He raruraru anō tō pēke? Me kōrero tātou mō te mate pukupuku! (Mate pukupuku)

He tangata koe kua tangohia katoatia tō kōpū me tō pūkahukahu i runga i te pokanga nā te mate hauora, ā, kua hangaia he 'pukoro ileum' hei whakakapi mōna? Mena koinā, tera pea ka pāngia koe e te mamae e pā ana ki tēnei pukoro i ētahi wā. Ko tētahi o ngā raruraru tino noa ka puta ko tā tātou e kōrero nei i tēnei rā, ko te 'Pouchitis'. Kaua e mataku ina rongo koe i tēnei. Me kōrero tātou mō ngā mea katoa me te mārama me te ngāwari.

He aha te Pouchitis? Kia mārama tātou.

Tuatahi, me titiro tātou ki te āhua o tēnei 'pukoro ileum'. Kia tangohia katoatia tō koroni me tō rectum (proctocolectomy katoa), me whai huarahi hou koe ki te tango i tō paru i roto i tō tinana. Ko tētahi otinga ko te pokanga putea ileum. Ko te mea e tupu ana i konei ko te whakamahi a ngā taote pokanga i te wāhanga whakamutunga o tō whekau iti (ileum) hei hanga i tētahi hanganga iti rite ki te putea.

Nō reira, ko tā tō whekau nui mahi i mua, arā, ko te kohikohi me te penapena paru mō te wā poto i mua i tōna wehenga atu, kua mahia inaianei e taua pēke. Arā, ko tētahi wāhanga o tō whekau iti he rite ki te whekau nui.

Ko te pouchitis te mate ina pupuhi, ina mumura rānei te putea mai i roto. He āhua rite ki te colitis (mumura o te koroni) te proctitis rānei (mumura o te rectum). He āhua noa tēnei mō te tangata he putea tōna.

Mō te nuinga o te iwi, he rangitahi noa iho tēnei (te mate pōkākā ū), engari mō ētahi tāngata he mate pumau (te mate pōkākā mau tonu) he mate hoki e puta mai ana.

He aha ngā tohu o te pouchitis?

Mena he mate pōkākā tōu, tera pea ka pāngia koe e tētahi, e ētahi rānei o ēnei tohu. He mea nui kia mōhio koe ki ēnei tohu.

He aha te take e puta ai te Pouchitis?

Kāore anō kia tino mōhiotia te tino take o tēnei, engari ko te ariā matua he kore taurite kei roto i ngā momo huakita e noho ana i roto i te pēke.

Whakaarohia, ina mahi tetahi wāhanga o tō whekau iti pērā i te whekau nui, ka puta mai ngā momo huakita hou. He 'pakanga' iti kei waenganui i ēnei huakita hou me ngā huakita tawhito. Mā tēnei huringa ka whakaaro te pūnaha ārai mate o te tinana kei reira he mate. Nō reira, hei whakautu ki tēnā, ka puta te mumura, ko te tikanga ka pupuhi te putea.

I ētahi wā, ka nui rawa te tipu o ngā huakita mate, ā, ka pā mai he mate. Ka rerekē te taurite o tēnei huakita i muri i te pokanga, ka nui ake te tūponotanga o ngā huakita kino ki te tipu.

Ētahi atu āhuatanga e whai wāhi ana ki te pouchitis pumau

Mō ētahi tāngata, ka mau tonu te mate pōkākā, kāore rānei e pai te urupare ki te rongoā. Tērā pea nā ētahi atu āhuatanga tēnei.

• Ngā āhuatanga hauora o mua (IBD): Mena i tangohia tō koroni nā te mate mumura o te puku (IBD) pērā i te Ulcerative Colitis, te mate a Crohn rānei, he nui ake te tūponotanga ki te pāngia e te pouchitis. Nā te mea ko te tikanga kotahi i puta ai taua mate ka pā ki te putea.
• Ngā huakita ātete ki ngā paturopi: Ko ētahi mate huakita, pērā i te C. difficile, he uaua ki te whakahaere ki ngā paturopi. Waihoki, ki te whakamahi tonu i ngā paturopi, ka ātete ētahi huakita ki a rātou. Ka taea hoki e tēnei te whakanui ake i te kore taurite o ngā huakita i roto i te putea.
• Ētahi atu mate urutā: I ētahi wā, ka puta te mumura o te pēke i ngā mate huaketo (cytomegalovirus) me ngā mate harore (candidiasis).
• Te ngoikore o te pūnaha ārai mate: Mena ka ngoikore te pūnaha ārai mate o tō tinana nā ētahi atu mate hauora, nā ētahi rongoā rānei, ka heke tō kaha ki te whawhai ki ngā mate.
• Te whakamahinga o ngā rongoā whakamamae mamae (NSAID): Mā te whakamahinga roa me te nui rawa o ngā rongoā whakamamae mamae pērā i te ibuprofen me te aspirin (ngā rongoā anti-inflammatory kore-steroidal - NSAID) ka kino te paparanga o roto o te putea.
• Te whakahekenga o te rere o te toto (ischemia): Ahakoa he tino onge, ka puta te mumura nā te aukati i te rere o te toto ki te putea.
• Mate PSC: Ko te `(Primary sclerosing cholangitis - PSC)` he mate e mumura ai ngā awaawa o te ate. He nui ake te mōrearea o te hunga whai mate pēnei ki te pāngia e te pouchitis.

He aha ngā raruraru ka pā mai i te pouchitis?

Kāore i te maha ngā raruraru nui e pā mai ana i te mate pōkākā rangitahi, engari ki te mau tonu te mate, ki te kore rānei e aro ki te maimoatanga, ka pā mai ētahi raruraru.

Me pēhea koe e mōhio ai mēnā he pouchitis tōu?

I muri i te whakarongo ki ō tohumate, ka whakahaerehia e tō tākuta ētahi whakamātautau hei whakaū i te āhua. Ko te whakamātautau tino nui ko te pouchoscopy (endoscopy) .

Ko te tikanga o tēnei ko te whakauru i tētahi ngongo angiangi rawa me tētahi kāmera e piri ana mā roto i tō pūwero, ā, ka tirotirohia te roto o te pēke. Kātahi ka taea e te tākuta te tirotiro mēnā he mumura, he whara rānei kei roto i te pēke. I taua wā anō, ka tangohia pea tētahi wahi kiko iti (koiora) hei tirotiro.

Hei tāpiritanga, ka taea te whakahaere i ngā whakamātautau e whai ake nei hei tirotiro i te āhua o te putea me ngā hanganga e karapoti ana:

• Pouchogram Whakarerekētanga
• `Matawai CT`
• `MRI`

He aha ngā maimoatanga mō te pouchitis?

Ko ngā kōwhiringa maimoatanga e whakawhirinaki ana ki te momo pouchitis kei a koe.

Te Maimoatanga mō te Pouchitis Whakapeka

Ko te maimoatanga tuatahi he rua wiki te roa o ngā rongoā paturopi. Mō te tini o te tangata, ka tata kore e kitea ngā tohumate e pā ana ki tēnei. Ahakoa ka pai ake ō tohumate, he mea nui kia tangohia te rongoā katoa i whakaritea e tō tākuta.

Te Maimoatanga mō te Pouchitis Whakahoki

Ki te hoki anō te mate pōkākā i muri i te maimoatanga, tera pea ka tohua e te tākuta ngā paturopi ōrite. Heoi, ki te puta ake i te toru ngā wā i te tau, ka kiia he mate mau tonu, ā, ka tīmata pea te rongoā pupuri hei ārai i te hokinga mai. Mō tēnei,

• Te hoatu i ngā paturopi mō te wā roa i ngā horopeta iti.
• Te Whakamahinga o ngā Pūmua: Ka taea e ngā pūmua, kei roto nei ngā huakita whai hua, te āwhina i te whakahoki mai i te taurite huakita i roto i te pēke.

Te rongoā mō te pouchitis kāore e aro ki ngā paturopi (CARP)

Ki te kore e āwhina ngā paturopi, i āwhina rānei i mua, ka kiia te mate ko te "Chronic antibiotic-resistant pouchitis (CARP)". I konei, ka rapu te tākuta i ētahi atu take, ā, ka whakatau i te maimoatanga e tika ana. He maha ngā kōwhiringa maimoatanga mō tēnei.

• Ngā enema kei roto ngā rongoā pēnei i te 'Mesalamine' me te 'Bismuth' rānei
• Corticosteroids, e whakaiti ana i te mumura
• Ngā rongoā ārai mate e whakahaere ana i te mahi a te pūnaha ārai mate
• Ngā rongoā hou pēnei i te 'Biologics'
• Ngā maimoatanga motuhake pēnei i te 'whakatō microbiota paru (FMT)'

Ka taea te whakahaere i te pouchitis mā te kai me te inu?

Ae, ki tētahi taumata ka taea. Ka taea e tō kai te ārai i te whanaketanga o te mate pōkākā, me te āwhina hoki ki te whakahaere i ngā tohu ina puta.

He mea nui: Ehara te kai iti-FODMAP i te mea me whai tonu koe. He mea me whai koe mō te wā poto, ina pāngia koe e ngā tohumate, i raro i te arataki a te tākuta, te tohunga kai rānei.

Ahakoa he māmā ake te oranga i muri i te pokanga putea ileum, he mea noa te manukanuka ina puta mai ngā raruraru pēnei i te pouchitis. Engari kia maumahara, he mate ka taea te rongoā tēnei e pā ana ki te tini o te tangata. Ka taea e koe te mahi tahi me tō tākuta ki te kimi i te otinga pai rawa atu māu.