Ingaba nawe usoloko unengxaki yesisu? Isenokuba yi-bile acid malabsorption!

Ngaba nawe unengxaki yokurhuda rhoqo, oko kukuthi, urhudo? Ngaba unengxaki yorhudo ekunzima ukuyiyeka, ngamanye amaxesha enamanzi, amaxesha amaninzi ngemini? Ke le yinto enokuba yinto ebalulekileyo kuwe. Namhlanje, siza kuthetha ngemeko ebizwa ngokuba yiBile Acid Malabsorption (BAM) . Nangona igama lisenokuvakala linzima kancinci, masilichaze ngokulula.

Yintoni iBile Acid Malabsorption?

Ngamafutshane, esi sisifo senkqubo yethu yokugaya ukutya . Ngokukodwa, sinokuba sisizathu esikhulu sorhudo olungapheliyo , oko kukuthi, urhudo oluqhubekayo. Xa ii-bile acids emathunjini ethu zingafunxwa kakuhle ngumzimba, ziyaqokelelana emathunjini. Emva koko ibhalansi yeekhemikhali ngaphakathi iyaphazamiseka. Ngenxa yale asidi ye-bile egqithisileyo, ikholoni yethu ithunyelwa umyalezo wokukhupha amanzi amaninzi. Yiyo loo nto urhudo olunamanzi luvela. Cinga ngalo njengamanzi ahamba ngepayipi, kodwa oku kwenzekayo xa loo manzi engalawuleki.

Zithini ii-bile acids?

Ngoku usenokuba uzibuza, "Zithini ezi asidi ze-bile?" I-Bile yinto eveliswa sisibindi sethu. Xa isibindi sicoca igazi lethu, sahlula izinto ezimdaka ezifana neetyhefu, iiseli zegazi ezifileyo, kunye ne-cholesterol egqithisileyo kwaye senza i-bile. Iindidi ezahlukeneyo ze-asidi kule bile ziyadibana ukuze zenze ii-asidi ze-bile . Ezi asidi zinceda ukugcina ii-lipids kulwelo lwe-bile.

Le nyongo isuka esibindini ithunyelwa ngemibhobho yenyongo iye emathunjini ethu amancinci ukuze incede ekugayeni ukutya. Emathunjini amancinci, ezi nyongo zinceda umzimba ukuba ugaye amafutha ekutyeni esikutyayo kwaye uwafunxe. Xa loo msebenzi ugqityiwe, ezi nyongo ziphinda zifunxwe emzimbeni wethu, zihambe ngegazi ziye esibindini, kwaye ziphinde zisetyenziswe ukwenza inyongo. Oku kufana nenkqubo yokuphinda kusetyenziswe .

Yintoni "iMalabsorption"?

"I-Malabsorption" ithetha nje ukuba amathumbu ethu awakwazi ukufunxa ngokufanelekileyo iikhemikhali ekufuneka sizifunxe. Oku kusenokubangelwa yingxaki ngamathumbu ngokwawo, okanye kunokubangelwa kukungalingani kweekhemikhali. Umzekelo, xa kukho ikhemikhali ethile eninzi kakhulu okanye encinci kakhulu, amathumbu asenokungakwazi ukuyifunxa ngokufanelekileyo.

Ngubani ochaphazeleka kakhulu yile meko?

Ngaphambili, i-bile acid malabsorption (BAM) yayingabonwa kubantu abaninzi kuba bekungekho ndlela zokuyixilonga ngokuchanekileyo. Nangona kunjalo, uphando lwakutshanje lubonisa ukuba iingxaki zorhudo olusebenzayo (ii-FDD)Kuqikelelwa ukuba ubuncinane ama-30% abantu abane-BAM banokuba nayo. Izifo ezisebenzayo ziimeko ezingenasizathu sicacileyo kwaye azifumaneki lula ngovavanyo lwezonyango. Umzekelo, imeko ebizwa ngokuba yi- (Irritable Bowel Syndrome - IBS) .

I-BAM inokubonwa kubantu abanezi meko zonyango zilandelayo:

• I-Microscopic colitis
• Isifo sikaCrohn
• I-enteritis enxulumene ne-HIV
• Urhudo oluqhubekayo emva kosulelo lwebhaktheriya
• Ukungasebenzi kakuhle kwe-pancreatic exocrine

Kwakhona, le meko inokwenzeka nakubantu abafumana unyango oluthile:

• Ukususwa okanye ukuguqulwa kwe-ileum ngotyando, inxalenye yokugqibela yamathumbu amancinci.
• Utyando lokususa inyongo (i-cholecystectomy) .
• Unyango lwemitha , ingakumbi esiswini nakwisinqe.
• Unyango ngamachiza .
• Ukusetyenziswa kweMetformin , iyeza elisetyenziselwa isifo seswekile sohlobo lwesibini.

Zithini iimpawu zoku?

Iimpawu eziqhelekileyo ezibonwayo zezi:

• Urhudo olumanzi
• Ukufuna rhoqo ukuya kwigumbi lokuhlambela
• Iintlungu ezibuhlungu esiswini
• Umnqweno wokuya kwigumbi lokuhlambela ngequbuliso kunye nobunzima bokubambelela esitulweni

Abanye abantu banokuba nezi mpawu zilandelayo:

• Ukudumba kwesisu
• Igesi kunye nentlungu ebangela yona
• Indle enamafutha (iSteatorrhea)
• Ukungagayi kakuhle kokutya

Iziphumo zexesha elide zingabandakanya:

• Ukuphelelwa ngamanzi emzimbeni
• Ukudinwa kakhulu nangona uphumle ngokwaneleyo
• Intloko ebuhlungu
• Isiyezi
• Isicaphucaphu
• Abanye abantu bayatyeba, abanye bayatyeba.

Uninzi lwexesha, malunga nesiqingatha sabo banezi mpawu bahlala benazo . Esinye isiqingatha siba nazo ngamaxesha athile .

Kutheni kukho urhudo olubangelwa yi-bile acid?

Uphawu oluphambili lwe-bile acid malabsorption yi -bile acid diarrhea (BAD) . Oku kubangelwa yi-bile acids eziqokelelana emathunjini ethu amakhulu (colon) , apho inkunkuma yokutya iguqulwa ibe yindle. Ngokwesiqhelo, i-95% yee-bile acids emathunjini ethu amancinci iphinda ifunxwe kwinxalenye yokugqibela yamathumbu amancinci, i-ileum, ngaphambi kokuba ifike emathunjini amakhulu.

Nangona kunjalo, ukuba ii-asidi ze-bile ezigqithisileyo azifunxwa ngale ndlela, zidlula kunye nezinye izinto ezingafunekiyo ziye emathunjini amakhulu. Emathunjini amakhulu, ezi asidi ze-bile ziyayicaphukisa ingaphakathi lamathumbu. Oku kubangela ukuba ikhuphe ulwelo oluninzi, kwaye izihlunu ezityhala isitulo phambili zisebenze ngakumbi. Yiyo loo nto urhudo lusenzeka rhoqo nangequbuliso, kwaye kuvela iintlungu zesisu.

Zithini izizathu zokuncipha kokufunxwa kwe-bile acid?

Ngoku umbuzo ngulo, kutheni ezi bhili acids ziqokelelana emathunjini? Abaphandi bahlukanise i-BAM zibe zizizathu ezine ezinokubakho. Ngamanye amaxesha ezi zikwahlulwa zibe zezona ziphambili nezizesibini .

• I-BAM ephambili: Oku kubangelwa kukuba isibindi sethu sivelisa ii-bile acids ezininzi kakhulu (iintlobo 2 kunye no-4).
• I-BAM yesibini: Oku kwenzeka xa amathumbu ethu amancinci onakele ngenxa yesifo, utyando, okanye unyango lwemitha (iintlobo 1 kunye no-3).

Uhlobo 1 lwe-BAM: Oku kubangelwa yingxaki kwi-ileum, inxalenye yokugqibela yamathumbu amancinci. Oku kubizwa ngokuba yi-malabsorption yokwenyani kuba ingxaki iqala kwinqanaba lokufunxa lomjikelo we-bile acid. Usenokuba ne-Type 1 ye-BAM ukuba ukhe wasuswa, watshintshwa, okanye wadlula inxalenye yokugqibela yamathumbu amancinci njengenxalenye yesinye isifo. I-ileum ingonakaliswa zizifo ezifana nesifo sikaCrohn kunye nonyango lwemitha. Ukuba kukho umonakalo omkhulu, ukufunxa kuyaphazamiseka.

Uhlobo lwe-2 BAM: Oku ngamanye amaxesha kubizwa ngokuba yi-"idiopathic." Oku kuthetha ukuba kwenzeka ngequbuliso, ngaphandle kwesizathu. Nangona kunjalo, uphando lwangoku lubonisa ukuba kubangelwa yingxaki yenkqubo yokubonisana kwamakhemikhali phakathi kwamathumbu ethu nesibindi. Le nkqubo yokubonisana idla ngokulawula ukujikeleza kwegazi emzimbeni. Ezi zimpawu zixelela isibindi ukuba senze nini kwaye sithumele ii-asidi ze-bile ezingaphezulu, kwaye nini ukuba ziyeke, ziphinde zifunxwe, kwaye ziphinde zisetyenziswe. Kodwa kwi-Type 2 BAM, umyalezo othi "yeka" awudluli kakuhle. Ngoko ke, isibindi siqhubeka sithumela ii-asidi ze-bile—ezingaphezulu kunokuba i-ileum inokufunxa.

Uhlobo lwe-3 BAM: Oku kubangelwa zizifo ezichaphazela i-ileum kunye nezinye iindawo zenkqubo yethu yokugaya ukutya. Umzekelo, iimeko ezifana nesifo se-celiac , i-pancreatitis engapheliyo , kunye ne -Small Intestinal Bacterial Overgrowth (SIBO) .

Uhlobo lwesi-4 lwe-BAM: Oku kwenzeka njengesiphumo esingesihle sokuthatha iyeza lesifo seswekile i-metformin , ebangela ukuveliswa kwe-bile acid eninzi.

Zithini iziphumo zexesha elide zale meko?

Ukuba kukho ukungafunxwa kakuhle kwe-bile acid, ukungabikho kwe-bile acid kunokuvela ngokuhamba kwexesha.Oku kunokwenzeka. Oko kukuthi, xa i-bile acid eninzi ikhutshwa endleni kwaye ingaphindi ibuyiselwe esibindini, isibindi asinazo ii-bile acid ezaneleyo zokwenza i-bile. Ukuba i-bile incinci emathunjini amancinci, ichaphazela ukugaya kwakho kunye nesondlo.

Ukunqongophala kwee-asidi ze-bile emathunjini amancinci kunciphisa ukufunxwa kwamafutha kunye neevithamini ezinyibilikayo kumafutha (A, D, E, kunye ne-K). Oku kunokukhokelela ekungondlekini kakuhle kunye neengxaki ezithile ezinxulumene nokunqongophala kweevithamini ezinyibilikayo kumafutha. Umzekelo, ukunqongophala kwe-vitamin D kuchaphazela amathambo, kwaye ukunqongophala kwe-vitamin A kuchaphazela umbono.

Abantu abane-Type 1 BAM, ngakumbi, banokuba nokungabikho kwe-vitamin B12 . Oku kungenxa yokuba i-vitamin B12 ifunxwa yi-ileum. Kwimeko enjalo, ukungabikho kwayo akubangelwa yi-BAM ngokwayo, kodwa yimeko ebangela i-Type 1 BAM - oko kukuthi, ukungasebenzi kakuhle kwe-ileum. Iimpawu ezifana nokucaphuka, isiyezi, kunye nokudinwa zinokuhamba nale nto.

Ukuba unesiphene se-bile acid, esinciphisa ukufunxwa kwamafutha kwaye sikuthintele ekutshiseni iikhalori ezaneleyo, unokunciphisa ubunzima. Nangona kunjalo, kwezinye iimeko, ukufunxwa kakubi kwe-bile acid kunokukhokelela ekutyebeni. Oku kubonakala ngathi kunxulumene nemetabolism. I-BAM, okanye iimeko ezibangela oku, inokuchaphazela indlela umzimba wakho osebenzisa ngayo iikhalori kwaye uzigcine njengamafutha.

Sifunyaniswa njani esi sifo?

Izikhokelo zonyango zangoku zicebisa ukuba nabani na onesifo sorhudo esingapheliyo ngaphandle kwesizathu esicacileyo kufuneka ahlolwe i-bile acid malabsorption. Kodwa ezi mvavanyo azifumaneki kuyo yonke indawo. Abanye oogqirha baya kujonga oku baze banike amayeza abizwa ngokuba yi-bile acid sequestrants ukuze babone ukuba ayanceda na.

Kukho iimvavanyo ezininzi ezinokusetyenziselwa ukuxilonga i-bile acid malabsorption:

• Uvavanyo lweSeHCAT: Olu luvavanyo oluthathwa njengolona lubalaseleyo lokufumanisa i-BAM, kodwa amazwe amaninzi, kuquka neSri Lanka, awanazo izixhobo zokwenza oku. Olu luvavanyo lokucinga ngamayeza enyukliya . Oko kukuthi, into ene-radioactive engaphantsi komthamo ifakwa emzimbeni, kwaye ikhompyutha ijonga indlela ehamba ngayo emzimbeni ize ithathe imifanekiso. Kolu vavanyo, uginya i-capsule equlethe i-bile acid yokwenziwa ebizwa ngokuba yiSeHCAT kunye nale nto ine-radioactive. Le capsule iya emathunjini amancinci kwaye ifunxwa ngokukhawuleza ngangokunokwenzeka yi-bile acids emzimbeni wakho. Ikhamera ye-gamma ilinganisa inqanaba leSeHCAT emzimbeni wakho ngosuku lokuqala nasemva kweentsuku ezisixhenxe. Ukuba kusele ngaphantsi kwama-85% eSeHCAT emva kweentsuku ezisixhenxe, inokufunyanwa njengene-BAM.

• Uvavanyo lwe-Serum C4:Olu luvavanyo lwegazi. Luthathwa njengolona khetho lulandelayo lulungileyo emva kovavanyo lweSeHCAT. Lulinganisa inqanaba le-enzyme ebizwa ngokuba yi-C4 egazini. Amanqanaba e-C4 anxulumene nokuba isibindi sakho sivelisa i-bile acids engakanani. Ukuba amanqanaba akho e-C4 aphezulu, luphawu oluhle lokuba une-BAM yokuqala (iintlobo 2 kunye no-4). Kubantu abane-BAM yesibini (iintlobo 1 kunye no-3), amanqanaba e-C4 anokuba phezulu ukuba isibindi siqala ukuvelisa ii-bile acids ezininzi ukuhlawula ukufunxwa okunciphileyo. Ke ngoko, olu vavanyo luluncedo kubantu abaninzi. Nangona kunjalo, lunokunika iziphumo ezingezizo kubantu abaneemeko ezithile, ezifana ne-cholesterol ephezulu kunye nesifo sesibindi esinamafutha esinganxilisiyo .

• Uvavanyo lwe-Fecal Bile Acid (Uvavanyo lwe-Fecal BA): Olu vavanyo lulinganisa ubungakanani be-bile acids kwindle yakho. Le yeyona ndlela ithe ngqo yokulinganisa i-bile acid malabsorption. Nangona kunjalo, ngobuchwephesha iyinkimbinkimbi ngakumbi kwaye ingenziwa kuphela kumaziko ezempilo akhethiweyo. Olu vavanyo lufuna ukulungiswa okukhethekileyo. Kuya kufuneka ulandele ukutya okukhethekileyo iintsuku ezimbalwa ngaphambi koko, uze emva koko uqokelele iisampulu zendle iiyure ezingama-48. Iingcali ziya kuvavanya indle yakho ukuze zibone ukuba i-bile acids ikwilabhoratri. Ukuba amanqanaba e-bile acid yakho aphezulu, oko kuthetha ukuba i-bile acid eninzi kakhulu iyafunxwa emathunjini amancinci kwaye idluliselwa emathunjini amakhulu, nto leyo ebangela urhudo lwe-bile acid.

Zeziphi iindlela zonyango ezilungileyo?

Unyango lokuqala lwe-bile acid malabsorption ludidi lwamayeza abizwa ngokuba yi-bile acid sequestrants okanye i-bile acid binders . I-Cholestyramine kunye ne -colestipol zezona ziqhelekileyo ezinikwayo. I-Colesevelam lukhetho olungenalayisenisi, kodwa abanye abantu bakufumanisa kulula ukuyisebenzisa.

Ezi ntlobo ze-bile acid ziingceba ezitshajiswe kakuhle ezibopha kwii-bile acids ezitshajiswe kakubi emathunjini, zithintela ukuba zingaqhekeki zibe ziingceba ezincinci ezinokufunxwa. Oku kubopha kukwathintela ii-bile acids ukuba zingasebenzi emathunjini amakhulu zize zibangele urhudo. Oku kunceda ukunciphisa iimpawu ze-BAM.

Ngaba kukho naziphi na iziphumo ebezingalindelekanga zonyango?

La mayeza adla ngokuza ekwimo yomgubo. Kufuneka axutywe nolwelo aze athathwe. Abanye abantu bakufumanisa kunzima ukuginya incasa kunye nokuthungwa kwawo. Abanye bafumana iimpawu ze-BAM kunye neziphumo ebezingalindelekanga ezingathandekiyo. Ezi ziquka ukuqhina , isicaphucaphu, ukudumba, kunye negesi.

Kwakhona, ii-bile acid sequestrants zinokubophelela kwiivithamini ezinyibilikayo kumathumbu amancinci. Oku kunokuthintela amathumbu amancinci ukuba angawafunxi. Abanye abantu abathatha ii-bile acid sequestrants banokufuna ukuthatha izongezo zeevithamini. Kusenokufuneka zithathwe ngendlela engayi kudlula inkqubo yokugaya ukutya, njengokufaka inaliti .

Ngaba le meko inganyangeka ngokupheleleyo?

Ukuba i-bile acid malabsorption inokunyangeka kuxhomekeke kwisizathu. Ezinye izizathu zinokunyangwa, ngelixa ezinye zingenakunyangwa. Ukuba isizathu esiyintloko sinyangwa ngokuthe ngqo, ngamanye amaxesha imeko ye-BAM inokuphucula. Kwezinye iimeko, nokuba isizathu asinakunyangwa, kukho ithuba elihle lokuba iimpawu zinokunyangwa ngempumelelo.

Kubalulekile: Musa ukoyika! I-BAM inokulawulwa. Eyona nto ibalulekileyo kukulandela imiyalelo kagqirha wakho.

Yintoni eyenza iimpawu zibe zimbi ngakumbi?

Umjikelo we-bile acid ubangelwa bubungakanani bamafutha ekutyeni kwakho. Ukuba kukho amafutha amaninzi kakhulu emathunjini amancinci, isibindi sifumana uphawu lwekhemikhali olusixelela ukuba "sithumele i-bile engaphezulu." I-bile engaphezulu ithetha ukuba ii-bile acids ezininzi ziya emathunjini amakhulu. Yiyo loo nto oogqirha becebisa ukutya okunamafutha aphantsi ukunceda ukulawula i-BAM.

Ufanele uye nini kugqirha?

Ukuba unesifo sohudo esingapheliyo ngaphandle kwesizathu esicacileyo, buza ugqirha wakho malunga nokungafunxwa kwe-bile acid. Esi sisifo esingaqondwa kakuhle kwaye asifumaneki kakuhle, ngoko ke ayingabo bonke oogqirha abaya kucinga ngaso ngoko nangoko. Ngoko cela ugqirha wakho ukuba akuvavanye, okanye akuthumele kwingcali eyaziyo ngaso.

Abantu abaninzi bachitha iminyaka bezama ukufumana ukuxilongwa okufanelekileyo kunye nonyango olusebenzayo lorhudo lwabo olungachazwanga. Kwabo bane-bile acid malabsorption, kukho ithemba lokuba ezo ntsuku ziya kuphela. Ngokwazi ngakumbi ngale meko kunye neendlela ezilula zokuyifumanisa, ukuxilongwa kuya kuphucuka.

Nangona zininzi izizathu zokungafunxwa kwe-bile acid, unyango lufana kuzo zonke iimeko. Ugqirha orhanela ukuba i-BAM inganika unyango, mhlawumbi njengendlela yokuqinisekisa oko. Abantu abaninzi abane-BAM banokukwazi ukulawula iimpawu zabo ngempumelelo ngokusebenzisa amayeza aqulethe i-bile acid kunye notshintsho kwindlela yokutya.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, masishwankathele oko sithethe ngako namhlanje:

• I-Bile acid malabsorption (BAM) yimeko enokuba yimbangela enkulu yorhudo olungapheliyo.
• Oku kwenzeka kuba ii-bile acids azifunxwa kakuhle ngamathumbu, kodwa ziqokelelana emathunjini amakhulu, nto leyo ebangela urhudo olumanzi.
• Iimeko ezahlukeneyo zonyango, utyando, kunye namayeza athile anokubangela oku.
• Iimpawu zingabandakanya urhudo oluqhelekileyo, iintlungu zesisu, kunye nokudumba.
• Esi sifo sinokufunyaniswa ngovavanyo olufana novavanyo lweSeHCAT, uvavanyo lwe-serum C4, kunye novavanyo lwe-fecal bile acid .
• Unyango oluphambili ngamayeza abizwa ngokuba yi -bile acid sequestrants kunye nokutya okunamafutha aphantsi .
• Ngokuxhomekeke kwisizathu, isenokunyangeka okanye inganyangeki ngokupheleleyo, kodwa iimpawu zinokulawulwa kakuhle.
• Ukuba unesifo sorhudo esingapheliyo, esingachazwanga, qiniseka ukuba ufuna ingcebiso kagqirha.Kwaye ubuze nge-BAM.

Ungakhathazeki, ukuba uyayiqonda le meko kwaye uyinyanga ngokufanelekileyo, nawe ungafumana isiqabu. Yiba sempilweni!

Iiasidi zeBile , urhudo, amathumbu, ukufunxwa, isibindi, iimpawu, unyango