Targeting Small Bitestinal Bacterial Overgrowth
Vatsvakurudzi vari kuona kuti maduku emubhakitiriya emukemikari (SIBO) anokanganisa vanhu vakawanda kudarika zvaimbofungidzirwa. Ichokwadi, inofungidzirwa kuti nhamba yevanhu vane zviratidzo vakaonekwa kuti vane chirwere chinosuruvarisa chirwere (IBS) chaizvoizvo vane SIBO.
SIBO imamiriro ezvinhu ehutano ayo mune zvakawanda zvinowedzera mabhakitiriya mumukati muduku.
(Muviri wakagwinya, kuvapo kwebhakitiriya akadaro mukati memukati maduku kunofanira kunge kusina kukwana, uye vanhu vakawanda vane mabhakitiriya akadaro aripo mumatumbo makuru.) SIBO inogona kukonzera zviratidzo zvakasiyana siyana-kusanganisira, zvakanyanya kukanganisa, kusakwana kwezvokudya . Iyo inowanzoongororwa kuburikidza nokufema kufema, kunyange zvazvo dzimwe nzira dziripo .
Kana iwe wakamboudzwa chiremba wako kuti une SIBO, iwe uchasimbiswa kuziva kuti inogona kurapwa. Muchidimbu ichi muchadzidza nezvenzira iyo SIBO iri kutarisirwa nayo iye zvino, pamwe chete nezvimwe zvinoshandiswa zviri pasi pekutsvakurudza. Idzi ruzivo ruchava rubatsiro kwauri apo iwe unoshanda nachiremba wako kuti ugadzire chirongwa chekurapa.
1) Chirwere cheArabicos Therapy
Nokuti ikozvino, mushonga we "golide" weSIBO inoshandiswa mushonga wemishonga inorwisa mabhakitiriya inotarirwa kuderedza kuwanda kwebhakitiriya mudumbu duku. Iyi mishonga inofungidzirwa kuti inogona kuderedza kusvibiswa kwembambo yemukati muduku iyo ingangodaro inokonzera kushaya malabsorption.
Zvinosuruvarisa, sayenzi inoshandiswa kushandiswa kwemishonga inorwisa mabhakitiriya yeSIBO ichiri mucheche hwayo. Vatsvakurudzi vanoziva kuti zvakawanda zvinoda kudzidziswa kuti ndeapi maitiro emishonga inorwisa mabhakitiriya yakakosha kune munhu mumwe nomumwe, uye zviyero zvakadini uye urefu hwekurapa huchashanda.
Ikozvino, mishonga inorwisa mabhakitiriya inoshandiswa ndeye Xifaxan .
Kutsvakurudza kunoratidza kuti Xifaxan inogona kunyatsoshanda pakurapa SIBO, nehuwandu hwevarwere vanobatsirwa nekurapa. Xifaxan yakaratidzwa kupedza marudzi akasiyana-siyana emabhakitiriya. Mune mishonga yakawanda yemakiriniki, yakaratidza kuva yakakosha kupfuura placebo nemamwe marudzi emishonga inorwisa mabhakitiriya ekuvandudza zviratidzo nemigumisiro yekufema. Zvisinei, vatsvakurudzi vari kuramba vachitsvaga kubudirira kwemamwe marudzi emishonga inorwisa mabhakitiriya kuitira kuti vazarurire mikana yekuwedzera mamwe maitiro ekurapa.
Mumumuviri, Xifaxan haisi kupinda muropa, saka kuderedza migumisiro yechirwere uye kuwedzera kukwanisa kwayo kugadzirisa zvakananga mabhakitiriya ari mukati memukati maduku. Uye kusiyana nemamwe emishonga inorwisa mabhakitiriya iwe ungangodaro uripo, Xifaxan haina zvakawanda zvinokonzera mabhakitiriya mukati memukati makuru uye saka haufaniri kukuita iwe zviratidzo zvepachiviri kana zvirwere zvemuvirwo iwe wave wakamboona nematangiro evanhu vanorwisa mishonga . Kazhinji, Xifaxan inoonekwa semishonga yakachengeteka, kunyange zvazvo zvisingaoneki migumisiro yakave yakataurwa.
Sezvakataurwa pamusoro apa, pane imwe zvino haisi kubvumirana kukuru pamusoro pekuti zvakakosha sei uye nguva ndeipi yekushandisa Xifaxan.
Mumakiriniki akawanda, mizinga yepamusoro yakaratidzwa kuva yakakosha kudarika maitiro mashoma. Mumakiriniki, Xifaxan inowanzotarisirwa mune zvidzidzo zvevhiki mbiri, nedzidzo dzakadzokororwa dzakarongerwa sezvinodiwa. Izvo zvinofanira kuonekwa kuti, sekutanga kwegore ra2017, Xifaxan haina kubvumidzwa neDFA mukurapa kweSIBO (kunyange ichibvumirwa kuti kurapwa kwehutachiwana hukuru hweBS nevarwere veharairi). Nokudaro, kurondedzera Xifaxan yeSIBO kunofungidzirwa se "off-label" kushandiswa.
Pasinei nehuwandu hwehupfumi hweXifaxan, SIBO inodzoka zvakare, saka varwere vanowanzoda mazano akawanda ekuregererwa kwakakwana.
Kune vamwe, zvinopfuura rimwe remishonga inorwisa mabhakitiriya inogona kunyorwa panguva imwe chete. Kune vamwe, kutarisana nehutano hwezvinetso zvehutano kana kushandura kudya uye maitiro emararamiro angave akadikanwa.
2) Nhepfenyuro Inofambisa Matambudziko
Mishonga inorwisa mabhakitiriya sezvakakurukurwa pamusoro apa ndiyo nzira inokosha yekurapa SIBO kune vanhu vasina izvo zvinokonzera kuti mamiriro acho aonekwe. Zvisinei, pane dzimwe nguva pane dambudziko rehutano hunotarirwa kunotarisirwa kuitira kuti kubvisa chero chinhu chinokurudzira kuwanda kwebhakitiriya mumukati muduku. Ichi chinetso chinogona kunge chiri chirwere kana chinogona kuva chimwe chinhu chinokanganisa chimiro chemukomana muduku.
Inorwara nechirwere: Mamwe mienzaniso yezvirwere zvinokonzera kuti kutanga kweSIBO kunosanganisira izvo zvinokanganisa motility (kukurumidza) kwemuviri kana madumbu maduku, zvakadai segastroparesis kana zviduku dysmotility. Izvi zvinogona kurapwa nemishonga yeprokinetic.
Chimwe chiitiko chirwere chechiliac , sezvo chakawanikwa kuti vanhu vane chirwere cheecliac vari pangozi yakakura yeSIBO. Kune vanhu ava, kunyatsoteerera kudya-gluten-pasina (zvinokosha kune utano hwavo!) Kunogona kubatsirawo kuvandudza zviratidzo.
Maitiro ekuremara: Izvi zvinotevera mimwe mienzaniso yezvikanganiso zvemuumbi zvinogona kubatsira pakusimudzirwa kweSIBO. Zvimwe zvezvikanganiso izvi zvinogona kugadziriswa kuburikidza nekuvhiyiwa.
- Mapofu mapofu
- Chivharo chinopisa
- Diverticula iripo mudumbu duku
- Fistulas
- Small bowel syndrome
- Zvidimbu
SIBO inogonawo kuonekwa nevaya vakawana rusarura (zvichida kunzi se subtotal) colectomy , nekuda kwekukanganisa kunokonzerwa nekuvhiringidza kwevhaocecal valve iyo inogona kubvumira mabhakitiriya emakoloni kuti adzokere kumashure mumukati muduku. Mukuwedzera, kunonoka kwevhudzi duku rekuchenesa, kuburikidza ne colectomy, rinogona kuisa danho kuti mabhakitiriya awedzere.
Mishonga yemigumisiro: Mune zvimwe zviitiko, mushonga unoshandiswa kurapa dambudziko rakasiyana-siyana rehutano ungave uchibatsira kumamiriro ezvinhu anokurudzira SIBO. Kurega kushandiswa kwavo kunogona kubatsira kuderedza zviratidzo zveSIBO. Iyi mishonga inosanganisira:
- Opiate mishonga (inowanzogadzirirwa marwadzo)
- Proton pump inhibitors (PPIs) (inowanzogadzirirwa GERD)
3) Zvokudya Zvokudya
Zvirongwa zvekudya zveSIBO zvinotarisirwa kuti zvigadzirise kukanganisa kwezvokudya kana kutarisa SIBO zvakananga kuburikidza nekushandiswa kwemishonga chaiyo.
Kutaura nezvekushayikwa kwezvokudya: Kana iwe uine chirwere cheSIBO, unofanirwa kushanda nachiremba wako kuti aone uye agadzirise chero kukanganisika kwekudya kunoita. Mishonga inofanira kutorwa chero ipi zvayo kana yese yevhitamini inotevera nemaminerari kana kushayikwa kunowanikwa:
- Vitamin A
- Vitamin B12
- Vitamin D
- Vitamin E
- Calcium
- Magnesium
Kana chiremba wako achidavira kuti steatorrhea uye / kana rumwe rudzi rwemafuta malabsorption riripo, vangakurudzira kuti utore pancreatic enzyme supplement .
Elemental Diet: Kudya kwezvokutanga kunosanganisira kupedzisira kwakakwana kwezvokudya kune imwe nzira yekudyisa mvura. Vamwe vashandi vanobatanidza hutano vari kurumbidza kushandiswa kwezvokudya zvepakutanga sechisiri chemishonga yekubata SIBO. Imwe kliniki yekudzidza yakaitwa umo vazhinji vevatori vechikamu vakawana kuderedzwa kwezviratidzo, uye kugadziriswa kwemhepo yekufema kuwanikwa, pashure pevhiki mbiri pazvokudya zvekutanga.
Zviri pachena kuti kutsvakurudza kwakawanda kunofanirwa kutarisirwa kuti uone kana izvi zvakaoma-kutevera zvinodhaka iSable chirwere chinokwanisa. Zvinokurudzirwa kuti urege kuedza izvi pamusha nekugadzirwa kwemaitiro nekuda kwehutano hwekukosha kwekudya kwekudya, izvo zvingaisa hutano hwako panjodzi.
Zvishoma-FODMAP Zvokudya: Zvokudya zvakaderera-FODMAP zvakagadzirirwa kuderedza zviratidzo zveBS nekudzivirira kwenguva pfupi kushandiswa kweFODMAPs, mahydrohydrates anowanikwa muzvokudya zvakafanana zvinogona kuita kuti zviratidzo zveBS zvivepo. NeSIBO, maviri ezvimhando dzakasiyana -siyana zveFODMAP , lactose uye fructose, inogona kunge ine malabsorbed pamusana pokuputika pamucheto wemukati muduku. Mukuwedzera kune aya maviri, mamwe maFODMAP asina kuomeswa angasvibiswa nemaabhakitiriya anogara asina kufanira mumucheche muduku, zvichiita kuti kuvhara uye zvimwe zviratidzo zvekudya.
Nokudaro, pasi-FODMAP yezvokudya inofanirwa kuti inobatsira SIBO nokuti kuderedzwa kwekodhihydrate kushandiswa kunogona "kushaya nzara" mabhakitiriya mudumbu duku. Kunyange zvakadaro, sekunge zvakadaro hakuna hutano hwekuchirapa panyaya iyi. Pakati pemitsetse yakafanana, kushanda kwezvakaderera-FODMAP kudya kune vanhu vane IBS inogona kuonekwa kune vamwe kune zvinobudirira zvekudya pane SIBO isingawaniki, asi zvakare sekuno, izvi zvinongokonzera.
Hazvizivikanwi zvakanyanya sekukodzera kwezvakaderera-FODMAP kudya kune munhu iye zvino anotora antibiotics yeSIBO. Zvinofungidzirwa kuti kudya kunogona kuderedza kushanda kwemishonga inorwisa mabhakitiriya nekuda kwekuisa mabhakiteriya mu dormancy. Nokudaro, zvinowanzotaurirwa kuti munhu adye kudya kwemazuva ose apo paine mishonga inorwisa mabhakitiriya obva achitevera zvokudya zvakaderera-FODMAP mushure mokunge mishonga yemishonga yakagadzirirwa senzira yekudzivirira mune ramangwana SIBO zvakare.
Sezvaunogona kuona zvakajeka, basa rekudya mune kutanga, kuchengetedza, uye kurapwa kweSIBO kunoramba kusinganzwisisiki. Tariro yakaramba ichitsvakurudza panyaya iyi ichajekesa ruzivo rwakakosha sekubatana pakati pekudya neSIBO.
Nguva Yemberi yeSIBO Kurapa
Sezvo SIBO iri kupiwa kutsvakurudza kwakawanda, mushonga mutsva unogona kubuda. Imwe nyanzvi inofadza yekutsvakurudza ndeyekuvandudzwa kwekombiki yepamusoro iyo ichapa kukwanisa kunyatsoziva kuvepo uye rudzi rwebhakitiriya ari mumucheche wemunhu. Panguva ino, mishonga iri muchikamu ichi zvinhu zvose zviri kutaridzirwa mukati mekuchengeteka kwavo nekubudirira kweSIBO.
Herbal Formulations
Ikoko kune imwe yenyaya yakabudiswa umo kushandiswa kwemishonga kwakagadzirwa kunge yakashata sekubudirira se Xifaxan mukurapa SIBO. Herbal formulations inobatawo vimbiso senzira yekudzivirira migumisiro yemigumisiro yemishonga inorwisa mabhakitiriya, yekurapa avo avo vanorapwa maantibhakitiriya asingashande, uye / kana kuti kudzivirira kudzokorora kweSIBO.
Prokinetic Medication
Sezvakakurukurwa pamusoro apa, mushonga weprokinetic, wakashandiswa kune vanhu vane zvirwere zvemimba zvinokonzera mishonga, zvinogona kuratidza kuti zvinobatsira mukurapa SIBO. Kutsvakurudza kwokutanga kunoratidza kuti kushandiswa kwemishonga iyi kunogona kubatsira zvikuru kune avo vane SIBO varipo pamwe ne scleroderma . Mishonga yakadaro inofungidzirwa kuti inobatsira SIBO, sezvo inowedzera simba remudumbu mutsva we "tsvina yekuchenesa" kushambidza mabhakitiriya kunze.
Probiotics
Panofungidzira, maitiro anonzi probiotic anowedzera angave anobatsira pakurapa SIBO nokuti vakaratidzirwa kuti vane maitiro akanaka ekugadzirwa kwebhakitiriya, kuvandudza hutano hwehuriri hwegomba, uye kuderedza kuputika. Zvisinei, kutsvakurudza kwakakosha pamusoro pekubudirira kwemaprobioti mukurapa SIBO kunoshaikwa.
Kudzivirira Kudzokorora
Sezvakataurwa pamusoro apa, pasinei nekugadzirisa kweSIBO kubudirira kuburikidza nekushandiswa kweXifaxan, ngozi yekudzokazve inogona kunge yakakwirira kwazvo. Hazvizivi zvakawanda zvinozivikanwa sokuti zvikamu zvinotevera kana zvinorongwa zvemishonga inorwisa mabhakitiriya zvingabatsira mukudzivirira kudzokazve. Kubva ikozvino, iyo yakakurudzirwa nzira yekuita ibasa iro vanhu vanochinja mararamiro avo kutevera nzira yemishonga inorwisa mabhakitiriya senzira yekuedza kuchengetedza zviratidzo zvekuvandudza, uye kutora mapurogiramu akawandisa emishonga inorwisa mabhakitiriya sezvaanoda.
Sezvambotaurwa pamusoro, kunzwisisa kwezvokudya izvozvi zvinogadziriswa zvingaita sevarombo. Zvingave zvinobatsira kutevera zvokudya zvakaderera-FODMAP kwenguva pfupi. Zvinogonawo kubatsira kudzivisa kudya zvine zvinotapira zvinenge zvakadai se aspartame, saccharin, uye sorbitol, iyo inobata mukana wekubatana neabhakitiriya ari mukati memukati maduku. Kana wakawana, kuburikidza nekushandiswa kwekufemerwa kana kupedza kudya, kuti iwe une lactose kusagadzikana kana fructose malabsorption , unogona kunge uchinge urege kudya izvo zvine shuga idzi nechikonzero chakafanana.
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