Malabsorbsiyon al\u0131nan besinlerin sindirim sisteminden yeterince emilememesi durumudur. Bu gibi haller a\u015fa\u011f\u0131da anlat\u0131lan hastal\u0131klar nedeniyle olabilir<\/p>\n
\u00c7\u00f6lyak Hastal\u0131\u011f\u0131:<\/p>\n
Bu\u011fday, Arpa, \u00e7avdar ve Yulaf gibi tah\u0131llarda do\u011fal olarak bulunan ‘gluten’ Maddesi baz\u0131 ki\u015filerde \u00e7\u00f6lyak hastal\u0131\u011f\u0131na neden olabiliyor. Hastal\u0131\u011f\u0131n ilac\u0131 yok. Tek tedavi y\u00f6ntemi \u00f6m\u00fcr boyu glutensiz bir diyet uygulamak.<\/p>\n
\u00c7\u00f6lyak, genetik k\u00f6kenli bir ince ba\u011f\u0131rsak allerjisi. Bu allerji bu\u011fday, arpa, yulaf ve \u00e7avdar gibi tah\u0131llarda bulunan ve g\u00fcn\u00fcm\u00fczde pek \u00e7ok g\u0131dada (bisk\u00fcvi, re\u00e7el gibi) k\u0131vam verici madde olarak kullan\u0131lan, gluten adl\u0131 Proteine kar\u015f\u0131 ince ba\u011f\u0131rsa\u011f\u0131n \u00f6m\u00fcr boyu s\u00fcren bir hassasiyet g\u00f6stermesinden kaynaklan\u0131yor. \u00a0<\/p>\n
K\u00f6r Halka Sendromu <\/p>\n
Gastrointestinal\u00a0 sistemdeki darl\u0131klar\u00a0 (ameliyat sonras\u0131, Crohn hastal\u0131\u011f\u0131 gibi), k\u00f6r luplar (Billroth II operasyonuna ba\u011fl\u0131 afferent lup staz\u0131, enteroenterik fist\u00fcller, ince barsak divertik\u00fclleri) veya ileokolektomi veya enterokolonik fist\u00fcl gibi( ince barsak ve kolonun direkt birle\u015fmesi ) a\u015f\u0131r\u0131 bakteri \u00e7o\u011falmas\u0131 yaparak safra Tuzu dekonjugasyonuna ba\u011fl\u0131 diyareye neden olurlar\u00a0<\/p>\n
Tropikal Sprue\u00a0<\/p>\n
Nedeni bilinmeyen kronik bir gastroenterittir. \u0130nce barsak mukozas\u0131nda par\u00e7al\u0131\u00a0da\u011f\u0131l\u0131m g\u00f6steren atrofi ile karakterize bir hastal\u0131kt\u0131r. Klinikte; ate\u015f, k\u0131rg\u0131nl\u0131\u011f\u0131 takiben ya\u011fl\u0131 ve Sulu ishal ile ortaya \u00e7\u0131kar. Kronik emilim bozuklu\u011fu, i\u015ftahs\u0131zl\u0131k, sindirim bozuklu\u011fu ile karakterizedir. AGA ve EMA negatiftir.\u00a0 Tedavide antidiareik ila\u00e7lar kullan\u0131l\u0131r. B12 vitamini, folik Asit, geni\u015f spektumlu oral antibiyotikler (tetrasiklin vb) verilir. Glutensiz diyetin bir etkisi olmaz<\/p>\n
Tropikal sprue, gittik\u00e7e daha \u015fiddetli hal alan ve besinsel maddelerin eksikli\u011fine yol a\u00e7an ince ba\u011f\u0131rsak yap\u0131 ve i\u015flev bozuklu\u011fu ile karakterize, kronik, edinsel bir hastal\u0131kt\u0131r. Hastal\u0131k, sadece belirli tropik b\u00f6lgelerde ya\u015fayan veya ziyaret edenlerde g\u00f6r\u00fcl\u00fcr.\u00a0<\/p>\n
Pankreatik Steatore<\/p>\n
Ya\u011f sindiriminin veya absorpsiyonunun (emilim) bozulmas\u0131 sonucu steatore (ya\u011fl\u0131 d\u0131\u015fk\u0131) olu\u015fur. Steatore G\u00fcnde 7 g’den daha fazla ya\u011f\u0131n d\u0131\u015fk\u0131 ile at\u0131lmas\u0131d\u0131r. Pankreatik lipaz eksikli\u011fi veya inaktivasyonu, ekzokrin pankreas yetersizli\u011fi(kronik pankreatit, pankreas\u00a0 kanseri, kistik fibroz) gibi pankreasa ba\u011fl\u0131 hastal\u0131k hallerinde steatore g\u00f6r\u00fclebilir. Steatore tan\u0131s\u0131nda sudan boyas\u0131 ile\u00a0d\u0131\u015fk\u0131 ya\u011f glob\u00fcllerinin (n\u00f6tral ya\u011f) say\u0131 ve b\u00fcy\u00fckl\u00fckleri ara\u015ft\u0131r\u0131l\u0131r. Sudan + asid + \u0131s\u0131tma ile de ya\u011f asidi saptan\u0131r. D\u0131\u015fk\u0131da n\u00f6tral ya\u011f artm\u0131\u015fsa pankreas ekzokrin yetersizli\u011fi d\u00fc\u015f\u00fcn\u00fclmelidir. D\u00fcz kar\u0131n grafisi pankreatik kalsifikasyonu g\u00f6stermesi a\u00e7\u0131s\u0131ndan kronik pankreatit tan\u0131s\u0131nda yararl\u0131d\u0131r. Sekretin, hassas fakat uygulamas\u0131 zor bir testtir.<\/p>\n
Bentiromide testi \u00fclkemizde yayg\u0131n kullan\u0131lmamas\u0131na kar\u015f\u0131 pankreas Enzim eksikli\u011fini g\u00f6steren kolay bir testtir. D\u0131\u015fk\u0131 kemotripsin aktivitesi \u00f6l\u00e7\u00fclerek pankreas konusunda bilgi sahibi olunabilir.\u00a0<\/p>\n
\u0130diyopatik (Nedeni Bilinmeyen) Steatore<\/p>\n
Steatore (Ya\u011fl\u0131 d\u0131\u015fk\u0131) d\u0131\u015fk\u0131da \u00e7ok fazla miktarda ya\u011f bulunmas\u0131d\u0131r. Nedenleri, glutene allerjiden, karaci\u011fer sirozuna kadar, \u00e7ok \u00e7e\u015fitli olabilir. D\u0131\u015fk\u0131, iri, soluk, k\u00f6p\u00fckl\u00fc ve k\u00f6t\u00fc kokuludur ve hastada vitamin, demir ve yiyecekle al\u0131nan bir\u00e7ok de\u011ferli maddenin emilim yetersizli\u011fi belirtileri ortaya \u00e7\u0131kar. \u00a0<\/p>\n
Tropikal Olmayan Sprue<\/p>\n
\u00c7\u00f6lyak hastal\u0131\u011f\u0131 (di\u011fer ad\u0131 ile \u00e7\u00f6lyak, tropik olmayan sprue, \u00e7\u00f6lyak sprue, gluten duyarl\u0131 enteropatisi), tah\u0131llarda bulunan genelde glutenin bulundu\u011fu baz\u0131 Protein zincirlerine kar\u015f\u0131 olu\u015fan kronik bir reaksiyondur. Bu reaksiyon ince ba\u011f\u0131rsakta vill\u00fcslerin y\u0131k\u0131m\u0131na neden olur ve bunun sonunda besin emilim bozuklu\u011fu ortaya \u00e7\u0131kar.\u00a0<\/p>\n
\u0130ntoleransa Ba\u011fl\u0131 Malabsorbsiyon<\/p>\n
Reaksiyon \u00f6zel bir g\u0131dan\u0131n ya da bile\u015fenin sindirilmemesinden ya da emilmemesinden kaynaklan\u0131r. Semptomlar ki\u015fiden ki\u015fiye de\u011fi\u015febilir. G\u0131da intolerans\u0131na \u00f6rnek laktoz intolerans\u0131, Bu\u011fday intolerans\u0131 ve f\u0131nd\u0131k intolerans\u0131d\u0131r. G\u0131da intolerans\u0131nda tam \u015fifay\u0131 sa\u011flayacak yeterli tedavi yoktur. Tan\u0131 konuldu\u011funda, problem yaratan g\u0131dadan sak\u0131nmak tek etkili tedavidir. Ancak, baz\u0131 \u00fclkelerde laktoz intolerans\u0131 i\u00e7in laktaz enzimi i\u00e7eren preparatlar bulunmaktad\u0131r. \u00a0<\/p>\n
G\u0131da alerjisi ve intolerans\u0131 tipleri : \u00a0<\/p>\n
Baz\u0131 durumlarda, ayn\u0131 \u00fcr\u00fcn\u00fcn hem intoleransa hem de allerjiye birlikte sebep olabildi\u011fi bilinmelidir: \u00a0<\/p>\n
S\u00fct: S\u00fctteki proteine kar\u015f\u0131 allerji, laktoza kar\u015f\u0131 intolerans \u00a0<\/p>\n
Bu\u011fday: Bu\u011fday proteinlerine kar\u015f\u0131 allerji, glutene kar\u015f\u0131 intolerans (\u00e7\u00f6lyak hastal\u0131\u011f\u0131)\u00a0<\/p>\n
Di\u011fer Malabsorsiyon Nedenleri<\/p>\n
Oral al\u0131nan maddeler ince barsakta tam olarak absorbe (emilme) edilemezlerse, l\u00fcmende ozmotik bir g\u00fc\u00e7 olu\u015fturup Suyun toplanmas\u0131na neden olurlar. Absorbe olmayan maddeler, emilemeyen veya sindirilemeyen g\u0131dalar veya ila\u00e7lar (Mg tuzlar\u203a) olabilir. L\u00fcmen ozmotik y\u00fck\u00fcn\u00fc art\u0131ranlar\u0131n ba\u015f\u0131nda karbonhidratlar gelir. Ya\u011flar da benzer etki g\u00f6sterirler. Ozmotik diyarede,\u00a0 a\u00e7 kal\u0131nca olmaz, beslenme eksikli\u011fi geli\u015fir. Bir grubunda d\u0131\u015fk\u0131 suludur, bir grubunda da artm\u0131\u015f ya\u011f i\u00e7erir.<\/p>\n
HAZIRLAYAN; Dr Ayfer SER\u0130N<\/p>\n
KAYNAKLAR:<\/p>\n
1- H. Uzunismail, \u0130.\u00dc. Cerrahpa\u015fa T\u0131p Fak\u00fcltesi S\u00fcrekli T\u0131p E\u011fitimi Etkinlikleri, Gastrointestinal Sistem Hastal\u0131klar\u0131 Sempozyumu, 11-12 Ocak 2001, \u0130stanbul, s.57-69<\/p>\n
2.\u00a0\u00a0\u00a0Fine KD. Diarrhea. In Feldman M, Scharschmidt B, Slesenger MH, eds. SlesengerFordtran’s Gastrointestinal and Hepatic Disease: Pathophisiology, Diagnosis, Management. 6th ed. Philadelphia, Saunders, 1998; 12852<\/p>\n
3. Friedman LS, Isselbacher KJ. Diarrhea and constipation. In Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL eds. Harrison’s Principles of Internal Medicine. 14th ed. New York Mc GrawHill, 1998; 23644<\/p>\n
4. American Gastroenterological Association Clinical Practice and Practice Economics Committee. AGA tecnical review on the evaluation and management of chronic diarrhea. Gastroenterology 1999; 116:146486<\/p>\n
5. Blaser MJ. Infectious diarrheas; acute, chronic, and iatrogenic. Ann Intern Med 1986; 105:7857<\/p>\n
6. Gastrointestinal Sistem Hastal\u0131klar\u0131 Sempozyumu, 11-12 Ocak 2001, \u0130stanbul, s.57-69 \u00a0\u00a0\u00a0 Schiller LR. Diarrhea. Med Clin Norh Am 2000; 84:125974<\/p>\n","protected":false},"excerpt":{"rendered":"
Malabsorbsiyon al\u0131nan besinlerin sindirim sisteminden yeterince emilememesi durumudur. Bu gibi haller a\u015fa\u011f\u0131da anlat\u0131lan hastal\u0131klar nedeniyle olabilir \u00c7\u00f6lyak Hastal\u0131\u011f\u0131: Bu\u011fday, Arpa, \u00e7avdar ve Yulaf gibi tah\u0131llarda do\u011fal olarak bulunan ‘gluten’ Maddesi baz\u0131 ki\u015filerde \u00e7\u00f6lyak hastal\u0131\u011f\u0131na neden olabiliyor. Hastal\u0131\u011f\u0131n ilac\u0131 yok. Tek tedavi y\u00f6ntemi \u00f6m\u00fcr boyu glutensiz bir diyet uygulamak. \u00c7\u00f6lyak, genetik k\u00f6kenli bir ince ba\u011f\u0131rsak allerjisi. Bu allerji bu\u011fday, arpa, yulaf[Devam\u0131n\u0131 Oku…]<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[22524],"tags":[23114,23117,23112],"_links":{"self":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts\/13212"}],"collection":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/comments?post=13212"}],"version-history":[{"count":0,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/posts\/13212\/revisions"}],"wp:attachment":[{"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/media?parent=13212"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/categories?post=13212"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/gncz.net\/index.php\/wp-json\/wp\/v2\/tags?post=13212"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}