Matenda a nthenda ya nthenda (NBS) ndi vuto limene munthu anakumana nalo lakumva kupweteka kwa m'mimba ndi zizindikiro zina za m'mimba chifukwa chomwa mankhwala ochizira opioid. Kugwiritsa ntchito mankhwala osokoneza bongo sikuyenera kukhala nthawi yaitali, monga momwe matenda amatha kukhalira patatha masabata angapo ogwiritsidwa ntchito. Mu NBS, kuwonjezeka kwa kupweteka sikungachepetse ngakhale palikuwonjezeka kwa mankhwala osokoneza bongo.
Mankhwalawa amatha kuwonjezereka ululu wotsatira. Zimagwiritsidwa ntchito kuti mankhwala osokoneza bongo opiate amatha kusintha kusintha kwa mitsempha ndi minofu m'magazi am'mimba omwe amachititsa kuti muzimva kupwetekedwa mtima komanso kuchepa kwa mankhwala ena.
Mmodzi samasowa kuti akhale ndi mbiri ya matenda oyambitsa matenda osakanikirana kuti apange NBS. Amatha kukhala ndi munthu aliyense amene amamwa mankhwala osokoneza bongo pambuyo pochita opaleshoni kapena ngati chithandizo chakumva ululu uliwonse. Anthu omwe ali ndi zizindikiro za matenda osapitirira malire kuchokera ku ma GI omwe amagwira ntchito monga IBS, kapena matenda ena osadya, monga IBD kapena diverticulitis , angapange NBS chifukwa madokotala awo alamula mankhwala osokoneza bongo pofuna kuchepetsa ululu m'mimba mwazimenezo. Kawirikawiri madokotala sakudziwa kuti mankhwala awo oledzera angakhale akuchititsa kuti vutoli likhale loipitsitsa.
Iwo amati ndi chiwerengero cha anthu omwe ali ndi NBS akukwera.
Ndi zovuta kwambiri kuwerenga kuti United States, yomwe ilipo pafupifupi 5 peresenti ya anthu padziko lapansi, imakhala 80% ya mankhwala osokoneza bongo padziko lapansi.
Zizindikiro
Kupweteka m'mimba ndi chizindikiro chachikulu cha NBS. Zizindikiro zina ndizo:
- Kutsekedwa
- Gasi ndi kuphulika
- Kutaya njala ndi / kapena kulemera
- Nausea
- Kuthamanga
Odwala ena a NBS amanena kuti kudya kungapangitse zizindikiro zowawa. Izi zingachititse kuti munthu asadye zakudya, zomwe zimachititsa kuti thupi liwonongeke.
Nthawi zina, X-ray ya mimba ikhoza kusonyeza kuti zimakhala zoletsedwa m'matumbo, pomwe kwenikweni zimangokhala zosavuta kuti zikhale ndi mpweya ndi mpweya, zomwe zimayambitsa matenda a m'mimba kapena mazira.
Chithandizo
Chithandizo choyamba ndicho kusiya kumwa mankhwala osokoneza bongo. Kwa ena, ndondomekoyi idzachitika pang'onopang'ono, komabe pazinthu izi zingathe kuchitika mofulumira. Kutalika kwa nthawi yomwe ikufunika kuchotsa kumwa mankhwala kumagwirizana ndi nthawi yayitali yomwe wakhala akugwiritsa ntchito mankhwala osokoneza bongo. Mwa kuyankhula kwina, munthu amene amapanga NBS mwamsangamsanga opaleshoniyo sangafunike njira yotsalira ngati munthu amene wakhalapo.
Kuletsa kumwa mankhwalawa kumagwiritsidwa ntchito limodzi ndi mankhwala ena ndi mankhwala omwe amathandiza kuchepetsa zotsatira za kuchotsa komanso kupereka njira zina zoperekera ululu. Nthaŵi zambiri, izi zikhoza kuchitika pamtunda. Komabe, odwala omwe akukumana ndi nseru, kusanza kapena zizindikiro za m'matumbo a chiberekero kapena kutsekedwa kwachinyengo kungafunikire kuchipatala.
Zingakhale zovuta kwa odwala kuganizira za kudzipukuta okha mwa mankhwala awo monga mankhwala omwe angapereke mpumulo.
Komabe, pa nthawi ya NBS, nkofunika kuzindikira kuti mankhwala osokoneza bongo akuchepetsanso matumbo ndikuthandizira kupweteka ndi zizindikiro zina zomwe zimayambitsa matenda.
Mankhwala ena a NBS ndi awa:
- Kudwala nkhawa, chifukwa cha kupweteka kwawo.
- Mankhwala odetsa nkhaŵa kuti athetse vuto la maganizo a kuchotsa njoka.
- Mankhwala opatsirana maganizo, monga CBT , kuti asamalire kupweteka.
- Naltrexone imathandiza anthu kupeŵa kugwiritsa ntchito mankhwala osokoneza bongo.
Madokotala ambiri amachiza NBS mofanana ndi momwe angapangire kudzimbidwa kwa opioid (OIC), pomwepo mankhwala monga Relistor (methylnaltrexone) adzalangizidwa.
Zotsatira:
Grunkemeier, D., et.al. "Narcotic Bowel Syndrome: Clinical Features, Pathophysiology ndi Management" Clinical Gastroenterology ndi Hepatology 2007 5: 1126-1122.
Minocha, A. & Adamec, C. (2011) The Encyclopedia of the Digestive System ndi Digestive Disorders (2nd Ed.) New York: Mfundo pa Fayilo.