ʻŌpū huhū? ʻAʻole hiki ke hoʻoheheʻe i ka meaʻai? E hele mai, e kamaʻilio kākou e pili ana i nā (Prokinetic Agents)!

Ke manaʻo nei ʻoe i kekahi manawa ua piha a ʻaʻole paha ʻoe e ʻeli pono i ka meaʻai ma hope o ka ʻai ʻana? A i ʻole he mau pilikia kou e like me ka ʻāʻī ʻana o ka puʻuwai a i ʻole ka indigestion? I kekahi manawa hiki ke hana ʻia kēia mau pilikia e ka hana pono ʻole ʻana o ko kākou mau ʻōpū. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano lāʻau lapaʻau kūikawā e kōkua mai i ia mau manawa. Ua kapa ʻia kēia mau mea he `(Prokinetic Agents)`.

He aha kēia mau `(Nā ʻĀpana Prokinetic)`? I ka ʻōlelo maʻalahi...

I ka ʻōlelo maʻalahi, ʻo `(Prokinetic Agents)` he ʻano lāʻau lapaʻau e hoʻonui ai i ka wikiwiki o ka neʻe ʻana o ka meaʻai ma o kāu ʻōnaehana hoʻoheheʻe ʻana, ʻo ia hoʻi, nā ʻōpū. Ke ale mākou i ka meaʻai, hoʻomaka nā ʻiʻo o ko mākou ʻōnaehana hoʻoheheʻe e ʻūlū mai luna a lalo e like me ke ʻano o nā nalu. Ua kapa ʻia kēia ʻo `(Peristalsis)`. Ua like ia me ke kaomi ʻana i ka meaʻai i lalo. Penei ka neʻe ʻana o ka meaʻai mai ka puʻu, i lalo o ka esophagus, i loko o ka ʻōpū, a laila i loko o nā ʻōpū. I loko o kēia huakaʻi e omo ai ko mākou kino i nā meaʻai e pono ai.

Eia nō naʻe, ma muli o kekahi mau maʻi a i ʻole nā ​​kumu ʻē aʻe, ʻaʻole paha e hana pono kēia kaʻina hana i kapa ʻia ʻo "Peristalsis". ʻO kēia ka wā e ʻike ʻia ai nā hōʻailona e like me ka paʻa ʻana o ka ʻōpū, ka ʻeha puʻuwai, a me ka manaʻo piha me ka ʻole o ka ʻai ʻana i ka meaʻai. Hiki i ka meaʻai ke noho i loko o ka ʻōpū no ka manawa lōʻihi, a laila ʻaʻole loaʻa i ke kino ka meaʻai e pono ai.

ʻO ia ka manawa e kōkua mai ai kēia mau lāʻau i kapa ʻia ʻo `(Prokinetic Agents)`. Hoʻonui kēia i ka neʻe ʻana o nā ʻōpū a kōkua i ka hele wikiwiki ʻana o ka meaʻai i loko o ke ala ʻai. Akā ʻo ka mea nui e hoʻomanaʻo ai, aia nā hopena ʻaoʻao koʻikoʻi e hiki ke hele mai me kēia mau lāʻau. No laila, ʻaʻole kuhikuhi koke nā kauka i kēia mau lāʻau. ʻO ka hapa nui o ka manawa, hāʻawi ʻia nā `(Proton Pump Inhibitors - PPIs)` a i ʻole `(H2 Blockers)` i nā lāʻau ʻē aʻe a laila manaʻo ʻia nā `(Prokinetic Agents)` inā ʻaʻole lākou e hāʻawi i ka hōʻoluʻolu. Eia nō naʻe, ma muli o kou kūlana olakino, hiki i kāu kauka ke kuhikuhi i kēia lāʻau.

Pehea e hana ai kēia mau `(Nā ʻAgent Prokinetic)`?

He ʻano paʻakikī iki ke ʻano o ka hana ʻana o kēia mau lāʻau lapaʻau, akā e mālama wau ia mea maʻalahi. Hoʻoulu lākou i nā aʻalolo i loko o kāu ʻōnaehana hoʻoheheʻe a kōkua i ka ʻūlū ʻana o nā ʻiʻo.

ʻO ia hoʻi:

• Hoʻonui ia i nā ʻūlū i loko o kou esophagus (paipu meaʻai), e kōkua ana i ka hoʻoneʻe koke ʻana i ka meaʻai i loko o ka ʻōpū.
• E hoʻoikaika i ka Lower Esophageal Sphincter (LES) ma lalo o kou esophagus. Ua like ka LES me kahi valve. ʻO ia ka ʻāpana o kou esophagus e hoʻopili ai i kou ʻōpū i kou esophagus. Inā ʻaʻole ia e pani pono a lilo i mea wehe, hiki i ka waikawa o ka ʻōpū ke piʻi hou i loko o kou esophagus a me ka puʻu. ʻO ia ka manawa e loaʻa ai iā ʻoe kēlā heartburn, heartburn, a me ka ʻeha o ka umauma. Ua kapa ʻia hoʻi kēia he Acid Reflux a i ʻole GERD.
• Hoʻonui ia i nā ʻūmiʻi o ka ʻōpū a kōkua i ka hoʻoneʻe koke ʻana i ka meaʻai i loko o ka ʻōpū liʻiliʻi.
• Hoʻemi kēia i ka manawa e pono ai no ka ʻōpū e hoʻokahe. Hoʻemi kēia i ka manawa kūpono o ka hoʻi hou ʻana mai o nā mea o loko o ka ʻōpū, e like me ke ʻano o ka `(Acid Reflux)`.

E noʻonoʻo, hana kēia lāʻau lapaʻau e like me ka mea e hoʻopilikia ai i ke kaʻa, a hele mai nā mākaʻi e hoʻomaʻemaʻe i ke ala no nā kaʻa e neʻe wikiwiki ai.

No nā kūlana hea e hoʻohana ʻia ai nā `(Prokinetic Agents)`?

Hoʻohana nui ʻia kēia mau lāʻau lapaʻau no nā kūlana penei:

• ʻO Gastroparesis (hana ʻino o ka ʻōpū/hoʻopaneʻe ʻana o ka ʻai): Ma kēia ʻano, ʻaʻole e ʻūlū pono nā ʻiʻo o ka ʻōpū, no laila ua lohi ka ʻai ʻana o ka meaʻai. Hoʻonui nā lāʻau lapaʻau prokinetic i kēia mau ʻūlū a hoʻoneʻe koke i ka ʻōpū. Hiki i ka poʻe me ka maʻi diabetes ke loaʻa i kēia ʻano i kapa ʻia ʻo Diabetic Gastroparesis. ʻO Metoclopramide wale nō ka lāʻau i ʻae ʻia e ka FDA ma ʻAmelika Hui Pū ʻIa no kēia. Hiki i kāu kauka ke kuhikuhi i kēia inā ʻaʻole kōkua nā lāʻau ʻē aʻe.

• ʻO GERD (Gastroesophageal Reflux Disease): ʻO kēia ka manawa e hoʻi hou mai ai ka waikawa o ka ʻōpū i luna o ka esophagus i loko o ka waha. Hana ʻia kēia i ka wā ʻaʻole pani pono ka LES (Lessive Esophageal Suppression System) aʻu i ʻōlelo ai ma mua. ʻAʻole kōkua nā mea Prokinetic wale nō iā GERD. Eia nō naʻe, inā lohi kou ʻōpū e hoʻokahe, hiki i kāu kauka ke kuhikuhi i kēia mau mea me nā lāʻau lapaʻau ʻē aʻe.

• ʻO ka Dyspepsia Hana: ʻO kēia ka wā e loaʻa ai iā ʻoe ka ʻeha mau o ka ʻōpū ma hope o ka ʻai ʻana, akā ʻaʻohe kumu maopopo e loaʻa. Hiki i kekahi poʻe ke ʻike e hiki i kēia mau lāʻau ke kōkua i ka hōʻemi ʻana i nā hōʻailona. Wahi a nā kānaka noiʻi e kōkua kēia mau lāʻau ma ka hoʻonui ʻana i nā ʻūlū o ka ʻōpū a me ka wikiwiki ʻana i ka hoʻokahe ʻana.

• Ka luaʻi a me ka luaʻi: ​​Hiki i ke kauka ke kuhikuhi i kēia lāʻau lapaʻau no ka luaʻi ʻana a i ʻole ka luaʻi mau ʻana i pane ʻole i nā lāʻau lapaʻau ʻē aʻe. Hoʻohana ʻia kekahi manawa no ka luaʻi ʻana i hoʻokumu ʻia e nā lāʻau chemotherapy no ka maʻi kanesa.

• ʻO ka Pseudo-obstruction ʻōpū mau loa: ʻO kēia ka manawa e ʻike ʻia ai nā hōʻailona o kahi ālai ʻana ʻoiai ʻaʻohe ālai maoli i loko o ka ʻōpū . Ke noiʻi nei nā kānaka noiʻi inā hiki i kekahi mau mea prokinetic ke kōkua me kēia kūlana.

He aha nā ʻano nui o nā `(Prokinetic Agents)`?

Hiki ke hoʻokaʻawale ʻia kēia mau lāʻau i ʻelua mau māhele nui: `(Agonists)` a me `(Antagonists)`.

• `(Agonists)`: Hana kēia mau mea e like me kekahi mau `(Neurotransmitters)` (nā kemika e lawe ana i nā leka ma waena o nā aʻalolo) i loko o kā mākou ʻōnaehana aʻalolo. ʻO ia hoʻi, hele kēia mau `(Agonists)` a hoʻopili i kahi aʻalolo, e haʻi ana i kēlā aʻalolo e "ʻaelike". E like me ka hana ʻana o nā `(Neurotransmitters)` pili i ka mea like.
• `(Nā Antagonist)`: Hana kēia mau mea ma ka pale ʻana i kekahi mau `(Neurotransmitters)` mai ka nakinaki ʻana i ke aʻalolo. ʻOi aku ka pololei, inā he mau `(Neurotransmitters)` e hoʻopilikia ana i ke kaʻina hana `(Peristalsis)`, e ālai kēia mau `(Nā Antagonist)` iā lākou mai ka nakinaki ʻana i ke aʻalolo.

Ua māhele hou ʻia kēia mau "Prokinetic Agents" i nā ʻano like ʻole, ma muli o ke ʻano o ka hana ʻana o kēlā me kēia lāʻau:

• `(Nā Agonists Cholinergic)`:Hana kēia mau mea e like me ka ``(Neurotransmitter)`` i kapa ʻia ʻo `(Acetylcholine)`. Hoʻoulu ka `(Acetylcholine)` i ka ʻūmiʻi ʻana o nā ʻiʻo i loko o nā ʻōpū. Nā laʻana: `(Baclofen)`, `(Bethanechol)`, `(Neostigmine)`, `(Pyridostigmine)`.
• `(Motilin Agonists)` (Macrolide Antibiotics): Hana kēia e like me ka `(Neurotransmitter)` i kapa ʻia ʻo `(Motilin). Hoʻoulu ka `(Motilin)` i nā ʻūmiʻi i loko o ka ʻōpū liʻiliʻi. ʻO kekahi mau lāʻau lapaʻau i loko o kēia hui he `(Antibiotics)` i hāʻawi ʻia e mālama i nā maʻi bacteria. Nā laʻana: `(Erythromycin)`, `(Azithromycin)`.
• Nā Agonists Serotonin: Hana kēia e like me ka neurotransmitter serotonin. E like me ka serotonin, hoʻoulu lākou i nā ʻūlū ʻōpū a kōkua i ka ʻōpū e hakahaka. Nā Laʻana: Cisapride, Prucalopride, Tegaserod.
• `(Dopamine Antagonists)`: Pale kēia i ka `(Neurotransmitter)` i kapa ʻia ʻo `(Dopamine)` mai ka hoʻopaʻa ʻana i nā hunaola nerve. Hoʻemi ka `(Dopamine)` i ka neʻe ʻana o ka ʻōpū a me nā ʻōpū, a hoʻomaha pū i ka `(LES)`. No laila, ke pau ka `(Dopamine)` i ka hoʻopaʻa ʻana, hoʻohuli kēia mau `(Dopamine Antagonists)` i kēlā hopena (ʻo ia hoʻi, hoʻonui i ka neʻe ʻana). Nā Laʻana: `(Metoclopramide)`, `(Domperidone)`.

ʻO kekahi mau laʻana o `(Prokinetic Agents)`

I kēia manawa, aia kekahi mau ʻano lāʻau lapaʻau "Prokinetic" i hoʻohana ʻia no ka mālama ʻana, a ua pāpā ʻia kekahi o ia mau mea ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa ma muli o nā hopena ʻaoʻao, a ʻo kekahi eia nō i ke kahua noiʻi.

• ʻO Azithromycin (Zithromax®): He agonist motilin. I kekahi manawa ua kuhikuhi nā kauka iā ia ma waho o ka lepili no ka gastroparesis.
• ʻO Baclofen (ED baclofen®): He agonist cholinergic. Ke aʻo ʻia nei kona mau pono no GERD.
• `(Bethanechol)` (Urecholine®): He `(Cholinergic Agonist). Kōkua ia i nā hōʻailona `(Gastroparesis)` a me `(GERD)`. Eia naʻe, ʻaʻole ia e hoʻohana nui ʻia no ka mea hiki ke hoʻoulu i nā hopena ʻino e like me ka ʻūlū ʻana o nā ʻiʻo a me ka ʻike maka pōwehiwehi.
• ʻO Cisapride (Propulsid®): He agonist serotonin. Kōkua i ka ʻōpū e hoʻokahe koke. Hoʻohana mua ʻia no GERD. Ua wehe ʻia mai ka mākeke US ma muli o nā hopena ʻaoʻao e pili ana i ka puʻuwai.
• `(Domperidone)` (Motilium®): He `(Dopamine Antagonist). Ma ʻAmelika Hui Pū ʻIa, ʻaʻole hiki ke loaʻa maʻalahi me ka ʻole o ka ʻae kūikawā. Hiki iā ia ke hana i nā pilikia puʻuwai koʻikoʻi e like me ka puʻuwai kūpono ʻole a me ka hōʻeha puʻuwai.
• ʻErythromycin (EES®): He Motilin Agonist. Hiki i ke kauka ke kuhikuhi iā ia ma waho o ka lepili no ka gastroparesis.
• ʻO Metoclopramide (Reglan®, Maxeran®, Gimoti®): He mea hoʻopilikia dopamine. ʻO ia wale nō ka lāʻau lapaʻau i ʻāpono ʻia e ka FDA no ka gastroparesis. Hoʻohana ʻia hoʻi ia e mālama i ka GERD i pane ʻole i nā lāʻau lapaʻau maʻamau. Eia nō naʻe, hele mai ia me kahi ʻōlelo aʻo e hiki ke hana i nā hopena ʻaoʻao e hoʻopilikia i ka ʻōnaehana nerve.
• `(Prucalopride)` (Motegrity®):He `(Serotonin Agonist)`. Hāʻawi ʻia ia no ka paʻa mau ʻana o ka ʻōpū. Kōkua nō hoʻi ia i ka hoʻokahe koke ʻana o ka ʻōpū.
• Pyridostigmine (Mestinon®): He agonist cholinergic. Hoʻohana nui ʻia ia e mālama i ka Myasthenia Gravis, akā hoʻohana ʻia hoʻi i kekahi manawa e mālama i ka Gastroparesis.

He aha nā hopena ʻaoʻao o ka hoʻohana ʻana i kēia mau `(Prokinetic Agents)`?

ʻO kēia ka mea nui e makaʻala ai. Hiki i nā mea hana Prokinetic ke loaʻa nā hopena ʻaoʻao koʻikoʻi. ʻO ia ke kumu e kānalua pinepine ai nā kauka e kuhikuhi iā lākou. Eia nō naʻe, ke holo pono ʻole nā ​​​​lāʻau lapaʻau maʻamau e like me PPI no GERD, hiki i ke kauka ke hoʻoholo e kuhikuhi i kahi mea hana prokinetic. A i ʻole, ma ke ʻano he akahele, hiki ke kuhikuhi ʻia i kahi mahele haʻahaʻa a i ʻole no kahi manawa pōkole.

Inā kuhikuhi ke kauka i kahi mea prokinetic nou, e nīnau e pili ana i nā hopena ʻaoʻao kikoʻī o kēlā lāʻau lapaʻau.

ʻO nā hopena ʻaoʻao maʻamau:

• ʻeha ka ʻōpū
• Ka luaʻi a me ka luaʻi
• Ka maʻi kahe (pehu ʻana)
• ʻIke pōwehiwehi
• ʻEha poʻo (ʻeha poʻo)
• Luhi
• Ka hiamoe, ka luhi nui, ka hiamoe pinepine (Lethargy)
• Kaumaha
• Hopohopo
• Nā ʻūmiʻi ʻiʻo i kāohi ʻole ʻia (Dystonia)
• Nā neʻe ʻana o nā ʻiʻo maka i kāohi ʻole ʻia (Tardive Dyskinesia)

Ua kāpae ʻia nā lāʻau lapaʻau e like me `(Cisapride)`, `(Domperidone)` a me `(Tegaserod)` mai ka mākeke ma muli o ka pilikia o nā pilikia puʻuwai koʻikoʻi. ʻO ia hoʻi:

• Ka lohi o ka puʻuwai (Bradycardia)
• Puʻuwai puʻuwai kūpono ʻole (Arrhythmia)
• Maʻi hohola

Ke nānā nei ka noiʻi o kēia manawa i nā mea hana prokinetic hou i ka hoʻomohala ʻana i nā lāʻau lapaʻau e hāʻawi ana i ka pono o ka hoʻoulu ʻana i nā ʻūlū ʻōpū me ka hoʻemi ʻana i ka pilikia o ia mau hopena ʻaoʻao.

He aha nā lāʻau Prokinetic i hoʻohana pinepine ʻia?

ʻO nā mea prokinetic i kuhikuhi pinepine ʻia ʻo Metoclopramide lāua ʻo Domperidone. Ma ʻAmelika Hui Pū ʻIa, ʻo Metoclopramide wale nō ka lāʻau lapaʻau i ʻāpono ʻia e ka FDA no ka gastroparesis. Eia nō naʻe, hiki i ke kauka ke kuhikuhi iā Domperidone me ka ʻāpono ʻia e ka FDA.

ʻOkoʻa nā mea hana prokinetic i ko lākou pono a me ka palekana i ka mālama ʻana i nā maʻi ʻōpū. Ma muli o ka pilikia o nā hopena ʻaoʻao, hiki i ke kauka ke hoʻāʻo i nā lāʻau lapaʻau ʻē aʻe ma mua o ke kuhikuhi ʻana i kahi mea hana prokinetic. Eia nō naʻe, inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi no ka mea ʻaʻole i ʻaelike pono kou ʻōpū, hiki i kahi mea hana prokinetic ke hāʻawi i ka hōʻoluʻolu e pono ai. Inā ʻoe e noʻonoʻo ana e lawe i kahi mea hana prokinetic, he mea nui e kūkākūkā i nā pono a me nā pilikia me kāu kauka.

Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

No laila, ke lana nei koʻu manaʻo ua aʻo ʻoe i kekahi mea mai kā mākou i kūkākūkā ai e pili ana i ka `(Prokinetic Agents)`. I ka hōʻuluʻulu manaʻo:

• ʻO nā mea hana Prokinetic kahi ʻano lāʻau lapaʻau e hoʻonui ai i ka neʻe ʻana o ke ala ʻai a kōkua i ke kaʻina hana ʻai.
• Hoʻohana ʻia kēia mau mea no nā kūlana e like me `(Gastroparesis)` a me `(GERD)`, a me nā mea e like me ka nausea a me ka luaʻi.
• Hana kēia lāʻau lapaʻau ma ka hoʻoulu ʻana i nā aʻalolo i loko o nā ʻōpū a me ke kumu e ʻuʻumi ai nā ʻiʻo.
• ʻO ka mea nui loa, hiki i kēia mau lāʻau lapaʻau ke loaʻa nā hopena ʻaoʻao koʻikoʻi i kekahi manawa. ʻO ia ke kumu e kuhikuhi ai ke kauka iā lākou me ke akahele nui.
• Mai hoʻohana i kēia ʻano lāʻau lapaʻau me ka ʻole o ke kūkākūkā ʻana me ke kauka. Pono ke kauka e hoʻoholo i ka lāʻau lapaʻau kūpono iā ʻoe a me ka lōʻihi o kou lawe ʻana.

Inā loaʻa iā ʻoe kahi ʻeha ʻōpū a i ʻole ka pilikia o ka ʻōpū e like me kēia, ʻo ka mea maikaʻi loa e hana ai, ʻo ia ke ʻike i ke kauka a kamaʻilio e pili ana i ia mea. A laila hiki iā ʻoe ke loaʻa ka lāʻau kūpono.

nā mea prokinetic, ʻeha o ka ʻōpū, indigestion, gastritis, GERD, gastroparesis, metoclopramide