Kodi inu kapena dokotala wanu mumaganizira kuti matenda a m'mimba oyambitsa matumbo aang'ono (SIBO) amadziwika ngati chidziwitso cha zizindikiro zanu zamkati za m'mimba? Kafukufuku wogwira mtima akusonyeza kuti SIBO ndi matenda osadziŵika bwino amene kupezeka kwawo kumafunika kudziwika kapena kulamulidwa kwa anthu omwe akukumana ndi mavuto omwe amatha kupuma.
Monga pali mankhwala omwe alipo kwa SIBO, kuzindikira kuti kupezeka kwake kumatsegula chitseko cha mpumulo wa zizindikiro.
Dokotala wanu ali ndi zisankho zitatu zomwe angakulimbikitseni kuti mupeze SIBO. Pano mungaphunzire pang'ono za njira iliyonse, zomwe mudzafunika kuchita musanakumane ndi mayesero kuti mukonzeke molondola, ndi zomwe muyenera kuyembekezera pa yeseso.
Ndani ayenera kuyesedwa kwa SIBO?
Chifukwa cha nkhawa imene anthu ambiri saidziwa kuti ali ndi matenda a m'mimba (IBS), ofufuza akulimbikitsa kuti aliyense amene ali ndi zizindikiro zowononga, kupweteka m'mimba, ndi kutsekula m'mimba ayenera kuyesedwa kwa SIBO. SIBO iyeneranso kutetezedwa kwa aliyense yemwe akusonyeza zizindikiro za kuchepa kwa zakudya.
Kuyeza kwa SIBO kumalimbikitsidwanso kwa aliyense amene akudwala zizindikiro za matendawa ngakhale kuti akudwala bwino: matenda opatsirana , Crohn's disease ndi scleroderma . Otsatira, SIBO amayesedwa kwa aliyense yemwe ali ndi matenda a celiac , koma amene akupitirizabe kuona zizindikiro ngakhale kuti amadya zakudya zopanda thanzi.
Kuyesedwa kwa Mpweya
Kuyesedwa kwa mpweya ndi mayeso osasokonezeka omwe amagwiritsidwa ntchito mobwerezabwereza monga njira yodziwira kapena kutulutsa SIBO. Chiyesochi chimayesa kuyesa kukhalapo kwa haidrojeni kapena methane mpweya panthawi yomwe munthu amamwa madzi omwe amakhala ndi shuga, monga shuga kapena lactulose.
Kukhalapo kwa hydrogen mu mpweya musanafike pamphindi 90 kumaganiziridwa kusonyeza kuti mabakiteriya amakhalapo m'matumbo aang'ono pamene akugwirizanitsa ndi shuga wotentha ndikumasula haidrojeni kapena methane, yomwe imatulutsidwa kudzera mpweya. Nthawi yochepetsedwayi imadalira kuti nthawi zambiri amatenga maola awiri kuti shuga wathyola amatha kufika mabakiteriya omwe amapezeka mkati mwa matumbo akuluakulu, omwe amapezeka m'madera oterewa.
Ngakhale kuti amagwiritsidwa ntchito kwambiri, nkhawa zokhudzana ndi kuyesa kupuma kwa SIBO zakulira. Chinthu chimodzi chodetsa nkhaŵa kwambiri ndi chakuti mayesero amabweretsa zotsatira zabwino zabodza, makamaka kwa anthu omwe amatha nthawi yofulumira kudya chakudya kudzera m'matumbo, kapena zotsatira zoipa zabodza, makamaka mwa anthu omwe ali ndi gastroparesis (kutaya pang'ono m'mimba).
Kuonjezera apo, palibe chigwirizano pazinthu zabwino zogwirira ntchitoyi, komanso palibe mgwirizano pa momwe mpweya uliri mu mpweya umakhala ndi zotsatira zabwino zoyesa. Koma ngakhale izi zikudetsa nkhaŵa, kuphweka ndi chitetezo cha mayesero ndi zifukwa zazikulu chifukwa iyi ndiyo njira yotchuka kwambiri yoyesa SIBO.
Mmene Mungakonzekerere Sitifiketi ya Phungu ya SIBO
Choyamba, muyenera kusankha malo oyesera omwe amayesa kukhalapo kwa hydrogen ndi methane. Mukatha kuchita zimenezi, dokotala wanu kapena malo oyesera okhawo adzakupatsani malangizo enieni a momwe akufuna kuti mukonzekere kuyesedwa. Ndikofunika kuti muzitsatira malangizo awo mosamala kuti mukwaniritse zolondola zanu. Nazi mfundo zina zomwe zingakonzedwenso kwa inu:
- Mwezi umodzi usanayambe: Musagwiritse ntchito mankhwala oyeretsa pakoloni (monga omwe amagwiritsidwa ntchito asanayambe colonoscopy ).
- Zaka ziwiri zisanachitike: Musatenge antibayotiki kapena maantibiotiki.
- Mlungu umodzi usanayambe: Musagwiritse ntchito mankhwala ofewetsa ofewa , ma fiber supplement or stool softeners .
- Maola 48 asanakhalepo: Pewani zakudya zakumwa zam'madzi ndi zakudya zopanda zakudya, makamaka mikate yonse ya tirigu kapena pastas. Mukhoza kudya nsomba yophika kapena nkhuku, mkate woyera kapena mpunga, mbatata, ndi khofi ndi tiyi. Ngati mukumwa mankhwala kwa GERD, kambiranani ngati simukuyenera kumwa mankhwala masiku omwe akutsogolera. Kawirikawiri ndibwino kuti musiye kugwiritsa ntchito mankhwala aliwonse a prokinetic, koma kuti mupitirize ndi mankhwala a PPI.
- 12 maola oyambirira: Musadye kapena kumwa chirichonse. Izi zikuphatikizapo gamu ndi maswiti. Ngati mumasuta musasute. Musamagwiritse ntchito masewera olimbitsa thupi, monga kuchita masewera olimbitsa thupi kungathetse zotsatira za mayeso
Zimene muyenera kuyembekezera Mukamayesedwa mu SIBO
Pamene mayeso ayamba, mungafunsidwe kuti mutsuke pakamwa panu ndi mouthwash kuti muchotse malo a mabakiteriya aliwonse amene angakhaleko. Mudzafunsidwa kuti mupereke chitsanzo choyambirira cha kupuma, makamaka poyesa buluni. Mudzapemphedwa kumwa zakumwa zamadzi zomwe zili ndi shuga kapena lactulose.
Mphindi 15 iliyonse mudzafunsidwa kuti mupereke chitsanzo china cha kupuma mwa kuwomba buluni. Ngati nyembazi zimakhala ndi shuga, mukhoza kuyembekezera kuti mayeserowa akhale maola awiri. Ngati chitsanzo cha madzi ndi lactulose, mutha kuyembekezera kuti mayeserowo akhale maola atatu.
Jejunal Aspiration (Chitsanzo Chimene Chinatengedwa Panthawi Yopitirira Kumapeto)
Zowonjezereka zambiri, koma zogwirizana mozama kuti zizindikire SIBO kusiyana ndi kuyesera mpweya, ndi mayeso omwe amatchedwa "jenial aspiration." Ndondomekoyi imachitika panthawi yopuma ndipo imafuna kuti chitsime cha madzi chimachotsedwe pakati pa gawo la matumbo ako. Chitsanzocho chimakambidwa ndikuyesedwa chifukwa cha kukhalapo kwa mabakiteriya.
Cholinga cha Jejunal sichigwiritsidwa ntchito nthawi zambiri. Zowonongeka zake ndizofunika kwambiri, nthawi yowonjezera, ndipo nthawi zambiri zimakhala zotetezeka, zimakhalabe zoopsa kuposa kupuma kwa mpweya. Ndondomekoyi imakhalanso ndi malire pofotokoza bwino kukhalapo kwa SIBO.
Ziphuphu zitha kuchitika chifukwa kukula kwa bakiteriya kumakhala kosiyana ndi zomwe zinachitidwa (mwachitsanzo, kupitirira m'mimba mwazing'ono). Zifukwa zina za zotsatira zowononga zolakwika zimaphatikizapo zitsanzo zomwe sizing'ono kapena kuti chikhalidwe chogwiritsidwa ntchito chinali chimodzi mwa mabakiteriya ena omwe sakula.
Chinthu cholakwika chingachitike ngati chitsanzocho chinadetsedwa chifukwa cha mabakiteriya omwe ali pakamwa, pa zipangizo zomwe amagwiritsidwa ntchito, kapenanso pogwiritsa ntchito zovutazo. Ndipo muzochitika zamagwiridwe nthawi zonse mosiyana ndi kafukufuku wa kafukufuku, madokotala akhoza kukhala otengera chitsanzo cha duodenum, gawo loyamba la matumbo aang'ono, mosiyana ndi jejunum. Mosasamala kanthu za zofooka zonsezi, ofufuza ambiri amawona jenial aspiration monga "muyezo wa golide" wa kuyesa SIBO.
Mmene Mungakonzekerere Kutentha kwa Jejunal
Dokotala wanu kapena malo oyesera adzakupatsani malangizo a zomwe mungachite kuti musakonzekeretsedwe. Mwinamwake malangizowa adzakhala ofanana ndi malangizo a kuyesera kupuma. Kusiyana kokha kumene kungakhale kokha kwa inu ngati muli ndi gastroparesis . Zikatero, monga mukulimbikitsira kuti mutenge chakudya chamadzimadzi kwa masiku atatu musanakhale mayeso.
Zimene muyenera kuyembekezera Mukamalowa mu Jjunjeni
Chiyesochi chidzachitika ku ofesi ya dokotala kapena pamalo oyesera. Poyambitsa ndondomekoyi, oyang'anitsitsa akhoza kuikidwa m'thupi lanu kuti dokotala akhoze kuyang'ana kupuma kwanu, kuthamanga kwa mtima, ndi kuthamanga kwa magazi. Vuto la IV likhoza kuyambitsidwa ndipo mudzalandira sedation yofatsa yomwe idzakupumulitsani, koma simungayambe mukutulutsa.
Kenaka, kupweteka kwapweteka kwamtundu wa magazi kudzaponyedwa pamtima pako. Kenaka kachidutswa kakang'ono kamene kadzaikidwa pansi pamtima pako. Simudzatha kulankhula, koma mutha kupuma. Dokotala wanu atenga zitsanzo zamadzimadzi m'matumbo anu aang'ono pogwiritsa ntchito catheter.
Mutangomaliza kukonza, chubuyo idzachotsedwa pamtima pako. Mukangomaliza, mutha kupuma kwa kanthawi kuti anesthesia ayambe kutaya. Ndikofunika kudziwa kuti chifukwa njirayi imafuna kuti munthu azikhala mowa, simungaloledwe kuyendetsa pakhomo potsatira chiyeso.
Kwa tsiku lonse la mayeso muyenera kusunga ntchito yanu kuchepa. Anthu ena amamva zotsatira zofewa monga kukhumudwa, kuphulika, kupweteka, kapena kupweteka kummero. Ngati mukukumana ndi zizindikiro zovuta, zachilendo, kapena zoopsa (monga kusanza kapena kukhetsa magazi), muyenera kuonana ndi dokotala mwamsanga.
Mayeso a Mankhwala
Njira yodziwika bwino ya madokotala kuti ayese kupezeka kwa SIBO ndi kugwiritsa ntchito mayeso a mankhwala a SIBO. Kupumula kwachizindikiro mwamsanga kumatanthauza kuti SIBO analipo.
Mankhwala omwe amagwiritsidwa ntchito kwambiri kwa SIBO ndi Xifaxan , omwe ndi antibiotic. Xifaxan ndi yosiyana ndi ma antibayotiki ambiri omwe mumadziwa nawo ngati sakudziwa thupi lanu m'mimba mwanu. M'malo mwake, amachitira m'deralo pa mabakiteriya aliwonse amene angakhale m'mimba mwao.
Ngakhale kuti palibenso miyezo yowonjezeramo nthawi, madokotala angasankhe kutsata malangizo a FDA kuti agwiritse ntchito Xifaxan pochiza kutsegula m'mimba kwambiri IBS (IBS-D). Zotsatira izi zimalimbikitsa kuti mankhwala atengedwe kwa milungu iwiri, ndiyeno mobwerezabwereza kwa sabata limodzi kapena awiri.
Mofanana ndi njira zina ziwiri, pali zoperewera ndi njira iyi "kuyesa". Chifukwa chimodzi, monga momwe mukuonera, palibe malangizo okhudza momwe maantibayotiki ayenera kukhalira. Palibenso zitsogozo zokhudzana ndi zomwe zimawoneka kuti ndizoyankhidwa bwino kwa mankhwala. Zonsezi zikukayikitsa kuti mungakhale mukumwa mankhwala ochepa kwambiri kapena ochepa kwambiri.
Tsogolo la kuyesa SIBO
Ochita kafukufuku akuyesetsa kumvetsetsa bwino za SIBO, komanso momwe angakwaniritsire njira zoyesera zogonana. Tikuyembekeza kuti m'tsogolomu, madokotala adzatha kuzindikira bwino kupezeka kwa SIBO, kuphatikizapo kuti mitundu yambiri ya mabakiteriya ikufalikira m'mimba mwa munthu aliyense ndikupereka zizindikiro zawo.
> Chitsime:
> Bohm M, Siwiec RM, Wo JM. "Kuzindikira ndi Kusamalira Mimba Yambiri ya Bakiteriya Yamkati Amatenda" Zakudya Zakudya Zamakono 2013; 28 (3): 289.299.
> Bures J, Cyrany J, Kohoutova D, et al. "Matenda aang'ono a mabakiteriya oyambitsa matenda a m'mimba." World Journal of Gastroenterology 2010; 16 (24): 2978-2990.
> Grace E, Shaw C, Whelan K, Andreyev H. "Mfundo yowonongeka: kuchepa kwabakiteriya kakang'ono ka m'mimba - kuchulukira, zochitika zachipatala, zamakono komanso kupanga mayesero opatsirana, ndi mankhwala" Pharmacology and Therapeutics 2013; 38 (7): 674-688 .
> Salem A, Roland BC "Kugwidwa kwa Bakiteriya Ochepa Kwambiri M'thupi (SIBO)" Journal of Stomach & Digestive System 2014; 4: 225