U ka 'na ua ipotsa hore na ke hobane'ng ha ngaka ea hao e ne e tla laela motho ea nang le bothata ba ho tepella maikutlo bakeng sa lefu la hao la bokooa (IBS) haeba u sa tepeletse maikutlo. Kapa, joaloka ba bangata ba nang le bothata ba IBS, u na le bothata ba ho tepella maikutlong kapa ho tšoenyeha haufinyane le IBS ea hau, kahoo khopolo eo e etsa hore u se ke ua utloisisa, empa u labalabela ho tseba hore na liphello tsa kokoana-hloko tsa IBS li ka ba le liphello life.
Sephethong se latelang se tla arabela potso ea hore na ke hobane'ng ha ka linako tse ling li-anti-depressing li sebelisoa e le phekolo bakeng sa IBS le ho u ruta mabapi le mefuta ea li-anti-depressants tse tloaelehileng ho bakuli ba IBS.
Ke Hobane'ng ha ho Tšebelisetsoa ho Itobela Kelello Bakeng sa IBS
Le hoja meriana ho sehlopha sena e ngotsoe e le ho imeloa kelellong, li na le liphello tse fetang ho tsitsisa maikutlo a tepeletseng maikutlo. Ho imetsoe ho imeloa kelellong ho fokotsa ho tšoenyeha le ho utloa bohloko ha ho ntse ho e-na le liphello tse ntle ho tsamaiso ea lijo .
Lingaka li ka 'na tsa laela motho ea nang le bothata ba ho itšireletsa maikutlong ho IBS, empa sena se nkoa e le "sehlahisoa" sa tšebeliso ea lithethefatsi, kaha ha ho na motho ea imetsoeng kelellong ea amohetseng tumello ea FDA e le phekolo ea IBS. Leha ho le joalo, American College of Gastroenterology, ka mor'a tlhahlobo e batsi ea lipatlisiso, e fihletse hore ho na le ts'ehetso e lekaneng ea lipatlisiso ka katleho ea lihlopha tse peli tsa lithethefatsi - TCA le SSRI - ho buella tšebeliso ea bona ho phekola IBS.
Haholo-holo, ho fumanoe hore batho ba nang le bothata ba ho tepella maikutlo ba na le tšusumetso e ntle meleng ea mokokotlo le hypressensitivity ea visceral . E 'nile ea tšeptjoa hore liphello tse molemo tsa ho imeloa kelellong matšoao a IBS ke phello ea meriana ea li-neurotransmitters tse fumanehang bokong le matlong.
Mefuta ea Batho ba nang le bothata ba ho tepella maikutlo ba sebelisetsoa phekolo ea IBS
Li-anti-depressing tse sebelisetsoang IBS li atisa ho oela sehlopheng se latelang:
Tricyclic Ho tepella maikutlo (TCAs)
Tricyclic ho loantšana ha maikutlo ke baeta-pele ba baholo ba nang le bothata ba ho tepella maikutlo. Ho 'nile ha boleloa hantle hore li-tricyclic tse loantšang likokoana-hloko li na le bothata ba ho loantša bohloko le matšoao-le ho lieha ho ba le litšobotsi,' me ho bonahala eka li etsa sena ka ho etsa li- serotonin tsa neurotransmitters le norepinephrine . Ho fokotseha ha motility mongobo ho etsa hore TCA e be e loketseng haholo bakeng sa phekolo ea letšollo-e leng eona e kholo ea IBS (IBS-D).
Ka bomalimabe, ketso e tšoanang ( phello ea anticholinergic ) e lebisang ho fokotsa tšitiso ea mala ea matšoafo ka linako tse ling e ka lebisa litlamong, ho kenyeletsa ho otsela, molomo o omeletseng, pono e phatsimang, mathata a ho kopanela liphate, mokelikeli, ho thothomela, hlooho le boima ba 'mele. Li-TCA li atisa ho behoa ka litekanyetso tse tlase ha li phekola IBS ho feta ha li sebelisoa ho phekola ho tepella maikutlo. Lintlha tse latelang ke mehlala ea TCA e ka 'nang ea fanoa bakeng sa IBS:
- Elavil (amitriptyline)
- Tofranil (imipramine)
- Norpramin (deipramine)
- Aventyl, Pamelor, Allegron (nortriptyline)
Selectional Serotonin Reuptake Inhibitors (SSRIs)
Selectional serotonin reuptake inhibitors (SSRIs) ke meriana e neng e etselitsoe ho eketsa boemo ba serotonin ea neurotransmitter tsamaisong ea methapo, e le hore ho be le phello e ntle moeeng.
Hobane feela serotonin ea methapo ea pelo e lebisitsoe ho eona, hangata SSRI e na le litla-morao tse fokolang ho feta ho tepella maikutlo ho tricyclic. Litla-morao tse tloaelehileng tsa ho nyeheloa ke pelo, letšollo, ho tšoenyeha le hlooho li atisa ho theoha ha 'mele o fetola meriana. Ho haelloa ke tšusumetso ho etsa hore SSRI e be khetho e molemo ho ba nang le bothata ba ho betoa haholo ka IBS (IBS-C).
Li-SSRI li ka boetse tsa fella ka litla-morao tse telele tsa mathata a thobalano (ho lahleheloa ke ho kopanela liphate le / kapa bothata ba ho finyella li-orgasm) le phaello ea boima. Ke habohlokoa ho hopola hore batho ba sa tšoaneng ba itšoara ka tsela e fapaneng 'me motho a ka mamella mofuta o mong oa SSRI ho feta o mong.
Lintlha tse latelang ke mehlala ea SSRI e tloaelehileng:
- Celexa (citalopram)
- Lexapro (escitalopram oxalate)
- Prozac (fluoxetine)
- Paxil (paroxetine)
- Zoloft (sertraline)
5-HT3 bakeng sa ho tepella maikutlo
Bafuputsi ba shebile meriana e shebaneng le libaka tse khethehileng tsa ho amohela li-serotonin tse tsejoang e le li-receptor tse 5-HT3. Lotronex ea qabang e oela sehlopheng sena.
Ka lebaka la kotsi ea litla-morao tse tebileng, FDA e behile meeli e tiileng ka taelo ea Lotronex. Ho na le e 5-HT3 e nang le bothata ba ho imeloa kelellong, Remeron (mirtazapine). Boitsebiso bo lekanyelitsoe mabapi le katleho ea Remeron bakeng sa IBS mme kahoo e ka 'na ea se ke ea romeloa ho bakuli ba IBS.
Lisebelisoa
Ford, A., et.al. " American College of Gastroenterology Monograph ka Tsamaiso ea Irritable Bowel Syndrome le Chronic Chronic Idiopathic Constipation " American Journal of Gastroenterology 2014 109: S2-S26.
Agrawal, A. & Whorwell, PJ "Matšoao a hlaselang malapa: ho hlahlojoa le ho laola" British Medical Journal , 2006 332: 280-283.
Jones, J. et.al. "Mokhatlo oa Brithani oa Gastroenterology bakeng sa tsamaiso ea lefu la boea le halefisang" Gut 2000 47: ii1-ii19.
Lacy, B., Weiser, K. & Lee, R. "Phekolo ea lefu la bowella la bohale" Tsoelo-pele ea kalafo ka Gastroenterology 2009 2: 221-238.
Sainsbury, A. & Ford, A. "Phekolo ea Irritable Bowel Syndrome: Beyond Fiber le Antispasmodic Agents" Tsoelo-pele ea Phekolo ea Meriana ea Matšoafo ea Mathata 2011 4: 115-127.