Isifo samathumbu esicasulayo

I-Irritable bowel syndrome (IBS) yisifo esiholela ezinhlungwini zesisu nezinguquko zamathumbu.

I-IBS ayifani nesifo samathumbu esivuthayo (IBD).

Izizathu zokuthi kungani i-IBS ikhula azicaci. Kungenzeka ngemuva kokutheleleka kwebhaktheriya noma ukutheleleka kwesinambuzane (i-giardiasis) yamathumbu. Lokhu kubizwa nge-postinfectious IBS. Kungase kube nezinye izimbangela, kufaka phakathi ukucindezeleka.

Amathumbu axhunywe ebuchosheni kusetshenziswa ama-hormone nezimpawu zemizwa eziya phambili naphambili phakathi kwamathumbu nobuchopho. Lezi zimpawu zithinta ukusebenza kwamathumbu nezimpawu. Izinzwa zingasebenza kakhulu ngesikhathi sokucindezeleka. Lokhu kungadala ukuthi amathumbu azwele kakhudlwana futhi asebenze kakhudlwana.

I-IBS ingenzeka nganoma yisiphi isikhathi. Imvamisa, iqala eminyakeni yobusha noma ebudaleni. Kuphindwe kabili kwabesifazane kunakubesilisa.

Akunamathuba amancane okuqala kubantu asebekhulile abaneminyaka engaphezu kwengu-50 ubudala.

Cishe i-10% kuya ku-15% yabantu e-United States banezimpawu ze-IBS. Kuyinkinga ejwayelekile emathunjini eyenza ukuthi abantu badluliselwe kochwepheshe bamathumbu (i-gastroenterologist).

Izimpawu ze-IBS ziyahlukahluka kuye ngomuntu nomuntu, futhi zisukela kokuphakathi kuya kwezinzima. Iningi labantu linezimpawu ezincane. Kuthiwa une-IBS uma izimpawu zikhona okungenani izinsuku ezintathu ngenyanga isikhathi esiyizinyanga ezintathu noma ngaphezulu.

Izimpawu eziyinhloko zifaka:

• Ubuhlungu besisu
• Igesi
• Ukugcwala
• Ukuqhakaza
• Shintsha imikhuba yamathumbu. Ungaba nohudo (IBS-D), noma ukuqunjelwa (IBS-C).

Ubuhlungu nezinye izimpawu zivame ukunciphisa noma zihambe ngemuva kokuhamba kwamathumbu. Izimpawu zingaqhuma lapho kunoshintsho kumvamisa wokuhamba kwamathumbu akho.

Abantu abane-IBS bangabuyela emuva naphambili phakathi kokuqunjelwa nohudo noma babe noma iningi babe nelinye noma elinye.

• Uma une-IBS enesifo sohudo, uzoba nezitulo ezivamile, ezixegayo nezinamanzi. Ungaba nesidingo esiphuthumayo sokunyakaza kwamathumbu, okungaba nzima ukuwalawula.
• Uma une-IBS ngokuqunjelwa, uzoba nesikhathi esinzima sokudlula, kanye nokunyakaza kwamathumbu okumbalwa. Ungadinga ubunzima ngokunyakaza kwamathumbu futhi ube namajaqamba. Imvamisa, yisamba esincane kuphela noma asikho nhlobo isitulo esizodlula.

Izimpawu zingase zibe zimbi kakhulu amasonto ambalwa noma inyanga, bese zincipha isikhashana. Kwezinye izimo, izimpawu zikhona isikhathi esiningi.

Ungase futhi ulahlekelwe isifiso sakho sokudla uma une-IBS. Kodwa-ke, igazi kwizitulo kanye nokwehla kwesisindo ngokungenhloso akuyona ingxenye ye-IBS.

Akukho sivivinyo sokuxilonga i-IBS. Isikhathi esiningi, umhlinzeki wakho wezokunakekelwa kwempilo angakwazi ukuxilonga i-IBS ngokuya ngezimpawu zakho. Ukudla ukudla okungenayo i-lactose amasonto amabili kungasiza umhlinzeki ukuthi abone ukuntuleka kwe-lactase (noma ukungabekezelelani kwe-lactose).

Ukuhlolwa okulandelayo kungenziwa ukukhipha ezinye izinkinga:

• Ukuhlolwa kwegazi ukubona ukuthi unesifo se-celiac noma isibalo segazi esiphansi (i-anemia)
• Ukuhlolwa kwesitokisi segazi lemilingo
• Ama-stool amasiko ukuhlola ukutheleleka
• Ukuhlolwa kweMicroscopic kwesampula yendle yama-parasites
• Ukuhlolwa kwesitokisi ngento ebizwa nge-fecal calprotectin

Umhlinzeki wakho angancoma i-colonoscopy. Phakathi nalokhu kuhlolwa, kufakwa ishubhu eliguquguqukayo ngokusebenzisa i-anus ukuhlola ikholoni. Ungadinga lokhu kuhlolwa uma:

• Izimpawu zaqala kamuva empilweni (ngaphezulu kweminyaka yobudala engama-50)
• Unezimpawu ezifana nokwehla kwesisindo noma indle enegazi
• Unezivivinyo zegazi ezingajwayelekile (njengezibalo eziphansi zegazi)

Ezinye izinkinga ezingadala izimpawu ezifanayo zifaka:

• Isifo seCeliac
• Umdlavuza wekoloni (umdlavuza akuvamile ukuthi ubangele izimpawu ezijwayelekile ze-IBS, ngaphandle kwalapho izimpawu ezifana nokulahleka kwesisindo, igazi ezansi, noma ukuhlolwa kwegazi okungajwayelekile kukhona)
• Isifo seCrohn noma i-ulcerative colitis

Umgomo wokwelashwa ukukhulula izimpawu.

Kwezinye izimo ze-IBS, izinguquko zendlela yokuphila zingasiza. Isibonelo, ukuzivocavoca umzimba njalo nokuthuthukisa imikhuba yokulala kunganciphisa ukukhathazeka futhi kusize ekunciphiseni izimpawu zamathumbu.

Izinguquko zokudla zingasiza. Kodwa-ke, akukho kudla okuqondile okunganconyelwa i-IBS ngoba lesi simo sihlukile komunye umuntu.

Izinguquko ezilandelayo zingasiza:

• Ukugwema ukudla neziphuzo okuvuselela amathumbu (njenge-caffeine, itiye, noma amakhola)
• Ukudla ukudla okuncane
• Ukwandisa i-fiber ekudleni (lokhu kungathuthukisa ukuqunjelwa noma isifo sohudo, kepha kwenze ukuqunjelwa kube kubi kakhulu)

Khuluma nomhlinzeki wakho ngaphambi kokuthatha imithi yamakhasimende.

Awukho umuthi owodwa osebenzela wonke umuntu. Okunye umhlinzeki wakho angakusikisela kufaka phakathi:

• Imithi ye-anticholinergic (i-dicyclomine, i-propantheline, i-belladonna, ne-hyoscyamine) ethathwe cishe isigamu sehora ngaphambi kokudla ukulawula ukuphazamiseka kwemisipha yamathumbu
• I-Loperamide yokwelapha i-IBS-D
• I-Alosetron (Lotronex) ye-IBS-D
• I-Eluxadoline (Viberzi) ye-IBS-D
• Ama-Probiotic
• Imithamo ephansi yama-tricyclic antidepressants ukusiza ukudambisa ubuhlungu bamathumbu
• ILubiprostone (amitiza) ye-IBS-C
• I-Bisacodyl yokwelapha i-IBS-C
• I-Rifaximin, isibulala-magciwane
• ILinaclotide (Linzess) ye-IBS-C

Ukwelashwa kwengqondo noma imishanguzo yokukhathazeka noma yokudangala kungasiza enkingeni.

I-IBS ingaba yisimo sempilo yonke. Kwabanye abantu, izimpawu ziyakhubaza futhi ziphazamise umsebenzi, ukuhamba, kanye nemisebenzi yomphakathi.

Izimpawu zivame ukuba ngcono ngokwelashwa.

I-IBS ayibangeli ukulimala okungapheli emathunjini. Futhi, ayiholeli esifweni esibi, njengomdlavuza.

Shayela umhlinzeki wakho uma unezimpawu ze-IBS noma uma ubona izinguquko emikhubeni yakho yamathumbu engapheli.

IBS; Ithumbu elicasulayo; I-Spastic colon; Ikholoni engacasuki; I-mucous colitis; I-spastic colitis; Ubuhlungu besisu - IBS; Uhudo - IBS; Ukuqunjelwa - IBS; IBS-C; IBS-D

• Ukuqunjelwa - yini okufanele uyibuze udokotela wakho

• Uhlelo lokugaya ukudla

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UFerri FF. Isifo samathumbu esicasulayo. Ku: Ferri FF, ed. Umeluleki Wemitholampilo kaFerri 2019. IPhiladelphia, PA: Elsevier; 2019: 798-801.

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I-Wolfe MM. Ukubonakaliswa okuvamile komtholampilo kwesifo samathumbu. Ku: Benjamin IJ, Griggs RC, Wing EJ, Fitz JG, ama-eds. U-Andreoli no-Carpenter’s Cecil Essentials of Medicine. Umhlaka 9. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 33.