Kiki ekituuka ku mubiri gwo bw’olya omulundi gumu ng’omaze okugenda nga tolina mmere? Ka tuyige ddala ku bulwadde bwa Refeeding Syndrome!

Wali weebuuzizza kiki ekituuka ku mubiri gwo ng’ogenda okumala ennaku nga tolya ate omulundi gumu n’otandika okuddamu okulya? Oluusi, bw’otandika okuliisa omubiri gwo mu bwangu, oyinza okufuna ebizibu by’otosuubira. Ekyo abasawo kye bayita "refeeding syndrome." Kino kiyinza okuwulikika ng’ekizibu, naye ka tukikuume nga kyangu.

Kino ``Obulwadde bw'okuddamu okulya'' kye ki?

Mu ngeri ennyangu, `(Refeeding Syndrome)` mbeera ya maanyi eyinza okubaawo ng'omuntu atali mu mmere nnungi azzeemu okulya . Endya embi omubiri gwo bwe gutafuna biriisa bye gwetaaga. Kale, oluvannyuma lw’okugenda nga tolina mmere okumala ebbanga eddene bwe lityo, bw’ofuna emmere mu bwangu, enkyukakyuka ennene zibaawo mu nkola z’eddagala mu mubiri gwaffe. Okusingira ddala, wayinza okubaawo obutakwatagana obunene mu bungi bw’eminnyo egimu emikulu (`(Electrolytes)`) mu mubiri. Kino kiyinza okwonoona ebitundu ebikulu ng’ebinywa byo , amawuggwe, omutima, n’obwongo .

Ani asinga okulwala obulwadde bwa ``Refeeding Syndrome''?

Kino kiyinza okutuuka ku muntu yenna abadde afunye endya embi era ng’atandise okuddamu okulya. Bw’oba ​​tofuna bimala kulya na kunywa, oyinza okuba nga tolina mmere nnungi. Ekirala, endya embi eyinza okubaawo olw’endwadde ezimu. Kubanga, olw’endwadde ng’ezo, oyinza obutasobola kulya oba omubiri gwo guyinza obutasobola kunyiga mmere gy’olya bulungi.

Abantu abalina ensonga zino wammanga ez'akabi batera okulwala ``Refeeding Syndrome``:

• Bw’oba ​​waakakendeeza ku buzito bw’omubiri gwo ebitundu ebisukka mu 10%. Okugeza bw’ozitowa kkiro 60, okufiirwa kkiro ezisukka mu 6 omulundi gumu kya bulabe.
• Bw’oba ​​omaze ennaku ezisoba mu musanvu nga tolina mmere, ng’olina situleesi mu birowoozo, ate ng’omubiri gwo guwulira nga munafu.
• Ku bantu abalina obuzibu mu kulya, gamba nga Anorexia Nervosa (obuzibu mu kulya) oba Bulimia Nervosa (obuzibu mu kulya).
• Abantu abalina endwadde eziremesa omubiri okunyiga obulungi emmere , gamba nga chronic pancreatitis oba inflammatory bowel disease.
• Ku abo abaludde nga bafuna emmere ey’omu lubuto.
• Ku balwadde ba kookolo n’abo abajjanjabwa eddagala.
• Ku abo abalina obulwadde bwa sukaali obutafugibwa (Diabetes Mellitus).
• Ku abo abanywa omwenge ekisusse okumala ebbanga.
• Ku abo abaludde nga bamira eddagala eriweweeza ku asidi oba okufulumya amazzi.

Kino ``Refeeding Syndrome'' kibaawo kitya?

Omubiri gwo bwe gutafuna biriisa bye gwetaaga, gukola enkyukakyuka ezimu okusobola okukyusaamu. Enkola omubiri gye gufuula emmere amaanyi eyitibwa metabolism.Mu kifo ky’ebirungo ebiyitibwa carbohydrates ebiva mu mmere, omubiri gutandika okwokya amasavu n’ebinywa byagwo okusobola okufuna amaanyi. Kino nakyo kikendeeza ku sipiidi y’okukyusakyusa ebiriisa mu mubiri. Omuwendo gw’amaanyi g’osaasaanya ng’owummudde (`Resting Metabolic Rate`) guyinza okukka ebitundu nga 20%.

Ekika kino eky’okukyusakyusa ebiriisa kikozesa eby’obugagga bitono. Vitamiini, ebiriisa, n'ebirungo ebiyitibwa ``electrolytes'' ebyogeddwako waggulu tebikozesebwa mu nkola eno, nga mu nkyukakyuka y'emmere eya bulijjo.

Naye, bw’otandika okuddamu okulya, ebirungo ebizimba omubiri bitandika okukyusibwakyusibwa mu ngeri eya bulijjo. Olwo omubiri ne gwetaaga omulundi gumu `(Micronutrients)` ezo okukola omulimu guno. Kiringa sitoowa bw’eggwaamu sitoowa ate amangu ago order ennene n’eyingira.Singa omubiri gwo guba n’ebiriisa bino ebitono ennyo ebiterekeddwa, awo obuzibu we butandikira.

Kiki ekituufu ekivaako `(Refeeding Syndrome)`?

Ensonga enkulu lwaki kino kibeerawo kwe butabeera na biriisa bitonotono ebimu mu mubiri gwo. Bino bikendeera ng’olina endya embi. Ebiriisa ebikulu ebizingirwa mu kino bye bino: Phosphorus, Potassium, ne Magnesium . Bw’otandika okuddamu okulya, obutoffaali bwo bwetaagibwa mangu obusannyalazo buno okukyusa emmere. Kino kireeta enkyukakyuka ennene mu bbalansi y’eddagala ly’omubiri gwo, ng’okukankana.

Zino `(Electrolytes)` mu musaayi gwo zitambuzibwa mangu nnyo mu butoffaali. Wabula olw’okuba tozimala mu mubiri gwo, emiwendo gya bino mu musaayi gyo gikendeera nnyo olw’enkyukakyuka eno. Kino kwe kukendeera kw'emiwendo gya `(Electrolyte)` mu musaayi gwo ekiyitibwa ``Deficiencies``. Olw’obuzibu buno, bbalansi y’eddagala mu mubiri etaataaganyizibwa, era ebizibu eby’enjawulo ebirabibwa mu `(Refeeding Syndrome)` bibaawo.

Bubonero ki obwa `(Refeeding Syndrome)`?

Embeera eno esobola okweyoleka mu ngeri ezitali zimu. Ekisinga okulabika kwe kubulwa phosphate. Kyokka, ebibulamu ebirala n’obutakwatagana nabyo bisobola okuvaako kino.

Obutabeera na phosphate (`(Hypophosphatemia)`) .

Obutabeera na phosphorus bwe bubonero obusinga okulabika mu ``Refeeding Syndrome.`` phosphate bweba wansi, bukosa enkola y'obutoffaali mu mubiri gwonna. Kino kiyinza okuleeta obubonero nga:

• Obunafu bw’ebinywa (nga ekitundu ky’omubiri ekigenda kizirika) .
• Okukaluubirirwa okussa.
• Okutandika okulaba ebintu mu bibiri (`Double Vision`).
• Okukaluubirirwa okumira.
• Okukonziba.
• Coma.
• Okunafuwa kw’ekinywa ky’omutima (`(Cardiomyopathy)`).

Singa obubonero buno buba bwa maanyi , ebitundu ebimu biyinza okulekera awo okukola obulamu ne buyinza okugwa mu matigga . N’olwekyo kino tekisaanye kutwalibwa ng’ekitono.

Obutabeera na magnesium (`(Hypomagnesemia)`) .

Magnesium era yeetaagibwa nnyo mu kukyusakyusa omubiri gwaffe. Magnesium bw’aba mutono, asobola okukosa buli kitundu ky’omubiri mu mubiri. Obubonero nga:

• Okuziyira n’okusiiyibwa.
• Anorexia (okubulwa okwagala okulya).
• Okukankana.
• Okusannyalala kw’ebinywa.
• Okukonziba.
• Coma.
• Okukendeera kw’omusaayi okutuuka ku mutima (Cardiac Ischemia).
• Obutabeera bulungi mu nnyimba z’omutima (`(Arrhythmia)`).

Obutabeera na potassium (`(Hypokalemia)`) .

Bw’oba ​​olina bbula lya potassium eritali ddene, oyinza obutafuna bubonero bwonna bunene. Kyokka singa obuzibu buno buba bwa maanyi, oyinza okufuna bino wammanga:

• Obunafu bw’ebinywa.
• Okuzimba ebinywa, obulumi.
• Okukoowa okuyitiridde.
• Ekyenda kikoma, ekivaako okuziyira okw’amaanyi.
• Obutabeera bulungi mu nnyimba z’omutima (`(Arrhythmia)`).
• Okulemererwa okussa.

Obutabeera na thiamine (Vitamin B1) (`Obulwadde bwa Thiamine`) .

Obutabeera na thiamine buno bweyolekera nnyo ng’emmere erimu ebirungo ebizimba omubiri (carbohydrates) ezzeemu okuyingizibwa. Kino kiyinza okuvaako obubonero obw’amaanyi obw’obusimu:

• Delirium, okutabulwa.
• Ebizibu by’okulaba.
• Okukendeera kw’ebbugumu ly’omubiri (`(Hypothermia)`).
• Ebizibu mu bbalansi n'okukwasaganya (`(Ataxia)`). "Okukaluubirirwa okutambula, ng'omuntu atamidde."
• Okubulwa okujjukira (`(Amnesia)`).
• Confabulation (okujjukira ebintu ebitabaddewo).

Obuzibu mu bbalansi y’amazzi mu mubiri

Enkyukakyuka mu nkyukakyuka mu mubiri ziyinza okukosa bbalansi ya sodium n’amazzi mu mubiri. Endya bw'eddamu, kino kiyinza okuvaako ``Fluid Overload`` oba ``Dehydration``. Kino kiyinza okuvaako embeera nga:

• Puleesa ekka (hypotension).
• Okusannyalala kw’ebinywa.
• Pulmonary edema (okukuŋŋaanyizibwa kw’amazzi mu mawuggwe).
• Okukosa enkola y’ekibumba.
• Omutima okulemererwa (`(Okulemererwa kw'omutima okuzimba)`).
• Okukonziba.

Obuzibu bwa sukaali mu musaayi

Bw’oddamu okuliisa, okuddamu okuyingiza glucose kiyinza okuvaako ssukaali okulinnya mu musaayi (hyperglycemia). Kino kiri bwe kityo kubanga:

• Okulumizibwa omutwe .
• Okulaba okutali kwa maanyi.
• Okufuka ennyo.
• Nkooye.

Otegeera otya `(Refeeding Syndrome)`?

Bw’omala okuddamu okulya, ttiimu yo ey’abasawo ejja kukebera buli kiseera obubonero bwo obukulu . Singa wabaawo ebitali bya bulijjo oba obubonero obulabika, bajja kukola ``Blood Test`` okunoonyereza. Kino kijja kubayamba okuzuula ddala obutakwatagana ki obw’enjawulo bw’olina mu mubiri gwo n’engeri gye bubaamu.

``Obulwadde bwa ``Refeeding Syndrome'' bujjanjabwa butya?

Nga tonnatandika kuddamu kulya, abasawo bo bajja kukukebera mu musaayi okukebera amasannyalaze go n’okuzuula obusobozi bwonna obubulamu. Olwo, bajja kwongera ebirungo bino ebitonotono ebiweddewo mu mmere yo ey’ebiriisa. Ekirowoozo kiri nti okusooka okujjuza ebiriisa bino ebitonotono ebiweddewo. Olwo, omubiri gwo gujja kuba gwetegese bulungi okukyusakyusa ebirungo ebiyitibwa carbohydrates.

Naye jjukira, oluusi, okukebera omusaayi okusooka tekulonda buzibu buno bwonna obwa `(Electrolyte)`. Olw`okuba omubiri tegunnatandika kuliisa, tegumanyi nti gujja kwetaaga `(Electrolyte)`s zino mu maaso. Enkyukakyuka ennene mu kukyusa `(Electrolyte)` okuva mu musaayi okudda mu butoffaali tennabaawo. Olw’ensonga eno, oluusi ebibulamu birabika ng’okuliisa kutandise.

Ttiimu yo ey’abasawo ejja kwongera okukulondoola okulaba oba olina obubonero. Bajja kukebera emiwendo gy’amasannyalaze go buli lunaku. Obulwadde bw’okuddamu okuliisa butera okubaawo mu nnaku ttaano ezisooka ng’omaze okuddamu okuliisa. Singa obubonero bubaawo, ttiimu yo ey’abasawo ejja kukendeeza ku sipiidi gy’oliisa. Zijja kukendeeza ku bungi bwa carbohydrates mu formula yo. Oyinza n’okuweebwa ebimu ku biriisa by’obuze ng’oyita mu IV.

Ngenda kuwona mangu ntya oluvannyuma lw’okujjanjabibwa?

Omusawo bw'amala okuzuula obulwadde bwa ``Refeeding Syndrome,'' basobola okubutereeza amangu. Wabula kiyinza okutwala wiiki eziwera ng’ebbula ly’ebiriisa ebitonotono mu kusooka liwona. Kino kitegeeza nti enkola y’okuddamu okuliisa mu bujjuvu etwala ekiseera.

Oyinza otya okukendeeza ku bulabe bwa `(Refeeding Syndrome)`?

Oluusi obwetaavu bw’okuddamu okuliisa tebusobola kwewalibwa. Kyokka, tusobola okukola ebintu ebimu eby’okwegendereza:

• Bw’oba ​​olina embeera emala ebbanga eddene ereeta endya embi, kikulu okugijjanjaba obulungi . Omusawo ayinza okukuwa amagezi okukozesa eddagala eriweweeza ku mmere, gamba nga vitamiini n’ebiriisa ebiyamba okufuna ebiriisa by’olina.
• Bw’oba ​​osiiba ennaku eziwera, kirungi okukikola ng’olabirirwa omusawo.
• Tokozesa bubi mwenge, ebiragalalagala, oba eddagala eriwandiikiddwa omusawo. Bw’oba ​​okozesa ekimu ku bino bulijjo, kirungi okugenda ew’omusawo akukebere mu bulambalamba n’okukeberebwa omusaayi.

Osobola okuwona `(Refeeding Syndrome)`?

Newankubadde ebizibu ebiva mu ``Refeeding Syndrome'' oluusi biyinza okutta, ebiseera ebisinga tebiba bya maanyi nnyo . Ttiimu y’abasawo bw’emala okutereeza obutakwatagana, obubonero bungi busobola okukyusibwa, ekitegeeza nti busobola okuwona.

``(Refeeding Syndrome)`` kizibu ekibaawo nga bajjanjabwa endya embi. Endya embi nayo mbeera eteeka situleesi nnyingi ku mubiri. Kiyinza okulabika ng’ekyewuunyisa gy’oli nti okuwa obujjanjabi obuyitiridde amangu ennyo kiyinza okuba eky’obulabe. Naye,Okuddamu okuliisa nkola nnyangu nnyo era nzibu. Kirungi kino okukikola ng’omusawo olabirirwa. Bw’oba ​​oddamu okuliisa ng’olabirirwa abasawo, bajja kukulondoola nnyo. Bajja kugezaako okutangira `(Refeeding Syndrome)` okubaawo, era bajja kuba beetegefu okukikola singa kibaawo.

Ebintu ebikulu by'olina okujjukira (Take-Home Message)

• Olina okwegendereza ennyo ng’otandika okuddamu okulya oluvannyuma lw’okumala akaseera nga tolina mmere nnungi.
• Nga bwe bagamba nti, "Olugendo olw'empola lwe lusinga obulungi," okuliisa kulina okukolebwa mpola mpola.
• Kisinga bulabe okuddamu okuliisa ng’omusawo olabirirwa naddala eri abo abali mu bibinja eby’akabi ennyo.
• Wuliriza omubiri gwo. Bw’oba ​​owulira ekintu kyonna ekitali kya bulijjo, tolwawo kunoonya magezi ga musawo.
• ``(Refeeding Syndrome)`` si kintu kya kutya, naye kikulu nnyo okukimanya.

Kale, nsuubira nti amawulire gano ga mugaso gy’oli. Sigala nga oli mulamu bulungi!

` Refeeding Syndrome, endya embi, electrolytes, endya, okusiiba, obubonero, obujjanjabi