Malabsorption - ndi chiyani ichi? Gawo ndipo zimayambitsa

Small intestine - mmodzi wa intestine lapansi. Iwo amachita zosiyanasiyana ntchito, masewero mbali yaikulu chimbudzi chakudya ndi mayamwidwe zakudya. Ndi chitukuko cha matenda ena akusokoneza dipatimenti imeneyi - zimaonekera malabsorption syndrome, amene chidule ngati CMA. Kodi mawu amenewa? syndrome Izi zimachitika chifukwa cha zimene zifukwa?

Zikhulupiriro Decoding

Mu mabuku a zamankhwala, mukhoza kupeza mawu monga "malabsorption". mawuwa amagwiritsidwa ntchito ponena kuti malabsorption matumbo mucosa zigawo zikuluzikulu chakudya. Palinso mawu monga "maldigestion". Izi njira kuphwanya kutembenuka kwa mafuta, mapuloteni ndi zimam'patsa chimbudzi mankhwala absorbable.

Akatswiri kuphatikiza zonse za mawu pamwambapa ( "malabsorption" ndi "maldigestion"), pamene munthu alankhula za matenda malabsorption. Amatanthauza mawonetseredwe zovuta matenda, akuwuka kuchokera kuyan'anila za M'mimbamo, khoma, Kakhungu chimbudzi ndi zoyendera mu intestine yaing'ono. Chifukwa kusintha zinkachitika mu thupi la munthu chifukwa zikamera wa syndrome malabsorption, matenda kagayidwe kachakudya kuonekera. Anthu anayamba amazunza zizindikiro zosasangalatsa.

Zimayambitsa SMA

malabsorption syndrome anati matenda ambiri cholowa ndiponso kobadwa nako imene kusokonezedwa mayamwidwe zinthu, yafupika ntchito enzyme. Mwachitsanzo, enaake fibrosis. Mu matenda, ndi AGR akufotokozera chifukwa ntchito enzyme ndi pancreatic matenda zinsinsi kukhuthala fungatira.

Kupangitsa malabsorption matenda syndrome chifukwa cha matenda ndi tizilombo, nthenda lymphatic ndi machitidwe magazi. CMA ndi anatinso ngati kuwonongeka za m'mimba ang'ono ndi kuchepetsa mayamwidwe m'dera (zotchedwa kusintha mu thupi, kukhala chifukwa cha chisokonezo chachikulu cha mitundu yambiri ya kuphana, thupi ndi stunting maganizo).

Choncho, malabsorption - akonzedwa zizindikiro zosasangalatsa zomwe zingachititse kwambiri zifukwa zosiyanasiyana. Iwo akhoza pamodzi motere:

1. Preenteralnaya gulu. Zikuphatikizapo matenda biliary thirakiti, chiwindi, m'mimba, enaake fibrosis.
2. Postenteralnaya gulu. Mbaliyi lymph ndi magazi matenda a intestine yaitali, limene lili pakati pa m'mimba ndi m'matumbo, exudative enteropathy, lymphosarcoma, matenda Hodgkin a.
3. Enteral gulu la zifukwa. Zikuphatikizapo galactose malabsorption, matenda celiac, disaccharidase kulephera, giardiasis, dermatitis herpetiformis.

Zizindikiro zenizeni kwa SMA

Ngakhale kuti malabsorption syndrome chibadidwe matenda osiyanasiyana, akhoza kukhala wolemekezeka zimaonetsa khalidwe la iye. Pamene CMA nseru, kusanza. Odwala ndi utachepa kudya. zizindikiro izi adawona monga bloating, kusintha m'manyi (m'mimba zambiri amapezeka). Zizindikiro zonsezi amatchedwa matenda dyspeptic. Iye akutsogolera mawonetseredwe matenda a SMA.

mwapadera akhale mpando. Kuona makhalidwe a ndowe, akatswiri kulandira zofunika kuti zimawathandiza kuika matenda lolondola:

• ndi frothy madzi chopondapo ndi fungo acidic - chizindikiro kuti akhale chibadidwe pathologies monga shuga-galactose malabsorption, disaccharidase akusowa;
• aliwonse chopondapo ali kapamba aakulu enaake fibrosis, dermatitis herpetiformis, exudative enteropathy syndrome Pearson, matumbo dysbacteriosis;
• chimbudzi aliwonse kwambiri anamuona pa enaake fibrosis, kobadwa nako lipase akusowa;
• madzi m'mimba - chizindikiro kumene kungachitike pamene matenda alowa m'thupi, osauka enterocolitis, malabsorption shuga ndi galactose.

Pamene MCA zina pali ululu. Nthawi zambiri, iwo amayambitsa matenda matumbo ndipo infestations. Ululu syndrome angayambe atamwa mowa mkaka. Iye pamodzi foamy mpando ndi fungo wowawasa, flatulence amasonyeza akusowa lactase. ululu m'mimba pa CMA ayende chifuwa chakudya, matumbo kuvutika, matenda Whipple a, anam'peza matenda a m'matumbo, matenda amene amatupitsa. Zizindikiro zotsatirazi anati ngakhale pamene malabsorption syndrome:

• zotupa pa khungu;
• kutopa;
• kumverera kufooka;
• bloating;
• matenda a anorexia.

Malabsorption ana limodzi ndi syndromes chofunika. Posasangalala kukula. Izi anawonetseredwa mu kuchepetsa thupi, kukula kwa zakudya m'thupi, kungokhala pamodzimodzi kukula. Vitamini akusowa limasonyeza mkhalidwe wa khungu. Khungu amakhala ouma ndi kuyamba peel kutali. Pa kuwonekera mawanga mdima. Tsitsi kupatulira ndi kuyamba kusiya. Misomali kukhala kamvekedwe kuzimiririka ndipo exfoliate. Pamene akusowa kashiamu zimachitika omangana, kupweteka kwa minofu ndi mafupa. Kupanda chitsulo, mkuwa, nthaka kumabweretsa maonekedwe a khungu totupa, chitsulo akusowa magazi m'thupi, kuwonjezera kutentha thupi.

Gawo alipo

malabsorption syndrome zikuphatikizapo oposa 70 matenda osiyana. Pankhani imeneyi, akatswiri nawo mavuto ena mu gulu la lokonzekera. Opambana kwambiri ndi gulu la cholowa ndipo anaphunziranso syndromes malabsorption:

1. Choyamba mwa zinthuzi ndi wapezeka mu 10% ya milandu. Cholowa SMA wadutsa kuchokera ku makolo mwana. Iye ndi chifukwa masinthidwe mbewu.
2. Kuthi malabsorption syndrome - chifukwa cha matenda matumbo ndipo extraintestinal (mwachitsanzo zotupa, immunodeficiencies, chiwindi ndi kapamba).

Palinso gulu lomwe zachokera azikhala syndrome malabsorption:

• Kalasi I (mawonekedwe wofatsa) - ana pang'ono yafupika kulemera kwa thupi, zizindikiro uka multivitamin kulephera anati disharmonious kukula;
• II digiri (pafupifupi mawonekedwe) - wodwalayo kuchepekedwa thupi misa (zopatuka mwakale ndi wamkulu kuposa 10%) zimawonedwa kwanthawi mu kukula, anawona kutchulidwa zizindikiro electrolyte akusowa ndi insufficiency multivitamin;
• Kalasi III (aakulu) - ana mumamenya underdeveloped, thupi misa kuchepekedwa kuposa 20% odwala ena pali Kuchedwa kukula psychomotor.

mitundu ya malabsorption

Mu 1977 unachitikira VIII World Congress wa Gastroenterology. Ndi akatswiri apeza mitundu yambiri ya malabsorption, malingana zimayambitsa:

• intracavitary;
• posttsellyulyarnaya;
• enterotsellyulyarnaya.

Kupanda ya ndulu tochoka ndi kapamba ndi zinthu zomwe zimakhudza chimbudzi recessed ndi chimayambitsa kuyenda, - malabsorption intracavitary mtundu. Ana Yak chifukwa enaake fibrosis, kobadwa nako hypoplasia a kapamba. Mu ana okulirapo maonekedwe intracavitary malabsorption syndrome zoyambitsa matenda monga matenda enaake, kapamba aakulu.

Mtundu wachiwiri wa SMA - posttsellyulyarnaya malabsorption. syndrome ichi, chimene amakhala ndi imfa ya madzi mapuloteni khoma matumbo. Iye anati ndi anomalies a dongosolo la magazi ndi lymphatic. Amodzi mwa matenda - ndi idiopathic matumbo lymphangiectasia. Iye ndi chibadidwe imfa waukulu wa calcium, lipids ndi mapuloteni kapepala kakuti m'mimba.

Enterotsellyulyarny mtundu Chili milandu kumene osweka Kakhungu chimbudzi kapena mayamwidwe chifukwa chilema kachitidwe enzyme wa matumbo maselo zaminyewa. Chotero kumachitika ana chifukwa cha matenda otengera kugwirizana ndi kuphwanya kwa:

• suction;
• Kakhungu chimbudzi;
• chimbudzi ndi mayamwidwe.

Ana okulirapo mtundu zaka enterotsellyulyarny wa syndrome malabsorption kumachitika chifukwa kuwonongeka kwa matumbo ndi selo imfa chifukwa chikoka cha matenda kapena tizilombo toyambitsa matenda, chifuwa chachikulu, zotupa za m'mimba yaing'ono, matenda amene amatupitsa.

Zitsanzo intracavitary malabsorption

Ndi mtundu uwu wa AGR kwakukulukulu kusokonezedwa chimbudzi mafuta. hydrolysis awo ikuchitika ndi lipase pancreatic, amene adamulowetsa ndi ya ndulu. Ndi kuchepa kwa zinthuzi limapezeka chizindikiro monga steatorrhea. Izi kusankha ndi ndowe owonjezera mafuta. Izi bwino kwambiri akuwonetseredwa mu aakulu kapamba steatorrhea. Osaonekera izi chizindikiro mu chiwindi ndi kapepala biliary.

Pakati zimayambitsa malabsorption intracavitary, muyenera kuganizira kobadwa nako hypoplasia a kapamba (hypoplasia). Zizindikiro kuonekera mu masiku oyambirira kapena masabata a moyo. Pali madzi olemera mpando mofulumira malodorous ndi aliwonse luster. Mafuta akhoza ngakhale nthawi zonse kutayikira mwa chotulukira lapansi.

Zitsanzo posttsellyulyarnoy malabsorption

Posttsellyulyarnaya matumbo malabsorption kumachitika pamene exudative enteropathy. Izi ndi matenda amene plasma mapuloteni atayika kudzera mucosa lapansi. Chifukwa cha enteropathy exudative kungakhale pamaso pa kobadwa nako malformation ziwiya lymphatic matumbo. Nthawi zambiri amayambitsa matenda syndrome Whipple matenda amene amatupitsa, zotupa yaing'ono matumbo, chakudya ziwengo.

Exudative enteropathy nthawi zina amapezeka popanda mawonetseredwe zoonekera matenda. Mwina amaonetsa zizindikiro monga kutsekula m'mimba ndi steatorrhea. Odwala amaoneka edema zotumphukira, isanafalikire pa nkhope, kumbuyo, perineum, miyendo.

Zitsanzo enterotsellyulyarnoy malabsorption

Enterotsellyulyarny mtundu AGR malabsorption mwina chifukwa kudwala monga shuga-galactose malabsorption. Izi ndi zimene tinatengera matenda kumene wosweka zoyendera yogwira shuga ndi galactose mu yaing'ono intestine mucosa. Matenda m'masiku oyambirira a moyo akuwonetseredwa ndi kutsekula m'mimba. Fecal allocated kwa nthawi 10 20 patsiku. Iwo ali madzi, chokhala mkodzo. The mwana aukitsa kutentha thupi, kusanza amapezeka. Ngati kuletsa yobweretsa mkaka ndi zizindikiro. Osauka kulolerana maswiti ndi mkaka chopereka moyo.

Chitsanzo china enterotsellyulyarnogo CMA - fructose malabsorption. Izi ndi osowa majini malabsorption. Zizindikiro zimachitika pambuyo mowa komanso zipatso timadziti, munali mu dongosolo lake wambirimbiri fructose. Ichi ndi maapulo ndi malalanje, ndi yamatcheri ndi chitumbuwa. fructose kuti si chosakanikirana ndi thupi, kuchititsa flatulence, kutsegula m'mimba madzi, ululu colicky m'mimba. Nthawi zina, pali kusanza. Popereka zizindikiro zimadalira kuchuluka kwa fructose analowa m'thupi.

Ambiri chifukwa enterotsellyulyarnoy malabsorption ndi mkhutu Kakhungu chimbudzi - izo disaccharidase akusowa. Ngati si kwathunthu unagawanika disaccharides. Iwo odzipereka pamene kulowa intestine wapotalikira ndi kukumana nayonso mphamvu bakiteriya ndi zamoyo wa hayidirojeni. Pali chifundo cha colic m'mimba, bloating, kutsekula m'mimba, utachepa kudya, kusanza, kusanza.

Enterotsellyulyarnaya matumbo malabsorption malabsorption ndi chimbudzi angayambe matenda celiac. Ndi aakulu cholowa matenda amene kuonongeka villi za m'mimba ang'ono ndi zakudya zina. matenda Celiac amasonyeza ana patangopita miyezi yochepa kumayambiriro mankhwala Catering glyutensoderzhaschih. Pamene matenda:

• defecation pafupipafupi ndi 2 mpaka 5 pa tsiku;
• chopondapo ndi mushy, nthawi zina frothy, ndi chibadidwe fungo fetid, kuwala;
• kumawonjezera m'mimba;
• pali osakwanira kunenepa (patapita nthawi ya misa kuchepekedwa akulowa akusowa kukula).

Kuchita diagnostics ndi matenda malabsorption

Matendawa malabsorption si ikuchitika. Akatswiri kudziwa SMA zizindikiro Kwalamulidwa kwa odwala awo kusintha mayesero apadera ndi kusanthula kutsimikiza njira imodzi kapena kudwala wina amaganiziridwa chikwiyire ndi mkhutu mayamwidwe kapena chimbudzi.

Pamene tikugwira diagnostics, madokotala motsogozedwa ndi pansipa aligorivimu anayamba ndi Organization World Gastroenterology:

• poyamba anagwira mbiri mokwanira, amatenga mfundo za mankhwala anachita posachedwapa kuyenda, kugwiritsa ntchito chakudya ndi zakumwa sanali m'gulu la zakudya mwachizolowezi;
• anaphunzira mbiri banja;
• ndi Kupenda thupi zizindikiro za malabsorption;
• anaphunzira chopondapo, kutenga nkhani makhalidwe awo;
• mayesero zasayansi akutsatiridwa kuti mumve zambiri.

Komanso matenda a syndrome malabsorption zikuphatikizapo zofufuza zochita matenda amaganiziridwa celiac, pamaso pa Giardia, tizilombo timene mu thupi. Zofunika matenda zambiri zimathandiza kupeza ultrasound wa ziwalo za zinthu zonse m'mimba. Kudzera ultrasound zotheka amanena mmene mfundo chiwindi, kapamba, chikhodzodzo ndulu, lymph.

Kuti achotse kapena atsimikizire gastritis autoimmune, matenda celiac, matenda amene amatupitsa mungachite esophagogastroduodenoscopy ndi biopsy za m'mimba ndi duodenum. Kutsimikiza kupanda exocrine pancreatic ntchito unachitikira chopondapo maphunziro, kompyuta ndi kumveka maginito tomography, retrograde cholangiopancreatography udzakhalire ducts. Kuphunzira za kukhalapo kapena kusapezeka kwa zotupa za ileum ndi akatswiri yoikidwiratu ileokolonoskopiyu ndi biopsy m'dera kuphunzira ndi m'matumbo.

Chithandizo cha matenda malabsorption

Pambuyo Kupeza Vuto zimayambitsa malabsorption madokotala etiotropic mankhwala mankhwala kuthetsa matenda omwe afunsidwa. Mwachitsanzo:

• Ngati matenda celiac ndi wapezeka, katswiri akuonetsa wodwalayo moyo wonse gilateni wopanda zakudya;
• ngati wapezeka malabsorption chakudya kapena tsankho chakudya, ndiye anatumizidwa ofanana An Kupha kapena zakudya kutipanikiza;
• njira opatsirana wasonyeza mankhwala;
• mu kagayidwe kachakudya ndi endocrine matenda amafuna chokwanira pathogenetic mankhwala.

Pamene asonyeza otsegula m'mimba matenda omwe amachititsa malabsorption, mankhwala akhoza kukhala etiologic, ndi pathogenetic symptomatic. Patogenetichekaya etiological mankhwala ndipo kungakhale kudya mwa njira zotsatirazi:

• maantibayotiki pa matenda otsekula m'mimba bakiteriya;
• "Metronidazole" ndi amebiasis;
• mankhwala anthelmintic helminthiasis;
• glucocorticoids, cytostatics, "infliximab" matenda yotupa matumbo;
• "Tetracycline", "Ceftriaxone", "Co-trimoxazole" matenda Whipple ndi;
• "Octreotide" ndi endocrine zotupa pa mundawo m'mimba.

chithandizo Symptomatic zikuphatikizapo probiotics, opiates, "Loperamide" absorbent wothandizila (bismuth kukonzekera "Diosmektita").

Kudzimvera chosatheka mu mwambo zizindikiro za SMA. Zilibe zotsatira zabwino. Komanso, malabsorption - kumasonyeza matenda aakulu ndiponso oopsa. Ngati mwakumana ndi zizindikiro za SMA Ndi bwino kukaonana ndi dokotala. Only katswiri angatchedwe chenicheni chimene chinayambitsa matenda ndi adzaika mankhwala ochiza Kupha matenda matenda.