Isisu siphazamisekile? Awukwazi ukugaya ukutya? Yiza, masithethe nge-(Prokinetic Agents)!

Ngaba ngamanye amaxesha uziva ugcwele okanye ungakugayi kakuhle ukutya emva kokutya? Okanye ngaba uneengxaki ezifana nesitshiso okanye ukungagayi kakuhle ukutya? Ngamanye amaxesha ezi ngxaki zinokubangelwa kukuba amathumbu ethu angasebenzi kakuhle. Namhlanje siza kuthetha ngohlobo oluthile lonyango oluza kunceda ngamaxesha anjalo. Ezi zibizwa ngokuba yi-`(Prokinetic Agents)`.

Zithini ezi `(Prokinetic Agents)`? Ngamafutshane...

Ngamafutshane, `(Ii-Prokinetic Agents)` luhlobo lonyango olunyusa isantya sokutya okuhamba kwinkqubo yakho yokugaya ukutya, oko kukuthi, amathumbu. Xa siginya ukutya, izihlunu kwindlela yethu yokugaya ukutya ziqala ukufinyela ukusuka phezulu ukuya ezantsi njengothotho lwamaza. Oku kubizwa ngokuba yi-`(Peristalsis)`. Kufana nokutyhala ukutya phantsi. Le yindlela ukutya okuhamba ngayo ukusuka emqaleni, ukuya e-esophagus, ukuya esiswini, kuze kungene emathunjini. Kukule ndlela umzimba wethu ufunxa ngayo izondlo ozifunayo.

Nangona kunjalo, ngenxa yezifo ezithile okanye ezinye izizathu, le nkqubo ibizwa ngokuba yi-"Peristalsis" isenokungasebenzi kakuhle. Kulapho kuvela khona iimpawu ezifana nokuqhinwa, isitshiso sentliziyo, kunye nokuziva ugcwele ngaphandle kokugaya ukutya. Ukutya kunokuhlala esiswini ixesha elide, uze umzimba ungafumani izondlo ezifunekayo.

Kulapho ke la mayeza abizwa ngokuba yi-`(Prokinetic Agents)` anceda khona. La mayeza andisa ukunyakaza kwamathumbu kwaye anceda ukutya ukuba kudlule ngokukhawuleza kwindlela yokugaya ukutya. Kodwa eyona nto ibalulekileyo ekufuneka uyikhumbule kukuba kukho iziphumo ebezingalindelekanga ezinokubakho ngala mayeza. Ke ngoko, oogqirha abadli ngokuwanika la mayeza ngoko nangoko. Uninzi lwexesha, `(Proton Pump Inhibitors - PPIs)` okanye `(H2 Blockers)` banikwa amanye amayeza kwaye emva koko `(Prokinetic Agents)` ziqwalaselwa kuphela ukuba aziniki ncedo. Nangona kunjalo, kuxhomekeke kwimeko yakho yempilo, ugqirha wakho unokukunika eli chiza.

Zisebenza njani ezi `(Prokinetic Agents)`?

Indlela ezisebenza ngayo ezi ziyobisi iyinkimbinkimbi kancinci, kodwa ndiza kuyigcina ilula. Zivuselela imithambo-luvo kwinkqubo yakho yokugaya ukutya kwaye zincede izihlunu ziqine.

Oko ikukuthi:

• Iyandisa ukushwabana kwesisu sakho (umbhobho wokutya), inceda ukuhambisa ukutya ngokukhawuleza esiswini.
• Qinisa iLower Esophageal Sphincter (LES) ezantsi kwe-esophagus yakho. I-LES ifana nevalvu. Yinxalenye ye-esophagus yakho edibanisa isisu sakho ne-esophagus yakho. Ukuba ayivaleki kakuhle kwaye ikhululeke, i-asidi yesisu inokubuyela kwi-esophagus yakho nasemqaleni. Kulapho ufumana khona isitshiso sentliziyo, isitshiso sentliziyo, kunye nentlungu yesifuba. Oku kukwabizwa ngokuba yi-Acid Reflux okanye i-GERD.
• Iyandisa ukushwabana kwesisu kwaye inceda ukuhambisa ukutya ngokukhawuleza emathunjini amancinci.
• Kunciphisa ixesha elithathwayo ukuba isisu siphume. Oku kunciphisa amathuba okuba okungaphakathi esiswini kubuye kuphakame, njengakwimeko ye-`(Acid Reflux)`.

Khawuthelekelele, eli yeza lisebenza njengengxinano yendlela, aze amapolisa eze avule indlela yokuba izithuthi zihambe ngokukhawuleza.

Zeziphi iimeko ezisetyenziselwa `(Ii-Prokinetic Agents)`?

La mayeza asetyenziswa kakhulu kwezi meko zilandelayo:

• I-Gastroparesis (ukungasebenzi kakuhle kwemisipha yesisu/ukucotha kokugaya): Kule meko, izihlunu zesisu azicutheki kakuhle, ngoko ke ukucotha kokutya kuyalibaziseka. Amayeza e-prokinetic ayandisa ukucutheka kwaye abangele ukuba isisu siphume ngokukhawuleza. Abantu abanesifo seswekile banokufumana le meko ebizwa ngokuba yi-Diabetic Gastroparesis. I-Metoclopramide yeyona yodwa iyeza elivunyiweyo yi-FDA e-United States ngoku ngenxa yoku. Ugqirha wakho unokukunika oku ukuba ezinye iindlela zonyango azincedi.

• I-GERD (Gastroesophageal Reflux Disease): Oku kwenzeka xa i-asidi yesisu ibuyela kwi-esophagus iye emlonyeni. Oku kwenzeka xa i-LES (Lessive Esophageal Suppression System) endikhankanyileyo ngaphambili ingavali kakuhle. Ii-prokinetic agents zodwa aziyi kunceda i-GERD. Nangona kunjalo, ukuba isisu sakho sicotha ukuphuma, ugqirha wakho unokukunika ezi kunye namanye amayeza.

• I-Dispepsia esebenzayo: Oku kwenzeka xa usoloko uneengxaki zesisu emva kokutya, kodwa akukho sizathu sicacileyo sifumanekayo. Abanye abantu banokufumanisa ukuba la mayeza anokunceda ekunciphiseni iimpawu. Abaphandi bathi la mayeza anceda ngokunyusa ukushwabana kwesisu kunye nokukhawulezisa ukuphuma kwegazi.

• Isicaphucaphu nokuhlanza: Ugqirha angakunika eli yeza lokuhlanza ngokukhawuleza okanye okungapheliyo okungakhange kuphendule kwezinye iindlela zonyango. Ngamanye amaxesha zikwasetyenziselwa ukuhlanza okubangelwa ngamayeza e-chemotherapy omhlaza.

• Ukuvaleka kwamathumbu okungamahlalakhona: Kulapho iimpawu zokuvaleka kwamathumbu zikhona nangona kungekho kuvaleka kwamathumbu . Abaphandi basaphanda ukuba ingaba ezinye ii-prokinetic agents zinokunceda na kule meko.

Ziziphi iintlobo eziphambili ze-`(Prokinetic Agents)`?

La mayeza anokwahlulwahlulwa abe ngamacandelo amabini aphambili: `(Agonists)` kunye `(Antagonists)`.

• `(Agonists)`: Ezi zisebenza njenge `(Neurotransmitters)` ezithile (iikhemikhali ezithwala imiyalezo phakathi kwemithambo-luvo) kwinkqubo yethu yemithambo-luvo. Oko kukuthi, ezi `(Agonists)` ziyahamba zize zinamathele kwimithambo-luvo, zixelela loo mithambo-luvo ukuba "inciphe". Kanye njengokuba `(Neurotransmitters)` efanelekileyo isenza into efanayo.
• `(Abachasi)`: Aba basebenza ngokuthintela `(Abathumeli beNeurotransmitter)` abathile ekubopheni kwimithambo-luvo. Ngokukodwa, ukuba kukho `(Abathumeli beNeurotransmitter)` abaphazamisana nenkqubo `(iPeristalsis)`, aba `(Abachasi)` bayabathintela ekubopheni kwimithambo-luvo.

Ezi "Prokinetic Agents" zahlulwe ngokwamaqela ahlukeneyo, kuxhomekeke kwindlela elisebenza ngayo ichiza ngalinye:

• `(Agonists abaneCholinergic)`:Ezi zisebenza njenge-``(Neurotransmitter)`` ebizwa ngokuba yi-`(Acetylcholine)`. `(Acetylcholine)` ivuselela ukufinyela kwemisipha emathunjini. Imizekelo: `(Baclofen)`, `(Bethanechol)`, `(Neostigmine)`, `(Pyridostigmine)`.
• `(Ama-Motilin Agonists)` (Ama-Macrolide Antibiotics): La asebenza njenge-`(Neurotransmitter)` ebizwa ngokuba yi-`(Motilin). `(Motilin)` ivuselela ukushwabana kwamathumbu amancinci. Amanye amayeza kweli qela ngokwenene yi-`(Ama-Antibiotics)` anikwa ukunyanga usulelo lweentsholongwane. Imizekelo: `(Erythromycin)`, `(Azithromycin)`.
• IiSerotonin Agonists: Ezi zisebenza njenge-neurotransmitter serotonin. Njenge-serotonin, zivuselela ukushwabana kwamathumbu kwaye zinceda isisu singabi nanto. Imizekelo: I-Cisapride, i-Prucalopride, i-Tegaserod.
• `(Ii-Dopamine Antagonists)`: Ezi zithintela i-`(Neurotransmitter)` ebizwa ngokuba yi-`(Dopamine)` ekubopheni kwiiseli zemithambo-luvo. `(Dopamine)` inciphisa intshukumo yesisu namathumbu, kwaye ikhulula i-`(LES)`. Ngoko ke, xa i-`(Dopamine)` iyeka ukubopha, ezi `(Ii-Dopamine Antagonists)` zitshintsha loo mpembelelo (oko kukuthi zonyusa intshukumo). Imizekelo: `(Metoclopramide)`, `(Domperidone)`.

Eminye imizekelo ye-`(Prokinetic Agents)`

Okwangoku kukho iintlobo ezithile zamayeza e-"Prokinetic" asetyenziselwa unyango, ezinye zazo eziye zavalwa kumazwe afana ne-United States ngenxa yeziphumo ebezingalindelekanga, kwaye ezinye zisesekwinqanaba lophando.

• I-Azithromycin (iZithromax®): I-motilin agonist. Oogqirha ngamanye amaxesha bayinika i-gastroparesis ngaphandle kwelebula.
• I-Baclofen (ED baclofen®): I-agonist ye-cholinergic. Iingenelo zayo kwi-GERD zisafundwa.
• `(Bethanechol)` (Urecholine®): I-`(Cholinergic Agonist). Inceda kwiimpawu ze-`(Gastroparesis)` kunye ne-`(GERD)`. Nangona kunjalo, ayisetyenziswa ngobuninzi kuba inokubangela iziphumo ebezingalindelekanga ezinzulu ezifana nokuxinana kwemisipha kunye nokungaboni kakuhle.
• I-Cisapride (Propulsid®): I-agonist ye-serotonin. Inceda isisu sikhuphe izinto ngokukhawuleza. Yayisetyenziswa ngaphambili kwi-GERD. Isusiwe kwimarike yase-US ngenxa yeziphumo ebezingalindelekanga ezinxulumene nentliziyo.
• `(Domperidone)` (Motilium®): `(I-Dopamine Antagonist). E-United States, ayifumaneki lula ngaphandle kwemvume ekhethekileyo. Inokubangela iingxaki ezinkulu zentliziyo ezifana nokubetha kwentliziyo okungaqhelekanga kunye nokuhlaselwa yintliziyo.
• I-Erythromycin (EES®): I-Motilin Agonist. Ugqirha angakunika le mithi ngaphandle kwelebula ye-gastroparesis.
• I-Metoclopramide (Reglan®, Maxeran®, Gimoti®): I-dopamine antagonist. Iyeza elilodwa elivunyiweyo yi-FDA le-gastroparesis. Ikwasetyenziselwa ukunyanga i-GERD engaphendulanga kunyango oluqhelekileyo. Nangona kunjalo, iza nesilumkiso sokuba inokubangela iziphumo ebezingalindelekanga ezichaphazela inkqubo yemithambo-luvo.
• `(Prucalopride)` (Motegrity®):I-`(Serotonin Agonist)`. Inikwa ukuqunjelwa okungapheliyo. Ikwanceda isisu sikhuphe yonke into ngokukhawuleza.
• I-Pyridostigmine (Mestinon®): I-agonist ye-cholinergic. Isetyenziswa kakhulu ukunyanga iMyasthenia Gravis, kodwa ngamanye amaxesha ikwasetyenziswa ukunyanga iGastroparesis.

Zithini iziphumo ebezingalindelekanga zokusebenzisa ezi `(Prokinetic Agents)`?

Le yeyona nto ibalulekileyo ekufuneka uyilumkele. Iiarhente zeprokinetic zinokuba nemiphumo emibi kakhulu. Yiyo loo nto oogqirha bedla ngokungafuni ukuzinika. Nangona kunjalo, xa unyango oluqhelekileyo olufana neePPI zeGERD lungasebenzi, ugqirha unokugqiba ekubeni anike iarhente yeprokinetic. Okanye, njengesilumkiso, zinokunikwa idosi ephantsi okanye ixesha elifutshane.

Ukuba ugqirha ukunike i-prokinetic agent, qiniseka ukuba ubuza ngemiphumo ethile yelo yeza.

Iziphumo ebezingalindelekanga eziqhelekileyo ziquka:

• Isisu esibuhlungu
• Isicaphucaphu nokuhlanza
• Urhudo (ukudumba)
• Umbono ofipheleyo
• Intloko ebuhlungu (intloko ebuhlungu)
• Ukudinwa
• Ukozela, ukudinwa kakhulu, ukozela rhoqo (ukudinwa)
• Uxinzelelo
• Ixhala
• Ukuxinana kwemisipha okungalawulekiyo (iDystonia)
• Iintshukumo zemisipha yobuso ezingalawulekiyo (iTardive Dyskinesia)

Iziyobisi ezifana ne-`(Cisapride)`, `(Domperidone)` kunye ne-`(Tegaserod)` zisusiwe kwimarike ngenxa yomngcipheko weengxaki ezinkulu zentliziyo. Oko kukuthi:

• Isantya sentliziyo esicothayo (iBradycardia)
• Ukubetha kwentliziyo okungaqhelekanga (i-Arrhythmia)
• Ukuhlaselwa yintliziyo

Uphando lwangoku malunga neearhente ezintsha zeprokinetic lugxile ekuphuhliseni amayeza anika inzuzo yokukhuthaza ukushwabana kwamathumbu ngelixa kunciphisa umngcipheko weziphumo ebezingalindelekanga ezinjalo.

Zeziphi ii-`(Prokinetic Agents)` ezisetyenziswa kakhulu?

Ii-prokinetic agents ezisetyenziswa kakhulu yiMetoclopramide kunye neDomperidone. E-United States, iMetoclopramide yeyona yodwa iyeza elivunyiweyo yi-FDA le-gastroparesis. Nangona kunjalo, ugqirha unokunika iDomperidone ngemvume ye-FDA.

Ii-prokinetic agents ziyahluka ngokusebenza kwazo kunye nokhuseleko lwazo ekunyangeni iingxaki zokugaya ukutya. Ngenxa yomngcipheko weziphumo ebezingalindelekanga, ugqirha unokuzama amanye amayeza ngaphambi kokuba anike i-prokinetic agent. Nangona kunjalo, ukuba uneempawu eziqatha kuba amathumbu akho awanciphi kakuhle, i-prokinetic agent inokubonelela ngoncedo olufunekayo. Ukuba ucinga ngokuthatha i-prokinetic agent, kubalulekile ukuxoxa ngezibonelelo kunye neengozi nogqirha wakho.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Ngoko ke, ndiyathemba ukuba ufunde okuthile koko sikuxubushileyo malunga ne-`(Prokinetic Agents)`. Ngamafutshane:

• Ii-prokinetic agents luhlobo lwamayeza anyusa intshukumo yomgudu wokugaya ukutya kwaye ancede kwinkqubo yokugaya ukutya.
• Ezi zisetyenziselwa iimeko ezithile ezifana ne-`(Gastroparesis)` kunye ne-`(GERD)`, kunye nezinto ezifana nesicaphucaphu nokuhlanza.
• Eli yeza lisebenza ngokuvuselela imithambo-luvo emathunjini kwaye libangele ukuba izihlunu zifinyele.
• Eyona nto ibalulekileyo kukuba la mayeza ngamanye amaxesha anokuba nemiphumo emibi kakhulu, ngoko ugqirha uya kuwanika ngononophelo olukhulu.
• Ungaze usebenzise olu hlobo lwamayeza ngaphandle kokubonisana nogqirha. Ugqirha kufuneka akhethe ukuba loluphi unyango olukufaneleyo kunye nexesha olithathayo.

Ukuba unengxaki yesisu okanye yokugaya ukutya efana nale, eyona nto ingcono onokuyenza kukubona ugqirha uze uthethe ngayo. Emva koko ungafumana unyango olufanelekileyo.

iiarhente zeprokinetic , ukuphazamiseka kwesisu, ukungagayi kakuhle kokutya, isifo segastritis, iGERD, i-gastroparesis, i-metoclopramide