Narcotic bowel syndrome (NBS) chirwere umo munhu akawana kurwadziwa kwepamuviri uye zvimwe zviratidzo zvepamuviri zvinokonzerwa nekudyiwa kwemishonga inodhaka yemahara. Kushandisa nharo yakadai hakufaniri kuva kwenguva refu, sezvo chirwere chinogona kukura mushure memavhiki mashomanana ekushandiswa. MuNBS, kuwedzera kwekutambudzika hakuderedze pasinei nekuwedzera kwemazwi emarwadzo ekurwadza-kunoderedza mishonga.
Maitiro akadaro akawedzerwa anoguma achishumira chete kungowedzera marwadzo anotevera. Inofungidzirwa kuti kushandiswa kusingaperi kweanicate narcotics kunokonzera kuchinja kumisungo nemisumbu mumugwagwa wezvokudya zvinotungamirira kuwedzera kurwadziwa kwekunzwa uye kupera kuderera kune mamwe mishonga.
Imwe haifaniri kuva nenhoroondo yepakutanga kwechirwere chepfungwa kuitira kuti iwedzere NBS. Inogona kukura kune ani naani anogamuchira mishonga yakawanda yemishonga yekurapa mushure mekuvhiyiwa kana kuti kurapwa kwemamiriro ose emarwadzo. Vanhu vane zvirwere zvisingagumi zvekudya zvichibva kune zvinetso zveGI zvakadai seBS, kana mamwe marudzi ezvirwere zvisingaperi zvekudya, zvakadai seBD kana kuti diverticulitis , inogona kukura NBS nokuti vanachiremba vavo vakaraira narcotics mukuedza kugadzirisa marwadzo emimba emamiriro iwayo. Kazhinji vanachiremba havazivi kuti mishonga yavo yemishonga inogona kunge ichiita kuti dambudziko racho riwedzere.
Inotarisirwa kuti nhamba yevanhu vane NBS iri kuwedzera.
Izvo zvinotyisa kuti uverenge kuti Unites States, iyo inenge inenge 5% yehuwandu hwevanhu, inotora 80% yezvinodhaka zvinoshandiswa pasi rese.
Zviratidzo
Kuchema kwemuviri ndiyo chiratidzo chikuru cheNBS. Zvimwe zviratidzo zvinosanganisira:
- Constipation
- Gasi uye kuputika
- Kurasikirwa kwechido uye / kana uremu
- Nausea
- Kudzora
Vamwe varwere veNBS vanorondedzera kuti kudya kunogona kuwedzera zviratidzo zvinorwadza. Izvi zvinogona kutungamirira mukudzivirirwa kwezvokudya, izvo zvinoguma nekurema kwekukura.
Mune zvimwe zviitiko, X-rays yemudumbu inogona kuratidza zviratidzo zvekudzivirira zvishoma mumatumbo, apo chaizvoizvo, inongova kuchengetedza kwechigaro nemhepo, zvichiita kuti kuongororwa kwemuviri wemukirini kana yekuputira.
Kurapa
Kunyanya kurapwa ndiko kurega chero kushandiswa kwemishonga inorapwa. Kune vamwe, izvi zvichaitika zvishoma nezvishoma, asi kune vakawanda izvi zvinogona kuitika nokukurumidza. Nguva yakareba iyo inoda kuregera kubva kumishonga inobatanidza nekureba kweiyo yave iri kushandisa narcotic mishonga. Mune mamwe mazwi, munhu anovandudza NBS nokukurumidza mushure-kuvhiyiwa haafaniri kudikanwa kwenguva yakareba sekuchera-kubvisa semunhu anenge aripo.
Uku kubviswa kwemishonga yemishonga kunoitwa pamwe chete nemimwe mishonga nemishonga inotarirwa kuderedza migumisiro yekuregera uye kupa dzimwe nzira dzekununura kurwadza. Muzviitiko zvizhinji, izvi zvinogona kuitwa pamusana pepfungwa. Zvisinei, varwere vari kutarisana nekushushikana, kurutsira kana zviratidzo zvemukati yeukisi kana kuvhiringidzika kwemazivo kunogona kudiwa muchechi.
Zvinogona kuva zvakaoma kuvarwere kuti vafunge pamusoro pokuzvichenesa kubva pamishonga yavo sezvo mishonga inogona kupa marwadzo ekurwadziwa.
Zvisinei, mumamiriro ezvinhu eNBS, zvinokosha kuziva kuti narcotics iri kunonoka hutumbu pasi uye inopa marwadzo uye zvimwe zviratidzo zvekudya zvinenge zvichiitika.
Zvimwe zvirongwa zveNBS zvinosanganisira:
- Anodzvinyirira, nemhaka yekurwadziwa kwavo-kuderedza nzvimbo.
- Kunyanya kuzvidya mwoyo nemishonga yekudzikisa kugadzikana kwepfungwa kwekunyangarika kwekushungurudza.
- Mafungiro epfungwa, akadai se CBT , nokuda kwekutambudzika kwekutambudzika.
- Naltrexone inobatsira vanhu kuti varege kushandisa zvinodhaka.
Vanachiremba vazhinji vanobata NBS nenzira imwecheteyo sezvavanenge vachiita kurapwa kweopioid-induced constipation (OIC), panguva iyo mishonga yakafanana neRisistor (methylnaltrexone) yaizogadzwa.
Sources:
Grunkemeier, D., et.al. "Narcotic Bowel Syndrome: Clinical Features, Pathophysiology uye Management" Clinical Gastroenterology uye Hepatology 2007 5: 1126-1122.
Minocha, A. & Adamec, C. (2011) The Encyclopedia of the Digestive System uye Digestive Disorders (2nd Ed.) New York: Facts on File.