Yize kunjalo, njengamanje, akukho ukwelashwa kwe-syndrome eyathukuthelisa (i-IBS), kunezinhlobo eziningi zemithi etholakalayo ezikhomba izimpawu ze-IBS . Ezinye zazo zilungisa kuphela uphawu lokugaya okuthile, kuyilapho izidakamizwa ezintsha ziza emakethe ezihloselwe ukubhekana ngokuqondile nokusebenza okungajwayelekile okuhambisana ne-IBS.
Lezi yizikhetho eziyinhloko zokwelashwa ezisetshenziselwa ukwelapha umuntu onayo i-IBS.
Khumbula ukuthi akuzona zonke izidakamizwa ezingahle zilungele wena. Ngumuphi umuthi udokotela wakho azokutusa, uma ukhona, uzoxhomeka emlandweni wakho wezokwelapha, ubunzima bezimpawu zakho, kanye nenkinga yakho yesifo sofuba. Ezinye zalezi mithi zitholakala ngomuthi kuphela, kanti ezinye zitholakala ngaphezulu kwe-counter. Khumbula ukuthi nje ngoba into etholakala ngaphandle kwemithi kadokotela akusho ukuthi ikufanelekile. Qinisekisa ukuthola imvume kadokotela wakho ngaphambi kokuzama into entsha.
Izinketho ZamaGciwane Ezijwayelekile ze-IBS
Izinhlobo ezilandelayo zemithi zingahle zinikezwe kunoma ubani ohlangabezana ne-IBS, kungakhathaliseki ukuthi uhlobo oluthile olunjani . (Qhubeka ufunda ukuthola ulwazi mayelana nemithi eqondisa ngqo isifo sohudo-kakhulu IBS (IBS-D) nokuqothulwa-okubaluleke kakhulu kwe-IBS (IBS-C).
Imithi ye-Antispasmodic
Imithi ye-Antispasmodic ijwayele ukuqondiswa kwe-IBS, njengoba ingasiza ekunciphiseni ubuhlungu besisu kanye nokweqa okuhambisana ne-IBS.
Kodwa-ke, bathambekele ekubeni nomphumela wokuqhaqhazela, ngakho-ke, kungenzeka ukuthi akuyona into engcono kakhulu kumuntu onayo i-IBS-C. Njengoba ucwaningo oluphathelene nokuphepha kwama-antispasmodics okusetshenziselwa ukusetshenziswa kwesikhathi eside lukhawulelwe, le mithi ingase ihambisane nokusebenzisa isikhathi esifushane kuphela. Ama-antispasmodics avamile anikezelwe i-IBS ahlanganisa:
- I-bentyl (i-dicyclomine)
- I-Buscopan (hyoscine butylbromide)
- Anaspaz, i-Cystospaz, i-Levbid, i-Levsin (i-hyoscamine)
- I-Mebeverine (ayitholakali e-United States)
Ama-antidepressants
Ama-antidepressants ngokuvamile asetshenziselwa amanani aphansi njengendlela yokwelapha izimpawu ze-IBS njengoba enezimfanelo zokukhulula ubuhlungu futhi ephephile ukusetshenziswa kwesikhathi eside. Udokotela wakho angase ancoma ukuthi u-anti-depressant noma ngabe awucindezelekile. Uma unesifo sokucindezeleka noma ukukhathazeka eceleni kwe-IBS yakho, kungenzeka ukuthi udokotela wakho angakhetha lolu khetho.
Ngaphezu kokunciphisa ubuhlungu, ama-anti-depressants ngezinye izikhathi anemiphumela emibi efaka ukugaya. Ngakho-ke, udokotela wakho angakhetha ngokusekelwe ukuthi unayo i-IBS-C noma i-IBS-D. Izinhlobo ezitholakalayo zifaka ama-antidepressants asebekhulile (okungcono ku-IBS-D) noma ezinye zezinketho ezintsha ezifana ne-serotonin reuptake inhibitors (SSRIs) ekhethekayo ye-serotonin-norepinephrine inuptake inhibitors, kokubili okungase kube ngcono ku-IBS-C.
Izinketho zemithi yokwelapha-i-IBS eyinhloko
I-standby endala yokusiza uhudo iqhubeka i- Imodium (loperamide), etholakala ngaphezulu kwe-counter. Noma kunjalo, imishanguzo emibili kadokotela isanda kuthola imvume ye-FDA yokwelashwa kwe-IBS-D:
I-Xifaxan (rifaximin) iyi-antibiotic eyayisetshenziselwa ukuphatha isifo sohudo kanye nezinambuzane ezincane zamathumbu emathumbu (SIBO).
Ukugunyazwa kwe-FDA kungokwelashwa "okungewona ukuqotshwa IBS." I-Xifaxan isebenza ngokungafani nemithi eminingi yama-antibiotic ngoba ayifaki engxenyeni yakho yegazi kepha kunalokho itholakale ukukhomba amabhaktheriya emathunjini akho amancane namakhulu. Kucatshangwa ukuthi kuphephile ukuyisebenzisa kuze kube yizifundo ezintathu zamasonto amabili.
I-Viberzi (i-eluxadoline) imithi ethinta ama-receptor opioid ohlelweni lwakho lokugaya ukuze unciphise izimpawu zesisu esiswini nesifo sohudo kubantu abane- diarrhea-ebaluleke kakhulu ye-IBS (IBS-D). Ngenxa yokuthi i-Viberzi iyimithi yokwelapha i-opiate, ihlukaniswa njengezinto ezilawulwayo futhi kunezinto ezithile ezikhathazayo mayelana nokukwazi ukulutha umlutha.
Izinketho zemithi yokwelapha i-IBS ePredominant
Ama-laxatives azo zonke izinhlobo asetshenziselwa ukunciphisa uphawu lokuqothulwa. I-Miralax (i-polyethylene glycol), engasadingi isidakamizwa, yiyona yodwa okuye yafundwa ngabacwaningi ngokuphumelela kwayo ekunciphiseni izimpawu ze-IBS. Ucwaningo olulodwa lwathola ukuthi kwakusizo ekunciphiseni ukuqotshwa kanye nezihlalo zokunciphisa, kodwa hhayi ukukhulula ubuhlungu be-IBS.
Kukhona okwamanje amakhemikhali ambalwa okuthola imithi yokwelashwa kwe-IBS-C:
I-Linzess (i-linaclotide) isebenza kuma-receptors ngaphakathi kwendlela yokugaya ukuze ukwandise inani lomkhuhlane emathunjini akho amakhulu. Ngaphandle kwe-IBS-C, i-Linzess i-FDA evunyelwe ukwelashwa kokuxilongwa okungapheli kwe-idiopathic (CIC) kubantu abadala. EYurophu, imithi ibizwa ngokuthi uConella.
I-Amitiza (i-lubipro stone) nayo i-FDA ivunyelwe ukwelashwa kwe-CIC kanye ne-IBS-C. Ama-amitiza amathengi ama-receptors ngaphakathi kwendwangu yamathumbu ukukhipha uketshezi oluthe xaxa. Ngeshwa, isiyaluyalu siwumphumela ovame kakhulu futhi ongajabulisayo we-Amitiza.
I-Resolor / Resotran (i-prucalopride) imithi etholakala kuphela eCanada naseYurophu. I-Resolor isebenza kwi-serotonin ye-neurotransmitter ngaphakathi kwamanzi futhi ngenxa yalokho, isigaba semithi efanayo njengoZelnorm , imithi eyasuswa emakethe ngenxa yemiphumela emibi kakhulu. Noma kunjalo, i-Resolor yenzelwe ngokuhlukile ukuze igweme lezo zinkinga ezinkulu. Kusukela manje, i-Resolor ivunyiwe kuphela yi-European Medicines Agency yokwelapha ukuqashwa okungapheli kwabesifazane.
Imishanguzo ye-IBS esigabeni sokuhlola
Imishanguzo emisha iza emakethe, kanti ezinye izindlela zokwelapha ezikhona zingena ezivivinyweni zokuphepha. Lezi yizivakashi ezintsha; konke kusezigaba ezihlukahlukene zokuhlolwa ngokuphepha nokusebenza kwazo. Ukufunda mayelana nezinketho zakho kungakusiza usebenze nodokotela wakho ukuthuthukisa uhlelo olusebenzayo lwezokwelapha lwe-IBS yakho.
I-Asimadoline imithi ehlolwa ukuhlolwa kwemithi njengokwelashwa kwe-IBS-D. Imishanguzo yezokwelapha izingosi ezithandwa kakhulu emathunjini amakhulu; kuyathemba ukuthi lokho okucacile kuzogcina imiphumela emibi kuncane. Ekuvivinyeni kokuqala, kubonakala sengathi umphumela omkhulu kunawo wonke wezokwelapha ukwelapha ubuhlungu besisu nokungahambi kahle.
I-Elobixibat imithi okwamanje iyaphenywa njengokwelashwa kwe-CIC. Isebenza ngokunciphisa ukuphindaphinda kabusha kwe-bile acid kusuka enkongweni ye-gallbladder, ngaleyo ndlela ukwandisa inani lala ma-acids angena emathunjini akho amakhulu. Lokhu kucatshangwa ukuthi kusize ukusheshisa inqubo yendaba yefecal ngokusebenzisa ikholoni. Kukhona, okwamanje, akukho ucwaningo olusemtholampilo lokusebenza kwe-elobixibat ku-IBS-C.
I-Plecanatide isebenza ngokufanayo ne-Linzess futhi njengamanje ihlolwa ukuhlolwa kwemithi njengokwelashwa kwe-IBS-C ne-CIC.
I-Tenapanor iyimithi yesifo sezinso. Isebenza ngokunciphisa ukumuncwa kwe-sodium emgqumeni wokugaya; ukwanda kwenani le-sodium kucatshangwa ukuthi kwande inani lamanzi emathunjini amakhulu. Ngenxa yalokhu, i-Tenapanor okwamanje ibhekene nokuhlolwa kwekliniki njengokwelashwa kwe-IBS-C.
Izwi elivela
Nakuba ungabona ukuthi kukhona imithi ehlukahlukene ye-IBS, abantu abaningi abane-IBS bathola ukuthi imithi abazama ngayo ayanele ngokwanele ukuqeda izimpawu zabo. Kwezinye izimo, bahlangabezana nemiphumela emibi futhi kufanele bayeke ukuthatha imithi. Ngenhlanhla, imithi akuyona kuphela imithi etholakalayo ye-IBS. Okunye okukhethwa kukho kufaka izixazululo ezingaphezu kwamakhompiyutha , ukuguqulwa kokudla , kanye nokwelapha kwengqondo. Gcina imigqa yokukhulumisana evulekile nodokotela wakho ukuze ufike ohlelweni olungcono kakhulu lokwelapha.
Imithombo:
ULacy, B., Chey, W. & Lembo, A. "Izinketho Zokwelashwa Ezisha Nezikhulayo Zama-Irritable Bowel Syndrome" I- Gastroenterology & Hepatology 2015 11: 1-19.
U-Lazaraki, uG., Chatzimavroudis, G. & Katsinelos, P. "Ukuthuthukiswa kwamuva kwindlela yokwelashwa kwemithi yesifo sofuba esicasulayo" I- World Journal of Gastroenterology 2014 20: 8867-8885.
U-Peyton, uL. & Greene, J. "I-Irritable Bowel Syndrome: Izinketho Zokwelashwa Zamanje Nezikhukhula" I- Pharmacy & Therapeutics 2014 39: 567-572, 578.
I-J, i-Vanuytsel T, i-Corsetti M. "Ukuphathwa Kwamanje Kwe-Irritable Bowel Syndrome: Okungaphezu Kwama-Motility." Izifo Zokugaya I- Digestive Diseases 2016; 34: 566-573.
I-Trinkley, K. & Nahata M. "Ukuphathwa Kwemithi Ye-Irritable Bowel Syndrome" Ukugonywa 2014 89: 253-267.