ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯈꯣꯡꯗꯥ ꯑꯅꯥꯕꯥ ꯂꯩꯕ꯭ꯔꯥ? ꯅꯍꯥꯛꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯂꯁꯔ ꯂꯩꯕ꯭ꯔꯥ? ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯊꯣꯀꯄꯥ ꯀꯟꯗꯤꯁꯟ (Zollinger-Ellison Syndrome) ꯑꯣꯏꯕꯥ ꯌꯥꯏ꯫

ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯅꯍꯥꯛꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯂꯁꯔ ꯅꯠꯠꯔꯒꯥ ꯒꯦꯁ꯭ꯠꯔꯥꯏꯇꯤꯁ ꯂꯩꯕ꯭ꯔꯥ? ꯅꯍꯥꯛꯅꯥ ꯂꯥꯏꯌꯦꯡ ꯆꯠꯊꯔꯕꯁꯨ ꯐꯒꯠꯂꯀꯄꯥ ꯉꯃꯗꯕꯥ ꯄꯔꯁꯤꯁ꯭ꯇꯦꯟꯇ ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯂꯁꯔꯁꯤꯡ ꯂꯩꯕ꯭ꯔꯥ? ꯅꯍꯥꯀꯁꯨ ꯗꯥꯏꯔꯤꯌꯥ ꯂꯩꯕ꯭ꯔꯥ? ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯍꯥꯌꯔꯤꯕꯁꯤꯡ ꯑꯁꯤ ꯅꯣꯔꯃꯦꯜ ꯑꯣꯏꯕꯥ ꯋꯥꯐꯃꯁꯤꯡꯅꯤ ꯍꯥꯌꯅꯥ ꯈꯜꯂꯤ, ꯑꯗꯨꯕꯨ ꯉꯁꯤꯗꯤ ꯑꯩꯈꯣꯌꯅꯥ ꯃꯁꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯂꯣꯠꯇꯨꯅꯥ ꯂꯩꯔꯤꯕꯥ, ꯑꯗꯨꯕꯨ ꯈꯔꯥ ꯍꯦꯟꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯑꯣꯏꯕꯥ ꯌꯥꯕꯥ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯊꯣꯀꯄꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯅꯔꯤ꯫ ꯃꯁꯤꯕꯨ ꯖꯣꯂꯤꯡꯒꯔ-ꯑꯦꯂꯤꯁꯟ ꯁꯤꯟꯗ꯭ꯔꯣꯝ ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫

ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯖꯣꯂꯤꯡꯒꯔ-ꯑꯦꯂꯤꯁꯟ ꯁꯤꯟꯗ꯭ꯔꯣꯝ (ZES) ꯍꯥꯌꯕꯁꯤ ꯀꯔꯤꯅꯣ?

ꯑꯩꯈꯣꯌꯒꯤ ꯈꯣꯡꯗꯥ ꯑꯦꯁꯤꯗ ꯄꯨꯊꯣꯀꯄꯥ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯕꯥ ꯁꯨꯏꯆ ꯑꯃꯥ ꯂꯩ ꯍꯥꯌꯅꯥ ꯈꯅꯕꯤꯌꯨ꯫ ꯒ꯭ꯌꯥꯁ꯭ꯠꯔꯤꯟ ꯀꯧꯕꯥ ꯍꯣꯔꯃꯣꯟ ꯑꯃꯅꯥ ꯁꯨꯏꯆ ꯑꯗꯨꯒꯨꯝꯅꯥ ꯊꯕꯛ ꯇꯧꯏ꯫ ꯅꯣꯔꯃꯦꯜ ꯑꯣꯏꯅꯥ, ꯑꯩꯈꯣꯌꯅꯥ ꯆꯥꯕꯥ ꯃꯇꯃꯗꯥ, ꯍꯣꯔꯃꯣꯟ ꯑꯁꯤ ꯊꯥꯗꯣꯀꯏ, ꯃꯗꯨꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯀꯅꯥ ꯆꯤꯟꯖꯥꯛ ꯍꯟꯖꯤꯅꯍꯅꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯅꯕꯥ ꯑꯦꯁꯤꯗ ꯄꯨꯊꯣꯀꯏ꯫ ꯊꯕꯛ ꯑꯗꯨ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯑꯦꯁꯤꯗ ꯄꯨꯊꯣꯀꯄꯥ ꯑꯗꯨ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯏ꯫

ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯖꯣꯂꯤꯡꯒꯔ-ꯑꯦꯂꯤꯁꯟ ꯁꯤꯟꯗ꯭ꯔꯣꯝ (ZES) ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯗꯥ, ꯍꯀꯆꯥꯡꯗꯥ ꯒꯦꯁ꯭ꯠꯔꯤꯅꯣꯃꯥ ꯀꯧꯕꯥ ꯇꯤꯎꯃꯔ ꯃꯈꯜ ꯑꯃꯥ ꯊꯣꯀꯏ꯫ ꯇꯤꯎꯃꯔꯁꯤꯡ ꯑꯁꯤ ꯑꯌꯥꯝꯕꯗꯤ ꯄꯦꯅꯛꯔꯤꯑꯦꯖ ꯅꯠꯠꯔꯒꯥ ꯑꯄꯤꯀꯄꯥ ꯏꯟꯇꯦꯁ꯭ꯇꯥꯏꯅꯒꯤ ꯃꯊꯛ ꯊꯪꯕꯥ ꯁꯔꯨꯛꯇꯥ (duodenum) ꯊꯣꯀꯏ꯫ ꯇꯤꯎꯃꯔꯁꯤꯡ ꯑꯁꯤꯅꯥ ꯇꯧꯔꯤꯕꯥ ꯑꯁꯤ ꯀꯟꯠꯔꯣꯜ ꯑꯃꯠꯇꯥ ꯂꯩꯇꯅꯥ ꯍꯣꯔꯃꯣꯟ ꯒ꯭ꯌꯥꯁ꯭ꯠꯔꯤꯟ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯄꯨꯊꯣꯀꯄꯅꯤ꯫ ꯃꯁꯤ ꯃꯇꯝ ꯄꯨꯝꯅꯃꯛꯇꯥ ꯁꯨꯏꯆ ꯑꯁꯤ ‘ꯑꯣꯟ’ ꯑꯣꯏꯕꯒꯨꯝꯅꯥ ꯑꯣꯏ꯫

ꯍꯥꯌꯔꯤꯕꯥ ꯒꯦꯁ꯭ꯠꯔꯤꯅꯣꯃꯥꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯶꯰% ꯗꯤ ꯀꯦꯟꯁꯔ ꯑꯣꯏꯕꯥ ꯌꯥꯏ , ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯃꯈꯣꯌꯕꯨ ꯇꯣꯌꯅꯥ ꯈꯉꯗꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯂꯥꯌꯦꯡꯕꯥ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫

ꯂꯥꯌꯅꯥ ꯑꯁꯤꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯀꯔꯤꯅꯣ? ꯑꯩꯈꯣꯌꯅꯥ ꯀꯔꯝꯅꯥ ꯈꯉꯒꯅꯤ?

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ, ꯖꯦ.ꯏ.ꯑꯦꯁ.ꯅꯥ ꯑꯍꯥꯅꯕꯥ ꯁ꯭ꯇꯦꯖꯗꯥ ꯂꯥꯏꯑꯣꯡ ꯑꯃꯠꯇꯥ ꯎꯠꯄꯥ ꯉꯃꯗꯕꯥ ꯌꯥꯏ꯫ ꯑꯗꯨꯕꯨ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤ ꯂꯥꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯃꯈꯣꯌ ꯑꯁꯤ ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯒꯦꯁ꯭ꯠꯔꯥꯏꯇꯤꯁꯇꯒꯤ ꯈꯔꯥ ꯍꯦꯟꯅꯥ ꯁꯥꯊꯤꯕꯥ ꯑꯣꯏꯕꯥ ꯌꯥꯏ꯫ ꯂꯥꯏꯑꯣꯡꯁꯤꯡꯒꯤ ꯁꯥꯊꯤꯕꯥ ꯑꯁꯤ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯂꯩꯔꯤꯕꯥ ꯇꯤꯎꯃꯔꯁꯤꯡꯒꯤ ꯁꯥꯏꯖ ꯑꯃꯁꯨꯡ ꯃꯁꯤꯡꯒꯤ ꯃꯇꯨꯡꯏꯟꯅꯥ ꯈꯦꯠꯅꯩ꯫

ꯃꯁꯤ ꯃꯈꯥꯒꯤ ꯇꯦꯕꯜ ꯑꯁꯤꯗꯥ ꯃꯈꯥ ꯇꯥꯅꯥ ꯁꯟꯗꯣꯛꯅꯥ ꯇꯥꯀꯄꯤꯁꯤ꯫

ꯀꯦꯁ ꯈꯔꯗꯗꯤ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯇꯤꯎꯃꯔꯁꯤꯡ ꯑꯁꯤ ꯂꯤꯚꯔꯗꯥ ꯁꯟꯗꯣꯔꯛꯂꯕꯗꯤ (ꯃꯦꯇꯥꯁ꯭ꯇꯦꯁꯤꯁ) , ꯃꯈꯣꯌꯅꯥ ꯂꯤꯚꯔ ꯀꯦꯟꯁꯔꯒꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡꯁꯨ ꯎꯠꯄꯥ ꯌꯥꯏ꯫ ꯈꯨꯗꯝ ꯑꯣꯏꯅꯥ, ꯃꯃꯤꯠ ꯑꯃꯁꯨꯡ ꯈꯣꯡꯗꯥ ꯌꯦꯔꯨꯝ ꯀꯣꯀꯄꯥ (joundice) ꯂꯩꯕꯥ ꯌꯥꯏ꯫

ꯀꯔꯤꯒꯤꯗꯃꯛ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯊꯧꯗꯣꯛ ꯑꯃꯥ ꯊꯣꯛꯂꯤꯕꯅꯣ?

ꯑꯌꯥꯝꯕꯥ ꯃꯇꯃꯗꯥ, ꯖꯦ.ꯏ.ꯑꯦꯁ.ꯅꯥ ꯁ꯭ꯄꯣꯔꯦꯗꯤꯛ ꯑꯣꯏꯅꯥ ꯊꯣꯀꯏ , ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯃꯁꯤ ꯁꯨꯞꯅꯇꯒꯤ ꯊꯣꯀꯏ꯫

ꯑꯗꯨꯕꯨ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯄꯦꯁꯦꯟꯇ 25%ꯗꯤ MEN ꯇꯥꯏꯞ 1 (Multiple Endocrine Neoplasia Type 1) ꯀꯧꯕꯥ ꯀꯟꯗꯤꯁꯟ ꯑꯁꯤ ꯂꯥꯀꯏ꯫ꯖꯦ.ꯏ.ꯑꯦꯁ.ꯅꯥ ꯀꯧꯕꯥ ꯖꯦꯅꯦꯇꯤꯛ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯒꯥ ꯂꯣꯌꯅꯅꯥ꯫ ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯊꯨꯅꯥ ꯊꯣꯀꯄꯥ ꯖꯦꯅꯦꯇꯤꯛ ꯀꯟꯗꯤꯁꯟ ꯑꯃꯅꯤ꯫ ꯃꯁꯤꯗꯥ, ꯃꯇꯝ ꯑꯃꯗꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯍꯣꯔꯃꯣꯟ ꯄꯨꯊꯣꯀꯄꯥ ꯒ꯭ꯜꯌꯥꯟꯗ ꯀꯌꯥꯗꯥ ꯇꯤꯎꯃꯔꯁꯤꯡ ꯁꯦꯝꯕꯒꯤ ꯔꯤꯁ꯭ꯛ ꯂꯩ꯫ ꯖꯦ.ꯏ.ꯑꯦꯁ.ꯅꯥ ꯃꯁꯤꯒꯤ ꯁꯔꯨꯛ ꯑꯃꯈꯛꯇꯅꯤ꯫

ꯃꯁꯤ ꯈꯪꯗꯣꯛꯅꯕꯥ ꯀꯔꯤ ꯇꯦꯁ꯭ꯇꯁꯤꯡ ꯇꯧꯕꯒꯦ?

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯃꯊꯛꯇꯥ ꯄꯅꯈ꯭ꯔꯤꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤ ꯂꯩꯔꯕꯗꯤ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ZES ꯂꯩꯔꯦ ꯍꯥꯌꯅꯥ ꯆꯤꯡꯅꯕꯥ ꯂꯩꯔꯕꯗꯤ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯇꯦꯁ꯭ꯠ ꯀꯌꯥ ꯑꯃꯥ ꯑꯣꯔꯗꯔ ꯇꯧꯕꯥ ꯌꯥꯏ꯫

ꯑꯍꯥꯅꯕꯥ ꯇꯦꯁ꯭ꯇꯁꯤꯡ꯫

• ꯕ꯭ꯂꯗ ꯇꯦꯁ꯭ꯇꯁꯤꯡ: ꯃꯁꯤꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯏꯗꯥ ꯂꯩꯔꯤꯕꯥ ꯍꯣꯔꯃꯣꯟ ꯒ꯭ꯌꯥꯁ꯭ꯠꯔꯤꯅꯒꯤ ꯆꯥꯡ ꯑꯗꯨ ꯌꯦꯡꯁꯤꯜꯂꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ZES ꯂꯩꯔꯕꯗꯤ, ꯂꯦꯚꯦꯜ ꯑꯁꯤ ꯑꯦꯕꯅꯣꯔꯃꯦꯜ ꯑꯣꯏꯅꯥ ꯋꯥꯡꯒꯅꯤ . ꯃꯁꯤꯕꯨ ꯍꯥꯏꯄꯔꯒꯦꯁ꯭ꯠꯔꯤꯅꯦꯃꯤꯌꯥ ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫
• ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯦꯁꯤꯗꯀꯤ ꯆꯥꯡ ꯇꯦꯁ꯭ꯠ ꯇꯧꯕꯥ: ꯅꯥꯀꯣꯡꯒꯤ ꯈꯨꯠꯊꯥꯡꯗꯥ ꯇꯨꯕ ꯑꯃꯥ ꯁ꯭ꯇꯣꯃꯥꯛꯇꯥ ꯊꯥꯗꯨꯅꯥ ꯑꯦꯁꯤꯗꯀꯤ ꯁꯦꯝꯄꯜ ꯑꯃꯥ ꯂꯧꯗꯨꯅꯥ ꯇꯦꯁ꯭ꯠ ꯇꯧꯏ꯫ ꯖꯦ.ꯏ.ꯑꯦꯁ.ꯇꯥ, ꯑꯦꯁꯤꯗꯀꯤ ꯆꯥꯡ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯋꯥꯡꯏ꯫
• ꯏꯃꯦꯖꯤꯡ ꯇꯦꯁ꯭ꯇꯁꯤꯡ: ꯄꯦꯅꯛꯔꯤꯑꯦꯖ ꯅꯠꯠꯔꯒꯥ ꯏꯟꯇꯦꯁ꯭ꯇꯥꯏꯅꯁꯤꯡꯗꯥ ꯇꯤꯎꯃꯔ ꯂꯩꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯌꯦꯡꯁꯤꯟꯅꯕꯥ ꯁꯤ.ꯇꯤ.ꯁ꯭ꯀꯦꯟ ꯅꯠꯠꯔꯒꯥ ꯑꯦꯝ.ꯑꯥꯔ.ꯑꯥꯏ.

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯇꯤꯎꯃꯔꯁꯤꯡ ꯀꯅꯐꯥꯔꯝ ꯇꯧꯔꯕꯗꯤ ꯃꯈꯥ ꯇꯥꯕꯥ ꯇꯦꯁ꯭ꯇꯁꯤꯡ꯫

ꯍꯥꯌꯔꯤꯕꯥ ꯇꯤꯎꯃꯔꯁꯤꯡ ꯑꯁꯤ ꯀꯗꯥꯏꯗꯥ ꯂꯩꯕꯒꯦ, ꯃꯈꯣꯌꯒꯤ ꯁꯥꯏꯖ, ꯑꯃꯁꯨꯡ ꯃꯈꯣꯌ ꯑꯁꯤ ꯀꯦꯟꯁꯔ ꯑꯣꯏꯕꯔꯥ ꯅꯠꯠꯔꯒꯥ ꯑꯣꯏꯗꯕꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯆꯨꯝꯅꯥ ꯈꯉꯗꯣꯛꯅꯕꯥ ꯃꯈꯥ ꯇꯥꯕꯥ ꯇꯦꯁ꯭ꯇꯁꯤꯡ ꯇꯧꯔꯤ꯫

• ꯑꯦꯅꯗꯣꯁ꯭ꯀꯣꯄꯤ (Endoscopy): ꯀꯦꯃꯦꯔꯥ ꯑꯃꯥ ꯌꯥꯎꯕꯥ ꯑꯄꯤꯀꯄꯥ ꯇꯤꯎꯕ ꯑꯃꯥ ꯃꯤꯠꯀꯤ ꯃꯅꯨꯡꯗꯥ ꯊꯥꯗꯨꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯃꯁꯨꯡ ꯑꯄꯤꯀꯄꯥ ꯏꯟꯇꯦꯁ꯭ꯇꯥꯏꯅꯒꯤ ꯃꯊꯛ ꯊꯪꯕꯥ ꯁꯔꯨꯛ ꯑꯗꯨ ꯌꯦꯡꯁꯤꯜꯂꯤ꯫ ꯃꯁꯤꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯂꯁꯔ ꯂꯩꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯌꯦꯡꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯏ꯫
• ꯑꯦꯟꯗꯣꯁ꯭ꯀꯣꯄꯤꯛ ꯑꯂꯠꯔꯥꯁꯥꯎꯟꯗ: ꯃꯁꯤ ꯑꯦꯟꯗꯣꯁ꯭ꯀꯣꯄꯤ ꯑꯃꯁꯨꯡ ꯑꯂꯠꯔꯥꯁꯥꯎꯟꯗ ꯁ꯭ꯀꯦꯅꯒꯤ ꯀꯝꯕꯤꯅꯦꯁꯟ ꯑꯃꯅꯤ꯫ ꯃꯁꯤꯅꯥ ꯄꯦꯅꯛꯔꯤꯑꯦꯖꯗꯥ ꯌꯥꯝꯅꯥ ꯑꯄꯤꯀꯄꯥ ꯇꯤꯎꯃꯔꯁꯤꯡ ꯐꯥꯎꯕꯥ ꯈꯪꯗꯣꯀꯄꯥ ꯉꯝꯃꯤ꯫
• ꯏ.ꯑꯥꯔ.ꯁꯤ.ꯄꯤ.: ꯃꯁꯤꯁꯨ ꯑꯈꯟꯅꯕꯥ ꯁ꯭ꯀꯦꯟ ꯑꯃꯅꯤ꯫
• ꯕꯥꯏꯑꯣꯞꯁꯤ (Fine-needle aspiration): ꯇꯤꯎꯃꯔꯗꯒꯤ ꯌꯥꯝꯅꯥ ꯑꯄꯤꯀꯄꯥ ꯇꯤꯁꯨ ꯑꯃꯥ ꯂꯧꯊꯣꯀꯏ ꯑꯃꯁꯨꯡ ꯃꯥꯏꯛꯔꯣꯁ꯭ꯀꯣꯄꯀꯤ ꯃꯈꯥꯗꯥ ꯌꯦꯡꯁꯤꯟꯗꯨꯅꯥ ꯃꯗꯨꯗꯥ ꯀꯦꯟꯁꯔ ꯁꯦꯂꯁꯤꯡ ꯂꯩꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯌꯦꯡꯁꯤꯜꯂꯤ꯫

ꯃꯁꯤꯒꯤ ꯂꯥꯏꯌꯦꯡꯁꯤꯡ ꯑꯁꯤ ꯀꯔꯤꯅꯣ?

ꯂꯥꯏꯌꯦꯡꯕꯒꯤ ꯑꯣꯄꯁꯅꯁꯤꯡ ꯑꯁꯤ ꯅꯍꯥꯛꯀꯤ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯗꯨꯒꯤ ꯃꯑꯣꯡ-ꯃꯇꯧ ꯑꯃꯁꯨꯡ ꯂꯝ ꯑꯗꯨ ꯀꯦꯟꯁꯔ ꯂꯩꯕ꯭ꯔꯥ ꯅꯠꯠꯔꯒꯥ ꯑꯣꯏꯗꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨꯒꯤ ꯃꯈꯥ ꯄꯣꯜꯂꯤ꯫ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯂꯥꯏꯌꯦꯡꯒꯤ ꯑꯣꯄꯁꯟ ꯑꯍꯨꯝ ꯂꯩ꯫

ꯐꯤꯚꯝ ꯑꯁꯤꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯑꯩꯒꯤ ꯇꯨꯡꯒꯤ ꯄꯨꯟꯁꯤ ꯑꯁꯤ ꯀꯔꯝꯅꯥ ꯑꯣꯏꯒꯅꯤ?

ꯃꯁꯤ ꯃꯤꯑꯣꯏ ꯀꯌꯥ ꯑꯃꯅꯥ ꯍꯪꯂꯀꯄꯥ ꯋꯥꯍꯪ ꯑꯃꯅꯤ꯫ ꯅꯍꯥꯛꯀꯤ ꯇꯨꯡꯒꯤ ꯄꯨꯟꯁꯤ ꯑꯁꯤ ꯅꯍꯥꯛꯅꯥ ꯂꯩꯔꯤꯕꯥ ꯀꯦꯟꯁꯔ ꯃꯈꯜ ꯑꯗꯨꯒꯤ ꯃꯈꯥ ꯄꯣꯜꯂꯤ꯫

• ꯅꯟ-ꯀꯦꯟꯁꯔ ꯇꯤꯎꯃꯔꯁꯤꯡ: ꯃꯈꯣꯌ ꯑꯁꯤ ꯄꯨꯟꯁꯤꯗꯥ ꯈꯨꯗꯣꯡꯊꯤꯅꯤꯉꯥꯏ ꯑꯣꯏꯗꯦ, ꯑꯗꯨꯕꯨ ꯅꯍꯥꯛꯅꯥ ꯁ꯭ꯇꯣꯃꯥꯛ ꯑꯦꯁꯤꯗ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯅꯕꯥ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯃꯈꯥ ꯇꯥꯅꯥ ꯂꯧꯕꯥ ꯃꯊꯧ ꯇꯥꯒꯅꯤ꯫
• ꯀꯦꯟꯁꯔꯅꯥ ꯅꯥꯕꯥ ꯇꯤꯎꯃꯔꯁꯤꯡ : ꯃꯐꯃꯁꯤꯗꯥ ꯐꯤꯚꯝ ꯑꯁꯤ ꯈꯔꯥ ꯇꯣꯉꯥꯜꯂꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯍꯀꯆꯥꯡꯗꯥ ꯂꯩꯔꯤꯕꯥ ꯀꯦꯟꯁꯔ ꯁꯦꯜ ꯄꯨꯝꯅꯃꯛ ꯁꯔꯖꯔꯤꯒꯤ ꯈꯨꯠꯊꯥꯡꯗꯥ ꯂꯧꯊꯣꯀꯄꯥ ꯉꯝꯂꯕꯗꯤ ꯂꯥꯌꯅꯥ ꯑꯁꯤ ꯃꯄꯨꯡ ꯐꯥꯅꯥ ꯐꯍꯅꯕꯥ ꯉꯃꯒꯅꯤ꯫ ꯃꯇꯝ ꯑꯗꯨꯗꯁꯨ ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯂꯥꯛꯂꯕꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯌꯦꯡꯅꯕꯒꯤꯗꯃꯛ ꯃꯈꯥ ꯇꯥꯅꯥ ꯃꯦꯗꯤꯀꯦꯜ ꯇꯦꯁ꯭ꯠ ꯇꯧꯕꯥ ꯃꯊꯧ ꯇꯥꯒꯅꯤ꯫

ꯑꯗꯨꯕꯨ ꯃꯁꯤ ꯋꯥꯈꯂꯗꯥ ꯊꯝꯃꯨ: ꯍꯥꯌꯔꯤꯕꯥ ꯁ꯭ꯇꯦꯇꯤꯁ꯭ꯇꯤꯀꯦꯂꯁꯤꯡ ꯑꯁꯤ ꯑꯅꯥꯕꯥ ꯂꯤꯁꯤꯡ ꯀꯌꯥꯒꯤ ꯗꯦꯇꯥꯗꯥ ꯌꯨꯝꯐꯝ ꯑꯣꯏꯕꯥ ꯑꯦꯚꯥꯔꯦꯖ ꯈꯛꯇꯅꯤ꯫ ꯅꯍꯥꯛꯀꯤ ꯃꯤꯑꯣꯏ ꯑꯃꯒꯤ ꯐꯤꯚꯝ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯇꯣꯉꯥꯅꯕꯥ ꯑꯣꯏꯕꯥ ꯌꯥꯏ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯀꯟꯗꯤꯁꯟ ꯑꯗꯨ ꯀꯔꯤꯅꯣ ꯍꯥꯌꯕꯗꯨ ꯆꯨꯝꯅꯥ ꯈꯪꯅꯕꯒꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯐꯕꯥ ꯃꯤꯑꯣꯏ ꯑꯗꯨꯗꯤ ꯅꯍꯥꯛꯀꯤ ꯂꯥꯏꯌꯦꯡꯂꯤꯕꯥ ꯗꯣꯛꯇꯔ ꯑꯗꯨꯅꯤ꯫

ꯑꯩꯅꯥ ꯏꯁꯥꯕꯨ ꯀꯔꯝꯅꯥ ꯌꯦꯡꯁꯤꯅꯕꯤꯒꯗꯒꯦ?

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯖꯦ.ꯏ.ꯑꯦꯁ.ꯅꯥ ꯅꯥꯔꯦ ꯍꯥꯌꯅꯥ ꯈꯪꯂꯕꯗꯤ, ꯅꯍꯥꯛꯀꯤ ꯄꯨꯟꯁꯤꯗꯥ ꯑꯍꯣꯡꯕꯥ ꯈꯔꯥ ꯄꯨꯔꯀꯄꯥ ꯃꯊꯧ ꯇꯥꯏ꯫

• ꯅꯍꯥꯛꯀꯤ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯑꯗꯨ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯂꯧꯕꯤꯌꯨ: ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯍꯥꯌꯔꯀꯄꯒꯤ ꯃꯇꯨꯡꯏꯟꯅꯥ, ꯑꯦꯁꯤꯗ ꯍꯟꯊꯍꯅꯕꯥ ꯍꯤꯗꯥꯀꯁꯤꯡ (PPIs) ꯃꯇꯝ ꯆꯥꯅꯥ ꯂꯧꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫
• ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯃꯦꯗꯤꯀꯦꯜ ꯆꯦꯀꯑꯞ ꯇꯧꯕꯥ: ꯃꯔꯨꯑꯣꯏꯅꯥ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯀꯦꯟꯁꯔꯒꯤ ꯇꯤꯎꯃꯔꯁꯤꯡ ꯂꯩꯔꯕꯗꯤ, ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯇꯥꯀꯄꯤꯔꯀꯄꯒꯤ ꯃꯇꯨꯡꯏꯟꯅꯥ ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯐꯣꯂꯣ-ꯑꯞ ꯆꯦꯀꯑꯞ ꯇꯧꯅꯕꯥ ꯆꯠꯀꯗꯕꯅꯤ ꯑꯃꯁꯨꯡ ꯂꯥꯌꯅꯥ ꯑꯁꯤ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯂꯥꯛꯂꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯌꯦꯡꯒꯗꯕꯅꯤ꯫
• ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯗꯨ ꯈꯪꯖꯤꯅꯕꯤꯌꯨ: ꯀꯔꯤꯒꯨꯝꯕꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯗꯨ ꯂꯥꯏꯌꯦꯡꯕꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯂꯥꯀꯄꯥ ꯇꯥꯔꯕꯗꯤ, ꯈꯨꯗꯛꯇꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯈꯪꯍꯅꯕꯤꯌꯨ .

ꯅꯍꯥꯛꯅꯥ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯌꯥꯝꯅꯥ ꯇꯣꯏꯅꯥ ꯊꯣꯀꯄꯥ ꯂꯥꯌꯅꯥ ꯑꯃꯥ ꯂꯩꯔꯦ ꯍꯥꯌꯕꯥ ꯈꯪꯂꯕꯥ ꯃꯇꯃꯗꯥ ꯋꯥꯈꯜ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯑꯃꯁꯨꯡ ꯋꯥꯈꯜ ꯅꯨꯡꯉꯥꯏꯇꯕꯥ ꯐꯥꯎꯕꯥ ꯍꯥꯌꯕꯁꯤ ꯅꯣꯔꯃꯦꯂꯅꯤ꯫ ꯑꯗꯣꯃꯒꯤ ꯋꯥꯍꯪ ꯀꯌꯥ ꯑꯃꯥ ꯂꯩꯔꯤ꯫ ꯃꯈꯣꯌ ꯄꯨꯝꯅꯃꯛꯀꯤ ꯃꯇꯥꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯒꯥ ꯑꯃꯨꯛꯇꯪ ꯋꯥꯔꯤ ꯁꯥꯕꯤꯌꯨ꯫ ꯅꯍꯥꯛꯀꯤ ꯇꯦꯁ꯭ꯇꯀꯤ ꯔꯤꯖꯜꯇ ꯑꯃꯁꯨꯡ ꯂꯥꯏꯌꯦꯡꯕꯒꯤ ꯊꯧꯔꯥꯡꯁꯤꯡ ꯅꯤꯡꯊꯤꯅꯥ ꯇꯥꯕꯤꯌꯨ꯫ ꯃꯈꯣꯌꯅꯥ ꯑꯗꯣꯃꯕꯨ ꯃꯇꯦꯡ ꯄꯥꯡꯅꯕꯥ ꯁꯦꯝ ꯁꯥꯗꯨꯅꯥ ꯂꯩꯔꯤ ꯑꯃꯁꯨꯡ ꯌꯥꯅꯤꯡꯏ꯫