He aha te pokanga Ileoanal Anastomosis J-Pouch? Te Whāinga, te Hātepe me ngā Hua

Ko te pokanga Ileoanal anastomosis me te J-pouch he tikanga e hanga ana i tētahi ara hou mō te whakakore i ngā para ina tika ana kia tangohia tō pūwero. Ka tangohia e tō tākuta te whekau nui kua pangia, ka honoa te whekau iti ki tō tōngā ma te whakamahi i tētahi pūhera i hangaia motuhake.

Ko tēnei pokanga ka taea e koe te pupuri i te mahi whekau māori mā tō tōngā, me te karo i te hiahia mō tētahi pēke colostomy tūturu. Ka mahi te J-pouch hei pūrua, e rongoa ana i ngā para kia rite ra anō koe ki te whai i tētahi nekehanga whekau, pērā i tō pūwero taketake.

He aha te pokanga Ileoanal Anastomosis J-Pouch?

E rua ngā mahi nui o tēnei pokanga: te tango i tō pūwero me te pūwero, kātahi ka hanga i tētahi pūhera ā-J mai i tō whekau iti. Ka riro te ingoa o te pūhera nā te mea he rite tonu te ahua ki te reta "J" ina tirohia mai i te taha.

I te wā o te tikanga, ka mau tō tākuta i te pito o tō whekau iti (e kīia ana ko te ileum) ka takai ki runga i a ia anō kia hanga ai tētahi pūrua. Ka honoa tēnei pūhera ki tō tōngā, e āhei ana koe ki te tuku i te tūtae i te ara māori. Ko te hoahoa ā-J e āwhina ana i te pūhera ki te pupuri i te nui ake o ngā para me te whakaiti i te auau o ngā nekehanga whekau.

Ko te nuinga o te tangata e hiahia ana ki tēnei pokanga nā te mate mumura whekau nui, ina koa ko te ulcerative colitis, te familial adenomatous polyposis (FAP) rānei. Ko ēnei āhuatanga e pā ana ki te mumura kino, te tipu rānei o ngā pūtau kōaro e kore e taea te whakahaere mā te rongoā anake.

He aha te take i mahia ai te pokanga Ileoanal Anastomosis J-Pouch?

Ka tūtohu tō tākuta i tēnei pokanga ina kua pangia tō pūwero, e kore e taea te mahi i te ara haumaru, whai hua rānei. Ko te whāinga tuatahi ko te tango i te pūtake o tō mate i te wā e pupuri ana i tō kaha ki te whai i ngā nekehanga whekau noa.

Ko te take tino nui he ulcerative colitis kare e aro ki nga rongoa, e puta ranei nga raruraru nui penei i te toto, te poka, te tupono ranei ki te mate pukupuku. Kāore i rite ki te mate o Crohn, ko te ulcerative colitis anake e pā ana ki te koroni me te rektum, na reira ka waiho tenei pokanga hei rongoa pea.

Me hiahia pea koe ki tenei pokanga mena he familial adenomatous polyposis koe, he mate ira e puta ai nga rau polyps i roto i to koroni. Ka mutu ka mate pukupuku enei polyps ki te kore e tangohia, no reira ka tika te pokanga aukati.

I etahi wa, ka tūtohu nga tākuta i te pokanga J-pouch mo te hunga e tino puhoi ana te kōroke, etahi momo mate pukupuku koroni ranei. I enei keehi, ka taea e te pokanga te whakapai ake i te kounga o te oranga me nga hua hauora mo te wa roa.

He aha te Tikanga mo te Pokanga Ileoanal Anastomosis J-Pouch?

Ko te tikanga ka puta tenei pokanga i roto i nga wahanga e rua, e toru ranei, i runga i to ahuatanga me to hauora katoa. He maha nga tangata e hiahia ana ki nga tikanga maha kia pai ai te whakaora i waenga i ia taahiraa.

I te wa o te wahanga tuatahi, ka tangohia e to taakuta pokanga to koroni me to rektum i te wa e tiaki ana i nga uaua anal sphincter e whakahaere ana i nga nekehanga whekau. Ka hangaia e ratou te J-pouch mai i to whekau iti engari kaore ano kia honoa ki to anus. Engari, ka hangaia e ratou he ileostomy rangitahi, ka kawe mai i tetahi waahanga o to whekau iti ki te mata o to puku.

Ka puta te wahanga tuarua i te 8-12 wiki i muri mai, i muri i te whakaoranga katoa o to J-pouch. Ka honoa e to taakuta pokanga te putea ki to anus ka kati i te ileostomy rangitahi. He maha nga tangata e hiahia ana ki te wahanga tuatoru mena ka puta nga raruraru, mena ranei e hiahia ana to ratou ahuatanga ki te wa whakaora atu.

E 3-5 haora te roa o ia pokanga, ka whiwhi koe i te rongoa rongoa whanui. Ka whakamahi to roopu pokanga i nga tikanga iti nei te whakaeke ina taea, ka taea te whakaiti i te wa whakaora me nga raruraru. Ko te huarahi tika e whakawhirinaki ana ki to anatomy, nga pokanga o mua, me te whānuitanga o to mate.

Me pēhea te whakarite mō tō pokanga Ileoanal Anastomosis J-Pouch?

Ka tīmata te whakarite i ngā wiki maha i mua i te rā o tō pokanga. Ka hiahia tō tākuta ki te whakapai ake i tō kai me te hauora whānui kia pai ake ai te whakaora me te whakaiti i ngā raruraru.

Tērā pea ka mutu i a koe ētahi rongoā ka piki ake te tūponotanga o te toto, pērā i ngā mea whakaheke toto, te aspirini, te rongoā anti-inflammatory rānei. Ka hoatu e te rōpū hauora ngā tohutohu motuhake ki a koe mō ngā rongoā hei whakamahi tonu, hei whakamutu rānei, me te wā hei whakarereke i ēnei mea.

I te rā i mua i te pokanga, me horoi katoa ō whekau mā te whakamahi i tētahi otinga whakarite whekau motuhake. He rite tēnei tukanga ki te whakarite mō te colonoscopy engari he tino whānui ake. Me nohopuku hoki koe i te kai me te nuinga o ngā wai mō ētahi haora i mua i te tukanga.

Whakaarohia te whakarite i te āwhina i te kāinga mō ētahi wiki i muri i te pokanga, i te mea ka hiahia koe ki te āwhina i ngā mahi o ia rā i te tīmatanga. Whakakiia ngā kākahu wātea, ngā kākahu pai hoki, me ngā taonga katoa e tūtohu ana tō rōpū hauora mō te tiaki ostomy mēnā he mea rangitahi tō.

Me pēhea te pānui i ngā hua o tō pokanga Ileoanal Anastomosis J-Pouch?

Ka inehia te angitu i muri i te pokanga J-pouch e ētahi mea, tae atu ki tō kaha ki te whakahaere i ngā nekehanga whekau me te kounga o te oranga. Ka tutuki i te nuinga o te tangata ngā hua pai, ahakoa ka roa te wā kia urutau tō tinana ki te hanganga hou.

I te tīmatanga, tērā pea 8-10 ngā nekehanga whekau i ia rā i te mea e ako ana tō pōkahu ki te pupuri i te para. I te roanga o te wā, ka heke tēnei ki te 4-6 ngā nekehanga i ia rā. Tērā pea ka roa ētahi marama kia tutuki te tino whakahaere i te mea e kaha ana ō uaua tūāpapa me te urutau.

Ka aroturukihia koe e tō tākuta mō ngā raruraru pērā i te pouchitis (te mumura o te pōkahu), e pā ana ki te 30-40% o te tangata i tētahi wā. Ko ngā tohu ko te piki ake o te auau, te ohorere, te kōpū, te toto rānei i roto i tō tūtae. Ka pai te urupare o te nuinga o ngā keehi ki te rongoā paturopi.

He whakahihiri ngā reiti angitu wā-roa, tata ki te 90-95% o te hunga e pupuri ana i tā rātou J-pouch mō te 10 tau neke atu. Heoi anō, tērā pea ka hiahia ētahi tāngata ki te pokanga whakatikatika i te pōtaka, i te wāhi rānei, ki te huri ki te ileostomy tūturu ki te kore e taea te whakatika i ngā raruraru.

Me pēhea te whakahaere i tō whakaora i muri i te pokanga J-Pouch?

Ka puta te whakaora i te wā, i roto i ngā marama maha, me ia wāhanga e kawe ana i ngā wero me ngā whakapainga hou. Ko ngā wiki tuatahi e arotahi ana ki te whakaora i te pokanga me te ako ki te whakahaere i tō ileostomy rangitahi ki te mea he kotahi tāu.

I muri i tō pokanga whakamutunga, tumanako ki ngā nekehanga whekau auau, ngawari i te tīmatanga i te mea e urutau ana tō pōtaka ki tōna tūranga hou. Ka mahi tahi koe me tō rōpū hauora ki te whakawhanake i ngā rautaki mō te whakahaere i te ohorere me te ārai i ngā aitua. Ka taea e ngā mahi papa pelvic te āwhina i te whakakaha i ngā uaua e whakahaere ana i te mau tonu.

He tūranga nui te kai i roto i tō whakaora me te angitu wā-roa. Tērā pea ka tīmata koe ki ngā kai ngawari te keri me te tāpiri haere i te momo i te urutau o tō pūnaha. E kitea ana e ētahi tāngata ko ētahi kai e nui ake ai te hau, te tūtae ngawari rānei, nō reira ka ako koe mā te wheako i te mea e pai ana mōu.

He mea nui ngā whakaritenga whai-ake auau mō te aroturuki i tō ahunga whakamua me te hopu i ngā raruraru i te wā wawe. Ka mahi tō tākuta i te pouchoscopy (te tirotiro i te pōtaka) i ia wā ki te tirotiro mō te mumura, ētahi atu take rānei e hiahia ana ki te rongoā.

He aha ngā āhuatanga tūpono mō ngā raruraru pokanga J-Pouch?

He maha ngā āhuatanga ka whakanui i tō tūponotanga ki ngā raruraru i muri i te pokanga J-pouch. Mā te māramatanga ki ēnei ka āwhina i a koe me tō rōpū hauora ki te mahi i ngā mahi hei whakaiti i ngā raruraru pea.

He nui te pānga o tō tūnga hauora whānui ki ngā hua pokanga. Ko ngā tāngata e tino kore kai ana, e kore e whakahaerehia te mate huka, e ngoikore ana rānei te pūnaha ārai mate e tūpono ana ki te nui ake o te mate me te kore pai o te whakaora. Ka mahi tō rōpū pokanga ki te whakatika i ēnei āhuatanga i mua i te haere tonu.

Ka pānga hoki te pakeke ki ngā putanga, ahakoa ehara i te arai tino ki te pokanga. Ko ngā pakeke ake pea he puhoi te whakaora me te nui ake o ngā tūponotanga, engari he maha tonu e whai hua ana. Ka whakataurite tō tākuta i ngā painga ki ngā tūponotanga i runga i tō āhuatanga takitahi.

Ko ngā pokanga puku o mua ka uaua ake te pokanga J-pouch i te hangarau i te mea he kiko kiko me te huri i te āhua o te tinana. Heoi, ka taea e ngā tākuta mātanga te mahi i ēnei wero i te nuinga o te wā. Ka nui ake te tūponotanga o te kai paipa, ā, me whakamutu i mua i te pokanga.

He aha ngā tūponotanga ka puta i te pokanga J-Pouch?

Ahakoa te nuinga o te tangata e pai ana i muri i te pokanga J-pouch, he mea nui kia mōhio ki ngā tūponotanga ka puta kia mōhio wawe koe ki a rātou me te rapu rongoā tika.

Ko te tūponotanga tino noa ko te pouchitis, e pā ana ki te mumura i roto i tō J-pouch. Ka pāngia pea e koe te nui haere o te auau o te kōpū, te ohorere, te kōpiko, te kirika, te toto rānei i roto i tō tūtae. Ko te nuinga o ngā take e pai ana ki te rongoā paturopi, ahakoa ka whakawhanake ētahi tāngata i te pouchitis mau tonu e hiahia ana ki te whakahaere tonu.

Ka puta hoki ngā raruraru miihini, pēnei i te aukati i te putanga o te pouch, te hanga rānei o te aukati. Ka uaua pea te whakawātea i tō pouch, ka puta te raruraru me te nui haere o te tūponotanga o te mate. Ka puta te aukati i te kōpū iti i te hanga o te kiko kiko, e hiahia ana ki te whakahaere whakatōpū, ki te pokanga atu rānei.

Ko ngā tūponotanga iti noa engari he nui te pōuri ko te rahunga o te pouch, kāore te pouch e mahi tika ahakoa ngā ngana ki te rongoā. Ka hiahia pea tēnei ki te huri ki te ileostomy tūturu. I te wāhi onge, ka whakawhanake te tangata i te mate pukupuku i roto i te kiko tūtae e toe ana, koinei te take he mea nui te tirotiro auau.

Ka puta pea ngā take e pā ana ki te whanaungatanga me te whakatipu uri, inā koa ki ngā wāhine, nā te pokanga nui i te puku. Ka kōrero tō tākuta i ēnei tūponotanga, ā, ka tūtohu pea kia kōrero koe ki ngā tohunga mēnā kei te whakamahere koe ki te whai tamariki ā muri ake nei.

Āhea ahau tūpono ai ki te kite i te tākuta i muri i te pokanga J-Pouch?

Whakapā atu ki tō kaiwhakarato hauora tonu mēnā ka pā ki a koe te mamae nui o te puku, te kirika nui, ngā tohu o te maroke, te kore rānei e taea te whakawātea i tō pōkahu. Ko ēnei tohumate ka tohu pea i ngā raruraru nui e hiahia ana ki te rongoā ohorere.

Me rapu hoki koe i te āwhina hauora mēnā ka kite koe i ngā huringa nui i roto i tō tauira whekau, pēnei i te piki ohorere o te auau, te toto i roto i tō tūtae, te kōpū nui rānei kāore e pai ake i ngā tikanga noa. Ko ēnei pea ngā tohu o te pouchitis, ētahi atu raruraru rānei e hiahia ana ki te arotake tere.

Kaua e whakaroa ki te waea atu mēnā e māharahara ana koe mō te ahunga whakamua o tō whakaora, he pātai rānei āu mō te whakahaere i tō J-pouch. E tūmanako ana tō rōpū hauora ki ēnei pātai, ā, ka taea e rātou te āwhina i a koe kia whai hua pai.

He mea nui ngā whakaritenga whai-whai tonu mō te angitu wā-roa, ahakoa kei te pai koe. Ka aroturuki tō tākuta i ngā raruraru, ā, ka mahi i ngā tikanga tirotiro kia kite wawe i ngā raruraru i te wā e taea ana te rongoā.

Ngā Pātai Auau mō te Pokanga J-Pouch

Q1: He rongoā te pokanga J-pouch mō te ulcerative colitis?

Āe, ka taea e te pokanga J-pouch te rongoā i te ulcerative colitis nā te mea ka tangohia katoa ngā kiko whekau tūroro kei reira te mumura. Kāore i rite ki te mate a Crohn, ka pā ki tētahi wāhanga o te ara kūnatu, ko te ulcerative colitis anake e pā ana ki te whekau me te pūwero.

I muri i te pokanga J-pouch angitu, e kore koe e hiahia ki nga rongoa i tangohia e koe mo te colitis ulcerative, a e kore koe e wheako i nga tohu o te mate kaha. Heoi, me urutau koe ki te oranga me te J-pouch, he rereke te mahi i to anatomy taketake.

Q2: Ka taea e au te noho i te oranga noa me te J-pouch?

Ko te nuinga o nga tangata whai J-pouches e noho ana i nga oranga katoa, kaha i muri i te otinga o to ratou whakaora. Ka taea e koe te korikori, te haere, te mahi, me te whai waahi ki te nuinga o nga mahi i pai ki a koe i mua i te pokanga, ahakoa me whakarereke etahi.

Ka nui ake pea nga nekehanga whekau i mua i te pokanga, te tikanga 4-6 nga wa ia ra. Ko te whakamahere i te uru ki te wharepaku ka nui ake te hiranga, ina koa i te tau tuatahi i te wa e urutau ana to putea. He maha nga tangata e kite ana he ngawari enei whakarereketanga ki te whakataurite ki te noho me te mate whekau mumura nui.

Q3: E hia te roa ki te ora mai i te pokanga J-pouch?

Tata ki te 6-12 marama te whakaora katoa, ahakoa he rereke tenei i waenga i nga tangata takitahi. Ko te noho i te hōhipera tuatahi he 5-7 ra te tikanga, a ka hoki haere koe ki nga mahi noa i roto i nga wiki maha.

Mena he tikanga e rua-waahanga to, ka hiahia koe ki te 2-3 marama i waenga i nga pokanga mo te whakaora tika. I muri i to pokanga whakamutunga, tatari mo etahi marama kia urutau katoa to putea me te whakatutuki i te pai o te noho me te whakahaere whekau.

Q4: He aha nga kai me karo e au me te J-pouch?

Ahakoa he iti ake te here o te kai i te mate whekau mumura, tera pea etahi kai ka raru mo nga turoro J-pouch. Ko nga kai muka nui, nati, purapura, me te kānga i etahi wa ka arai, ka nui ake te hanga hau.

Me karo pea koe i nga kai raukikini rawa, te waipiro, me te kawhe i te tuatahi, na te mea ka riri enei i to putea, ka nui ake ranei te auau o te whekau. Heoi, he maha nga tangata e whakahoki haere ana i enei kai i te wa e urutau ana to ratou putea. Ma te mahi tahi me te tohunga kai ka awhina koe ki te whakawhanake i tetahi mahere kai.

Q5: Ka taea te kore angitu o te pokanga J-pouch, ā, he aha te mea ka tupu i muri mai?

Ka puta te korenga o te J-pouch i te 5-10% o ngā tūāhua, te nuinga nā te pouchitis tawhito kāore e aro ki te rongoā, ngā raruraru ā-miihini, te mahi kino rānei o te pouch. Ki te pēnei te āhuatanga, me huri koe ki te ileostomy tūturu.

Ahakoa he mea pouri tēnei putanga, he tokomaha ngā tāngata e kite ana he pai ake te kounga o te oranga o te ileostomy e pai ana te mahi i tō te J-pouch e kore nei e pai. Nā ngā taonga ostomy hou me ngā pūnaha tautoko ka ngāwari ake tēnei huringa i ngā wā o mua.