Maʻi Crohn

ʻO ka maʻi Crohn kahi maʻi kahi e wela ai nā ʻāpana o ka digestive tract.

• Hoʻokomo pinepine ia i ka hopena haʻahaʻa o ka ʻōpū liʻiliʻi a me ka hoʻomaka ʻana o ka ʻōpū nui.
• Hiki paha ia i kekahi o nā ʻōnaehana digestive mai ka waha a hiki i ka hopena o ke kiko (anus).

ʻO ka maʻi Crohn kahi ʻano o ka maʻi ʻōpū (IBD).

ʻO ke ʻano ulcerative colitis kahi ʻano pili.

ʻAʻole ʻike ʻia ke kumu kūpono o ka maʻi Crohn. Kū ia i ka wā e hoʻouka kuhi hewa a pale ka kino o kou kino i nā kino o ke kino (maʻi autoimmune).

Ke pehu a pehu paha nā ʻāpana o ka digestive, e mānoanoa ana nā paia o nā ʻōpū.

ʻO nā kumu i pāʻani i ka maʻi Crohn me:

• Kou genes a me ka moʻolelo o ka ʻohana. (ʻO ka poʻe keʻokeʻo a i ʻole he lāhui Iudaio ʻEulopa Hikina ka nui o ka makaʻu.)
• Nā kūlohelohe.
• ʻO ka maʻamau o kou kino e hana hou i nā bacteria ma nā ʻōpū.
• Puhipaka.

Hiki ke loaʻa i ka maʻi Crohn i kēlā me kēia makahiki. Hana ʻia ia i ka poʻe ma waena o nā makahiki 15 a me 35.

Pili nā ʻōuli i ka ʻāpana o ka digestive tract i pili. Kūleʻa nā ʻōuli mai ka ʻoluʻolu a i ʻole ke koʻikoʻi, a hiki ke hele a hele, me nā wā o ka hoʻā ahi.

ʻO nā ʻōuli nui o ka maʻi Crohn ʻo:

• ʻO kaʻeha Crampy i loko o ka'ōpū (kahi o ka'ōpū).
• Fiva.
• Ka luhi.
• Ka nele o ka makemake a me ka pohō kaumaha.
• Ke manaʻo nei ʻoe e pono e hele i nā noho, ʻoiai ua hakahaka kou ʻōpū. Pili paha ia i ka kānana, ʻeha, a me ka cramping.
• ʻO ka diarrhea wai, ka mea he koko paha.

Hiki i nā ʻōuli ʻē aʻe ke:

• Konipōpō
• ʻO nā ʻeha a ʻū paha i nā maka
• Ka ninini ʻana i ka pā, mauʻu, a i ʻole nā ​​noho mai ka puni o ka poli a i ʻole ka anus (i hoʻokumu ʻia e kekahi mea i kapa ʻia he fistula)
• ʻEha hui a pehu
• Ulcer waha
• Kahe koko a me nā noho koko
• Gums pehu
• Mālie, puʻupuʻu ʻulaʻula (nodule) ma lalo o ka ʻili, i lilo i ʻeha ʻili

Hiki i kahi hoʻokolohua kino ke hōʻike i ka nui a palupalu paha i loko o ka ʻōpū, ʻeha ka ʻili, nā hui pehu, a nā puʻupuʻu waha paha.

ʻO nā hoʻāʻo e kuhikuhi ai i ka maʻi Crohn e komo pū ana:

• ʻO ka enema Barium a i ʻole ka papa kiʻekiʻe GI (gastrointestinal)
• ʻO Colonoscopy a sigmoidoscopy paha
• CT scan o ka ʻōpū
• Kāpena endoscopy
• MRI o ka ʻōpū
• Hoʻokena
• ʻO MR enterography

Hana ʻia kahi moʻomeheu noho aliʻi e kāpae i nā kumu kūpono ʻē aʻe o nā ʻōuli.

Hiki i kēia maʻi ke hoʻololi i nā hopena o nā hōʻike aʻe:

• Papa haʻahaʻa albumin
• Kuhi helu kiʻekiʻe
• Hoʻokiʻekiʻe CRP
  
• Momona fecal
• Helu koko haʻahaʻa (hemoglobin a me hematocrit)
• Nā hoʻāʻo koko akepa ʻole
• Helu keʻokeʻo kiʻekiʻe keokeo
• ʻO ka pae kiʻekiʻe calecotectin fecal i ka pahu

Nā ʻōlelo aʻoaʻo no ka mālama ʻana i ka maʻi Crohn ma ka home:

HAIPAU A ME NUTRITION

Pono ʻoe e ʻai i ka papaʻai kaulike, olakino olakino. Hoʻopili i ka nui o nā calorie, protein, a me nā meaʻai mai nā ʻano meaʻai like ʻole.

ʻAʻole hōʻike ʻia kahi papaʻai kikoʻī e hana i nā ʻōuli o Crohn i ʻoi aku ka maikaʻi a maikaʻi ʻole paha. Hiki ke ʻokoʻa nā ʻano pilikia o ka meaʻai mai kēlā me kēia kanaka.

Hiki i kekahi mau mea ʻai ke hoʻonui i ka palahī a me ke kinoea. I mea e hōʻoluʻolu ai i nā ʻōuli, e hoʻāʻo:

• ʻO ka ʻai ʻana i nā meaʻai liʻiliʻi i ka lā holoʻokoʻa.
• Ke inu nei i ka nui o ka wai (inu pinepine i nā mea liʻiliʻi i ka lā holoʻokoʻa).
• Ke pale nei i nā meaʻai o ke fiber kiʻekiʻe (bran, beans, nati, nā hua, a me nā popcorn).
• ʻO ka pale ʻana i nā mea momona, momona a palai paha a me nā mea ʻono (ka waiūpata, ka margarine, a me ka momona momona).
• Ka palena ʻana i nā huahana waiū inā pilikia ʻoe i ka ʻai ʻana i nā momona o ka waiū. E hoʻāʻo i nā paʻi waiū lactose haʻahaʻa, e like me Swiss a me cheddar, a me kahi huahana enzyme, e like me Lactaid, e kōkua ai e wāwahi i ka lactose
• ʻO ka pale ʻana i nā meaʻai āu e ʻike ai ke kumu o ke kōkō, e like me nā pīni a me nā mea kanu i loko o ka ʻohana kāpeti, e like me ka broccoli.
• Ka pale ʻana i nā meaʻai nīoi.

E noi i kāu mea mālama ola e pili ana i nā huaora a me nā minelala keu e pono ai, e like me:

• ʻO nā mea hoʻohui hao (inā he anemia ʻoe).
• Kalipona a me nā huaora D e kōkua i ka ikaika o kou iwi.
• ʻO ka Vitamin B12 e pale aku i ka anemia, keu hoʻi inā ua hemo ka hopena o ka liʻiliʻi (ileum).

Inā loaʻa iā ʻoe kahi ileostomy, pono ʻoe e aʻo:

• Hoʻololi nā meaʻai
• Pehea e hoʻololi ai i kāu ʻeke
• Pehea e mālama ai i kāu stoma

KAUOHE

Hiki paha iā ʻoe ke hopohopo, hilahila, a i ʻole kaumaha a kaumaha hoʻi e pili ana i ka maʻi ʻōpū. ʻO nā hanana koʻikoʻi ʻē aʻe i kou ola, e like me ka neʻe ʻana, kahi nalowale hana, a i ʻole ka nalo ʻana o kahi mea aloha e hiki ai ke hōʻeha i nā pilikia digestive.

E noi i kāu mea hāʻawi no nā ʻōlelo aʻoaʻo e pili ana i ka hoʻokele i kou koʻikoʻi.

NA LAAU LAPAAU

Hiki iā ʻoe ke lawe i ka lāʻau e mālama ai i ka palahō maikaʻi ʻole. Hiki ke kūʻai ʻia ʻo Loperamide (Imodium) me ka ʻole o ka lāʻau. E kamaʻilio mau i kāu mea hoʻolako ma mua o ka hoʻohana ʻana i kēia mau lāʻau.

Nā lāʻau ʻē aʻe e kōkua me nā ʻōuli e like me:

• ʻO nā mea kōkua puluniu, e like me ka pauka psyllium (Metamucil) a i ʻole methylcellulose (Citrucel). E noi i kāu mea hāʻawi ma mua o ka lawe ʻana i kēia huahana a i ʻole nā ​​laxatives.
• Acetaminophen (Tylenol) no kaʻeha māmā. Hōʻalo i nā lāʻau e like me aspirin, ibuprofen (Advil, Motrin), a i ʻole naproxen (Aleve, Naprosyn) i hiki ke hōʻeha i kāu mau ʻōuli.

Kauoha paha kāu mea hāʻawi i nā lāʻau e kōkua ai i ka mālama ʻana i ka maʻi Crohn:

• ʻO Aminosalicylates (5-ASAs), nā lāʻau e kōkua i ke kaohi i nā ʻōuli akahai. Lawe ʻia kekahi ʻano o ka lāʻau e ka waha, a ʻo nā mea ʻē aʻe e pono e hāʻawi pololei ʻia.
• Hana nā Corticosteroids, e like me prednisone, mālama i ka maʻi Crohn kūpono a paʻakikī. Lawe ʻia lākou i ka waha a i ʻole hoʻokomo ʻia i loko o ka pā.
• Nā lāʻau e hoʻomaha ai i ka hopena o ka ʻōnaehana pale.
• Nā Antibiotics e mālama i nā abscesses a i ʻole fistulas.
• ʻO nā lāʻau Immunosuppressive e like me Imuran, 6-MP, a me nā mea ʻē aʻe e hōʻalo ai i ka hoʻohana wā lōʻihi o nā corticosteroids.
• Hiki ke hoʻohana ʻia ka lāʻau biologic therapy no ka maʻi Crohn koʻikoʻi e pane ʻole i nā ʻano lāʻau ʻē aʻe.

NA MEA HANA

Pono paha kekahi poʻe me ka maʻi Crohn i kahi ʻoki e wehe i kahi ʻino i hōʻino ʻia a maʻi paha o ka ʻōpū. I kekahi mau hihia, hemo ka ʻōpū nui āpau, me ka ʻole o ka pololei.

ʻO ka poʻe i loaʻa i ka maʻi Crohn ʻaʻole pane i nā lāʻau e pono ai ke ʻoki e mālama i nā pilikia e like me:

• Kahena
• ʻAʻole e ulu (i nā keiki)
• Fistulas (pili pili ʻole ma waena o nā ʻōpū a me kahi ʻē aʻe o ke kino)
• Nā maʻi ʻino
• Pihikihi o ka ʻōpū

ʻO nā ʻoki lāʻau hiki ke hana ʻia me:

• Ileostomy
• ʻO ka hemo ʻana o kahi ʻāpana o ka ʻōpū nui a i ʻole ʻōpū liʻiliʻi
• ʻO ka hemo ʻana o ka ʻōpū nui i ka kiko
• Ka hemo ʻana o ka ʻōpū nui a me ka hapa nui o ka pololei

Hāʻawi ka Crohn's a me Colitis Foundation o ʻAmelika i nā hui kākoʻo a puni ka United States - www.crohnscolitisfoundation.org

ʻAʻohe lāʻau lapaʻau no ka maʻi Crohn. Kuhi ʻia ke ʻano e nā manawa o ka hoʻomaikaʻi a ukali ʻia e nā uila. ʻAʻole hiki ke hoʻōla ʻia ka maʻi Crohn, ʻoiai me ke kahakaha ʻana. Akā hiki i ka lāʻau hoʻomalu ke hāʻawi i kōkua nui.

Nui aʻe kāu makaʻu no ka ʻōpū liʻiliʻi a me ka maʻi ʻaʻai kolona inā loaʻa ʻoe i ka maʻi Crohn. Hōʻike paha kāu mea hāʻawi i nā hoʻokolohua e nānā ai no ka maʻi ʻaʻai kolona. Paipai pinepine ʻia kahi colonoscopy inā loaʻa iā ʻoe ka maʻi Crohn e pili ana i ke kolona no 8 a ʻoi paha mau makahiki.

ʻO kēia mau pilikia me ka poʻe i loaʻa i ka maʻi Crohn ʻoi loa.

• Loaʻa ʻole a maʻi paha i nā ʻōpū
• Anemia, ka nele o nā hunaola ʻulaʻula
• Pā paʻa ʻōpū
• ʻO nā fistula i loko o ka puhā, ʻili, a i ʻole pūnana
• Hoʻonui lohi a me ka ulu ʻana o ka moekolohe i nā keiki
• ʻO ka pehu ʻana o nā hono
• Ka nele o nā meaola nui, e like me ka wikamina B12 a me ka hao
• Nā pilikia me ka mālama ʻana i kahi kaupaona olakino
• ʻO ka pehu ʻana o nā lāʻau bile (cholangitis sclerosing mua)
• ʻO nā maʻi ʻili, e like me ka pyoderma gangrenosum

Kāhea i kāu mea hāʻawi inā ʻoe:

• He ʻeha ʻōpū maikaʻi ʻole
• ʻAʻole hiki ke kāohi i kou palahī me nā loliʻai a me nā lāʻau
• Ua lilo kaupaona, a i ʻole ke hele a ke keiki i ke kaumaha
• Loaʻa i ke kahe o ke kahe, ka hoʻokahe, a i ʻole nā ​​ʻeha
• Loaʻa i ke kuni e mau ana ma mua o 2 a 3 mau lā, a i ʻole ke kuni i ʻoi aku ma mua o 100.4 ° F (38 ° C) me ka ʻole o ka maʻi.
• Loaʻa ka nausea a me ka luaʻi e ʻoi aku ma mua o hoʻokahi lā
• Loaʻa i nā ʻeha ʻili e hoʻōla ʻole ai
• Loaʻa i kaʻeha hui e pale iā ʻoe mai ka hana ʻana i kāu hana o kēlā me kēia lā
• Loaʻa nā hopena ʻaoʻao mai nā lāʻau āu e lawe nei no kāu kūlana

Maʻi ʻo Crohn; Maʻi maʻi ʻōpū - Crohn disease; Enteritis āpana; Ileitis; ʻO ka ileocolitis Granulomatous; IBD - maʻi Crohn

• Papaʻai Bland
• Constipation - he aha e nīnau aku ai i kāu kauka
• Maʻi Crohn - hoʻokuʻu
• Diarrhea - he aha e nīnau aku ai i kāu kahu mālama ola - makua
• ʻO Ileostomy a me kāu keiki
• Ileostomy a me kāu papaʻai
• Ileostomy - mālama i kāu stoma
• Ileostomy - ke hoʻololi nei i kāu ʻeke
• Ileostomy - hoʻokuʻu
• Ileostomy - he aha e nīnau aku ai i kāu kauka
• ʻO ka ʻōpū nui o ka ʻōpū - hoʻokuʻu
• Noho me kāu ileostomy
• ʻAiʻai haʻahaʻa
• Hoʻokiʻi liʻiliʻi o ka ʻōpū - hoʻokuʻu
• Nā ʻano o ka ileostomy

• ʻŌnaehana Digestive
• Maʻi Crohn - X-ray
• Maʻi maʻi ʻōpū
• Nā fistula Anorectal
• Maʻi Crohn - nā wahi i hoʻopili ʻia
• Ulcerative colitis
• Maʻi maʻi ʻōpū - series

Le Leannec IC, Wick E. Hoʻokele o Crohn's colitis. I: Cameron AM, Cameron JL, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 13th ed. Piladelapia, PA: Elsevier; 2020: 185-189.

Lichtenstein GR. Maʻi maʻi ʻōpū. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 132.

Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE. Kuhi Alakaʻi ACG: Ka mālama ʻana i ka maʻi o Crohn i ka poʻe mākua. ʻO Am J Gastroenterol. 2018; 113 (4): 481-517. PMID: 29610508 www.ncbi.nlm.nih.gov/pubmed/29610508.

Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Kolona a me ka pololei. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 51.

Sandborn WJ. ʻO ka loiloi a me ka mālama ʻana o ka maʻi ʻo Crohn: mea hana hoʻoholo hoʻoholo. Gastroenterology. 2014; 147 (3): 702-705. PMID: 25046160 www.ncbi.nlm.nih.gov/pubmed/25046160.

ʻO Sands BE, Siegel CA. Maʻi ʻo Crohn. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 10 o ka lā. Piladelapia, PA: Elsevier Saunders; 2016: chap 115.