I intestines-a hun rei tak a awm avangin i hrehawm nasa hle mai thei. Damdawi hmang pawhin a dinhmun hi thunun harsa tak a ni mai thei. Chutiang dinhmunah chuan doctor chuan natna nei intestine lian tak chu operation hmanga lak chhuah a, taksa chhungah bawlhhlawh khawlkhawm theihna tur pouch bik siam theihna tur solution a rawn rawt thei che a ni. Chu chu ileal pouch kan tih chu a ni. Engkim hi a awlsam zawngin sawi ila.
A awlsam zawngin, ileal pouch tih hi eng nge ni?
I intestine lian (colon) leh rectum zawng zawng chu natna avanga surgery hmanga lakchhuah vek niin han ngaihtuah teh. He surgery hi ``Total Proctocolectomy'' an ti a. Chuvangin a lak chhuah hnuah chuan taksa atanga chaw ei zawh hnua lo piang bawlhhlawh (stool) te chu khawlkhawmna leh dahkhawmna tur hmun i mamawh a ni.
Chu chu surgeon-te chuan i taksa chhunga pouch te tak te siam nan nangmah ngeiin i small intestine (the ileum) tawp chu an hmang a ni. Hei hi ileal pouch an ti a .
Hei hi a thatna lian ber chu i pum pawn lama bawlhhlawh khawlkhawm tur chuan pawn lam pouch/bag i bun a ngai lo. Bowel control chu a pangngai angin i vawng reng thei bawk.
Eng damdawi lam dinhmunah nge he surgery hi tih a ngai?
Mi zawng zawng hian he surgery hi an nei vek lo. Doctor-te chuan he duhthlanna hi an ngaihtuah nasa hle a, a bik takin damdawi lam thil engemaw zat chu damdawi hmanga thunun theih loh a nih chuan. He surgery hi `(Ileal Pouch-Anal Anastomosis - IPAA)` tia koh hi a hnuaia thil awm danah hian hman a ni ber a:
- Ulcerative Colitis: Hei hi hun rei tak chhung chu intestine lianah inflammation leh swelling a thlen thin a ni. Damdawi in a thawh loh hunah hei hi duhthlan tur tha ber a ni.
- Familial Adenomatous Polyposis (FAP): Hei hi thlahtute atanga lo piang natna a ni a, chu chuan colon chhunga thil te te (polyps) za tam tak a siam a, cancer ah a chang thei a ni.
- Colorectal/Colon Cancer: A then phei chuan cancer vei an awm.
- Rectal Cancer: Cancer thenkhat tan chuan rectum chunglam atanga lo awm, a hnuai lam aiin.
Heng pouche chi hrang hrang engzat nge awm?
Ni e, heng internal pouches hi surgeon-te siam chi thum a awm a.
| Pouch chi hrang hrang | A sawifiahna awlsam tak |
|---|---|
| J-pouch a ni | Hei hi hman tam ber chi a ni . Pouch hi small intestine chu ‘J’ letter angin fold-in siam a ni. Anus nen direct-a inzawm a nih avangin normal takin i efecate thei a ni. |
| S-pouch a ni | Hei hi ‘S’ hawrawp angin siam a ni. J-pouch nen a inang hle. Anus nen pawh a inzawm bawk. |
| Kock pouch / K-pouch hmanga siam a ni | Hei hi a rare type a ni. A chi dang pahnih nei thei lote tan tih a ni. Hetah hian pouch chu pum vunah hawnna (stoma) siam nen an inzawm a ni. |
Chuti a nih chuan he surgery hi tute tan nge a inhmeh a, tu tan nge a inhmeh lo?
He surgery hi hlawhtling tur chuan i taksa peng thenkhat chu a thawk tha a ngai a ni. Tin, damdawi lam harsatna thenkhat nei tan pawh a tha lo thei bawk.
| He Surgery atana Candidate tha tak tak te | Surgery atana rawt lohte (May Not Be Eligible) . |
|---|---|
| Digestive system a la awmte chu a thawk tha hle te. | Crohn natna vei te (he natna hian pouch siam thar pawh a nghawng thei a ni). |
| Anal sphincter muscle tha tak tak nei leh an riltam control theihna nei te. | Mite chuan fecal incontinence nei tawhte . |
| Mite chu pelvic nerve-ah chhiatna nei lote. | Mi thau lutuk (Class III thau lutuk) . |
| Kum 20 leh 50 inkar tan result hi a hlawhtling hle a, mahse mi hrisel kum 50 chunglam pawhin hei hi an ti thei bawk. | Rectal cancer hniam nei te. |
Operation hnuah eng nge beisei tur?
Hei hi vawi khat surgery a ni lo. A tlangpuiin stage hnih emaw pathum emaw ah tih thin a ni . Surgery zawhah chuan kar khat vel damdawi inah i awm a ngai dawn a ni.
A tirah chuan i pum pawnah temporary pouch dah a ni ang a, chutih lai chuan pouch siam thar chu a dam leh ang. Hei hi thla thum atanga thla ruk chhung a daih thei. Tichuan, operation tlemte tih a ni ang a, chu chu lakchhuah a ni ang a, internal pouch chu hna thawk tan tir a ni ang. Hemi chhung hian medical team ten an enkawl tha hle ang che. Zawhna i neih chuan biak pawh hlau suh.
Hei hi engtiang chiahin nge a hlawhtlin? Risk a awm em?
Hei hi surgery hlawhtling tak a ni. Hlawhtlinna rate hi 95% vel a ni . Hun kal zelah i nunphung chu nasa takin a lo tha chho zel dawn a ni. Entirnan, mi pakhatin `(Ulcerative Colitis)` a vei tawh chuan a hmaa an lo neih thin angin bathroom-a kal nghal duhna chu a nei tawh lovang.
A vaiin ni khatah vawi sarih vel i bawlhhlawh paih a ngai a ni. Mahse a pawimawh ber chu a tul huna hmanhmawh ngai lova thunun theih hi a ni.
Mahse, surgery lian zawng zawng ang bawkin risk leh complication a awm.
- Pouchetis: Hei hi harsatna awm tam ber a ni. Pouch siam thara inflammation emaw infection emaw a ni.
- Harsatna dangte chu:
- Operation hnua pouch atanga leakage awm.
- Small bowel tihkhawtlai a ni.
- Thisen zam emaw thisen chhuak emaw.
- Pouch leh taksa peng dang inkara inzawmna pangngai (fistula) lo awm.
- Bowel movement tam vangin anus vel vunah a nuam lo.
Heng harsatnate hi 5% leh 10% inkar a ni. Chutiang a nih chuan operation dang emaw, permanent stoma neih emaw a ngai mai thei. Heng zawng zawng hi doctor nen sawiho a pawimawh.
Engtikah nge doctor i hmuh vat ang?
Operation hnua symptom thar emaw, danglam bik emaw i neih chuan doctor thurawn lak nghal a pawimawh hle. Heng symptoms te hi i neih chuan doctor hnenah hrilh nghal rawh.
| Symptoms fimkhur tur |
|---|
| Darkar hnih atanga darkar thum aia rei pum chhunga hring emaw, natna (cramps) emaw a awm thei. |
| Thisen chhuak. |
| (Temporary pouch a awm chuan) stoma a inthlak emaw, hliam emaw a awm. |
| Efecation harsat. |
| Leakage tam lutuk a awm. |
| Natna nasa tak a nei. |
| Nausen natna, luak chhuak, emaw, luak chhuak emaw. |
Nun pangngaia kir leh tur hian eng chen nge a la ngai ang? Ei leh in tur chu engtin nge ni ang?
Kar li atanga kar riat chhungin hna leh thiltih hrang hrangah i kir leh thei tlangpui . I dam hnuah i doctor chuan kum khat emaw kum hnih emaw danah pouchoscopy (camera te tak te, pouch chhunga en thei) a ti ang a, engkim a tha em tih a chiang ang.
When it comes to food , a tir lamah chuan i digestive system thar awm theihna turin i ei leh inah inthlak danglamna engemaw zat i siam a ngai mai thei. Thurawn la turin nutritionist rawn la a tha ber. Mahse mi tam zawk chuan a tawpah chuan an duh duh an ei thei tawh ang.
As for pregnancy , he surgery hian fa neih theihna a nghawng lo tlangpui. Mahse, nau neih laiin rectum ruhte a chhiat loh nan i doctor chuan cesarean section neih a rawt thei ang .
Take-Home Thuchah a ni
- Ileal Pouch surgery hi colon natna vei tan chuan an pum chhunga pouch awm lovin nun pangngaia an nun theihna hun tha tak a ni.
- Hei hi surgery a ni a, hlawhtlinna rate sang tak (95%) a nei a, nunphung pawh nasa takin a tisang a ni.
- Mahse, hei hi surgery lian tak a ni a, risk leh complication awm lo a ni lo. Complication awm tam ber chu pouchitis an tih hi a ni.
- Operation hnua a dam leh theih nan hun engemaw chen a ngai a, hun rei tak hriselna atan doctor nena inenkawl fo hi a pawimawh hle.
- Hemi chungchanga zawhna i neih chuan i doctor zawh hreh suh.
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