He aha te fistula? Me kōrero taipitopito tātou mōna!

Kua rongo koe i te kupu "fistula"? Tērā pea kua rongo koe i tēnei kupu mai i tō tākuta, i tētahi mema rānei o te whānau. He ahua whakamataku pea te whakarongo ki tēnei kupu, engari kaua e manukanuka. I tēnei rā, ka kōrero tātou mō te tikanga o te fistula, te take i puta ai, me ngā maimoatanga e wātea ana mōna i roto i tētahi huarahi māmā, e mārama ana hoki.

He aha te fistula? Kia mārama tātou.

He whakarāpopototanga noa iho, he hononga hou te fistula i waenganui i ngā wāhanga e rua o tō tātou tinana kāore i te hono tahi tetahi ki tetahi. He rite ki tētahi kauhanga iti. Whakaarohia he kauhanga iti i waenganui i ngā whekau e rua i roto i tō tinana, i waenganui rānei i ngā uaua toto e rua, i tētahi ngongo rānei e puta mai ana i roto i tō tinana ki te mata o tō kiri. Mā roto i tēnei kauhanga, ka taea e ngā mea pēnei i te pūkahukahu, te paru, me te toto te haere ki ngā wāhi o tō tinana kāore e tika ana kia haere.

I te nuinga o te wā, he mea rerekē tēnei fistula, arā, he mate. Nō reira, me rongoā. Heoi, i ētahi wā ka hangaia e ngā tākuta ngā fistula hei rongoā. Hei tauira, ka hangaia e rātou he hononga i waenga i te uaua me te uaua hei āwhina i te maimoatanga dialysis mō ngā tūroro whatukuhu.

Ka mamae pea koe i ngā fistula, ā, ka uaua hoki te mahi i ngā mahi o ia rā. Engari ko te rongo pai, he maha ngā wā ka taea te rongoā, inā koa mā te pokanga. Mō ētahi tāngata, ina pāngia rātou e te fistula, kāore e hoki mai anō. Mō ētahi atu, ka hoki mai anō, ā, me rongoā pea rātou mō ngā marama, mō ngā tau rānei. Heoi, mā tō rōpū hauora koe e whakarato ki te rongoā me te tautoko e hiahiatia ana e koe.

Me pēhea te whanaketanga o te fistula? He aha ngā momo?

He maha ngā momo fistula. Ka whakarōpūtia ēnei i runga i te wāhi i hangaia ai. Me titiro tātou ki ngā momo matua o ngā fistula e kitea ana:

Te pūwero o te ihu

Koinei te momo fistula tino noa. He ngongo iti tēnei e puta mai ana i roto i tō nono ki te kiri e karapoti ana. He maha ngā wā ka puta mai tēnei i te mate (`(Infection)`) te mumura rānei (`(Inflammation)`) o ngā repe e karapoti ana i tō nono, ka puta ai he whēwhe (`(Parianal abscess)`). E mōhio ana pea koe, ko te hunga whai mate hauora pēnei i te `(Crohn's disease)`, he nui ake te mōrearea ki te whakawhanake i tēnei momo mate me te fistula. Ka mamae pea i te wā e noho ana, e neke ana rānei te puku, ā, ka puta mai he wai.

Te fistula Arteriovenous (AV)

E rua ngā momo oko toto i roto i tō tātou tinana, e kiia ana ko ngā uaua toto me ngā uaua toto. I te nuinga o te wā, ka haere motuhake ēnei e rua. Engari i roto i te `(AV) fistula`, ka hangaia he hononga tika i waenganui i te uaua toto me te uaua toto. Ko te take matua o tēnei ko te whara. Engari ehara i te mea he kino katoa ngā `(AV) fistula`. E ai ki te kōrero i mua ake nei, ka hangaia e ngā tākuta tēnei momo hononga hei āwhina i te hunga e pāngia ana e te ngoikore o te whatukuhu, ā, kei runga i te `(Dialysis)`.

Ngā hononga i waenga i te aorta me te whekau iti (Aortoenteric fistula)

He tino morearea tēnei, ā, ka taea te whakamomori i te ora.He momo fistula. He hononga tēnei i waenganui i te aorta, te uaua toto matua o roto i tō tātou tinana, me te whekau iti. Ka taea e tēnei te whakaputa toto nui mai i te pūnaha gastrointestinal (toto GI), ka mate pea mēnā kāore e tere te mahi pokanga ohorere. E rua ngā momo o ēnei, ko te tuatahi me te tuarua. Ka puta ngā mea tuatahi nā te ngoikore o te pakitara o te aorta (Aortic aneurysm), te mate pukupuku, te mate kohi, ngā mate pēnei i te syphilis. Ka puta ngā mea tuarua hei pānga taha tino onge o te pokanga e pā ana ki te aorta.

Te fistula e puta ana i roto i te taringa (fistula perilymphatic)

Ka puta tēnei ina puta he kōhao, he haehae rānei i roto i te kiriuhi angiangi e wehe ana i tō tātou taringa waenga i tō tātou taringa o roto. Mā tēnei ka taea te turuturu o te wai mai i te taringa o roto ki roto i te taringa waenga. Ka puta pea he panoni i te pēhanga o te taringa, ka pā ki te whakarongo me te taurite. Ko te nuinga o te tangata me pokanga hei whakatika i tēnei, engari ka ora ētahi mā te takoto i runga i te moenga.

Te pūwero tracheoesophageal (TEF)

He hononga tēnei i waenganui i tō tātou pūhā (trachea) me tō tātou korokoro (oesophagus). I te nuinga o te wā, he mate whānau tēnei, arā, ka kitea pea i te whānautanga. I te nuinga o te wā ka tātaritatia, ka rongoātia hoki e ngā tākuta i te wā e pēpi tonu ana ngā pēpi. Heoi, ka pāngia hoki ētahi pakeke e tēnei mate nā ētahi atu mate hauora, pērā i te mate pukupuku.

Te pūwero tara

Koinei te wā e puta ai he kōhao i te pakitara o te tara o te wahine. Ka taea e tēnei kōhao te hono i te tara ki tētahi okana e tata ana, pērā i te kōpū (`(Uterus)`), te pūhā (`(Bladder)`), te rectum (`(Rectum)`), te whekau nui (`(Large intest)`), te whekau iti rānei (`(Small intest)`). Ka kiia tēnei e ngā tākuta he ``Vesicovaginal fistula`` mēnā kei waenganui i te tara me te pūhā, ā, he ``Rectovaginal fistula`` mēnā kei waenganui i te tara me te rectum. Ko te fistula tara e puta ana hei raruraru i te wā whānau ka kiia hoki he ``Obstetric fistula``.

He mea nui: I ētahi wā ka hangaia e ngā tākuta he fistula hei rongoā. Hei tauira, ko te `(Mucous fistula)`. I roto i tēnei, ka honoa te whekau iti, te whekau nui rānei ki tētahi kōhao iti (`(Stoma)`) i hangaia i roto i te kiri o te puku. He mea āwhina tēnei mō te hunga kua pokangahia hei tango i tētahi wāhanga o te whekau nui (`(Colostomy)`) mō te hunga rānei kua pokangahia hei tango i tētahi wāhanga o te whekau iti (`(Ileostomy)`).

He aha te whakamahinga o te fistula mō te dialysis?

Ko te fistula dialysis he fistula "Arteriovenous - AV". Nā te mea ka hono i te uaua me te uaua. Engari, he rerekē ki ētahi atu "(AV) fistula", ehara ēnei i te mea nā ngā whara tūpono, engari nā ngā taote pokanga i hanga hei āwhina i te maimoatanga dialysis.

Ka honoa e te taote pokanga tētahi uaua toto me tētahi uaua i roto i tō ringaringa. Nā tēnei ka nui ake te rere o te toto i roto i te uaua toto i te mea noa. Kei te tere ake te rere o te toto mai i te uaua toto toto, ā, kei te pēhanga teitei ake. Nō reira, ina hurihia ētahi o ēnei toto ki roto i te uaua toto ...

Mena e hiahia ana koe ki tētahi dialysis fistula, ma tō rōpū hauora koe e whakamārama ngā painga me ngā huakore, ā, ma rātou anō hoki koe e ako ki te tiaki i te fistula i te kāinga.

He aha ngā tohu o te fistula?

He rerekē ngā tohu o te fistula i runga i te momo. Anei ētahi o ngā tohu ka pā ki a koe me ētahi momo fistula:

• Te pūwero o te ihu:
• Te mamae tonu me te pupuhi huri noa i te nono.
• Te mamae i te wā e tūtae ana.
• He rerenga mai o te pūkahukahu, te wai toto rānei mai i te kiri huri noa i te nono, he haunga kino i ētahi wā.
• Te mākūkū me te whero o te kiri huri noa i te nono.
• Te kirika.
• Te pūwero tara:
• Te turuturu o te mimi, o te paru rānei mai i te tenetene.
• He rerenga haunga kino mai i te tenetene.
• Ngā mate urutā auau o te tara, o te ara mimi rānei.
• Te mamae i te wā e moe ai.
• Te mamae me te mākūkū o te kiri huri noa i te tara.
• Te pūwero tracheoesophageal (TEF):
• Te maremare me te poto o te manawa i te wā e kai ana, e inu ana rānei.
• Ngā mate pāwera o te uma (pērā i te niumōnia).
• Mō te pēpi, ka kikorangi te tae i te wā e whāngai ana i te u.
• Te pupuhi i roto i te taringa ('Perilymphatic fistula'):
• Pōuriuri, te āhua e takahurihuri ana.
• Te ngaro o te taurite i a koe e hikoi ana.
• Te ngaronga o te rongo.
• Te rongonga i te haruru i roto i ngā taringa.
• Te pupuhi o te uaua o roto o te uaua o te uaua:
• Te mamae puku kino ohorere.
• Te ruaki toto.
• Ngā tūtae mangu, toto rānei.
• Pōuriuri, hemo (nā te toto).
• Te kirika.

Mena kei a koe tētahi, ētahi rānei o ēnei tohu, me tino toro atu ki te tākuta.

He aha ngā take o te hanganga o te fistula?

He rerekē ngā take o te hanganga o te fistula i runga i te momo. I te nuinga o te wā, ka puta te hanganga o te fistula i:

• Te mumura me/ranei te mate urutā: Koinei te tino take.
• Whara, whara rānei ki tētahi wāhanga o te tinana: Tērā pea ka puta ētahi atu aituā i te wā e pokangahia ana.
• Hei pānga taha o te pokanga ('Te uauatanga o te pokanga'): Kāore e maha ngā wā ka puta mai ngā fistula i muri i ētahi pokanga.
• Hei pānga taha o te maimoatanga: Hei tauira, te rongoā irahiko mō te mate pukupuku.
• Ngā huringa e puta ana i te whanaketanga o te pēpi i roto i te kōpū: Ko te tikanga ka puta ngā raruraru i te wā e noho tonu ana te pēpi i roto i te kōpū.

Me pēhea te tautuhi a te tākuta i te fistula?

Koinei te huarahi e tautuhia ai e ngā tākuta he fistula:

1. Kōrero ki a koe mō ō tohumate: pātai atu mō ō kare ā-roto me te roa o te wā kua pāngia koe e ēnei raruraru.

2. Whakamātautau tinana: Ka whakahaerehia he whakamātautau tinana hei tirotiro mēnā kei te kitea he fistula, mēnā rānei ka tirohia ētahi wāhanga o te tinana (me tō whakaae).

3. Ētahi atu whakamātautau: Ka mahia ngā whakamātautau hei rapu i te āhua o te mea e tupu ana i roto i te tinana.

He aha ngā whakamātautau e mahia ana?

Mā ēnei whakamātautau ka āwhina i ngā tākuta kia mārama ake ki ngā mea e tupu ana i roto i tō tinana. Ahakoa kei te whakapae koe he fistula tōu i runga i ngā tohu e whakaahuahia ana e koe, kāore ētahi fistula e kitea. Nō reira, mā ngā whakamātautau ka taea te tango pikitia o ō whekau o roto ka āwhina i te kimi i ēnei mea:

• He aha te momo fistula kei a koe?
• Kei hea tonu?
• He aha te pānga ki ngā kiko e karapoti ana?

Ko ngā whakamātautau e hiahiatia ana e koe ka whakawhirinaki ki te momo fistula kei a koe. Mā tō tākuta rātou e kōrero ki a koe. Heoi anō, ka tonoa pea koe kia mahi i ēnei whakamātautau e whai ake nei:

• Ngā whakamātautau toto, mimi rānei: Tirohia mēnā he pupuhi, he mate pāwera rānei.
• Ngā hihi-X, ngā matawai CT (ngā matawai tomography rorohiko) te MRI rānei: Tirohia ngā wāhanga rerekē o te tinana.
• Ultrasound endoscopic: Tirohia te roto o te pūnaha nakunaku.
• Sigmoidoscopy ngāwari, colonoscopy rānei: Tirohia te roto o te whekau nui.
• Cystoscopy: Tirohia te roto o te pūkahukahu me te urethra.
• Pūnaha tirotiro manawa, te Endoscopy rānei: Tirohia roto i ngā ara manawa (ko te tikanga o te endoscopy i konei ko ngā ara manawa).
• Angiogram: Hei tirotiro mō ngā aukati i roto i ngā oko toto.

He aha ngā maimoatanga mō te fistula?

Ko ngā rongoā me/ranei te pokanga te rongoā me te/ranei te pokanga hei rongoā māu. Mā tō tākuta koe e tohutohu ko tēhea te rongoā e tika ana mō tō āhuatanga.

Hei tauira, ka tohua pea e tō tākuta he rongoā hei whakaiti i te pupuhi, hei whakarerekē rānei i te mahi a te pūnaha ārai mate o tō tinana. Ka taea e ēnei rongoā te rongoā i te pūtake o te fistula. Mena he mate hohe tōu, ka hoatu pea he paturopi ki a koe. Mena kāore e mahi ngā rongoā, ki te kore rānei e ranea ngā rongoā anake, me pokanga pea koe.

Me ako tātou mō te pokanga fistula.

He tikanga te pokanga fistula e whakatika ana i te hononga rerekē i waenga i ngā wāhanga e rua o te tinana. Ka āwhina tēnei ki te whakaiti i ō tohu me te ārai i ngā raruraru a meake nei. Ka rerekē ngā taipitopito o te pokanga i runga i te momo fistula kei a koe, tōna rahi, me tōna wāhi. He tino māmā ētahi pokanga fistula, engari he uaua ētahi. Mena he fistula uaua tōu, me maha pea ngā pokanga e hiahiatia ana.

Kia maumahara, he tino rerekē te pokanga mō te fistula rectal i te pokanga mō te fistula taringa. Nō reira, mā tō rōpū hauora koe e whakamārama ki te pokanga, ngā mōrearea e pā ana, me te wā whakaora.

He aha ngā mea ka puta mēnā he fistula tōu? Ngā mea hei tumanako atu

He ngāwari noa iho te rongoā i ngā fistula, engari me toro atu koe ki te tākuta hei tīmata i te maimoatanga. Kāore e āwhina ngā rongoā kāinga, te tatari rānei kia memeha noa ngā tohu. Ki te rongo koe, ki te kite rānei i tētahi mea rerekē, toro atu ki te tākuta tonu.

Mā tō tākuta koe e kī atu ki ngā mea hei tumanako atu māu, i runga i tō āhuatanga. I ētahi wā, i muri i te maimoatanga, ka ngaro katoa te raruraru, ā, ka wareware noa koe. Engari i ētahi wā ka hoki mai anō te fistula, te mate rānei. Kātahi ka hiahia pea koe ki ētahi atu maimoatanga, ki tētahi atu pokanga rānei. He tino taumahatanga tēnei. Engari mā tō tākuta koe e āwhina i ia taahiraa o te huarahi, ā, ka whakamārama he aha i mahia ai ēnei mea.

Ka taea te ārai i te hanganga o te fistula?

Kāore he mea e taea e tātou te mahi hei ārai i te nuinga o ngā fistula kei puta. Nā ngā whara, ngā mate rānei kāore e taea e tātou te whakahaere.

Heoi, i ētahi wā ka taea e ngā tākuta te ārai i te fistula obstetric, he raruraru o te whānautanga. Ka puta pea tēnei momo fistula ina whānau wawe rawa te pēpi, ina kore rānei e tukuna he tiaki hauora ohorere (pēnei i te C-section) i te wā tika. I ngā whenua pēnei i a Sri Lanka, he onge ēnei raruraru nā te mea ka tiakina pai e ngā tākuta te whaea me te pēpi i te wā e whānau ana. Heoi, kāore ēnei whare hauora i te rite i ngā wāhi katoa o te ao. Kei te ngana ngā whakahaere pēnei i te World Health Organization (WHO) ki te ārai i te fistula obstetric mā te whakapai ake i ngā whare hauora.

Me pēhea taku tiaki i ahau anō? He mea nui anō hoki te hauora hinengaro!

He uaua te noho me te fistula, inā koa mēnā he fistula uaua tōu, kua maha ngā pokanga kua mahia, kua mau tonu rānei ō mate. He mea mārama kei te arotahi koe ki tō tinana i tēnei wā. Engari kaua e wareware ki te whakaaro ki tō hauora hinengaro hoki.

He maha ngā take e pāngia ai koe e te ahotea, e te manukanuka rānei. Tērā pea kei te whakaaro koe:

• Ka angitu rānei te maimoatanga?
• Ka hoki anō te fistula?
• He rerekē ōku kare ā-roto mō tōku tinana.
• He aha te pānga o tēnei ki aku whanaungatanga whaiaro?

He mea noa te rongo i ēnei mea, ā, he mea nui ō kare ā-roto. Engari kaua e waha i tēnei taumahatanga ko koe anake. Kōrero ki tō tākuta mō ō kare ā-roto. Tērā pea ka taea e ia te tuku i a koe ki tētahi ratonga pēnei i te kaunihera, ki ngā rōpū tautoko rānei hei tūtaki mā ētahi atu tāngata whai fistula. Ka mārama ētahi atu tāngata e pāngia ana e te mea kotahi me koe, ā, ka taea e rātou te āwhina i a koe kia anga whakamua.

He aha ngā wā pai rawa atu hei toro atu ki te tākuta?

Mena ka puta ngā tohu o te fistula, ka kite rānei koe i tētahi mea rerekē, me toro atu ki te tākuta tonu.

Mena kei te whiwhi maimoatanga koe mō te fistula, waea atu ki tō tākuta i ngā wā katoa:

• Mena ka puta he tohu hou, ka rerekē rānei ngā tohu o nāianei.
• Mena he pātai āu mō tō mahere maimoatanga.
• Mena ka puta mai ngā tohu hou i muri i te pokanga, ka hoki mai rānei ngā tohu o mua.

Ngā pātai nui hei pātai atu ki tō tākuta

Ina haere koe ki te kite i tō tākuta, he pai pea te pātai i ēnei pātai:

• He aha te momo fistula kei a au?
• He aha taku e taea ai te whakahaere i ngā tohumate i te kāinga?
• He aha ngā kōwhiringa maimoatanga kei a au?
• He aha ngā mōrearea o te pokanga?
• Kia pēhea te roa e ora ai?
• He aha te mea me mahi e au, ā, he aha hoki ngā mea kāore e tika kia mahia e au i te wā e ora ana?
• He aha te tūponotanga ka hoki anō te fistula?
• Me aha ahau hei ārai i te hanganga o ngā fistula a muri ake nei?

Kāore pea koe i rongo i te fistula i mua, engari kua whakaarohia pea e koe mai i te wā i kitea ai he fistula tōu. Ka taea e ngā fistula te whakararuraru i ō mahi o ia rā, ā, ka pā ki tō whakaaro mōu ake. Waimarie, ka taea e te maimoatanga te āwhina i a koe ki te whakahoki mai i te mana whakahaere ki ngā wāhanga o tō tinana kua ngaro i a koe te mana whakahaere. Heoi, ka roa pea te wā e ora ai. Ka taea e tō tākuta te kōrero atu ki a koe mō tēnei me te whakarato atu i ngā tautoko tāpiri e hiahiatia ana e koe.

Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)

• Ehara te fistula i te mea hei wehi, engari he mate e hiahia ana kia aro wawe atu ki te taote.
• Mena ka puta ngā tohu o te fistula, me toro atu ki te tākuta tonu.
• He maha ngā momo fistula ka taea te rongoā angitu, inā koa mā te pokanga.
• Tērā pea ka roa te tukanga maimoatanga, engari mā te manawanui me te whai i ngā tohutohu a tō tākuta, ka taea e koe te ora.
• He rite tonu te hiranga o tō hauora hinengaro ki tō hauora tinana. Kaua e mangere ki te tono āwhina mēnā e hiahia ana koe.

Ko tāku tumanako ka whai hua ēnei kōrero ki a koe. Kia ora tonu!

` fistula, fistula anal, fistula AV, fistula tara, tohu fistula, maimoatanga fistula, pokanga fistula