Okushiwo Udokotela Wakho Ngokuphatha Ukuqashwa Okungapheli
I-American College of Gastroenterology yashicilela ngezikhathi ezithile imihlahlandlela, ngokususelwa ekuhlaziyweni okubanzi kocwaningo, ekwelapheni izinkinga ezihlukahlukene zokugaya ukudla. Lesi sihloko sifingqa ukutholakala kokubuyekezwa kwamuva kunokwelashwa kwesidakamizwa esingapheli (i-CIC), esinezimpawu ezifanayo nokuqothulwa-kakhulu (i-IBS-C) , kodwa ngaphandle kwesimpawu sobuhlungu okuphawulekayo kwe-IBS.
Imikhombandlela ye-ACG ihloselwe ukukhonza njengendlela "engcono kakhulu" yezinyanga ekusebenzeni neziguli zabo. Ukukwazi ukuthi udokotela wakho uyazi kungasiza ekuthuthukiseni ubudlelwane obaluleke kakhulu odokotela nodokotela.
Okulandelayo ngamathuluzi amakhulu udokotela wakho anayo esikhwameni sabo samathuluzi ekusizeni ukuthi uphathe ukuqotshwa kwakho okungapheli:
I-Fiber
Yize kunjalo, ababuyekezi be-ACG batusa i-fibre njengendlela yokungena ngokuphumelelayo yokuphathwa kwe-CIC, bayenza iphuzu lokuhlukanisa phakathi kwezinhlobo ezimbili ze-fiber. Baphetha ngokuthi i -fiber encibilikile ingase ibe usizo ngaphezu kwe- fibre engenayo , ngenxa yokwanda kwezimpawu ezihlobene negesi nokuqhaqha lapho i-fibre engenayo kakhulu ingathathwa ngokushesha. I-Psyllium ifomu le-fibre e-soluble, kanti i-bran uhlobo lwe-fibre engenalutho.
Ama-laxatives
1. Ama- laxatives ase-Osmotic : Ababuyekezi be-ACG batusa ukusetshenziswa kwe-Miralax (PEG) ne-lactulose. Ucwaningo olwenziwa kuze kube yimanje lubonakala lubonisa ukuthi ingozi yemiphumela emibi ye-osmotic laxatives iphansi kakhulu.
2. Laxatives eshukumisayo: Ababuyekezi batusa ama-laxatives ashukumisayo, i-picosulfate ye-sodium, ne-bisacodyl. Ngenxa yokuntuleka kocwaningo, abaphakamisi ukusetshenziswa kwezinye izinhlobo zama-laxatives akhuthazayo.
Imithi
Imithi emihlanu ye-5-HT 4: Le mithi yenzelwe ukugqugquzela i-serotonin ye-neurotransmitter, okucatshangwa ukuthi ikhulise uketshezi ngaphakathi kwamathumbu, ikhulise i- motility futhi iyancipha isikhathi sokuhamba , konke okuyosiza ekunciphiseni ukuqotshwa.
Ababuyekezi baphetha ngokuthi imithi emihlanu ye-5-HT 4 inenzuzo ye-CIC - ukukhishwa kwe-prucalopride ne-velusetrag. Nokho, noma imithi ayitholakali e-US. I-Prucalopride iyatholakala eCanada ngaphansi kwegama elithi "Resotran" naseYurophu ngaphansi kwegama elithi "Resolar." Ababuyekezi bayiqaphele ukuthi le mithi ayibonakali engozini yokubhekana nezinkinga ezinkulu zenhliziyo ezaholela ekutheni i-Zelnorm eyandulele isuswe emakethe.
2. Imishanguzo ye-Prosecretory: Imithi kuleli klasi ihlanganisa i-Linzess, eyaziwa nangokuthi uConella, (linaclotide) no- Amitiza (i-lubiprostone). I-ACG itusa ukusetshenziswa kwe-Linzess, iphawula ukusekelwa okuqinile kocwaningo ngokusebenza kwayo kanye nephrofayela yayo yokuphepha. Umthelela ohlangothini oluyinhloko obikiwe yisifo sohudo. Ababuyekezi babenomthelela omuhle ngo-Amitiza, futhi babhekisela irekhodi labo lokusekela okucwaningayo okuqinile. Isifo sohudo kanye nesiphithiphithi sibalwa njengemiphumela emibi. Kodwa-ke, benza iphuzu ukusho ukuthi noma imithi ayiqhathaniswa nokusetshenziswa kwama-laxatives noma i-fiber, ngakho-ke akukho mqondo ongaboniswa ngokuthi yikuphi ukwelashwa okufanele kunconywe kuqala.
I-Biofeedback
Ababuyekezi baphetha ngokuthi i- biofeedback ingaphumelela ekunakekeleni ukudliwa okungapheli kwiziguli eziye zabonwa njengezinkinga zokukhubazeka kweplavic .
Bayaqaphela ukuthi kunzima iziguli ukuthola abahlengikazi abaqeqeshiwe ngempela kule ndawo.
Okubhaliwe, ababuyekezi baphetha ngokuthi akukho okwanele ukusekelwa kocwaningo ukukhombisa ukuthi ama-probiotics asebenza kahle ekuqokeni okungapheli.
Umthombo:
I-Ford, A., etal. "I- American College of Gastroenterology Monograph ekuphathweni kwe-Irritable Bowel Syndrome ne-Chronic Idiopathic Constipation " I- American Journal of Gastroenterology 2014 109: S2-S26.