Yu dɔn ɛva fil lɛk se sɔntin dɔn stɔp na yu bɛlɛ, yu bɛlɛ de big, ɛn yu de fil lɛk se i go bɔn? I bin tan lɛk se yu intestin dɛn dɔn blok kpatakpata. Bɔku tɛm, dat kin apin we sɔntin rili blok na yu insay. Bɔt wan strenj tin de we nɔ kin apin so ɔltɛm we yu intestinal dɛn kin stɔp fɔ wok wantɛm wantɛm ɛn nɔ gɛt ɛnitin fɔ stɔp insay. Tide, wi go tɔk bɔt wan kɔndishɔn we bɔku pipul dɛn nɔ ɛva yɛri bɔt. We wi de tɔk bɔt mɛrɛsin, wi kin kɔl dis Ogilvie Syndrome ɔ Acute Colonic Pseudo-obstruction (ACPO) .
Fɔ tɔk am simpul wan, wetin na Ogilvie Syndrome?
Imajin se trafik bɔku, bɔt aksidɛnt ɔ tin nɔ de we de ambɔg di rod. Di motoka dɛn jɔs tinap wansay. Ogilvie Syndrome na sɔntin lɛk dat. Di muvmɛnt fɔ it ɛn dɔti insay yu kɔlon kin stɔp wantɛm wantɛm. I kin tan lɛk se sɔntin dɔn stɔp na yu kɔlon, bɔt fɔ tru, nɔbɔdi nɔ de ambɔg yu bɔdi. Di prɔblɛm de na di nervɔs sistɛm we de kɔntrol di mɔsul dɛn na yu kɔlon. biכs i nכ de wok fayn, di muvmεnt fכ di kכlon (wi kכl dis ``peristalsis``) de stכp, εn di tin dεm we de insay de stכk na wan ples. Dis kin mek di kɔlon de dilayt smɔl smɔl, ɔ bulge.
di wכd ``pseudo-obstruction'' na in nem min ``false obstruction.'' Dis min se i de prεzεnt di simptom dεm lεk se i de obstrכkshכn, pan כl we fכ tru, nכ obstrכkshכn de.
Aw dis difrɛn frɔm ɔda prɔblɛm dɛn we kin apin na di bɔdi?
difrεn kכndyushכn dεm de we de mek di intestinal fכ wok fayn. So lɛ wi si aw Ogilvie Syndrome difrɛn frɔm dɛn.
- we yu kכmpεr wit כda `Intestinal Pseudo-obstruction` kכndishכn dεm: Ogilvie Syndrome na `acute` kכndishכn. Dat min se, i kin kam wantɛm wantɛm, ɛn na fɔ shɔt tɛm nɔmɔ . Ɛn na di big intestin nɔmɔ i kin afɛkt . Bɔt sɔm pipul dɛn kin gɛt `chronic` `pseudo-obstruction` kɔndishɔn. Bɔrku tɛm, na ɔda sik wae nɔr de mɛn ɔr wan sik wae dɛn kin bɔn wit.
- Di difrɛns wit `Paralytic Ileus`: Yu go dɔn yɛri di wɔd `Paralytic Ileus`. Dɛn kin yuz am fɔ tɔk bɔt wan sik we di intestinal dɛn kin stɔp fɔ wok fɔ sɔm tɛm, mɔ afta dɛn dɔn ɔpreshɔn di bɛlɛ. I rili kɔmɔn. I min se di smɔl ɛn big intestinal dɛn kin stɔp fɔ wok fɔ sɔm tɛm ɛn afta dat i kin wɛl fɔ dɛnsɛf insay sɔm dez. Bɔt, Ogilvie Syndrome na wan sik we kɔmpleks ɛn we nɔ kin apin so ɔltɛm . i kin mεntal afekt di big intestin , spεshal wan di sεkum.
Udat de pan denja fɔ gɛt dis sik?
Pan ɔl we i kin kam pan ɛnibɔdi, i kin bɔku pan ol pipul dɛn we dɔn pas 60 ia we gɛt bɔku ɔda wɛlbɔdi prɔblɛm dɛn.Dɛn kin ripɔt dis sik pan lɛk wan pan ɛvri 1,000 pipul dɛn we de na ɔspitul.
Fɔ tɔk am simpul wan, dis kin apin ɛnitɛm we di bɔdi gɛt bɔku strɛs. Tink bɔt big ɔpreshɔn, siriɔs aksidɛnt, at atak, ɔ bad bad infekshɔn. Dɛn tin ya kin afɛkt di we aw wi nervɔs sistɛm de wok. dis nεv sεstem na in de tεl di mכsul dεm na di intestinal dεm fכ "muv." So we i nɔ balans de, di intestinal dɛn kin stɔp fɔ wok ɛn Ogilvie Syndrome kin apin.
Wetin na di sayn dɛm wae de sho se yu gɛt Ogilvie Syndrome?
We briz, wata, ɛn it we yu nɔ digest kin trɔp na yu intestinal, yu kin gɛt sayn dɛn lɛk dis. Dɛn tin ya kin bigin wantɛm wantɛm ɛn dɛn kin bɔku smɔl smɔl.
| Di sayn we de sho se di sik de | Tɔk bɔt |
|---|---|
| Di bɛlɛ we de kɔmɔt na di bɛlɛ | Dis na di men ɛn di sayn we de sho klia wan. Di bɛlɛ blo lɛk balɔ ɛn i kin fil tranga. |
| Pɔsin we de fil pen na di bɛlɛ | Yu kin gɛt bɛlɛ pen ɔltɛm. Sɔmtɛm dis pen kin fil lɛk se i de go ya ɛn de. |
| Fil fɔ it | A nɔ de fil fɔ it bikɔs mi bɛlɛ ful-ɔp. |
| Nɔs ɛn vɔmit | Bikɔs di tin dɛn we de insay di intestinal nɔ kin ebul fɔ go bifo, dɛn kin kam bak ɔp ɛn vɔmit. |
| Kɔnstipɛshɔn ɔ dayarɛa | Bɔrku tɛm, di bɔdi we de muv ɛn di flatulɛns kin stɔp kpatakpata. Bɔt sɔntɛnde, na di wata pat dɛn nɔmɔ we dɔn trɔp kin pas, ɛn dis kin mek pɔsin gɛt wan sik we tan lɛk dayarɛa. |
Wetin mek dis kin apin? Lɛ wi tek tɛm luk di rizin dɛn.
Pan ɔl we di rayt tin we mek dis kin apin stil nɔ klia 100%, sayɛnsman dɛn biliv se na bikɔs wi ɔtonomik nɛvɔ sistɛm nɔ de wok fayn . Tink bɔt am, di tin dɛn we kin apin ɔtomɛtik wan na wi bɔdi, lɛk di at bit, brith, ɛn dijeshɔn, na dis nervɔs sistɛm we de wok lɛk ``ɔto-paylɔt.'' So, bikɔs ɔf bɔku strɛs na di bɔdi, dis ``ɔto-paylɔt'' sistɛm kin kɔmɔt na di balans, ɛn di signal dɛn we de kɔntrol di bɔdi we de muv kin ambɔg.
Wi kin sheb di men rizin dɛm wae kin mek dis kayn tin apin to difrɛn kayn tin dɛm.
| Men tin dɛm wae kin mek yu gɛt Ogilvie Syndrome | |
|---|---|
| 1. Imejɛnsi mɛdikal kɔndishɔn ɛn ɔpreshɔn | |
| At atak | Sivεr infεkshכn dεm (e.g. nyumonia, sepsis) . |
| Kɔnjɛstiv at we nɔ de wok fayn | Ɔpreshɔn fɔ opin at |
| Injuri we kin mek pɔsin fil bad | Ɔpreshɔn fɔ di bon dɛn, lɛk fɔ chenj di hip |
| Big big ɔpreshɔn fɔ di bɛlɛ | Sizarian sɛkshɔn `(C-sekshɔn)` |
| 2. Wɛlbɔdi prɔblɛm dɛn we bin dɔn de bifo | |
| Kidni we nɔ de wok fayn | Di sik dɛm we de mek pɔsin nɔ ebul fɔ blo fayn `(Respiratory failure)` |
| Sik dεm na di nεv sεstem (e.g. Parkinson’s disease) . | Di sik we de ambɔg di at ɛn di blɔd |
| Kansa | Ilektrolayt imbalans na di bɔdi |
| 3. Sɔm mɛrɛsin dɛn | |
| Sɔm mɛrɛsin fɔ mental sik (Antipsychotics) . | Strɔng pen kil (Opioid) . |
| Di kayn stɛroyd dɛn `(Kɔtikosterɔyd)` | Spinal anestezi we dɛn kin yuz |
Yu tink se dis kin rili siriɔs? Wetin na di prɔblɛm dɛn we kin apin?
Yɛs, if dɛn nɔ no bɔt dis ɛn trit am fayn, i kin mek i gɛt prɔblɛm dɛn we rili siriɔs ɛn ivin we kin mek pɔsin in layf de pan denja . Imajin, wetin go apin if yu kɔntinyu fɔ blo briz insay balyɔn? I kin bɔs. Di intestines na di sem we.
di nכmal dayamita fכ di kכlon na lεk 8 sεntimita. Bɔt pan Ogilvie Syndrome, if i big pas 12 sɛntimita, di risk fɔ gɛt prɔblɛm dɛn kin bɔku.
Di men prɔblɛm dɛn we kin apin na:
- Ischemia: We di intestinal wɔl dɛn strɛch pasmak, dat kin mek di dilik blɔd vesel dɛn we de gi blɔd to dɛn kin kɔnstrikt, ɛn dis kin mek di blɔd nɔ gɛt bɛtɛ blɔd . dis kin mek di intestכn inflameshn (ischemic colitis), we if dεn nכ trit am, i kin mek di tisu dεm day (necrosis).
- Pɔrfɔreshɔn: We di tisu day, di intestinal wɔl kin wik ɛn smɔl ol kin fɔm . Dis kin rili denja bikɔs di jem ɛn dɔti tin dɛn we de kɔmɔt na di intestinal kin lik insay di bɛlɛ, we kin mek i gɛt siriɔs infɛkshɔn (peritonitis).
- Sepsis: Na infεkshכn we dεn spre to di bכdi nכ de stכp de. I kin go insay di blɔd ɛn i kin skata ɔlsay na di bɔdi.Dis na sik we de mek pɔsin in layf de pan denja ɛn i nid fɔ gɛt mɛrɛsin kwik kwik wan. I kin ivin mek di ɔgan dɛn nɔ wok, wan bay wan.
If dɛn kɔmplikeshɔn ya apin, na tin we rili impɔtant ɛn siriɔs. So, i rili impɔtant fɔ no di sayn dɛm ɛn go to dɔktɔ kwik kwik wan. If yu gɛt ɛni wan pan dɛn sik ya, mɔ if yu de gɛt tritmɛnt na ɔspitul, tɛl yu dɔktɔ ɔ nɔs wantɛm wantɛm.
Aw fɔ no dis sik kɔrɛkt wan?
Dɔktɔ dɛn kin bisin mɔ bɔt tu tin dɛn we dɛn de no bɔt dis sik.
1. Fɔs, wi de chɛk if rili sɔntin de we de ambɔg di bɔdi.
2. If dis kayn tin nɔ de we de ambɔg am, dɛn kin no if di tin we kin mek dɛn gɛt dɛn sik ya na Ogilvie Syndrome ɔ ɔda tin.
Dɛn de du difrɛn tɛst dɛn fɔ dis.
- X-ray ɛn CT skan: We dɛn yuz ɛkstrem rayt ɔ CT skan na di bɛlɛ, i kin sho klia wan di big intestinal, we dɔn swel ɛn ful-ɔp wit briz. sכmtεm, dεn kin gi spεshal likwid (wan `kכntrast ejen`) fכ drink כ as injεkshכn fכ gεt klia imej dεm.
- Gastrografin Enema: Dis na wan spɛshal tɛst we rili spɛshal. Na bikɔs na tɛst ɛn sɔntɛnde na tritmɛnt. na ya, dεn de put wan likwid we de sכlv insay wata we dεn kכl `gastrografin` insay di intestin tru di rεktum, εn dεn de wach di we aw i de muv along di intestin wit vidio εks-ray `(fluoroscopy)`. Dis kin no kɔrɛkt wan if sɔntin de we de ambɔg di intestin ɔ nɔ de ambɔg am. כlso, dis `gastrografin` likwid gεt laxative prכpati dεm. So, sכmtεm di ifekt we i de gi kin εp fכ stat bak di aktiviti fכ di intestin we dεn stכp.
Wetin na di tritmɛnt dɛm fɔ dis?
Di tritmɛnt dipen pan aw yu kɔlon blo ɛn if yu de pan risk fɔ gɛt kɔmplikeshɔn. Ɛnitɛm we i pɔsibul, dɔktɔ dɛn kin tray fɔ trit am wit simpul sɔpɔt tritmɛnt (`kɔnsɔvativ tritmɛnt`) pas fɔ yuz tin dɛn lɛk ɔpreshɔn.
Kɔnsɔvativ Tritmɛnt
Fɔs, dɛn kin du dis tritmɛnt we dɛn de tek tɛm wach di pɔsin in kɔndishɔn.
- Fɔ trit di ɔndalayn kɔndishɔn: If wan ɔndalayn kɔndishɔn de, lɛk infekshɔn ɔ at sik, dat na fɔ trit fɔs.
- Fɔ stɔp fɔ tek mɛrɛsin: Dɛn kin stɔp fɔ tek di mɛrɛsin dɛn we dɛn tink se de mek pɔsin gɛt Ogilvie Syndrome fɔ sɔm tɛm.
- Rɛst di bɔdi: Fɔ stɔp di it ɛn wata we yu de it wit yu mɔt kpatakpata.
- IV Saline: di bכdi in nid fכ fכm wata εn sכlt dεm de gi tru wan vein (IV fluid dεm).
- Wach ɛn chenj pozishɔn: If i pɔsibul, ɛnkɔrej di pɔsin fɔ waka rawnd smɔl ɛn chenj in pozishɔn na bed. Dis kin mek yu bɔdi de muv.
- intubeshכn: dεn de put wan tכb (`Nasogastric tube`) tru di nos insay di bεlε fכ pul di εksyכs briz εn wata. wan tכb (`Rεktal tכb`) dεn de put am bak tru di an fכ alaw di briz fכ kכmכt.
We dɛn de du dis tritmɛnt, dɔktɔ dɛn kin du ɛkstrem rayt ɛn blɔd tɛst ɔltɛm fɔ no aw di intestinal dɛn de ɛn ɛni prɔblɛm we kin apin.
Wetin fɔ du if di tritmɛnt we de sɔpɔt pɔsin nɔ wok fayn?
If di sik nɔ bɛtɛ afta lɛk 72 awa so, ɔ if di intestinal dɔn dilayt pas 12 sɛntimita, di dɔktɔ dɛn go go to di nɛks step.
- Kolonoskopik Dikompreshכn: insay dis, dεn de put wan tכb we gεt kεmεra we dεn ataya (wan `kolonoskop`) tru di an εn di briz we dεn kכlכm na di kכlon de sכk kכmכt tru di tכb. Dis kin ridyus di prɛshɔn we de na di kɔlon wantɛm wantɛm. Bɔt bikɔs dis na tin we nɔ kin izi fɔ du ɛn sɔntɛnde i kin gɛt smɔl risk fɔ mek di kɔlon pɔrfyu, dɛn kin tek tɛm du am.
- Neostigmine Injection: Dis na wan rili pawaful mכsul stimulant. Dɛn kin yuz am fɔ ɛp di mɔsul dɛn fɔ wɛl afta dɛn dɔn anestez am. We dɛn gi dis mɛrɛsin as injɛkshɔn we dɛn kin put insay di bɛlɛ (IV) to pipul dɛn we gɛt Ogilvie Syndrome, di intestinal mɔsul dɛn kin bigin fɔ wok bak, ɛn dɛn kin gɛt gud rizɔlt. Bɔt bikɔs dis mɛrɛsin kin mek di at rit sloslo, dɛn kin jɔs gi am ɔnda dɔktɔ we de na di say we dɛn de kia fɔ pipul dɛn we sik bad bad wan (ICU) .
- Ɔpreshɔn (Colectomy / Colostomy): If, pan ɔl dɛn tritmɛnt ya, di bɔdi kɔntinyu fɔ swel, ɔ if siriɔs kɔmplikeshɔn lɛk we pɔrfɔreshɔn apin, ɔpreshɔn kin bi di las tin we dɛn go du. insay dis kes, dεn kin kכt di pat we dεn dכn pwεl na di bכdi εn pul am (Colectomy). Sɔntɛnde, dɛn kin nid fɔ mek say we di bɛlɛ opin fɔ sɔm tɛm ɔ fɔ ɔltɛm fɔ mek di stɔl pas. Wi kɔl dis wan Kɔlɔstomi.
Yu tink se dis sik kin mek pɔsin in layf de pan denja?
If yu nɔ gɛt prɔblɛm, di risk fɔ day fɔ pɔsin we gɛt Ogilvie Syndrome nɔmɔ na lɛk 15%. Bɔt dis pasɛnt kin inklud bak di ifɛkt dɛn we ɔda mɛrɛsin dɛn we di pɔsin gɛt kin gɛt.
כltu, if siriכs komplikashכn lεk intestinal pεrforeshכn apin, di mכtalman rεt de hכy lεk 40%. Dis de sho aw dis sik kin siriɔs.
De tin wae impɔtant pas ɔl na fɔ pe atɛnshɔn to de sik wae de kam kwik kwik wan, no bɔt de sik kwik kwik wan, ɛn bigin fɔ trit am. If yu du dat, yu kin mek yu nɔ gɛt siriɔs prɔblɛm dɛn ɛn yu kin wɛl kwik kwik wan wit simpul tritmɛnt dɛn.
Mɛsej we dɛn kin kɛr go na os
- Ogilvie Syndrome na wan kכndyushכn we dεn kכl "pseudo-obstruction" we di intestinal fכnshכn de stכp wan wan we nכ rial obstrכkshכn na di intestinal.
- Dɛn kin si dis mɔ pan ol pipul dɛn we dɛn dɔn ɔpreshɔn ɛn we gɛt bɔku ɔda sik dɛn.
- Di men sayn dɛm na fɔ blo (ful) ɛn bɛlɛ de pen.
- If dɛn nɔ no dis sik fayn fayn wan, i kin mek yu gɛt prɔblɛm dɛn we rili denja lɛk we yu intestinal pɔrfyushɔn.
- If yu ɔ pɔsin we yu sabi, mɔ pɔsin we de gɛt tritmɛnt na ɔspitul, gɛt ɛni wan pan dɛn sik ya, i impɔtant fɔ tek dɛn siriɔs wan ɛn tɛl yu dɔktɔ wantɛm wantɛm. If pɔsin gɛt tritmɛnt kwik kwik wan, dat kin sev pɔsin in layf.
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