Ama-proton-pump inhibitors angakhuphula ingozi yezinkinga ezithile.
Emlandweni wezokwelapha, ezimbalwa izidakamizwa ziye zaba ngempumelelo ngokuphumelelayo ekunciphiseni kabi njengeproton-pump inhibitors (PPIs) , noma imithi efana ne-omeprazole (generic), i-Prevacid ne-Nexium.
I-proton-pump inhibitors isiza izigidi zabantu baseMelika ukuthola ukukhululeka ekufweni kwe-reflux ye-gastroesophageal (GERD). Isifo se-reflux se-gastroesophageal ngokuvamile senzeke lapho isisu siphoqa okuqukethwe kwayo esiyi-acidic emuva kwesigcawu, noma ipayipi yokudla, ngaleyo ndlela kuholele ukucasuka noma ukushaya inhliziyo.
(Abambalwa babantu bahlangabezana ne-GERD yesibili ekhonjisiwe kuya ekuphuculeni okuphansi kwe-sphincter esezansi ephansi noma ama- TLESR .)
Ngokuyinhloko, ama-PPI aphephile ngempela. Kodwa-ke, sekukhona ukukhononda phakathi kwamalungu omphakathi wezokwelapha ukuthi ama-PPI angaholela ekutheni ama-bone ahlukane phakathi kwabantu asebekhulile (ikakhulukazi abesifazane asebekhulile abengozini enkulu ye- osteopenia noma i-osteoporosis).
Ukwengeza, kuye kwaba nokukhathazeka okucacile ukuthi ama-PPI angangenelela ngandlela-thile engozini yezintambo ze- hip fractures , okubangela izindleko ezinkulu, ukukhubazeka, ukugula nokufa okuhlobene.
Ukusetshenziswa Kwama-PPIs Kusakazeke Kanjani?
I-proton-pump inhibitors inhle ngempela ekunciphiseni inani le-asidi elifihliwe yisisu. Ngokuphawulekayo, ama-PPI angcono ekunciphiseni ukuvinjwa kwe-asidi esiswini kunezinhlobo ze-H2, noma imithi yokuvimbela i-histamine, njenge-Zantac noma i-cimetidine.
E-United States ngo-2009, imiyalelo engaba ngu-120 million ye-PPI yabhalwa.
Ngaphezu kwalokho, lowo nyaka ukuthengiswa kwama-PPIs kuye kwaba ngu-13.5 billion.
Amaphesenti angaba ngu-40 abantu abadala baseMelika bahlangabezana nezimpawu ze-GERD inyanga zonke, futhi abantu abaningi basebenzisa ukwelashwa kwe-PPI okwesikhathi eside ukuze kunciphise ukushaya kwenhliziyo.
I-PPIs ingaba kanjani nomthelela we-Bone Fracture Risk?
Indlela eyodwa ecacile yokuthi ama-PPI angabangela ingozi yokulahleka kwethambo ihilela ukunciphisa i-calcium ngokwemigqa yesisu.
Ukuphathwa okungapheli kwalezi zidakamizwa kunganciphisa ukungenwa kwe-calcium, okudingekayo ekwenzeni amathambo, ukugcinwa, nokulungisa.
Nakhu okunye ukucabanga okuchaza ukuthi ama-PPIs angakwandisa kanjani ingozi yamathambo.
- Ama-PPI akhulisa ukukhululwa kwe-gastrin, enye i-hormone yesisu, okuphazamisa umsebenzi we -roid. I-thyroid ifihla i-calcitonin ne-hormone ye-parathyroid (PTH) , elawula amazinga e-calcium egazini nasethambo le-metabolism.
- Ama-PPI angathinta ngqo ama-osteoclasts nama-osteoblasts, noma amaseli aphuka futhi akhe isifuba ngokulandelana.
- Abantu abasebenzisa njalo i-PPIs bangase babe nokunye ukubhekana nezinye izimo kanye nokudla okungahle kube nomthelela ekulahlekelweni kwe-calcium kanye nokwephulwa kwethambo, njengokusetshenziswa okwandisiwe kwe-thiazide diuretics noma ezinye izifo zesisu. Ngaphezu kwalokho, laba bantu bangaphinde baphuze utshwala obuningi, okwenza futhi i-calcium ixhumane nesifo samathambo.
- Abantu abasebenzisa njalo ama-PPIs bangalungisa izidlo zabo ukuze banciphise izimpawu ze-GERD ngale ndlela ngandlela-thile banciphise ukumuncwa kwe-calcium.
Okushiwo yi-Research
Sekuyisikhathi eside, ucwaningo oluxhumanisa ukusetshenziswa kwe-PPI lwesikhathi eside kanye ne-bone fractures lwaluhlanganisiwe. Kwaze kwaba ngo-2010 ukuthi sibone isifundo sokuqala esihle kakhulu sokuhlola isixhumanisi phakathi kwalezi ziguquko ezimbili.
Ukusebenzisa idatha evela ku-Women's Health Initiative, isifundo sezempilo sikazwelonke esihlola abesifazane abangu-161 808 abavela ezizindaweni ezihlukahlukene ezineminyaka ephakathi kuka-50 no-79, abacwaningi baklanyelwe isilingo esasizohlolwa esasihlolisisa ubudlelwane obuphakathi kokusetshenziswa kwe-PPI yesikhathi eside, ingozi yokulahleka kwamathambo kanye ne-bone mineral mass (enye inkomba amathambo ezempilo).
Ngokusho kwemiphumela yalolu cwaningo, ukusetshenziswa kwe-PPI yesikhathi eside kwahlotshaniswa nengozi eyengeziwe yokwelashwa kwemithi, isibhamu, isibindi kanye nokuhlukana okuphelele. Kodwa-ke, ukusetshenziselwa i-PPI yesikhathi eside akuzange kuhlotshaniswe nengozi eyengeziwe yokwehlukana kwe-hip noma ukwehla kwamathambo omzimba.
Lokho Ucwaningo Lusho Kuwe?
Uma usukhulile futhi udokotela wakho ekumemezele ukwelashwa kwe-PPI yesikhathi eside ukuze uthole impumuzo evela ku-GERD, kufanele uqhubeke nokuthatha le mithi futhi uhlangane nodokotela wakho njalo.
Ukukhathazeka okuncane mayelana nama-PPI okuholela ekuphukeni kwamathambo akufanele kukuvimbele ekutholeni ukukhululeka kwesisu okudingayo.
Kodwa-ke, udokotela wakho kufanele ahlole ngokucophelela ukuthi ngabe uyadinga ngempela ama-PPI futhi, uma kunjalo, uhlose ukubeka isilinganiso esincane sokusebenza. Ngaphezu kwalokho, ngenkathi ukhona kuma-PPIs, kufanele uqiniseke ukuthi udla ukudla okulinganiselayo okugcwele i-calcium eyanele. Udokotela wakho angase adinge ukukunika izithako ze-calcium.
Uma usuhlale uthatha ama-PPI angaphezulu-a-counter ukuze uphathe ukushaya kwenhliziyo kepha ungakaze ubonwe udokotela ngale nkinga, kuwumqondo omuhle ukwenza i-aphoyintimenti futhi uhlolwe.
Imithombo:
"I-Proton Pump Inhibitor Ukusebenzisa, ukuphuza ama-Hip, nokuguquka kwe-Bone Mineral Density kuma-Postmenopausal Women: Imiphumela evela ku-Women's Health Initiative" yi-SL Grey kanye nabalobi ababambisene nabo abashicilelwe kwi- Archives of Internal Medicine ngo-2010.
"I-Proton of Long-term Proton Pump Inhibitor Therapy Ne-Bone Fractures and Effects on Acorption of Calcium, Vitamin B12, Iron, kanye Magnesium" ngo-T Ito no-RT Jensen kwi- Current Gastroenterology Reports ngo-2010.