Ungase uzibuze ukuthi kungani udokotela wakho enquma ukuthi unesixazululo sokucindezeleka ngenxa yesifo sakho sofuba esiswini (IBS) uma ungacindezelekile. Noma, mhlawumbe njengezinkinga eziningi ze-IBS, uhlushwa ukucindezeleka noma ukukhathazeka eceleni kwe-IBS yakho, ngakho-ke lo mbono wenza umqondo omncane kakhulu, kodwa unesifiso sokuthi ingabe i-anti-depressant ingase ibe nemiphumela yamabonakaliso akho e- IBS .
Ukubuka konke okulandelayo kuzophendula umbuzo othi kungani izidakamizwa zokulwa nokucindezeleka zivame ukusetshenziswa njengokwelashwa kwe-IBS futhi zikufundise ngezinhlobo zezidakamizwa ezicindezelayo ezivame ukushiwo iziguli ze-IBS.
Kungani Izidakamizwa Zokucindezeleka Zisetshenziselwa I-IBS
Nakuba imithi kuleli klasi ibizwa ngokuthi i-anti-depressants, inezimo ezihamba ngaphezu kokuqiniswa kwemizwa ecindezelekile. Kuye kwaboniswa ukuthi ukucindezeleka nokucindezeleka kunomthelela ekunciphiseni izidakamizwa ngesikhathi kunemiphumela emihle ohlelweni lokugaya ukudla .
Odokotela bangase babone isiguli se-IBS ngesifo sokucindezeleka, kodwa lokhu kubhekwa njengendlela yokusebenzisa i-"off-label", njengoba kungekho-anti-depressant athola imvume ye-FDA njengokwelashwa kwe-IBS. Kodwa-ke, i-American College of Gastroenterology, ngemuva kokuhlaziywa kocwaningo olunzulu, iphetha ukuthi kunokwesekwa okwanele kokucwaninga ekusebenzeni kwamakilasi amabili ezidakamizwa - ama-TCA kanye nama-SSRIs - ukuncoma ukusetshenziswa kwabo ekuphatheni i-IBS.
Ngokuqondile, kutholakala ukuthi izidakamizwa zokudambisa izidakamizwa zithonya elihle emzimbeni wesisu kanye ne- visceral hypersensitivity . Kuye kwacatshangelwa ukuthi imiphumela ezuzisayo yezidakamizwa zokuhlukunyezwa kwizimpawu ze-IBS ziwumphumela wesenzo sale mithi kuma- neurotransmitters atholakale ebuchosheni nasemathunjini.
Izinhlobo ze-Anti-depressants ezisetshenziswa ku-IBS Treatment
Ama-anti-depressants asetshenziselwa i-IBS ngokuvamile awela kwelinye lamakilasi alandelayo:
I-Tricyclic Antidepressants (TCAs)
Ama-anti-depressants e-Tricyclic angama-state abadala ase-anti-depressants. Kuye kwacatshangelwa kahle ukuthi ama-anti-depressants e-tricyclic anama-anti-ubuhlungu kanye nezimpawu ezihamba kancane, futhi kubonakala sengathi enza lokhu ngokusebenza kwi- serotonin ye-neurotransmitters ne- norepinephrine . Lokhu kwehla kwe-gut motility kwenza ama-TCA afaneleke kangcono ukwelashwa kwesifo sohudo-okubaluleke kakhulu kwe-IBS (IBS-D).
Ngeshwa, isenzo esifanayo ( umphumela we-anticholinergic ) oholela ekunciphiseni umuthi wamathumbu kungase kuholele eminye imiphumela emibi, kubandakanya ukulala, umlomo owomile, umbono obonakalayo, izinkinga zobulili, isizungu, ukuthuthumela, ukukhanda ikhanda kanye nokuzuza kwesisindo. Ama-TCA ngokuvamile akhishwa ngamanani aphansi lapho uphatha i-IBS kunalokho uma isetshenziselwa ukuphatha ukucindezeleka. Okulandelayo yizibonelo ze-TCA ezingase zibekwe i-IBS:
- Elavil (amitriptyline)
- I-Tofranil (i-imipramine)
- I-Norpramin (deipramine)
- I-Aventyl, i-Pamelor, i-Allegron (i-nortriptyline)
I-Serotonin Reuptake Inhibitors Ekhethiwe (SSRIs)
I-serotonin reuptake inhibitors ekhethiwe (SSRIs) yimithi eyenzelwe ukwandisa izinga le-neurotransmitter serotonin ohlelweni lwezinzwa, ukuze kube nomphumela omuhle kumzwelo.
Ngenxa yokuthi i-serotonin kuphela ye-neurotransmitter ihloselwe, ama-SSRI ayenamiphumela emibi kakhulu kune-tricyclic antidepressants. Imiphumela emibi evamile yokuzihlambalaza, isifo sohudo, ukukhathazeka, kanye nokukhanda ikhanda kuvame ukuncipha njengoba umzimba ulungisa imithi. Ukuntuleka komphumela wokuqothula kwenza ama-SSRI abe yinto engcono kulabo ababhekene nokuqothulwa okukhulu kwe-IBS (IBS-C).
Ama-SSRI angabangela nemiphumela emibi yesikhathi eside yobunzima bobulili (ukulahlekelwa kobulili kanye / noma ubunzima bokufinyelela i-orgasm) nokuzuza kwesisindo. Kubalulekile ukukhumbula ukuthi abantu abahlukene bayasabela ngokuhlukile futhi umuntu angabekezelela uhlobo olulodwa lwe-SSRI kangcono kunolunye.
Okulandelayo yizibonelo ze SSRI ezijwayelekile:
- Celexa (citalopram)
- I-Lexapro (i-escitalopram oxalate)
- I-Prozac (i-fluoxetine)
- I-Paxil (i-paroxetine)
- I-Zoloft (sertraline)
5-HT3 yokucindezeleka
Abacwaningi baye babheka imishanguzo eqondisa izindawo ezithile ze-serotonin receptor ezaziwa njenge-5-HT3 receptors. I- Lotronex enengxabano iwela kulolu hlobo.
Ngenxa yengozi yemiphumela emibi kakhulu, i-FDA inqume imingcele eqinile emthethweni weLotronex. Kunesifo esisodwa sokucindezeleka esingu-5-HT3, i-Remeron (i-mirtazapine). Idatha ilinganiselwe mayelana nokusebenza kwe-Remeron ye-IBS ngakho-ke kungase kungabi ngaphansi kweziguli ze-IBS.
Imithombo
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.
Agrawal, A. & Whorwell, PJ "I-irritable bowel syndrome: ukuxilongwa nokuphathwa" i- British Medical Journal , ka-2006 332: 280-283.
Jones, J. et.al. "I-British Society ye-Gastroenterology imihlahlandlela yokuphathwa kwesifo sofuba esiswini" I- Gut 2000 47: ii1-ii19.
ULacy, B., Weiser, K. & Lee, R. "Ukwelashwa kwesifo sofuba esiyingozi" Ukwelashwa Kwemithi Ye- Gastroenterology 2009 2: 221-238.
Sainsbury, A. & Ford, A. "Ukwelashwa kwe-Irritable Bowel Syndrome: I-Beyond Fiber ne-Antispasmodic Agents" Impumelelo Yezokwelapha ku-Gastroenterology 2011 4: 115-127.