Yu dɔn du ɔpreshɔn fɔ pul yu gal blad? Yu stil gɛt bad bad pen wan wan tɛm na di ɔp rayt say na yu bɛlɛ? I tan lɛk di pen we yu kin gɛt we yu gɛt galston? Bɔku pipul dɛn kin tink se afta dɛn dɔn pul dɛn gal blad, dɛn bɛlɛ pen kin dɔn kpatakpata. Bɔt sɔntɛnde, di tin we kin mek wi gɛt dis pen nɔto wetin wi de tink, bɔt na ɔda tin. Na dat wi go tok abaut tide.
Fɔ tɔk am simpul wan, wetin na di Sfincter of Oddi?
Fɔ ɔndastand dis, lɛ wi fɔs luk di dijestiv prɔses na wi bɔdi. Na tin we rili kɔmpleks, we wɔndaful. Bɔku ɔgan dɛn lɛk wi liva ɛn pankrias kin wok togɛda fɔ chenj di it we wi de it to ɛnaji.
- Liva: Na dis say dɛn kin mek di kemikal we dɛn kɔl bayl. Dɛn kin kip am fɔ sɔm tɛm na di gal blad.
- Pankrias: Dis gland de mek enzym dεm we de εp fכ digεst it.
di bayl we de kכmכt na di liva εn di εnzym dεm we de kכmכt na di pankrias dεn tu fכ fכlכ tכgeda insay wi sכmכl intestin. Di smɔl mɔsul we de kɔntrol da waka de, we de wok lɛk get, dɛn kɔl am di Sfincter of Oddi .
we i wok fayn, dis mכsul we dεn kכl di Sphincter of Oddi de opin di rayt tεm, we de mek di bayl εn di εnzym dεm pas insay di sכmכl intestin. Dɔn i kin lɔk bak.
So wetin na Sfincter of Oddi Disfunction (SOD)?
Fɔ tɔk am simpul wan, Sphincter of Oddi Dysfunction na we da get we wi bin tɔk bɔt, di mɔsul we dɛn kɔl Sphincter of Oddi, nɔ de opin fayn we i fɔ opin. Wetin kin apin da tɛm de? dat bayl εn pankrεas εnzym dεm nכ kin ebul fכ go insay di sכmכl intestin εn stכk insay da tכb de. We i stɔp lɛk dis, i kin mek yu bɛlɛ pen bad bad wan, lɛk aw i kin apin we yu gɛt gal ston.
dis kכndyushכn dεn kin si am mכst pan pipul dεm we dεn dכn pul dεn gal blad (cholecystectomy). fכ dis rizin, sכmtεm dεn kin kכl am "post-cholecystectomy syndrome."
Wetin na di men kayn ɛn kategori dɛm fɔ dis sik?
Dɛn kin sheb dis kɔndishɔn to tu men kayn ɛn tri kategori. I impɔtant fɔ no dis, bikɔs di tritmɛnt de pan dis kayn.
| Tayp / Kategori | Fɔ ɛksplen am simpul wan |
|---|---|
| Tu Men Tayp dɛn | |
| Diskinɛsia we de na di biliari | dis kin apin we di bayl dakt dεm blכk, we de mek di bayl nכ fכ fכlכ insay di sכmכl intestin. |
| Pankriaytis we gɛt sik | insay dis kes, di blכk de apin na di pankrias, we de mek di pankrias inflameshn. |
| Tri Men Kategori dɛn | |
| Kategori I ɛn II | Insay dɛn tu kategori ya, dɔktɔ dɛn kin fɛn klia pruf fɔ di prɔblɛm tru tɛst. fכ egzampl, bכdi tεst dεm we nכ nכmal כ wan כltra saund skan we de sho di bayl dakt dεm we dεn dilayt כ pankrεas dakt dεm. |
| Kategori III | Dis na di kayn we we at fɔ no. Bikɔs no klia pruf nɔ de fɔ dis na di blɔd ripɔt, skan, ɛn ɔda tin dɛn.Di wangren pruf fɔ dis sik na di pɔsin in bɛlɛ pen. So, fɔ trit dis bak kin kɔmplikt smɔl. |
Wetin na di sayn dɛm fɔ dis sik?
Di men ɛn kɔmɔn sayn fɔ dis sik na bad bad bɛlɛ pen, we fiba di pen we pɔsin kin gɛt we gal ston fɔm.
- Usay di pen kɔmɔt: Bɔn pen we de bigin na di ɔp rayt say na di bɛlɛ.
- Prɛd pen: Sɔmtɛm dis pen kin fil lɛk se i de go na di rayt sholda ɔr bak.
- Tεm tεm wae yu de fil pen: De pen kin kכmכt afta lεk 30 minit to wan awa. Bɔt, i kin kam bak wan de.
Apat frɔm dis men pen, yu kin si sɔm ɔda sayn dɛm:
- Nɔs ɛn vɔmit
- Fiva
- Chills we de mek pɔsin kol
- Rɔnbɛlɛ
De impɔtant tin na dat, dɛn sayn ya nɔr kin bi di sem ɔltɛm. Sɔm dez dɛn kin kam ɛn go, ɛn ɔda dez dɛn nɔ kin ebul fɔ bia.
Wetin mek dis kin apin? Wetin na di tin dɛn we kin mek pɔsin gɛt dis sik?
No wan rizin nɔ de fɔ mek dis apin. Sɔntɛnde, di bayl dakt dɛn we gɛt skata ɔ inflamɛns kin mek di bayl nɔ flɔ. כda tεm dεm, we nכ blכk, i kin kכz fכ prכblεm wit di sphincter fכ di Oddi mכsul insεf.
Bɔt sɔm grup dɛn de wae gɛt bɔrku risk fɔ gɛt dis sik.
- Di wan dɛn we kin apin mɔ: Uman dɛn we ol bitwin 20-50 ia we dɛn dɔn ɔpreshɔn fɔ pul dɛn gal blad.
- Ɔda tin dɛn we kin mek pɔsin gɛt dis sik:
- Pipul dɛn we dɔn gɛt ɔpreshɔn fɔ lɛ dɛn nɔ gɛt bɔku bɔku bɔdi (Gastric bypass surgery).
- Pipul dɛn we kin gɛt pankrias we kin kam bak.
- Pipul dɛn we bin gɛt galston.
- Pipul dɛn we dɔn gɛt liva transplant.
- Pipul wae gɛt ɔnda-aktiv tayroyd (Hypothyroidism).
- Pipul dɛn we gɛt Irritable Bowel Syndrome (IBS).
- Pipul dɛn we de drink rɔm pasmak.
- Pipul wae de yuse sɔm kayn pen kil (especially opiate).
Yu tink se i go denja if dɛn nɔ trit am?
Dis nɔto sik we de mek pɔsin in layf de pan denja, ɛn big big prɔblɛm dɛn nɔ kin apin so ɔltɛm. Bɔt di bad bad pen we i kin gɛt kin bi big tin we kin mek yu nɔ ebul fɔ wok fayn fayn wan.
Bɔt if i kɔntinyu we dɛn nɔ gɛt tritmɛnt, dɛn tin ya nɔ kin apin so ɔltɛm:
- Chronic pancreatitis: Di damej we nɔ go ebul fɔ chenj to di pankrias we kin kam bikɔs i kɔntinyu fɔ inflamɛns.
- Jandis: Na di skin we de yɔlɔ ɛn di yay wayt we di bilirubin we na wan pat pan di bayl de gɛda na di bɔdi.
Aw di dɔktɔ kin no bɔt dis sik?
If yu gɛt dɛn sik ya, di fɔs tin we yu dɔktɔ go du na fɔ chɛk fɔ ɔda tin dɛn we kin mek yu bɛlɛ pen, bikɔs dis kayn pen kin kam frɔm bɔku ɔda tin dɛn.
Fɔ ɛgzampul, yu nid fɔ mek shɔ se nɔr siriɔs tin lɛk peptik ɔlsa sik, kɔledokolitiasis, ɔ pankrias ɔ bayl dakt kansa. I sɔprayz fɔ no se di pen we sɔm at prɔblɛm dɛn kin gɛt (lɛk angina) kin fil bak lɛk bɛlɛ pen.
Afta yu dɔn pul ɔl dɛn tin ya, yu dɔktɔ kin aks yu fɔ du dɛn tɛst ya:
- Blɔd tɛst: Chɛk fɔ si if di liva ɛn pankrias ɛnzaym lɛvɛl dɔn go ɔp.
- Di tɛst dɛn we dɛn kin du fɔ tek pikchɔ:Chek fכ eni abnכmaliti na di sphincter na di Oddi mכsul כ di dakt dεm. dis kin inklud tεst dεm lεk Abdominal Ultrasound, CT skan, Endoscopic Ultrasound (EUS), Upper Endoscopy, εn Magnetic Resonance Cholangiopancreatography (MRCP).
Speshal tɛst: ERCP wit Manɔmɛtri
Sɔntɛnde, if ɔl dɛn tɛst ya nɔ klia, di dɔktɔ kin sɛn yu to wan spɛshal tɛst we dɛn kɔl Endoscopic Retrograde Cholangiopancreatography (ERCP) wit manometry .
dis involv fכ go na di Sphincter of Oddi wit di εp fכ endoskop, insay wan rili sכmכl plastic tכb, εn mכsu di prεshכn fכ si aw da mכsul de kכntrakt εn εkspכnd fayn fayn wan.
Bɔt dis ERCP tɛst kin kam wit smɔl risk. Sɔm pipul dɛm, lɛk 15 to 30 pan 100, kin gɛt pankrias afta dis tɛst. So, dɔktɔ dɛn kin du dis afta dɛn tek tɛm tink bɔt am ɛn na if i rili nid fɔ du am.
Wetin na di tritmɛnt dɛm fɔ dis?
Di we aw dɛn de trit yu kin dipen pan aw yu sik dɛn kin tranga ɛn us kategori yu de.
1. If di pen nɔ tu bad (especially fɔ kategori III):
Di dɔktɔ go gi yu mɛrɛsin fɔ mek yu fil pen (we nɔ gɛt opioid) ɛn mɛrɛsin fɔ mek yu mɔsul rilaks.
2. If di pen rili bad (fɔ kategori I ɛn II):
If i nɔ izi fɔ kɔntrol am wit mɛrɛsin, di dɔktɔ kin sɛn yu to wan tritmɛnt we dɛn kɔl ERCP wit sphincterotomy . Dɛn kin du dis ɔnda anestezi ɔ ɔnda anestezi. Di dɔktɔ we de du di ɔpreshɔn de yuz ɛndoskɔp fɔ go na di Sphincter of Oddi, kɔt smɔl pan di mɔsul we dɔn stɔp, ɛn lus am. Na di sem tɛm, dɛn kin chɛk fɔ si if ston de na di bayl dakt dɛn.
Risk dɛm fɔ trit sfincterotomy
Dis tritmɛnt de ɛp fɔ ridyus pen pan bɔku pasɛnt dɛn we gɛt kategori I ɛn II. Bɔt na kɔmpleks we fɔ du tin bak wit sɔm prɔblɛm dɛn.
- Na lɛk 10% - 15% pan di sik pipul dɛn kin gɛt kɔmplikeshɔn lɛk pankrias.
- Pan ɔl we dis inflamɛns nɔ kin at bɔku tɛm, sɔntɛnde i kin rili bad ɛn ivin kin mek pɔsin in layf de pan denja.
- If na so i bi, yu kin gɛt fɔ de na ɔspitul fɔ lɔng tɛm fɔ gɛt tritmɛnt.
So, dɔktɔ dɛn kin jɔs yuz dis tritmɛnt if dɛn nɔ ebul fɔ kɔntrol am wit ɔda tritmɛnt dɛn.
Mɛsej we dɛn kin kɛr go na os
- If yu kɔntinyu fɔ gɛt bɛlɛ pen afta dɛn dɔn pul yu gal blad, nɔ ignore am. Fɔ tru, yu go si dɔktɔ.
- Dis pen kin bi bikɔs ɔf Sphincter of Oddi Dysfunction (SOD), we na wan sik we kin apin ivin if di gal blad nɔ de.
- Bɔku kayn dis sik de. Sɔm kin izi fɔ no bay we dɛn de tɛst, bɔt ɔda wan dɛn (espɛshali tayp III) nɔ kin izi fɔ no.
- Tritmεnt dεm de lεk pils εn ERCP wit sphincterotomy, we dεn kin du כnli if nid de. Bɔt mɛmba se dɛn we ya gɛt sɔm prɔblɛm dɛn bak.
- Tɔk to yu dɔktɔ bɔt yu sik, aw dɛn kin kam, ɛn aw yu de fil. Dis go ɛp yu fɔ pik di tritmɛnt we go fayn ɛn we nɔ bad fɔ yu.
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