So wo nso wo yafunu mu acid sua? Wɔfrɛ eyi hypochlorhydria!

So wotaa nya aduan a ɛnyɛ yiye, wo koma yɛ wo yaw, anaa wo koma yɛ wo yaw? Yɛtaa susuw sɛ yafunu mu acid anaa yafunu mu yare pii na ɛde eyinom ba. But did you know that even if there is not enough stomach acid, that is, low acid, these symptoms can also occur ? Ɛno ne nea yɛfrɛ no hypochlorhydria wɔ aduruyɛ mu. Sɛ yɛbɛka no tiawa a, eyi kyerɛ sɛ hydrochloric acid (HCl), acid titiriw a ɛwɔ wo yafunu mu no so tew. Enti, ɛnnɛ yɛbɛka eyi ho asɛm akɔ akyiri.

Dɛn ne hypochlorhydria?

Sɛ yɛbɛka no tiawa a, hypochlorhydria yɛ bere a wo yafunu no ntumi nnya hydrochloric acid (HCl) a ɛdɔɔso. Hydrochloric acid ne acid titiriw a ɛyɛ den sen biara a yɛn yafunu yɛ. Ɛho hia ma yɛn aduan mu nhyehyɛe ne yɛn nipadua mu tumi a ɛko tia nyarewa no nso.

Susuw ho hwɛ, saa acid yi boa ma aduan a yedi, titiriw protein, no mu paapae na ɛyam yiye. Ɛho hia nso ma aduannuru a yɛn nipadua hia, sɛ nhwɛso no, vitamin B12 ne dade a ɛtwetwe. Ade foforo nso ne sɛ saa acid yi nso boa ma yesiw mmoawa ne mmoawa a wopira a wɔde aduan hyɛn yɛn yafunu mu no so, na ɛbɔ yafunu no ho ban fi nyarewa ho.

Enti, sɛ wowɔ hypochlorhydria a, ɛyɛ den ma wo sɛ wobɛyam aduan yiye, titiriw protein. Bere kɔ so no, eyi betumi ama obi anya aduannuru a ɛho yɛ na kɛse . Ɛnyɛ ɛno nko, na mmom ɛyɛ mmerɛw sɛ wubenya nyarewa ahorow nso. Saa nyarewa yi betumi asɛe wo yafunu ne wo aduan mu nneɛma nyinaa bio.

Nsonsonoe bɛn na ɛda Hypochlorhydria ne Hyperchlorhydria ntam?

Saa nsɛmfua abien yi di nsɛ kakra, enti wobetumi afrafra. Sɛ nhwɛso no, "Hypo-" kyerɛ sɛ "ɛsua." "Hyper-" kyerɛ sɛ "ɛboro saa."

Ɛno kyerɛ sɛ:

• Hypochlorhydria yɛ tebea a ɛma yafunu no ntumi nyɛ hydrochloric acid (HCl) kakraa bi dodo.
• Hyperchlorhydria yɛ hydrochloric acid (HCl) a ɛba yafunu mu dodo.

Nnipa pii a wɔwɔ yɛn man yi mu, sɛ wonya yafunu mu yare ne yafunu mu yare ho sɛnkyerɛnne a, wosusuw sɛ nea ɛde ba ne yafunu mu acid a ɛkɔ soro, a wɔfrɛ no hyperchlorhydria. Ɛno nti na wɔtaa de nnuru a ɛtew acid so di dwuma no.

Nanso nea ɛyɛ nwonwa no, ebia sɛnkyerɛnne ahorow a ɛtɔ mmere bi a wuhu, te sɛ komayare ne dɛ a ɛyɛ akisikuru wɔ wo menewam (acid reflux anaa laryngopharyngeal reflux) no fi yafunu mu acid a ɛba fam, anaasɛ hypochlorhydria!

Wobɛyɛ dɛn ahu saa? Sɛ yafunu mu acid no sua a, aduan no ntumi nwe yiye. Afei, saa aduan a wɔanwe yi ma mframa a ɛyɛ kurukuruwa ba yafunu no mu. Sɛ mframa a ɛyɛ ahurututu yi kɔ soro a, yafunu mu acid no bi tumi foro kɔ aduan no mu kɔ menewa no mu. Afei, acid kakraa bi a ɛkɔ menewam mpo betumi ama woate nka sɛ wowɔ "acid pii dodo." So wote ase?

Ɔkwan bɛn so na hypochlorhydria ka yɛn nipadua?

Yafunu mu acid nyɛ ade a efi mu ba kɛkɛ. Ɛho hia ma yɛn akwahosan wɔ akwan pii so.

Asiane a ɛwɔ aduannuru a wonnya nni mu

Sɛnea yɛadi kan aka no, yɛn nipadua hia yafunu mu acid pa na ama atumi atwe protein, vitamin B12, ne mineral afoforo pii yiye. Enti, sɛ acid yi sua a, nipadua no ntumi nsɛe aduannuru yi yiye na ennye. Ne saa nti, aduan a wɔanwe ne aduannuru a enni mu ba.

• Protein ne vitamin B12 a enni nipadua mu no betumi ama mogya a ɛtɔ kɔ nipadua mu a dade nnim, ne mogya a enni nipadua mu nso. Saa tebea horow yi nso ka yɛn ntini ahorow.
• Calcium ne magnesium a enni nipadua mu no betumi ama nnompe ayɛ mmerɛw, tebea bi a wɔfrɛ no nnompe mu yare.

Ɔhaw ahorow a ɛba bere tenten a ɛma aduan mu yɛ den

Wɔ bere tiaa mu no, sɛ wunya aduan a wonnyae wɔ wo aduan mu a, ebetumi ama wo yafunu ayɛ wo yaw kɛse. Bere tenten mu no, eyi betumi de ɔhaw ahorow a emu yɛ den kɛse aba.

Sɛ nhwɛso no, nnuan a wɔanwe no betumi ayow wɔ dwensɔtwaa no mu, na ama mmoawa a wɔmpɛ anyin wɔ dwensɔtwaa ketewa no mu. Wɔfrɛ eyi ``Small Intestin Bacterial Overgrowth (SIBO)``.

Ɛnyɛ ɛno nko, sɛ yafunu mu acid so tew a, mmoawa a wɔtaa yɛ te sɛ `H. pylori` nso tumi nyin a wontumi nni so. Saa `(H. pylori)` mmoawa yi yɛ ade titiriw a ɛde yafunu mu yare a enni sabea ne yafunu mu akisikuru ba.

Dɛn nti na hypochlorhydria ba? Dɛn ne nneɛma atitiriw a ɛde ba?

Nneɛma atitiriw pii nti na tebea yi ba:

Atrophic yafunu mu yare

Eyi ne ade a ɛtaa de hypochlorhydria ba. Atrophic gastritis yɛ tebea a nkwammoaa a ɛma acid fi yafunu no mu no wuwu nkakrankakra na entumi nyɛ adwuma yiye. Eyi ba esiane yafunu no mu ɔfe a ɛtra hɔ kyɛ a wɔfrɛ no yafunu mu yare a enni sabea nti. Nneɛma pii na ɛde yafunu mu yare a enni sabea ba. Nhwɛso ahorow bi ne mmoawa a wɔde nyarewa ba (titiriw H. Pylori), nsa a wɔnom boro so, ne nyarewa bi a nipadua no tumi ko tia nyarewa.

H. pylori yare mmoawa

Eyi yɛ ɔyare mmoawa a abu so yiye. Sɛnea akontaabu bi kyerɛ no, nnipa a wɔwɔ wiase no mu bɛyɛ fã na wɔanya saa ɔyare yi. Nnipa binom tumi nya saa mmoawa yi wɔ wɔn nipadua mu a wonni sɛnkyerɛnne biara. Nanso wɔ nnipa binom fam no, saa mmoawa yi nyin ntɛmntɛm wɔ wɔn nipadua mu, na ɛmma yafunu mu acid ntumi nyɛ adwuma, na bere kɔ so no, ɛtew acid dodow so. Nea ɛyɛ nwonwa no, yafunu mu acid a ɛso tew no nso ma tebea pa ba ma mmoawa `(H. pylori)` nyin.

Nnuru a ɛtew acid so a wɔbɛkɔ so de adi dwuma

Nnuru te sɛ antacids, H2 receptor blockers, ne titiriw no proton pump inhibitors (PPIs) a wɔde di dwuma bere tenten nso yɛ ade titiriw a ɛma yafunu mu acid so tew.

Fa no sɛ, wowɔ komayare bere nyinaa. Enti wokɔ nnurutɔnbea kɔnom aduru bi a wɔde sa yafunu mu yare (ebia PPIs). Bere bi akyi no, ɔfe no ano brɛ ase. Nanso sɛ wokɔ so nom nnuru yi mfe pii a wunnya aduruyɛfo afotu a, ntini a ɛwɔ wo yafunu mu a efi awosu mu ma acid no betumi ayɛ adwuma kɛse nkakrankakra. Ɛno ne bere a wufi ase nya hypochlorhydria. Nokwarem no, mfiase no na wɔpenee nnuru te sɛ PPI so sɛ wɔmfa nni dwuma bere tiaa bi nkutoo. Nanso mprempren wɔkyerɛw ma wɔ mmeae pii ma tebea horow a enni sabea te sɛ GERD (yafunu mu yare a ɛsan kɔ yafunu mu) ne komayare, ɛtɔ mmere bi a ɛho nhia.

Nneɛma afoforo nti

Wɔ nneɛma atitiriw yi akyi no, nneɛma afoforo pii betumi aka ho:

• Mpanyinyɛ: Bere a yɛrenyin no, nkwammoaa a ɛwɔ yɛn nipadua mu no nso nyin. Bere kɔ so no, nkwammoaa a ɛma yafunu mu acid no nso betumi afi ase awuwu.
• Adwennwen a enni sabea: Ɛnyɛ adwennwen nketenkete a yehyia da biara da no nkutoo na eyi yɛ. Nanso sɛ wowɔ adwennwen a enni sabea a ɛkɔ soro a, ebetumi aka yafunu mu acid a ɛba nso.
• Yafunu mu oprehyɛn: Wonim sɛ yafunu mu oprehyɛn bi te sɛ yafunu mu oprehyɛn betumi aka yafunu mu acid a ɛba no.

Dɛn ne hypochlorhydria ho sɛnkyerɛnne ahorow?

Wobetumi akyekyɛ tebea yi ho sɛnkyerɛnne mu abien.

Nnuan a wɔyam mu haw ahorow a ɛba mpofirim

Eyinom ne sɛnkyerɛnne ahorow a edi kan a ɛda adi:

• Yafunu mu yaw
• Yafunu a ɛho ayɛ kurukuruwa, yafunu a ɛyɛ mmerɛw
• Gas a wɔhyehyɛ
• Atiridiinini (akisikuru) .
• Ayamtim
• Aduan a wɔanwene a wɔde fa nsu mu
• Reflux, Koma mu yare

Aduan pa a wonnya nni ho sɛnkyerɛnne a ɛtra hɔ kyɛ

Sɛ hypochlorhydria kɔ so a, aduannuru a enni nipadua mu nso betumi de sɛnkyerɛnne ahorow te sɛ:

• Nnadewa bubu ntɛmntɛm, ɛyɛ mmerɛw
• Nwi a ɛtɔ
• Wora a ɛyɛ mmerɛw
• Ɔbrɛ a ɛtaa ba, ɔbrɛ
• Nipadua mu mmerɛwyɛ
• Ntini a ɛyɛ mmerɛw, a ɛyɛ mmerɛw wɔ akwaa no mu
• Nkae a ɛyera
• Tipaeɛ

Dɛn ne asiane ahorow a ɛde hypochlorhydria ba?

Hena na ɛda adi sɛ obenya saa tebea yi?

• Wɔn a wɔadi boro mfe 65 no fam
• Nnipa a wɔnom nnuru a ɛtew acid so te sɛ antacids anaa PPIs bere tenten
• Wɔn a wɔwɔ `H. pylori` ɔyare mmoawa
• Wɔn a wɔadi kan anya yafunu mu yare anaa yafunu mu akuru no fam
• Wɔn a wɔayɛ wɔn yafunu oprehyɛn no fam

Mɛyɛ dɛn ahu sɛ me yafunu mu acid sua?

Hypochlorhydria ho sɛnkyerɛnne – kyerɛ sɛ, aduan mu haw, aduannuru a enni hɔ, ne mpo mmoawa a wɔde nyarewa ba – betumi ayɛ tebea afoforo dodow bi ho sɛnkyerɛnne. Enti, sɛ wunya saa sɛnkyerɛnne ahorow yi nkutoo a, ɛnkyerɛ sɛ wowɔ hypochlorhydria. Eyi yɛ ade biako pɛ a ebetumi de aba. Nanso, sɛ wowɔ asiane ahorow a yɛadi kan aka ho asɛm no pii a, ebia wubesusuw sɛ wowɔ saa ɔhaw yi.

Nanso, ɔkwan biara nni hɔ a wobɛfa so ahu no yiye sɛ ebia tebea yi wɔ hɔ anaasɛ enni hɔ a wɔnyɛ yafunu mu acid nhwehwɛmu.

Sɔhwɛ a ɛnyɛ den a wubetumi ayɛ wɔ fie - baking soda sɔhwɛ no

Eyi yɛ ɔkwan a ɛnyɛ den a wubetumi asɔ ahwɛ wɔ fie. Nsusuwii a ɛwɔ eyi akyi ne sɛ, sɛ baking soda (sodium bicarbonate) ne yafunu mu acid bom a, ɛma carbon dioxide (`CO2`) mframa. Saa mframa yi ma wopɛ sɛ wokɔ aguaree ntɛm.

Sɛnea wɔyɛ no:

1. Ɛsɛ sɛ wɔyɛ no wɔ yafunu a hwee nni mu (a wonnidi).

2. Fa baking soda teaspoon fra nsu kuruwa fã (bɛyɛ ɔuns 4), kankan no yiye, na nom. Dodow a nsu no yɛ nwini no, dodow no ara na eye.

3. Afei hwɛ bere tenten a egye ansa na woadu Gudus.

Nsusuwii no ne sɛ: Sɛ woankɔ nsu mu wɔ simma abiɛsa kosi anum mu a, ɛkyerɛ sɛ wunni acid a ɛdɔɔso wɔ wo yafunu mu.

Nea ɛho hia: Eyi nyɛ sɔhwɛ a ɛyɛ pɛpɛɛpɛ 100%. Nanso ebetumi ama woanya adwene bi. Sɛ wunya fie nhwehwɛmu te sɛ eyi mu ba a ɛyɛ papa a, ɛbɛyɛ papa sɛ akyinnye biara nni ho sɛ wobɛkɔ oduruyɛfo a ɔfata nkyɛn akɔhwehwɛ afotu.

Nhwehwɛmu ahorow a nnuruyɛfo yɛ

Wo duruyɛfo betie wo yare no ho sɛnkyerɛnne, w’ayaresa ho abakɔsɛm, na wayɛ wo nipadua mu nhwehwɛmu. Sɛ osusuw sɛ hypochlorhydria wɔ hɔ a, ebia ɔbɛkamfo nhwehwɛmu pii a wɔbɛyɛ de ahwɛ sɛnea wo yafunu mu asikre dodow no mu biako akyerɛ.

Eyinom ne sɔhwɛ atitiriw a wɔde di dwuma no bi:

• Heidelberg pH sɔhwɛ: Wɔ sɔhwɛ yi mu no, womene aduru ketewaa bi a radio afiri bi wom. Ɛsusuw wo yafunu no pH. Sɛ wosusuw wo pH a ɛfata wie a, wɔma wo baking soda aduru bi a nom na ama wo yafunu mu acid no ayɛ nea ɛho nhia. Afei, oduruyɛfo no susuw bere tenten a egye ansa na wo yafunu no asan akɔ ne acid dodow a ɛfata mu. Eyi ma wo duruyɛfo hu sɛnea wo yafunu no reyɛ acid yiye na ɛreyi afi mu.
• SmartPill sɔhwɛ no:SmartPill nso yɛ wireless transmitter a womene. Sɛ́ anka ɛbɛsusuw pH te sɛ Heidelberg sɔhwɛ no, ɛsusuw acid dodow a ɛwɔ wo yafunu mu no tẽẽ.
• Yafunu mu hama sɔhwɛ: Wɔ sɔhwɛ yi mu no, wɔmene aduru bi a wɔde abata hama bi ho na afei woyi fi hɔ wɔ simma 10 akyi denam hama no a wɔde kura mu no so. Afei wɔde pH krataa sɔ ahama no hwɛ. Mpɛn pii no, yafunu a ɛwɔ apɔwmuden no pH yɛ 1 kosi 2. Eyi kyerɛ sɛ ɛyɛ acidic kɛse (pH a ɛyɛ 0 na ɛyɛ acidic sen biara). Sɛ wowɔ hypochlorhydria a, ebia wo yafunu mu acid no pH bɛyɛ 3 kosi 5. Sɛ pH no boro 5 a, ɛyɛ tebea a emu yɛ den. Wɔfrɛ eyi achlorhydria . Eyi kyerɛ sɛ ɛkame ayɛ sɛ wo yafunu nni hydrochloric acid (HCl) biara.

Sɛ wo nhwehwɛmu ahorow no si so dua sɛ wowɔ hypochlorhydria a, wo duruyɛfo nso betumi ahyɛ sɛ wɔnyɛ nhwehwɛmu foforo mfa nhwɛ sɛ aduannuru a enni mu anaasɛ ɔyare mmoawa wɔ wo mu anaa. Wɔde saa nsɛm yi nyinaa bɛyɛ ayaresa nhyehyɛe a ɛfata wo.

Ɔkwan bɛn so na wɔsa hypochlorhydria?

Sɛ wɔresa eyi ho dwuma a, wosusuw nneɛma atitiriw abiɛsa ho:

1. Nea ɛde ba no a wɔbɛsa

Sɛ wo duruyɛfo tumi hu nea ɛde wo hypochlorhydria ba no yiye a, ade a edi kan a ɛsɛ sɛ woyɛ ne sɛ wobɛsa saa ade a ɛde ba no. Ebia eyi bɛhwehwɛ sɛ wobɛsesa wo nnuru, wobɛsa tebea bi a ɛda adi, anaasɛ wode nnuru a ekum ɔyare mmoawa sa ɔyare mmoawa bi.

2. Hydrochloric acid (HCl) a wɔde ma a wɔde ma

Sɛnea ɛbɛyɛ na woasa hydrochloric acid a enni nipadua no mu no, ebia wo duruyɛfo bɛkamfo HCl a wode bɛka ho akyerɛ sɛ fa ka aduan ho. Sɛ nhwɛso no, aduru bi a wɔde ka aduan ho a wɔfrɛ no Betaine hydrochloride. Saa HCl nnuru yi taa de enzyme bi a wɔfrɛ no Pepsin ba. Saa nnuru a wɔde ka aduan ho yi boa wo aduan a wobɛyam no. Ɛtɔ mmere bi a, sɛ wode eyinom di dwuma a, nkakrankakra wo yafunu mu acid san ba sɛnea na ɛte kan no, na wubetumi agyae nnuru a wɔde ka ho yi nom. Ɛwom sɛ wobetumi anya eyinom wɔ aduruyɛdan mu de, nanso ɛnyɛ nea ɛfata obiara. Enti nsɔ wɔn nhwɛ wɔ w’ankasa wo ho a wo ne oduruyɛfo nkasa.

3. Nnuru a wɔde ka aduannuru a wonnya nni ho a wɔde bɛma

Sɛ wo yafunu mu acid a ɛba fam no ama aduannuru afoforo a enni wo te sɛ iron, calcium, anaa vitamin B12 aba a, ebia wo duruyɛfo bɛkamfo nnuru a wɔde ka aduan ho aboa ma woasan ahyɛ saa aduannuru no ma.

So wobetumi asa hypochlorhydria?

Mpɛn pii no, wobetumi asan tebea yi anaasɛ wɔde HCl a wɔde ka ho ayɛ no yiye. Nanso, ɛho hia yiye sɛ wodi nea ɛde ba no ho dwuma.Sɛ wowɔ ɔyare mmoawa, yareɛ, anaa ɔfe tebea bi a, ɛbɛtumi de ɔhaw a ɛkɔ so aba – ɛnyɛ hypochlorhydria nko, na mmom ɔhaw foforɔ nso. Enti, ɛho hia sɛ wɔyɛ aduruyɛ mu nhwehwɛmu a edi mũ ansa na wɔafi ase de HCl a wɔde ma no sa yare. Wo duruyɛfo betumi aboa wo ma woasa nea ɛde hypochlorhydria ba ne nea efi mu ba te sɛ aduannuru pɔtee bi a wunni no yiye.

Aduan bɛn na ɛfata ma nnipa a wɔn yafunu mu acid sua?

Adidi nkutoo ntumi mma wo yafunu mu acid nsan mma bio. Nanso, saa afotu ahorow yi betumi aboa ma wo aduan a wobɛyam no ayɛ mmerɛw bere a wo ne hypochlorhydria te no:

• Di kan di protein wɔ adidi mu: Sɛ wudi nnuan a protein wom (te sɛ mpataa, nam, nkesua, atoko) wɔ adidi mfiase a, ɛboa ma yafunu mu acid yɛ kɛse.
• Twentwɛn nsu a wobɛnom ase: Kwati sɛ wobɛnom nsu anaa anonne foforo anyɛ yiye koraa no simma 30 bere a woadi akyi. Eyi ma wo yafunu nya bere pii de yɛ acid na ɛyam protein.
• Di nnuan a probiotics wom: Sɛ wudi nnuan a probiotics te sɛ yogurt, miso, ne sauerkraut a, ebetumi aboa ma mmoawa pa dodow a ɛwɔ wo dwensɔtwaa mu no akɔ soro na asiw mmoawa bɔne ano.
• Kwati nnuan a srade pii wom ne nea wɔayɛ no foforo: Ɛyɛ den sɛ wobɛyam saa nnuan yi na aduannuru kakraa bi na ɛwom.
• Hwɛ yiye titiriw wɔ w’aduan ho sɛ woyɛ obi a odi afifide a: Aduan pa a enni nipadua mu (protein, iron, calcium, vitamin B12) a ɛbata yafunu mu acid a ɛba fam ho no pii wɔ mmoa nneɛma mu (nam, mpataa, nufusu mu nneɛma). Sɛ woyɛ obi a onni nam a, hwɛ hu sɛ wubenya saa aduannuru yi afi nnuru a wɔde ka aduan ho anaa nnuan afoforo a ɛfata mu. Ebia akwahosan ho wosow a wɔde afra a ɛyɛ papa bɛyɛ ɔkwan a ɛyɛ mmerɛw a wobɛfa so ayɛ eyi.
• Di nnuan nketenkete na wee no yiye: Sɛnea ɛbɛyɛ a wubenya hokwan a eye sen biara sɛ wobɛpaapae aduan mu na woayam no yiye no, di nnuan nketenkete sen sɛ wubedi nnuan akɛse prɛko pɛ. Afei nso, we na mene w’aduan no yiye.
• Di w’aduan a etwa to nnɔnhwerew abien kosi abiɛsa ansa na woada: Ma wo nipadua no bere a ɛdɔɔso ma ɛyam aduan ansa na woada.

Awiei koraa no, ade a ɛho hia sen biara a ɛsɛ sɛ yɛkae!

Hypochlorhydria, anaa yafunu mu acid a ɛba fam no yɛ tebea a abu so nanso wontumi nhu no yiye sen sɛnea yesusuw. Nsɛnkyerɛnne te sɛ komayare ne komayare a wɔtaa di mfomso bu sɛ ɛyɛ yafunu mu acid pii (Hyperchlorhydria) no betumi afi yafunu mu acid a ɛba fam no mu ankasa.

Nnuru a wɔde ma yafunu mu acid yɛ kɛse no betumi aboa ma yafunu mu acid so atew na ama aduan mu haw ahorow asɛe kɛse.

Enti, ahwɛyiye a wɔde hwehwɛ yare no mu na wɔsɔ hwɛ ho hia na ama wɔatumi ayɛ ayaresa no yiye.Aduruyɛ mu nhwehwɛmu betumi aboa ma woahu sɛ ebia wo yafunu mu acid sua anaasɛ ɛdɔɔso, ne nneɛma afoforo a ɛho hia a ebia ɛrenya wo sɛnkyerɛnne ahorow no so nkɛntɛnso. Sɛ wo duruyɛfo nya nsɛm a ɛfata a, obetumi aboa wo ma woayɛ ayaresa nhyehyɛe a wode bedi nea ɛde hypochlorhydria ba ne nea efi mu ba no ho dwuma. Enti, sɛ wowɔ saa sɛnkyerɛnne ahorow yi bi a, hwɛ hu sɛ wobɛhwehwɛ aduruyɛfo afotu.

` Hypochlorhydria, yafunu mu acid, hydrochloric acid, aduan a wɔyam, aduannuru a enni mu, yafunu mu ɔfe, yafunu mu yare, SIBO, H. pylori, PPIs