Kodi mumavutikanso m'mimba pafupipafupi? Kungakhale kusamwa bwino kwa bile acid m'thupi lanu!

Kodi mumavutikanso ndi matumbo pafupipafupi, kutanthauza kutsegula m'mimba? Kodi mumavutikanso ndi kutsegula m'mimba komwe kumakhala kovuta kuletsa, nthawi zina kumakhala ndi madzi, kangapo patsiku? Ndiye ichi ndi chinthu chomwe chingakhale chofunikira kwa inu. Lero, tikambirana za vuto lotchedwa Bile Acid Malabsorption (BAM) . Ngakhale dzinalo lingamveke lovuta pang'ono, tiyeni tifotokoze mwachidule.

Kodi Bile Acid Malabsorption ndi chiyani?

Mwachidule, iyi ndi matenda a m'mimba mwathu. Makamaka, ikhoza kukhala chifukwa chachikulu cha kutsegula m'mimba kosatha , kutanthauza kutsegula m'mimba kosalekeza. Pamene ma asidi a bile m'matumbo mwathu salowedwa bwino ndi thupi, amasonkhana m'matumbo. Kenako mankhwala omwe ali mkati mwake amasokonezeka. Chifukwa cha kuchuluka kwa ma asidi a bile, m'matumbo mwathu mumatumizidwa uthenga woti titulutse madzi ambiri. Ndicho chifukwa chake kutsegula m'mimba kwa madzi kumachitika. Taganizirani ngati madzi akutuluka mu chitoliro, koma izi ndi zomwe zimachitika madziwo akatha mphamvu.

Kodi ma asidi a bile ndi chiyani?

Tsopano mwina mukudabwa kuti, "Kodi ma asidi a bile awa ndi chiyani?" Bile ndi chinthu chomwe chimapangidwira ndi chiwindi chathu. Chiwindi chikatsuka magazi athu, chimalekanitsa zinyalala monga poizoni, maselo akufa amagazi, ndi cholesterol yochulukirapo ndikupanga bile. Mitundu yosiyanasiyana ya ma asidi mu bile iyi imaphatikizana kupanga ma asidi a bile . Ma asidi awa amathandiza kusunga mafuta mu bile.

Nthendayi yochokera m'chiwindi imatumizidwa kudzera m'mitsempha ya ndulu kupita kumatumbo athu ang'onoang'ono kuti ithandize kugaya chakudya. M'matumbo ang'onoang'ono, ma asidi a ndulu amenewa amathandiza thupi kugaya mafuta omwe ali muzakudya zomwe timadya ndikuyamwa. Ntchito imeneyi ikatha, ma asidi a ndulu amenewa amalowanso m'thupi lathu, kuyenda kudzera m'magazi kupita ku chiwindi, ndipo amagwiritsidwanso ntchito kupanga ndulu. Izi zili ngati njira yobwezeretsanso .

Kodi "Malabsorption" ndi chiyani?

"Malabsorption" imangotanthauza kuti matumbo athu sangathe kuyamwa bwino mankhwala omwe timafunikira kuyamwa. Izi zitha kukhala chifukwa cha vuto la matumbo okha, kapena zitha kukhala chifukwa cha kusalingana kwa mankhwala. Mwachitsanzo, ngati pali mankhwala enaake ambiri kapena ochepa, matumbo sangathe kuyamwa bwino.

Ndani amene akukhudzidwa kwambiri ndi vutoli?

Kale, vuto la bile acid malabsorption (BAM) silinkadziwika mwa anthu ambiri chifukwa panalibe njira zodziwira matendawa molondola. Komabe, kafukufuku waposachedwapa akusonyeza kuti matenda otsegula m'mimba (FDDs)Akuti anthu osachepera 30% omwe ali ndi BAM akhoza kukhala ndi vutoli. Matenda ogwirira ntchito ndi matenda omwe alibe chifukwa chomveka bwino ndipo sapezeka mosavuta poyesedwa ndi dokotala. Mwachitsanzo, matenda otchedwa (Irritable Bowel Syndrome - IBS) .

BAM imapezeka mwa anthu omwe ali ndi matenda awa:

• Matenda a m'matumbo a microscopic
• Matenda a Crohn
• Matenda a m'mimba okhudzana ndi kachilombo ka HIV
• Kutsegula m'mimba kosalekeza pambuyo pa matenda a bakiteriya
• Kulephera kwa pancreatic exocrine

Komanso, vutoli lingachitike mwa anthu omwe akulandira chithandizo chamankhwala:

• Kuchotsa kapena kusintha ileum, gawo lomaliza la matumbo ang'onoang'ono, opaleshoni.
• Opaleshoni yochotsa ndulu (cholecystectomy) .
• Chithandizo cha radiation , makamaka pamimba ndi m'chiuno.
• Mankhwala a chemotherapy .
• Kugwiritsa ntchito Metformin, mankhwala ogwiritsidwa ntchito pochiza matenda a shuga amtundu wa 2.

Kodi zizindikiro za izi ndi ziti?

Zizindikiro zomwe zimawoneka nthawi zambiri ndi izi:

• Kutsegula m'mimba m'madzi
• Kufunika kopita ku bafa pafupipafupi
• Kupweteka m'mimba
• Kulakalaka kupita kuchimbudzi mwadzidzidzi komanso kuvutika kugwira chopondapo

Anthu ena angakhalenso ndi zizindikiro zotsatirazi:

• Kutupa m'mimba
• Mpweya ndi ululu womwe umayambitsa
• Chimbudzi chodzaza ndi mafuta (Steatorrhea)
• Kusagaya bwino chakudya

Zotsatirapo za nthawi yayitali zingaphatikizepo:

• Kusowa madzi m'thupi
• Kutopa kwambiri ngakhale mutapuma mokwanira
• Mutu
• Chizungulire
• Kusanza
• Anthu ena amalemera, ena amachepa thupi.

Nthawi zambiri, pafupifupi theka la anthu omwe ali ndi zizindikirozi amakhala nazo nthawi zonse . Theka lina limakhala ndi zizindikiro nthawi zina .

Nchifukwa chiyani kutsegula m'mimba kwa bile acid kumachitika?

Chizindikiro chachikulu cha kusamwa bwino kwa asidi ya bile ndi kutsegula m'mimba kwa asidi ya bile (BAD) . Izi zimachitika chifukwa cha ma asidi a bile omwe amasonkhana m'matumbo athu akuluakulu (colon) , komwe chakudya chimasanduka ndowe. Nthawi zambiri, 95% ya ma asidi a bile m'matumbo athu ang'onoang'ono amatengedwanso m'chigawo chomaliza cha matumbo ang'onoang'ono, ileum, asanafike m'matumbo akulu.

Komabe, ngati ma asidi a bile ochulukirapo salowetsedwa mwanjira imeneyi, amadutsa limodzi ndi zinyalala zina kupita ku matumbo akuluakulu. M'matumbo akuluakulu, ma asidi a bile awa amakwiyitsa matumbo. Izi zimapangitsa kuti atulutse madzi ambiri, ndipo minofu yomwe imakankhira ndowe patsogolo imayamba kugwira ntchito kwambiri. Ichi ndichifukwa chake kutsegula m'mimba kumachitika pafupipafupi komanso mwadzidzidzi, ndipo m'mimba mumachitika kupweteka.

Kodi ndi zifukwa ziti zomwe zimapangitsa kuti asidi a bile achepe?

Tsopano funso nlakuti, n’chifukwa chiyani ma bili acid amenewa amasonkhana m’matumbo? Ofufuza agawa BAM m’zifukwa zinayi zomwe zingachitike. Nthawi zina izi zimagawidwanso m’magulu apakati ndi apakati .

• BAM Yoyamba: Izi zimachitika chifukwa chiwindi chathu chimapanga bile acids yambiri (mitundu 2 ndi 4).
• BAM yachiwiri: Izi zimachitika pamene matumbo athu ang'onoang'ono awonongeka chifukwa cha matenda, opaleshoni, kapena chithandizo cha radiation (mitundu 1 ndi 3).

Mtundu 1 wa BAM: Izi zimachitika chifukwa cha vuto mu ileum, gawo lomaliza la matumbo ang'onoang'ono. Izi zimatchedwa malabsorption yeniyeni chifukwa vutoli limayamba mu gawo loyamwa la bile acid cycle. Muthanso kukhala ndi Mtundu 1 wa BAM ngati mwachitidwa opaleshoni, kusinthidwa, kapena kuletsedwa gawo lomaliza la matumbo ang'onoang'ono ngati gawo lina la matenda. Ileum ikhozanso kuwonongeka ndi matenda monga matenda a Crohn ndi chithandizo cha radiation. Ngati pali kuwonongeka kwakukulu, kuyamwa kumachepa.

Mtundu wachiwiri wa BAM: Izi nthawi zina zimatchedwa "idiopathic." Izi zikutanthauza kuti zimachitika mwadzidzidzi, popanda chifukwa. Komabe, kafukufuku waposachedwa akusonyeza kuti izi zimachitika chifukwa cha vuto la makina olumikizirana pakati pa matumbo athu ndi chiwindi. Njira yolumikizirana imeneyi nthawi zambiri imalamulira kuyenda kwa magazi m'thupi. Zizindikirozi zimauza chiwindi nthawi yoti chipange ndikutumiza ma asidi ambiri a bile, komanso nthawi yoti chiyimitse, chiyamwitsenso, ndikubwezeretsanso. Koma mu Mtundu wachiwiri wa BAM, uthenga woti "siyani" sudutsa bwino. Chifukwa chake, chiwindi chimapitiliza kutumiza ma asidi a bile - kuposa momwe ileum ingatengere.

Mtundu wachitatu wa BAM: Izi zimachitika chifukwa cha matenda omwe amakhudza ileum pamodzi ndi ziwalo zina za m'mimba mwathu. Mwachitsanzo, matenda monga matenda a celiac , matenda a kapamba osatha , ndi kukula kwa bakiteriya m'matumbo ang'onoang'ono (SIBO) .

Mtundu 4 wa BAM: Izi zimachitika ngati zotsatira zoyipa za kumwa mankhwala a shuga a metformin , omwe amachititsa kuti bile acid ipange kwambiri.

Kodi zotsatira zake za nthawi yayitali ndi ziti?

Ngati pali vuto lalikulu la bile acid malabsorption, kusowa kwa bile acid kungachitike pakapita nthawi.Izi zitha kuchitika. Izi zikutanthauza kuti, ngati asidi wambiri wa bile atulutsidwa mu ndowe osabwezeretsedwanso ku chiwindi, chiwindi sichikhala ndi asidi okwanira opangira ndulu. Ngati ndulu ili yochepa m'matumbo ang'onoang'ono, zimakhudza kugaya chakudya ndi zakudya zanu.

Kusowa kwa ma asidi a bile m'matumbo ang'onoang'ono kumachepetsa kuyamwa kwa mafuta ndi mavitamini osungunuka ndi mafuta (A, D, E, ndi K). Izi zingayambitse kusowa kwa zakudya m'thupi komanso mavuto ena okhudzana ndi kusowa kwa mavitamini osungunuka ndi mafuta. Mwachitsanzo, kusowa kwa vitamini D kumakhudza mafupa, ndipo kusowa kwa vitamini A kumakhudza masomphenya.

Makamaka anthu omwe ali ndi mtundu woyamba wa BAM, amathanso kukhala ndi vuto la kusowa kwa vitamini B12 . Izi zili choncho chifukwa vitamini B12 imalowa m'chiwindi. Pankhaniyi, kusowa kwa vitamini sikumachitika chifukwa cha BAM yokha, koma chifukwa cha vuto lomwe limayambitsa mtundu woyamba wa BAM - ndiko kuti, kusagwira bwino ntchito kwa chiwindi. Zizindikiro monga nseru, chizungulire, ndi kutopa zitha kutsagana ndi izi.

Ngati muli ndi vuto la kusowa kwa asidi m'thupi, zomwe zimachepetsa kuyamwa kwa mafuta ndikukulepheretsani kutentha ma calories okwanira, mutha kuchepetsa thupi. Komabe, nthawi zina, kuyamwa bwino kwa asidi m'thupi kungayambitse kunenepa. Izi zikuwoneka kuti zikugwirizana ndi kagayidwe kachakudya. BAM, kapena matenda omwe amayambitsa izi, angakhudze momwe thupi lanu limagwiritsira ntchito ma calories ndikuwasunga ngati mafuta.

Kodi matendawa amapezeka bwanji?

Malangizo azachipatala omwe alipo pano amalimbikitsa kuti aliyense amene ali ndi kutsegula m'mimba kosalekeza popanda chifukwa chomveka bwino ayenera kuyesedwa ngati ali ndi bile acid malabsorption. Koma mayesowa sapezeka kulikonse. Madokotala ena amafufuza izi ndikulemba mankhwala otchedwa bile acid sequestrants kuti awone ngati akupereka chithandizo.

Pali mayeso angapo omwe angagwiritsidwe ntchito pozindikira vuto la bile acid malabsorption:

• Kuyesa kwa SeHCAT: Uku kumaonedwa kuti ndi mayeso abwino kwambiri odziwira BAM, koma mayiko ambiri, kuphatikizapo Sri Lanka, alibe malo ochitira izi. Uku ndi kuyesa kojambula mankhwala a nyukiliya . Ndiko kuti, chinthu chotsika cha radioactive chimalowetsedwa m'thupi, ndipo kompyuta imayang'anira momwe chimayendera m'thupi ndikujambula zithunzi. Mu mayesowa, mumameza kapisozi yokhala ndi bile acid yopangidwa yotchedwa SeHCAT pamodzi ndi chinthu ichi cha radioactive. Kapisozi imapita kumatumbo ang'onoang'ono ndipo imayamwa mwachangu momwe mungathere ndi bile acids m'thupi lanu. Kamera ya gamma imayesa kuchuluka kwa SeHCAT m'thupi lanu tsiku loyamba komanso patatha masiku asanu ndi awiri. Ngati kutsala kwa SeHCAT kochepera 85% patatha masiku asanu ndi awiri, ikhoza kupezeka kuti ili ndi BAM.

• Kuyesa kwa Serum C4:Uku ndi kuyesa magazi. Kumaonedwa kuti ndi njira yabwino kwambiri pambuyo pa mayeso a SeHCAT. Kumayesa kuchuluka kwa enzyme yotchedwa C4 m'magazi. Kuchuluka kwa C4 kumakhudzana ndi kuchuluka kwa ma bile acid omwe chiwindi chanu chimapanga. Ngati kuchuluka kwa C4 kuli kokwera, ndi chizindikiro chabwino kuti muli ndi BAM yoyamba (mitundu 2 ndi 4). Mwa anthu omwe ali ndi BAM yachiwiri (mitundu 1 ndi 3), kuchuluka kwa C4 kumathanso kukhala kokwera ngati chiwindi chiyamba kupanga ma bile acid ambiri kuti chichepetse kuyamwa. Chifukwa chake, mayesowa ndi othandiza kwa anthu ambiri. Komabe, angaperekenso zotsatira zabodza kwa anthu omwe ali ndi matenda enaake, monga cholesterol yambiri ndi matenda a chiwindi omwe si a mowa .

• Kuyesa kwa Fecal Bile Acid (Kuyesa kwa Fecal BA): Izi zimayesa kuchuluka kwa ma asidi a bile mu ndowe yanu. Iyi ndi njira yolunjika kwambiri yoyezera kusamwa kwa bile acid. Komabe, mwaukadaulo ndi yovuta pang'ono ndipo ingachitike kokha kuzipatala zina. Kuyesaku kumafuna kukonzekera kwapadera. Muyenera kutsatira zakudya zapadera kwa masiku angapo musanayambe, kenako nkusonkhanitsa zitsanzo za ndowe kwa maola 48. Akatswiri adzayesa ndowe yanu kuti awone ngati muli ndi ma asidi a bile mu labu. Ngati kuchuluka kwa asidi a bile kuli kokwera, zikutanthauza kuti bile acid yambiri ikuyamwa m'matumbo ang'onoang'ono ndipo ikupititsidwa m'matumbo akulu, zomwe zimapangitsa kuti bile acid ituluke m'mimba.

Kodi mankhwala abwino kwambiri ndi ati?

Chithandizo choyamba cha bile acid malabsorption ndi gulu la mankhwala otchedwa bile acid sequestrants kapena bile acid binders . Cholestyramine ndi colestipol ndi omwe amaperekedwa kwambiri. Colesevelam ndi njira yopanda chilolezo, koma anthu ena amaona kuti ndi yosavuta kugwiritsa ntchito.

Ma sequestrant a bile acid awa ndi tinthu tating'onoting'ono tomwe timalumikizana ndi ma bile acid omwe ali ndi charge yoipa m'matumbo, zomwe zimawaletsa kuti asasweke m'zidutswa zazing'ono zomwe zimatha kuyamwa. Kulumikizana kumeneku kumalepheretsanso ma bile acid kugwira ntchito m'matumbo akulu ndikuyambitsa kutsegula m'mimba. Izi zimathandiza kuchepetsa zizindikiro za BAM.

Kodi pali zotsatirapo zilizonse za mankhwalawa?

Mankhwalawa nthawi zambiri amabwera mu mawonekedwe a ufa. Amafunika kusakaniza ndi madzi ndikumwa. Anthu ena amavutika kumeza kukoma ndi kapangidwe kake. Ena amakumana ndi zizindikiro za BAM komanso zotsatirapo zoyipa. Izi zikuphatikizapo kudzimbidwa , nseru, kutupa, ndi mpweya.

Komanso, mankhwala ophera asidi a bile amatha kumamatira ku mavitamini osungunuka mafuta m'matumbo ang'onoang'ono. Izi zingalepheretse matumbo ang'onoang'ono kuyamwa. Anthu ena omwe amamwa mankhwala ophera asidi a bile angafunike kumwa mavitamini owonjezera. Angafunikenso kumwedwa mwanjira yoti alepheretse kugaya chakudya, monga jakisoni .

Kodi vutoli lingachiritsidwe kwathunthu?

Kaya vuto la bile acid malabsorption lingachiritsidwe kutengera chomwe chimayambitsa. Zina mwa zifukwa zimatha kuchiritsidwa, pomwe zina sizingatheke. Ngati chifukwa chake chachiritsidwa mwachindunji, nthawi zina vuto la BAM limatha kusintha. Nthawi zina, ngakhale chifukwa chake sichingathe kuchiritsidwa, pali mwayi waukulu kuti zizindikiro zitha kuchiritsidwa bwino.

Chofunika: Musachite mantha! BAM ikhoza kuthandizidwa. Chofunika kwambiri ndikutsatira malangizo a dokotala wanu.

Kodi n’chiyani chimapangitsa zizindikirozo kukhala zovuta kwambiri?

Kuchuluka kwa asidi m'matumbo kumayamba chifukwa cha kuchuluka kwa mafuta m'zakudya zanu. Ngati muli mafuta ambiri m'matumbo ang'onoang'ono, chiwindi chimalandira chizindikiro cha mankhwala chomwe chimachiuza kuti "chitumize ndulu yambiri." Ndulu yambiri imatanthauza kuti ndulu yambiri ikupita m'matumbo akulu. Ichi ndichifukwa chake madokotala amalangiza kudya zakudya zopanda mafuta ambiri kuti zithandize kuchepetsa BAM.

Kodi muyenera kupita kwa dokotala liti?

Ngati mukutsegula m'mimba kosalekeza popanda chifukwa chomveka, funsani dokotala wanu za vuto la bile acid malabsorption. Ili ndi vuto lomwe silikudziwika bwino komanso silikudziwika bwino, kotero si madokotala onse omwe angaganizire nthawi yomweyo za vutoli. Choncho funsani dokotala wanu kuti akuyeseni, kapena akutumizireni kwa katswiri wodziwa bwino za vutoli.

Anthu ambiri amakhala zaka zambiri akuyesera kupeza njira yoyenera yodziwira matenda awo otsegula m'mimba mosadziŵika bwino. Kwa iwo omwe ali ndi vuto la bile acid malabsorption, pali chiyembekezo chakuti masiku amenewo adzatha. Podziwa bwino za vutoli komanso njira zosavuta kuzizindikira, matenda adzapita patsogolo.

Ngakhale pali zifukwa zambiri zomwe zimayambitsa kusamwa bwino kwa bile acid m'thupi, chithandizocho chimakhala chimodzimodzi nthawi zonse. Dokotala amene akukayikira kuti BAM ndi yothandiza akhoza kupereka chithandizo, mwina ngati njira yotsimikizira izi. Anthu ambiri omwe ali ndi BAM amatha kuthana ndi zizindikiro zawo bwino pogwiritsa ntchito mankhwala ochepetsa shuga m'thupi komanso kusintha zakudya.

Zinthu zofunika kwambiri kukumbukira (Uthenga Wopita Nawo Kunyumba)

Chabwino, tiyeni tifotokoze mwachidule zomwe takambirana lero:

• Kusamwa bwino kwa bile acid (BAM) ndi vuto lomwe lingayambitse kutsegula m'mimba kosatha.
• Izi zimachitika chifukwa chakuti ma asidi a bile salowetsedwa bwino m'matumbo, koma amasonkhana m'matumbo akulu, zomwe zimapangitsa kutsegula m'mimba kwamadzi.
• Matenda osiyanasiyana, opaleshoni, ndi mankhwala ena angayambitse izi.
• Zizindikiro zake zingakhale kutsegula m'mimba pafupipafupi, kupweteka m'mimba, komanso kudzimbidwa.
• Matendawa amatha kupezeka kudzera mu mayeso monga mayeso a SeHCAT, mayeso a serum C4, ndi mayeso a fecal bile acid .
• Mankhwala akuluakulu ndi mankhwala otchedwa bile acid sequestrants ndi zakudya zopanda mafuta ambiri .
• Kutengera ndi chifukwa chake, chingachiritsidwe kapena sichingachiritsidwe kwathunthu, koma zizindikiro zake zitha kuthetsedwa bwino.
• Ngati muli ndi kutsegula m'mimba kosatha komanso kosamveka bwino, onetsetsani kuti mwapeza upangiri wa dokotala.Ndipo funsani za BAM.

Musadandaule, ngati mutamvetsa vutoli ndikulichiza bwino, nanunso mutha kupeza mpumulo. Khalani ndi thanzi labwino!

` Ma asidi a bile, kutsegula m'mimba, matumbo, kuyamwa, chiwindi, zizindikiro, chithandizo