Ngaba wena okanye ugqirha wakho wucinga ukuba ukuxilongwa kwe- binsary intestinal overgrowth (SIBO) njengengcaciso yezibonakaliso zakho ezingapheliyo emathunjini? Uphando olusakhulayo lubonisa ukuba i-SIBO yimeko engaphantsi kwe-diagnostic apho ubukho bufanele kubonwe okanye bugwetyelwe kubantu abanobuchule obuqhubekayo bokubhenca kunye neengxaki zesisu.
Njengoko kukho unyango olutholakalayo kwi-SIBO, ukuchonga ubukho balo buvula umnyango wokunceda impawu.
Ugqirha wakho unokukhetha ezintathu eziphambili anokukucebisa kuwe ukufumanisa i-SIBO. Apha uya kufunda encinane malunga nenketho nganye, oko kuya kufuneka ukuba wenze ngaphambi kokuvavanya ukuphucula ukuchaneka kwayo, kunye noko ukulindela kulo vavanyo ngokwalo.
Ngubani omele ahlolwe i-SIBO?
Ngenxa yokuxhalabisa abantu abaninzi njengokuba banesifo esilumkileyo esiswini (IBS), abaphandi bancoma ukuba nabani na ofumana iimpawu ezingapheliyo zokubetha, iintlungu zesisu, kunye nesifo sohudo kufuneka kuhlolwe i-SIBO. I-SIBO nayo kufuneka ilawulwe ngaphandle kwanoma ubani obonisa iimpawu zokunqongophala kwezondlo.
Uvavanyo lwe-SIBO lunconywa nanoma ubani ofumana ubunzima beempawu zeemeko zempilo zilandelayo nangona unyango olwaneleyo: i-pancreatitis engapheliyo , isifo sikaCrohn kunye ne- scleroderma . Ekugqibeleni, ukuhlolwa kwe-SIBO kunconywa kunoma ubani ophethe isifo se-celiac , kodwa oqhubeka efumana iimpawu nxamnye nokunyamekela kokutya okungahambisani ne-gluten.
Vavanyo lwe Breath
Uvavanyo lokuphefumula luvavanyo olungelona oluvakalayo olusetyenziswa ngokuthe tye njengendlela yokufumanisa okanye ukulawula i-SIBO. Uvavanyo lusebenza ngokuvavanya ubukho be-hydrogen okanye i-methan ekuphefumuleni kwixesha elithile emva kokuba umntu atywala isisombululo esinesisombululo seshukela, njenge-glucose okanye i-lactulose.
Ubukho be-hydrogen kwindawo yokuphefumula ngaphambi kokuba umatshini we-90 ucatshulwa ukuba ubonisa ukuba ibhaktheriya ikhona emathunjini amancinci njengoko ixubana neshukela esetshenzisiweyo kwaye ikhulula i-hydrogen okanye i-methan, ekhutshwa ngokuphefumula. Ixesha eliqingqiweyo lixhomekeke kwinto yokuba kuthatha iiyure ezimbini ukuba ushukela onotyiweyo ufike kumathambo angamaqanda ekhona emathunjini amakhulu, apho iikholoni ezinjalo kufuneka zibe khona.
Nangona kusetyenziswe ngokubanzi, ukukhathazeka malunga nokuqinisekiswa kovavanyo lokuphefumula kwe-SIBO kuye kwaphakanyiswa. Enye yeyona nkxalabo enkulu kukuba ukuba uvavanyo luvelisa iziphumo ezintle ezimbi, ngokukodwa kubantu abahamba ngokukhawuleza ngexesha lokutya ngokusebenzisa inkqubo yokutya, okanye iziphumo ezingalunganga, kakhulu kubantu abantu abanomdla wokugonywa esiswini).
Ukongezelela, akukho mvumelwano malunga neenkqubo ezifanelekileyo zokuqhuba uvavanyo, kwaye akukho vu melwano malunga nokuba ixabiso legesi ekhoyo ekuphefumuleni liyimiphumo emihle yokuvavanya. Kodwa nangona ezi nkxalabo, ukulula kunye nokukhuselwa kovavanyo zizathu eziphambili zokuba kutheni le ndlela yindlela ethandwa kakhulu kwi-SIBO.
Indlela yokulungiselela ukuhlolwa kwe-SIBO Breath
Okokuqala, uya kuthanda ukhetha isikhungo sokuvavanya ukuba iimvavanyo zombini ubukho be-hydrogen kunye neemethane. Emva kokuba wenze njalo, ugqirha okanye isikhungo sokuvavanya ngokwayo siya kukunika imiyalelo ethile malunga nendlela abafuna ukuba ulungele ngayo uvavanyo. Kubalulekile ukuba ulandele ngqo iinkcukacha zabo ukulungiselela ukuchaneka kweziphumo zakho. Nazi ezinye izikhokelo eziza kunconywa kuwe:
- Inyanga enye ngaphambili: Musa ukusebenzisa nayiphi na imveliso yehlambululi (njengokuba isetyenziswe ngaphambi kwe-colonoscopy ).
- Kwiiveki ezimbini ngaphambi: Musa ukuthatha nayiphi na i-antibiotics okanye i-probiotic.
- Iveki enye ngaphambili: Musa ukusebenzisa nayiphi na i- laxatives , i-fiber supplements okanye i- stool softeners .
- Kwiiyure ezingama-48 ngaphambili: Gwema ukutya okuphezulu kwe-carbohydrate kunye nokutya okutyiwayo, ngokukodwa ukutya kwesonka okanye i-pastas. Unokutya intlanzi okanye i inkuku, isonka esimhlophe okanye ilayisi, iitapile, kunye nekhofi kunye neyeyi. Ukuba uthabatha unyango lweGERD, xubusha ukuba okanye awufanele uqhubeke nokuthatha iyeza kwiintsuku ezikhokelela ekuvavanyeni. Ngokuqhelekileyo kucetyiswa ukuba uyeke ukusetyenziswa kwanamaphi amayeza enkqubo, kodwa ukuba uqhubeke neyeza lePPI.
- Kwiiyure ezili-12 ngaphambili: Musa ukutya okanye ukusela nayiphi na into. Oku kubandakanya i-gum kunye ne-candy. Ukuba utshaya akabheki. Musa ukusebenzisa, njengokuba umzimba unokukhupha iziphumo zokuvavanya.
Yintoni enokuyilindela xa ufumana uvavanyo lwe-SIBO Breath
Xa uvavanyo luqala, unokucelwa ukuba uhlambe umlomo wakho ngomlomo ukuze ususe indawo yiphina ibhaktheriya enokuba khona. Emva koko uya kucelwa ukuba unike isampula yokuphefumula, ngokuqhelekileyo ngokuphefumula ibhaluni. Emva koko uya kucelwa ukuba uphuze inani elincinci le-liquide equkethe i-glucose okanye i-lactulose.
Yonke imizuzu eyi-15 uya kucelwa ukuba unikeze enye isampuli yokuphefumula ngokukhupha ibhaluni. Ukuba isampuli yamanzi iqulethe i-glucose, unokulindela ukuba uvavanyo lugqibe iiyure ezimbini. Ukuba isampuli yamanzi i-lactulose, unokulindela ukuba uvavanyo lugqibe iiyure ezintathu.
IJejunal Impurelelo (Isampuli Eyithathwe Ngethuba le-Endscopy High)
Eyona nto ingenayo, kodwa ingqwalasela echanekileyo yokufumanisa i-SIBO kunokuvavanya umoya, luvavanyo oluthiwa "i-jejunal aspiration." Le nqubo yenzeka ngexesha lokugcina i- endoscopy kwaye idinga ukuba isampuli yamanzi ifakwe kwinqanaba eliphakathi kwamathumbu amancinci. Isampuli ke ikhutshwe kwaye ihlolwe ngenxa yobukho bebhaktheriya.
Iinjongo zeJejunal isingasetyenziswa ngokuqhelekileyo. Ukuphahla kwayo kukuba kuyindleko, ixesha elidliwayo, kwaye ngoxa ngokuqhelekileyo kuthathwa njengekhuselekile, kusenomngcipheko ophezulu kunokuba uvavanyo lokuphefumula. Le nkqubo inemida yayo ngokuchaneka ngokuchanekileyo ubukho be-SIBO.
Ingxaki engafanelekiyo ingenzeka ngenxa yokuba i-bergterial overgrowth ikhona kwindawo eyahlukileyo ukusuka kweso sampuli esithathiweyo (umzekelo, uhamba phambili emathunjini amancinci). Ezinye izizathu zesiphumo sovavanyo olungalunganga ziquka isampula engenayo ngokwaneleyo okanye ukuba inkcubeko esetyenzisiweyo yayiyodwa apho iibhaktheriya ezithile zingakhuli.
Iimeko ezintle ziyakwenzeka ukuba isampuli ingcoliswe ngenxa yeebhaktheriya ezikhoyo emlonyeni, kwizixhobo ezisetyenzisiweyo, okanye ngokuphathwa kakubi kwesampuli. Kwaye ngokuqhelekileyo ukwenziwa kweekliniki ngokuchasene nophando lwezophando, oogqirha banokuthi bathathe isampuli kwi-duodenum, inxalenye yokuqala yesisu esincinci, ngokuchasene nejejunum. Nangona yonke le mingcele, abaphandi abaninzi babona iinjongo zeJejunal njenge "standard standard" ye-SIBO yokuvavanya.
Indlela yokuyilungiselela ukuPhumela kweJejunal
Ugqirha okanye isikhungo sokuvavanya siya kukunika imiyalelo malunga nokwenza ntoni ukulungiselela inkqubo yokufuna. Kungenzeka ukuba le miyalelo iya kufana nemiyalelo yokuhlola ukuphefumula. Ukwahlukana kuphela okukuphela okukuchaphazelayo ukuba unayo i- gastroparesis . Kwimeko enjalo, njengoko kunokucetyiswa ukuba ulandele ukutya okunesondlo iintsuku ezintathu phambi kovavanyo.
Yintoni enokuyilindela xa usebenzisa i-Jejunal Impure
Uvavanyo luya kwenzeka okanye kwi-ofisi yakho ugqirha okanye kwindawo yokuvavanya. Ukuze uqalise inkqubo, abahloli bangabekwa emzimbeni wakho ukuze ugqirha wakho agcine iliso ngokuphefumla, intliziyo yakho, kunye negazi. I-IV iya kuqaliswa kwaye uza kufumana i-sedation emnene eya kukukhulula, kodwa ingenakukubeka ngokupheleleyo.
Emva koko, i-anesthetic ephazamisayo iya kufakwa emqaleni wakho. Emva koko ibhubhu elincinci liya kufakwa phantsi komqala wakho. Ngeke ukwazi ukuthetha, kodwa uya kusakwazi ukuphefumula. Ugqirha wakho uya kuthi athathe isampuli yetsholongwane emathunjini akho amancinci usebenzisa i-catheter yokufuna.
Emva kokuba inkqubo iphelele, ityhubhu iya kususwa emqaleni wakho. Emva kokuba inkqubo iphelile, unokuphumla ixesha elide ukuvumela i-anesthesia ukuba igule. Kubalulekile ukwazi ukuba ngenxa yokuba inkqubo iyafuna ukudalwa, awuyi kuvunyelwa ukuba uziqhube ekhaya emva kovavanyo.
Ngalo lonke usuku lovavanyo kufuneka ugcine umsebenzi wakho ubuncinci. Abanye abantu banemiphumo emibi yecala efana nokuqhaqhaqhaqhaqhaqha, ukuqhaqhaqhaqhaqha, ukuchithwa, okanye ukukhathazeka emqaleni. Ukuba ufumana naziphi iimpawu ezinzima, ezingaqhelekanga, okanye ezixakekayo (ezifana nokuhlanza okanye ukukhwehlela igazi), kufuneka uqhagamshelane nodokotela wakho ngokukhawuleza.
Uvavanyo lweMithi
Indlela eqhelekileyo yokuba oogqirha bahlole ukuba khona kwe-SIBO kukusetyenziswa kwelingo lweSIBO. Ngoko ke ukukhutshwa kwezibonakaliso ngokukhawuleza kuya kubonisa ukuba iSIBO yayikho.
Isiza esetyenziswa kakhulu kwi-SIBO yi- Xifaxan , eyilwabiyotiki . I-Xifaxan iyahluke kuninzi yee-antibiotics oziqhelayo njengoko ingaxhunyiwe emzimbeni esiswini sakho. Esikhundleni salokho, lisebenza kwimeko nganye kwiibhakteria ezinokuthi zibe kwisisu sakho esincinane.
Nangona kunjalo kungabikho imigangatho yokulingana kunye nexesha, oogqirha banokukhetha ukulandela izikhokelo ze-FDA zokusetyenziswa kwe-Xifaxan kunyango lwe- diarrhea ebaluleke kakhulu kwi-IBS (IBS-D). Ezi zikhokelo zincoma ukuba amayeza athathwe kwiiveki ezimbini, kwaye aphindaphindiwe enye enye okanye iiveki ezimbini.
Nje ngezinye iindlela ezimbini, kukho ukulinganiselwa kunye nale ndlela "yezilingo zokwelapha". Ngomnye, njengoko ubonayo, akukho zikhokelo malunga nendlela amayeza okulwa nawo kufuneka abekwe ngayo. Akukho zikhokelo malunga noko kuthathwa njengempendulo enhle kumachiza. Konke oku kungaqiniseki kuthetha ukuba ungathabatha kakhulu okanye uncinci lonyango.
Ikusasa le-SIBO Testing
Abaphandi basebenza ngokuqonda kangcono i-SIBO ngokwayo, kunye nendlela yokuphucula ukuqinisekiswa kweendlela zokuvavanya. Kuthemba ukuba kwixesha elizayo, oogqirha baya kuba nako ukuchonga ngokuthe ngqo ukuba khona kwe-SIBO, kubandakanywa ukuba zeziphi iintlobo zeebhaktheriya ezixhaphaza umathumbu omncinci ngamnye ngamnye kunye negalelo kwiimpawu zabo.
> Umthombo:
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> Bures J, Cyrany J, Kohoutova D, et al. "Ubuncinane be-bacterial syndrome". I- World Journal ye-Gastroenterology 2010; 16 (24): 2978-2990.
> Grace E, Shaw C, Whelan K, Andreyev H. "Umbhalo wokuhlaziya: Ubuncinane bebhaktile obunamazinyo obuninzi - ukusabalalisa, iimpawu zeklinikhi, ezikhoyo kunye nokuphuhlisa iimvavanyo zokuxilonga, kunye nonyango" I- Pharmacology kunye neTherapeutics 2013; 38 (7): 674-688 .
> Salem A, Roland BC "Ukugqithiswa kweBatter Smallest intestinal (SIBO)" Journal of Gastrointestinal & Digestive System 2014; 4: 225