IBS-D Inogona Kukonzerwa Nechinetso NeChirungu Chechidimbu
Bile acid diarrhea (BAD) inenge iyo iyo iyo bile acids haina kunyatsogadziriswa mukati mekudya kwekudya , zvichiita kuti zviratidzo zvekurwara kusingaperi. Izvi zvinogonawo kuzivikanwa se bile acid malabsorption (BAM). Zvisinei, tsvakurudzo inoratidza kuti mamiriro acho angasave nguva dzose nekuda kwema malabsorption.
Vatsvakurudzi munharaunda ino vanodavira kuti BAD haisi sevasingawanzoita sezvakambofungidzirwa.
Vanodavirawo kuti BAD chirwere chisingazivikanwi-icho chinofanirwa kufungidzirwa kune ani zvake ari kuine chirwere chisingaperi chisingazivikanwi-kunyanya, vanhu vane zviratidzo zvehurwere-zvinowanzovhiringidza bowel syndrome (IBS-D) kana kushanda chirwere . Dambudziko rei izvi zvisingazivikanwi ndezvokuti zvinogona kudzivirira vanhu kuti varege kurapa zvakakodzera.
Overview
Kuti unzwisise zvakanakisisa BAM, zvinobatsira kudzidza kuti kudyiwa kunofanirwa kushanda sei. Bile acids inobudiswa nechiropa chako uye inochengetwa muuru yako. Apo iwe uchingodya zvokudya zvine mafuta, aya acid anosunungurwa mumukati muduku kuitira kuti mafuta angaputsika pasi uye apinde mumuviri wako.
Bile acids inobva yadzoserwa pahutachiwana hutumbu huchidzokera muchiropa kuitira kuti isunungurwa zvakare sezvinodiwa. Kazhinji kacho kaduku kadiki kemaatisi aya anoita nzira yavo kupinda mumuviri mukuru.
Zvisinei, apo BAD iripo, kuwandisa kwakanyanya kweBacid acid inoputirwa mumatumbo makuru .
Izvi zvinoita kuti kuwedzere kusvibiswa kwemvura, zvichiita mumadziro emvura uye kumhanya kwemukumbo motility -iyo inoguma nezviratidzo zvehurwere.
Kunyangwe zvaive zvichifungidzirwa kuti kusagadzikana kunosanganisira malabsorption, kutsvakurudza kwakaitwa munguva pfupi kunoratidza kuti dambudziko racho rinogona kunge riri kunyanya kudengenyeka kwe bileic acid.
Izvi zvingave zvakakonzerwa nekusavhiringidza mumashoko ekutaura anokonzera kunofanira kudzivisa kubudiswa kwe bileic acid.
Zvinokonzera
Zvinetso zvehutano zvinotevera zvinogona kubatsira pakuvandudzwa kweBAD:
- Ileal (musikana muduku) chirwere
- Ileal chirurudzo (kazhinji sekurapa kwaCrohns chirwere)
- Gallbladder kubviswa (cholecystectomy)
- Muduku webhakitiriya bhakitiriya rinoputika (SIBO)
- Kusagadzikana kwepancreatic
- Radiation for cancer
- Microscopic colitis
- Short bowel syndrome
Zviratidzo
BAD inonyanya kuratidza sechiitiko chezvisingagumi zvekurara. Zvimwe kana zvose zvezviratidzo zvinotevera zvinogonawo kuvapo:
- Mvura yakasununguka
- Dhairrhea nekukurumidza
- Dhairrhea pakati peusiku
- Njodzi dzomumhepo
- Bloating
Kuziva
Vanachiremba vanoita bile acid malasorption nerudzi, zvichienderana nechinokonzera:
- Tanga 1: Sekondari kune ileal chirwere kana resection
- Rudzi rwechipiri: Idiopathic kana kuti primary (chikonzero hachizivikanwi)
- Tora 3: Sekondari kune mamwe marudzi ose ezvirwere zvepachimwere
Tichifunga nezvekutsva kwemaitiro ekudzivisa maitiro ezvinyorwa zvekushandiswa kwebibi acids, izwi rokuti idiopathic bile acid malabsorption (I-BAM) rinogona kubuda kunze.
Kuedzwa
Izvo zvakakosha kuongororwa muedzo wekuvapo kweBAD kunonzi 75Se-homocholic acid taurine (75SeHCAT) test. Iyi ndiyo mhirizhonga yemishonga yenyukireya umo murwere anopiwa capsule kuti amedze nemuromo uye anozoperera muviri wose.
Kudzokorora kudzokororwa kunorongwa mazuva manomwe gare gare.
Iyo capsule ine SeHCAT, iyo inoshandiswa kuongorora kukwanisa kwemukati mudumbu kuchengeta bile acids. Chiyero chekuchengetedza chiri pasi pasi pe15 muzana chinonzi chinoratidza kuvapo kweBAM.
Zvinosuruvarisa, muedzo hauwanikwi muUnited States. Zvinotendwa kuti kushayikwa kwekuwana mukana weSeHCAT unobatsira kuongorora kweBAD.
Vamwe vanachiremba vanotendeukira kune muedzo wemishonga yeBAD seimwe nzira yekutarisa 75SeHCAT. Kana mishonga inobatsira pakuvandudzwa kwezviratidzo, BAD (kana BAM) inova kuonekwa.
Chimwe chikonzero cheizvi ndechekuti imwe yemishonga inoshandiswa yeBAD haina kubvumirwa zvakanaka. Inowanzorambidzwa-nharaunda apo vanhu vasina kugamuchira tsanangudzo yekujekesa iyo inogona kubatsira nemishonga inoteerera.
Panewo nzira yechitatu, inofungidzirwa yakagadziriswa, iyo isingawanzoshandiswa sezvo inoda 24-hour stool yekuunganidza uye kuwanika kweboka duku rekuongorora mahara laboratories.
IBS-D kana Functional Diarrhea
BAD vatsvakurudzi vanotenda kuti vanhu vazhinji vane IBS-D kana kuti zvirwere zvinoshanda zviripo vane BAD. Zvidzidzo zvinoratidza kuti BAD inogona kunge iri kumashure kwechetatu chezviitiko zveBS-D uye 40 kusvika ku50 muzana yezviitiko zvehutachiwana hunoshanda.
Kurapa
Mumamiriro ezvinhu apo BAD ndiyo chikonzero chechirwere chinozivikanwa, kurapwa kunotarisa pakugadzirisa chirwere chacho pachako. Mumamiriro ezvinhu apo hapana chinokonzera chikonzero chinogona kuonekwa, BAD yaizobatwa nekirasi yemishonga inozivikanwa se bile acid sequestrants kana kusunga.
Mishonga yakadaro inoita seyokushanda pazviratidzo zveBAD nekusunga kune acid uye nokudaro nekuderedza migumisiro yadzo pamatumbo makuru. Idzi ndidzo nhengo dzezvino dzekirasi iyi, mishonga iyo yeBAD yaizoonekwa seye-label:
- Colestyramine (Questran)
- Colesevelam (WelChol)
- Colestipol (Colestid)
Iyi mishonga inowanzobudirira mukubvisa zviratidzo zveBAD. Zvisinei, apo mishonga inorayirwa pamutengo wechiitiko icho vane FDA inogamuchirwa, semuenzaniso cholesterol yakakura, kuvimbiswa uye zvimwe zviratidzo zvekudya zvinogona kuitika. Kana iwe wakarongerwa imwe yemishonga iyi, zvakakosha kushanda nachiremba wako kuti uwane muyero wakakodzera iwe.
Zvakakosha kucherechedza kuti mishonga iyi inogona kukanganisa kushandiswa kweimwe mishonga iwe unogona kutora. Saka, dzinofanirwa kutorwa maawa mana kusvika matanhatu mushure mokunge kana mushure mimwe mimwe inoda kurapa.
Shoko Rinobva
Kunyange zvazvo kuenderera mberi kutsvakurudza kunodiwa, ikozvino kwaizoonekwa kuti BAD yakawanda kupfuura yaimbofungidzirwa. Kana iwe wakamboonekwa uine IBS-D kana kuti uchitarisana nezviratidzo zvehutachiwana hwekugara-uye chiremba wako haasati atonga BAD-iwe unogona kuda kukurukura nyaya yacho pamwe chete kuti uone kana izvi zvisingazivikanwe hutano huri mumudzi yezviratidzo zvako.
> Sources:
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> Pattni S, Walters J. Kufambira mberi Kwakaitika Mukunzwisisa kweBile Acid Malabsorption. British Medical Bulletin. 2009 92: 79-93.
> Walters JRF, Pattni SS. Kutarisa Bhiri Acid Diarrhea. Kurapa Kwokurapa muGastroenterology. 2010; 3 (6): 349-357.
> Wedlake L, et.al. Kuongorora kwakarongeka: kuwandisa kweIdiopathic Bile Acid Malabsorption Sezvinoratidzwa neSeHCAT Kuverenga Muvarwere Ane Dharare-Predominant Irritable Bowel Syndrome. Alimentary Pharmacology uye Therapeutics. 2009. 30: 707-717.