I-Malabsorption

I-Malabsorption ifaka izinkinga ngekhono lomzimba lokuthatha (ukumunca) izakhamzimba ekudleni.

Izifo eziningi zingadala i-malabsorption. Ngokuvamile, i-malabsorption ihilela izinkinga zokumunca ushukela, amafutha, amaprotheni, noma amavithamini athile. Kungabandakanya nenkinga ephelele ngokumunca ukudla.

Izinkinga noma ukulimala emathunjini amancane okungaholela ezinkingeni zokumunca izakhi zomzimba ezibalulekile. Lokhu kufaka phakathi:

• Isifo seCeliac
• I-tropical sprue
• Isifo seCrohn
• Isifo semvubu
• Ukulimala kokwelashwa ngemisebe
• Ukwanda kwamagciwane emathunjini amancane
• Ukutheleleka nge-parasite noma nge-tapeworm
• Ukuhlinzwa okususa konke noma ingxenye yamathumbu amancane

Ama-enzyme akhiqizwa amanyikwe asiza ukumunca amafutha nezinye izakhamzimba. Ukwehla kwala ma-enzyme kwenza kube nzima ukuncela amafutha nezakhi ezithile zomsoco. Izinkinga ngamanyikwe zingabangelwa:

• ICystic fibrosis
• Ukutheleleka noma ukuvuvukala kwamanyikwe
• Ukuhlukumezeka kwamanyikwe
• Ukuhlinzwa ukususa ingxenye yamanyikwe

Ezinye zezinye izimbangela ze-malabsorption zifaka:

• Ingculazi kanye ne-HIV
• Imithi ethile (i-tetracycline, amanye ama-antacids, eminye imithi esetshenziselwa ukwelapha ukukhuluphala, i-colchicine, i-acarbose, i-phenytoin, i-cholestyramine)
• I-Gastrectomy kanye nokwelashwa kokuhlinzwa kokukhuluphala
• ICholestasis
• Isifo esingalapheki sesibindi
• Ukungabekezelelani kwamaprotheni obisi lweCow
• Ukungabekezelelani kwamaprotheni obisi lweSoy

Ezinganeni, isisindo samanje noma isilinganiso sokuzuza kwesisindo kuvame ukuba ngaphansi kakhulu kunezinye izingane ezineminyaka efanayo nobulili. Lokhu kubizwa ngokwehluleka ukuchuma. Ingane kungenzeka ingakhuli futhi ikhule ngokujwayelekile.

Abantu abadala bangase futhi bahluleke ukuchuma, ngokuncipha, ukuncipha kwemisipha, ubuthakathaka, kanye nezinkinga zokucabanga.

Izinguquko ezitokisini zivame ukubakhona, kepha hhayi njalo.

Izinguquko ezithweni zingafaka:

• Ukuqunjelwa, ukuqunjelwa, negesi
• Izindle ezinamandla
• Uhudo olungamahlalakhona
• Izitulo ezinamafutha (steatorrhea)

Umhlinzeki wakho wezokunakekelwa kwempilo uzokwenza isivivinyo. Ukuhlolwa okungenziwa kufaka phakathi:

• Ukuhlolwa kwegazi nomchamo
• I-CT scan yesisu
• Ukuhlolwa komoya we-Hydrogen
• MR noma i-CT
• Ukuhlolwa kweSchilling kokushoda kukavithamini B12
• Isivivinyo sokukhuthaza i-Secretin
• I-biopsy encane yamathumbu
• Isiko lesiko noma isiko le-aspirate yamathumbu amancane
• Ukuhlolwa kwesitokisi samafutha
• Ama-X-ray wamathumbu amancane noma okunye ukuhlolwa kwe-imaging

Ukwelashwa kuya ngesizathu futhi kuhloswe ngakho ukukhulula izimpawu nokuqinisekisa ukuthi umzimba uthola izakhamzimba ezanele.

Ukudla okunama-kilojoule amaningi kungazama. Kufanele inikeze:

• Amavithamini ayisihluthulelo namaminerali, njenge-iron, i-folic acid, ne-vitamin B12
• Ama-carbohydrate anele, amaprotheni, namafutha

Uma kudingeka, imijovo yamanye amavithamini namaminerali noma izici ezikhethekile zokukhula zizonikezwa. Labo abanomonakalo kumanyikwe kungadinga ukuthatha ama-enzyme e-pancreatic. Umhlinzeki wakho uzokunquma lokhu uma kunesidingo.

Imithi yokwehlisa ijubane ukunyakaza kwamathumbu ingazanywa. Lokhu kungavumela ukudla ukuthi kuhlale emathunjini isikhathi eside.

Uma umzimba ungakwazi ukudonsa izakhi ezanele, inani lokudla okunomsoco we-parenteral (TPN) lizanywa. Kuzokusiza wena noma ingane yakho ukuthola umsoco kwifomula ekhethekile ngomthambo emzimbeni. Umhlinzeki wakho uzokhetha inani elifanele lamakhalori nesisombululo se-TPN. Kwesinye isikhathi, ungadla futhi uphuze ngenkathi uthola umsoco ku-TPN.

Umbono uncike kulokho okubangela i-malabsorption.

I-malabsorption yesikhathi eside ingaholela ku:

• Ukushoda kwegazi
• Amatshe amatshe amade
• Amatshe ezinso
• Amathambo azacile futhi abuthakathaka

Shayela umhlinzeki wakho uma unezimpawu ze-malabsorption.

Ukuvimbela kuncike esimweni esidala i-malabsorption.

• Uhlelo lokugaya ukudla
• ICystic fibrosis
• Izitho zohlelo lokugaya ukudla

UHögenauer C, uHammer HF. I-Maldigestion kanye ne-malabsorption. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 104.

USemrad CE. Sondela esigulini ngesifo sohudo kanye ne-malabsorption. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 131.