E aʻo kākou e pili ana i ka Zollinger-Ellison Syndrome ma nā ʻōlelo maʻalahi.

Ua lohe paha ʻoe i ka Zollinger-Ellison Syndrome ? He inoa ʻē paha ia, akā he ʻano ia e hiki ke hoʻopilikia i ko kākou ʻōpū a he mea ia e hopohopo ai. Hoʻoulu ia i nā ʻōpū ʻeha nui a me ka maʻi diarrhea mau loa ma muli o ka hana nui ʻana o ka waikawa i loko o ko kākou ʻōpū. No laila, e kamaʻilio kākou e pili ana i ia mea me nā kikoʻī hou aku i kēia lā, ʻeā?

He aha maoli ka Zollinger-Ellison Syndrome?

I ka ʻōlelo maʻalahi, ʻo ke kumu nui o kēia maʻi i kapa ʻia ʻo Zollinger-Ellison Syndrome (ZES) he ʻano puʻupuʻu liʻiliʻi e ulu ana i loko o ko mākou kino, ʻoi aku hoʻi ma ka pancreas a i ʻole ka ʻaoʻao o luna o ka ʻōpū liʻiliʻi (duodenum). Kāhea mākou i kēia mau puʻupuʻu he gastrinomas . He ʻano puʻupuʻu neuroendocrine kēia.

E nānā, hana kēia mau gastrinomas i kahi hormone i kapa ʻia ʻo gastrin . ʻO kēia hormone gastrin ka mea e hōʻailona ai i ko mākou ʻōpū e "ʻAe, e hoʻomaka e hana i ka waikawa i kēia manawa." No laila, ke hana kēia mau puʻupuʻu i ka nui o ka hormone gastrin, hana pū ka ʻōpū i ka nui o ka waikawa. E noʻonoʻo wale iā ia e like me kahi faucet e kahe ana ka wai me ka ʻole o ka pani paʻa ʻana, piʻi nui ka waikawa o ko mākou ʻōpū me ka hiki ʻole ke kāohi. ʻO kēia waikawa keu ka mea e hoʻoulu ai i nā pilikia e like me nā ʻōpū ʻōpū a me ka reflux waikawa.

He mea hopohopo iki ia he hiki i kahi 60% o kēia mau gastrinomas ke lilo i maʻi kanesa . Akā, mai hopohopo, e like me nā mea ʻē aʻe a pau, aia kekahi lāʻau lapaʻau no kēia. I kekahi manawa, kapa pū nā kauka i kēia maʻi "pancreatic ulcerogenic tumor syndrome."

He aha nā hōʻailona o kēia? Pehea ko mākou manaʻo?

I kekahi manawa, ʻaʻole paha e hōʻike ka maʻi Zollinger-Ellison (ZES) i kekahi mau hōʻailona. Eia nō naʻe, ke kū mai nā hōʻailona, ​​​​hiki iā lākou ke komo pū me:

• ʻŌpū wela a ʻeha paha: Manaʻo paha ʻoe i kahi ʻano wela i loko o kou ʻōpū, a i ʻole me he mea lā e ʻai ana kekahi mea iā ʻoe. ʻO ke kumu o kēia o ka nui o ka waikawa.
• Koko i loko o ka luaʻi a i ʻole ke koko i loko o ka ʻōpala: Hana ʻia kēia e ke kahe ʻana o ke koko mai nā ʻeha i loko o nā ʻōpū (ke kahe ʻana o ka ʻōpū).
• Luhi a me ka nāwaliwali: E like me ka mea i ʻōlelo ʻia ma luna, ma muli o ke kahe ʻana o ke koko, hiki iā ʻoe ke luhi a nāwaliwali hoʻi ma muli o ka anemia.
• Nā ʻōpala ʻaila, lana: E ʻike paha kekahi poʻe i kahi loli i ko lākou mau ʻōpala, kahi mea i ʻoi aku ka ʻaila.
• ʻĀʻī: I ka pololei, he ʻano wela ia i loko o ka umauma i hoʻokumu ʻia e ka waikawa e piʻi mai ana i ka esophagus.
• ʻO ka pehu ʻana, ka ʻōpū ʻana: Hiki ke ʻike hou ʻia kēia, ʻoi aku hoʻi ma hope o ka ʻai ʻana i kahi meaʻai momona.
• ʻAʻohe ʻono o ka meaʻai.
• Ka luaʻi a me ka luaʻi.
• Ka wiwi ʻana me ke kumu ʻole.

ʻO ke koʻikoʻi o kēia mau hōʻailona e pili ana i ka nui a me ka helu o nā gastrinomas. Hoʻopuka nā ʻōpū nui i ka gastrin hou aʻe, ka mea e hoʻoulu ai i ka ʻōpū e hana i ka waikawa hou aʻe. Hiki i kēia ke hoʻonui i nā hōʻailona o ka maʻi ʻōpū peptic.

E hoʻomanaʻo, i kekahi manawa hiki i kēia mau puʻupuʻu ke hoʻopili i ke akepaʻa, e alakaʻi ana i ka maʻi ʻaʻai akepaʻa. Inā hana ʻia kēlā, hiki ke loaʻa nā hōʻailona e like me ka maneʻo, ka melemele o nā keʻokeʻo o nā maka, a me ka melemele o ka ʻili (jaundice).

No ke aha lā kēia kūlana iā kākou? He aha nā kumu?

ʻO ka hapa nui o ka manawa, kū pinepine ʻole ka Zollinger-Ellison Syndrome (ZES), ʻo ia hoʻi he paʻakikī ke ʻike i ke kumu pololei.

Eia nō naʻe, ua ʻike ʻia ma kahi o 25% o ka poʻe me kēia maʻi he maʻi genetic i kapa ʻia ʻo MEN Type 1 (Multiple Endocrine Neoplasia Type 1) . He maʻi hoʻoilina ka MEN Type 1 kahi e hiki ai i nā ʻōpū ke ulu i loko o nā kelepa endocrine he nui i loko o ko mākou kino.

He aha nā pilikia e hiki mai ana mai kēia maʻi? Pono anei au e hopohopo?

ʻAe, ʻo Zollinger-Ellison Syndrome (ZES) kahi kūlana i hiki ke hoʻoweliweli i ke ola . No ka laʻana, inā ālai kahi gastrinoma i ka ʻaoʻao o luna o ka ʻōpū liʻiliʻi (duodenum), hiki iā ia ke pahū. Hiki iā ia ke laha i ke akepaʻa. Hiki ke kahe koko nui ma muli o ka nui o ka waikawa o ka ʻōpū.

Eia naʻe, mai hopohopo ke lohe ʻoe i kēia mau mea. Inā ʻike mua ʻia ka maʻi a mālama pono ʻia, hiki ke pale nui ʻia kēia mau pilikia.

Pehea e ʻike ai nā kauka i kēia maʻi? (Diagnosis)

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​e nānā mua ke kauka iā ʻoe, e nīnau e pili ana i kāu mau hōʻailona a inā paha ua loaʻa i kekahi o kou ʻohana kēia mau maʻi. A laila, hiki iā lākou ke hana i nā hoʻokolohua e like me:

• Nā hoʻāʻo koko: Hiki i kēia ke nānā inā kiʻekiʻe loa kou pae hormone gastrin i ke koko (hypergastrinemia).
• Nā hoʻāʻo kiʻi: Hiki ke hana ʻia kahi CT scan a i ʻole MRI scan e ʻike inā he mau ʻōpū gastrinoma i loko o ka pancreas a i ʻole duodenum.
• Hoʻāʻo ʻakika ʻōpū: Ma kēia hoʻāʻo, hoʻokomo ke kauka i kahi ʻōmole liʻiliʻi i loko o ka ʻōpū ma o ka ihu a i ʻole ka waha a lawe i kahi hāpana o ka waikawa ma laila.

Inā ʻike kēia mau hoʻokolohua mua i nā ʻōpū, hiki i ke kauka ke hana i kekahi mau hoʻokolohua hou aʻe:

• Endoscopy: Ma kēia hoʻāʻo, hoʻokomo ʻia kahi ʻōmole liʻiliʻi me kahi kāmela i hoʻopili ʻia ma o ka waha a nānā ʻia ka esophagus, ka ʻōpū, ka ʻaoʻao o luna o ka ʻōpū liʻiliʻi (duodenum), a me ka pancreas.
• ʻO ka ultrasound endoscopic: He hui pū ʻana kēia o ka ultrasound a me ka endoscopy. Hiki iā ia ke hana i nā kiʻi ʻoi aku ka maopopo.
• ERCP (Endoscopic Retrograde Cholangiopancreatography): He scan kūikawā nō hoʻi kēia. Nānā ia i loko o nā ʻauwai bile a me nā ʻauwai pancreatic.
• ʻO ka ʻume ʻana i ka nila maikaʻi: Inā he puʻupuʻu, hoʻohana ʻia kēia ʻano hana e lawe i kahi ʻāpana liʻiliʻi o ia mea a hoʻāʻo iā ia no nā hunaola kanesa (biopsy).

He aha nā lāʻau lapaʻau no kēia? (Lāʻau lapaʻau)

Aia nā koho lapaʻau i ke koʻikoʻi o kāu mau hōʻailona a inā he maʻi kanesa ka gastrinoma. ʻEkolu mau ʻano lapaʻau nui:

1. Lāʻau lapaʻau:

• ʻO ka lāʻau lapaʻau nui i kuhikuhi pinepine ʻia, ʻo ia nā mea hoʻopaʻa i ka pamu proton (PPI) . Hana kēia mau lāʻau lapaʻau ma ka hoʻēmi ʻana i ka nui o ka waikawa i hana ʻia i loko o ka ʻōpū. I ka ʻōlelo maʻalahi, kāohi lākou i ka waikawa keu i hana ʻia.

2. ʻOki kino:

• Hiki i kāu kauka ke ʻōlelo aku i ke ʻoki kino e wehe i ka puʻupuʻu. Aia kekahi mau ʻano ʻoki kino:
• Duodenectomy: Wehe ʻia ka puʻupuʻu ma o kahi ʻoki liʻiliʻi ma ka ʻaoʻao o luna o ka ʻōpū liʻiliʻi (duodenum).
• Gastrectomy: Wehe ʻana i kahi hapa a i ʻole ka ʻōpū holoʻokoʻa.
• ʻO ke ʻoki ʻana i ke akepaʻa: Inā he mau puʻupuʻu i loko o ke akepaʻa, e wehe ʻia lākou.
• Pancreatectomy: Wehe ʻana i kahi hapa a i ʻole ka pancreas āpau.
• Ka hoʻopau ʻana i ka puʻupuʻu: Inā he mau puʻupuʻu ma ke poʻo o ka pancreas, ʻo ia mau mea wale nō e wehe pono ʻia.

3. Ka lāʻau lapaʻau no ke kanesa:

• Inā he maʻi kanesa ka puʻupuʻu, hiki i kāu kauka ke ʻōlelo i nā lāʻau lapaʻau e like me ka chemotherapy . Hiki i kēia mau lāʻau lapaʻau ke kōkua i ka hōʻemi ʻana i nā hōʻailona a hoʻolohi i ka laha ʻana o ka puʻupuʻu.

Hiki i ka lāʻau lapaʻau ke ho'ōla loa iā ia?

Inā hiki ke wehe loa ʻia kahi gastrinoma kanesa me ke ʻoki ʻana, hiki ke ho'ōla loa ʻia ke ʻano. Eia nō naʻe, pono kēia e wehe i nā hunaola kanesa āpau i loko o ke kino. ʻOiai inā holomua ke ʻoki ʻana, pono pinepine ʻoe e lawe i ka lāʻau lapaʻau e kāohi i ka waikawa o ka ʻōpū no ke koena o kou ola.

Inā loaʻa iaʻu kēia maʻi, he aha kaʻu e manaʻo ai? (Prognosis)

ʻO ka wānana no ʻoe me kēia maʻi e pili ana i ke ʻano o ka puʻupuʻu. ʻAʻole hoʻoweliweli ke ola o nā gastrinomas noncancerous. Eia nō naʻe, pono ʻoe i ka mālama mau e kāohi i nā pae waikawa o ka ʻōpū.

Eia nō naʻe, loli ke kūlana inā loaʻa iā ʻoe nā puʻupuʻu kanesa. I kēlā hihia, pono paha ʻoe i ke ʻoki ʻana a me ka mālama ʻana i ka maʻi kanesa.

ʻOkoʻa nā helu ola no ka poʻe me Zollinger-Ellison syndrome (ZES). Wahi a ka ʻikepili, ma hope o ka wehe ʻia ʻana o nā gastrinomas āpau ma ke ʻoki ʻana, ʻoi aku ma mua o 90% o ka poʻe e ola ana no 5 a 10 mau makahiki . Eia nō naʻe, inā ʻaʻole hiki ke wehe ʻia nā puʻupuʻu āpau, hāʻule ka helu ola 5 makahiki i 43%. He mea nui e hoʻomanaʻo he mau helu wale nō kēia. Inā loaʻa iā ʻoe kēia maʻi, e kamaʻilio me kāu kauka e pili ana i ka mea hiki iā ʻoe ke manaʻo.

Pehea e mālama ai iaʻu iho? He aha kaʻu e hiki ai ke hana?

Aia nō ia i kou kūlana. Pono ka nui o ka poʻe e lawe i ka lāʻau lapaʻau e hōʻemi i ka waikawa o ka ʻōpū no ke koena o ko lākou ola. ʻO ka maʻi Zollinger-Ellison (ZES) ke kumu o nā gastrinomas. Hiki i ka hapa nui o kēia mau puʻupuʻu ke lilo i maʻi kanesa. No laila, inā ua loaʻa iā ʻoe nā puʻupuʻu kanesa, pono ʻoe e hoʻomau i ka ʻike ʻana i kāu kauka no ka mālama ʻana e ʻike inā ua hoʻi mai lākou.

Āhea wau e ʻike hou ai i ke kauka?

Ma hope o ka lāʻau lapaʻau, inā e ʻoi aʻe ka ʻino o kāu mau hōʻailona Zollinger-Ellison Syndrome (ZES) a i ʻole e ʻike ʻia nā hōʻailona hou, pono ʻoe e ʻike koke i ke kauka.

Ke ʻike ʻoe he maʻi laha ʻole kou, e kahaha paha ʻoe a makaʻu iki. He mea paʻakikī paha ke lohe koke i kahi mea e like me kēia, ʻoiai ʻaʻohe ou hōʻailona. He nui paha kāu mau nīnau e pili ana i ka hopena o ZES iā ʻoe. Hiki ke ʻokoʻa loa nā pane i kēlā mau nīnau ma muli o kou kūlana.

ʻO ka mea nui loa, ʻo ia ke kūkākūkā i kāu mau nīnau a me nā kānalua a pau me ke kauka. E wehewehe lākou i nā mea āpau iā ʻoe a hāʻawi iā ʻoe i ke kākoʻo āu e pono ai.

Leka Lawe-Home:

ʻAe, e hoʻomanaʻo kākou i kekahi o nā mea nui loa mai nā mea a mākou i kamaʻilio ai:

• ʻO ka Zollinger-Ellison Syndrome (ZES) kahi maʻi i hoʻokumu ʻia e kahi puʻupuʻu i kapa ʻia ʻo gastrinoma, ka mea e hoʻoulu ai i nā ʻōpū ʻōpū a me ka maʻi palahēhē ma muli o ka nui o ka waikawa ʻōpū.
• Hiki ke ʻike ʻia nā hōʻailona e like me ka ʻeha o ka ʻōpū, ka luaʻi ʻana i ke koko, ka ʻeha o ka umauma, a me ka pohō kaumaha.
• Hiki i ka hapa nui o kēia mau puʻupuʻu ke lilo i maʻi kanesa.
• Hoʻomaopopo ʻia ka maʻi ma o nā hoʻokolohua e like me nā hoʻokolohua koko, nā scan, a me ka endoscopy.
• Hoʻokomo ʻia ka lāʻau lapaʻau i nā lāʻau lapaʻau (PPI), ke ʻoki kino, a me ka chemotherapy.
• Hiki i ka ʻike mua ʻana a me ka mālama ʻana ke pale i nā pilikia a hoʻoulu i ka ho'ōla hou ʻana.
• Inā loaʻa iā ʻoe kēia ʻano, e hahai pololei i nā ʻōlelo a kāu kauka, e hoʻāʻo ʻia i ka manawa kūpono, a e kamaʻilio me kāu kauka me ka ʻole o ka hūnā ʻana i kekahi mea.

Manaʻolana wau he mea pono kēia ʻike iā ʻoe. E ola kino!

ʻO Zollinger-Ellison Syndrome, gastrinoma, waikawa ʻōpū, ʻōpū peptic ulcer, diarrhea, hormones, maʻi kanesa