Mwachidule cha Gluten Sensitivity
Mpaka posachedwa, anthu omwe ali ndi zotsatira zoipa pamayesero a magazi komanso m'mimba yamatumbo omwe amapezeka kuti adziwe matenda a celiac adamuwuza kuti adye chilichonse chimene akufuna - gluten sanali vuto lawo.
Komabe, ambiri mwa anthuwa ankayesa kudya zakudya zopanda thanzi -chakudya chomwe chinachotsa zakudya zonse monga gluten tirigu, balere, ndi rye-ndipo zinalembedwa kuti zimakhala bwino kwambiri. Zizindikiro zawo (zomwe zinaphatikizapo kutopa, zodandaula za kugaya, ndi matenda a ubongo) zinachotsedwa pamene zidya za gluten.
Ambiri mwa anthuwa amamva kuti ali ndi nkhawa kapena samagwirizana ndi mapuloteni a gluten , ngakhale kuyesedwa kumasonyeza kuti alibe matenda a celiac. Nthaŵi zina, madokotala awo anagwirizana ndi mayeso awo ndipo anavomera kuti sayenera kudya gluten. Nthawi zina, iwo amangopitiriza kupewa gluten popanda madalitso a dokotala.
Tsopano, ochita kafukufuku ambiri (ngakhale kuti si onse) amakhulupirira kuti vutoli lokhudzana ndi vuto la mbewu za gluten (vuto lomwe si matenda a celiac) likupezeka.
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8 Zizindikiro Zozizwitsa Zomwe Mungachite Kuti Mukhale ndi Matenda Aakulu a Gluten
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Ngati Gluten Sensitivity Ndi Yeniweni, Ndi Anthu Ambiri Otani Amene Ali ndi Icho?
Iwo amatcha "kutchuka kwa gluten," "kutengeka kwa gluten" ("NCGS"), "" kukhudzidwa kwa tirigu wosakwanira, "" kusalolera kwa gluten , "kapena ngakhale" kuluma kwa gluten . "
Komabe, kukhalapo kwa chikhalidwe sikunatsimikizidwe motsimikizirika, ndipo pakadalibebe kufotokozera chifukwa chake zimachitika komanso momwe zingakhudzire ndi matenda a leliac. Ngakhale kulibe dzina lovomerezedwa ndi anthu onse, ngakhale kuti akatswiri ambiri a m'munda adalumikizana ndi "chidwi chokhalitsa cha" gluten "kapena" chisamaliro cha tirigu chosafunika. "
Siziwonekeratu ngati ndi mapuloteni a tirigu, balere, ndi rye omwe amachititsa zizindikiro za chikhalidwe.
Ndipotu, ofufuza apeza mankhwala ena a tirigu, makamaka, akuti akhoza kukhala ndi udindo . Ena mwa mankhwalawa, otchedwa FODMAPS, amapezeka mu zakudya zina, monga adyo ndi anyezi, komanso tirigu.
Kuonjezera apo, kafukufuku wofalitsidwa mu Julayi 2016 akuwonetsa kuti wolakwira mu zinyama zosakanizidwa / tirigu zokhudzana ndi tirigu zingakhale zowonongeka. Phunzirolo, lochitidwa ndi ofufuza ku Columbia University Medical Center, linapeza kuti iwo omwe ali ndi mphamvu ya tirigu anali ndi chitetezo cha mthupi chosonyeza kuti "systemic immune activation."Zotsatira za phunziroli zikusonyeza kuti kuyambitsidwa kwa chitetezo cha mthupi kumachitika chifukwa tizilombo toyambitsa matenda ndi mapuloteni a chakudya akudutsa m'mimba mwazi m'magazi, zomwe zimachititsa kutupa kwakukulu.
Potsirizira pake, ngakhale kafukufuku waposachedwapa omwe amasonyeza kuti mphamvu ya gluten ikhoza kukhalapo, madokotala ambiri samavomereza kuti ndizochitika zenizeni zachipatala, ndipo palibe chiyeso chovomerezedwa chachipatala kwa izo. Kafukufuku akupitiriza kufunafuna choonadi ponena za kulimbikitsidwa kwa tirigu / gluten, ndipo pakuwonjezereka zotsatira, adokotala akhoza kukhala okhulupirira kwambiri.
Zizindikiro za Kukhumudwa kwa Gluten
Zizindikiro zokhudzana ndi umutu wa gluteni zimamveka mofanana ndi zomwe zimakhudzana ndi matenda a diliyake: mavuto a m'mimba, kuphulika, ndi kutopa .
Mavuto monga kutsegula m'mimba, kudzimbidwa, ndi kupweteka kwa m'mimba zimachitika kawirikawiri kwa omwe amapezeka kuti ali ndi mphamvu zowonjezera. Iwo amakhalanso wamba mwa iwo omwe amafotokoza kuti akudwala ndi zakudya zamtundu wa gluten, koma omwe alibe matenda.
Kupweteka kumodzi, kumutu, ndi ubongo kumaganizidwe kawirikawiri, ndipo pali phunziro limodzi laling'ono lomwe linapeza kuti gluteni ingayambitse kuvutika maganizo kwa anthu omwe alibe matenda a celiac .
Sizodziwika ngati zizindikirozi zikuwonetsa zowonongeka ku machitidwe a thupi lanu, kapena akungokuwonetsani kuti mudya chinachake chomwe sichigwirizana ndi inu. Akatswiri ena amanena kuti anthu omwe ali ndi thanzi labwino amatha kuvulaza ziwalo zina ndi machitidwe awo, makamaka machitidwe awo a ubongo, koma izi sizinatsimikizidwe mufukufuku wa sayansi.
Sensitivity vs. Matenda a Celiac
Mukapezeka kuti muli ndi matenda a celiac , nthawi zambiri amatanthauza kuti mwakhala ndi zovuta zothandizira kuchipatala-mumayambitsa matumbo anu a m'mimba (omwe amadziwika kuti ndi atrophy oopsa ) omwe amayamba chifukwa cha zakudya zomwe zimayambitsa matenda a gluten.
Matenda a Celiac amakhudza pafupifupi munthu mmodzi mwa anthu 133 alionse ku US, zomwe zimachititsa kuti zikhale zosavomerezeka.
Anthu ambiri omwe amasonyeza zizindikiro za matenda a leliac alibe vuto, koma ena mwa anthuwa amapeza mpumulo ku zizindikiro zawo pa zakudya zopanda thanzi, ndipo amatha kukhala ndi mphamvu zowononga.
Madokotala amafunika kutulutsa matenda a soliyumu asanathe kupeza matenda a gluten . Izi nthawi zambiri zimatanthauza kuti mudzafunika kuyesedwa magazi ndiyeno ngati (mwinamwake) mankhwala osapitirira nthawi, madokotala amatha kuyang'ana pamatumbo anu aang'ono. Ngati mayesowa sakuwonetsa zizindikiro za matenda a celiac, ndiye kuti iwe ndi dokotala mungathe kupeza njira zowonjezereka zowonjezereka, kuphatikizapo kutengeka kwa gluten.
Zosankha Zowonetsera Kutenga kwa Gluten Khalanibe Unproven
Popeza ochita kafukufuku ambiri samavomereza kuti kutengeka kwa gluten kulipo, palibe chitsimikizo chotsimikizirika kuti mudziwe vutoli . Ndiye mungachite chiyani kuti muyese ngati mukuganiza kuti izi zingakhale vuto lanu?
Pamene inu ndi dokotala wanu mwadula matenda a celiac, muli ndi njira zingapo zomwe mungayesere kuti muyesedwe.
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Komabe, muyenera kudziwa bwino kuti palibe njira ina yomwe yatsimikiziridwa ndi kafukufuku wamankhwala.
Mwachitsanzo, madokotala ena amagwiritsa ntchito zotsatira zabwino pamayesero ena a magazi - mayesero omwe amawoneka mwachindunji ma antibodies a gluten m'magazi anu - kuthandizira kudziwa kutchuka kwa gluten. Anthu ena angapo adzakupezerani kuti mumadalira kuti mumayesetsa kudya zakudya zopanda thanzi-mumaganizo ena, ngati mumachotsa gluten ndikumverera bwino, mumakhala otupa.
Muli ndi mwayi wofuna kuyesa kugwiritsira ntchito mlingo wodalirika kudzera mu EnteroLab - dziwani kuti njira yoyesera yogwiritsira ntchito labuyi siinatsimikizidwe kapena kuvomerezedwa ndi madokotala ambiri.
Mafunso Ambiri Osayankhidwa pa Gluten Sensitivity
Ndizotheka kuti mphamvu ya gluten ndi matenda a chililiac akuimira mbali zosiyana za chikhalidwe chomwecho, koma zikutheka kuti zimayimira mikhalidwe yosiyana. Popeza ochita kafukufuku sakuvomerezana ndi kutanthauzira kwa mphamvu ya gluteni, sitinganene motsimikiza kuti zingatheke bwanji komanso momwe zingakhudzire ndi matendawa.
Kuonjezerapo, ndizomwe sikuti aliyense amene amapewa gluten ayenera kuchita zimenezo. Ngati mutaya zakudya zowonongeka ndikudya bwino, mukhoza kukhala osamalitsa kapena osaganizira za gluten. Koma pakhoza kukhala zifukwa zina za kusintha kwa thanzi lanu.
Mwachitsanzo, anthu ena amamva bwino chifukwa chakuti amadya zakudya zowonjezera-mwa kudula mchere, mumadula mitundu yambiri ya zakudya zowonongeka ndi zopanda kanthu. Ndipotu ichi ndi chimodzi mwa zifukwa zomwe zimachititsa kuti anthu ambiri asamadye zakudya zakutchire .
N'zotheka kuti mumve bwino chifukwa mumakhulupirira kuti mukuchita zabwino pa thanzi lanu, mwachitsanzo, kumverera bwino pa zakudya zopanda thanzi kumaimira zotsatira za placebo.
Sindikunena izi mopitirira malire, madokotala ambiri amatsutsa komanso amatsutsa zizindikiro za gluten, ndipo "zonsezo ziri m" mantra "zikupitirirabe m'madera ena azachipatala, ngakhale zikupita patsogolo. Koma zowona kuti anthu ena omwe amakhulupirira kuti sangathe kulekerera gluten akhoza kupirira bwino, monga umboni wakuti anthu ena omwe amati ndi amphwayi amatha "kunyenga" pa zakudya popanda zizindikiro zomveka bwino.
Ndipotu, kafukufuku wambiri wapeza kuti anthu ena omwe amakhulupirira kuti ali ndi gudde samamva kuti ali ndi gluteni yeniyeni, kapena kuti ali ndi mbewu zamtundu wa gluten, akamadya zinthuzo mu phunziro lochititsidwa khungu. Ena amachitapo kanthu, zomwe zimapereka umboni wakuti mkhalidwe ulipo.
Chithandizo cha Kukhudzidwa kwa Gluten: Zakudya Zakudya za Gluten
Mofanana ndi matendawa, matenda okhawo omwe amachititsa kuti thupi la gluten limve mphamvu ndi zakudya zopanda thanzi .
Pali zotsutsana zambiri zokhudzana ndi momwe chakudyacho chimakhalira cholimba kwa munthu amene "angokhala" wodetsedwa. Madokotala ena angakuuzeni kuti mupitirize kunyenga nthawi zina, pamene ena amalimbikitsa zakudya zosasunthika za gluten.
Sizodziwikiratu ngati kutsatira zakudya zopanda thanzi kungakupatseni zithandizo zaumoyo kuposa zomwe mumangomva bwino, kapena ngati kudya masamba a gluten mukakhala ovuta kumakhudza zoopsa zaumoyo . Monga ndanenera poyamba, pakhala pali kafukufuku wochepa omwe amasonyeza kuti mukuwonongeka ndi gluten (ziribe kanthu momwe zizindikiro zomwe mumakumana nazo zingakhale zosasangalatsa). Koma palinso palibe kafukufuku wosonyeza kuti simuwonongeka. Iyi ndi malo omwe ofufuza ayamba kufufuza.
Monga ndi zonse zomwe zimakhudza kutengeka kwa gluten, pali maphunziro owerengeka okha omwe amapereka kuzindikira, ndipo kafukufuku wina wamankhwala mpaka lero wakhala akutsutsana. Pomaliza, asayansi akuyembekeza kupereka mayankho ambiri. Padakali pano, ngati mutapezeka kuti muli ndi mphamvu zowonongeka, muyenera kudzipangira nokha-mukukambirana ndi dokotala-kuti mumatsatire kwambiri zakudya zopanda thanzi.
Zotsatira:
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Biesiekierski J et al. Palibe zotsatira za gluten kwa odwala omwe amadzipangitsa kuti asamveke bwino chifukwa cha zakudya zowonjezera m'mimba, pambuyo pa kuchepetsa zakudya za fermentable, zakudya zosakanizika, zochepa. Gastroenterology . 2013 Aug; 145 (2): 320-8.e1-3.
Elli L et al. Umboni Wakuti Kukhalapo kwa Magulu Osagwirizana ndi Gluten Kuzindikira kwa Odwala Ndi Ogwira Ntchito Ogwira Mimba Zizindikiro: Zotsatira kuchokera ku Multicenter Randomized Gluten Challenge Double-Blind Placebo-Controled Challenge. Mavitamini . 2016 Feb 8; 8 (2). pii: E84.
Fasano A et al. Kusokonezeka kwa matumbo kumapangidwe ndi ma genetic immune mucosal m'maganizo awiri ogwirizanitsa: matenda a celiac ndi mphamvu ya gluten. BMC Medicine 2011, 9:23. lembani: 10.1186 / 1741-7015-9-23.
Fasano A et al. Matenda okhudzana ndi umoyo wa gluten: mgwirizanowu pa dzina latsopano ndi mndandanda. BMC Medicine . BMC Medicine 2012, 10:13 chiku: 10.1186 / 1741-7015-10-13. Lofalitsidwa: 7 February 2012
Uhde M et al. Kuwonongeka kwa Cell Intestinal ndi Kusintha Kwambiri Kwambiri kwa M'madzi mwa Anthu Aliyense Kulengeza Kuzindikira kwa Tirigu Wopanda Matenda a Celiac. Kutha . 2016. do: 10.1136 / gutjnl-2016-311964.