Malabsorption - ihe bụ nke a? Nhazi ọkwa na-akpata

Obere mgbiri afọ - onye nke eriri afọ. Ọ rụrụ a dịgasị iche iche nke ọrụ, ekere òkè bụ isi na mgbaze nri na absorption nke nri. Na mmepe nke ọrịa ụfọdụ akwusila a ngalaba - doro malabsorption syndrome, nke na-abbreviated dị ka CMA. Gịnị bụ ihe a okwu? Nke a syndrome e mere site Olee ihe ndị mere?

nyopụta echiche

Na ahụ ike na akwụkwọ, i nwere ike ịhụ a okwu ndị dị ka "malabsorption". Nke a na okwu a na-eji na-ezo aka malabsorption nsia mucosa nri mmiri. E nwekwara a okwu ndị dị ka "maldigestion". Nke a mebiri akakabarede Filiks nke abụba, protein na carbohydrate mgbaze ngwaahịa absorbable.

Ndị ọkachamara na-ikpokọta ma nke n'elu okwu ( "malabsorption" na "maldigestion"), mgbe otu onye na-ekwu okwu nke malabsorption syndrome. Na-ezo aka mgbagwoju adakarị ngosipụta, ịda nke imebi nke uji eze, mgbidi, akpụkpọ ahụ mgbaze na iga na obere eriri afọ. N'ihi na mgbanwe na-ewere ọnọdụ n'ime ahụ mmadụ ruru ka ntoputa nke malabsorption syndrome, metabolic ọrịa na-egosi. People amalite emekpa wetara ihe mgbaàmà.

Na-akpata sma

malabsorption syndrome hụrụ ọtụtụ butere n'aka na congenital ọrịa na nke nsogbu absorption nke bekee, belata enzyme ọrụ. Dị ka ihe atụ, cystic fibrosis. Na nke a ọrịa, AGR amalite n'ihi belata enzyme ọrụ na pancreatic ọrịa nzuzo viscosity.

Iji ime ka malabsorption syndrome ọrịa ndị na-efe efe na nje ndị ọzọ, ọrịa ntutu ịdapụsị lymphatic na nrugharị ọbara usoro. CMA na-ahụ kwukwara na ikpe nke na mmebi nke obere eriri afọ ma mbenata absorption ebe (akpọ mgbanwe ndị ahụ n'ahụ, na-a na-akpata oké nsogbu nke ọtụtụ iche iche nke mgbanwe, anụ ahụ na nke uche stunting).

N'ihi ya, malabsorption - a set nke wetara ihe mgbaàmà nke nwere ike ime ka a otutu dị iche iche ihe. Ha nwere ike ikpokọta dị ka ndị a:

1. Preenteralnaya otu. Ndị a gụnyere biliary tract ọrịa, imeju, afo, cystic fibrosis.
2. Postenteralnaya otu. Ọ na-agụnye ndị Lymph na ọbara ọrịa na ogologo eriri afọ, bụ nke dị n'agbata afo na colon, exudative enteropathy, lymphosarcoma, Hodgkin oria.
3. Enteral otu ihe kpatara ya. Ndị a gụnyere galactose malabsorption, celiac ọrịa, ọdịda disaccharidase, giardiasis, dermatitis herpetiformis.

Mgbaàmà kpọmkwem ka sma

N'agbanyeghị eziokwu na ndị malabsorption syndrome pụta ụwa ọrịa dị iche iche, nwere ike ịbụ na-akwanyere ùgwù na atụmatụ e ji mara ya. Mgbe CMA ọgbụgbọ, vomiting. Na ọrịa na-ebelata agụụ. ndị a mgbaàmà na-hụrụ dị ka bloating, mgbanwe stool (afọ ọsịsa abụkarị). All ndị a ihe ịrịba ama na-akpọ dyspeptic syndrome. Ọ na-eduzi ndị na-adakarị ngosipụta nke sma.

Special ntị kwesịrị oche. Ịchọpụta àgwà nke feces, ndị ọkachamara na-enweta ihe ọmụma dị mkpa na-enye ha ohere etinye ihe na-arịa:

• na frothy mmiri mmiri stool na acidic isi - a mgbaàmà ahụ nwere ike ịbụ pụta ụwa pathologies dị ka glucose-galactose malabsorption, disaccharidase erughi;
• kegriiz stool bụ na-adịghị ala ala pancreatitis, cystic fibrosis, dermatitis herpetiformis, exudative enteropathy syndrome Pearson, nsia dysbacteriosis;
• ukwuu kegriiz stools hụrụ cystic fibrosis, congenital lipase erughi;
• mmiri afọ ọsịsa - a mgbaàmà nke nwere ike ime mgbe onye ọrịa abatakwa ahụ, na-emepe emepe enterocolitis, malabsorption nke glucose na galactose.

Mgbe MCA mgbe ụfọdụ e nwere ihe mgbu. Ọtụtụ mgbe, ha ime ka nsia-efe efe na infestations. Pain syndrome nwere ike ime mgbe na-ewe Mmiri ara ehi na ngwaahịa. Ọ jikọtara na foamy oche na a gbara ụka ísì ụtọ, flatulence na-egosi a lactase erughi. Abdominal mgbu n'oge CMA eso nri allergies, nsia abnormalities, Whipple ọrịa, ọnyá afọ, Crohn oria. Ndị na-esonụ mgbaàmà na-hụrụ ọbụna mgbe malabsorption syndrome:

• akpụkpọ ọkụ ọkụ;
• ike ọgwụgwụ;
• a mmetụta nke adịghị ike;
• bloating;
• anorexia.

Malabsorption na ụmụ so site kọrọ ọrịamkpokọta. Nsogbu n'obi nkịtị development. Nke a na-egosipụta na Mbelata arọ ahụ, mmepe nke nri, stunted ibu. On vitamin erughi na-egosi na steeti nke anụ. The akpụkpọ aghọ akọrọ na-amalite bee apụ. On ya apụta ọchịchịrị tụrụ. Hair thinning na-amalite iji dobe pụta. The mbọ na-dull ụda ma exfoliate. Mgbe calcium erughi ime cramps, ihe mgbu na uru na ọkpụkpụ. Enweghị ígwè, ọla kọpa na zinc na-eduga ná mpụta nke anụ ọkụ ọkụ, ígwè-erughi anaemia, ntọt ke okpomọkụ nke ahụ.

ẹdude nhazi ọkwa

malabsorption syndrome-agụnye ihe karịrị 70 dị iche iche ọrịa. Na nke a, ndị ọkachamara na-zutere ụfọdụ ihe isi ike na nhazi ọkwa nke nkwadebe. Ihe ịga nke ọma bụ nkewa nke butere n'aka na enwetara malabsorption ọrịamkpokọta:

1. Nke mbụ n'ime ha achọpụtara na 10% nke ikpe. Butere n'aka sma na-ebugharị nne na nna na nwa. Ọ na-bụ n'ihi na site n'usoro mmụba.
2. Enwetara malabsorption syndrome - n'ihi nsia na extraintestinal ọrịa (e.g. etuto ahụ, immunodeficiencies, imeju na-na pancreas).

E nwekwara a nhazi ọkwa nke dabeere ogo malabsorption syndrome:

• Mezuwo m (nwayọọ ụdị) - ụmụ ubé belata ahu arọ, mgbaàmà ibili multivitamin ọdịda hụrụ disharmonious nkịtị development;
• II ogo (nkezi udi) - onye ọrịa nwere ahu uka mpe (ndiiche si norm dị ukwuu karịa 10%) a hụrụ lag nkịtị mmepe, hụrụ akpọ ịrịba ama electrolyte erughi na insufficiency multivitamin;
• Mezuwo III (oké) - ụmụaka ahụ na-anụ underdeveloped, ahụ uka mpe karịa 20%, na ụfọdụ ọrịa na e nwere a na-egbu oge na psychomotor development.

ụdị malabsorption

Na 1977 ẹkenịmde nke Asatọ World Congress of Gastroenterology. Ọ ọkachamara kwuru na ọ bụ ọtụtụ ụdị nke malabsorption, dabere na ya na-akpata:

• intracavitary;
• posttsellyulyarnaya;
• enterotsellyulyarnaya.

Enweghị bile secreted anyịnya na bekee nke na-emetụta ndị recessed mgbaze na-akpata iro, - malabsorption intracavitary ụdị. Na-amụ ije ha na-adapụta ruru cystic fibrosis, congenital hypoplasia nke pancreas. Na ụmụaka okenye ọdịdị intracavitary malabsorption syndrome akpasu ọrịa ndị dị ka imeju, ala ala pancreatitis.

The abụọ ụdị sma - posttsellyulyarnaya malabsorption. Nke a syndrome, nke e ji ọnwụ nke plasma protein site nsia mgbidi. Ọ hụrụ na anomalies nke ọbara na lymphatic usoro. Otu n'ime ihe ndị ọrịa - ihe mgbawa nsia lymphangiectasia. Ọ bụ pụta ụwa na arọ ọnwụ nke calcium, lipids na-edozi ahụ na eriri afọ tract.

Enterotsellyulyarny ụdị agwakọta ndị ahụ ebe gbajiri akpụkpọ ahụ mgbaze ma ọ bụ absorption ruru ka a ntụpọ nke enzyme usoro nke nsia epithelial mkpụrụ ndụ. Ndị dị otú ahụ nwere ike ime na-eto eto ụmụ n'ihi na nke butere n'aka ọrịa metụtara na ndị mebiri:

• mmiri;
• akpụkpọ ahụ mgbaze;
• mgbaze na absorption.

The ụmụ ndị okenye afọ enterotsellyulyarny ụdị malabsorption syndrome emee n'ihi mmebi nke eriri afọ na cell ọnwụ n'ihi na mmetụta nke na-efe efe ma ọ bụ nje ndị ọzọ, ụkwara nta, etuto ahụ nke obere eriri afọ, Crohn oria.

Ihe Nlereanya intracavitary malabsorption

Na ụdị AGR n'ụzọ dị ukwuu nsogbu n'obi abụba mgbaze. Ha hydrolysis a rụrụ site pancreatic lipase, nke na-arụ ọrụ site bile. Na ụkọ ndị a ihe na-egosi mgbaàmà ndị dị otú ahụ dị ka steatorrhea. Nke a nhọrọ na na nsị ngafe abụba. Nke a na ọtụtụ doro anya na-egosipụta na-adịghị ala ala pancreatitis steatorrhea. -Anaghị achọpụta a mgbaàmà na imeju na-na biliary tract.

Otu n'ime ihe ndị na-akpatara ndị intracavitary malabsorption, kwesịrị ịtụle congenital hypoplasia nke pancreas (hypoplasia). Mgbaàmà-egosi na n'ụbọchị ndị mbụ ma ọ bụ izu nke ndụ. E nwere a mmiri mmiri ọgaranya ngwa ngwa oche malodorous na kegriiz luster. Abụba pụrụ ọbụna mgbe niile ihihi nke ike.

Ihe Nlereanya posttsellyulyarnoy malabsorption

Posttsellyulyarnaya nsia malabsorption na-adị mgbe exudative enteropathy. Nke a bụ a syndrome na nke plasma protein na-efu site na mucosa. The akpata exudative enteropathy nwere ike ịbụ na ọnụnọ nke congenital malformation nke lymphatic bowel arịa. Ọtụtụ mgbe ime ka syndrome Whipple ọrịa, Crohn ọrịa, obere bowel etuto ahụ, nri ahu anataghi.

Exudative enteropathy mgbe ụfọdụ etịbe enweghị n'ụzọ pụtara ìhè na-adakarị n'obiọma. Nwere ike mgbaàmà ndị dị otú ahụ dị ka afọ ọsịsa na steatorrhea. Ọrịa na-egosi elu edema, metụtara nanị akụkụ ụfọdụ na ihu, azụ, perineum, aka na ụkwụ.

Ihe Nlereanya enterotsellyulyarnoy malabsorption

Enterotsellyulyarny ụdị AGR malabsorption nwere ike ịbụ n'ihi a daa ọrịa ndị dị otú ahụ dị ka glucose-galactose malabsorption. Nke a bụ ihe ketara ọrịa ebe agbajikwa ifịk iga nke glucose na galactose na obere eriri afọ mucosa. Ọrịa n'ụbọchị ndị mbụ nke ndụ a na-egosipụta site afọ ọsịsa. Nsị na ekenyela site 10 ruo 20 ugboro kwa ụbọchị. Ha na-mmiri, yiri mmamịrị. The nwa-akpọlite ndị ahu okpomọkụ, vomiting emee. Ọ bụrụ na ị kagburu mmiri ara ehi esenyịn bụ ihe mgbaàmà. Ogbenye ndidi nke ato uto na mmiri ara ehi na-anọgide maka a ndụ.

Ihe atụ ọzọ enterotsellyulyarnogo CMA - fructose malabsorption. Nke a bụ a obere mkpụrụ ndụ ihe nketa malabsorption. Mgbaàmà ime mgbe oriri nke mkpụrụ osisi na juices, nwere na ya Ọdịdị a nnukwu ego nke fructose. Nke a bụ apụl na oroma, na cherị na udara. Na fructose na-adịghị etinye obi gị dum site ahụ, na-eme flatulence, mmiri afọ ọsịsa, colicky mgbu na afo. N'oge ụfọdụ, e nwere na-vomiting. Ogo mgbaàmà na-adabere na ego nke fructose banyere ozu.

The kasị eji enterotsellyulyarnoy malabsorption na mkpọchị akpụkpọ ahụ mgbaze - ya disaccharidase erughi. Ọ bụrụ na ọ na-adịghị kpamkpam kewaa disaccharides. Ha na-adịghị etinye obi gị dum mgbe abanye distal eriri afọ na-ata nje gbaa ụka na evolushọn nke hydrogen. E nwere oké nke nsia colic, bloating, afọ ọsịsa, na-ebelata agụụ, vomiting, vomiting.

Enterotsellyulyarnaya nsia malabsorption malabsorption na mgbaze nwere ike ime na celiac ọrịa. Ọ bụ a-adịghị ala ala ọrịa e ketara eketa na nke mebiri emebi villi nke obere eriri afọ site iri ihe ụfọdụ. Celiac ọrịa na-egosipụta na ụmụ a ọnwa ole na ole mgbe iwebata isi nri glyutensoderzhaschih ngwaahịa. Mgbe ọrịa:

• defecation ugboro bụ 2 to 5 ugboro a ụbọchị;
• stool bụ mushy, mgbe ụfọdụ, frothy, ọ bụ pụta ụwa a fetid ísì, na-enwu;
• enwekwu afo;
• e nwere ezughi oke ibu ibu (mgbe ụfọdụ oge uka mpe enyekwara ibu erughi).

Ịrụ nchọpụta nsogbu na malabsorption syndrome

Diagnosis malabsorption na-adịghị rụrụ. Ndị ọkachamara na-na-akọwapụta sma mgbaàmà kenyere ha ọrịa mgbanwe nke pụrụ iche ule na nyochara na-egosi otu ụzọ ma ọ bụ ọzọ enyo enyo daa ọrịa iwe na mkpọchị absorption ma ọ bụ mgbaze.

Mgbe arụ nchọpụta nsogbu, ndị dọkịta na-eduzi ndị na-n'okpuru algọridim mepụtara site World Gastroenterology Organization:

• mbụ rụrụ a ọma ihe mere eme, nakọtara ozi banyere ọgwụ mere na nso nso njem, na ojiji nke nri na ọṅụṅụ na-agunyeghi na-emebu nri;
• mụọ akụkọ ezinụlọ;
• site ahụ nnyocha maka ihe ịrịba ama nke malabsorption;
• mụọ stool, na-ewere na ha mara;
• laabu ule na-rụrụ maka ozi ndị ọzọ.

Ọzọkwa nchoputa nke malabsorption syndrome agụnye Ịrụ nnyocha maka enyo enyo celiac ọrịa, ọnụnọ nke Giardia, bacteria na nje ndị ọzọ ke idem. Mkpa na-achọpụta ọrịa ọmụma na-enye ohere iji nweta ultrasound nke esịtidem akụkụ nke abdominal uji eze. Site ultrasound omume na-eme atụmatụ na ọnọdụ nke imeju, pancreas, ńsí eriri afo, Lymph.

Ewepu ma ọ bụ gosi na autoimmune mgbu, celiac ọrịa, Crohn ọrịa mkpa esophagogastroduodenoscopy na biopsy nke afo na duodenum. Iji gosi na enweghị exocrine pancreatic ọrụ ẹkenịmde stool ọmụmụ, na kọmputa na-magnetik resonance tomography, retrograde cholangiopancreatography ka iji anya nke uche ducts. Iji mụta banyere ọnụnọ ma ọ bụ na-anọghị nke ọnya nke ileum, ndị ọkachamara họpụtara ileokolonoskopiyu na a biopsy nke amụ na colon.

Ọgwụgwọ nke malabsorption syndrome

Mgbe Ịchọpụta Otú Nsogbu ndị na-akpata malabsorption etiotropic dọkịta nye iwu ọgwụgwọ iji na-agwa okwu na-mata ọrịa. Dị ka ihe atụ:

• Ọ bụrụ na celiac ọrịa a na-ahụrụ, na-ọkachamara na-atụ aro ọrịa a na ndụ gluten-free nri;
• ma ọ bụrụ na ahụrụ malabsorption nke carbohydrates ma ọ bụ nri ekweghị ibe nọrọ, mgbe ahụ, ọ na e kenyere ya kwekọrọ ekwekọ An mkpochapu ma ọ bụ restrictive nri;
• na-efe efe Filiks gosiri ọgwụ nje;
• na metabolic na endocrine ọrịa na-achọ ezigbo pathogenetic ọgwụ.

Mgbe kwuru diarrheal syndrome nke na-akpata malabsorption, ọgwụgwọ nwere ike etiologic, na pathogenetic symptomatic. Patogenetichekaya etiological ọgwụ na nwere ike ịbụ ihe oriri nke ndị na-esonụ n'aka:

• ọgwụ nje maka nje afọ ọsịsa;
• "Metronidazole" na amebiasis;
• anthelmintic ọgwụ ọjọọ helminthiasis;
• glucocorticoids, cytostatics, "infliximab" na mkpali bowel ọrịa;
• "Tetracycline", "Ceftriaxone", "Co-trimoxazole" Whipple ọrịa;
• "Octreotide" na endocrine etuto ahụ nke eriri afọ tract.

Symptomatic ọgwụgwọ na-agụnye na-anata probiotics, opiates, "Loperamide" absorbent gị n'ụlọnga (bismuth preparations "Diosmektita").

Iji onwe-agaghị ekwe omume na ihe omume nke mgbaàmà nke sma. Ọ na-enye ezi ihe. Ke adianade do, malabsorption - bụ ngosipụta nke oké ize ndụ ọrịa. Ọ bụrụ na ị na-enwe ihe ịrịba ama nke sma ọ na-atụ aro ka ịkpọ onye dọkịta. Naanị a ọkachamara nwere ike na-akpọ ezi ihe kpatara nke syndrome na ndimek irè ọgwụ maka n'ikpochapụ ọrịa chọpụtara.