I-IBS-D ingabangela inkinga nge-Acile Bids
I-Bile acid isifo sohudo (BAD) yisimo lapho i-bile acids engacubunguli kahle ngaphakathi kwesimiso sokugaya , okwenza kube nezimpawu zesifo sohudo esingavamile. Lesi simo singaziwa nangokuthi i-bile acid malabsorption (BAM). Noma kunjalo, ucwaningo lubonisa ukuthi lesi simo angeke sibe njalo ngenxa ye-malabsorption.
Abacwaningi kule ndawo bakholelwa ukuthi i-BAD ayiyona into engavamile njengokwakucatshangwa ngaphambili.
Bakholelwa ukuthi i-BAD yinkinga engaphansi kokuhlolwa-eyodwa okufanele ibhekwe kunoma ubani othola isifo sohudo esingavamile-ikakhulukazi, abantu abanezibonakaliso zesifo sohudo-esiyingozi kakhulu isifo sofuba (IBS-D) noma ukusebenza isifo sohudo . Inkinga ngalokhu okungaxilongwa ukuthi iyakwazi ukuvimbela abantu ekutholeni ukwelashwa okufanele.
Sibutsetelo
Ukuze uqonde kangcono i-BAM, kusiza ukufunda ukuthi ukugaya kufanele kusebenze kanjani. Ama-acide bile akhiqizwa isibindi sakho futhi agcinwe ku-gallbladder yakho. Uma udla ukudla okunamafutha, la ma-acids akhishwa emathunjini amancane ukuze amafutha aphulwe futhi angene emzimbeni wakho.
Ama-acid we-bile abuye aphinde abuyele ezingeni lezinambuzane ezincane emuva kwesibindi ukuze aphinde akhululwe uma kudingeka. Ngokuvamile kuphela inani elincane lalezi zikhali ezenza amathumbu amakhulu.
Kodwa-ke, uma i-BAD ikhona, inani eliningi kakhulu le-bile acid lihlwithwa emathunjini amakhulu .
Lokhu kuholela ekukhusheni uketshezi oluthe xaxa, okuholela ekuguleni kwamanzi kanye nokusheshisa kwamathumbu emathumbu-okuyinto ekugcineni ngayo izimpawu zesifo sohudo.
Nakuba kwakucatshangwa ukuthi ukungasebenzi kahle kuhilelekile ku-malabsorption, ucwaningo lwamuva luveza ukuthi inkinga kungenzeka ukuthi empeleni ingabe i-overproduction ye-bile acid.
Lokhu kungahle kube ngenxa yokungasebenzi emsebenzini we-loop impendulo okufanele ivimbele ukukhiqizwa kwe-acidi ye-bile.
Izimbangela
Izinkinga zezempilo ezilandelayo zingabangela ekuthuthukiseni i-BAD:
- Ileal (isifo samathumbu amancane)
- Ukuhlinzeka nge-Ileal (ngokuvamile njengokwelashwa kwezifo ze-Crohns)
- Ukususwa kwe-Gallbladder (cholecystectomy)
- Ukukhukhulwa kwamagciwane amancane emathunjini (SIBO)
- Ukungakwazi ukusebenza kwe-Pancreatic
- Umsindo womdlavuza
- I-microscopic colitis
- Isifo samathumbu esifushane
Izimpawu
I-BAD ibonakalisa ngokuyinhloko njengenhlanganiso yezinkinga ezingavamile zesifo sohudo. Ezinye noma zonke izimpawu ezilandelayo zingase zibe khona:
- Isisu sohudo
- Isifo sohudo ngokuphuthuma
- Isifo sohudo phakathi nobusuku
- Izingozi zemvula
- Ukuvimbela
Ukuxilongwa
Odokotela babonisa ukuthi i-bile acid malasorption ngohlobo, kuye ngokuthi imbangela yayo:
- Thayipha 1: Isifo sesibili kuya kwelebula noma ukuthengiswa
- Thayipha 2: Idiopathic noma eyinhloko (imbangela ayingaziwa)
- Thayipha 3: Sekondari kuzo zonke ezinye izinhlobo zezifo zamathunjini
Njengoba sibheke ukubukeka okusha kwendima yokuvimbela i-feedback loop ye-synthesis ye-bile acids, igama elithi idiopathic bile acid malabsorption (I-BAM) lingase lingafuni.
Ukuhlola
Isivivinyo sokuhlolisisa kahle sokuba khona kwe-BAD kuthiwa i-75Se-homocholic acid taurine (75SeHCAT) yokuhlolwa. Lokhu kuhlolwa kwemithi yenuzi lapho isiguli sinikezwa i-capsule ukugwinya ngomlomo bese ihamba ngokukhipha umzimba.
Ukuhlola okuphindiwe kuhlelwe izinsuku eziyisikhombisa kamuva.
I-capsule iqukethe i-SeHCAT, esetshenziselwa ukuhlola ikhono lomathumbu omncane ukugcina i-bile acid. Izinga lokugcina elingaphansi kwamaphesenti angu-15 libhekwa njengelibonisa ukuthi kukhona khona i-BAM.
Ngeshwa, ukuhlolwa akutholakali e-United States. Kukholelwa ukuthi ukungabi nalutho lokufinyelela kuhlolo lwe-75SeHCAT kunomthelela ekuhlolisweni kwe-BAD.
Abanye odokotela baphendukela ekuvivinyweni kwemithi ye-BAD njengenye indlela yokuhlolwa kwe-75SeHCAT. Uma le mithi iholela ekuthuthukiseni izimpawu, i-BAD (noma i-BAM) isifo.
Enye iphuzu lokhu ukuthi omunye wemithi eyinhloko esetshenziselwa i-BAD ayibekezelelwanga kahle. Ngokuvamile kuvinjelwe-okuyizinhlayiya lapho abantu bengatholi ukuxilongwa okuqondile okungasiza ekutholeni imithi.
Kukhona indlela yesithathu, ethathwa njengokucacile, engavamile ukusetshenziswa ngoba kudinga ukuqoqwa kwe-stool yamahora angu-24 nokutholakala kweqembu elincane lama laboratories okucwaninga.
I-IBS-D noma i-Diarrhea esebenzayo
Abacwaningi be-BAD bakholelwa ukuthi abantu abaningi abane-IBS-D noma i-diarrhea esebenzayo babe ne-BAD. Ucwaningo lubonisa ukuthi i-BAD ingase ibe ngemuva kwesigamu sezingxenye ezintathu kwezimpawu ze-IBS-D nama-40 kuya kwangu-50 wamaphesenti amachibi ahudo olusebenzayo.
Ukwelapha
Ezimweni lapho i-BAD yimbangela yezifo ezibonakalayo, ukwelashwa kuzogxila ekubhekaneni nesifo ngokwayo. Ezimweni lapho kungabonakali khona imbangela eyinhloko, i-BAD ingelashwa ngesigaba semithi eyaziwa ngokuthi i-bile acid sequestrants noma izibophezelo.
Imithi enjalo ibonakala isebenza ezimpawu ze-BAD ngokubopha ama-acid futhi ngaleyo ndlela ukunciphisa imiphumela yabo emathunjini amakhulu. Lawa angamalungu wamanje aleli klasi, umshwalense we-BAD ongacatshangelwa ngaphandle-ilebula:
- I-Colestyramine (i-Questran)
- I-Colesevelam (i-WelChol)
- I-Colestipol (i-Colestid)
Le mithi isebenza ngokuphumelelayo ekuqedeni izimpawu ze-BAD. Kodwa-ke, uma imishanguzo ishiwo ngomthamo wesimo abanayo i-FDA imvume, isib. I-cholesterol ephezulu, ukuqotshwa nezinye izimpawu zokugaya kungase kube nakho. Uma ngabe kunqunywe enye yale mithi, kubalulekile ukusebenza nodokotela wakho ukuthola isilinganiso esilungele wena.
Kubalulekile ukuthi uqaphele ukuthi le mithi ingathinta ukumuncwa kweminye imithi ongase uyithathe. Ngakho-ke, kufanele kuthathwe amahora amane kuya kwanguyisithupha ngaphambi noma ngemuva kwanoma yimiphi imithi edingekayo.
Izwi elivela
Nakuba ucwaningo oluqhubekayo luyadingeka, manje luzovela ukuthi i-BAD ivame kakhulu kunalokho okucatshangwa ngaphambili. Uma uthola ukuthi une-IBS-D noma okunye okubhekana nezimpawu zesifo sohudo olungapheli-nodokotela wakho akakakaze akhiphe ngaphandle kwe-BAD-ungase ufune ukuxoxa ngale ndaba nabo ukuze ubone ukuthi ngabe isimo sempilo esingaphansi kwesifo esitholakalisiwe sisempande izimpawu zakho.
> Imithombo:
> DiBaise JK, Islam RS. I-Acile ye-Bile: Isizathu esingaziwa futhi esinganakwa esibhedlela sesifo sohudo esingapheli . I-Gastroenterology esebenzayo ka-2012 36 (10): 32-44.
> Pattni S, J. Walters J. Izintshumayelo Zamuva Kuqondwa Kwe-Bile Acid Malabsorption. I-Bulletin Yezokwelapha yaseBrithani 2009 92: 79-93.
> Walters JRF, uPattni SS. Ukuphatha i-Acid ye-Acid yesifo sohudo. Ukuthuthukiswa Kwezokwelapha ku-Gastroenterology. 2010; 3 (6): 349-357.
> Wedlake L, et.al. Ukubuyekezwa okuhlelekile: Ukusabalalisa kwe-Idiopathic Bile Acid Malabsorption njengoba kutholakala yi-SeHCAT Ukukhishwa kweziguli ezine-Diarrhea-i-Irritable Bowel Syndrome. I-Pharmacy ejwayelekile kanye Nezokwelapha. 2009. 30: 707-717.