I-irritable bowel syndrome (i-IBS) yinkinga yokusebenza yamakoloni (amathumbu amakhulu) abangela ubuhlungu besisu esiswini, ukubhubhisa, ukuqotshwa, kanye / noma isifo sohudo. I-IBS ibhekwa njengesiyaluyalu esisebenza kahle ngoba kungabangela imbangela yesakhiwo noma yezinto eziphilayo ukuchaza izimpawu. Lapho kuhlolwa ukuhlolwa, ikholoni ayibonisi ubufakazi besifo ezifana nezilonda noma ukuvuvukala.
Ngakho-ke, i-IBS itholakale kuphela ngemuva kokunye ukugula nokugula okusemandleni okugaya okuphethwe ngaphandle.
I-IBS ivame ukungaqondakali kahle noma ingabizwa ngokuthi i-colitis, i-colitis ye-mucous, i-colon spastic, isifo sofuba esicasulayo, noma isifuba se-spastic (colon). Lezi zinkinga ziqhubeka, yize i-IBS manje isimweni esaziwayo futhi esinokuphathwa. Ukuthinta abantu abayizigidi ezingu-25 no-55 e-United States, i-IBS ibangele ukuvakashelwa odokotela ngezigidi eziyisi-2.5 kuya kwezi-3.5 ngonyaka. Amaphesenti angama-20 kuya kwangu-40 azo zonke izivakashele ezigungwini ze-gastroenterologists ngenxa yezimpawu ze-IBS.
Izimpawu
Izimpawu ze-IBS zingabandakanya:
- Igesi
- Ubuhlungu
- Ukuvimbela
- I-nausea
- Ukuvota
- I-Mucus esitokisini
- Ukuqokwa
- Uhudo
I-Cramps ivame ukukhululeka ngokunyakaza kwamathumba, kodwa abanye abantu abane-IBS bangase babe nezikhwama futhi bangakwazi ukudlula noma yini. Ubunzima bezimpawu buhluka, futhi kungenzeka ukuthi noma yikuphi ukucasula okubuhlungu okwenza kube nzima. Igazi elisesitokisini , umkhuhlane, ukulahlekelwa isisindo, ukuhlanza i-bile, nokuhlunguphazela okuqhubekayo akuzona izimpawu ze-IBS futhi kungase kube umphumela wenye inkinga. I-IBS ayiholele kunoma yiziphi izifo eziphilayo, njenge-Crohn's disease noma i-ulcerative colitis, noma yiluphi uhlobo lomdlavuza wesifuba.
Izimbangela
Imisipha ekoloni ivame ukubambisana ngezikhathi ezimbalwa ngosuku, ukuhambisa izidakamizwa ndawonye futhi ekugcineni kubangele ukunyakaza kwamathumbu. Kukholelwa ukuthi kumuntu onen-IBS, lezi zinhlanzi zizwela ngokukhethekile emithonjeni ethile, noma edala.
Abacwaningi abaqinisekisi kahle ukuthi kungani imisipha emgqonyeni womuntu one-IBS ezwela kakhulu.
Nokho, i-IBS ayibangelwa ukucindezeleka noma imizwelo eqinile. Abanye abantu baqala ukuphazamiseka kwezimpawu ze-IBS ngesikhathi sokucindezeleka empilweni yabo njengokufa kwesihlobo noma ukulahlekelwa umsebenzi. Kodwa-ke, lezi zinkinga azizange zenze lesi simo kodwa kunalokho zenze kube nzima ukufika lapho zabonakala khona noma ziphazamisa.
Amafomu ahlukene we-IBS
Kunezinhlobo ezintathu ezahlukene ze-IBS: I-Diarrhea-enkulu kakhulu (i-D-IBS), ukuqothulwa-okubaluleke kakhulu (i-C-IBS), nokuqokwa kwesinye nesifo sohudo (A-IBS). Izimpawu zamafomu ahlukene zihlanganisa:
- I-D-IBS: ukuhlukunyezwa kwesisu noma ubuhlungu, ukuphuthuma, nokuhuda
- I-C-IBS: ukuhlukunyezwa kwesisu noma ubuhlungu, ukuvinjelwa nokuqothulwa
- A-IBS: Izimpawu ezingenakwenzeka ze-D-IBS no-C-IBS
Ukuxilongwa
I-IBS ixilongwa ngokukhishwa, okusho ukuthi izifo eziphilayo, ukutheleleka, noma enye imbangela yezimpawu kumele kukhishwe. Ngo-1988 iqembu labadokotela lichaza indlela yokuhlola ngokucophelela i-IBS. Eyaziwa ngokuthi i- Rome Criteria , le setha yemihlahlandlela eveza izimpawu futhi isebenzise imingcele njengemvamisa kanye nobude kwenza kube nokuxilongwa okunembile kwe-IBS.
Izibonakaliso ku-Criteria yaseRoma aziwona kuphela izinkomba ze-IBS. Izimpawu ezingasetshenzisiwe zihlanganisa:
- I-nausea
- Ukukhathala
- Ukuzwa okugcwele emva kokudla okuncane
- Ukuvota
Izivivinyo ezisetshenziselwa ukuxilongwa
Ngaphezu kokusebenzisa i-Rome Criteria, odokotela bangase bahlole ukuhlolwa okuningana ukuqinisekisa ukuthi akukho ukuvuvukala noma ukutheleleka emzimbeni.
Ukuhlolwa kwegazi. Ukuhlolwa kwegazi kungasetshenziselwa ukunquma inani legazi elimhlophe noma uma i- anemia ikhona. Ukubalwa kwamangqamuzana egazi ezimhlophe kwenza odokotela babonise ukuthi ukuvuvukala kwenzeka endaweni ethile ngaphakathi komzimba. Ukuvuvukala akuwona uphawu lwe-IBS.
Ukuvivinya kwegazi le-Fecal. Lokhu kuhlolwa kungathola ukuphuma kwegazi cishe noma yikuphi lapho kuhamba khona, ngisho noma kungabonakali iso.
Igazi kulesi sikhundla akuyona uphawu lwe-IBS.
Isiko lokugcina. Udokotela angase afune ukulawula ezinye izimbangela zokuhuda, njengokutheleleka kwebhaktheriya noma i-parasite, ngesiko lesitokisi. Uma kukhona amabhaktheriya atholakele, ososayensi bangawahlola ukuze banqume ukuthi yiziphi izinhlobo zezilwane futhi ukuthi zingcono kanjani ukuphatha.
Barium enema. I-barium enema (noma uchungechunge oluphansi lwamathumbu) lisebenzisa i-barium sulfate nomoya ukuchaza uhlaka lwe-rectum ne-colon. Ukungajwayelekile kwamathumbu kungase kubonakale njengama-silhouettes amnyama noma amaphethini eduze kwamathambo emathumbu emzimbeni we-X.
I-Sigmoidoscopy. I-sigmoidoscopy iyindlela yokuba udokotela ahlole ingxenye yesithathu yokugcina amathumbu amakhulu. I-biopsy ingathathwa ngenkathi yenqubo, ezohlolwa ukuze kusize udokotela aqonde imbangela yanoma yisiphi ukuvuvukala.
I-Colonoscopy. I-colonoscopy isetshenziselwa ukuhlola ngaphakathi kwekhaloni ngaphesheya kwezindawo i-sigmoidoscopy ingafinyelela. Ama-biopsies athathwe ngesikhathi sokuhlolwa futhi iziguli zihlala zihlala noma zinikezwa "ukulala ebuthongweni" ukuze zingabi nobuhlungu.
Ezinye izivivinyo zingase zisetshenziswe odokotela njengoba kudingeka ukuze uhlolisise i-IBS noma ukulawula ezinye izifo zokuhlola ezikhona.
Imithi yokwelapha
Izinhlobo eziningana zezidakamizwa zingasetshenziswa ukuphatha i-IBS. Umgomo wemithi ukunciphisa izimpawu ze-IBS ezinzima ezifana nesifo sohudo, ukuchotshozwa, ubuhlungu noma ukuqothulwa.
Anticholinergics. Leli klasi lezidakamizwa lichaphazela amangqamuzana omzimba noma izintambo zezinzwa futhi zisetshenziselwa ukunciphisa izidumbu ze-muscle emathunjini futhi zisize izimpawu ze-IBS ezifana nokuchoboza ubuhlungu noma isifo sohudo.
- I-Dicyclomine (i-Bentyl). I-Dicyclomine ivuselela imisipha yamathumbu nesisu ukuze ivimbele ukungena kwegazi futhi kunciphise inani le-esiswini elikhiqizwayo. I-Dicyclomine ingasetshenziswa ngokuphepha isikhathi eside, ngaphansi kokuqondiswa udokotela. Imiphumela emibi evamile ihlanganisa ukuqotshwa, ukuma komlomo, impumu, umphimbo, noma isikhumba nokunciphisa amandla okufiphala (okungabangela ukushisa ukushisa).
- Belladonna / Phenobarbital (Donnatal, Antispas, Barbidonna, Donnapine, Hyosophen, Spasmolin). Le nhlanganisela yezidakamizwa ezimbili isetshenziselwa ukuphumula imisipha kulesi sifo kanye namathumbu kanye nokunciphisa i-asidi yesisu. I-Phenobarbital iyindlela yokudambisa emnene ingaba yinto yokuziphatha. Imiphumela emibi evamile ye-belladonna / phenobarbital ihlanganisa ikhanda, isicanucanu, ukuqothulwa, ukuqhuma nokuhlanza. Lesi sidakamizwa singathatha izinsuku ezingu-4 noma ezingu-5 ukuze ziphumelele, futhi, ngaphansi kokuqondiswa udokotela, zingasetshenziswa ngokuphepha isikhathi eside.
- Hyoscyamine (Levsin, Anaspaz). Lokhu kuhlanganiswa kwezidakamizwa ezimbili, i-alkaloid ye-belladonna kanye ne-barbiturates, isetshenziselwa ukuphumula imisipha emgqonyeni kanye namathumbu kanye nokunciphisa isisu se-esiswini. Imiphumela emibi ejwayelekile ifaka phakathi ikhanda, isicashu, ukuqothulwa, ukuqhuma nokuhlanza. I-Hyoscyamine ingathathwa isikhathi eside ngaphansi kokuqondiswa udokotela uma nje imiphumela emibi ingekho noma ibekezeleleka.
- I-Chlordiazepoxide / i-clidinium (i-Librax) . I-Chlordiazepoxide / i-clidinium ivimbela ukugaxeka emathunjini kanye nesibindi. I-Chlordiazepoxide iyidala futhi ingase ibe umkhuba. Imiphumela emibi evamile ihlanganisa umuzwa okhuniwe, wehla ukujuluka, isizungu, ukulala, ukuma komlomo kanye nokukhanda ikhanda. Lesi sidakamizwa singathatha izinsuku ezingu-4 noma ezingu-5 ukuze sisebenze, futhi, ngaphansi kokuqondiswa udokotela kungasetshenziswa ngokuphepha isikhathi eside.
Antidiarrheals. Ama-Antidiarrheals asetshenziselwa ukunciphisa umphumela wegciwane. Lezi zidakamizwa zingasetshenziswa ukuvimbela isifo sohudo esivela ku-IBS.
- I-diphenoxylate / atropine (i-Lomotil). Ingxenye ye-diphenoxylate yalesi sidakamizwa isetshenziselwa ukwelapha isifo sohudo, kuyilapho i-atropine ikhulula izigaxa ze-muscle emanzini. Imiphumela emibi evamile ihlanganisa ikhanda, isizungu, ukulala, umbono obonakalayo, umlomo omile, nokuqothulwa. Nakuba akuyona inkinga, i-diphenoxylate itholakala kuma-narcotics futhi ingahle ijwayele ukujwayela. I-diphenoxylate / i-atropine ngokuvamile ihlelwe ukulawula isifo sohudo esikhathini esifushane futhi ayikhuthazwa ukusetshenziswa kwesikhathi eside.
- I-Alosetron hydrochloride (i-Lotronex). Lesi sidakamizwa sisetshenziswa kuphela ukuphatha abesifazane abane-D-IBS enzima. I-Alosetron hydrochloride yamukelwa bese isuswa emakethe yi-FDA emva kwamacala amaningana emibi kakhulu kwabesifazane abayithatha. Manje sekuvunyelwe ukusetshenziswa kuphela ngesisekelo esinqunyiwe. I-Alosetron hydrochloride iphazamisa isenzo se-seratonin, ikhemikhali emzimbeni onomthelela ekunyameni kwamathumbu kanye nobuhlungu. Ukwelashwa kuvame ukuqala ngesilingo sesonto eli-4 futhi kungenziwa ukuqhubeka kwamanye amaviki angu-4 ngaphansi kokuqondiswa udokotela.
Izithako Zokusiza Ngezibonakaliso
Abantu abaningi abane-IBS bangase bafake izithako ukuze bathenge noma bathathe indawo yokwelashwa yendabuko. Kukhona izithako ezingasiza ngemibonakaliso ye-IBS, kodwa kubalulekile ukuqaphela ukuthi bangase babe nemiphumela emibi, futhi ukusetshenziswa kwabo kufanele njalo kubikwe odokotela bathanda noma yisiphi isidakamizwa somuthi.
I-Acidophilus. I-Acidophilus yiyona "ibhaktheriya enhle" ehlala kolononi yakho. I-supplement ingasiza ama-bacteria ahlala enempilo ekhula ngenkathi ehlisa amabhaktheriya ayingozi. I-Fructo-oligosaccharides (i-FOS) ingezwa ngama-acidophilus amaphilisi. Ama-FOS angama-carbohydrate engagciniwa ngabantu, kodwa akhonze ukusiza amabhaktheriya anenzuzo ukuba akhule. I-Acidophilus ifika efomini ye-capsule, futhi amabhaktheriya kumele aphile ukuze asebenze.
I-Chamomile . I-Chamomile yi-anti-spasmodic eyaziwa futhi inganciphisa imisipha egazini lokugaya. Ngenkathi kungekho zifundo zomuntu ezenziwe kulokhu okungeziwe ngokuphathelene ne-IBS, kuye kwafakazelwa ukuthi kuncishiswa ukucasula nokwehliswa kwezilwane. I-Chamomile ingathathwa njengetiye, noma njenge-capsule.
I-Ginger . Sekuyisikhathi eside i-Ginger ikwazi ukusiza nge-nausea, futhi ingase ibe usizo ekuvuseleleni i-peristalsis nokunciphisa ama-cramps abuhlungu. I-ginger ingathathwa njengetiye, i-capsule, noma ngisho nokudla.
I-Peppermint Oil . I-Peppermint ingakwazi ukuphumula imisipha kuyo yonke indlela yokugaya. Lokhu kusiza ukunciphisa ama-spasms ku-colon, kodwa kungaphinde kukhulule umsizi ophansi we-sphincter futhi kubangele ukuqhuma noma ukukhuphula isifo se-reflux ye-gastroesophageal . Amafutha e-Peppermint angathathwa ngendlela ye-capsule noma ifomu. Nakuba ziphumelela kakhulu, ama-capsules angabangela ukucasuka kwesilwane.
Okunye okunye nokwelashwa okuhambisanayo
Hypnosis. Ukutadisha komhlaba ngo-1984 kwabonisa ukuthi iziguli ze-IBS eziphathwe nge- hypnotherapy azibonanga ukuthuthukiswa okuphawulekayo ezimpawu zabo kodwa futhi azizange zibuyele emuva ngesikhathi sokutadisha kwezinyanga ezintathu. I-Gut Direct Hypnotherapy yasungulwa ngokuqondile kweziguli ze-IBS futhi kuye kwafakazelwa ukuthi kunciphisa izimpawu ngamacala angu-80%.
Ukwelashwa Kokuziphatha Okuqondayo . Ukwelashwa kokuziphatha kusiza ukuhlanza izinhlangano eziphakathi kwezimo ezibuhlungu nokuphendula komuntu okujwayelekile kubo. Ukwelashwa kwengqondo kuhlolisisa ubuhlobo obuphakathi kwemicabango nezibonakaliso. Ngokubili lezi zindlela ezimbili ziyaziwa ngokuthi yi-ctnitive therapy (CBT). Ukwelashwa kungase kuqale ngedayari yezimpawu ze-IBS, bese uqhubekela phambili ku-biofeedback, ukuzwakalisa ukukhuluma okuhle, nokunciphisa izimpendulo ezingalungile zokucindezeleka.
Indlela Ukudla Okuthinta I-IBS
Nakuba ukudla kungabangeli i-IBS, ukudla ukudla okunye, okubizwa ngokuthi "ukudla okuyisisindo" kungase kukhishwe izimpawu zokuhuda, ukubhuqa noma ubuhlungu. Ngeshwa, akukho okudla okuzosebenza kubo bonke abantu abane-IBS, kodwa kunezinye iziqondiso ezingasiza.
Ukudla ukudla okuncani eziningana phakathi nosuku, kunokuba kube nezinkulu ezintathu ezingasiza ukunciphisa izimpawu (ukudla okukhulu kungabangela ukugwinya nokuhuda). Ukwengeza, kungase kube usizo ukugcina ukudla okuphansi kwamafutha futhi okuphezulu kuma-carbohydrate njengama-bread breads, i-pasta, ilayisi, izithelo, imifino kanye nokudla okusanhlamvu. I-fat fat, high protein diet may also help in the pain experienced after eating.
Ukudla kwe-trigger okuvamile kuhlanganisa:
- Utshwala
- Ama-sweetener noma ama-sugar substitutes
- Amafutha okufakelwa (u-Olestra)
- Iziphuzo ezidakayo
- Ubisi lwekakhukhunathi
- Ikhofi (ngisho ne-decaffeinated)
- Ubisi
- Izikhumba zamaqanda
- Ukudla okuthosiwe
- Amafutha
- Izinkukhu zesikhumba kanye nenyama emnyama
- inyama ebomvu
- Ukunciphisa
- Ushokoledi oqinile
I-fibre e-soluble inezinzuzo eziningana ezingase zinciphise izimpawu ze-IBS. I-fibre ingavimbela ukuphahlazeka ngoba igcina ikholoni ihlehlisiwe. Iphinde ibambe amanzi, okusiza ukugcina izihlalo zibe nzima kakhulu ngakho-ke kunzima ukudlula. Ekuqaleni ukushintshela ekudleni okuphezulu kwefayibha kungandisa uketshezi lwegesi, kodwa lezi zimpawu kufanele zinciphise emavikini ambalwa njengoba umzimba ulungisa.
Izithako zingase zibe usizo ekwengezeni i-fibre edingekayo ekudleni. Kunezinhlobo ezintathu eziyinhloko zama-fibre supplements (solllium, methylcellulose, ne-polycarbophil) futhi ngayinye inezindlela ezihlukahlukene zokusebenzisa, imiphumela emibi, kanye nezakhiwo.
Ukunciphisa ukudla okubangela igesi lwamathumbu kungasiza ekunciphiseni ukuqhuma. Ukufuna i-gum kwandisa igesi emzimbeni, njengokugwinya emoyeni ngenkathi bedla (okungahle kwenzeke uma kuphuza uketshezi noma ukukhuluma ngenkathi bedla). Iziphuzo ezidakayo (ezifana ne-soda pop noma amanzi aphuzizayo) zingaholela ekugwedeni nasegesi emathunjini (kanye nokubhekwa).
Ukukhathazeka kokudla
Abanye abantu abane-IBS bangase babe nezinzwa zokudla. Ukuzwela kokudla kuhlukile kunokudla okuyiqiniso kokudla, ngakho-ke kungase kungatholakali ekuvivinyweni kobuchopho bendabuko. Ezinye zezimbangela ezivame kakhulu zokuzwela kokudla zihlanganisa:
- I-sorbitol (esikhundleni soshukela)
- I-Fructose (etholakala kumusi wezithelo nezithelo zomisiwe)
- I-Lactose (etholakala ebisi)
- Igatsha lesikoro
Ukwehlukana kwe-Lactose yisimo esivamile esiwumphumela wokungakwazi komzimba ukugaya i-lactose, noma ishukela lobisi. Izimpawu zihlanganisa igesi, ukuqhuma, futhi ngezinye izikhathi ngisho nobuhlungu. Uma kucatshangwa ukuthi ukungahambisani ne-lactose, ukugwema ubisi nemikhiqizo yobisi kufanele kunciphise izimpawu.
Ukuthola I-IBS Trigger Foods Yakho
Ukugcina idayari yokudla kanye nesifo kuyindlela enhle yokulandelela ukudla okuholela ekuhlaselweni kwe-IBS. Idayari yokudla kufanele ihlanganise isikhathi hhayi nokudla okudliwe kuphela, kepha futhi lapho kudliwe khona, nohlaka lwengqondo noma imizwa. Kubalulekile ukufaka konke ukudla (ngisho neswidi oyidla kulesi sitsha kwideski lomsebenzi wakho) nendlela ukuthi ilungiswe ngayo (okungukuthi "inkukhu ethosiwe", hhayi nje "inkukhu"). Idayari kufanele igcwaliswe izikhathi eziningana ngosuku ngakho akukho okukhohliwe. Ngemuva kwamasonto amaningana, udokotela noma isazi sezinsiza angasiza ekubuyekezeni idayari ukuze athole amaphethini wokudla.