La Crohn ka maʻi he ka maʻi ʻeha mau ʻo ka ʻōnaehana hoʻoheheʻe ʻana (ka ʻōpū nui), e hoʻololi ʻia e nā wehe a me nā pae o ke kala ʻana. Ua ike nui ia e na pilikia o abdominal eha a diarrhea, hiki ke lōʻihi i kekahi mau pule a i ʻole mau mahina. Hiki ke hiki mai ka luhi, ka pohō kaumaha a me ka ʻai ʻole inā ʻaʻohe mālama ʻia. I kekahi mau hihia, hōʻailona non-digestive, pili i ka ili, ami a maka paha me ka ma'i. 

Pehea ʻoe e ʻike ai i nā hōʻailona o ka maʻi o Crohn? 

Ināʻoe he Crohn ka maʻi, hiki i ka mumū ke hoʻopilikia i kekahi ʻāpana o ka digestive tract, mai ka waha a i ka anus. Akā ʻo ka hapa nui e noho ana ma ka hui o kaʻōpū liʻiliʻi a ka pae ('ōpū nui).

Diagram of Crohn's disease

He aha nā kumu o ka maʻi o Crohn?

La Crohn ka maʻi ma muli o ka mumū mau o nā paia a me nā papa hohonu o ka ʻaoʻao digestive. Hiki i kēia mumū ke alakaʻi i ka mānoanoa o nā paia ma kekahi mau wahi, nā māwae a me nā ʻeha ma nā wahi ʻē aʻe. ʻAʻole ʻike ʻia nā kumu o ka mumū a he nui paha, e pili ana i nā genetic, autoimmune a me nā mea kūlohelohe.

Nā mea genetic

ʻOiai ʻaʻole he maʻi genetic holoʻokoʻa ka maʻi o Crohn, hiki i kekahi mau genes ke hoʻonui i ka manawa e loaʻa ai. I nā makahiki i hala iho nei, ua ʻike ka poʻe noiʻi i kekahi mau genes susceptibility, me ka NOD2 / CARD15 gene, e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i ka maʻi ʻehā a ʻelima mau manawa.⁶. He kuleana ko kēia gene i ka ʻōnaehana pale o ke kino. Eia naʻe, nā kumu'ē aʻe pono no ka ma'i. E like me nā maʻi ʻē aʻe he nui, ʻike ʻia kahi predisposition genetic i hui pū ʻia me nā kumu kūlohelohe a i ʻole ke ʻano o ka nohona e hoʻoulu i ka maʻi.

Nā kumu Autoimmune

E like me ka ulcerative colitis, loaʻa i ka maʻi o Crohn nā hiʻohiʻona o kahi maʻi autoimmune (= maʻi kahi e hakakā ai ka ʻōnaehana pale i kona mau cell ponoʻī). Manaʻo ka poʻe noiʻi ua pili ka mumū o ka digestive tract i ka overrection o ke kino o ka ʻōnaehana pale i nā maʻi a i ʻole bacteria i loko o ka ʻōpū.

Nā mea a puni

Ua ʻike ʻia ʻoi aku ka nui o ka maʻi o Crohn ma nā ʻāina hana a ua maʻa mau ka hoʻonui ʻana mai ka makahiki 1950. Hōʻike kēia i nā mea pili i ke kaiapuni, pili paha i ke ʻano o ke ola o ke Komohana, hiki ke loaʻa ka hopena nui i ka hoʻomaka ʻana o ka maʻi. Akā naʻe, ʻaʻohe kumu kikoʻī i ʻike ʻia. Ke aʻo ʻia nei kekahi mau ala. ʻO ka loaʻa ʻana i kekahi mau lāʻau antibiotic, ʻoi aku ka maikaʻi mai ka papa tetracycline, kahi kumu pilikia³¹. ʻOi aku ka pilikia o ka poʻe puhi puhi i ka maʻi. ʻOi aku ka hopena o ka poʻe noho noho ma mua o ka poʻe i ʻoi aku ka hana³².

Hiki nō, akā, ʻaʻohe mea hōʻoiaʻiʻo, ʻo ka ʻai nui i nā momona maikaʻi ʻole, ka ʻiʻo a me ke kō e hoʻonui i ka pilikia.³³. 

Ke nānā nui nei ka poʻe noiʻi i ke kuleana o kahi maʻi e a mea hoʻomaʻi ai ole ia, he hua'ōlelo (salmonella, campylobacter) i ka hoʻoulu ʻana i ka maʻi. Ma waho aʻe o ka maʻi e ka microbe "waho", a hoʻohaunaele flora ʻōpū (ʻo ia hoʻi ka bacteria i loaʻa maoli i loko o ka digestive tract) hiki ke komo pū¹⁸.

Eia kekahi, ʻike ʻia kekahi mau mea i ka hopena pale. ʻO kēia ka meaʻai momona i ka fiber a me ka hua, hoʻopili ma mua o ka makahiki hoʻokahi me nā pōpoki a holoholona mahiʻai paha, appendectomy, a me ka loaʻa ʻana o ka gastroenteritis a i ʻole nā ​​maʻi. hanu hanu³⁴. ʻAʻohe hui ma waena o ka maʻi MMR (measles-rubella-mumps) a me ka maʻi o Crohn.³⁵.

Nāʻike noʻonoʻo

Ua manaʻo lōʻihi e hiki ke hoʻoulu i ke kaumaha. Eia naʻe, ʻike ʻia nā haʻawina i hana ʻia a hiki i kēia manawa ke hōʻole i kēia kuhiakau.

Kanaka pilikia

• Kanaka me ka moolelo ohana ʻO ka maʻi ʻeha o ka ʻōpū (Crohn's disease or ulcerative colitis). ʻO kēia ka hihia no 10% a 25% o ka poʻe i hoʻopilikia ʻia.
• Kekahi mau heluna kanaka ʻoi aku ka pilikia ma mua o nā mea ʻē aʻe, ma muli o kā lākou genetic makeup. ʻO ke kaiāulu Iudaio (no Ashkenazi kumu), no ka laʻana, he 4 a 5 mau manawa i hoʻopilikia ʻia e ka maʻi o Crohn.^3,4.

Pehea ka holomua o ka maʻi o Crohn?

He maʻi maʻi mau loa ia i ke ola a pau. ʻO ka pinepine ka Crohn ka maʻi e ulu ana i loko o nā lapalapa i hoʻopili ʻia me nā manawa kala ʻia e hiki ke mau no kekahi mau mahina. Ma kahi o 10% a 20% o ka poʻe i loaʻa ke kala mau loa ma hope o ka puka mua ʻana o ka maʻi. ʻO ka nā hana hou (a i ʻole nā ​​pilikia) hahai kekahi i kekahi ma ke ʻano hiki ʻole ke ʻike ʻia a he ʻokoʻa ka ikaika. I kekahi manawa ua ikaika loa nā hōʻailona (hiki ʻole ke ʻai, kahe ʻana o ke koko, ka maʻi maʻi, a me nā mea ʻē aʻe) e pono ai ka halemai.

Hiki i nā pilikia a me nā hopena

La Crohn ka maʻi hiki ke alakaʻi i nā pilikia olakino. Eia nō naʻe, ʻokoʻa ka paʻakikī o nā hōʻailona a me nā pilikia mai kēlā me kēia kanaka.

Nā pilikia i hiki

• A keakea o ka digestive tract. Hiki i ka ʻeha mau ke kumu e mānoanoa ai ke kapa o ka ʻāpana digestive, hiki ke alakaʻi i ka ʻāpana a i ʻole ka paʻa ʻana o ka ʻāpana digestive. Hiki i kēia ke alakaʻi i ka bloating, constipation, a i ʻole ka luaʻi ʻana o nā feces. Pono ka halema'i ulia pōpilikia e pale aku i ka puka ʻana o ka ʻōpū.
• ʻO nā maʻi maʻi ma ka ʻaoʻao o ka digestive tract.
• ʻO nā ʻeha a puni ka anus (fistula, māwae hohonu a i ʻole abscesses mau).
• ʻO ke koko mai ka ʻāpana hoʻoheheʻe, kakaʻikahi akā paʻakikī i kekahi manawa.
• ʻO ka poʻe me ka maʻi o Crohn o ke kolonā ua piʻi iki ka pilikia o ka ulu ʻana i ka maʻi maʻi ʻaʻai, ʻoi aku ka nui ma hope o kekahi mau makahiki o ka maʻi, a inā lākou e mālama ʻia. No laila, pono e hoʻopaʻa mua ʻia no ka maʻi maʻi ʻaʻai koko.

Nā hopena hiki

• A kaiakaha, no ka mea, i ka wā pilikia, ʻai liʻiliʻi ka poʻe maʻi no ka ʻeha. Hoʻohui ʻia ka hiki ke komo i ka meaʻai ma ka paia o ka ʻōpū, ma ka ʻōlelo olakino ke kamaʻilio nei mākou no ka malabsorption.
• Un hoʻoulu ulu a me ka opiopio i na keiki a me na opio.
• ʻO ka anemia nele o ka hao, ma muli o ke kahe ʻana o ke koko i loko o ka digestive tract, hiki ke hana ʻia me ka leo haʻahaʻa a ʻike ʻole ʻia e ka maka ʻōlohelohe.
• ʻO nā pilikia olakino ʻē aʻe, e like me ka maʻi ʻāʻī, ka ʻili o ka ʻili, ka ʻā o nā maka, ka ʻeha waha, nā ʻāʻī a i ʻole nā ​​ʻāʻī.
• ʻO ka maʻi o Crohn, i ka wā i loko o ka "active" phase, hoʻonui i ka pilikia ohāpai keiki kū wale i na wahine hapai i loaa. Hiki iā ia ke paʻakikī i ka ulu ʻana o ka pēpē. No laila, he mea nui i nā wāhine makemake e hāpai i ka mālama pono ʻana i ko lākou maʻi me ke kōkua o nā lāʻau lapaʻau a kūkākūkā pū me kā lākou kauka.

ʻEhia ka poʻe i loaʻa i ka maʻi o Crohn?

Wahi a ka pūnaewele Afa, aia ma Northwest Europe a me ʻAmelika Hui Pū ʻIa mākou e ʻike ai i ka hapa nui o ka poʻe i loaʻa i ka maʻi o Crohn. Ma Farani, ma kahi o 120.000 poʻe i ʻōlelo ʻia e hoʻopilikia ʻia. Ma kēia mau ʻāpana, helu ʻo Afa i 4 a 5 mau hihia no 100.000 mau kānaka i kēlā me kēia makahiki. 

 Ma Kanada, ka Crohn ka maʻi pili ma kahi o 50 poʻe no 100 heluna kanaka ma nā ʻāina ʻenehana, akā nui ka ʻokoʻa ma ka ʻāina. ʻO ka wahi o ka honua me nā hihia i hōʻike ʻia ma Nova Scotia, kahi mokuʻo Kanada, kahi e piʻi ai ka helu i 000 no 319 mau kānaka. Ma Iapana, Romania a me South Korea, emi ka helu ma mua o 100,000 no 25²⁹.

Hiki ke loaʻa ka maʻi i kēlā me kēia makahiki, me ka wā kamaliʻi. ʻIke pinepine ʻia ia i nā poʻe 10 a 30 mau makahiki³⁰.

ʻO ka manaʻo o kā mākou kauka i ka maʻi

Ma ke ʻano o kāna ala kūpono, kono ʻo Passeportsanté.net iā ʻoe e ʻike i ka manaʻo o kahi loea olakino. Hāʻawi ʻo Dr Dominic Larose, ke kauka pilikia i kona manaʻo ma ka Crohn ka maʻi :