʻole ʻia o ka meaʻai. |
| Ka luaʻi ʻana a i ʻole ke kahe ʻana o ke koko i loko o ka ʻōpala | ʻO kēia ka mea hiki ke hana i ka wā e kahe ana ke koko mai nā ʻōpū ʻeha. Hiki i ka luaʻi ke ʻeleʻele e like me ke kope kope a i ʻole hiki i ka ʻōpala ke ʻeleʻele e like me ke kēpau. |
| Nā noho ʻaila, lana | Ke pilikia ka ʻeli ʻana o ka momona ma muli o ka nui o ka waikawa, hoʻokuʻu ʻia ka momona i ʻeli ʻole ʻia i loko o ka ʻōpala. |
| ʻO ka puʻuwai pinepine | Hiki mai kēia maʻi ma muli o ka nui o ka waikawa o ka ʻōpū e neʻe ana i luna i loko o ka esophagus (acid reflux). |
| ʻAnorexia a me ka pohō kaumaha | ʻO ka ʻeha mau a me nā pilikia o ka ʻōpū e hiki ai ke emi i ka makemake a me ka pohō kaumaha. |
| Luhi a me ka nāwaliwali | I ka wā e kahe mālie ai ke koko o nā ʻeha o ka ʻōpū, hiki paha iā ʻoe ke luhi ma muli o ka anemia. |
I kekahi mau hihia, inā pālahalaha kēia mau puʻupuʻu i ke akepaʻa (metastasis) , hiki iā lākou ke hōʻike i nā hōʻailona o ke kanesa o ke akepaʻa. No ka laʻana, aia paha ka maneʻo, ka melemele o nā maka a me ka ʻili (jaundice).
No ke aha lā e hana ʻia ai kekahi mea e like me kēia?
ʻO ka hapa nui o ka manawa, hiki pinepine ʻole ʻia ka ZES, ʻo ia hoʻi, he mea hana wale ia.
Akā ma kahi o 25% o nā maʻi e loaʻa ana i kēia ʻano i kapa ʻia ʻo MEN Type 1 (Multiple Endocrine Neoplasia Type 1).Me kahi maʻi genetic i kapa ʻia ʻo ZES. I ka ʻōlelo maʻalahi, he maʻi genetic kakaikahi kēia. Ma kēia, aia kahi pilikia o ka hoʻokumu ʻia ʻana o nā puʻupuʻu i loko o kekahi mau kelepa hana hormone i loko o ko mākou kino i ka manawa like. ʻO ZES kekahi ʻāpana wale nō ia.
He aha nā hoʻokolohua e hana ʻia e ʻike ai i kēia?
Inā loaʻa iā ʻoe nā hōʻailona i ʻōlelo ʻia ma luna nei, e kauoha paha kāu kauka i kekahi mau hoʻokolohua inā manaʻo lākou he ZES kāu.
Nā hoʻokolohua mua
- Nā Hoʻāʻo Koko: Nānā kēia i ka pae o ka hormone gastrin i loko o kou koko. Inā loaʻa iā ʻoe ʻo ZES, e kiʻekiʻe loa kēia pae. Ua kapa ʻia kēia he hypergastrinemia.
- Ke hoʻāʻo ʻana i nā pae waikawa o ka ʻōpū: Hoʻokomo ʻia kahi paipu ma o ka ihu i loko o ka ʻōpū a lawe ʻia kahi hāpana o ka waikawa. I ka ZES, kiʻekiʻe loa kēia pae waikawa.
- Nā Hoʻāʻo Kiʻi: Hana ʻia kahi CT scan a i ʻole MRI scan e nānā i nā ʻōpū i loko o ka pancreas a i ʻole nā ʻōpū.
Nā hoʻokolohua hou aʻe inā ua hōʻoia ʻia nā puʻupuʻu
Ke hana ʻia nei nā hoʻokolohua hou aʻe e hoʻoholo pono ai i kahi o kēia mau puʻupuʻu, ko lākou nui, a inā he maʻi kanesa a ʻaʻole paha.
- Endoscopy: Hoʻokomo ʻia kahi ʻōmole lahilahi me kahi kāmela ma o ka waha e nānā i ka ʻōpū a me ka ʻaoʻao o luna o ka ʻōpū liʻiliʻi. Hiki i kēia ke kōkua i ka ʻike inā he mau ʻōpū ʻōpū.
- ʻO ka Endoscopic Ultrasound: He hui pū ʻana kēia o ka endoscopy a me ka ultrasound scan. Hiki iā ia ke ʻike i nā ʻōpū liʻiliʻi loa i loko o ka pancreas.
- ERCP: He scan kūikawā nō hoʻi kēia.
- Biopsy (Fine-needle aspiration): Lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka puʻupuʻu a nānā ʻia ma lalo o kahi microscope e ʻike inā he mau hunaola kanesa.
He aha nā lāʻau lapaʻau no kēia?
Aia nā koho lapaʻau i ke koʻikoʻi o kāu mau hōʻailona a inā he maʻi kanesa ka puʻupuʻu a ʻaʻole paha. ʻEkolu mau koho lapaʻau nui.
| ʻAno lapaʻau | Wehewehena |
|---|---|
| Lāʻau lapaʻau | ʻO nā mea hoʻopaʻa pamu proton (PPI) i hoʻohana nui ʻia.He mau lāʻau lapaʻau kēia e kāohi ana i ka hana ʻana o ka waikawa o ka ʻōpū. Pono paha ʻoe e lawe i kēia mau lāʻau lapaʻau no ke koena o kou ola. |
| ʻoki kino | Inā hiki ke wehe ʻia ka puʻupuʻu, ua ʻōlelo ʻia ke ʻoki ʻana. ʻOkoʻa ke ʻano o ke ʻoki ʻana ma muli o ka wahi o ka puʻupuʻu (e.g., Pancreatectomy - wehe ʻana i kahi ʻāpana o ka pancreas, Duodenectomy - wehe ʻana i kahi ʻāpana o ka ʻōpū liʻiliʻi). |
| Ka Lapaʻau ʻAʻai | Inā he maʻi kanesa nā puʻupuʻu a ua pālahalaha i nā ʻāpana ʻē aʻe o ke kino, hāʻawi ʻia nā lāʻau lapaʻau e like me ka chemotherapy . Hana kēia e kāohi i ka ulu ʻana o nā hunaola kanesa a hōʻemi i nā hōʻailona. |
Pehea lā koʻu wā e hiki mai ana me kēia kūlana?
He nīnau kēia a nā poʻe he nui. Aia kou wā e hiki mai ana i ke ʻano o ka maʻi kanesa āu e loaʻa nei.
- ʻO nā puʻupuʻu ʻaʻole cancerous: ʻAʻole kēia mau mea e hoʻoweliweli i ke ola, akā pono ʻoe e hoʻomau i ka lawe ʻana i ka lāʻau lapaʻau e kāohi i ka waikawa o ka ʻōpū.
- Nā puʻupuʻu kanesa: He ʻokoʻa iki ke kūlana ma ʻaneʻi. Inā hiki ke wehe ʻia nā hunaola kanesa āpau i loko o ke kino ma o ke ʻoki ʻana, hiki ke ho'ōla loa ʻia ka maʻi. ʻOiai i kēlā manawa, pono ʻoe e hoʻomau i nā hoʻokolohua lapaʻau e ʻike ai inā e hoʻi mai ka maʻi.
Wahi a nā helu loea, ʻoi aku ma mua o 90% o nā maʻi i wehe ʻia ko lākou mau puʻupuʻu a pau ma ke ʻoki ʻana e ola no 5-10 mau makahiki. Inā ʻaʻole hiki i ke ʻoki ʻana ke wehe i nā puʻupuʻu a pau, ʻo ka nui o ke ola no 5 makahiki ma kahi o 43%.
Akā e hoʻomanaʻo i kēia: He awelika wale nō kēia mau helu helu ma muli o ka ʻikepili mai nā tausani o nā maʻi. He ʻokoʻa loa paha kou kūlana pilikino. No laila, ʻo ke kanaka maikaʻi loa e ʻike pono i kou kūlana ʻo ia kāu kauka lapaʻau.
Pehea lā wau e mālama ai iaʻu iho?
Inā ua ʻike ʻia ʻoe me ZES, pono ʻoe e hana i kekahi mau hoʻololi i kou ola.
- E lawe pono i kāu lāʻau lapaʻau: He mea nui e lawe i nā lāʻau hoʻemi waikawa (PPI) i ka manawa kūpono, e like me ke kauoha a kāu kauka.
- Nā hoʻokolohua lapaʻau maʻamau: ʻOiai inā loaʻa iā ʻoe nā puʻupuʻu kanesa, pono ʻoe e hele no nā hoʻokolohua ma hope i nā manawa maʻamau e like me ke kuhikuhi a kāu kauka e ʻike ai inā ua hoʻi hou mai ka maʻi.
- E makaʻala i nā hōʻailona: Inā hoʻi hou mai nā hōʻailona e like me ka ʻeha o ka ʻōpū a me ka maʻi kahe ma hope o ka mālama ʻana, e hoʻomaopopo koke i kāu kauka .
He mea maʻamau ka hopohopo a me ka makaʻu ke ʻike ʻoe he maʻi laha ʻole kou e like me kēia. He nui kāu mau nīnau. E kamaʻilio ākea me kāu kauka e pili ana iā lākou āpau. E hoʻolohe pono i kāu mau hopena hoʻāʻo a me nā hoʻolālā lapaʻau. Ua mākaukau lākou a makemake e kōkua iā ʻoe.
Leka Lawe-Home
- ʻO ka Zollinger-Ellison Syndrome (ZES) kahi maʻi laha ʻole i hoʻokumu ʻia e kahi puʻupuʻu i kapa ʻia ʻo gastrinoma e hana ana i ka waikawa ʻōpū keu.
- ʻO nā hōʻailona nui e pili ana i kēia , ʻo ia nā ʻōpū ʻōpū pinepine ʻaʻole i pane i ka lāʻau lapaʻau a me ka maʻi diarrhea lōʻihi.
- Hiki i kēia mau puʻupuʻu ke lilo i maʻi kanesa a ʻaʻole paha, no laila he mea nui ka ʻike mua ʻana.
- Hiki ke hoʻomalu pono ʻia kēia maʻi me nā lāʻau lapaʻau kūpono, ke ʻoki kino, a inā pono, ka mālama ʻana i ka maʻi kanesa.
- Inā loaʻa iā ʻoe kēia mau hōʻailona, mai hopohopo a nīnau koke aku i ke kauka kūpono no ka ʻōlelo aʻo.
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