He maha ngā mamae o tō puku? Tērā pea he ngoikore te mimiti o te waikawa au!

Kei te pāngia hoki koe e te nekeneke pinepine o te puku, arā, te mate korere? Kei te pāngia hoki koe e te mate korere e uaua ana ki te whakamutu, he wai i ētahi wā, he maha ngā wā i te rā? He mea nui pea tēnei ki a koe. I tēnei rā, ka kōrero tātou mō tētahi āhuatanga e kiia nei ko te Bile Acid Malabsorption (BAM) . Ahakoa he ahua uaua te ingoa, me whakamārama noa iho.

He aha te ngoikore o te waikawa aporo?

He kupu ngāwari tēnei, he mate tēnei o tō tātou pūnaha nakunaku . Ina koa, he tino take tēnei o te mate korere mau tonu , arā, te mate korere tonu. Ina kore e mimiti tika ngā waikawa au i roto i ō tātou whekau e te tinana, ka kohia ki roto i ngā whekau. Kātahi ka raruraru te taurite matū i roto. Nā te nui rawa o ngā waikawa au, ka tukuna he karere ki tō tātou koroni kia whakaputahia he wai. Koia te take ka puta ai te mate korere wai. Whakaarohia he rite ki te wai e heke ana ki raro i te paipa, engari koinei te mea ka tupu ina kore e taea te whakahaere i taua wai.

He aha ngā waikawa au?

Tērā pea kei te whakaaro koe, "He aha ēnei waikawa au?" He matū te au e hangaia ana e tō tātou ate . Ina horoia e te ate ō tātou toto, ka wehea e ia ngā hua para pēnei i ngā paitini, ngā toto mate, me te cholesterol nui, ā, ka hangaia he au. Ka honoa ngā momo waikawa rerekē o tēnei au hei hanga i ngā waikawa au . Ka āwhina ēnei waikawa ki te pupuri i ngā lipid i roto i te wai au.

Ka tukuna tēnei au mai i te ate mā roto i ngā awa au ki tō tātou whekau iti hei āwhina i te nakunaku kai. I roto i te whekau iti, ka āwhina ēnei waikawa au ki te tinana ki te nakunaku i ngā ngako i roto i te kai e kainga ana e tātou, me te mimiti i aua ngako. Ina oti taua mahi, ka mimitihia anō ēnei waikawa au ki roto i tō tātou tinana, ka haere mā roto i te toto ki te ate, ā, ka whakamahia anō hei hanga au. He rite tēnei ki te tukanga hangarua .

He aha te "Malabsorption"?

Ko te tikanga o te "Malabsorption" ko te kore e taea e ō tātou whekau te mimiti tika i ngā matū e hiahiatia ana e tātou. Tērā pea nā te raruraru o ngā whekau tonu tēnei, nā te kore taurite o ngā matū rānei. Hei tauira, ina nui rawa, ina iti rawa rānei te matū o tētahi matū, kāore pea e taea e ngā whekau te mimiti tika.

Ko wai te mea tino pāngia e tēnei āhuatanga?

I ngā wā o mua, kāore i kitea te mate mimiti waikawa bile (BAM) i roto i te tini o te tangata nā te mea kāore he tikanga hei tātaritanga tika. Heoi, e whakaatu ana ngā rangahau hou ko ngā mate korere mahi (FDD)E ai ki te whakatau tata, neke atu i te 30% o te hunga whai BAM ka pāngia pea e tēnei mate. Ko ngā mate mahi he āhuatanga kāore i te mārama te pūtake, ā, kāore e ngāwari te kitea mā te tirotiro hauora. Hei tauira, he āhuatanga e kiia nei ko te (Irritable Bowel Syndrome - IBS) .

Ka kitea te BAM i roto i ngā tāngata whai mate hauora e whai ake nei:

• Te mate pukupuku iti
• Te mate a Crohn
• Te mate puku e pā ana ki te HIV
• Te mate korere tonu i muri i te mate huakita
• Te ngoikore o te repe taiaki

Waihoki, ka puta pea tēnei āhuatanga i roto i te hunga e whiwhi ana i ētahi maimoatanga hauora:

• Te tango pokanga, te whakarerekētanga rānei o te ileum, te wāhanga whakamutunga o te whekau iti.
• Te pokanga tango i te pūkahukahu (cholecystectomy) .
• Te rongoā irahiko , inā koa ki te puku me te hope.
• Te rongoā matū .
• Te whakamahinga o te Metformin, he rongoā e whakamahia ana mō te mate huka momo 2.

He aha ngā tohu o tēnei?

Ko ngā tohu e kitea whānuitia ana ko:

• Mate korere wai
• Te hiahia pinepine ki te haere ki te wharepaku
• Ngā mamae mamae i roto i te puku
• Te hiahia ohorere ki te haere ki te kaukau me te uaua ki te pupuri i te tūtae

Tērā pea ka pāngia ētahi tāngata e ēnei tohu:

• Te pupuhi o te puku
• Te hau me te mamae e pā mai ana
• Ngā tūtae momona (Steatorrhea)
• Te koretake o te kai

Ko ngā pānga mō te wā roa ka uru atu ki:

• Te maroketanga
• Ngenge rawa ahakoa te okiokinga pai
• Ānini
• Pōuriuri
• Whakapairuaki
• Ka piki te taumaha o ētahi tāngata, ka heke te taumaha o ētahi.

He maha ngā wā, tata ki te haurua o te hunga e pāngia ana e ēnei tohu ka pāngia tonutia e ngā tohu . Ko te haurua kē ka pāngia e ngā tohu i ētahi wā noa iho .

He aha te take e puta ai te mate korere waikawa au?

Ko te tohu matua o te koretake o te waikawa au ko te mate korere au (BAD) . Ka puta tēnei i te kohikohinga o ngā waikawa au i roto i tō tātou whekau nui (koroni) , ka hurihia ngā para kai hei paru. I te nuinga o te wā, 95% o ngā waikawa au i roto i tō tātou whekau iti ka mimitihia anō ki te wāhanga whakamutunga o te whekau iti, te ileum, i mua i te taenga ki te whekau nui.

Heoi, ki te kore e mimitia ngā waikawa au nui i tēnei ara, ka haere tahi me ētahi atu hua para ki roto i te whekau nui. I roto i te whekau nui, ka whakararuraru ēnei waikawa au i te arai o te whekau. Mā tēnei ka nui ake te wai e tukuna ana, ā, ka kaha ake te mahi a ngā uaua e pana ana i te tūtae ki mua. Koia te take e puta pinepine ai te korere, ā, ka puta ai ngā mamae o te puku.

He aha ngā take e heke ai te mimiti o te waikawa ate?

Ko te pātai inaianei, he aha i kohia ai ēnei waikawa au i roto i ngā whekau? Kua wehea e ngā kairangahau te BAM kia whā ngā take pea. I ētahi wā ka whakarōpūtia hoki ēnei hei tuatahi me hei tuarua .

• BAM Tuatahi: Ka puta tēnei i te nui rawa o ngā waikawa au (momo 2 me te 4) e whakaputaina ana e tō tātou ate.
• BAM Tuarua: Ka puta tēnei ina pakaru tō tātou whekau iti nā te mate, te pokanga, te rongoā irahiko rānei (momo 1 me te 3).

Momo 1 BAM: Ka puta tēnei i te raruraru i roto i te ileum, te wāhanga whakamutunga o te whekau iti. Ka kiia tēnei ko te malabsorption tūturu nā te mea ka tīmata te raruraru i te wāhanga absorption o te huringa waikawa bile. Tērā pea kei a koe te Momo 1 BAM mēnā kua tangohia te wāhanga whakamutunga o te whekau iti mā te pokanga, kua whakarerekētia, kua karohia rānei hei wāhanga o tētahi atu mate hauora. Ka taea hoki te pakaru o te ileum e ngā mate pēnei i te mate a Crohn me te radiotherapy. Mēnā he kino nui, ka ngoikore te absorption.

Momo 2 BAM: I ētahi wā ka kiia tēnei he "idiopathic". Ko te tikanga ka puta ohorere, kāore he take. Heoi, e kī ana ngā rangahau o nāianei he raruraru kei roto i te pūnaha tohu matū i waenga i ō tātou whekau me te ate. Ko tēnei pūnaha tohu te tikanga e whakahaere ana i te tohanga toto o roto. Ka kī atu ēnei tohu ki te ate āhea me hanga me te tuku atu i ngā waikawa au, ā, āhea me mutu, me mimiti anō, me hangarua anō hoki. Engari i roto i te Momo 2 BAM, kāore te karere kia "mutu" e tika ana te puta. Nō reira, ka tukuna tonutia e te ate ngā waikawa au—he nui atu i te mea ka taea e te ileum te mimiti.

Momo 3 BAM: Ka puta mai tēnei i ngā mate e pā ana ki te ileum me ētahi atu wāhanga o tō tātou pūnaha nakunaku. Hei tauira, ko ngā āhuatanga pēnei i te mate celiac , te pancreatitis mau tonu , me te tipu nui o te huakita o te puku iti (SIBO) .

Momo 4 BAM: Ka puta tēnei hei pānga taha o te tango i te rongoā mate huka metformin , e hua ai te nui rawa o te waikawa ate.

He aha ngā pānga roa o tēnei āhuatanga?

Mena he nui te koretake o te mimiti o te waikawa au, ka puta pea te ngoikore o te waikawa au i roto i te wā.Ka taea tēnei te tupu. Arā, ina nui rawa te waikawa au e tukuna ana i roto i te tūtae, ā, kāore e whakahokia anō ki te ate, kāore e ranea ngā waikawa au o te ate hei hanga au. Mena he iti iho te au i roto i te whekau iti, ka pā ki tō nakunaku me tō kai.

Ka whakaitihia te mimiti o ngā ngako me ngā huaora wairewa-ngako (A, D, E, me te K) e te korenga o ngā waikawa au i roto i te whekau iti. Ka arahi pea tēnei ki te kore kai pai me ngā raruraru motuhake e pā ana ki te korenga o ngā huaora wairewa-ngako. Hei tauira, ka pā te korenga o te huaora D ki ngā wheua, ā, ka pā te korenga o te huaora A ki te tirohanga.

Tērā pea ka pāngia te hunga whai BAM Momo 1 e te korenga o te huaora B12 . Nā te mea ka mimitihia te huaora B12 mā te ileum. I tēnei wā, ehara i te mea nā te BAM tonu te korenga, engari nā te āhuatanga e hua ai te BAM Momo 1 - arā, te korenga o te mahi a te ileum. Tērā pea ka haere tahi mai ngā tohu pēnei i te whakapairuaki, te whanoke, me te ngenge.

Mena he ngoikore tō waikawa au, ka whakaiti i te mimiti ngako, ā, ka kore e taea e koe te tahu i ngā kaora e tika ana, ka heke pea tō taumaha. Heoi, i ētahi wā, ka piki ake te taumaha nā te ngoikore o te mimiti waikawa au. Te āhua nei e pā ana tēnei ki te pākia o te tinana. Ko te BAM, arā, ngā āhuatanga e hua ai tēnei, ka pā ki te whakamahinga a tō tinana i ngā kaora me te penapena i aua kaora hei ngako.

Me pēhea te tautuhi i tēnei mate?

E taunaki ana ngā aratohu hauora o nāianei kia whakamātauria te hunga e pāngia ana e te mate korere pumau, kāore hoki he tino take, mō te korenga o te mimiti waikawa o te au. Engari kāore ēnei whakamātautau e wātea ana i ngā wāhi katoa. Ka tirohia e ētahi tākuta tēnei, ā, ka tohua he rongoā e kiia nei ko ngā kaitahuri waikawa o te au, kia kite ai mēnā ka whakaora i te mate.

He maha ngā whakamātautau ka taea te whakamahi hei tautuhi i te koretake o te waikawa bile:

• Whakamātautau SeHCAT: E kiia ana koinei te whakamātautau pai rawa atu hei tātaritanga i te BAM, engari he maha ngā whenua, tae atu ki a Sri Lanka, kāore i a rātou ngā ratonga hei mahi i tēnei. He whakamātautau whakaahua rongoā karihi tēnei. Arā, ka werohia he matū irahiko iti-horomanga ki roto i te tinana, ā, ka aroturukihia e te rorohiko te nekehanga o te matū irahiko i roto i te tinana, ka tangohia he pikitia. I roto i tēnei whakamātautau, ka horomia e koe he kāpū kei roto he waikawa au hangai e kiia nei ko te SeHCAT me tēnei matū irahiko. Ka haere tēnei kāpū ki te whekau iti, ā, ka mimitihia wawetia e ngā waikawa au i roto i tō tinana. Ka inehia e te kāmera gamma te taumata o te SeHCAT i roto i tō tinana i te rā tuatahi me muri i ngā rā e whitu. Mena he iti iho i te 85% o te SeHCAT e toe ana i muri i ngā rā e whitu, ka taea te tātaritanga he BAM tōna.

• Whakamātautau toto C4:He whakamātautau toto tēnei. Koinei te kōwhiringa pai rawa atu i muri i te whakamātautau SeHCAT. Ka ine i te taumata o te whākōkī e kiia nei ko te C4 i roto i te toto. E pā ana ngā taumata C4 ki te nui o ngā waikawa au e hangaia ana e tō ate. Mena he teitei ō taumata C4, he tohu pai tēnei kei a koe te BAM tuatahi (momo 2 me te 4). Mō te hunga whai BAM tuarua (momo 1 me te 3), ka teitei anō hoki ngā taumata C4 mena ka tīmata te ate ki te whakaputa i ngā waikawa au hei utu mō te mimiti iti. Nō reira, he whai hua tēnei whakamātautau mō te tini o te tangata. Heoi anō, ka taea hoki e ia te whakaputa hua teka mō te hunga whai mate pēnei i te cholesterol teitei me te mate ate momona kore-waipiro .

• Whakamātautau Waikawa Auē (Whakamātautau BA Auē): Ka ine tēnei i te nui o ngā waikawa auē i roto i tō tūtae. Koinei te huarahi tino tika ki te ine i te ngoikore o te mimiti o te waikawa auē. Heoi, he uaua ake te hangarau, ā, ka taea anake te mahi i ētahi pokapū hauora kua tohua. Me whakarite motuhake tēnei whakamātautau. Me whai koe i tētahi kai motuhake mō ētahi rā i mua, kātahi ka kohia he tauira tūtae mō ngā haora 48. Ka whakamātautauhia tō tūtae e ngā tohunga mō ngā waikawa auē i roto i te taiwhanga. Mena he teitei ō taumata waikawa auē, ko te tikanga he nui rawa te waikawa auē e mimitihia ana i roto i te whekau iti, ā, kei te tukuna ki roto i te whekau nui, ka puta te mate korere waikawa auē.

He aha ngā maimoatanga pai rawa atu?

Ko te rongoā tuatahi mō te koretake o te waikawa o te ate he momo rongoā e kiia nei ko ngā herenga waikawa o te ate, ko ngā herenga waikawa o te ate rānei . Ko te Cholestyramine me te colestipol ngā mea e tino tohua ana. He kōwhiringa kore raihana a Colesevelam , engari he māmā ake te whakamahi mō ētahi tāngata.

He matūriki utu pai ēnei matūriki pupuri waikawa au e herea ana ki ngā waikawa au e utu kino ana i roto i ngā whekau, e ārai ana i a rātou kia pakaru ki ngā wahi iti ake ka taea te mimiti. Mā tēnei herenga ka ārai hoki i ngā waikawa au kei pā ki te whekau nui, ā, ka puta te mate korere. Ka āwhina tēnei ki te whakaiti i ngā tohu o te BAM.

He pānga taha kei te rongoā?

Ko te tikanga, ka puta mai ēnei rongoā i roto i te paura. Me whakaranu ki te wai, kātahi ka tangohia. He uaua ki ētahi tāngata te horomi i te reka me te kakano. Ko ētahi ka pāngia e ngā tohu BAM me ngā pānga kino. Kei roto i ēnei ko te mate puku kōroke , te whakapairuaki, te pupuhi, me te hau.

Waihoki, ka taea e ngā mea e pupuri ana i te waikawa au te here ki ngā huaora wairewa-ngako i roto i te whekau iti. Ka ārai pea tēnei i te ngongo o te whekau iti i a rātou. Ko ētahi tāngata e tango ana i ngā mea e pupuri ana i te waikawa au me tango pea i ngā tāpiringa huaora. Me tango pea i roto i tētahi huarahi e kore e uru ki te pūnaha nakunaku, pērā i te werohanga .

Ka taea te whakaora katoa i tēnei mate?

Ko te āheinga o te rongoā i te ngoikore o te mimiti waikawa o te ate, kei te pūtake. Ka taea te rongoā i ētahi take, ko ētahi kāore e taea. Mena ka rongoā tikahia te pūtake, i ētahi wā ka pai ake te āhua o te BAM. I ētahi atu wā, ahakoa kāore e taea te rongoā i te take, he nui te tūponotanga ka taea te rongoā angitu i ngā tohu.

He mea nui: Kaua e mataku! Ka taea te whakahaere i te BAM. Ko te mea nui ko te whai i ngā tohutohu a tō tākuta.

He aha te mea e kino ake ai ngā tohu?

Ka whakaohokia te huringa waikawa au e te nui o te ngako i roto i tō kai. Mēnā he nui rawa te ngako i roto i te whekau iti, ka whiwhi te ate i tētahi tohu matū e kī ana kia "tukuna atu he au." Ko te tikanga o te nui ake o te au he nui ake ngā waikawa au e haere ana ki roto i te whekau nui. Koia te take e taunaki ana ngā tākuta i tētahi kai iti-ngako hei āwhina i te whakahaere i te BAM.

Āhea koe me toro atu ki te tākuta?

Ki te pāngia tonutia koe e te mate korere, kāore he take e kitea ana, pātai atu ki tō tākuta mō te koretake o te mimiti o te waikawa o te ate. He mate tēnei kāore i te tino mārama, ā, kāore anō kia tautuhia, nō reira, kāore ngā tākuta katoa e whakaaro tonu ki tēnei. Nō reira, tonoa atu ki tō tākuta kia whakamātauria koe, kia tukuna rānei koe ki tētahi tohunga e mōhio ana ki tēnei mate.

He maha ngā tāngata e whakapau ana i ngā tau ki te rapu i te tautuhi tika me te rongoā whai hua mō tā rātou mate korere kāore i te whakamāramatia. Mō te hunga he ngoikore te mimiti o te waikawa o te ate, kei te tumanakohia ka mutu aua rā. Mā te mōhio nui ake ki te mate me ngā tikanga māmā ake ki te kite, ka pai ake te tautuhi.

Ahakoa he maha ngā take o te kore mimiti o te waikawa au, he rite tonu te maimoatanga i ngā wā katoa. Tērā pea ka tohua he maimoatanga e te tākuta e whakapae ana he BAM, hei huarahi pea hei whakaū i tēnā. He maha ngā tāngata whai BAM ka taea te whakahaere angitu i ō rātou tohu mā te whakamahi i ngā rongoā aukati waikawa au me ngā whakarerekētanga kai.

Ngā mea tino nui hei maumahara (Karere hei kawe ki te kāinga)

Āe, me whakarāpopoto tātou i ngā mea i kōrerohia e tātou i tēnei rā:

• Ko te koretake o te waikawa arero (BAM) he āhuatanga ka waiho hei tino take o te mate korere mau tonu.
• Ka puta tēnei nā te mea kāore ngā waikawa au e mimiti tika ana e ngā whekau, engari ka kohia ki roto i te whekau nui, ka puta te mate korere wai.
• Ka taea tēnei e ngā āhuatanga hauora maha, ngā pokanga, me ētahi rongoā.
• Ko ētahi o ngā tohu ko te korere auau, te mamae o te puku, me te pupuhi.
• Ka taea te tautuhi i te mate mā roto i ngā whakamātautau pēnei i te whakamātautau SeHCAT, te whakamātautau toto C4, me te whakamātautau waikawa au i roto i te paru .
• Ko ngā maimoatanga matua ko ngā rongoā e kiia nei ko ngā bile acid sequestrants me te kai iti-ngako .
• I runga i te pūtake, tērā pea ka taea te whakaora katoa, kāore rānei, engari ka taea te whakahaere pai i ngā tohumate.
• Mena kei te pāngia koe e te mate korere roa, kāore he whakamārama, me rapu tohutohu hauora.Pātai atu hoki mō BAM.

Kaua e manukanuka, ki te mārama koe ki tēnei mate, ā, ki te rongoā tika koe, ka kitea hoki e koe te whakaoranga. Kia ora!

Ngā waikawa au, te korere, ngā whekau, te mimiti, te ate, ngā tohu, te maimoatanga