Kei te kai pai koe, engari kei te whakaaro koe kāore tō tinana e whiwhi ana i ngā matūkai tika? Kei te mamae tonu tō puku, kei te kī tonu, kei te heke rānei tō taumaha, kāore he take? I tēnei rā ka kōrero tātou mō tētahi mate hauora kei muri i ēnei mea katoa, engari he tokomaha kāore e mōhio ana. Ko te ingoa o tēnei ko te EPI, arā, ko te Exocrine Pancreatic Insufficiency. Ahakoa he uaua te ahua o te ingoa, kia māmā noa iho.
He aha te EPI?
Whakaarohia kei roto i tō puku, i muri i tō puku, he okana iti e kiia nei ko te repeure . He rite ki tētahi wheketere iti i roto i tō tātou tinana. Ka hangaia e tēnei wheketere ngā matū motuhake, e kiia nei ko ngā whākōkī nakunaku, hei āwhina i a tātou ki te nakunaku i te kai e kainga ana e tātou.
He rite ngā whākōkī ki ngā kaimahi ririki e wawahi ana i te kai. Ko tā rātou mahi he wawahi i ngā matūkai o te kai e kainga ana e tātou kia iti noa iho kia taea ai e te tinana te mimiti.
Nā, koinei te mea ka pā ki te tangata whai EPI:
Kāore tō repe taiaki, te wheketere whākōkī, e mahi tika ana. Arā, kāore e nui ana ngā whākōkī (aua kaimahi) e hangaia ana hei keri i te kai. Kāore rānei e mahi tika ana ngā whākōkī e hangaia ana e ia. Ka aha rā? Kāore te kai e kainga ana e tātou e keri tika ana, kāore ngā matūkai nui kei roto e mimitihia e te tinana, ā, ka puta noa atu i te tinana.
Ki te kī ngāwari, ko te EPI he āhuatanga e kore ai e nui ngā whākōkī e whakaputaina e tō repeure hei nakunaku tika i te kai e kainga ana e koe, arā, kāore tō tinana e whiwhi i ngā matūkai e hiahiatia ana.
E toru ngā momo whākōkī matua e whakaputaina ana e tō tātou repeure:
- Amylase: Koinei te mea e nakunaku ai ngā warowaihā e kainga ana e tātou (pērā i te taro me te raihi).
- Lipase: Koinei te mea e nakunaku ai ngā ngako (hinu, pata, me ētahi atu) e kainga ana e tātou.
- Protease me te Elastase: Ka whakamahia ēnei hei nakunaku i ngā pūmua e kainga ana e tātou (pērā i te mīti, te ika, te hua manu).
I roto i te EPI, ka tino heke te whākōkī lipase, e keri ana i te ngako.
He aha i puta ai te EPI? Me titiro tātou ki ngā take.
He rerekē ngā take o te EPI mō ngā pakeke me ngā tamariki.
Ngā take o te EPI i roto i ngā pakeke
Ko te tino take o te EPI i roto i ngā pakeke ko te pancreatitis mau tonu . Ki te kī ngāwari, koinei te wā e mumura ana, e pupuhi ana hoki te repe taiaki mō te wā roa. Whakaarohia he patunga e pīrori tonu ana. I roto i te wā, ka whakangaromia haeretia ngā pūtau o te repe taiaki e hanga ana i ngā whākōkī. Tata ki te waru i roto i te tekau ngā pakeke e pāngia ana e tēnei mate ka pāngia e te EPI.
Hei tāpiritanga, he maha atu anō ngā take.
| Take | He whakamārama māmā |
|---|---|
| Mate Celiac | Te tauhohenga a te tinana ki te kuruteni i roto i te paraoa witi. |
| Mate huka | Tērā pea ka kino te repe taiaki i te mate huka roa, kāore e taea te whakahaere. |
| Te mate puku mumura (IBD) | Ngā mate mumura roa o ngā whekau, pērā i te mate a Crohn. |
| Matepukupuku Repeure | Te ngoikore o te repeure nā ngā pūtau matepukupuku. |
| Pokanga puku | Te pokanga puku, te pokanga whekau rānei, tae atu ki te pokanga whakaiti taumaha. |
Ngā take o te EPI i roto i ngā tamariki
Ko te tino take o te EPI i roto i ngā tamariki nohinohi me ngā pēpi he mate e kiia nei ko te cystic fibrosis . He mate ira tēnei e tukuna iho ana mai i ngā mātua ki ngā tamariki. Mā tēnei mate ka nui rawa te hūpē matotoru, piri o te tinana e whakaputa. Ka taea e tēnei hūpē te hanga i roto i ngā pukahukahu, ka uaua ai te manawa, ā, ka taea hoki e ia te aukati i ngā awaawa o te repeure, ka aukati i te haerenga o ngā whākōkī i hangaia e te repeure ki ngā whekau.
Ko tētahi atu āhuatanga ira e kiia nei ko te Shwachman-Diamond Syndrome (SDS) he take anō hoki o te EPI i roto i ngā tamariki.
He aha ngā tohu o te EPI?
Ko te ngako i roto i te kai te nuinga e pāngia ai te tangata whai EPI.Kāore e tika te nakunaku. He maha ngā raruraru whakararuraru, whakararuraru hoki e pā ana ki te pūnaha nakunaku.
| Ngā tohu noa | |
|---|---|
| Te mamae o te puku, te pupuhi, me te hauhautanga | Ko te kai kāore anō kia nakunaku e whakapūpū ana i roto i ngā whekau ka puta ai ēnei mamae. |
| Te kōroke | Tērā pea ka pāngia ētahi tāngata e te mate kōroke. |
| Korere | He tokomaha ngā tāngata e pāngia ana e te mate korere. |
| Ngā tūtae momona | He tohu tino motuhake tēnei o te EPI. He mā te tūtae, he hinuhinu, he mānu i roto i te wai, ā, he tino kino te haunga . |
| Te ngaronga taumaha me te kore take | Ka puta te whakahekenga taumaha nā te mea kāore te tinana e mimiti i ngā matūkai. Tērā pea ka pōturi te tipu o ngā tamariki nohinohi. |
Me pēhea te tātaritanga a te tākuta i te EPI?
Nā te mea he rite ēnei tohu ki ētahi atu mate puku, ko tō tākuta anake ka taea te kī tino mēnā kei a koe te EPI. Mēnā he mate kē atu tōu e pā ana ki te repe taiaki (pērā i te mate huka), tera pea ka whakapae tō tākuta kei a koe te EPI.
Ka taea te whakahaere i tētahi, i ētahi atu rānei o ngā whakamātautau e whai ake nei hei whakatau i te mate:
- Whakamātautau Elastase Tutae (FE-1): Ka whakamātauhia he tauira o tō tutae hei tirotiro mēnā kei a koe he whākōkī e kiia nei ko te elastase, e āwhina ana ki te keri i ngā pūmua. Mena he iti, tera pea kei a koe te EPI.
- Whakamātautau Ngako Para:Ka ine tēnei i te nui o te ngako kei roto i te tūtae. Ko te tikanga o te nui rawa o te ngako kāore e mimitia e te tinana.
- Whakamātautau Mahi Repeure o te Hukarere: He whakamātautau uaua ake tēnei. I roto i tēnei whakamātautau, ka tukuna he homoni e kīia nei ko te 'secretin' ki roto i te tinana mā roto i tētahi uaua i te ringa. Ka 'tohu' tēnei homoni ki te repeure kia whakaputa i ngā whākōkī. Kātahi ka kohia e te tākuta te wai mai i te repeure mā te whakamahi i tētahi tikanga pēnei i te endoscopy, ā, ka tirohia mēnā kei roto ngā whākōkī.
Hei tāpiritanga, ka taea te whakahaere i ngā whakamātautau pēnei i te matawai CT , te matawai ultrasound rānei hei tirotiro i ngā raruraru o te repe taiaki.
He aha ngā raruraru o te EPI?
Ko te mōrearea matua o te EPI ko te ngoikore o te mimiti kai . Ko te tikanga tēnei kāore e taea e te tinana te mimiti i ngā matū whai hua o te kai, pērā i te ngako, te pūmua, me te warowaihā. He mea nui ēnei matūkai kia whakarato pūngao ai ō tātou tinana, kia tika ai hoki te mahi a ngā whekau.
Ki te kore tonu koe e kai i tētahi kai pēnei, ka ngoikore tō tinana. Ka kiia tēnā he koretake o te kai .
| Ngā tohu o te kore kai pai | |
|---|---|
| Kiri maroke, whao pakarukaru, me te ngaro o te makawe | |
| Te pouri | |
| Te pupuhi o ngā kiko o te tinana (Edema) | |
| Te ngenge nui, te whanoke rānei | |
| Te mātao i ngā wā katoa | |
| Te koretake o te manawa, te tere o te riri | |
| He uaua ki te maumahara me te arotahi | |
| Te ngoikore o te uaua | |
He aha ngā maimoatanga mō te EPI?
He mate mō te wā roa te EPI. Ko te tikanga, kāore e taea te whakaora katoa. Heoi, mā te maimoatanga tika, ka taea te whakahaere pai, ā, ka taea e koe te noho noa i te ao. Ko te whāinga matua o te maimoatanga he whakarato i ngā matūkai e hiahiatia ana e tō tinana.
- Te Whakaora Whakakapinga Whākōkī Repeure (PERT): Koinei te maimoatanga matua. He māmā noa iho, he pire (kāpū) e hoatu ana ki a koe ngā whākōkī kāore e hangaia e tō tinana. Ka tangohia e koe tēnei pire i ia kai me ia kai . Ka āwhina ngā whākōkī i roto i te pire i a koe ki te nakunaku i te kai e kainga ana e koe.
- He kai nui-kaiora, he nui-ngako: He mea nui kia nui ngā kaora me te ngako e whiwhi ana i te kai. He mea tika tēnei nā te mea ka āwhina te ngako i te tinana ki te mimiti i ngā matūkai. He mea āwhina pea te rapu tohutohu mai i tētahi tohunga kai mō tēnei.
- Ngā Huaora: Kāore pea e taea e te hunga whai EPI te mimiti i ngā huaora wairewa-ngako, pērā i ngā huaora A, D, E, me K. Nō reira, ki te hiahia koe ki ēnei huaora, ka tohua e tō tākuta hei rongoā.
Ko te mea nui ko te whakahaere tika i te mate hauora matua (hei tauira, te Pancreatitis Mau tonu) i puta ai te EPI.
He ara hei ārai i tēnei āhuatanga?
Kāore e taea te ārai i ngā mate ira e hua ai te EPI (pērā i te Cystic Fibrosis). Heoi, ka taea te whakaiti i te mōrearea o te pancreatitis mau tonu, te tino take i waenga i ngā pakeke.
He tino taumaha te momi hikareti me te inu waipiro mō te repe taiaki. Ka whakanui ake ēnei i te mōrearea o te mumura o te repe taiaki (pancreatitis) me te whakawhanake i te EPI. Nō reira, he mea tino nui te karo rawa i te momi hikareti me te inu waipiro mō te hauora o te repe taiaki.
Āhea te wā e kite ai koe i tō tākuta
Mena kei a koe tētahi, ētahi rānei o ngā tohu e whai ake nei, me toro atu ki tō tākuta i te wā e taea ai.
| Rapua tonutia he tohutohu hauora: | |
|---|---|
| • Ki te tino ngenge koe, ki te pōuri rānei | |
| • Mena he hinuhinu, he haunga hoki ngā tūtae | |
| • Ki te puta mai ngā tohu o te kore kai pai (pēnei i te kiri maroke, te ngaro o te makawe) | |
| • Ki te mea kei te whakaitihia tō taumaha, kāore he take e kitea ana | |
He tino āwhina māu te pātai i ēnei pātai ina toro atu koe ki tō tākuta:
- He aha te take e pāngia ai ahau e te EPI?
- Ko tēhea maimoatanga te mea pai mōku?
- He aha ngā huringa me mahi e au ki taku kai?
- Me tango e au ngā huaora?
- He aha ngā raruraru me āwangawanga ahau?
He uaua pea te noho me te EPI, engari kia maumahara mā te maimoatanga tika me ngā huringa momo noho, ka taea e koe te ora i tētahi oranga hauora tino pai.
Karere Tangohia ki te Kāinga
- Ko te EPI he āhuatanga e kore ai e nui ngā whākōkī nakunaku e whakaputaina e te repe taiaki, ā, ka whakararu i te kaha o te tinana ki te mimiti i ngā matūkai.
- Ko te tohu matua, ko te putanga mai o ngā tūtae hinuhinu, kakara piro, me te wai.
- Ko te rongoā matua ko te PERT (Rehabilitasi Whakakapinga Whākōkī Pankreas). Me tango tēnei i ia kai.
- Kaua e warewarehia ngā tohu pēnei i te whakahekenga taumaha kāore i te whakamāramatia, te pupuhi rānei. Tirohia tonutia tō tākuta.
- Hei pupuri i te hauora o te repe taiaki, me karo rawa i te kai hikareti me te inu waipiro.
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