Kulabo abaneentlungu ezingapheliyo, ukumbanjwa kungabangela ingxaki ebalulekileyo
Ukugqithiswa kwe-Opioid (OIC) yimeko eqhelekileyo eyenzeka njengempembelelo embi yokusetyenziswa kwee-painkillers (analgesics). I-opioids yi-painkillers equkethe into efana ne-alkaloids efumaneka kwi-opium poppy.
Imithi yonyango equkethe i-opioids iquka i- methadone , i- percocet , i- vicodin , i- demerol , i- dilaudid , kunye ne- fentanyl .
Ziyalelwe ukuba zityhuphe intlungu, ngokuqhelekileyo zintlungu ezinzima ezifana nokulimala okanye ukuhlinzwa, kodwa kunye neentlungu zentsuku ezide zibangelwa ngumhlaza. Kwezinye iimeko, i-opioids isetyenziselwa ukuphatha isifo sohudo, ngokuqhelekileyo kwisilinganiselo esincinci ukukhusela iimiphumo ezichaphazelekayo.
Ucwaningo luye lwabonisa ukuba abaninzi oogqirha abazi ukuba izigulane zabo zivalelwa xa zifumana i-opioids. Nangona kunjalo, malunga nazo zonke izigulane ezifumana i-opioids zibika ukuba iziphumo ezichaphazelekayo zokugaya kunye nokufikelela kuma-40 ekhulwini zinokuqhawulwa.
Ukugqithiswa kunokunciphisa umgangatho wobomi ngokugqithiseleyo kwaye ngoko ke, kukufanelekile ukuthetha ngogqirha ukuze ufumane unyango kwaye ufumane uncedo.
I-OIC ngokuBambisana nokuSebenza
Ukugqithwa kwenzeka xa izitshixo zingapheliyo, nzima, kwaye kunzima ukudlula. Nangona kunjalo, akusiyo inzululwazi ngokuchanekileyo ngenxa yokuba izitishi zomntu kunye nokuba zihlala zidlula ngaphi.
Ngokuqhelekileyo, ukunyuka kwezilwanyana ezinempilo kunokuthetha ukuhamba naphaya kwezihlandlo ezintathu ngosuku ukuya kathathu ngeveki.
Nangona kunjalo, utshintsho kwimizimba yokunyakaza lungabonisa ukutyunjwa. Ukuba ngokukhawuleza kunzima ukuya kwindlu yokuhlambela-oku kunokuthetha ukuxhamla kwisitya sezindlu zangasese okanye ukunyakaza kwezilwanyana ezininzi kangako-ukuzithiba kunokubakho.
Iimpawu zokubanjwa zingabandakanya:
- Izitambo ezinzima
- Ukuvakalelwa njengentshukumo yokubilisa ingapheli
- Ukucoca kwisitya se ngasese
Ukugqithiswa kwe-opioid-induced protipation ihluke kunokugqitywa okusebenzayo . Ukuqhawulwa kwemisebenzi kunokuvela kwiimeko ezininzi ezivela kwi-fiber eyaneleyo kwisondlo kwisifo okanye imeko kwisigca sokutya. Ukugqithiswa kwe-opioid, nangona kunjalo, yiphumo elichanekileyo kwindlela i-opioid mayeza ayichaphazela ngayo intliziyo encinci kunye nekoloni , ngokunciphisa ukugonya.
Kutheni i-Opioids ibangela ukuxhatshazwa?
I-opioids ineempembelelo ezininzi ezahlukileyo. Kwesisu, i-opioids ingabangela i- gastroparesis , oko kuthetha ukuba isisu sithatha ixesha elide ukuba singabi nalutho kunokuba kufanelekile ngenxa yokuba imisipha ayisebenzi kakuhle.
Ukutya kudlulela emathunjini amancinci ngenxa yeengxabano zomzimba ezibizwa ngokuba yi- peristalsis . I-opioids ithintela phakathi emathunjini amancinci (jejunum) ngokunyuka kwee-circular muscle contractions, eziyizicatshulwa ezingezona ezenziwayo, kwaye oku kunciphisa i-peristalsis edla ngokutya. Oku kunokwenza izikhundla ezinzima, okwenza kube nzima ukugqithisa.
I-opioids iyakuchaphazela nendlela i-sphincter eyimpendulo isabela ngayo kwiyeza. Xa isitulo sisegumbini kukho inqweno yemvelo yokuya kwindawo yokuhlambela kwaye uyidlulise.
I-opioids inokunciphisa le ntluko ukwenzela ukuba xa kukho isitulo sidluliselwa, umntu akayiva. Oko kunokukhokelela ekubanjeni izitulo ixesha elide.
Ngokubanzi, le miphumo kwinkqubo yokugaya ifuna ukuba abanye abantu baya kubanjwa xa besebenzisa i-opioids. Kubantu abadinga ulawulo lweentlungu zangexesha elide ngala mayeza, oku kungaba yingxaki ebalulekileyo.
Unyango lwe-Opioid-Induced Constipation
Utyando lwe-opioid-stimulated constipation lungabandakanya zombini iinguqulelo zokuphila kunye neyeza. Inkqubo yokonyango iya kuxhomekeka kakhulu kwiimeko ezikhoyo zempilo kunye nezinye izinto ezifana neyeza.
Kwiimeko ezininzi, indlela yokuphila iguquka kwaye phezu kweelayisiteli ayiyiyo ngokwaneleyo ukubonelela ngoncedo olupheleleyo kunye nemithi.
Indlela yokuphila
Ukwenza utshintsho oluthile kwiindlela eziqhelekileyo zemihla ngemihla, kunye nezinye iindlela zonyango, kunokuncedisa ngokuqhaqha.
Ukutya kukuyinto ekubambeni ngenxa yokutya okwaneleyo iintlobo ezifanelekileyo zefiber kunye nokusela amanzi aneleyo kunokunceda ukufumana isilwane sishukumise kwaye sigcine izithambile zilula kwaye zigqithise kalula. I-fiber engenayo i-insoluble, efumaneka ngokukodwa kwiziqhamo kunye nemifuno, yenza izitshixo zibe mncinci kwaye zikhuphe. I-fiber e-soluble iya kuchithwa kwi-substance efana ne-gel kwaye iya kunceda ekunqandeni ukuqhenyiswa.
I-Fiber iyakongezwa ekudleni kodwa inokuthi ithathwe njengesongezelelo . Abanye abantu baya kufuneka ukuzama ukuncedisa okuhlukeneyo kwaye banqume ukuba luhlobo luni lwefayibha luya kusebenza okusemgangathweni ukuze lukhuphe ukuzitywa. I-dietitian iyakwazi nokunciphisa ukhetho lwe-fiber kunye nokucebisa utshintsho lwezinto zokutya kunye nezongezelelo, kuquka ukutya okudalwa yi-laxative yemvelo (njengengqungquthela).
Ukusela amanzi aneleyo kunye nolunye utywala imihla ngemihla kunokukunceda ekujonganeni nokuqhaqha. Izitofu zilula ukugqithisa xa kukho amanzi okwaneleyo athatywe kwisilonda ukuze abenze ukuba bahambe. Kulabo asele basele bele, ukongeza amanzi okanye ezinye iiryuji ekudleni akuyi kuba nefuthe elikhulu kwinkqubo yokugaya ifuthe i-opioids. Nangona kunjalo, ukuhlanjululwa ngokufanelekileyo kubalulekile kwimpilo yonke, ngoko kukufanelekile ukubeka ingqalelo indlela amanzi athatyathwa ngayo imihla ngemihla.
Ukuzivocavoca ngenye into enokukunceda ukukhulula. Kwakhona, amandla okusebenzisa uya kuxhomekeka kwimpilo yonke. Nangona kunjalo, nokuba uhamba kungenza umehluko xa kuziwa ekuhambiseni amathambo rhoqo. Oogqirha banokukunceda ekuphakanyiseni indlela efanelekileyo yokusebenza kunye nokuba kuyimfuneko, ukuthunyelwa kwiphilisi yomzimba kunokunceda ekuphuhliseni isicwangciso esiphezulu esithatha nayiphi na imeko yezempilo.
Laxatives
Iingxube eziphikisana nemiphumo yokuqhayisa i-opioids ingafuneka kwiimeko ezininzi kwaye zinokumiselwa ngexesha elifanayo ne-opioid. Ngokuqhelekileyo, i-laxative ingaba yindlela yokuqala yokukhusela kunye / okanye ukunyanga.
I-laxatives ye-Osmotic yilabo abahambisa amanzi amaninzi emathunjini, anesiphumo sokwenza izitulo ezincinci kwaye zilula ukudlula. Ezinye i-laxatives ezise-osmotic ziyafumaneka kwi-counter kodwa ezinye ziyi-prescription, kwaye ezinye zeentlobo ezahlukeneyo ziquka i-miralax, i-lactulose, nobisi lwe-magnesia (engagqithwanga rhoqo). Akunakudla imiphumo emibi yecala kunye neentlobo ze-laxatives-ngokuqhelekileyo zibhekwa njengezikhuselekileyo kwaye zisebenzayo, kodwa abanye abantu banokubethwa okanye ukuhanjiswa.
I-laxatives ezikhuthazayo nazo ziyafumaneka kwi-counter kwaye zibandakanya i-bisacodyl, i-bicarbonate ye-sodium kunye ne-bitartrate ye-potassium, i-senna, kunye neoli ye-castor. Olu hlobo lweexative lusebenza ngokunyusa ukuhamba kwemisipha kwinkqubo yokutya (peristalsis). Abaqhelekanga batyunjwe ukusetyenziswa kwexesha elide ngenxa yeziphumo ezinobungozi, kwaye ukunyamezela kuyahluka (oku kuthetha ukuba ingayeka ukusebenza emva kwexesha).
Amanyathelo angenelelo
Kwezinye iimeko, ukususa isitulo esichaphazelekayo kunokufuneka. Oku kunokwenziwa nge- enema okanye i-colonic irrigation (amanzi okanye enye i-liquid efakwe kwi-anus nakwi-rectum), i-suppositories, okanye ukuphuma kwikhowudi .
I-Glycerin suppositories ingaba isinyathelo sokuqala ekuhambeni kwesitulo, ilandelwe yi-enema, ukunkcenkceshela, okanye ukuphuma kwikhompyutheni (ukufaka umlenze ogqityiweyo kwi-rectum ukuphula i-stool uze uyisuse).
Imithi yeMigqirha
Kukho imishanguzo yonyango etholakalayo kunyango lwe-opioid-stimulated constipation. U-Relistor no-Movantik babini iziyobisi. Ezi zonyango zisebenza ngokuthintela imiphumo ye-opioids ekunciphiseni isilonda.
Ezi zonyango zinganceda ekuhambiseni intshukumo emfutshane emva kokuthatha okanye ukufumana. Ezinye zeempembelelo ezichaphazelekayo zala mayeza angabandakanya isicongconi, isifo sohudo, intlungu yesisu kunye negesi.
ILizwi
Ukugqithiswa kwe-opioid yinto eqhelekileyo kubantu abafumana i-opioids ekwenzeni unyango, kwaye ngokukodwa, ngenxa yobuhlungu obungapheliyo. Ingxaki inokuhlazisa abantu abaninzi ukuba baxoxe, kodwa ukugqithwa kunokunciphisa kakhulu umgangatho wobomi, ngoko kukufanelekile ukuyihambisa nodokotela.
Ukongezelela, kukho unyango olulungekileyo olukhuselekileyo nolunempumelelo kwaye lunokunciphisa iimpawu zokuqhaqhazela kwaye ngaloo ndlela lugweme iingxaki. Nangona ukuqothulwa kuyisihloko esinzima ukukhupha kwintetho yokugqirha, yinto enye engalindelekanga xa ujamelana nentlungu engapheliyo.
> Imithombo:
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> Galligan JJ, Sternini C. "Ukuqonda kwiNgqungquthela yama-Opioid Receptors kwiGI Tract: Ubufakazi kunye nokuPhepha kweMpilo." I-Handb Exp Pharmacol. 2017; 239: 363-378. I-doi: 10.1007 / 164_2016_116
> Gupta S, Patel H, Scopel J, Mody RR. "Impembelelo yokuqhawulwa kolawulo lwamayeza opioid phakathi kwabasebenzisi base-opioid bexesha elide, ngokusekelwe kwisigulane sesigulane." J Managing Opioid.
> LoCasale RJ, uDatto C, uMargolis MK, uCoyne KS. "Ukwaneliswa ngonyango phakathi kwezigulane ezine-Pain Noncancer Pain". "I- J Care Care Spec Pharm ." 2016;
> LoCasale RJ, uDatto C, uWilson H, amaYomans K, uCoyne KS. "Umthwalo we-Opioid-Induced Constipation: Ukwahlukana phakathi kweeNgxelo zeMpilo kunye neZempilo zoMboneleli ngezeMpilo." I- J Care Care Spec Pharm 2016: 22: 236-45.