Mwinamwake mukudabwa chifukwa chake dokotala angakupatseni mankhwala opatsirana pogonana chifukwa cha matenda anu opweteka (IBS) ngati mulibe maganizo. Kapena, mofanana ndi odwala ambiri a IBS, mumakhala ndi matenda ovutika maganizo kapena osokonezeka pamodzi ndi IBS yanu, choncho lingaliro limapangitsa kuti musamvetsetse, koma mukufuna kudziŵa zomwe zimayambitsa matenda othetsera matenda a IBS .
Zowonetsera mwachidule ziyankha yankho la chifukwa chake anti-depressants nthawi zina amagwiritsidwa ntchito ngati mankhwala a IBS ndikukuphunzitsani za mitundu yodzitetezera yomwe imaperekedwa kwa odwala IBS.
Chifukwa Chimene Amagwiritsira Ntchito Matenda Opatsirana Amagwiritsidwa Ntchito ku IBS
Ngakhale mankhwala opezeka m'kalasiyi amalembedwa kuti ndi olemala, amakhala ndi zotsatira zoposa kuchepetsa nkhawa. Mankhwala owonetsetsa bwino awonetsedwa kuti athe kuchepetsa nkhawa ndi kumva ululu pamene akukhala ndi zotsatira zabwino pa kapangidwe ka zakudya .
Madokotala angapereke mankhwala opatsirana maganizo kwa wodwala wa IBS, koma izi zimaonedwa kuti ndi "mankhwala osokoneza bongo" ogwiritsira ntchito mankhwala, popeza palibe wodwalayo wodwalayo amene walandila FDA monga chithandizo cha IBS. Komabe, a American College of Gastroenterology, atapenda kafukufuku wochulukirapo, adatsimikiza kuti pali zowonjezera zowonjezera kafukufuku pazochitika za magulu awiri a mankhwala - TCAs ndi SSRIs - kulangiza ntchito zawo pochiza IBS.
Makamaka, anti-depressants apezeka kuti ali ndi zotsatira zabwino pamatumbo amtundu komanso mawonekedwe opatsirana . Zimagwiritsidwa ntchito kuti zotsatira zopindulitsa za matenda opatsirana pogonana pa zizindikiro za IBS zimachokera ku mankhwalawa pa neurotransmitters omwe amapezeka mu ubongo ndi matumbo.
Mitundu ya Operewera Maganizo Amagwiritsidwa Ntchito mu Chithandizo cha IBS
Mankhwala ogwilitsika ntchito omwe amagwiritsidwa ntchito ku IBS amapezeka m'gulu limodzi mwazi:
Tricyclic Antidepressants (TCAs)
Tricyclic zowonongeka maganizo ndi akulu omwe amalimbikitsa anthu ovutika maganizo. Zakhala zatsimikiziridwa bwino kuti tricyclic anti-depressants ali ndi anti-ululu ndi matumbo-kuchepetsa mikhalidwe, ndipo zimawoneka kuti amachita izi mwa kuchita pa neurotransmitters serotonin ndi norepinephrine . Kuwongolera kuchepa kwa mtsempha kumachititsa kuti ma TCA akhale oyenerera kuchiza kutsekula m'mimba-makamaka IBS (IBS-D).
Mwatsoka, zochitika zomwezo (zomwe zimapangitsa kuti thupi lichepetse m'mimba) nthawi zina zimabweretsa mavuto, kuphatikizapo kugona, pakamwa, khungu, maso, kugonana, kupwetekedwa mtima, kupweteka mutu komanso kulemera. Ma TCA amadziwika kuti ndi otsika poyerekeza ndi IBS kusiyana ndi momwe amagwiritsira ntchito kuchiza. Zotsatirazi ndi zitsanzo za TCA zomwe zikhoza kuperekedwa kwa IBS:
- Elavil (amitriptyline)
- Tofranil (imipramine)
- Norpramin (desipramine)
- Aventyl, Pamelor, Allegron (nortriptyline)
Serveonin Reuptake Inhibitors (SSRIs)
Kusankha serotonin reuptake inhibitors (SSRIs) ndi mankhwala omwe anapangidwa kuti apange mlingo wa serotonin wa neurotransmitter mu mitsempha ya mitsempha, kuti athandize phindu la maganizo.
Chifukwa chakuti serotonin yokha ndiyo yomwe imayendetsedwa, SSRIs imakhala ndi zotsatira zochepa kusiyana ndi tricyclic anti-depressants. Zotsatira zoyipa za mseru, kutsegula m'mimba, nkhawa, ndi mutu kumachepa nthawi zambiri pamene thupi limasintha mankhwala. Kuperewera kwa chidziwitso kumapangitsa SSRI kukhala yabwino kwa iwo omwe amavutika ndi kuvomereza IBS (IBS-C).
SSRI ingakhalenso ndi zotsatira zowonjezereka za zovuta zogonana (kutha kwa kugonana ndi / kapena kuvutika kukwaniritsa zolaula) ndi kupindula kulemera. Ndikofunika kukumbukira kuti anthu osiyanasiyana amachita mosiyana ndipo munthu akhoza kulekerera mtundu umodzi wa SSRI kuposa wina.
Zotsatirazi ndizo zitsanzo za ma SSRI omwe amalembedwa:
- Celexa (citalopram)
- Lexapro (escitalopram oxalate)
- Prozac (fluoxetine)
- Paxil (paroxetine)
- Zoloft (sertraline)
5-HT3 kwa Chisokonezo
Ochita kafukufuku ayang'ana mankhwala omwe akuwongolera malo omwe amatchedwa serotonin receptor sites known kuti 5-HT3 receptors. Lotronex yotsutsana ikugwera mbali iyi.
Chifukwa cha chiopsezo chachikulu, FDA yaika malire okhwima pamtundu wa Lotronex. Pali 5-HT3 yodetsa nkhawa, Remeron (mirtazapine). Deta ndi yoperewera yeniyeni ya Remeron ya IBS ndipo motero sizingaperekedwe kwa odwala IBS.
Zotsatira
Ford, A., etal.al. " American College of Gastroenterology Monograph pa Ulamuliro wa Irritable Bowel Syndrome ndi Chronic Idiopathic Constipation " American Journal of Gastroenterology 2014 109: S2-S26.
Agrawal, A. & Whorwell, PJ "Matenda owopsa: matenda ndi matenda" British Medical Journal , 2006 332: 280-283.
Jones, J. et.al. "Bungwe la British Society of Gastroenterology kuti liziyendetsedwa ndi matenda osokoneza bongo" Gut 2000 47: ii1-ii19.
Lacy, B., Weiser, K. & Lee, R. "Chithandizo cha matenda opweteka a m'mimba" Kupititsa patsogolo kwachipatala mu Gastroenterology 2009 2: 221-238.
Sainsbury, A. & Ford, A. "Kuchiza kwa Irritable Bowel Syndrome: Kupitirira Fiber ndi Antispasmodic Agents" Kupititsa patsogolo Kwachidwi mu Gastroenterology 2011 4: 115-127.