'O Malabsorption ke aha? Ke kūlana a me nā kumu

'O ka'ōpū li'ili'i kekahi o nā'ōpū. Hana nui'o ia i nā hana, ho'okani nui i ka hana o ka digesting food and absorbing nutrients. Me ka ho'oulu'ana o kekahi mau ma'i, ua ho'opau'ia ka hana a kēia ke'ena - ua hō'ike'ia ka ma'i malabsorption syndrome, a ua ho'opau'ia e like me CMA. He aha kēia hua'ōlelo? He aha nā kumu o kēia ma'i?

Ka wehewehe o ka mana'o

Ma nā puke lapa'au, hiki i kekahi ke loa'a kahi manawa e like me "malabsorption". Ho'ohana'ia kēia hua'ōlelo no ka hō'eha i ka lawe'ana o ka mucosa me ka'ōpū o nā mea'ai. Aia kekahi manawa e like me "maldigestia". He hana hewa kēia i nā hana o ka ho'ohuli'ana i nā momona, nā protein a me nā'ōpelu i loko o nā huapalapala pale.

Mau loea, hui pu iho la laua no ka mea ma luna makahiki ( "malabsorption" a me ka "maldigestion"), ka wā i kekahi olelo o ka malabsorption maʻi pale. 'O kēia ka pilikia o nā hō'ailona hō'ailona ma muli o ka uhaki'ia'ana o ka cacamitary, li'ili'i, ka digestion o ka membrane a me ka lawe'ana ma ka'ōpū li'ili'i. Ma muli o nā loli i hana'ia i loko o ke kino o ke kanaka no ka'ike'ana o ka ma'i malabsorption, hiki mai nā ma'i mai ka ma'i. Ho'omaka ka pilikia o nā po'e.

Ke kumu o ka hele'ana o AGR

Ho'omaopopo'ia ka ma'i Malabsorption i nā ma'i kūlohelohe a me nā ma'i kūlohelohe, kahi i'ele'ele ai ka inu o nā mea, a emi iho ka hana o nā enzymes. 'O ke'ano he cystic fibrosis. Ma kēia ma'i, e ulu ana ka SMA ma muli o ka emi'ana o ka hana o nā enzymes pancreatic a me ka'ae'ana i ka viscosity o nā mea huna.

'O ka ma'i Malabsorption ka hopena o nā ma'i i hana'ia e nā ma'i a me nā pāpālua, nā ma'i o ka lymphatic a me ka holo'ana. Ho'omaopopo pū'ia ka SMA me ka hō'ino'ana i ka'ōpū li'ili'i a me ka emi'ana ma kahi o ka absorption ('o kēia mau ho'ololi i hana'ia ma ke kino no ka nui o nā ku'i'ana o nā'ano like'ole, ka hopena kino a me ka no'ono'o i ka ulu'ana).

No laila, malabsorption he hō'ailona o nā hō'ailona maika'i'ole, a he mea hiki ke ho'onui i nā kumu like'ole. Hiki ke hui 'ia penei:

1. 'O ka'ao'ao Preenteral. 'O kēia nā ma'i o ka'ōpū biliary, ka ate, ka'ōpū, cystic fibrosis.
2. 'O ka papa inoa Postnatal. 'O ia nā ma'i o ke kahe'ana o ka lymph a me ka holo'ana ma ka hapa lō'ihi o ka'ōpū, aia ma waena o ka'ōpū a me ka'ōpū nui, ka imperopathy exudative, lymphosarcoma, a me lymphogranulomatosis.
3. Nā hui kaiaulu o nā kumu. Mau nā galactose malabsorption, celiac maʻi, disaccharidase e hemahema, giardiasis, dermatitis herpetiformis.

Nā hō'ailona ma'amau no SMA

'Oiai'o ka ma'i malabsorption i loko o nā ma'i like'ole, hiki ke'ike i nā hō'ailona o kona'ano. Me ka AGR, ka'aihue a me ka lua'i. I nā ma'i ua kaumaha ka'ona. 'O nā hō'ailona like ka flatulence, he loli o ka waihona ('oi pinepine ka ma'i wela). 'O kēia mau hō'ailona a pau i kapa'ia he ma'i ma'i dyspeptic. Ke alaka'i nei'o ia i nā hō'ailona o SMA.

Pono pono ka nānā'ana i kahi noho. Ke hō'oia'ana i nā hi'ohi'ona o nā lehulehu fecal, nā mea lapa'au e lawe i ka'ike nui e hiki ai iā lākou ke hana i ka hō'oia pololei:

• 'O ka wai wai a me ka pahu me ka mea'alapona, he hō'ailona ia e hiki ke komo i loko o nā ma'i e like me ka malabsorption glucose-galactose,'a'ohe pilikia o ka disaccharidase;
• ka waʻa noho i loko o maʻi pancreatitis, cystic fibrosis, dermatitis herpetiformis, exudative enteropathy maʻi pale Pearson, intestinal dysbacteriosis;
• Hiki ke mālama'ia ke kino momona i ka cystic fibrosis, pono'ole ka lipase o ka ma'i'ole;
• Ka wai wehe - he hō'ailona e hiki ke hana i ka wā e komo ai ka ma'i, e kūkulu i ka enterocolitis, malabsorption o ka glucose a me ka galactose.

Ke loa'a ka SMA i kekahi manawa he pilikia. 'O ka hapanui pinepine o nā ma'i'eha a me nā hō'eha. Ho'oma'i'ia ka ma'i'eha ma hope o ka'ai'ana i nā mea'ai. Ua hui pū'o ia me kahi hi'i ululu me kahi'ala'ala'ala,'o ka flatulence ke kuhikuhi i ka lactase. 'O ka'eha i loko o ka'ōpū o ka'ōpū me ka AGA e pili pū ana i ka ma'i hānai'ai, nā ma'i kūlohelohe o ka na'au, ka ma'i o Pīpī, ulitisrative colitis, ma'i o Crohn. I ka ma'i o ka ma'i palbsorption, ua mālama'ia nā hō'ailona hou:

• Nā hau i ka'ili;
• 'Aluhi;
• Ka mana'o o ka nawaliwali;
• Ke koko;
• Anorexia.

'O ka ma'i male i nā keiki e hele pū me ka ma'i li'ili'i. Ho'opilikia'ia ke kino. Hō'ike'ia kēia ma ka emi'ana o ke kaumaha o ke kino, ka ulu'ana o ka hypotrophy, ka lohi ulu. 'O ka hemahema o nā huaora ua hō'ike'ia e ka moku o ka'ili. Mālo'o ka'ili, ho'omaka e pele. Aia ma luna o laila he wahi pua'a. E lilo i lauoho ka lauoho a ho'omaka e hā'ule. Loa'a nā nails i ka malu a me ka exfoliate. I ka wā o ka pau'ole o ke kīpika, ka pa'i, ka'eha ma nā'i'o a me nā iwi. 'O ka nele o ka hao, ke keleawe a me ka zinc ke alaka'i'ia i ke'ano o ka'ili o ka'ili, ka ulu'ana o ka anemia o ka hao, ka nui o ka mahana o ke kino.

Nā papa ho'okoe'ana

'O ka ma'i o ka malabsorption e hui pū i nā ma'i like'ole he 70. I kēia kūlana,'ike nā mea lapa'au i nā pilikia i ka ho'omākaukau'ana i ka ho'ohālikelike'ana. 'O ka mea'oi loa ka lanakila o ka mahele'ana i loko o ka hapalua a loa'a nā syndromes o ka malabsorption:

1. 'O ka mua o lākou e hō'ike'ia i 10% o nā hihia. Lawe'ia ka SMA pūnaewele i ke keiki mai nā mākua mai. Ke hana nei no ia ma muli o ka ho'ololi'ana.
2. 'O ka ma'i malabsorption loa'a ka hopena o ka ho'omohala'ana i nā ma'i'ōpū a me nā ma'i extraintestinal (e like me nā'ōpū, nā'ano immunodeficiency, nā hānai, a me nā ma'i ma'i'ā'ī).

Aia kekahi mahele'ana ma muli o ka ma'i o ka ma'i malabsorption:

• 'Imi wau ('ano'āliki) - ua emi iho ka nui o ke kaumaha o ke kino o nā keiki, aia nā hō'ailona o ka nui o ka multivitamin, he ulu kino kino'ole;
• II kahe (puka waena) - ua loa'a i ka po'e ma'i ka hā'ule o kahi kino (ke ho'ololi'ia ma ke ka'ina ma'amau ma mua o 10%), aia he lag i ka ulu'ana o ke kino, ua'ike'ia nā hō'ailona o ke kūpono o nā mea electrolytes a me ka hapa'ole o ka maha;
• III'ae (puka ko'iko'i) - ua ho'opau'ia nā keiki ma ke kino, hā'ule ka hapa o ke kino i 20%, i kekahi mau ma'i i ho'olā'ihi i ka ulu'ana o psychomotor.

Nā'ano o malabsorption

I ka makahiki 1977, ua mālama'ia ka VIII Hale Ho'onā Mō'ī o Gastroenterologists. Ma luna o laila ua'ike'ia nā'ano lapa'au e ka ma'i malabsorption, ma muli o nā kumu e kumu ai:

• 'Āpena kino;
• Kālena Postcellular;
• Enterocellular.

Loa'a'ole ka bile a hūnā'ia e ka pancreas, e pili ana i ka lua digestion a me ka hana'ana i ka hewa,'o ia ka malabsorption o ke'ano kino'ole. I loko o nā pēpē, ua ala lākou mai cystic fibrosis, hypoplasia āpau o ka pancreas. Ma nā keiki'ōpio, ke'ano o ka ma'i ma'i palupala pūpū e ho'onāukiuki i nā ma'i e like me ka cirrhosis o ke ake, a me ka pancreatitis mau.

'O ka lua o ka SMA, he malabsorption postcellular. 'O kēia ma'i, i'ike'ia e ka nalo'ana o ka protein plasma ma ka paia o ka'ōpū. Ua'ike'ia i nā'ano'ino o ka pūnaha holoholo a me ka lymphatic. 'O kekahi o nā ma'i he lā'au'opi'i idiopathic lymphangiectasia. Loa'a iā ia ka nalowale nui o ka mea konupūmā, lipids a me nā protein i loko o ka'ekepili'ōpū.

Ho'opili ke'ano o ka enterocellular i kēlā mau hihia ke ho'opilikia'ia ka'omi'ana o ka membrane ma muli o kahi hemahema ma nā pūnaha enzyme o nā pūnaewele epithelial o ka'ōpū. Hiki ke mālama'ia kēia mea ma nā'ōpiopio'ōpio no ka ma'i o nā ma'i i pili i ka hewa:

• 'Alia;
• 'O ka digestion ma'amala;
• 'O ka digalina a me ka absorption.

I loko o ke kōpiopio,'o ka ma'i enterscellular o ka ma'i malabsorption ka hopena ma muli o ka hō'ino a me ka make'ana o nā pūpū o ke kino e pili ana i ka hopena o nā ma'i a me nā palapē, ka ma'i tuma, nā ma'i pūpū li'ili'i, ka ma'i o Crohn.

Nā hi'ohi'ona o ka ma'i palupalu

I kēia'ano AGR, ua'oi aku ka hō'ino'ia'ana o ka'ona'ana o nā momona. Ho'opuka'ia ko lākou waihohe e ka lipase o ka pancreas, e ho'ohana'ia ana e ka bile. Me ka shortage o kēia mau mea akaka symptom e like me steatorrhea. Keia koho me feces ka liki ole momona. 'O ka steatorrhoea māmā loa loa i ka pancreatitis mau. 'O ka mea i'ike'ole'ia,'o ia kēia ma'i i nā ma'i o ke ake a me ka mana biliary.

Ma waena o nā kumu o ka ma'i palupalu ma'i'ole, pono e no'ono'o i ka hypoplasia pili pono o ka pancreas (hypoplasia). Hō'ai'ia nā hanana mai nā lā mua a i'ole nā wiki o ke ola. Aia kekahi wai, nui, ho'onani i ka waihona me kahi'ala maika'i'ole a me kahi'ālohilohi. Hiki i ka momona ke lele pinepine mai ka anus.

Nā lālā o ka malabsorption postcellular

Ua'ike'ia ka malabsorption postcellular o ka'ōpū me ka impelropathy exudative. 'O kēia kahi ma'i kahi e nalowale ai ke kinua plasma ma ka membrane mucous. 'O ke kumu o ka imperopathy exudative e hiki ke lilo i kahi hemahema kūpono o nā ipu inu o ka'ōpū. 'O ka hapanui pinepine,'o ka ma'i ka hopena o nā ma'i o Whipple, Crohn, nā pūpū li'ili'i li'ili'i, nā mea'eha'ai.

'O ke'ano o ka ho'opalehu'ana i kekahi manawa me ka'ike'ole o nā hō'ailona'ike. 'O nā hō'ailona pēnei i ka diahū a me ke steatorrhea e hiki ke kū. Ho'okumu ka po'e ma'i i ka edema ākea, i kau'ia ma ka'ao'ao, lalo ha'aha'a, perineum, mau hope.

Nā hi'ohi'ona o ka Malabsorption Enterocellular

'O ka Enterocellular'ano o ka SMA me ka ho'onāwaliwali'ole e hiki ke hana'ia e nā pilikino e like me ka malabsorption glucose-galactose. 'O kēia kahi ma'i ma'i'ole kahi e ho'opilikia'ia ai ka lawe'ana o ka galactose a me ka glucose i ka mucosa o ka'ōpū li'ili'i. 'O ke ma'i mai nā lā mua o ke ola e hō'ike'ia e ka ma'i pa. Ho'ohālikelike'ia nā lehulehu i ka 10 a 20 manawa i ka lā. He waiwai lākou, he mele ho'omana'o. Pi'i ka mahana o ke kino o ka'ōpiopio, hiki i ka lua'i'ana. Me ka ho'opau'ia'ana o ka mea'ai lawai'a, ha'alele nā hō'ailona. 'O ka noho'ole o ka momona a me ka waiū e koe no ke ola.

'O kekahi kumu'ē a'e o CMA enterocellular he mea ia e haki ai i ka'ona o ka palapona. He ma'i ma'amau ka ma'i. Noho'ia nā hanana ma hope o ka'ai'ana i nā hua a me nā wai e piha ana i ka palapona i kā lākou hana. 'O kēia a me nā'ōla'a, a me nā alani, a me nā cherries, a me nā cherries. 'O kēlā hua'awa'awa, ka mea i komo'ole'ia e ke kino, ke kumu o ka pupuhi, ka wai o ka wai, ka'eha'eha i ka'ōpū. I kekahi mau mea, hiki i ka lua'i. 'O ke ko'iko'i o nā hō'ailona e pili ana i ka nui o ka'alapona i komo i loko o ke kino.

'O ka kumu kumu ma'amau o ka malabsorption enterocellular me ka uhaki'ana i ka digesona membrane he lawa'ole kaccabididase. Me ia,'a'ole i'oki loa'ia nā kīke'a. 'A'ole lākou e komo i ke komo'ana i nā wahi'āpana o ka'ōpū a ho'okomo'ia i ka waipa'a bacterial me ka ho'oku'u'ana o ka waihā. Loa'a ka hopena o ka colic intestinal, bloating, diarrhea, ho'emi iho i ka makemake, regurgitation, vomiting.

Ho'oma'i'ia ka ma'i maso e like me ka ma'i celiac. 'O kēia kahi ma'i ma'i mau loa o nā ma'i i ho'opoino'ia ai ka'ōpū o ka'ōpū li'ili'i e kekahi mau mea'ai. Noho ka ma'i Celiac i loko o nā keiki he mau mahina ma hope o ka ho'okomo'ia'ana o nā mea'ai o ka lama i ka'ai. Ke ma'i:

• 'O ke alapine o ka make'ana he 2 a 5 manawa i ka lā;
• 'O nā kinona lele he mushy, i kekahi manawa he pumehana, he'ano'ala o lākou, he'ālohilohi;
• Ho'onui ka maha;
• 'A'ole hiki ke kau i ke kaumaha o ka kaumaha (ma hope o kekahi manawa, ua ho'ohui'ia kahi hapa o ka ulu'ana i ka hapa nui).

Hana i ka hō'ailona o ka ma'i ma'i malabsorption

'A'ole i ho'okō'ia ka hō'ailona o ka malabsorption. 'O nā mea kūikawā i ka'ike'ana i nā hō'ailona o SMA e hā'awi i ko lākou mau ma'i i ka ho'oku'u'ana i nā ho'ā'o kūikawā a me nā hō'oia'ana e hō'oia'i'o i kekahi mau ma'i i mana'o'ia e ho'onāukiuki i ka lawe'ana a i'ole ka'ai'ana.

Ke alaka'i'ia nā diagnostics, e alaka'i'ia nā kauka e ka mea algorithm e ho'opili'ia nei e ka Worldast Gastroenterological World:

• 'O ka mea mua, e hō'ili'ili'ia kahi mo'olelo no'ono'o,'ike'ia nā'ike e pili ana i nā lā'au i lawe'ia, nā hele e hele nei, e'ai ana a inu,'a'ole e pili i ka mea'ai ma'amau;
• Ke a'o'ia nei ka mea o ka 'amena;
• Ho'ohālike'ia kekahi'imi i ke kino e hō'ike i nā hō'ailona o ka malabsorption;
• 'O nā haumāna stool kula, e no'ono'o ana i kā lākou mau'ano;
• Ho'olālā'ia nā ho'okolohua laboratory no ka loa'a'ana o ka'ike hou aku.

'O ka hō'ailona hou o ka ma'i ma'i malabsorption e pili ana i ka hana o nā noi'ana me ka kānalua o ka ma'i celiac, ka noho'ana o lamblia, bacteria a parasites i ke kino. 'O ka'ike'ike'ike nui ka mea e hiki iā'oe ke loa'a i ka nānā'ana o nā'ōpū o loko o ka'ōpū. Mahalo i ka'ōpona, hiki ke'ike i ke'ano o ke akepa'a, ka pancreas, ka li'ili'i, nā kīpili lymph.

E hookaawale ia a hoʻokūpaʻa i ka autoimmune gastritis, celiac maʻi, Crohn ka maʻi pono esophagogastroduodenoscopy me biopsy o ka opu a me ka duodenum. No ka hō'oia'i'o'ana i ka lawa'ole o ka hana exocrine o ka pancreas, feces, computer and magnetic resonance imaging, retrograde cholangiopancreatgraphy no ka'ike'ana o nā leke. No ka'ike e pili ana i ka hiki a i'ole ka nele o ka pilikia homeum, nā luna lapa'au e ho'onohonoho i ka haleocolonoscopy me kahi biopsy mai kahi ma lalo o ke a'o a me ka pana.

Ho'oma'o'ia no ka ma'i ma'i palbsorption

Ma hope o ka wehewehe'ana i ke kumu o ka malabsorption, ho'opuka ke kauka i ka ho'oponopono āpau e pili ana i ka ho'opau'ana i ka ma'i i'ike'ia. Eia kekahi la'ana:

• Inā'ike'ia ka ma'i celiac,'ōlelo ka mea kauka i ka mea ma'i i ka mea'ai e ola ai'o ia;
• Inā'ike'ia ka malabsorption o nā huapi'a a i'ole ka'ai'ole o ka'ai, a laila, ua kau'ia ka'ai kūpono a ho'opau'ole'ia;
• Ma nā hana'ele'ele e mālama'ia me nā lā'au'alopelo e hō'ike'ia;
• Me nā ma'i e pili ana i nā ma'i a me nā ma'i'elepona e pono ai ka lā'au lapa'au kūpono.

Me ka ma'i diarrheal diarrh, ka mea e hihia ai ka ma'i, hiki ke hana i ka lā'au a me ke'ano o ka ma'i. Hiki ke ho'ohana i ke'ano o nā kumuhana a me nā ma'i pathogenetic:

• 'O nā lā'au'ūlika no ka wīwī bacterial;
• "Metronidazole" me ka amoebiasis;
• Nā lā'au Anthelmintnyh no nā helminthiash;
• Glucocorticoids, cytostatics, "Infliximab" i loko o nā ma'i o ke kīpalipuni;
• "Tetracycline", "Ceftriaxone", "Co-trimoxazole" me ka ma'i o Whipple;
• 'O "Octreotide" me nā ma'i o endocrin o ka'āpana o ka ma'i.

'O ka ho'ohana'ana i nā hō'ailona like'ole i ka lawe'ana i nā pīpīpika, nā opiates, Loperamide, nā mea ho'olaha ho'olaha (hana ho'omākaukau'ana, Diosmectite).

I ka pakiko-mea hiki ole i loko o ka hanana o symptoms o SMA. Ia, aole ia e haawi maikaʻi hopena. Eia hou kekahi, malabsorption - mea he kīnā o ke kaumaha a me ka pilikia maʻi. Inā e 'ike i nā hōʻailona o SMA ka mea, ua pono, e nīnau aku i ke kauka. Wale i ka hoʻomalu hiki ke kapa i ke kumu oiaio o ka maʻi pale, a, e hoonoho i ka hoʻokō Inc no ka hoʻopau o ka maʻi diagnosed.