Ingabe i-Diarrhea ku-IBS ingaba ne-Bile Acid Malabsorption Problems?
Ekuphishekeleni ukuqonda okujulile kwezici ezibangelwa isifo sofuba (IBS), abanye abacwaningi baye banaka isimo esaziwa ngokuthi idiopathic bile acid malabsorption (I-BAM).
Kuyini I-BAM?
Ama-acide bile yizinto ezikhiqizwa yisibindi sakho futhi zigcinwe ku- gallbladder yakho. I-bile acid isekela inqubo yokugaya amafutha, okwenzeka ngaphakathi emathunjini akho amancane.
Ngokuvamile, i-bile acids iyamuncwa emathunjini amancane futhi ibuyele esibindi ukuze iphinde iphinde isetshenziswe iphinde isetshenziswe kaningi izikhathi ezingu-10 ngosuku. Inani elincane kuphela le-bile acids (amaphesenti angu-5) ngokuvamile lidlulisela ekolon, emathunjini amakhulu .
Kodwa uma ama-bile acids amaningi enza indlela yokungena emathunjini amakhulu, avuselela ukufihla oketshezi, okwenza kube lula, izimbiza kanye nesifo sohudo. Lesi simo saziwa njenge- bile acid malabsorption (BAM). Uma kungabikho isifo noma ukulimala okubonakalayo okubonakalayo, i-malabsorption ibonakala njengohlobo lwe-2 BAM, okungaziwa ngokuthi idiopathic noma i-BAM eyinhloko (I-BAM noma i-P-BAM).
Ngokuvamile i-I-BAM icatshangwa ukuthi iyisimo esingavamile. Kodwa-ke, ukuhlolwa kocwaningo kwatholakala ukuthi cishe amaphesenti angama-25 kuya kwangu-30 weziguli ezinezinhlobo ze-IBS-D ezihlolwe kahle nge-I-BAM besebenzisa i-75SeHCAT scan.
Njengengxenye yalokhu kubuyekezwa, idatha ikhombise ukuthi iziguli ezinikezwe imithi ehlosiwe yemithi ye-bile acid sequestrants ephathelene nezinga le-malabsorption njengoba lilinganiselwe ukukhishwa kwemithi yamandla enyukliya kubonise ukuthuthukiswa komzimba.
Abacwaningi baphetha ngokuthi ukuhlolwa okungakahleleki kwe-I-BAM ngenxa yokungazi ngokusakazeka kwayo nokuntuleka kokufinyelela kuthwebuli (ayitholakali e-US) kungaholela ekutheni iziguli eziningi ze-IBS-D zingatholi ukwelashwa okufanelekayo .
Imfundiso Eyodwa Ebonakalayo
Abacwaningi bebelokhu bezama ukuqonda ukuthi yini engase idale le nkinga ye-acid malabsorption.
Esinye isizathu esingahle sibe yi-ileal (amathumbu amancane) amathumbu, i-FGF19, enesibopho sokulawula ukukhiqizwa kwe-bile acid. Kungenzeka ukuthi amazinga aphansi ale hormone aholela ekutheni ngokweqile inani le-bile acids elidala ukungena emathunjini amakhulu. Ukucwaninga kuqhubeka ukuqonda kangcono le dysfunction, ngethemba lokuthi kungaholela emithini eqondisa ngqo inkinga.
Okubalulekile
Njengoba kumangalisa njengoba izinombolo ezingu-25 kuya ku-30 zikhona, kubalulekile ukuqaphela ukuthi le ndawo yokuphenya ibonakala iqhutshwa iqembu elilodwa labacwaningi. Futhi, ngeshwa, njengoba ukuskena kwe-75SeHCAT kungatholakali e-US, akufani nokuthi kuhlolwa okusheshayo kwegazi ukuthola ukuthi i-IBS-D yakho i-I-BAM ngempela. Kodwa-ke, uma uhlale ukhululekile, izitshalo zamanzi njengengxenye yesithombe sakho sesibonakaliso, ungase uthande ukukhuluma nodokotela wakho ukuze ubone ukuthi uzoba yini umbuzo wokuhlolwa kwemithi esetshenziselwa ukuphatha i-BAM.
Imithombo:
Pattni, S. & Walters, J. "Ukuthuthukiswa kwakamuva ekuqondeni i-bile acid malabsorption" I- British Medical Bulletin 2009 92: 79-93.
UWalters, J. "Ukuchaza isifo sohudo e-bile esiyinhloko: ukwenza ukuxilongwa nokuqaphela isifo" Ukuhlolwa kobuchwepheshe 2010 4: 561-567.
Wedlake, L., et.al. "Ukubuyekezwa kwesistimu: ukusabalalisa kwe-idiopathic bile acid malabsorption njengoba kutholakala ukukhishwa kwe-SeHCAT kuziguli ezine-diarrhea-eyingozi kakhulu emathunjini amathumba" I- Alimentary Pharmacology and Therapeutics 2009 30: 707-717.
UWalters, J. "Ukuchaza isifo sohudo e-bile esiyinhloko: ukwenza ukuxilongwa nokuqaphela isifo" Ukuhlolwa kobuchwepheshe 2010 4: 561-567.