Ukujoliswa kweNgcinci yeBestinal Intestinal Overgrowth
Abaphengululi bafumanisa ukuba inqwaba ye-bacterial bladder (SIBO) encinci ichaphazela abantu abaninzi kunokuba babecinga ngaphambili. Enyanisweni, kuqikelelwa ukuba inani elibonakalisiweyo labantu abaye bafumanisa ukuba baneengxaki zesifo sengqondo (IBS) ngokwenene baneSIBO.
I-SIBO yimeko yempilo apho kukho inani elincinci leebhaktheriya emathunjini amancinci.
(Emzimbeni ophilileyo, ubukho beebhaktheriya ezincinane ngaphakathi emathunjini amancinci kufuneka ukuba buncinci, kunye nenani elikhulu leebhaktheriya ezikhoyo emathunjini amakhulu.) I-SIBO inokubangela iimpawu ezahlukahlukeneyo-kubandakanya, ngokugqithiseleyo, ukusilela kwondlo . Ngokuqhelekileyo ixilongwa ngokuphefumula, nangona ezinye iindlela zifumaneka .
Ukuba uxelelwe ngugqirha wakho ukuba unayo i-SIBO, uya kuqinisekiswa ukuba uyazi ukuba imeko yonyango. Kule ngqungquthela uza kufunda malunga neendlela uSIBO okwangoku kunyangwa ngazo, kunye nezinye iindlela ezenziwa phantsi kophando. Le ngcaciso iya kuba luncedo kuwe njengoko usebenza nogqirha wakho ukuze uzalise isicwangciso soonyango.
1) Ulwaphulo lwe-Antibiotics
Okwangoku, i-"standard standard" yonyango ye-SIBO yindlela yokusebenzisa imithi yonyango ejoliswe ekunciphiseni ukugqithisa kwebhaktheriya kwisisu esincinci. Ezi ziyeza zicatshangelwa ukunciphisa ukuvuvukala kwimbumba yesisu esincinci esinokubangela ukuba i-malabsorption enesondlo.
Ngelishwa, inzululwazi emva kokusetyenziswa kwee-antibiotiki ze-SIBO isasesikweni sayo sesantwini. Abaphandi bayaqaphela ukuba kuninzi kufuneka bafunde ukuba zeziphi iindidi ze-antibiotics ezifanelekileyo kumntu ngamnye ngamnye, kwaye ziphi na amayeza kunye nobude bonyango obuya kusebenza kakhulu.
Okwangoku, i-antibiotics ephambili esebenzisa i- Xifaxan .
Uphando lubonisa ukuba i-Xifaxan inokusebenza kakuhle ekuphatheni i-SIBO, ininzi yezigulane ezixhamla kunyango. I-Xifaxan iboniswe ukucima iindidi ezahlukeneyo zebhaktheriya. Kwiimvavanyo ezininzi zekliniki, kuye kwabonakaliswa ukuba kusebenza ngakumbi kune-placebo kunye nezinye iintlobo ze-antibiotics ekuphuculeni iimpawu kunye neziphumo zokuvavanya ukuphefumula. Nangona kunjalo, abaphandi baqhubeka bephanda uphando lwezinye iintlobo ze-antibiotics ukwenzela ukuvula amathuba okufumana unyango olongezelelweyo.
Emzimbeni, i-Xifaxan ayifakwanga kwigazi, ngoko ukunciphisa imiphumo emibi kunye nokwandisa amandla ayo okusebenza ngqo kwiibhaktheriya ezikhoyo emathunjini amancinci. Kwaye ngokungafani nemininzi yamachiza onokuthi ube nayo, i-Xifaxan ayinayo impembelelo kwiibhaktheriya ngaphakathi emathunjini amakhulu kwaye akufanele ibenze iimpawu zesisu okanye izifo zesilonda onokuzifumanisa nazo ngezifundo zangaphambili ze-antibiotics . Ngokubanzi, i-Xifaxan ithathwa njengemveliso ekhuselekileyo, nangona imiphumo engathandekiyo emibi iye yabikwa.
Njengoko kuchazwe ngasentla, kukho njengokuba akukho mvumelwano ngokubanzi malunga nokuba yiyiphi i-dosage efanelekileyo kunye nexesha lokusebenzisa i-Xifaxan.
Kwiinkoliso ezininzi zeeklinikhi, i-dosage ephezulu iboniswe ukuba isebenze ngakumbi kunezifo ezisezantsi. Kwiinkqubo zonyango, i-Xifaxan idla ngokuphindaphindiweyo kwizifundo zeveki ezimbini, ngezifundo eziphindaphindiweyo ezifunekayo njengoko ziyimfuneko. Kufuneka kuqatshelwe ukuba, njengasekuqaleni kuka-2017, i-Xifaxan ayizange ivunyiwe yi-FDA yokunyangwa kwe-SIBO (nangona ivunyiwe ukunyangwa kwe- diarrhea ebaluleke kakhulu kwi-IBS kunye ne-diarrhea). Ngoko ke, ukucacisa i-Xifaxan ye-SIBO ithathwa ngokuba yi-"off-label".
Nangona i-success rates ephezulu ye-Xifaxan, i-SIBO ibuyelela kwakhona, ngoko ke izigulane zidla ngokufuna iikhosi ezininzi zokunceda okwaneleyo.
Kweminye, i-antibiotic engaphezu kweyodwa inokumiselwa ngexesha elifanayo. Kwabanye, ukujongana neengxaki zonyango okanye ukutshintsha ukutya kunye nemikhwa yokuphila kunokufuneka.
2) Iingxaki ezijoliswe kwiNkcazo
Ulwaphulo lwe-antibiotics njengoko kuxoxwa ngasentla luyiyona ndlela eyona ndlela yokuphatha iSIBO kubantu abangabonakaliyo. Nangona kunjalo, ngamanye amaxesha kukho ingxaki yezempilo engundoqo efuna ukujongiswa ukuze kupheliswe nayiphi na into ekhuthaza ukugqithisa kweebhaktheriya kwintlungu encinane. Le ngxaki ingasisifo okanye ingaba yinto echaphazela isakhiwo samathumbu amancinci ngokwawo.
Isifo esisisigxina: Iminye imizekelo yezifo ezisisigxina ezifaka isandla ekuqaleni kwe-SIBO ziquka ezo ziphazamisa i-motility (isivinini) sesisu okanye intlungu encinci, njengegastroparesis okanye i- dysmotility encinci. Ezi zinokuphathwa ngamachiza enkqubo.
Omnye umzekelo isifo se-celiac , njengoko sele kufunyenwe ukuba abantu abanesifo se-celiac basengozini ephezulu ye-SIBO. Kuba bantu, ukunamathela ngokuthe ngqo kwi-gluten-free food (kubalulekile kwimpilo yabo!) Kunokukunceda ekuphuculeni iimpawu.
Iziphene zesakhiwo: Ezi zilandelayo ziyimimiselo yeziphene ezakhiwayo ezinokubangela ukuphuhliswa kwe-SIBO. Ezinye zezi ziphoso zingalungiswa ngokuhlinzwa.
- Izilophu eziyimfama
- Isithintelo somzimba
- I-Diverticula ekhoyo emathunjini amancinci
- IFistula
- Isifo sesilwanyana esincinci
- Izithintelo
I-SIBO ikwafumaneka kwakhona ngabantu abaye bafumana i- colectomy (engaziwa ngokuba yi-subtotal), ngenxa yezinto ezinokubangela ukuphazamiseka kwintsimbi ye-ileocecal leyo leyo ingavumela ukuba ibhaktheriya ye-colonic ibuyele emuva emathunjini amancinci. Ukongezelela, ukunciphisa umtsalane omancinci wokuhlambulula amathumbu, ngenxa ye-colectomy, unokubeka isigaba sokuba iibhaktheriya zanda.
Imiphumo emibi yezobisi: Kwezinye iimeko, amayeza asetyenziselwa ukunyanga ingxaki yempilo eyahlukeneyo inokuba negalelo kwiimeko ezikhuthaza i-SIBO. Ukuyeka ukusebenzisa kwabo kunokunceda ukunciphisa iimpawu ze-SIBO. La mayeza aquka:
- Amachiza opiate (ngokuqhelekileyo anikwe intlungu)
- Iproton pump inhibitors (i-PPIs) (ngokuqhelekileyo imiselwe iGERD)
3) Ukungenelela ngeZidlo
Ukungenelela nge-Dietary ye-SIBO kujoliswe ekujonganeni nokungaphumeleli kwesondlo okanye ukujongana ne-SIBO ngokuthe ngqo ngokusetyenziswa kwezidlo ezithile.
Ukujongana nokusilela kweZondlo: Ukuba ufumene i-SIBO, kufuneka usebenze kunye nogqirha wakho ukuchonga kunye nokujongana naluphi na ukusilela kwondlo. Izibonelelo kufuneka zithathelwe nayiphi na okanye zonke iivithamini kunye neemaminerali ezilandelayo ukuba kukho ukusilela:
- IVithamini A
- IVithamini B12
- Vitamin D
- Vitamin E
- ICalcium
- Magnesium
Ukuba ugqirha wakho ukholelwa ukuba i- steatorrhea kunye / okanye olunye uhlobo lwe-fatbs malabsorption lukhoyo, banokucebisa ukuba uthathe isongezelelo se-enzyme ye-pancreatic .
Ukutya okuQalayo: Ukutya kokuqala kubandakanya ukulungelelaniswa okupheleleyo kokutya kwindlela ethile yokutya yokutywala. Abanye abalingani bezempilo badibanisa ukusetyenziswa kokutya kokuqala njengendlela engeyonyango yokuphatha iSIBO. Olunye uphando lwekliniki lwaluqhutyelwa apho ininzi yabathathi-nxaxheba bafumana ukuncipha kweempawu, kunye nokuqhelanisa ukufunyanwa kwemiphumo yokuphefumula, emva kweveki ezimbini kwisondlo sokuqala.
Kucacile ukuba uphando olongezelelweyo lufuneka luqhutywe ukuze lubone ukuba olu lukhuni lokulandela ukutya lusetyenziso olufanelekileyo lwe-SIBO. Kunconywa ukuba ungazami okwenziwe ekhaya ngokuqulunqa okwenziweyo ngenxa yengozi yokunqongophala okunokondla, okuya kubeka impilo yakho engozini.
Ukutya okungezantsi-FODMAP: Ukutya okuphantsi kwe-FODMAP kwenzelwe ukunciphisa iimpawu ze-IBS ngokukhawulela okwesikhashana ukusetyenziswa kwe-FODMAP, i-carbohydrates efumaneka kwizidlo eziqhelekileyo ezinokubangela iimpawu ze-IBS. Nge-SIBO, ezimbini zeentlobo ezahlukeneyo zeFODMAP , i-lactose kunye ne-fructose, ingaba ne-malabsorbed ngenxa yokuvuvukala kwimbombo yesisu esincinci. Ukongezelela kwezi zimbini, ezinye i-FODMAP ezingabanjwanga ziyakunqandwa ngamabhaktheriya ahlala ngokungalunganga kumathumbu amancinci, ekhokelela ekubheni kunye nezinye iimpawu zokugaya.
Ngenxa yoko, ukutya okuphantsi kwe-FODMAP kunokuba luncedo ku-SIBO ngenxa yokuba ukunciphisa ukusetyenziswa kwe-carbohydrate "kunokulamba" ibhaktheriya kwintlungu encinane. Nangona kunjalo, njengokuba kunjalo akukho zifundo zonyango kule ndaba. Ngendlela efanayo, ukuphumelela kokutya okuphantsi kwe-FODMAP kubantu abane-IBS kunokubanjelwa kwezinye iinjongo zokutya kwi-SIBO engaboniswanga, kodwa kwakhona ngoku ngoku, oku kuqikelele.
Akukho nto eyaziwa ngokufanelekileyo kokutya okuphantsi kwe-FODMAP kumntu okwangoku uthabatha i-antibiotics ye-SIBO. Kucatshangelwa ukuba ukutya kunokunciphisa ukuphumelela kwonyango lwe-antibiotic ngenxa yokubeka ibhaktheriya kwi-dormancy. Ngoko ke, ngokuqhelekileyo kucetyiswa ukuba umntu adle ukutya okuqhelekileyo ngelixa kulwa ne-antibiotics aze alandele ukutya okuphantsi kwe-FODMAP emva kokuba ikhosi yeeyeza sele igqityiwe njengendlela yokukhusela i-SIBO kwakhona.
Njengoko unokubona ngokucacileyo, indima yokutya ekuqaleni, ukugcinwa, kunye nonyango lwe-SIBO ihlala iqondwa kakuhle. Ngethemba lokuba uphando oluqhubekayo luya kubonisa ulwazi oluchanileyo malunga nokusebenzisana phakathi kokutya kunye ne-SIBO.
Ikusasa le-SIBO Treatment
Njengoko i-SIBO inikwe ingqwalasela yocwaningo olongezelelweyo, uphuhliso olutsha luya kuvela. Injongo ekhethekileyo yophando kukuba uphuhliso lwe teknoloji ephakamileyo eza kunika amandla okuchonga ngokuchanekileyo ubukho kunye nohlobo lweebhaktheriya ezikhoyo emathunjini omntu omncinci. Okwangoku, unyango kwili candelo lizo zonke izinto ezibhekiselwe kulo ukhuseleko kunye nokusebenza kwe-SIBO.
Iimveliso zeHermal
Kukho uphando olupapashiweyo oluye lwafunyanwa ukuba luncinci lusebenza njenge Xifaxan ekuphatheni iSIBO. Ukuqulunqwa kwemifuno kubambe isithembiso njengendlela yokuphepha imiphumo emibi yeyeza-antibiotics, ukunyanga abo abaphikisana neyeza-antibiotics, kunye / okanye ukukhusela ukuphindaphinda kwe-SIBO.
Prokinetic Medication
Njengoko kuthethwe ngentla, imishanguzo yeprokinetic, esetyenziselwa abantu abaneengxaki zesisu esiswini, ingaba luncedo ekuphatheni iSIBO. Uphando oluphambili lubonisa ukuba ukusetyenziswa kwezi zonyango kunokuba luncedo kakhulu kulabo abahlala kwi-SIBO kunye ne- scleroderma . Ezi zonyango zicingelwa ukuba zincedo kwi-SIBO, njengoko zikhulisa amandla emathunjini amancinci "ukutshiza" ukuhlamba ibhaktheriya.
Probiotics
Ngokwicatshulwa, i- probiotic supplements ingaba luncedo ekuphatheni i-SIBO kuba baye baboniswa ukuba banefuthe elihle kwi-makeup ye-bacteria, ukuphucula impilo yegumbi lokugaya, nokunciphisa ukuvuvukala. Nangona kunjalo, uphando olunzulu malunga nokusebenza kweprobiotics ekuphatheni i-SIBO ayinakho.
Ukuthintela Ukubuyela KwiNkundla
Njengoko kuphawuliwe ngasentla, nangona isisombululo esifanelekileyo se-SIBO ngokusebenzisa i-Xifaxan, umngcipheko wokuphindaphinda ungasentla. Ayikho into eyaziwayo ukuba ingaba iikhosi ezilandelelanayo okanye ezicwangcisiweyo zeziyeza zonyango ziya kuba luncedo ekukhuseleni ukubuya kwakhona. Ukususela ngoku, inkqubo yokucetyiswa kwezenzo i-regimen apho abantu batshintsha ukutya kwabo emva kwekhosi ye-antibiotics njengendlela yokuzama ukugcina ukuphuculwa kwesimboli, nokuthatha izifundo eziphindaphindiweyo ze-antibiotics njengoko kuyimfuneko.
Njengoko kukhankanywe ngasentla, ukuqonda ukuba zeziphi izidlo zokutya ziza kubonakala ngathi zihluphekile. Kungaba luncedo ukulandela ukutya okuphantsi kwe-FODMAP ixesha elifutshane. Kwakhona kunokuba luncedo ukuphepha ukutya okuqukethe i-aspartame, i-saccharin, ne-sorbitol, enokubambisana neebhaktheriya ezikhoyo emathunjini amancinci. Ukuba ufumene, ngokusetyenziswa kokuphefumula okanye ukutya kokunciphisa, ukuba unokunyanzeliswa kwe-lactose okanye i- fructose malabsorption , unokufuna ukuphepha ukutya okuqulethe iishukela ngenxa yesizathu esifanayo.
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