Une dambudziko remudumbu here? Zvingave kusabatwa zvakanaka kwe bile acid!

Unorwarawo nekufamba-famba kwedumbu nguva nenguva here, kureva manyoka? Unorwarawo nechirwere chemanyoka chinonetsa kumisa, dzimwe nguva chichiita mvura yakawanda, kakawanda pazuva here? Saka ichi chinhu chingave chakakosha kwauri. Nhasi, tichataura nezvechirwere chinonzi Bile Acid Malabsorption (BAM) . Kunyangwe zita racho ringanzwika serakaoma, ngatitsanangure zviri nyore.

Chii chinonzi Bile Acid Malabsorption?

Zvichitaurwa zviri nyore, ichi chirwere chemudumbu medu. Zvikuru sei, chinogona kuva chikonzero chikuru chechirwere chenyoka chisingaperi , kureva kuti, chirwere chenyoka chinoenderera mberi. Kana bile acids mudumbu medu isinganyudzwe zvakanaka nemuviri, inoungana mudumbu. Ipapo makemikari ari mukati anokanganiswa. Nekuda kwehuwandu hwe bile acids, ura hwedu hunotumirwa meseji yekuburitsa mvura yakawanda. Ndosaka manyoka ane mvura achiitika. Funga nezvazvo semvura inopinda mupombi, asi izvi ndizvo zvinoitika kana mvura iyoyo yabuda muropa.

Chii chinonzi bile acids?

Zvino ungave uchishamisika kuti, "Chii chinonzi bile acids idzi?" Bile chinhu chinogadzirwa nechiropa chedu. Kana chiropa chikachenesa ropa redu, chinoparadzanisa tsvina yakaita sechepfu, masero eropa akafa, uye cholesterol yakawandisa yobva yaumba bile. Mhando dzakasiyana dzemaacids ari mubile iyi dzinobatana kuti dzigadzire bile acids . Aya maacids anobatsira kuchengetedza mafuta ari mumvura yebile.

Dumbu iri rinobva muchiropa rinotumirwa kuburikidza neducts yedumbu kuenda kudumbu redu diki kuti ribatsire kugaya chikafu. Mudumbu redu diki, maasidhi edumbu aya anobatsira muviri kugaya mafuta ari muchikafu chatinodya uye kuanyudza. Kana basa iroro rapera, maasidhi edumbu aya anotorwazve mumuviri wedu, ofamba nemuropa kuenda kuchiropa, uye anoshandiswa zvakare kugadzira dumbu. Izvi zvakafanana nemaitiro ekudzokorodza .

Chii chinonzi "Malabsorption"?

"Malabsorption" zvinongoreva kuti ura hwedu hahukwanisi kupinza makemikari atinofanira kupinza. Izvi zvinogona kukonzerwa nedambudziko reura pachahwo, kana kuti zvinogona kukonzerwa nekusawirirana kwemakemikari. Semuenzaniso, kana paine kemikari yakawandisa kana shoma, ura hunogona kutadza kuinyora zvakanaka.

Ndiani anonyanya kukanganiswa nemamiriro ezvinhu aya?

Kare, bile acid malabsorption (BAM) yaisazivikanwa muvanhu vazhinji nekuti pakanga pasina nzira dzekuiongorora nemazvo. Zvisinei, tsvakiridzo yazvino inoratidza kuti functional diarrhea disorders (FDDs)Zvinofungidzirwa kuti vanhu vanosvika 30% vane BAM vanogona kunge vaine chirwere ichi. Zvirwere zvemuviri zvirwere zvisina chikonzero chakajeka uye hazvionekwi nyore nekuongororwa nachiremba. Semuenzaniso, chirwere chinonzi (Irritable Bowel Syndrome - IBS) .

BAM inogona kuonekwa muvanhu vane zvirwere zvinotevera:

• Microscopic colitis
• Chirwere cheCrohn
• chirwere chegomarara chine chekuita neHIV
• Manyoka anoramba achiitika mushure mehutachiona hwebhakitiriya
• Kusakwana kwe exocrine pancreatic

Uyewo, chirwere ichi chinogona kuitika kune vanhu vari kurapwa nemamwe marapirwo:

• Kuvhiyiwa kubvisa kana kuchinja ileum, chikamu chekupedzisira cheura hudiki.
• Kuvhiyiwa kwekubvisa dundira (cholecystectomy) .
• Kurapa nemwaranzi , kunyanya mudumbu nemuchiuno.
• Kurapa nemakemikari .
• Kushandisa Metformin, mushonga unoshandiswa kune chirwere cheshuga cherudzi rwechipiri.

Ndezvipi zviratidzo zveizvi?

Zviratidzo zvinowanzoonekwa ndeizvi:

• Manyoka ane mvura
• Kuda kuenda kuchimbuzi kakawanda
• Marwadzo anorwadza mudumbu
• Kuda kuenda kuchimbuzi kamwe kamwe uye kunetseka kubata chituru

Vamwe vanhu vanogonawo kuva nezviratidzo zvinotevera:

• Kuzvimba mudumbu
• Gasi uye marwadzo aro
• Chituru chine mafuta (Steatorrhea)
• Kusagadzikana kwekugaya chikafu

Migumisiro yenguva refu inogona kusanganisira:

• Kushaya mvura mumuviri
• Kuneta kwakanyanya pasinei nekuzorora zvakakwana
• Musoro
• Dzungu
• Kusvotwa
• Vamwe vanhu vanorema, vamwe vanodzikira uremu.

Kazhinji, hafu yevanhu vanotambura nezviratidzo izvi vanozviita nguva dzese . Imwe hafu inosangana nezviratidzo izvi nguva nenguva .

Sei manyoka e bile acid achiitika?

Chiratidzo chikuru chekushaya manyowa e bile acid idambudziko remanyoka e bile acid (BAD) . Izvi zvinokonzerwa nemanyowa e bile acids anoungana muura hwedu hukuru (colon) , uko tsvina yechikafu inoshandurwa kuita tsvina. Kazhinji, 95% yemanyowa e bile acids muura hwedu hudiki anotorwazve muchikamu chekupedzisira cheura hudiki, ileum, asati asvika muura hukuru.

Zvisinei, kana maasidhi e bile akawandisa asina kunyudzwa nenzira iyi, anopinda pamwe chete nemamwe marara muura hukuru. Muura hukuru, maasidhi aya ebile anotsamwisa jira reura. Izvi zvinoita kuti ribudise mvura yakawanda, uye tsandanyama dzinosundidzira tsvina mberi dzinotanga kushanda zvakanyanya. Ndokusaka manyoka achiitika kakawanda uye kamwe kamwe, uye kurwadziwa mudumbu kunoitika.

Ndezvipi zvikonzero zvekudzikira kwekunyudzwa kwe bile acid mumuviri?

Zvino mubvunzo ndewokuti, sei maasidhi aya e bile achiungana muura? Vaongorori vakapatsanura BAM muzvikamu zvina zvinogona kukonzera. Dzimwe nguva izvi zvinoiswawo muzvikamu zvekutanga nechipiri .

• BAM Yekutanga: Izvi zvinokonzerwa nekuti chiropa chedu chinoburitsa bile acids yakawandisa (mhando 2 ne4).
• BAM yechipiri: Izvi zvinoitika kana ura hwedu hudiki hwakuvara nekuda kwechirwere, kuvhiyiwa, kana kurapwa nemwaranzi (mhando 1 ne3).

Rudzi rwekutanga rweBAM: Izvi zvinokonzerwa nedambudziko riri muileum, chikamu chekupedzisira cheura hudiki. Izvi zvinonzi malabsorption chaiyo nekuti dambudziko rinotanga padanho rekunyudzwa kwe bile acid cycle. Unogonawo kuva neRudzi rwekutanga rweBAM kana wakavhiyiwa kubvisa chikamu chekupedzisira cheura hudiki, kuchinjwa, kana kudziviswa sechikamu cheimwe chirwere. Iyo ileum inogonawo kukuvara nemamiriro akadai sechirwere cheCrohn uye kurapwa nemwaranzi. Kana paine kukuvara kukuru, kunyudzwa kunokanganiswa.

Rudzi rwechipiri rweBAM: Izvi dzimwe nguva zvinonzi "idiopathic." Izvi zvinoreva kuti zvinoitika kamwe kamwe, pasina chikonzero. Zvisinei, tsvakiridzo yazvino inoratidza kuti zvinokonzerwa nedambudziko remakemikari ekutumira zviratidzo pakati pematumbu edu nechiropa. Rudzi urwu rwekutumira zviratidzo runowanzo dzora kufamba kweropa muropa. Zviratidzo izvi zvinoudza chiropa nguva yekugadzira nekutumira mamwe maasidhi e bile, uye nguva yekumisa, kunwazve, uye kuadzokorodza. Asi muRudzi rwechipiri rweBAM, meseji yekuti "mira" haipfuuri zvakanaka. Saka, chiropa chinoramba chichitumira maasidhi ebile—anopfuura ayo ileum inogona kunwisa.

Rudzi rwechitatu rweBAM: Izvi zvinokonzerwa nezvirwere zvinokanganisa ileum pamwe chete nezvimwe zvikamu zvemuviri wedu wekugaya chikafu. Semuenzaniso, zvirwere zvakaita sechirwere checeliac , pancreatitis isingaperi , uye Small Intestinal Bacterial Overgrowth (SIBO) .

Rudzi rwechina rweBAM: Izvi zvinoitika semhedzisiro yekunwa mushonga wechirwere cheshuga metformin , iyo inokonzera kugadzirwa kweasidhi ye bile yakawandisa.

Ndeipi migumisiro yenguva refu yechirwere ichi?

Kana paine kusabatwa zvakanaka kwe bile acid mumuviri, kushomeka kwe bile acid mumuviri kunogona kuitika nekufamba kwenguva.Izvi zvinogona kuitika. Kureva kuti, kana bile acid yakawandisa ikaburitswa mutsvina uye isingadzokeri kuchiropa, chiropa hachina bile acid yakakwana yekugadzira bile. Kana bile shoma muura hudiki, zvinokanganisa kugaya kwako uye kudya kwako.

Kushaikwa kwe bile acids muura hudiki kunoderedza kunwa kwemafuta nemavhitamini anonyungudika mumafuta (A, D, E, naK). Izvi zvinogona kukonzera kushaya chikafu chakakwana uye matambudziko chaiwo ane chekuita nekushaikwa kwemavhitamini anonyungudika mumafuta. Semuenzaniso, kushomeka kwevhitamini D kunokanganisa mapfupa, uye kushomeka kwevhitamini A kunokanganisa kuona.

Vanhu vane chirwere cherudzi rwekutanga cheBAM, kunyanya, vanogonawo kuva nekushomeka kwevhitamini B12 . Izvi zvinokonzerwa nekuti vhitamini B12 inonyudzwa kuburikidza neileum. Muchiitiko ichi, kushomeka hakukonzerwi neBAM pachayo, asi nechirwere chinokonzera Type 1 BAM - kureva kuti, kusashanda zvakanaka kweileum. Zviratidzo zvakaita sekusvotwa, dzungu, uye kuneta zvinogona kuperekedzwa neizvi.

Kana uine kushomeka kweasidhi ye bile, izvo zvinoderedza kunyudzwa kwemafuta uye zvinokutadzisa kupisa macalorie akakodzera, unogona kudzikira uremu. Zvisinei, mune dzimwe nguva, kusanyudzwa zvakanaka kweasidhi ye bile kunogona kutungamira mukuwedzera uremu. Izvi zvinoita sekunge zvine chekuita nemetabolism. BAM, kana mamiriro ezvinhu anokonzera, anogona kukanganisa mashandisiro anoita muviri wako macalorie uye kuachengeta semafuta.

Chirwere ichi chinoonekwa sei?

Mitemo yekurapa iripo inokurudzira kuti chero munhu ane manyoka anoramba achiitika asina chikonzero chakajeka anofanira kuongororwa kuti ane bile acid malabsorption here. Asi bvunzo idzi hadziwanikwe kwese kwese. Vamwe vanachiremba vanoongorora izvi uye vanopa mishonga inonzi bile acid sequestrants kuti vaone kana ichibatsira.

Kune miedzo yakati wandei inogona kushandiswa kuongorora bile acid malabsorption:

• Kuongororwa kweSeHCAT: Uku ndiko kunoonekwa sekuyedzwa kwakanakisa kwekuongorora BAM, asi nyika zhinji, kusanganisira Sri Lanka, hadzina nzvimbo dzekuita izvi. Uku kuyedzwa kwekufungidzira mishonga yenyukireya . Kureva kuti, chinhu chine radioactive chine mwero mudiki chinopinzwa mumuviri, uye komputa inoongorora kuti chinofamba sei mumuviri uye inotora mifananidzo. Mukuyedzwa uku, unomedza kapusule ine synthetic bile acid inonzi SeHCAT pamwe chete nechinhu ichi chine radioactive. Kapusule iyi inoenda muura hudiki uye inonyudzwa nekukurumidza sezvinobvira ne bile acids mumuviri wako. Kamera ye gamma inoyera huwandu hweSeHCAT mumuviri wako pazuva rekutanga uye mushure memazuva manomwe. Kana pasi pe85% yeSeHCAT yasara mushure memazuva manomwe, inogona kuonekwa seine BAM.

• Kuongororwa kweSerum C4:Uku kuongororwa kweropa. Ndiyo nzira inotevera yakanakisa mushure mekuongororwa kweSeHCAT. Inoyera huwandu hweenzyme inonzi C4 muropa. Mazinga eC4 ane chekuita nehuwandu hweasidhi yebile muchiropa chako. Kana mazinga eC4 ako akakwira, chiratidzo chakanaka chekuti une BAM yekutanga (mhando 2 ne4). Muvanhu vane BAM yechipiri (mhando 1 ne3), mazinga eC4 anogonawo kukwira kana chiropa chikatanga kugadzira asidhi yebile yakawanda kuti chidzore kunyudzwa kwakaderera. Nokudaro, bvunzo iyi inobatsira vanhu vazhinji. Zvisinei, inogonawo kupa mhedzisiro yenhema kune vanhu vane mamwe mamiriro ezvinhu, akadai secholesterol yakakwira uye chirwere chechiropa chisina doro .

• Kuongororwa kweAcid yeBile Bile (Kuongororwa kweBA yeFecal): Izvi zvinoyera huwandu hweasidhi yebile mutsvina yako. Iyi ndiyo nzira yakatwasuka yekuyera kusabatwa kwebile acid. Zvisinei, zvine musoro kuti zvakaoma uye zvinogona kuitwa chete panzvimbo dzehutano dzakasarudzwa. Kuongororwa uku kunoda kugadzirira kwakakosha. Uchafanirwa kutevedzera kudya kwakakosha kwemazuva mashoma usati watanga, wozotora sampuro dzetsvina kwemaawa makumi mana nemasere. Nyanzvi dzichaedza tsvina yako kuti ione kana ine bile acids murabhoritari. Kana mazinga ebile acid yako akakwira, zvinoreva kuti bile acid yakawandisa iri kunyudzwa muura diki uye iri kupfuudzwa muura hukuru, zvichikonzera manyoka ebile acid.

Ndeapi marapirwo akanakisisa?

Mushonga wekutanga wekurapa bile acid malabsorption imhando yemishonga inonzi bile acid sequestrants kana kuti bile acid binders . Cholestyramine necolestipol ndizvo zvinonyanya kunyorerwa. Colesevelam isarudzo isina rezenisi, asi vamwe vanhu vanoona zviri nyore kushandisa.

Izvi zvinosanganisa bile acid zvidimbu zvine positive charge zvinobatana ne negative charge bile acids muura, zvichidzivirira kuti zvisaputswe kuita zvidimbu zvidiki zvinogona kunyudzwa. Kubatana uku kunodzivirirawo bile acids kuti isashande paura hukuru uye kukonzera manyoka. Izvi zvinobatsira kuderedza zviratidzo zveBAM.

Pane migumisiro yakaipa here yekurapwa kwacho?

Mishonga iyi inowanzouya iri muchimiro cheupfu. Inofanira kusanganiswa nemvura yotorwa. Vamwe vanhu vanoomerwa nekumedza kuravira kwayo uye magadzirirwo ayo. Vamwe vanowana zviratidzo zveBAM pamwe nemigumisiro isingafadzi. Izvi zvinosanganisira kuvimbiwa , kuda kurutsa, kuzvimba, uye gasi.

Uyewo, zvinosanganisa bile acid zvinogona kusunganidza mavhitamini anonyungudika muura hudiki. Izvi zvinogona kudzivirira ura hudiki kuti husanyungudike. Vamwe vanhu vanotora bile acid sequestrants vangada kutora mavhitamini ekuwedzera. Zvinogonawo kutorwa nenzira inodzivirira kugaya chikafu, senge nekubaya jekiseni .

Dambudziko iri rinogona kurapwa zvachose here?

Kana bile acid malabsorption ichigona kurapwa zvinoenderana nechikonzero chacho. Zvimwe zvikonzero zvinogona kurapwa, asi zvimwe hazvigone kurapwa. Kana chikonzero chacho chikarapwa zvakananga, dzimwe nguva chirwere cheBAM chinogona kuvandudzika. Mune zvimwe zviitiko, kunyangwe chikonzero chacho chisingagoni kurapwa, pane mukana wakanaka wekuti zviratidzo zvacho zvigone kurapwa zvinobudirira.

Zvakakosha: Usavhunduke! BAM inogona kugadziriswa. Chinhu chakakosha kutevedzera mirairo yachiremba wako.

Chii chinoita kuti zviratidzo zviwedzere kuipa?

Kutenderera kweasidhi ye bile kunokonzerwa nehuwandu hwemafuta ari mukudya kwako. Kana paine mafuta akawandisa muura hudiki, chiropa chinowana chiratidzo chemakemikari chichichiudza kuti "tumira bile yakawanda." Bile yakawanda zvinoreva kuti bile acid yakawanda iri kupinda muura hukuru. Ndosaka vanachiremba vachikurudzira kudya kusina mafuta akawanda kuti zvibatsire kudzora BAM.

Unofanira kuona chiremba rini?

Kana uine manyoka anoramba aripo pasina chikonzero chakajeka, bvunza chiremba wako nezvekusabatwa zvakanaka kwe bile acid. Ichi chirwere chisinganzwisisike uye chisinganyatsoonekwi, saka havasi vanachiremba vese vanozofunga nezvazvo ipapo ipapo. Saka kumbira chiremba wako kuti akuongorore, kana kuti akutumire kuna chiremba anoziva nezvazvo.

Vanhu vazhinji vanopedza makore vachiedza kuwana nzira chaiyo yekuongorora chirwere ichi uye nzira inoshanda yekurapa manyoka avo asina kutsanangurwa. Kune avo vane bile acid malabsorption, pane tariro yekuti mazuva iwayo achapera. Nekuziva kwakanyanya nezvechirwere ichi uye nzira dziri nyore dzekuchiwana, kuongororwa kuchave nani.

Kunyangwe paine zvikonzero zvakawanda zvinokonzera kusabatwa kwe bile acid mumuviri, kurapwa kwacho kwakafanana mune zvese zviitiko. Chiremba anofungidzira kuti BAM anogona kunyora mushonga, pamwe senzira yekusimbisa. Vanhu vazhinji vane BAM vanogona kubata zviratidzo zvavo zvinobudirira nekushandisa bile acid sequestrants uye kuchinja kudya.

Zvinhu zvakakosha zvekurangarira (Mharidzo Yekuenda Kumba)

Zvakanaka, ngatipfupisei zvatataura nezvazvo nhasi:

• Bile acid malabsorption (BAM) chirwere chinogona kuva chikonzero chikuru chechirwere chemanyoka chisingaperi.
• Izvi zvinoitika nekuti bile acids hainyudzwe nemazvo neura, asi inoungana muura hukuru, zvichikonzera manyoka ane mvura.
• Zvirwere zvakasiyana-siyana, kuvhiyiwa, uye mimwe mishonga zvinogona kukonzera izvi.
• Zviratidzo zvinogona kusanganisira manyoka anogara achiitika, kurwadziwa mudumbu, uye kuzvimba.
• Chirwere ichi chinogona kuonekwa kuburikidza nemiedzo yakaita seyeSeHCAT test, serum C4 test, uye fecal bile acid test .
• Mishonga mikuru inonzi bile acid sequestrants uye kudya kusina mafuta akawanda .
• Zvichienderana nechikonzero chacho, chingave chinorapika kana kusarapika zvachose, asi zviratidzo zvacho zvinogona kudzorwa zvakanaka.
• Kana uine manyoka asingatsananguriki, iva nechokwadi chekutsvaga rubatsiro rwechiremba.Uye bvunzawo nezveBAM.

Usazvidya moyo, kana ukanzwisisa chirwere ichi uye ukachirapa nemazvo, iwewo unogona kuwana zororo. Iva neutano hwakanaka!

` Maasidhi emudumbu, manyoka, ura, kunyudzwa, chiropa, zviratidzo, kurapwa