Kua pāngia koe e te mamae me te kore whakamarie o te puku mō ngā rā? Tērā pea kua kōrerotia e tō tākuta he mate mumura puku (IBD) tōu pērā i te mate a Crohn. Ina roa koe e pāngia ana e tēnei mate, ka tīmata te whaiti haere o ētahi wāhi o roto i ō whekau. He rite ki te paipa wai e mau ana i waenganui. Nō reira, ka kiia tēnei pokanga motuhake hei whakawhānui i ēnei wāhi whaiti ko 'Strictureplasty'. I tēnei rā, ka kōrerohia e tātou ngā mea katoa i roto i ngā kupu māmā.
He aha tonu te Strictureplasty?
He whakarāpopototanga noa iho, he pokanga te strictureplasty e whakawhanui ana i tētahi wāhi whaiti, kua āraia rānei i roto i tō whekau (e kiia ana ko te stricture). Ko te tikanga o tēnei he mumura mau tonu, e puta mai ana i ngā mate mumura o te whekau (IBD) pērā i te mate a Crohn me te Ulcerative Colitis. Ka puta he kiriuhi i ngā pakitara o te whekau nā tēnei mumura, ka matotoru, ka whaiti hoki.
Ko ēnei momo tuitui ka tino puta i roto i:
- Te wāhanga o raro o te whekau iti (ileum)
- Mō te takirere e hono ana i te whekau iti me te whekau nui (te 'takirere ileocecal').
Heoi anō, ka taea hoki tēnei āhuatanga te puta i roto i te koroni, te pūhā, me te nono. Ko te whāinga matua o tēnei pokanga he whakawhānui i te wāhanga whaiti o te whekau me te whakahoki mai i te nekehanga kai noa, me te kore e tango i tētahi wāhanga o te whekau.
He aha koe i hiahia ai ki tēnei pokanga?
Ina whaiti haere tētahi wāhanga o tō whekau pēnei, kāore e taea e te kai te neke tika ki raro. Ka puta he maha ngā tohu tino whakararuraru, tino mamae hoki.
| Tohu | He whakamārama māmā |
|---|---|
| Te mamae nui o te puku me te totitoti | Ka puta tēnei mamae nā te mea ka kōpiri ngā whekau i a rātou e ngana ana ki te tuku i te kai mā roto i te mea kua āraia. |
| Te pupuhi o te puku me te hauhautanga | Ka pupuhi te puku nā te mea kāore e taea e te kai me te hau te heke tika, ka piri ki te wāhi kotahi. |
| Whakapairuaki me te ruaki | Mena he nui te aukati, kāore pea te kai e taea te heke ki raro, engari ka piki ake anō. |
| Te kōroke | Ka uaua te tūtae nā te puhoi o te tukanga nakunaku. |
| Te ngaronga o te hiahia kai me te mate taimaha | Nā te mamae me te kore whakamarie, ka ngaro te hiahia ki te kai, ā, kāore e taea e te tinana te mimiti tika i ngā matūkai. |
| Te ngenge me te anemia | He maha ngā wā ka puta he mate pukupuku i ēnei wāhi whaiti. Ka āta toto haere ēnei mate pukupuku, ka roa te wā ka puta he anemia. Ka memeha haere tēnei āhuatanga i muri i te pokanga. |
Ko te mea nui rawa: Ki te piki haere tonu tēnei whaiti, ka taea te aukati katoa i te whekau (te aukati i te whekau). He tino morearea tēnei āhuatanga, ā, he mate pea. Nō reira, ki te puta ngā tohu, me toro atu koe ki te tākuta tonu.
Mā wai tēnei pokanga e tino tika ana, ā, mā wai hoki e kore e tika?
Ehara te pokanga strictureplasty i te mea mā te katoa. Mā tō tākuta e whakatau te whakatau pai rawa atu i runga i tō āhuatanga.
| Te hunga e tika ana mō te pokanga | Ngā wā kāore i te tūtohutia te pokanga |
|---|---|
| Mena he maha ngā whaiti i ētahi wāhi i te taha roa o te whekau. | Mena he maha ngā whaiti i roto i tētahi wāhanga poto o te whekau, me whakatata tetahi ki tetahi. |
| Mena kua tangohia te puku i mua. | Mena he whara, he mumura, he fistula, he tipu rerekē rānei kei te wāhi whaiti. |
| Mena he mate puku poto tōu. | Kei te tata te whaiti ki te wāhi i pokangahia ai i mua (anastomosis). |
| Mena he whaiti noa iho, kāore he mumura, he whara rānei i te wāhi whaiti. | Mena he puku poka tōu. |
| Mena he maha ngā tohu o te mate a Crohn kei a koe. | Mena kei te pāngia koe e te matekai nui. |
Me pēhea te whakarite i mua i te pokanga?
Nā te mea he pokanga kua whakaritea tēnei, ka whakahaerehia e tō tākuta ētahi whakamātautau i mua.
- Ngā Whakamātautau Whakaahua: Ka mahia he whakamātautau pēnei i te matawai CT, te Magnetic Resonance Enterography (MRE) rānei hei tirotiro i te wāhi e whaiti ana ngā whekau me te roa o aua whaiti.
- Ngā Whakamātautau Toto: Ka mahia ngā whakamātautau toto hei tirotiro i tō āhua kai. Mena kāore koe i te kai pai, ka hoatu pea he tāpiringa kai mā roto i tētahi uaua (`IV`) mō ētahi rā i mua i te pokanga. Mā tēnei ka tere ake tō ora i muri i te pokanga.
- Stoma (pēke Ostomy): I ētahi wā, i muri i te pokanga, me hanga he whakatuwheratanga rangitahi (`stoma`) ki te mata o te kiri o te puku kia puta ai te paru, ā, me tāpiri pea he pēke (`pēke ostomy`) ki reira kia ora rā anō te whekau. Kaua e manukanuka ki tēnei. Mena he mea tika tēnei, mā tō tākuta e whakamārama atu ki a koe i mua i te pokanga.
Me pēhea te mahi i te pokanga?
He pokanga nui te Strictureplasty e mahia ana i raro i te mate whakamoe whānui. Me noho koe ki te hōhipera mō ētahi rā. I mua i te tīmatanga o te pokanga, ka hoatu he mate whakamoe whānui ki a koe, kia kore ai koe e mamae, e maumahara rānei ki te pokanga.
I te wā o te pokanga, ka tapahia e te taote pokanga te taha whaiti o te whekau, ka tuia kia tuwhera. Whakaarohia he tapahi i tētahi ngongo kua purua kia roa, e wehe ana i ngā pito e rua o te pokanga, ka tuitui tahi. Ina whānui te whekau, ka ngāwari ake te neke o te kai mā roto. Mena he maha ō uauatanga, ka taea e koe te rongoā i ngā mea katoa i te pokanga kotahi.
He maha ngā momo Strictureplasty, i runga i te roa o te whaiti:
Heineke-Mikulicz Strictureplasty
Koinei te tikanga e whakamahia whānuitia ana. Ka mahia mō ngā whakawhāititanga poto iho i te 10 henimita (tata ki te 4 inihi).
Te Tātaritanga o Finney, Jaboulay rānei
Ka whakamahia ēnei mō ngā whakawhāiti i waenga i te 10-20 henimita (tata ki te 8 inihi) te roa. I roto i tēnei pokanga, ka whakapikohia te whekau kia rite ki te āhua 'U'.
Te Whakatōtikanga o Michelassi
He tikanga motuhake tēnei mō ngā uauatanga neke atu i te 20 henimita te roa. I roto i tēnei tikanga, ka whakapikohia te wāhanga whaiti o te whekau kia rua, ka honoa ngā taha e rua, ka tapahia he tapa roa, ā, ka tuia ngātahitia ngā mea e rua.
Kia pēhea te roa o te wā e ora ai i muri i te pokanga?
He pokanga nui tēnei, nō reira ka roa pea te wā e ora ai koe. Me noho pea koe ki te hōhipera mō te wiki pea . Mena he raruraru, me noho pea koe mō te wā roa.
- Mamae: Tērā pea ka pāngia koe e te mamae o te puku i ngā rā tuatahi i muri i te pokanga. Ka hoatu e te tākuta he rongoā whakamamae mamae ki a koe mō tēnei.
- Ngā Here: Kāore e taea e koe te mahi i ngā mea pēnei i te hiki taumaha, te taraiwa rānei mō ētahi wiki.
- Kia tūpato ki ngā mate urutā: Me tino tupato koe kei pāngia koe e te mate urutā i muri i te pokanga. Mena ka pā mai ngā tohu pēnei i te mamae nui, te kirika, te whero, te pupuhi rānei i te wāhi i pokangahia, te puta rānei o te wai rere rerekē mai i te patunga, me whakamōhio tonu atu koe ki tō tākuta .
- Kai: I runga i tō āhua, ka tūtohu pea tō tākuta, tō tohunga kai rānei i tētahi kai motuhake ('kai ngohengohe GI').
- Maimoatanga IBD: Ko te mea nui kia maumahara ko tēnei pokanga ka whānui noa iho i te whaiti. Kāore e whakaora i te IBD taketake (pērā i te mate a Crohn). Nō reira, me haere tonu koe ki te tango i ētahi atu rongoā mō tō mate.
He aha te rerekētanga i waenga i te 'Strictureplasty' me te 'Bowel Resection'?
He pātai tēnei e pātaihia ana e te tini tāngata. He rerekētanga nui kei waenganui i ēnei pokanga e rua.
| Āhuatanga | Te whakawhanuitanga o te kiri (strictureplasty) | Te Tangohanga o te Puku |
|---|---|---|
| Me aha? | Kua whānui ake te wāhanga whaiti o te whekau. | Ka tapahia te wāhanga whaiti o te whekau, ā, ka honoa ngā wāhanga e rua e toe ana. |
| Painga matua | Ka tiakina te roanga katoa o te whekau, ka whakaiti i te tūponotanga o te 'Short Bowel Syndrome' (ngā raruraru mimiti kai) . | Tērā pea ka paku whakaitihia te mōrearea o te puta anō o tētahi raruraru i te wāhi kotahi. |
| Mōrearea ā muri ake nei | He nui te tūponotanga ka hiahiatia anō te pokanga a muri ake nei. | He iti noa te tūponotanga e hiahiatia ana he pokanga anō a muri ake nei. |
He maha ngā wā ka whakamātau tuatahi ngā tākuta i te strictureplasty, nā te mea he mea tino nui te tiaki i te roa o te whekau mō te kai.
Karere Tangohia ki te Kāinga
- He pokanga te Strictureplasty hei whakawhānui i ngā wāhi whaiti o te puku nā ngā mate pēnei i te mate a Crohn. Kāore e hiahiatia he tapahi i ngā wāhanga o te puku.
- Ka taea e tēnei pokanga te whakakore i ngā tohu pēnei i te mamae o te puku me te pupuhi, me te whakaiti i te mōrearea kino o te aukati katoa o te whekau.
- Kāore tēnei pokanga e pai mō te katoa. Mā tō tākuta e whakatau te maimoatanga tino tika i runga i tō āhua.
- He pokanga nui tēnei, nō reira he roa te wā e ora ai. Tērā ētahi mōrearea pēnei i te mate urutā me te toto.
- Ka rongoā noa iho te whaiti o te uaua i tēnei pokanga. Me rongoā te mate pūtake (IBD).
- Mena he pātai āu mō tēnei, kaua e wehi ki te kōrero ki tō tākuta kia whakamāramahia ngā mea katoa.
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