I-IBS-D inokubangela Ingxaki nge-Acile Acids
I-Bile acid isifo sohudo (BAD) yimeko apho i-bile acids ayilungiswanga kakuhle kwinkqubo yokutya , okubangelwa yimpawu zesifo sohudo esingapheliyo. Le meko ingaziwa nangokuthi i-bile acid malabsorption (BAM). Nangona kunjalo, uphando lubonisa ukuba imeko ayinakuhlala ikhona ngenxa ye-malabsorption.
Abaphandi kulo mmandla bakholelwa ukuba i-BAD ayinanto engavumelekanga njengoko kwakucatshangwe ngaphambili.
Bakholelwa ukuba i-BAD yimeko engaphantsi kwe-diagnosti-enye enokuthi ithathelwe ingqalelo kunoma ubani ofumana isifo sohudo esingapheliyo-ngokukodwa, abantu abaneempawu zesifo sohudo-esisifo esilumkileyo se-bowel syndrome (IBS-D) okanye esebenzayo isifo sohudo . Ingxaki ngolu hlobo lokuxilongwa ngolu hlobo kukuba lunokuthintela abantu ukuba bafumane unyango olufanelekileyo.
Sibanzi
Ukuqonda kakuhle i-BAM, kunceda ufunde indlela ukugaya kufuneka kusebenze ngayo. I-bile acids iveliswa sisibindi sakho kwaye igcinwe kwi-gallbladder yakho. Xa udla ukutya okunamanqatha, ezi zi-acids zikhutshwa kwisitembu esincinci ukuze amafutha aphulwe kwaye angene emzimbeni wakho.
I-bile acids yabuyiselwa kwakhona kumgangatho wesisu esincinci kwisibindi sokukhutshwa kwakhona njengoko kufuneka. Ngokuqhelekileyo inani elincinane lala ma-acids lenza indlela yawo emathunjini amakhulu.
Nangona kunjalo, xa i-BAD ikhoyo, ubuninzi obukhulu be-acid acids bahluthelwa emathunjini amakhulu .
Oku kukukhokelela ekukhuseleni ukukhushulwa kwamanzi, okubangelwa kwiisityambo zamanzi kunye nokukhawuleza kwamathumbu emathumbu emathunjini-apho ekupheleni kweempawu zesifo sohudo.
Nangona bekuye kucatshulwa ukuba ukungasebenzi kwabandakanya i-malabsorption, uphando olutshanje luchaza ukuba ingxaki inokuthi ibe yinto engaphantsi kwama-bile acids.
Oku kungakho ngenxa yokungasebenzi kwi-loop ye-feedback okumele ivimbele ukuveliswa kwe-bile acid.
Izizathu
Ezi nkalo zempilo zilandelayo zingabangela inxaxheba ekuphuhlisweni kweBAD:
- Ileal (isisu esincinci)
- Utyando lwe-Ileal (ngokuqhelekileyo njengonyango lwezityalo zeCrohns)
- Ukususwa kweGallbladder (cholecystectomy)
- Ukugqithisa kwebhakterini encinci ye-intestinal (SIBO)
- Ukungakwazi ukusebenza kwePancreatic
- Isiza somhlaza
- Microscopic colitis
- Isifo esifutshane samathumbu
Iimpawu
I-BAD ibonakalisa ngokuyinhloko njengamava okuhlala engapheliyo kwirhudo. Ezinye okanye zonke iimpawu ezilandelayo zikhona:
- Uhudo lwamanzi
- Idayarrha ngokukhawuleza
- Idayarrha phakathi kobusuku
- Iingozi zomoya
- Ukuqhawula
Ukuxilongwa
Oogqirha babonakalisa i-bile acid malasorption ngohlobo, kuxhomekeke kwisizathu salo:
- Uhlobo lwe-1: Isisondeza kwisifo se-leal okanye u-resection
- Uhlobo lwe-2: Idiopathic okanye oyintloko (isizathu esingaziwa)
- Uhlobo lwe-3: ISekondari kuzo zonke ezinye iintlobo zesifo sesisu
Ngenxa yokujonga okutsha kwendima yokukhutshwa kwe-feedback loop ye-synthesis ye-bile acids, igama elithi idiopathic bile acid malabsorption (I-BAM) lingahle lithandeke.
U vavanya
Uvavanyo olufanelekileyo lokuxilonga ukuba ubukho beBAD lubizwa ngokuba yi-75Se-homocholic acid taurine (75SeHCAT). Olu luvavanyo lwenzonyana lwenyukliya apho isigulane sinikwa i-capsule ukuba igxume ngomlomo ize iqhube i-scan epheleleyo yomzimba.
Uvavanyo oluphinda lusetyenziswe iintsuku ezisixhenxe kamva.
I capsule iqulethe i-SeHCAT, esetyenziselwa ukuvavanya amandla okomathumbu amancinci ukugcina i-acid acids. Izinga lokugcina ngaphantsi kwama-15 ekhulwini libhekwa njengeliso lobukho beBAM.
Ngelishwa, uvavanyo alufumaneki eUnited States. Kukholelwa ukuba ukungabikho kokufikelela kuvavanyo lwe-75SeHCAT kuncedisa ekuxilongweni kwe-BAD.
Abanye oogqirha bajika kwiilingo zamachiza kwi-BAD njengenye indlela yokuvavanywa kwe-75SeHCAT. Ukuba loo mayeza aphumela ekuphuculweni kweempawu, i-BAD (okanye i-BAM) iyayixilongwa.
Enye yecala le yinto yokuba enye yemichiza ephambili esetyenziselwa i-BAD ayinyanzelwanga kakuhle. Idla ngokuphindaphindiweyo-i-particularry xa abantu bengayifumananga ukuxilongwa ngokucacileyo okunokukunceda ukuthotyelwa kwamachiza.
Kukho indlela yesithathu, ebonwa ingqiqo, engasetyenziswanga ngokuqhelekileyo njengoko idinga ukuqokelela kweeyure ezingama-24 kunye nokufumaneka kweqela elincinci leelabhu zezifundo ezifanelekileyo.
IBS-D okanye iDirrhea esebenzayo
Abaphandi be-BAD bakholelwa ukuba abaninzi abantu abane-IBS-D okanye i-diarrhea esebenza ngokufanelekileyo banamathuba. Izifundo zibonisa ukuba i-BAD ingasemva kwe-third-case ye-IBS-D kunye ne-40 ukuya kuma-50 ekhulwini lamatyala ehudo olusebenzayo.
Unyango
Kwiimeko apho i-BAD ingumphumo wezifo ezichonga, unyango lujolise ekujonganeni nesi sifo ngokwaso. Kwiimeko apho kungekho nto ebangela ukuba ichongiwe, i-BAD iya kunyangwa ngeklasi leyeza elibizwa ngokuba yi-bile acid okanye izibophelelo.
Ezi zonyango zibonakala zisebenza kwiimpawu ze-BAD ngokuzibophelela kwi-acids kwaye ngaloo ndlela zinciphise iziphumo zazo emathunjini amakhulu. Lawa ngamalungu okwangoku kweli klasi, imirhumo ye-BAD eya kuqwalaselwa kuyo-ilebula:
- Colestyramine (Questran)
- Colesevelam (WelChol)
- Colestipol (iColestid)
La mayeza asebenza ngokufanelekileyo ekupheliseni iimpawu zeBAD. Nangona kunjalo, xa amayeza enqunywe kumlinganiselo weimeko abanayo imvume ye-FDA, umzekelo, i-cholesterol ephakamileyo, ukuqotshwa kunye nezinye iimpawu zokutya zingase zibe namava. Ukuba umiselwe enye yale myeza, kubalulekile ukusebenza kunye nogqirha wakho ukufumana umyinge olungele wena.
Kubalulekile ukuba uqaphele ukuba ezi zonyango zingathintela ukutshatyalaliswa kwamanye amayeza onokuyithatha. Ngoko ke, kufuneka bathathwe iiyure ezine ukuya ezintandathu ngaphambi okanye emva kweyiphi na imithi.
ILizwi
Nangona uphando oluqhubekayo lufunekayo, ngoku kuya kubonakala ukuba i-BAD ixhaphake kakhulu kunokuba yayicinga ngaphambili. Ukuba ufumene uvavanyo lwe-IBS-D okanye ngenye indlela ojongene neempawu zesifo sohudo-kwaye ugqirha wakho akakakhange akhuphe ngaphandle kwe-BAD-unokufuna ukuxubusha umcimbi nabo ukuba babone ukuba le nkcazo yezempilo engaphantsi kwayo iyingcambu zakho iimpawu.
> Imithombo:
> DiBaise JK, Islam RS. I-Acile ye-Bile: I-Caffeyr Chronicle eyaziwayo engaphantsi kwaye yaqonda . I-Gastroenterology eSebenzayo ka- 2012 36 (10): 32-44.
> UPatni S, uWalters J. Uphuhliso olusandul 'ukuSondlo lwe-Acile Acid Malabsorption. IBritish Medical Bulletin. 2009 92: 79-93.
> Walters JRF, uPattni SS. Ukulawula i-Acid Acid yesifo sohudo. Uphuhliso lwezonyango kwi-Gastroenterology. 2010; 3 (6): 349-357.
> Wedlake L, et.al. Ukuphononongwa ngokuSingqungquthela: Ubuninzi be-Idiopathic Bile Acid Malabsorption njengoko zifunyenwe yi-SeHCAT Iskrini kwizigulane ezine-Diarrhea-I-Irritable Bowel Syndrome. I-Pharmacology kunye neeTherapeutics. 2009. 30: 707-717.