Kei te mamae tō puku me te toto hoki? Tērā pea nā te mate puku puku (UC) tēnei.

He maha ngā wā ka hiahia koe ki te haere ki te wharepaku? Kei te mamae tō puku pērā i te maripi? Kua kite koe i tētahi toto iti i roto i tō tūtae? Kaua e whakakorekore i ēnei mea he mea noa. Nā te mea he tohu pea ēnei o tētahi mate e kiia nei ko te Ulcerative Colitis (UC), e hiahia ana kia arohia. Kaua e mataku, ehara i te mea morearea pērā i tō whakaaro. Me kōrero tātou mō tēnei i roto i tētahi huarahi māmā, hoahoa hoki, kia mārama ai ngā mea katoa.

He aha te tikanga o te Ulcerative Colitis (UC)?

He mate mō te wā roa te mate puku ulcerative (UC) e kore e taea te rongoā engari ka taea te whakahaere pai. Ka puta te mumura me ngā mariao iti (ngā mate puku) i roto i te arai o te whekau nui (koroni) me te pūkahukahu. I roto i ngā kupu māmā, ka mumura, ka mamae te roto o te whekau.

Ko te UC tētahi o ngā mate nui e rua o te rōpū mate e kiia nei ko te Inflammatory Bowel Disease (IBD) . Ko tētahi atu ko te mate a Crohn. Tērā pea ka pāngia te tangata whai UC e ngā tohu pēnei i te korere auau, te mamae o te puku, me te toto i roto i te tūtae.

Ko te āhua o tēnei mate, kāore e rite tonu ngā tohu i ngā wā katoa.

• Ngā mura ake: I tēnei wā, ka kaha ake ngā tohu.
• Murunga (wā o te murunga): I tēnei wā, ka taea e koe te noho noa me te kore he tohu.

Ko te whāinga matua o te maimoatanga ko te whakaiti i te kaha o te mate me te whakaroa i te whakaoranga i te mea ka taea.

He aha ngā momo matua o te UC?

Ka whakarōpūhia e ngā tākuta te UC i runga i te wāhi e puta ai te mumura i roto i tō whekau nui. I te nuinga o te wā ka tīmata tata ki te nono, ki te pūkahukahu rānei. Kātahi ka horapa puta noa i te whekau nui. Me titiro tātou ki tēnei tūtohi hei āwhina i a koe ki te mārama ake ki tēnei.

Haunga ēnei momo, ka whakarōpūtia te UC hei ngawari, hei whakaōrite, hei kino rānei i runga i te kaha o ngā tohu. Ko te momo tino kino, he tino onge, ā, ka taea te whakararu i te ora, ka kiia ko te fulminant ulcerative colitis . I roto i ēnei take, me aro tonu ki te hauora.

He aha ngā tohu o tēnei mate?

Ka piki haere pea ngā tohu o te UC i roto i te wā. I ngā wāhanga tōmua, ka pāngia pea koe e ētahi tohu ngawari. Ā muri ake nei, i te haere whakamua o te mate, ka puta ake pea ētahi atu tohu. Me titiro motuhake tātou ki ēnei.

He pānga anō kei tua atu i ngā whekau?

Āe. Mō te 25% o ngā tūroro UC, ka pā pea tēnei mumura ki ētahi atu wāhanga o te tinana, tae atu ki ngā whekau. Kātahi ka puta mai anō hoki ngā tohu e pā ana.

• Te mamae me te pupuhi o ngā hononga: Ka mamae, ka pupuhi hoki ngā hononga pēnei i ngā turi me ngā tuke.
• Ngā raruraru kanohi: Tērā pea ka puta te whero, te mumura, me te mākūkū o ngā kanohi.
• Ngā raruraru kiri: Tērā pea ka puta he puku mamae, he ira, he mariao rānei ki te kiri.

He aha i puta ai tēnei mate? He aha ngā āhuatanga mōrearea?

Ina hoki, kāore anō kia kitea te tino pūtake o te UC. Heoi, e whakapono ana ngā kairangahau he maha ngā āhuatanga i puta ai.

Ko te whakaaro matua ko te take o tēnei he pūnaha ārai mate kaha rawa . Whakaarohia pērā i tō tātou ope taua ā-motu. Ko tāna mahi he tiaki i te tinana mai i ngā whakaekenga ke pērā i ngā iroriki me ngā huaketo. Engari i ētahi wā ka hē tēnei pūnaha, ka tīmata ki te whakaeke i ō tātou ake pūtau hauora. I roto i te UC, ka whakaekea e te pūnaha ārai mate ngā pūtau i roto i te koroni. Koinei te take o tēnei mumura me te whara.

He maha ngā āhuatanga mōrearea ka whai wāhi ki tēnei āhuatanga:

• Tau: Ko te nuinga o te wā ka kitea tēnei mate i roto i ngā taiohi i waenga i te 15-30 tau te pakeke, i roto rānei i ngā kaumātua i muri i te 60 tau te pakeke.
• Ira: Mena kei roto i tō whānau te mate UC, te mate a Crohn rānei, pērā i tō whaea, tō pāpā, tō teina rānei, he nui ake tō tūponotanga ki te pāngia e taua mate.
• Ngā microbiome o te puku: Kei roto i tō tātou puku ngā miriona huakita whai hua, tae atu ki ngā huakita kino, ngā huaketo, me ngā harore. Kua kitea ko ngā huringa o te taurite o tēnei pūnaha rauropi ka whai wāhi pea ki te UC.

He aha atu ngā raruraru ka puta mai i te UC?

Ka paku piki ake te mōrearea o ētahi atu raruraru hauora nā te mate puku ulcerative, nō reira he mea nui kia noho tonu koe i raro i te tirotiro a te tākuta.

• Ko te toto toto iti: Ka taea e te toto tonu mai i ngā whekau te whakaheke i te maha o ngā toto toto whero i roto i te tinana, ka arahi atu ki te mate toto iti.
• Matepukupuku koroni: He nui ake te tūponotanga o te hunga whai UC ki te pāngia e te matepukupuku koroni i te taupori whānui. Ka whakawhirinaki tēnei tūponotanga ki te roa o tō pāngia e te UC me te wāhanga o tō koroni e pāngia ana. He mea nui kia kōrero koe ki tō tākuta mō tēnei mea, kia whiwhi hoki i ngā whakamātautau koroni auau.
• Osteoporosis: Ka taea e te mumura roa o te tinana me ētahi maimoatanga te whakangāwari i ngā wheua me te whati ngāwari.
• Ngā raruraru ate: I ētahi wā, ka pā anō hoki tēnei mumura ki te ate, ka puta he āhuatanga e kiia nei ko te primary sclerosing cholangitis .
• Ngā pānga ki te tipu o ngā tamariki: Mēnā ka pāngia te tamaiti e te UC, ka āraihia pea tōna tipu nā te mea kāore e taea e ia te mimiti tika i ngā matūkai mai i ngā whekau.

Ngā āhuatanga ohorere e hiahia ana kia aro wawe ki te hauora

Ki te puta ēnei tohu, he āhuatanga ohorere tēnei. Haere tonu ki te Tari Ohorere (ETU) o te hōhipera e tata ana.

• Te matewai: Ka matewai pea te tinana i te nui o te mate korere, ka arahi atu ki te matewai. I ngā wā tino kino , ka hoatu pea he wai IV (tote) ki te hōhipera.
• Te poka o te whekau nui: Ki te kaha te mumura, ka poka pea te pakitara o te whekau nui. He āhuatanga tino morearea tēnei.
• Te toto nui rawa: Ki te nui rawa tō toto kāore e taea te whakahaere, me whai whakawhiti toto pea koe.
• Te megacolon paitini: He raruraru tino kino, he onge hoki tēnei. I tēnei wā, ka pupuhi te whekau nui, ka mutu te mahi, ā, ka tīmata te mimiti i ngā paitini mai i roto ki te tinana.
• Ngā toto totoka: Ka whakanui ake te UC i te mōrearea o te hanga toto totoka i roto i ngā oko toto o te tinana.

Me pēhea te tautuhi i tēnei mate?

I muri i te whakarongo ki ō tohu, ka whakaritea e te tākuta ētahi whakamātautau hei whakaū i tēnei mate.

• Ngā whakamātautau toto: Tirohia mēnā he anemia (he iti te tatau toto) he tohu rānei o te mumura.
• Ngā whakamātautau tūtae: Tirohia mēnā he toto, he iroriki, he pirinoa rānei kei roto i te tūtae.
• Ngā whakamātautau whakaahua: Mā ngā whakamātautau pēnei i te hihi-X, te matawai CT, te MRI rānei ka taea te whakaatu i te āhua o te whekau.
• Whakamātautau endoscopic: Koinei te huarahi tino tika ki te tautuhi i te UC. Ka whakauruhia he ngongo angiangi, ngāwari me te kāmera (endoscope) mā te nono, ā, ka tirohia te roto o te whekau nui i runga i te mata. Ka kiia tēnei whakamātautau he colonoscopy , he sigmoidoscopy rānei. I tēnei wā, ka tangohia he wahi iti o te kiko mai i te koroni hei tirotiro. Ka kiia tēnei he biopsy .

Me pēhea te rongoā?

E rua ngā whāinga matua o te maimoatanga. Ko tētahi he whakahaere i ngā tohu i te wā e puta ake ana te mate, me te whakaora i te mate. Ko te tuarua he pupuri i te whakaora mō te roa e taea ai. Ko te nuinga o tēnei ka mahia mā te whakamahi i ngā rongoā me te pokanga.

Ngā rongoā

He maha ngā momo rongoā ka taea te whakaiti i te mumura i roto i ngā whekau.

• Aminosalicylates: He momo rongoā e whakamahia whānuitia ana mō te UC ngawari ki te ngoikore. Tauira: sulfasalazine, mesalamine .
• Ngā corticosteroids:He rongoā kaha ēnei hei ārai i te mumura. Ka hoatu noa mō te wā poto i te wā e pāngia ana e te mate pukupuku. Nā te mea he nui ake ngā pānga taha o te whakamahinga mō te wā roa. Hei tauira: prednisone, budesonide .
• Ngā rongoā ārai mate: Ngā rongoā hei whakahaere i te kaha rawa o te pūnaha ārai mate. Hei tauira: azathioprine, methotrexate .
• Ngā rongoā koiora: He rongoā hou ake ēnei, he rongoā arotahi e aro ana ki ngā wāhanga motuhake o te pūnaha ārai mate e puta ai te mumura. Hei tauira: infliximab (Remicade®), adalimumab (Humira®) .
• Ngā aukati JAK: He momo rongoā hou anō hoki ēnei e aukati ana i te tukanga e puta ai te mumura. Hei tauira: tofacitinib (Xeljanz®) .

Pokanga

Mena kāore e taea te whakahaere i te mate mā te rongoā, mēnā rānei ka puta he raruraru nui, me mahi pokanga pea. Tata ki te 30% o te hunga whai UC ka hiahia ki te pokanga i a rātou e ora ana.

E rua ngā momo pokanga matua. E rua ngā momo pokanga e kiia nei ko te proctocolectomy , arā, ko te tango i te whekau nui me te wāhanga whakamutunga o te rectum.

1. Te tango i te puku me te pēke ileum: Koinei te pokanga tino noa. I tēnei tikanga, ka tangohia te whekau nui, ka hangaia he pēke mai i tētahi wāhanga o te whekau iti, ā, ka honoa ki te nono. I muri i te whakaora, ka taea e koe te neke haere i te puku i ngā wā katoa.

2. Proctocolectomy me te ileostomy: Ka mahia tēnei ina kore e taea te pokanga i runga ake nei. I tēnei tikanga, ka tangohia te whekau nui katoa, ka hangaia he kōhao (stoma) ki roto i te puku, ā, ka tāpirihia he putea hei kohi paru mai i waho.

He aha ngā mea ka taea te mahi hei ārai i te kino haere o te mate?

Mā te tautuhi i ngā mea e whakaoho ana i tō mate pukupuku me te karo i aua mea ka tino whakaiti i te tūponotanga o te pikinga ake o te mate pukupuku.

• Whakahaerehia te ahotea: Kia nui te moe, kia nui te korikori tinana, me te mahi i tētahi mea whakamarie pēnei i te whakaaroaro.
• Āraia ētahi rongoā mamae: Ka taea e ngā NSAID (hei tauira, ibuprofen, diclofenac) te whakararu i ngā tohu o te UC. He pai ake te tango i tētahi rongoā pēnei i te paracetamol mō te kirika, te mamae rānei. Me kōrero tonu ki tō tākuta i mua i te tango i tētahi rongoā.
• Āraia ngā kai e whakaoho ana i te UC: Kāore e rite ngā whakaoho o te katoa. Ko ētahi tāngata he pāwera ki ngā mea miraka, ko ētahi he pāwera ki ngā kai muka nui. Ko te huarahi pai ki te mōhio he aha ngā mea e whakaoho ana i a koe ko te pupuri i tētahi pukapuka kai me te tuhi i ngā kai e kainga ana e koe me ngā tohu e pā ana ki a koe. Kātahi, kōrero ki tō tākuta ka whakatakoto i tētahi mahere kai e pai ana māu.