Ingabe wena noma udokotela wakho ucabange ukuthi ukuxilongwa kwe-infinite infestinal infestal (SIBO) emathunjini amancane njengencazelo yezibonakaliso zakho ezingaguliwe emathunjini? Ucwaningo oluvusa phambili lubonisa ukuthi i-SIBO yisimo esingatholakali ngaphansi kwayo okumele kubonakale khona noma kubhekwe abantu ababhekana nezinkinga eziqhubekayo zokuvimbela nezifo.
Njengoba kunezindlela zokwelashwa ezitholakalayo ku-SIBO, ukukhomba ukuthi ubukhona bayo kuvulwa umnyango wokuphumula kwesifo.
Udokotela wakho unezinketho ezintathu eziyinhloko ezingakuncoma ngazo ukuze uhlolisise i-SIBO. Lapha uzothola okuncane mayelana nenketho ngayinye, okuzodinga ukuyenza ngaphambi kokuhlolwa ukuthuthukisa ukunemba kwayo, nokuthi yini ongayilindela ekuhloleni ngokwayo.
Ngubani okufanele ahlolwe i-SIBO?
Ngenxa yokukhathazeka ukuthi abantu abaningi abahlukunyezwa ngokuthi banesifo sofuba (IBS), abacwaningi bancoma ukuthi noma ubani ozwa izimpawu ezingapheli zokuqhaqhaza, ubuhlungu besisu, nesifo sohudo kufanele ahlolwe i-SIBO. I-SIBO nayo kufanele ilahlwe noma ubani okhombisa izimpawu zokuntuleka kokudla okunomsoco.
Ukuhlolwa kwe-SIBO kunconywa nanoma ubani ohlangabezana nokubuhlungu kwezimpawu zezempilo ezilandelayo naphezu kokwelashwa okwanele: i-pancreatitis engapheli , isifo se-Crohn kanye ne- scleroderma . Okokugcina, ukuhlolwa kwe-SIBO Kunconywa kunoma ubani onesifo se-celiac , kodwa oqhubeka ezwa izimpawu naphezu kokunamathela kahle ekudleni okungenalutho kwe-gluten.
Ukuhlolwa kwe-Breath
Ukuhlola ukuphefumula kuyisimo esingenasidingo esisetshenziselwa njalo njengendlela yokuhlonza noma ukukhipha i-SIBO. Ukuhlolwa kusebenza ngokuhlola ukutholakala kwe-hydrogen noma i-methane ekuphefumuleni ngezikhathi ezithile emva kokuba umuntu ephuza uketshezi olunesishukela soshukela, njenge-glucose noma i-lactulose.
Ukuba khona kwe-hydrogen ekuphefumuleni ngaphambi komaka wamaminithi angu-90 kucatshangelwa ukuthi kubonisa ukuthi amabhaktheriya akhona emathunjini amancane njengoba ehlangana noshukela oqothileyo futhi ekhulula i-hydrogen noma i-methane, ekhishwa ngokuphefumula. Lesi sikhathi esinqunyiwe sisekelwe eqinisweni lokuthi kuthatha amahora amabili ukuba ushukela ogwetshiwe ukuze ufinyelele amabhaktheriya asegulini akhona ngaphakathi emathunjini amakhulu, okuyilapho kufanele khona khona amakoloni.
Naphezu kokusetshenziswa kwayo okubanzi, ukukhathazeka mayelana nokufaneleka kokuhlolwa kokuphefumula kwe-SIBO kukhuliswe. Enye yezinto ezikhathazayo kakhulu ukuthi ukuhlolwa kuveza imiphumela emibi kakhulu yamanga, ikakhulukazi kubantu abanokuhamba ngokushesha kokudla ngokusebenzisa uhlelo lokugaya, noma imiphumela emibi engamanga, cishe kubantu abanegastroparesis (ukuthungatha okuncane kancane isisu).
Ngaphezu kwalokho, akusivumelanisi ngokuqondene nezinqubo ezihamba phambili zokuhlola, futhi akukho ukuvumelana ngokulingana ukuthi inani lamagesi ekhona emphefumulweni linikeza imiphumela emihle yokuhlolwa. Kodwa naphezu kwalokhu okukhathazayo, ukulula nokuphepha kovivinyo yizizathu eziyinhloko ukuthi lokhu kuyindlela evelele kakhulu yokuhlola i-SIBO.
Indlela Yokulungiselela Ukuhlolwa kwe-SIBO Breath
Okokuqala, uzofuna ukukhetha isikhungo sokuhlola esivivinyayo kokubili kwe-hydrogen ne-methane. Uma usuwenzile kanjalo, udokotela wakho noma isikhungo sokuhlola ngokwayo uzokunikeza imiyalelo ethize mayelana nendlela abafuna ukuthi ulungele ngayo ukuhlolwa. Kubalulekile ukuthi ulandele izinkomba zabo ngokucophelela ukuze ukwandise ukunemba kwemiphumela yakho. Nazi ezinye iziqondiso ezingase zinconywe kuwe:
- Inyanga eyodwa ngaphambili: Ungasebenzisi noma yimaphi imikhiqizo yokuhlanza ikoloni (njengaleyo esetshenziswa ngaphambili kwe-colonoscopy ).
- Amasonto amabili ngaphambili: Ungathathi noma yikuphi ama-antibiotics noma ama-probiotics.
- Iviki elilodwa ngaphambili: Ungasebenzisi noma yiziphi izixube , ama-fiber supplements noma izithambile zokunciphisa .
- Amahora angu-48 ngaphambili: Gwema ukudla okuphezulu kwamakhemikhali kanye nokudla okulula, ikakhulukazi izinkwa zokusanhlamvu konke noma i-pastas. Ungadla inhlanzi egaziniwe noma inkukhu, isinkwa esimhlophe noma irayisi, amazambane, nekhofi kanye netiyi. Uma uthatha imithi ye-GERD, xoxa ukuthi kufanele yini uqhubeke nokuthatha imithi ezinsukwini eziholela ekuvivinyeni noma cha. Ngokuvamile kunconywa ukuba uyeke ukusetshenziswa kwanoma imiphi imithi yokwelapha, kodwa ukuthi ungaqhubeka nemithi ye-PPI.
- Amahora angu-12 ngaphambili: Ungadli noma uphuze noma yini. Lokhu kubandakanya i-gum ne-candy. Uma ungumuntu obhemayo ungabhemi. Ungazivocavoca, njengoba ukuzivocavoca kungakhipha imiphumela yokuhlolwa.
Okumele Ukulindele Uma Uhlolwa Isilwane SIBO Breath
Lapho uhlolo luqala, ungacelwa ukuba uhlanza umlomo wakho ngomlomo ukuze ususe indawo yanoma iyiphi ibhaktheriya engase ibe khona. Khona-ke uzocelwa ukuba unikeze isampula yokuphefumula esisekelo, ngokuvamile ngokushaya ibhaluni. Khona-ke uzocelwa ukuba uphuze inani elincane le-liquid eliqukethe i-glucose noma i-lactulose.
Njalo imizuzu engu-15 uzocelwa ukuba unikeze esinye isampula yokuphefumula ngokushaya ibhaluni. Uma isampula lesampula iqukethe i-glucose, ungalindela ukuthi uhlolo luzohlala amahora amabili. Uma isampula isampula i-lactulose, ungalindela ukuthi uhlolo luzohlala amahora amathathu.
I-Jejunal Aspiration (isampula esithathwe ngesikhathi se-Endoscopy ephezulu)
Okungenayo okuningi, kodwa okucatshangwa ukuthi kunembile ekuhloleni i-SIBO kunokuhlolwa kokuphefumula, kuyisivivinyo esibizwa ngokuthi "i-jejunal aspiration." Le nqubo iyenzeka ngesikhathi sokuphela kwe - endoscopy futhi idinga ukuba isampula yamanzi ashutheke kusukela esigabeni esiphakathi somathumbu wakho omncane. Isampula ke ikhuliswe futhi ihlolwe ngokuba khona kwama-bacterium.
I-Jejunal aspiration ayisetshenziswa kakhulu. Ukuhlaselwa kwayo kungukuthi kuyindleko, kudla isikhathi, futhi kuyilapho ngokuvamile kubhekwa sengathi kuphephile, kusenomthelela ongaphezu kokuhlolwa kokuphefumula. Le nqubo ibuye ibe nokulinganiselwa kwayo ngokukhomba ngokunembile ukutholakala kwe-SIBO.
Amandla angalungile angenzeka ngoba ukuqhubekela phambili kwebhaktheriya kukhona endaweni ehlukile kwesinye isampula esithathwe (isibonelo, phambili emathunjini amancane). Ezinye izizathu zomphumela wokuhlola ongalungile zihlanganisa isampula esingenakwanele noma ukuthi isiko esetshenzisiwe kwakuyodwa lapho amabhaktheriya athile angakhuli khona.
I-positive positive ingenzeka uma isampula ingcolisiwe ngenxa yamabhaktheriya akhona emlonyeni, ezintweni ezisetshenzisiwe, noma ngokuphatha kahle isampula. Futhi ngokujwayelekile okwenziwa emtholampilo ngokumelene nezifundo zocwaningo, odokotela bangase babe namathuba amaningi okuthatha isampula kusukela ku-duodenum, ingxenye yokuqala yomathumbu amancane, ngokumelene ne jejunum. Naphezu kwazo zonke lezi zimingcele, abacwaningi abaningi babona isifiso seJejun njengoba "izinga legolide" lokuhlolwa kwe-SIBO.
Indlela Yokulungiselela Ukuphefumula KweJejunal
Udokotela wakho noma isikhungo sokuhlola uzokunikeza imiyalelo ngokuthi yini okufanele uyenze ukulungiselela inqubo yokufisa. Cishe lezo ziqondiso zizofana neziqondiso zokuhlolwa kokuphefumula. Umehluko kuphela ukuthi kungenzeka ukuthi ukhuluma kuwe kuphela uma une gastroparesis . Kuleso simo, njengoba kungase kuphakanyiswe ukuthi ulandele ukudla okuneketshezi izinsuku ezintathu ngaphambi kokuhlolwa.
Okufanele Ukulindele Uma Uthola Ukuphefumula KweJejunal
Ukuhlolwa kuzokwenzeka ehhovisi likadokotela noma endaweni yokuhlola. Ukuze uqale inqubo, abaqaphi bangase babekwe emzimbeni wakho ukuze udokotela wakho agcine iso lokuphefumula, izinga lenhliziyo, nokucindezelwa kwegazi. Kungenzeka ukuthi i-IV izoqala futhi uzothola sedation emnene ezokwenza uphumule, kodwa ngeke ikukhiphe ngokuphelele.
Okulandelayo, i-anesthetic eyinkimbinkimbi iyohlanzwa emqaleni. Khona-ke ithubhu elincane lizofakwa phansi emqaleni wakho. Ngeke ukwazi ukukhuluma, kodwa usazokwazi ukuphefumula. Udokotela wakho uzothatha isampula ketshezi kusuka emathunjini akho amancane usebenzisa i-catheter yokufuna.
Uma inqubo isiphelile, i-tube izosuswa emqaleni wakho. Uma inqubo isiphelile, ungase uphumule okwesikhashana ukuvumela ukuthi i-anesthesia igqoke. Kubalulekile ukwazi ukuthi ngoba inqubo idinga ukuguqulwa, ngeke uvumeleke ukushayela ekhaya ngemva kokuhlolwa.
Ngalo lonke usuku lokuhlolwa kufanele ugcine umsebenzi wakho ube mncane. Abanye abantu babhekana nemiphumela emibi efana ne-gassiness, bloating, cramping, noma soreness endaweni yomphimbo. Uma uhlangabezana nanoma yiziphi izimpawu ezinzima, ezingavamile, noma ezibuhlungu (njengokuhlanza noma ukukhwehlela igazi), kufanele uxhumane nodokotela wakho ngokushesha.
Ukuhlolwa Kwemithi
Indlela ejwayelekile kakhulu yokuthi odokotela bahlole ukutholakala kwe-SIBO ngukusetshenziswa kwesilingo semithi ye-SIBO. Ukuphulukiswa kwesimiso esisheshayo kungakhombisa ukuthi i-SIBO ikhona.
Imithi evame ukusetshenziswa kakhulu ye-SIBO yi- Xifaxan , okuyinto i-antibiotic. I-Xifaxan ihlukile kunezinhlobo eziningi zama-antibiotic owaziyo njengoba engangeni emzimbeni esiswini sakho. Esikhundleni salokho, lisebenza endaweni yangakini kunoma yiziphi amagciwane angase abe emathunjini akho amancane.
Nakuba njengamanje kungekho izindinganiso zokulinganisa kanye nobude besikhathi, odokotela bangase bakhethe ukulandela imihlahlandlela ye-FDA yokusetshenziswa kwe-Xifaxan yokwelapha isifo sohudo esibaluleke kakhulu kwi- IBS (IBS-D). Lezi ziqondiso zincoma ukuthi imithi ithathwe isikhathi seviki ezimbili, bese iphinda iphinde isetshenziswe elinye noma amabili amasonto.
Njengazo ezinye izindlela ezimbili, kukhona ukulinganiselwa nale ndlela "yokulinga kwezokwelapha". Ngolunye, njengoba ubona, ayikho imihlahlandlela yokuthi ama-antibiotics kufanele abekwe kanjani. Awukho nemikhombandlela mayelana nalokho okubhekwa njengempendulo enhle kumuthi. Konke lokhu kungaqiniseki kusho ukuthi ungase uthathe imithi eminingi kakhulu noma encane kakhulu.
Ikusasa lokuhlolwa kwe-SIBO
Abacwaningi basebenza ngokuqonda okungcono kwe-SIBO ngokwabo, kanye nendlela yokuthuthukisa ukufaneleka kwezinqubo zokuhlola zokuxilonga. Kuthemba ukuthi esikhathini esizayo, odokotela bazokwazi ukukhomba ngokunembile ukuba khona kukaSIBO, kuhlanganise nokucacisa ukuthi yiziphi izinhlobo zamabhaktheriya ezithinta isitho samathumbu amancane omuntu ngamunye futhi enikeze izimpawu zabo.
> Umthombo:
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> Bures J, Cyrany J, Kohoutova D, et al. "Umzimba wezinhlungu ezincane wamathumbu emathumbu emathunjini." I- World Journal of Gastroenterology 2010; 16 (24): 2978-2990.
> U-E E, Shaw C, Whelan K, Andreyev H. "Isihloko sokubukeza: ukwanda okukhulu kwamagciwane emathumbu - ukusabalalisa, izici zomtholampilo, ukuhlolwa kwamanje nokuthuthukiswa kokuhlola, kanye nokwelashwa" I- Alimentary Pharmacology and Therapeutics 2013; 38 (7): 674-688 .
> Salem A, Roland BC "Inqwaba Yokugaya Amagciwane Emathunjini Omzimba (SIBO)" Journal of Gastrointestinal & Digestive System 2014; 4: 225