Malabsorption - menene wannan? Rarrabuwa da kuma haddasawa

Kananan hanji - daya daga cikin hanji. Shi aikin da dama ayyuka, taka muhimmiyar rawa a cikin narkewa abinci da sha na gina jiki. Tare da ci gaban wasu cututtuka lalace wannan sashen - bayyananne malabsorption ciwo, wanda aka rage tsawon matsayin CMA. Menene wannan lokaci? Wannan ciwo ne ya sa ta abin da dalilai?

dikodi mai Concepts

A likita wallafe-wallafe, za ka iya samun wani ajali kamar "malabsorption". Wannan kalma an yi amfani da su koma ga malabsorption hanji mucosa abinci aka gyara. Akwai kuma wani lokaci kamar "maldigestion". Wannan take hakkin hira tafiyar matakai na kitse, da furotin da kuma carbohydrate narkewa kayayyakin absorbable.

Masana sun hada duka biyu na sama lokaci ( "malabsorption" da "maldigestion"), a lokacin da daya ya yi maganar malabsorption ciwo. Yana nufin da hadaddun asibiti manifestations, tasowa daga keta kogo, da bango, membrane narkewa da kai a cikin kananan hanji. Saboda da canje-canje faruwa a jikin mutum saboda zargin malabsorption ciwo, rayuwa cuta bayyana. Mutane fara azãba da m bayyanar cututtuka.

A Sanadin SMA

malabsorption ciwo lura a da yawa hereditary da nakasar cututtuka a wadda gaji da damuwa da sha na abubuwa, rage enzyme aiki. A matsayin misali, cystic fibrosis. A wannan cuta, da AGR tasowa saboda runtse enzyme aiki da pancreatic cuta asirin danko.

Don sa malabsorption ciwo cututtuka da cututtuka da kuma parasites, mahaukaci lymphatic da Sistem tsarin. CMA ne ma lura a hali na lalacewar da kananan hanji da kuma rage sha yanki (da ake kira da canje-canje a cikin jiki, zama dalili na tsanani disturbances na mutane da yawa irin na mu'amala, jiki da hankali stunting).

Saboda haka, malabsorption - wani sa na m bayyanar cututtuka da za su iya haifar da wani yawa daban-daban dalilai. Su za a iya hada kamar haka:

1. Preenteralnaya kungiyar. Wadannan sun hada da biliary fili cututtuka, hanta, ciki, cystic fibrosis.
2. Postenteralnaya kungiyar. Yana hada da Lymph da jini wurare dabam dabam cuta a cikin dogon hanji, wanda aka located tsakanin ciki da kuma ciwon, exudative enteropathy, lymphosarcoma, Hodgkin ta cutar.
3. Enteral kungiyar na dalilai. Wadannan sun hada da galactose malabsorption, celiac cuta, disaccharidase gazawar, giardiasis, dermatitis herpetiformis.

Alamun takamaiman to SMA

Duk da cewa da malabsorption ciwo muhimmi a cikin cututtuka daban-daban, za a iya bambanta siffofi da halayyar shi. Lokacin da CMA tashin zuciya, amai. A marasa lafiya da rage ci. wadannan cututtuka da ake ma gani kamar yadda bloating, canji a stool (zawo sau da yawa yakan faru). Duk wadannan ayoyi suna kira dyspeptic ciwo. Yana jagorantar asibiti manifestations SMA.

Musamman hankali ya kamata a kujera. Kimantawa da halaye na tumbi, masana sami muhimmanci bayanai da damar da su zuwa saka da daidai ganewar asali:

• kuma frothy ruwa stool da wani acidic wari - wani alama da za su iya zama muhimmi a pathologies kamar glucose-galactose malabsorption, disaccharidase rashi.
• m stool ne a kullum pancreatitis, cystic fibrosis, dermatitis herpetiformis, exudative enteropathy ciwo Pearson, hanji dysbacteriosis.
• sosai m stools lura a cystic fibrosis, nakasar lipase rashi.
• na ruwa zawo - wani alama da za su iya faruwa lokacin da kamuwa da cuta shiga jiki, masu tasowa, enterocolitis, malabsorption na glucose da kuma galactose.

Lokacin da MCA wani lokacin akwai azaba ne tukuna. Mafi sau da yawa, da suka sa na hanji cututtuka da kuma infestations. Pain ciwo zai iya faruwa bayan cinyewa kiwo kayayyakin. Ya hada da foamy kujera da wani m wari, flatulence nuna wani lactase rashi. Ciki zafi a lokacin CMA bi abinci allergies, hanji munanan, Whipple ta cuta, ulcerative colitis, Crohn ta cuta. Wadannan cututtuka ne kiyaye ko da malabsorption ciwo:

• fata rash.
• gajiya.
• a ji rauni.
• bloating.
• anorexia.

Malabsorption a yara tare da gurgunta syndromes. Gaji da damuwa da jiki ci gaba. Wannan yana bayyana a cikin akan rage jiki nauyi, ci gaban da ciwon tamowa, tsumburai girma. A bitamin rashi nuna jihar na fata. A fata ya zama bushe da farawa zuwa kwasfa kashe. A da shi ya bayyana duhu aibobi. Gashi thinning da kuma fara janye daga. A kusoshi zama maras ban sha'awa sautin kuma exfoliate. Lokacin da alli karanci faruwa cramps, zafi a cikin tsokoki da kuma kasusuwa. Rashin baƙin ƙarfe, jan kuma tutiya take kaiwa zuwa bayyanar fata rash, da baƙin ƙarfe-karanci anemia, kara a yanayin jiki.

data kasance rarrabuwa

malabsorption ciwo hada da fiye da 70 daban-daban cututtuka. A wannan batun, masana sun ci karo da wasu matsaloli a cikin rarrabuwa na cikin shirye-shiryen. A mafi nasara ne da rabo daga hereditary kuma samu malabsorption syndromes:

1. A farko daga cikin wadannan da aka gano a cikin 10% na lokuta. Hereditary SMA an shige daga iyaye zuwa yaro. Ya kuma shi ne saboda gene maye gurbi.
2. An samo malabsorption ciwo - sakamakon hanji da kuma extraintestinal cuta (msl marurai, immunodeficiencies, hanta da kuma pancreas).

Akwai kuma rarrabuwa wanda dogara ne a kan mai tsanani daga malabsorption ciwo:

• Grade I (m form) - yara dan kadan rage jiki nauyi, bayyanar cututtuka bayyana multivitamin gazawar lura disharmonious jiki ci gaba;
• II digiri (talakawan siffar) - da mãsu haƙuri yana da jiki taro gaira (karkacewa daga na kullum ne mafi girma daga 10%) an kiyaye fada a jiki ci gaba, gani furta ãyõyi electrolyte rashi da kuma insufficiency multivitamin.
• Grade III (tsanani) - yara ne jiki underdeveloped, jiki taro gaira wuce 20%, a wasu marasa lafiya akwai wani bata lokaci ba a psychomotor ci gaba.

iri malabsorption

A shekarar 1977 da aka gudanar Sabunta Duniya Congress of Gastroenterology. Yana kwararru sun gano dama iri malabsorption, dangane da ta haddasawa:

• intracavitary.
• posttsellyulyarnaya.
• enterotsellyulyarnaya.

Rashin bile secreted da pancreas da kuma abubuwa wanda rinjayar da recessed narkewa kuma Yanã shigar da warwarewarsu, - malabsorption intracavitary irin. Toddlers suka bayyana saboda cystic fibrosis, nakasar hypoplasia na pancreas. A yara mazan bayyanar intracavitary malabsorption ciwo tsokane cututtuka irin su cirrhosis, na kullum pancreatitis.

Nau'i na biyu na SMA - posttsellyulyarnaya malabsorption. Wannan ciwo, wanda aka halin asarar jini gina jiki ta hanyar da hanji bango. Ya lura da anomalies na Sistem da lymphatic tsarin. Daya daga cikin cututtuka - wani idiopathic hanji lymphangiectasia. Ta shi ne muhimmi a cikin mãsu nauyi asarar alli, lipids da sunadarai a cikin gastrointestinal fili.

Enterotsellyulyarny irin hadawa waɗannan lokuta inda karye membrane narkewa ko sha saboda wani aibi na enzyme tsarin da na hanji epithelial Kwayoyin. Irin wannan na iya faruwa a matasa da yara saboda hereditary cututtuka hade da cin zarafi:

• tsotsa.
• membrane narkewa.
• narkewa da sha.

The yara a cikin mazan shekaru enterotsellyulyarny irin malabsorption ciwo ya auku saboda lalacewar da hanjinsu da cell mutuwa saboda tasirin da ciwon ya kama ko parasites, da tarin fuka, marurai na kananan hanji, Crohn ta cuta.

Misalai intracavitary malabsorption

Tare da irin wannan AGR sun fi mayar gaji da damuwa mai narkewa. Su hydrolysis da aka za'ayi da pancreatic lipase, wanda aka kunna ta bile. Tare da kasawa da wadannan kayan bayyana alama kamar steatorrhea. Wannan selection da tumbi da wuce haddi mai. Wannan ne mafi fili bayyana a kullum pancreatitis steatorrhea. Kadan m wannan alama a hanta da kuma biliary fili.

Daga cikin Sanadin intracavitary malabsorption, kamata la'akari da nakasar hypoplasia na pancreas (hypoplasia). Alamun bayyana a farko kwanaki ko makonni na rayuwa. Akwai wani ruwa mai arziki m kujera malodorous kuma m luster. Fat iya ko da kullum zuba daga dubura.

Misalai posttsellyulyarnoy malabsorption

Posttsellyulyarnaya hanji malabsorption faruwa a lokacin exudative enteropathy. Wannan shi ne wani ciwo a cikin abin da jini da furotin da ake rasa hanyar da mucosa. A sabili da exudative enteropathy iya zama a gaban nakasar malformation na lymphatic hanji tasoshin. Mafi sau da yawa sa ciwo Whipple ta cuta, Crohn ta cuta, kananan hanji marurai, abinci alerji.

Exudative enteropathy wani lokacin yakan faru ba tare da overt asibiti manifestations. Iya samun bayyanar cututtuka irin su gudawa da kuma steatorrhea. Marasa lafiya bayyana gefe edema, sarrafa a kan fuskarsa, baya, perineum, wata gabar jiki.

Misalai enterotsellyulyarnoy malabsorption

Enterotsellyulyarny irin AGR malabsorption iya zama saboda wani Pathology kamar glucose-galactose malabsorption. Wannan sigar gaji cuta inda karya aiki kai na glucose da kuma galactose a cikin kananan hanji mucosa. Rashin lafiya a farkon zamanin rayuwar aka bayyana da zawo. Fecal kasaftawa daga 10 zuwa 20 sau da rana. Su na ruwa, kama fitsari. The yaro kiwata jiki zazzabi, amai ya auku. Idan ka soke madara wadata ne bayyanar cututtuka. Poor haƙuri da sweets da kuma madara da ya rage na rayuwa.

Wani misali enterotsellyulyarnogo CMA - fructose malabsorption. Wannan shi ne wani rare kayyade malabsorption. Alamun faruwa bayan amfani da 'ya'yan itatuwa da kuma juices, dauke da cikin da tsarin babban adadin fructose. Wannan shi ne apples da lemu, da kuma cherries da ceri. Wannan fructose ba samamme ta jiki, haddasa flatulence, na ruwa zawo, colicky zafi a ciki. A wasu lokuta, a can ne amai. A tsanani daga cututtuka dogara a kan adadin fructose shiga cikin jiki.

Mafi na kowa dalilin enterotsellyulyarnoy malabsorption tare da mai illa membrane narkewa - shi disaccharidase rashi. Idan shi ba gaba daya raba disaccharides. Su ba su tunawa lokacin shigar da distal hanji da kuma sha kwayan fermentation tare da ci gaba na hydrogen. Akwai bouts na hanji colic, bloating, zawo, rage ci, amai, amai.

Enterotsellyulyarnaya hanji malabsorption malabsorption da kuma narkewa iya faruwa a celiac cuta. Yana da wani kullum hereditary cuta a cikin wanda lalace villi na kananan hanji da wani abinci. Celiac cutar aka bayyana a cikin yara 'yan watanni bayan gabatarwar catering glyutensoderzhaschih kayayyakin. Lokacin da cutar:

• defecation mita ne 2 zuwa 5 a rana sau.
• stool ne mushy, wani lokacin frothy, shi ne muhimmi a cikin wani fetid wari, shine;
• qara ciki.
• akwai kasa nauyi riba (bayan wasu lokaci zuwa taro gaira shiga girma karanci).

Yin bincikowa da malabsorption ciwo

Ganewar asali malabsorption ba za'ayi. Masana sun gano SMA cututtuka wajabta wa marasa lafiya da canji na musamman gwaje-gwaje da kuma na nazarin tabbatar ko ta wani hanya da ake zargi Pathology tsokane ta illa sha ko narkewa.

Lokacin dauke da fitar ganowa, likitoci suna shiryar da kasa algorithm ci gaba da Duniya Gastroenterology Organization:

• farko da za'ayi cikakken tarihi, tattara bayanai game da magani jajirce kwanan nan tafiya, da yin amfani da abinci da ruwan sha ba a hada a cikin saba rage cin abinci.
• karatu iyali tarihi.
• ta jiki jarrabawa ga alamun malabsorption.
• karatu stool, shan la'akari da halaye;
• dakin gwaje-gwaje gwaje-gwaje suna da za'ayi don ƙarin bayani.

Bugu da ari ganewar asali malabsorption ciwo ya hada da yin bincike domin zargin celiac cuta, gaban Giardia, kwayoyin da parasites a cikin jiki. Muhimmanci diagnostic bayanai damar zuwa samu duban dan tayi na ciki gabobin da kogon ciki. Ta hanyar duban dan tayi yiwu ga kimanta yanayin da hanta, pancreas, gall mafitsara, Lymph nodes.

Don ware ko tabbatar da autoimmune gastritis, celiac cuta, Crohn ta cuta da bukata esophagogastroduodenoscopy da biopsy na ciki da kuma duodenum. Don tabbatar da rashin exocrine pancreatic aikin gudanar da stool karatu, kwamfuta da Magnetic rawa tomography, retrograde cholangiopancreatography zuwa ganin ducts. Su koyi game da gaban ko babu raunuka na ileum, da masana nada ileokolonoskopiyu tare da wani biopsy na binciken yankin da kuma ciwon.

Jiyya na malabsorption ciwo

Bayan diagnosing haddasawa malabsorption etiotropic likitoci rubũta lura da nufin magance gano cutar. Ga misali:

• Idan celiac cuta da aka gano, da gwani ya bada shawarar da mãsu haƙuri a lifelong Alkama-free rage cin abinci.
• idan gano malabsorption na carbohydrates ko abinci rashin ha} uri, to, shi ne sanya wa m An kawar ko hana rage cin abinci.
• dauke da kwayar cutar matakai nuna maganin rigakafi.
• a rayuwa da kuma endocrine cututtuka na bukatar isasshen pathogenetic far.

Lokacin da ya bayyana diarrheal ciwo wanda ya haddasa malabsorption, magani iya zama etiologic, kuma pathogenetic symptomatic. Patogenetichekaya etiological far da kuma iya zama wani ci daga cikin wadannan hanyoyi:

• maganin rigakafi ga kwayan zawo.
• "Metronidazole" tare da amebiasis.
• anthelmintic kwayoyi helminthiasis.
• glucocorticoids, cytostatics, "infliximab" a kumburi hanji cuta.
• "Tetracycline", "Ceftriaxone", "Co-trimoxazole" Whipple ta cutar.
• "Octreotide" tare da endocrine marurai na gastrointestinal fili.

Symptomatic magani hada da samun probiotics, opiates, "Loperamide" absorbent wakili (bismuth shirye-shirye "Diosmektita").

Don kai-ba zai yiwu ba a taron na bayyanar cututtuka na SMA. Yana ba ya ba da sakamako mai kyau. Bugu da kari, malabsorption - na bayyana da tsanani da kuma hatsari cututtuka. Idan ka fuskanci ãyõyin SMA shi ne shawarar tuntubar likita. Kawai wani gwani za a iya kira da gaskiya hanyar da ciwo da kuma sanya wani tasiri far ga kawar da cutar jinya.