Iwe unogona kunge uri kushamisika kuti nei chiremba wako achizopa anodzvinyirira kuora mwoyo kwako (IBS) kana iwe usina kuora mwoyo. Kana, zvichida sevamwe vanorwara neBIB, unotambudzika nokuora mwoyo kana kufunganya pamwe chete neBS yako, saka pfungwa yacho inonyanya kuve yakanzwisisa, asi iwe unofunga kuti zvinokonzerwa nehutachiona hwepabonde hungave sei pane zviratidzo zveBS .
Mhedziso inotevera inopindura mubvunzo wekuti nei zvirwere zvinorwisana nevanoshandiswa dzimwe nguva zvinoshandiswa sechirapa yeBS nekukudzidzisa semhando dzevanhu vanorwisa zvinodzvinyirirwa izvo zvinowanzogadzirirwa kuvarwere veBBS.
Nei Anodzvinyirirwa Anoshandiswa kuBS
Kunyange zvazvo mishonga iri mukirasi iyi yakanyorwa sevanorwisa zvinodhaka, zvinokonzera zvinopfuura kuderedza kuora mwoyo. Zvinodzvinyirira zvakave zvichiratidzwa kuderedza kuzvidya mwoyo uye kurwadziwa kwepfungwa apo pave nemigumisiro yakanaka pane chirwere chekudya .
Vanachiremba vanogona kupa chirongwa chekurwisa mwoyo kune mumwe murwere weBS, asi izvi zvinonzi se "off-label" kushandiswa kwechirwere, sezvo pasina antidipressant yakagamuchirwa FDA semubatanidzwa weBS. Zvisinei, iyo American College of Gastroenterology, mushure mekuongorora kwakanyatsotsvakurudza, yakagumisa kuti pane zvakakwana zvekutsvakurudza rubatsiro pamusoro pekubudirira kwemakira maviri emishonga - TCAs uye SSRIs - kurumbidza kushandisa kwavo mukurapa IBS.
Kunyanya, zvinodzvinyirira zvakawanikwa zvakave nemigumisiro yakanaka pamvura inoshandiswa uye kutenderera kwechirwere . Yakave yakanyatsofungidzirwa kuti zvinobudirira zvinokonzerwa nehutachiona hwezvirwere zvezviratidzo zveBS zvinokonzerwa nekuita kwemishonga iyi pamakumbo eurotransmitter anowanikwa muuropi uye mumatumbo.
Marudzi eAndidepressants Akashandiswa kuBS Treatment
Anodzvinyirira anoshandiswa kweBS kazhinji anowira mune imwe yezvikoro zvinotevera:
Tricyclic Anodzvinyirira (TCAs)
Tricyclic vanodzvinyirira ndevakuru vakuru vehurumende vevanodzvinyirira. Ive yakanyatsorongedzwa kuti tricyclic inodzvinyirira inopesana nemarwadzo uye chirwere-kunononoka maitiro, uye inoita seichiita izvi nekuita neurotransmitters serotonin uye norepinephrine . Izvi zvishoma nezvishoma zvinoita kuti maTCA ave akakodzera zvakakodzera kurapwa kwehurwere-kunyanya IBS (IBS-D).
Zvinosuruvarisa, chiito chimwe chete ( anticholinergic effect ) chinokonzera kuderedzwa kwepachiviri chemukati chinogona kuisa dzimwe nguva migumisiro yechirwere, kusanganisira kurara, yakaoma muromo, kusvibiswa kwemaonero, zvinetso zvepabonde, dutu, kudengenyeka, kuora musoro uye kuwedzerwa kwekureruka. TCAs dzinowanzotaurwa nezvemasero maduku pakurapwa kweBS kupfuura apo inoshandiswa kurapa kuora mwoyo. Izvi zvinotevera mienzaniso yeTCAs inogona kunyorwa kuBS:
- Elavil (amitriptyline)
- Tofranil (imipramine)
- Norpramin (deipramine)
- Aventyl, Pamelor, Allegron (nortriptyline)
Sarudzo yeSerotonin Reuptake Inhibitors (SSRIs)
Kusarura serotonin reuptake inhibitors (SSRIs) mishonga yakagadzirirwa kuwedzera huwandu hweeurotransmitter serotonin mumutambo wenheyo, kuitira kuti zvive nemigumisiro inobatsira mafungiro.
Nemhaka yokuti serrotonin yeurotransmitter chete ndiyo inotarirwa, SSRI inowanzova nemigumisiro shomanana kupfuura tricyclic inodzvinyirira. Nzira dzakawanda dzinowanzokonzerwa nekutsvaga, kuora, kushungurudzika, uye kuora musoro kunowedzera kuderera sezvo muviri uchichinja kumishonga. Kushaikwa kwechikonzero chekudzivirira kunoita kuti SSRI ive sarudzo yakanaka kune avo vanotambura nekuvhiringidzwa kukuru kweBS (IBS-C).
SSRI inogonawo kuguma nemigumisiro yakareba yehutano hwepabonde (kurasikirwa kwepabonde rekuita zvepabonde uye / kana kuoma mukuwana orgasm) uye kuwedzera kuwedzera. Zvakakosha kuyeuka kuti vanhu vakasiyana vanoita zvakasiyana uye munhu angarega rumwe rudzi rwe SSRI huri nani kune rumwe.
Izvi zvinotevera mimwe mienzaniso inowanzopiwa SSRIs:
- Celexa (citalopram)
- Lexapro (escitalopram oxalate)
- Prozac (fluoxetine)
- Paxil (paroxetine)
- Zoloft (sertraline)
5-HT3 yekuDambudziko
Vatsvakurudzi vakatarisa mishonga inotarisa nzvimbo dzakasikwa dzinonzi serotonin dzinotumidzwa se5-HT3 receptors. Iro Lotronex inokakavara inowira munharaunda iyi.
Nokuda kwehutachiwana hwemigumisiro yakakomba, FDA yakaisa mitemo yakasimba pamutemo weLotronex. Pane imwe 5-HT3 inodzvinyirira, Remeron (mirtazapine). Dhiyabhorosi isingakwanisi kuenderana nekubudirira kwaRemeron kweBS uye naizvozvo inogona kunge isingawanzogadziriswa kuvarwere veBS.
Sources
Ford, A., etal. " American College of Gastroenterology Monograph paKutonga kweIriritable Bowel Syndrome uye Chronic Idiopathic Constipation " American Journal of Gastroenterology 2014 109: S2-S26.
Agrawal, A. & Whorwell, PJ "Irritable bowel syndrome: kuongororwa uye kutungamirirwa" British Medical Journal , 2006 332: 280-283.
Jones, J. et.al. "British Society of Gastroenterology mirayiridzo yehutungamiri hwehutsinye hwemapuviri echirwere" Gut 2000 47: ii1-ii19.
Lacy, B., Weiser, K. & Lee, R. "Kurapa kwekusagadzikana kwechirwere chirwere" Kurapa Kwokuwedzera muGastroenterology 2009 2: 221-238.
Sainsbury, A. & Ford, A. "Kurapa kweIrritable Bowel Syndrome: Beyond Fiber uye Antispasmodic Agents" Kubudirira kweUrwere muGastroenterology 2011 4: 115-127.