Kuwongolera Kugwedeza Kwambiri Kwabakiteriya Amatumbo
Ofufuza akupeza kuti kuchuluka kwa mabakiteriya a m'mimba (SIBO) kumakhudza anthu ambiri kuposa momwe ankaganizira poyamba. Ndipotu, akuganiza kuti chiwerengero cha anthu omwe amapezeka kuti ali ndi matenda opweteka kwambiri (IBS) kwenikweni ali ndi SIBO.
SIBO ndi thanzi limene muli mabakiteriya ochulukirapo m'matumbo aang'ono.
(Mu thupi labwino, kupezeka kwa mabakiteriya otere m'matumbo aang'ono ayenera kukhala osakwanira, ndipo mabakiteriya ambiri amakhalapo m'matumbo akuluakulu.) SIBO ikhoza kuyambitsa zizindikiro zosiyanasiyana-kuphatikizapo, moperewera kwambiri, kuperewera kwa zakudya . Kaŵirikaŵiri amapezeka mwa kupima kupuma, ngakhale njira zina zilipo .
Ngati mwauzidwa ndi dokotala kuti muli ndi SIBO, mudzalimbikitsidwa kuti mudziwe kuti ndizotheka. Mwachidule ichi, mudzaphunzira za njira zomwe SIBO akuchitiramo chithandizo, komanso njira zina zomwe zikufufuzidwa. Kudziwa izi kudzakuthandizani pamene mukugwira ntchito ndi dokotala kuti mupange dongosolo la mankhwala.
1) Thandizo la antibiotic
Pakali pano, chithandizo cha "golide" cha SIBO ndi mankhwala a antibiotic omwe amachepetsa kuchepa kwa bakiteriya m'matumbo aang'ono. Mankhwalawa amagwiritsidwanso kuti amachepetsa kutupa kwa chiwalo cha m'mimba mwaching'ono chomwe chingayambitse matenda osokoneza bongo.
Mwamwayi, sayansi yokhudza kugwiritsa ntchito mankhwala opha tizilombo a SIBO akadakali pachiyambi. Ochita kafukufuku amadziwa kuti zambiri zimafunika kudziŵa kuti ndi mitundu iti ya antibiotic yomwe ili yabwino kwa munthu aliyense, ndipo ndiyeso yanji ndi kutalika kwa mankhwala kudzagwira ntchito kwambiri.
Pakalipano, mankhwala oyambirira omwe amagwiritsidwa ntchito ndi Xifaxan .
Kafukufuku akusonyeza kuti Xifaxan ingakhale yothandiza kwambiri pochiza SIBO, ndi odwala ambiri omwe amapindula ndi chithandizochi. Xifaxan yasonyezedwa kuti athetse mitundu yambiri ya mabakiteriya. M'mayesero ambiri a zachipatala, zatsimikiziridwa kukhala zogwira mtima kwambiri kuposa placebo ndi mitundu ina ya maantibayotiki kuti apange zizindikiro ndi kupuma kwa zotsatira. Komabe, ochita kafukufuku akupitiriza kufufuza za mphamvu za mitundu ina ya maantibayotiki kuti athetse njira zowonjezereka zamankhwala.
Mu thupi, Xifaxan sichitha kulowa m'magazi, motero kuchepetsanso zotsatira zake ndikuwonjezera mphamvu zake zogwira ntchito mwachindunji mabakiteriya omwe ali m'mimba mwachinyamatayo. Ndipo mosiyana ndi ma antibiotic ambiri omwe mwinamwake mwakhala nawo, Xifaxan sichikhudza kwambiri mabakiteriya mkati mwa matumbo akuluakulu ndipo siziyenera kukupangitsani inu zizindikiro za m'mimba kapena matenda a yisiti omwe mwakhala mukukumana nawo ndi kalembedwe ka antibiotics . Kawirikawiri, Xifaxan imatengedwa kuti ndi mankhwala otetezeka, ngakhale kuti zotsatira zosayembekezeka zakhala zikudziwika.
Monga tafotokozera pamwambapa, palibenso mgwirizanowu wokhudzana ndi momwe mungagwiritsire ntchito nthawi yoyenera kugwiritsa ntchito Xifaxan.
M'mayesero ambiri a kachipatala, mayeza akuluakulu asonyezedwa kuti ndi othandiza kwambiri kusiyana ndi mlingo wochepa. Pochita masewera olimbitsa thupi, Xifaxan kaŵirikaŵiri imatchulidwa mu maphunziro a masabata awiri, ndi maphunziro opitidwa mobwerezabwereza. Tiyenera kukumbukira kuti, kuyambira kumayambiriro kwa chaka cha 2017, Xifaxan sinavomerezedwe ndi a FDA kuti azitsatira SIBO (ngakhale kuvomerezedwa kuchiza kutsekula m'mimba kwambiri kwa IBS ndi kutsekula m'mimba). Choncho, kulongosola Xifaxan kwa SIBO kumatengedwa ngati "off-label" ntchito.
Ngakhale kuti Xifaxan ikuyenda bwino, SIBO imabwereranso, choncho odwala nthawi zambiri amafunika maphunziro angapo kuti athandizidwe mokwanira.
Kwa ena, mankhwala oposa ma antibiotic angapangidwe nthawi yomweyo. Kwa ena, kuthetsa vuto lachipatala kapena kusintha zakudya ndi zizoloŵezi za moyo kungakhale kofunikira.
2) Mauthenga Otsutsana Ndi Mauthenga
Chithandizo cha antibiotic monga momwe tanenera pamwambapa ndi njira yoyamba yothandizira SIBO mwa anthu omwe palibe chifukwa chothetsera vutoli. Komabe, nthawizina pali vuto lalikulu la thanzi limene likufunika kuthandizidwa kuti athetse chirichonse chomwe chikulimbikitsa mabakiteriya ochulukirapo m'matumbo aang'ono. Vutoli likhoza kukhala matenda kapena lingakhale chinthu chomwe chimakhudza kapangidwe kamene kakang'ono ka m'mimba.
Matenda owopsa: Zitsanzo zina za matenda opatsirana omwe amachititsa kuti SIBO iyambike ndizo zomwe zimawononga mofulumira m'mimba kapena m'mimba, monga gastroparesis kapena dysmotility. Izi zikhoza kuchiritsidwa ndi mankhwala a prokinetic.
Chitsanzo china ndi matenda a celiac , monga apeza kuti anthu omwe ali ndi matenda a Celiac ali pachiopsezo chachikulu cha SIBO. Kwa anthuwa, kutsatira kwambiri zakudya zopanda thanzi (zofunika pa umoyo wawo!) Kungathandizenso kusintha zizindikiro.
Zowonongeka: Zotsatirazi ndi zitsanzo za zolakwika zomwe zingathandize kuti SIBO ikhale yolimba. Zina mwa zolakwika zimenezi zingakhale zoyenerera kudzera opaleshoni.
- Loops zakhungu
- Kulepheretsana
- Diverticula imapezeka m'matumbo aang'ono
- Fistula
- Matenda aang'ono a m'mimba
- Miyeso
SIBO ikhonza kuonanso ndi anthu omwe ali ndi colectomy (osadziwika kuti ndi ochepa), chifukwa cha kuwonongeka kwa valve ya ileocecal yomwe ingalole kuti mabakiteriya a colonic alowe mmbuyo m'mimba yaing'ono. Kuonjezera apo, kuyendetsa kang'onopang'ono kwa m'mimba, chifukwa cha colectomy, kukhoza kuyambitsa mabakiteriya kuti afalikire.
Zotsatira za mankhwala: Nthaŵi zina, mankhwala omwe amagwiritsidwa ntchito pochiza matenda ena amtheradi angakhale akuthandizira ku zikhalidwe zomwe zimalimbikitsa SIBO. Kusiya ntchito zawo kungathandize kuchepetsa zizindikiro za SIBO. Mankhwalawa ndi awa:
- Mankhwala othandizira odwala (omwe amaperekedwa kuti apweteke)
- Proton pump inhibitors (PPIs) (kawirikawiri amaperekedwa kwa GERD)
3) Zowonjezera Zakudya
Zakudya zothandizira SIBO zimayesetsanso kuthana ndi kuchepa kwa zakudya kapena kulumikiza SIBO mwachindunji pogwiritsa ntchito zakudya zinazake.
Kulimbana ndi Zofooka Zakudya: Ngati mwapezeka ndi SIBO, muyenera kugwira ntchito ndi dokotala kuti muzindikire ndi kuthetsa vuto lililonse la zakudya. Zakudya ziyenera kutengedwa chifukwa cha mavitamini ndi mchere ngati awa alionse:
- Vitamini A
- Vitamini B12
- Vitamini D
- Vitamini E
- Calcium
- Magnesium
Ngati dokotala akukhulupirira kuti steatorrhea ndi / kapena mtundu wina wa mafuta malabsorption alipo, angakulimbikitseni kuti mutenge suppress enzymes .
Chakudya Chakumayambiriro: Zakudya zoyambirira zimaphatikizapo zakudya zonse zomwe zimayambitsa kudya zakudya zina. Akatswiri ena othandizira zaumoyo akulimbikitsa kugwiritsa ntchito zakudya zoyambirira monga njira yosagwiritsira ntchito mankhwala pochitira SIBO. Phunziro limodzi lachipatala linayendetsedwa pamene ambiri mwa iwo adapeza kuchepetsa zizindikiro, ndi kuwerengera kafukufuku wa kupuma, pambuyo pa masabata awiri pa zakudya zoyambirira.
Mwachiwonekere, kufufuza kwina kuyenera kuchitidwa kuti tiwone ngati chakudya chovuta kutsatira ndi chithandizo choyenera cha SIBO. Ndibwino kuti musayese izi kunyumba mwakukonzekeretsani nokha chifukwa cha kufooka kwakukulu kwa zakudya, zomwe zingachititse kuti thanzi lanu likhale pangozi.
Zakudya Zochepa-FODMAP: Chakudya chochepa cha FODMAP chinapangidwa kuti chichepetse zizindikiro za IBS mwa kuchepetsa kanthawi kochepa chakudya cha FODMAP, zakudya zomwe zimapezeka mu zakudya zomwe zingathe kuchititsa zizindikiro za IBS. Ndi SIBO, mitundu iwiri yosiyanasiyana ya FODMAP , lactose ndi fructose, ikhoza kukhala ndi malabu chifukwa cha kutupa pamtunda wa m'mimba. Kuwonjezera pa izi ziwiri, ma FODMAP ena omwe sali odziwika akhoza kuyaka ndi mabakiteriya omwe akukhala osayenera m'matumbo aang'ono, omwe amachititsa kuti ziphuphu komanso zizindikiro zina zowonongeka zikhale zowonongeka.
Choncho, chakudya chochepa cha FODMAP chikhoza kukhala chothandiza kwa SIBO chifukwa kuchepetsa zakudya zamagazi kungakhale "njala" mabakiteriya m'matumbo aang'ono. Komabe, monga pano palibe maphunziro a zachipatala pankhaniyi. Momwemonso, mphamvu ya chakudya chochepa cha FODMAP kwa anthu omwe ali ndi IBS amatha kunena kuti zotsatira za zakudya pa SIBO zomwe sizinazindikiridwe, koma panopa, izi ndi zongoganizira chabe.
Zambiri sizikudziwika kuti zoyenera kudya za FODMAP ndizoyenera kwa munthu amene akumwa mankhwala a SIBO pakalipano. Zikudziwika kuti zakudyazo zingachepetse mphamvu ya mankhwala ophera tizilombo chifukwa choika mabakiteriya mu dormancy. Choncho, kawirikawiri amalimbikitsidwa kuti munthu adye zakudya zoyenera pamene ali ndi mankhwala ophera tizilombo ndikutsatira zakudya zochepa za FODMAP pambuyo poti mankhwalawa atsirizidwa ngati njira yotetezera kubwerera kwa SIBO.
Monga momwe mukuonera, udindo wa zakudya muyambe, kusamalira, ndi chithandizo cha SIBO sichimvetsetsedwa bwino. Tikukhulupirira kuti kupitiriza kufufuza pa nkhaniyi kudzatithandiza kudziwa zambiri zokhudzana ndi mgwirizano pakati pa zakudya ndi SIBO.
Tsogolo la Chithandizo cha SIBO
Pamene SIBO ikupatsidwa chisankho chowonjezereka, mankhwala atsopano akhoza kuwonekera. Kafukufuku wochititsa chidwi kwambiri ndi chitukuko cha zipangizo zamakono zomwe zimapereka mphamvu yodziwira bwino kukhalapo ndi mtundu wa mabakiteriya omwe ali m'mimba mwachinyamatayo. Padakali pano, mankhwalawa mu gawo ili ndi zinthu zonse zomwe zikuyang'aniratu kuti zikhale zotetezeka komanso zogwira mtima kwa SIBO.
Makhalidwe a Zitsamba
Pali phunziro limodzi lomwe lafalitsidwa lomwe mchitidwe wa mankhwala akupezeka kuti ndi wovuta kwambiri monga Xifaxan pochiza SIBO. Mankhwala a zitsamba amachitiranso lonjezo monga njira yopewera zotsatira za mankhwala ophera maantibayotiki, pochiza omwe mankhwala omwe amachiza maantibayotiki samagwira ntchito, ndi / kapena pofuna kupewa SIBO.
Prokinetic Mankhwala
Monga tafotokozera pamwambapa, mankhwala opatsirana, omwe amagwiritsidwa ntchito kwa anthu omwe ali ndi matenda a motility, angakhale othandiza pochiza SIBO. Kufufuza koyamba kumasonyeza kuti kugwiritsa ntchito mankhwalawa kungakhale kothandiza makamaka kwa omwe SIBO ilipo pamodzi ndi scleroderma . Mankhwala oterewa amaganiziridwa kuti ndi othandiza kwa SIBO, pamene amalimbikitsa mphamvu ya "mawonekedwe okuyeretsa" a m'mimba mwake kuti asambe mabakiteriya.
Mapulojekiti
Mwachidziwitso, ma prostbio angapangitse zothandizira kuchiza SIBO chifukwa adasonyezedwa kuti ali ndi zotsatira zabwino pa bakiteriya, kupititsa thanzi lakumtunda, ndi kuchepetsa kutupa. Komabe, kufufuza kwakukulu pazothandiza za ma probiotics pakuchiza SIBO kulibe.
Kuletsa Kubwerera
Monga tanenera pamwambapa, ngakhale kuti SIBO yatsutsidwa bwino pogwiritsa ntchito Xifaxan, chiopsezo chobwezeretsa chikhoza kukhala chokwanira kwambiri. Palibe zambiri zomwe zimadziwika ngati maphunziro opatsirana kapena omwe angakonzedwe ka mankhwala a antibiotic angakhale othandiza popewera kubwerera. Kuyambira panopa, njira yabwinoyi ndi njira yomwe anthu amasinthira zakudya zawo motsatira njira yothetsera maantibayotiki ngati njira yowonjezera kusungira zizindikiro, komanso kuti azigwiritsa ntchito mankhwalawa mobwerezabwereza.
Monga tafotokozera pamwambapa, kumvetsetsa kuti zomwe zakudyazo zimasintha zingakhale ngati osauka. Zingakhale zothandiza kutsatira chakudya chochepa cha FODMAP kwa kanthawi kochepa. Zingakhalenso zothandiza kupewa zakudya zomwe zimakhala ndi zotsekemera monga aspartame, saccharin, ndi sorbitol, zomwe zimatha kukhala ndi mabakiteriya omwe ali m'mimba mwachinyamatayo. Ngati mwapeza, pogwiritsa ntchito mpweya woyesera kapena kutaya zakudya, kuti mwina mukumana ndi lactose kusagwirizana kapena fructose malabsorption , mungapewe zakudya zomwe zili ndi shuga izi chifukwa chomwecho.
> Zotsatira:
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