Kei te mamae anō hoki koe i te taha matau o tō puku i muri i te kai? Tērā pea he (Biliary Dyskinesia)!

I ētahi wā ka pāngia koe e te mamae nui i te taha matau o runga o tō puku i muri i te kai, inā koa he kai momona? Kei te whakapairuaki koe, kei te hiahia rānei koe ki te ruaki? He tokomaha te hunga e whakaaro ana ko ngā kōhatu o te puku te take o tēnei. Engari ehara i te mea koinei tonu te āhua. I tēnei rā ka kōrero tātou mō tētahi atu raruraru puku e puta ai ngā tohu rite, engari ehara i te mea nā ngā kōhatu i puta. He āhuatanga tēnei e kiia nei ko te Biliary Dyskinesia .

He aha te Biliary Dyskinesia? Kia mārama tātou!

Āe, me titiro tuatahi tātou ki te aha te Biliary Dyskinesia. He kupu ngāwari noa iho, he raruraru tēnei kei te mahi a tō pūkahukahu. I ētahi wā, ka pā pea ki te mahi a te sphincter, he uaua iti e whakahaere ana i te rere o te au ki roto i ngā whekau. Ko te mea e tupu ana i konei, kāore te pūkahukahu e mahi tika. Ara, ehara i te mea he kōhatu pūkahukahu e mau ana i roto i te pūkahukahu, engari he raruraru kei te mahi a te pūkahukahu.

I mōhio koe ko te mahi matua o tō tātou pūkahukahu he penapena i te au, he mea hanga e te ate, kātahi ka tukuna ki te whekau iti hei āwhina i te nakunaku kai ina kai tātou. Ina kai tātou, ka tukuna e ngā homoni mai i te whekau iti he tohu ki te pūkahukahu, me te mea, "Āe, tukuna te au inaianei." Kātahi ka whakawhāiti te pūkahukahu, ko te tikanga ka whakaiti, ka tukuna te au mā roto i ngā awa au ki te whekau iti.

I roto i te dyskinesia biliary, he raruraru kei roto i tēnei tukanga. Tērā pea he raruraru ki te tohu homoni, he raruraru rānei ki ngā io e whiwhi ana i te tohu, he ngoikore rānei i roto i ngā uaua e tika ana kia mahi i runga i te tohu. Kāore e taea e ngā tākuta te kī tonu he aha te take o tēnei, engari e mārama ana rātou kāore te pūkahukahu e tuku ana i te nui o te au.

He aha ngā mea ka pā ki te tinana nā te Biliary Dyskinesia?

Nā, he aha te mea ka tupu ina kore e taea e te pūkahukahu te whakawātea tika i tōna au? Ka kohia taua au i roto i te pūkahukahu, ka pupuhi, ka pupuhi. He rite tēnei ki te mea ka tupu ina piri te kōhatu pūkahukahu ki roto i te pūkahukahu. Ka taea e tēnei pupuhi me te kohikohinga o te au te arahi ki ngā mate, te mumura o te pūkahukahu (cholecystitis), me te mamae.

Tērā pea ka pāngia koe e te mamae i te taha matau o runga o tō puku i ētahi wā. Ka haere mai, ka haere atu. He maha ngā wā ka haere tahi tēnei mamae me te whakapairuaki, inā koa ka kōpiri te puku au i muri i te kai. Ka kiia tēnei ko te biliary colic . Hei tāpiri, kāore pea ngā whekau e whiwhi i te nui o te au, ka puta ai te pupuhi, te whakapairuaki, te ruaki, me te uaua ki te nakunaku i te kai, inā koa ka kai i ngā kai ngako.

Kua roa te whakapono ko te mamae o te ate ka puta mai i ngā kohatu o te puku (cholelithiasis). Engari kua mōhio ngā tākuta inaianei kāore i te pēnei tonu. Inaa, ko te mate e kiia nei ko te biliary dyskinesia kei te mōhiotia inaianei ko tētahi o ngā tino take o te mate puku. Ka pāngia ngā tamariki pakeke me ngā pakeke .

Ko wai te mea ka nui ake te tūponotanga ki te pāngia e te Biliary Dyskinesia?

Kua roa nei te kōrero mō ngā mate pūkahukahu mahi, inā koa i ngā whenua pēnei i te Hononga o Amerika. Kāore anō kia mārama mēnā kei te piki haere te mate, kāore rānei i te mōhiotia i nāianei. Kāore anō hoki kia mārama ko wai te hunga ka nui ake te tūponotanga ki te pāngia e tēnei mate. Heoi, e whakaarohia ana ka nui ake te mōrearea o te hunga momona me te mate huka .

E mōhio ana koe, he maha ngā pānga o te momona ki te pākia o te tinana. Ka taea e ia te whakaemi i te ngako ki roto i ō tātou whekau, ā, ka taea hoki e ia te mumura mau tonu. Ka pā ēnei mea e rua ki te nekenekehanga o te pūkahukahu. Ina noho te au i roto i te pūkahukahu ki te wāhi kotahi, ka matotoru, ka paru. Koinei te take o ngā kohatu pūkahukahu. Ko te momona tetahi o ngā take nui mō ngā kohatu pūkahukahu. Heoi, ka taea hoki te whakawhanake i ngā kohatu pūkahukahu i muri i te mate e kiia nei ko te Biliary Dyskinesia.

He aha te āhua o tēnei ngoikore o te pūkahukahu?

Ko te nuinga o te tangata ka pāngia e te mamae o te pūkahukahu i te wāhi tonu e tū ana te pūkahukahu - i te taha matau o runga o te puku, i raro noa i te rara matau. Engari ko ētahi ka pāngia i waenganui o te puku, ko ētahi i te pakihiwi matau, i te tuara rānei. Ka pā mai i ētahi wā, ā, kāore e pumau tonu. Engari ina pā mai, ka roa pea mō ngā hāora. Ka piki haere te mamae i roto i ngā meneti 20 tuatahi, kātahi ka heke haere.

Ka puta mai, ka ngaro atu ēnei mamae, ehara i te mea i ngā wā katoa. I te nuinga o te wā ka puta i muri i te kai, inā koa i muri i te kai i tētahi kai taumaha, momona. Koinei te wā e kōpiri ai te pūkahukahu, ā, me tuku te au ki roto i te whekau. He tino kino te mamae, ā, ka whakararu i ō mahi o ia rā, ka whakaara ake i a koe i te pō, ka hiahia rānei koe ki te haere ki te rūma whawhati tata. He mea noa anō hoki te whakapairuaki me te ruaki .

He aha ngā tohu o te Biliary Dyskinesia?

Ko te tangata e pāngia ana e te Biliary Dyskinesia ka pāngia pea e ēnei tohu:

• Te mamae i te taha matau o runga o te puku.
• Ka puta te mamae i ētahi wā, ka kaha rawa, kātahi ka heke.
• Te whakakī i te puku, te pupuhi.
• Whakapairuaki me te ruaki.
• Te whakahekenga taumaha koretake.

Ka kōrerohia anō hoki e ētahi atu tohu:

• Te mamae o te upoko.
• Te ngenge mau tonu, te ngenge rawa.
• Te rerenga waikawa mau tonu.
• Te koretake o te puku me/ranei (IBS - Irritable Bowel Syndrome).
• Te Manukanuka me/ranei te Pouri.

He aha ngā take o te Biliary Dyskinesia?

Ina hoki, kāore anō kia tino mōhio ngā tākuta he aha te take o ēnei mate nekehanga. I ētahi wā, ka pāngia pea ngā io motuhake, pērā i te io vagus. Engari i roto i te nuinga o ngā wā, he uaua ki te tohu tika kei hea te raruraru. I ētahi wā, ka pāngia te nekehanga o te pūkahukahu, te uaua kati rānei o te awaawa biliary e te mate pāwera whānui, te mate nekehanga puku rānei.

Me pēhea te tautuhi i te Biliary Dyskinesia?

E maha ngā taahiraa e taea ai te tātaritanga o te biliary dyskinesia. Me whakaū ngā tākuta i ēnei e whai ake nei:

1. He tohu ō tohu mō te mamae o te ate me te puku, he mamae rānei i roto i te puku?

2. Kāore he mate pūkahukahu motuhake āu, pērā i te kōhatu pūkahukahu.

3. Kāore tō pūkahukahu e whakaputa ana i te nui o te au.

4. Ka puta ō tohu ina kukū te pūkahukahu.

5. Kāore ngā rongoā e tangohia ana e koe, me ētahi atu āhuatanga rānei, e pā ki te nekehanga o te pūkahukahu.

Tirotiro tohu

Tuatahi, ka pātai atu te tākuta ki a koe mō ō tohumate, ā, ka tirohia mēnā he tohumate motuhake kei a koe e pā ana ki te mate biliary colic. Ka whakaarohia e rātou ēnei paearu:

• Ka puta te mamae i te puku o runga, i te nuinga o te wā i te taha matau.
• Ka hoki anō te mamae i ētahi wā, ā, ka roa mō te 30 meneti pea te roa.
• Ka piki haere te mamae, ka tae ki te taumata ngawari, kino rānei, kātahi ka tau.
• Te mamae kāore e marino i te ruaki, te tūtae, te huri tūnga, te tango rānei i ngā rongoā antacid.
• Kua toru marama pea te roa o te mamae e pāngia ana e ēnei āhuatanga i ia wā, i ia wā.

Te whakakorenga i ētahi atu āhuatanga hauora

I muri i te whakaū kei te tutuki ō tohu i ēnei paearu, ka ngana tō tākuta ki te whakakore i ētahi atu take noa o te mamae o te puku. Kei roto pea i tēnei:

• Ngā whakamātautau toto: Ka tirohia ngā taumata whākōkī repeure me te whākōkī ate. Mena he teitei ngā taumata whākōkī, he tohu pea tēnei kei te raru ēnei whekau, kei te pupū ake rānei te au o te ate (ina koa ko te bilirubin teitei).
• Te ine-oro o te puku: Ka tirohia te pūkahukahu me ngā awaawa au. Ka rapua ngā take hanganga pēnei i ngā kōhatu au, te matotoru o te pakitara o te pūkahukahu, te whānui rānei o ngā awaawa au.

Te tirotiro i te mahi a te pūkahukahu

Mena he noa ō whakamātautau toto me te matawai ultrasound, ko te mahi e whai ake nei ko te tirotiro i te mahi a tō pūkahukahu. Ka mahi ngā tākuta i tēnei mā te whakamahi i tētahi whakamātautau whakaahua rongoā karihi motuhake e kiia nei ko te matawai HIDA . I roto i tēnei whakamātautau, ka werohia e te tohunga hangarau he isotope radioactive (he tracer) ki roto i tō uaua. I a te tracer e haere ana i roto i tō pūkahukahu, ka pānuihia e te matawai rorohiko ka hangaia he whakaahua ki runga i te mata.

Hei tirotiro i te mahi a te pūkahukahu, ka tāpirihia e ngā tākuta tētahi atu taahiraa ki tēnei whakamātautau. Ka kiia ko te tirotiro cholecystokinin . Ko te Cholecystokinin he homoni e kī ana ki te pūkahukahu kia kuiti me te tuku i te au ki roto i ngā awa au. Ka werohia e te tohunga hangarau te cholecystokinin ki roto i tō uaua, ā, ka tangohia he raupapa whakaahua anō i te kuititanga o te pūkahukahu. Ka aroturukihia e rātou, ā, ka tangohia he inenga.

Ka pātai atu tō tākuta ki a koe mēnā kei te mamae tō pūkahukahu i kōrerotia e koe i mua ake nei ina kōpiri tō pūkahukahu. Ka inehia hoki e rātou te "ejection fraction" o tō pūkahukahu. Koinei te nui o te au ka tukuna ina kōpiri tō pūkahukahu. Mēnā he iti iho i te 40% tō ejection fraction, ā, kāore koe e tango ana i ētahi atu rongoā, i ngā maimoatanga homoni rānei e whakaroa ana i te nekehanga o tō pūkahukahu, ka tātaritatia koe he biliary dyskinesia.

Whakaarohia he "whakamātautau hauora" mō te pūkahukahu. Ka ine i te whai huatanga o te mahi a te pūkahukahu.

He tino onge te mahi a te tākuta i tētahi whakamātautau tino motuhake hei ine i te pai o te whakatuwheratanga o te sphincter o Oddi, te uaua kei te hononga i waenga i te awaawa au me te whekau, hei whakautu ki ngā tohu mai i te tinana. Ka taea anake te mahi i tēnei whakamātautau i roto i ngā pokapū motuhake. Ka whakamoea koe e te tākuta, ka whakauru i tētahi endoscope motuhake mā roto i tō waha, he rite ki te endoscopy o runga, ki te EGD rānei. Kātahi ka tukuna te endoscope ki te wāhanga tuatahi o tō whekau iti, ka ine i te whakangā o tō sphincter o Oddi.

He maha ngā wā, ka taea e ngā tākuta te tātaritanga i te ngoikore o te sphincter o Oddi i muri i te whakakorenga i ngā take katoa o ngā mate nekenekehanga biliary. I ētahi wā, ka mahia tēnei tātaritanga ina kore ngā tohu o te tūroro e pai ake ahakoa kua tangohia te pūkahukahu.

(Te Tākirikiri Piriwai) Ka pai ake rānei i a ia anō?

Kāore he taunakitanga e whakaatu ana ka pai ake te biliary dyskinesia i a ia anō. Ko te tikanga, ka kitea te biliary dyskinesia i muri i te toru marama pea o te kitenga o ngā tohu. I taua wā, kāore tetahi e hiahia ana ki te tatari kia pai ake. Mena ka pai ake i a ia anō, ehara pea i te mate mahi, engari he momo mate nekehanga rerekē i puta mai i ngā āhuatanga rangitahi.

Me pēhea te rongoā mō te Biliary Dyskinesia?

Ko te tango i te cholecystectomy te maimoatanga angitu anake mō te dyskinesia biliary. He tikanga iti noa te whakaekenga (pokanga laparoscopic). Ko te tikanga ka mahia te pokanga mā roto i ētahi tapahi iti. Ka taea e koe te hoki ki te kāinga i taua rā anō. Ka tere ake te ora o te pokanga laparoscopic, ka iti ake te kiripaka, ā, ka iti ake te mamae. Ka taea e koe te ora pai me te kore he gallbladder. Kātahi ka pupuhi tika tō ate i te au ki roto i te whekau iti.

Heoi, ki te whakatau te tākuta ko te uaua o te uaua puku te take o te mate nekehanga, ka taea te whakawhanui, te whakatuwhera rānei i te uaua mā te whakamahi i tētahi tikanga endoscopic. I te nuinga o te wā ka mahia tēnei mena ka mau tonu ngā tohu i muri i te tangohanga o te pūkahukahu. Inaa, he uaua ki te tautuhi i te ngoikore o te pūkahukahu, ā, he tino onge te mate nekehanga ka herea ki taua uaua anake. He maha ngā wā ka pāngia hoki te pūkahukahu.

He aha ngā mea ka tupu i muri i te pokanga tango i te pūkahukahu (cholecystectomy)?

E rua wiki pea te roa mō tō pūnaha nakunaku ki te taunga ki te ngaro o tō pūhā. I tēnei wā, tera pea ka uaua ki a koe te nakunaku i ngā ngako. He maha ngā tākuta e kī ana kia whakarerekēhia tō kai mō te wā poto hei karo i te korenga o te puku. Āta karohia ngā kai parai me ngā kai momona i te tuatahi. Me arotahi hoki ki ngā kai he nui te muka. Tāpirihia mārire ngā witi katoa, ngā huawhenua, me ngā pīni ki roto i tō kai. Mā tēnei ka āwhina i te aukati i te pupuhi me te hau.

Kei te pēhea te āhua i muri i te maimoatanga mō te Biliary Dyskinesia?

Mō te hunga e tutuki ana i ngā paearu katoa mō te tātaritanga, e 90% te whai huatanga o te cholecystectomy ki te rongoā i te biliary dyskinesia. Heoi, kāore e tutuki i te katoa ēnei paearu katoa. Me whakamātautau anō ēnei tāngata i mua i te pokanga, nā te mea tera pea he mate kē atu kei a rātou. Ki te kore e tino mārama te tātaritanga, kāore te tango i te gallbladder e whakapai ake i ngā tohu.

He tohu motuhake kei te mamae o te pūkahukahu. Mēnā ka taea e koe te tautuhi i te mate (Biliary Colic), ka whakapae pea koe me tō tākuta he kohatu pūkahukahu. Kāore i te hē tēnā. Engari, me pēhea mēnā kāore i kitea he kohatu pūkahukahu te take o ō tohu? Tērā pea he mate pūkahukahu mahi tōu (Biliary Dyskinesia). He tukanga te tautuhi i te Biliary Dyskinesia. Engari, ki te tika te tautuhi, he nui ake te tūponotanga ka angitu te maimoatanga.

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

Ki te pāngia koe e te mamae tonu i te taha matau o runga o tō puku i muri i te kai, inā koa i muri i te kai i ngā kai momona, me ngā tohu pēnei i te whakapairuaki me te ruaki, kaua e kīia he gastritis. He kohatu pūkahukahu pea, he mate rānei pērā i te mea i kōrerohia e tātou i tēnei rā (Biliary Dyskinesia).

Kia maumahara, ehara i te mea he rite katoa ngā mamae o te puku. Kia tino aro ki ō tohu. He mea nui kia kite i te tākuta kia kitea ai te tino take. Mā te tātaritanga tika me te maimoatanga tika, ka taea e koe te whakakore i tēnei mamae. Kaua e mataku, engari me whai i ngā tohutohu a tō tākuta.

Mā te whakawhāiti i te kai i ngā kai hinuhinu me ngā kai momona, me te pupuri i te taumaha hauora, ka āwhina i a koe ki te tiaki i a koe mai i ēnei mate. Engari, whakarongo ki tō tinana.

`Pūngāwerewere, Tākihi Piripiri, Piripiri, Mamae puku, Tātaritanga o te puku, Matawai HIDA, Nakunaku