Irritable bowel syndrome (IBS) - ua rau, tsos mob thiab kho

Cov txheej txheem:

Irritable bowel syndrome (IBS) - ua rau, tsos mob thiab kho
Irritable bowel syndrome (IBS) - ua rau, tsos mob thiab kho
Anonim

Irritable bowel Syndrome

Nws yuav luag tsis tuaj yeem ntsib tus neeg uas tsis muaj qhov tsis xis nyob uas tshwm sim los ntawm kev cuam tshuam ntawm kev ua haujlwm ntawm txoj hnyuv. Nws tuaj yeem yog cov xwm txheej ntawm lub plab zom mov uas ua rau cem quav, raws plab, colic, flatulence. Nyob rau hauv txhua rooj plaub, nws twv yuav raug hu cuam tshuam lub niaj zaus atherosclerosis ntawm lub neej, rhuav nws. Qhov ua rau ntawm txoj kev loj hlob ntawm cov hnyuv tsis yog ib txwm muaj cov kab mob uas ua rau muaj kab mob, lossis kab mob ntawm lub plab zom mov ntawm cov organic.

Muaj cov txheeb cais qhia meej tias nyob rau hauv 30% ntawm cov neeg ua txhaum ntawm tag nrho cov kab mob ntawm cov hnyuv me thiab loj yog kev ua haujlwm tsis zoo ntawm lawv lub cev muaj zog. Cov kab mob hauv cov tshuaj no raug hu los ntawm ib lub sij hawm - chim siab plob tsis so tswj syndrome.

Dab tsi yog qhov mob plab plob tsis so tswj?

chim siab plob tsis so tswj syndrome
chim siab plob tsis so tswj syndrome

Irritable plob tsis so tswj yog ib qho mob rov tshwm sim ntawm cov quav, nrog rau kev hnov mob, yog tias tsis muaj lwm yam ua rau muaj kev cuam tshuam. Xws li yog vim li cas tej zaum yuav yog: fungal, kab mob los yog kis kab mob ntawm txoj hnyuv, nws lub cev tiv thaiv kab mob, colonization los ntawm protozoa los yog helminths, muaj ib tug qog, congenital anomalies ntawm anatomical txoj kev loj hlob. Nyob rau tib lub sijhawm, txhua qhov kev sim kuaj hauv ib tus neeg yuav tsum zoo li qub, yuav tsum tsis muaj kev hloov pauv ntawm cov ntshav thiab quav.

Raws li qhov teeb meem ntawm cov txiv neej thiab poj niam cov pej xeem, cov poj niam feem ntau raug kev txom nyem los ntawm qhov teeb meem no. Lawv nquag ua rau mob plab plob tsis so tswj hauv 15-25% ntawm cov neeg mob, thiab cov txiv neej hauv 5-15% ntawm cov neeg mob. Feem ntau, cov no yog cov neeg muaj hnub nyoog 20 xyoo, qhov tshwm sim siab tshaj plaws ntawm lawv poob rau 35-50 xyoo. Kwv yees li 40% ntawm cov neeg uas muaj kev tsis txaus siab nyob rau hauv lub hnub nyoog no.

Tsawg dua 40% ntawm cov neeg mob nrhiav kev pab tsim nyog, ntawm uas tsuas yog 28% mus rau kws kho mob plab nrog lawv qhov teeb meem, thiab 12% mus rau cov kws kho mob.

Cas of irritable bowel syndrome

Nws tsis tuaj yeem xaiv ib qho laj thawj vim li cas kev ua haujlwm ntawm lub plab hnyuv loj tuaj. Txawm li cas los xij, cov kws tshawb fawb tau txheeb xyuas qhov feem ntau yuav ua rau mob plab hnyuv siab raum, suav nrog:

  • Kev ntxhov siab. Nws tau pom tias cov teeb meem plab hnyuv ntawm qhov tsim nyog feem ntau tshwm sim tawm tsam keeb kwm ntawm kev tsis txaus ntseeg thiab kev txaus siab ntawm lub paj hlwb. Kev ntxhov siab ntev ua rau muaj kev phom sij tshwj xeeb hauv qhov no. Tib lub laj thawj piav qhia qhov tseeb tias ntawm cov neeg mob feem ntau yog cov poj niam, ntxiv rau, ntawm cov hluas.

    Feem ntau yog ib lub voj voog vicious tsim: ib qho kev xav tsis zoo tom qab tshwm sim, nws ua rau muaj kev ntxhov siab, kev ntxhov siab ua rau lub plab zom mov, teeb meem nrog lub plab zom mov ua rau tus neeg muaj kev nyuaj siab, lwm yam kab mob thiab lub cev raug kev txom nyem vim qhov no. Yog li ntawd, feem ntau nyob rau hauv cov neeg uas muaj kev chim siab plob tsis so tswj syndrome, ib tug neuropsychiatrist qhia ntau yam neuroses thiab cwm pwm tsis zoo.

    Muaj txawm tias muaj lus tso dag ntawm cov neeg sawv cev ntawm cov tshuaj: es tsis txhob lo lus "irritable plob tsis so tswj", lawv siv lub sij hawm "irritated head syndrome". Qhov no yog vim lub fact tias nyob rau hauv parallel nrog cov teeb meem nyob rau hauv kev ua hauj lwm ntawm lub gastrointestinal ib ntsuj av, muaj teeb meem nrog lub hauv paus paj hlwb thiab autonomic regulation.

  • Kev ua txhaum ntawm txoj hnyuv motility. Tus mob no tuaj yeem yog vim kev ua txhaum ntawm txoj hnyuv ua haujlwm, ua tsis tiav hauv kev ua haujlwm ntawm cov hnyuv ntawm cov leeg ntawm cov hlab ntsha, uas ua rau lub plab zom mov. cog lus. Nyob rau hauv rooj plaub no, nws tsis tuaj yeem kuaj pom qhov sib txawv hauv kev ua haujlwm ntawm lub paj hlwb ntawm txoj hnyuv lossis hauv cov hnyuv ntawm phab ntsa nws tus kheej. Kev so thiab kev cog lus tshwm sim ntawm lub sijhawm tsis kawg tshwm sim ntawm lawv tus kheej.
  • Cov neeg zoo li no feem ntau raug kev txom nyem los ntawm kev ua kom puv plab thiab mob plab, lawv qhov mob hnyav nce ntxiv.
  • Koj tuaj yeem tsim qee qhov kev sib raug zoo ntawm cov tshuaj hormones hloov hauv lub cev thiab exacerbations ntawm cov tsos mob pathological. Feem ntau, cov poj niam nco ntsoov tias nyob rau hnub kawg thiab thawj hnub ntawm kev coj khaub ncaws tom ntej, lawv muaj mob raws plab, mob plab hnyuv. Cov kws kho mob piav qhia qhov no los ntawm kev nce qib ntawm prostaglandin E hauv cov ntshav.
  • plab hnyuv tuaj yeem tshwm sim vim qhov suav nrog hauv cov zaub mov ntawm cov zaub mov muaj roj ntau uas muaj calorie ntau ntau. Txawm li cas los xij, tsis yog zaub mov xwb, tab sis kuj haus dej haus tuaj yeem ua rau tsis xis nyob. Qhov txaus ntshai tshaj plaws hauv qhov no yog: kas fes thiab tshuaj yej, cawv thiab dej qab zib.
  • Tsis txhob hnov qab txog qhov kev hloov pauv ntawm kev hloov pauv rau cov kev mob no. Yog tias muaj teeb meem plab hnyuv siab raum tau kuaj pom hauv cov niam txiv, ces nws yuav ua rau cov menyuam yaus thab ntau dua.
  • Cov kab mob hauv plab yav dhau los tuaj yeem ua rau IBS. Qhov no muaj txog li ntawm 30% ntawm txhua tus neeg uas muaj tus cwj pwm tsis zoo.
  • Tsis muaj cov tshuaj ballast uas ua kom tsim cov enzymes digestive, nrog rau dysbacteriosis - tag nrho cov mob no tuaj yeem ua rau ua rau mob plab plob tsis so tswj.

Cov tsos mob thiab cov cim qhia ntawm kev chim siab plob tsis so tswj

Cov tsos mob thiab cov tsos mob ntawm irritable plob tsis so tswj syndrome
Cov tsos mob thiab cov tsos mob ntawm irritable plob tsis so tswj syndrome

Cov tsos mob ntawm plab hnyuv siab raum zoo ib yam li cov kab mob hauv plab.

Muaj ntau ntau qhov sib txawv ntawm cov kab mob pathology nrog cov cim qhia rau txhua tus ntawm lawv:

  1. Irritable bowel syndrome zoo li zawv plab. Kev xav kom plab zom mov tshwm sim tam sim tom qab noj mov lossis thaum noj mov. Ib tug neeg tuaj yeem ntsib qhov tsis xis nyob ntau zaus thaum nruab hnub. Feem ntau qhov no tshwm sim thaum sawv ntxov, lossis thaum sawv ntxov.

    • Mob plab feem ntau nrog kev ntxhov siab, ntshai, ntxhov siab. Hauv cov tib neeg, koj tuaj yeem hnov ib lo lus xws li kab mob dais uas ua rau tus mob zoo li no. Qhov sib piv tau kos nrog tus neeg nyob hauv hav zoov no vim yog vim li cas. Nws yog nws leej twg reacts txaus ntshai los yog ntshai los ntawm ib tug ua ntawm involuntary defecation. (Nyeem ntxiv: Cov tsos mob, xim thiab ua rau raws plab)
    • mob plab heev, mob nyob rau sab xis thiab sab laug, nrog rau hauv qab ntawm lub plab - cov no yog cov tsos mob uas ua rau lub siab sai sai rau cov hnyuv. Tom qab mus saib hauv chav dej, ib tug neeg tau txais kev pab zoo.
  2. Irritable bowel syndrome zoo li cem quav. quav quav tuaj yeem pom tau ntev dua 3 hnub. Nyob rau hauv cov ntaub ntawv no, tus neeg kuj yuav muaj kev xav ntawm tsam plab, mob nyob rau hauv ib tug yam ntxwv cheeb tsam. Qee zaum mob rhiab heev tshwm sim raws li colic, qee zaum lawv mob hauv qhov xwm txheej. Thaum tso quav tso, qhov mob me ntsis dulled, tab sis tsis txhob ploj tag nrho. Cov quav zoo ib yam li cov yaj cov quav uas muaj cov quav dawb los yog ntshiab mucous impurities.

    Vim qhov tsis muaj peev xwm ua rau lub plab zom mov tas mus li, ib tus neeg muaj kev noj qab haus huv, kub siab lossis xeev siab tuaj yeem ua raws li nws, qhov tsis txaus siab tom qab noj hauv qhov ncauj. (Nyeem ntxiv: cem quav - ua rau, tsos mob thiab kho)

  3. Irritable bowel syndrome nrog alternating cem quav thiab raws plab. Mob los ua ntej ntawm qhov no. Cov quav quav thiab zawv plab alternate.

Summarizing, nws tuaj yeem raug sau tseg tias mob plab hnyuv siab raum nrog cov tsos mob hauv qab no:

  • Variability ntawm quav quav nrog ntau tshaj ntawm cem quav los yog raws plab, los yog nrog lawv alternation.
  • mob plab uas zoo tuaj tom qab tso quav.
  • Kev xav tawm ntawm qhov tsis tuaj yeem muaj cov quav.
  • Flatulence nrog rau qhov mob hnyav.
  • Mucus impurities hauv quav.
  • Kev xav tias lub plab zom mov tsis tiav tom qab mus rau chav dej.

Kev kuaj mob IBS

Kev kuaj mob ntawm "kev mob plab hnyuv siab raum" nthuav tawm qee qhov nyuaj rau cov kws kho mob, txij li cov ntsuas ntawm cov ntshav thiab cov quav, kev kuaj X-ray thiab biopsy hauv ib tus neeg nyob hauv qhov qub. Yog li ntawd, lub rooj sib tham tau muaj nyob rau hauv Rome, uas cov txheej txheem rau kev kuaj mob plab hnyuv siab raum tau hais meej meej.

Cov tsos mob ntawm cov kab mob no suav tias yog: mob thiab tsis xis nyob hauv cov hnyuv rau 3 hnub hauv ib hlis. Lub sijhawm ntawm qhov mob no yog rau lub hlis lossis ntau dua. Tom qab kev ua ntawm defecation, ib tug neeg yuav tsum tau txais kev pab. Kev hloov ntawm cov quav thiab nws cov duab yuav tsum tau tshwm sim thaum lub sijhawm tus neeg mob thawj zaug pom qhov mob ntawm nws tus kheej.

Cov txheej txheem ntxiv los pab qhia meej qhov kev kuaj mob yog:

  • Kev tso quav tso zis ntau zaus thiab tshwm sim ntau dua 3 zaug hauv 24 teev, lossis txo qis thiab tshwm sim tsawg dua 3 zaug hauv 7 hnub. Qhov ntawd yog, tus neeg raug cem quav lossis raws plab.
  • Cov quav hloov pauv: ua kua nrog ua npuas ncauj lossis tawv thiab ntxhib.
  • Kev tshem tawm yog qhov nyuaj lossis tsis tuaj yeem tiv taus.

Tib lub sijhawm, kev kuaj mob sib txawv yog qhov tseem ceeb, uas tso cai rau kom paub qhov txawv ntawm lub plab hnyuv siab raum los ntawm lwm yam, cov kab mob hnyav dua ntawm lub cev. Tias yog vim li cas tus neeg mob uas muaj cov yam ntxwv tsis txaus siab yuav tsum raug xa mus rau qhov kev xeem hauv qab no:

  • CBC;
  • ntshav chemistry;
  • Coprogram;
  • Raws li cov lus qhia, dhau mus rau irrigoscopy lossis sigmoidoscopy;
  • Yog tias tsim nyog, kev kuaj ntshav ntawm lub plab zom mov yog ua.

Nws tau raug tsim los tias feem ntau ntawm cov neeg mob, uas yog 90% ntawm cov neeg, tom qab mus ntsib kws kho mob thiab kuaj xyuas IBS, nws tus kheej tiv thaiv cov tsos mob ntawm cov kab mob thiab tsis xav tias lawv tus kheej muaj mob. Txawm li cas los xij, tshuav 10% ntawm cov neeg paub lawv tus kheej li cov neeg mob uas tsis muaj kev cia siab. Lawv mob siab mus kuaj ntau thiab ntau dua uas tsis qhia txog tus kab mob loj dua lossis tsawg dua hauv lawv. Txawm li cas los xij, tib neeg tseem ntseeg tau tias lawv muaj kab mob hnyav heev thiab feem ntau nyob hauv kev sib cais vim li no.

Differential Diagnosis of IBS

Kev kuaj mob sib txawv ntawm IBS
Kev kuaj mob sib txawv ntawm IBS

Teeb meem nrog kev tso quav thiab mob plab tsis yog ib txwm qhia tias mob plab hnyuv siab raum. Yog li, kev kuaj mob sib txawv yog qhov tseem ceeb heev, tso cai rau koj los tsim cov tsos mob rau tus mob no uas tsis yog yam ntxwv.

Nrog lawv:

  • Kev tshwm sim ntawm tus mob pathological hauv lub hnub nyoog laus;
  • Kev mob nkeeg;
  • Kev muaj cov tsos mob hnyav, nws yog ib qho tseem ceeb kom nco ntsoov IBS yog ib tus kab mob ntev;
  • Cov tsos mob ntawm plab zom mov tshwm sim thaum hmo ntuj;
  • Los ntawm lub qhov quav muaj tawm nrog cov ntshav impurities;
  • Zoo nrog mob;
  • Muaj cov rog nyob hauv cov quav (steatorrhea);
  • Lub cev kub nce;
  • Y Nws tsis kam rau gluten, lactose, fructose;
  • Cov neeg txheeb ze tau kuaj pom tias muaj mob plab hnyuv lossis lwm yam mob.

Nws yog ib qho tseem ceeb kom paub qhov txawv IBS los ntawm cov xwm txheej hauv qab no kom tsis txhob muaj qhov tsis zoo:

Ua rau mob plab hnyuv cuam tshuam nrog tib neeg txoj kev ua neej
  • Kev haus cawv, khoom ua rau flatulence, kas fes;
  • noj zaub mov muaj roj;
  • Cov zaub mov txawv;
  • noj cov hlau lossis cov tshuaj potassium, tshuaj tua kab mob, cov kua tsib acids, mesoprostol thiab lwm yam tshuaj;
  • Kev ntxhov siab, ntshai, kev ntxhov siab hnyav (tom qab so, cov tsos mob yuav tsum ploj mus).
Natural hormonal fluctuations in a women's body
  • Cov tsos mob Premenstrual;
  • Climax;
  • Lub sijhawm muaj menyuam.
Gynecological kab mob
  • YEndometriosis;
  • YPlastic cicatricial peritonitis.
kab mob plab hnyuv ntawm cov hauv paus chiv keeb
  • Kev muaj diverticula hauv txoj hnyuv;
  • plab hnyuv puas los ntawm Mycobacterium tuberculosis;
  • mob qog noj ntshav lossis mob qog noj ntshav;
  • YGranulomatous enteritis;
  • Ulcerative colitis;
  • Microscopic colitis;
  • plab hnyuv polyp;
  • kab mob kis kab mob;
  • Pathological lengthening ntawm sigmoid nyuv (dolichosigma);
  • Short bowel syndrome.
Cov qog plab hnyuv ntawm cov keeb kwm neuroendocrine
  • YZollinger-Ellison syndrome;
  • pib theem ntawm carcinoid syndrome.
YPathologies ntawm endocrine etiology
  • YThyrotoxicosis;
  • Dabetic enteropathy hauv ntshav qab zib mellitus.

Txoj kev kho IBS

Lub luag haujlwm tseem ceeb ntawm kev kho mob yog tshem tawm nws cov tsos mob tsis zoo uas ua rau tib neeg lub neej tsis zoo. Txawm li cas los xij, ua ntej yuav mus rau kev saib xyuas kev kho mob, ib tus yuav tsum tig mus rau cov lus qhia ntawm Academician Pavlov thiab nco qab txog nws txoj kev xav, uas ua rau lub fact tias tag nrho cov kab mob nrog lawv cov hauv paus hniav loj hlob los ntawm CNS mob. Nws yog nyob rau hauv kev cuam tshuam rau lub plab hnyuv siab raum uas nws cov lus qhia tseem ceeb heev. Cov tshuaj siv tau ua pov thawj tias ntau yam kev ua ub no uas tsom mus rau kev ua tiav lub siab lub ntsws ntawm tus neeg yuav muaj txiaj ntsig zoo rau tus neeg mob IBS.

Yog li ntawd, thaum cov tsos mob ntawm tus kab mob no tshwm sim ib ntus, thiab tus neeg nws tus kheej tsis tuaj yeem tiv nrog kev ntxhov siab ntev, teeb meem hauv zej zog, lossis hauv tsev neeg, nws yuav tsum tau nrhiav kev pab tsim nyog los ntawm kws kho mob hlwb. Thaum lub phobia ntawm lub plab zom mov lossis kev nyuaj siab ntxhov siab tshwm sim tawm tsam keeb kwm ntawm IBS, kev pab ntawm tus kws kho mob hlwb thiab kws kho mob hlwb yog qhov yuav tsum tau ua.

Thaum tus mob tsis hnyav, ua ntej hloov kho kho, koj tuaj yeem sim ua raws li cov lus pom zoo hauv qab no:

  • Hloov lub neej;
  • Tsim khoom noj khoom haus;
  • Tsis suav haus luam yeeb thiab dej cawv;
  • Kev ua lub cev yuav tsum yog txhua hnub, tab sis ua tau;
  • Siv sijhawm ntau sab nraum zoov tsuas yog taug kev.

Cov lus qhia yooj yooj yim no muaj peev xwm pab daws qhov tsis txaus ntseeg ntawm lub paj hlwb thiab daws cov teeb meem nrog cov hnyuv thaum lawv "loj" ntawm lub taub hau.

Kev noj haus

Noj zaub mov
Noj zaub mov

Raws li kev hloov pauv mus rau kev noj zaub mov zoo rau lub plab zom mov, nws tsis tas yuav tsum tau. Txawm li cas los xij, qee cov cai tseem yuav tsum tau ua raws. Ua ntej tshaj plaws, koj yuav tsum tau kho cov zaub mov. Nws yuav tsum yog feem ntau thiab tshwm sim hauv qhov chaw nyob ntsiag to.

Nyob ntawm seb cov tsos mob twg tshwm sim hauv tus neeg mob plab hnyuv siab raum, cov lus pom zoo hauv qab no yuav tsum tau ua raws:

  • Thaum raws plab yuav tsum tsis suav nrog cov khoom uas ua rau lub plab zom mov. Cov no yog tag nrho cov zaub thiab txiv hmab txiv ntoo nrog ntxhib, indigestible fiber, nrog rau txiv apples, plums, thiab beets.
  • Rau cem quav, zam cov zaub mov kib thiab rog.
  • Nrog cov roj ntau ntxiv, koj yuav tsum tsis txhob noj ntau cov legumes, txiv hmab txiv ntoo, pastries, zaub qhwv, txiv ntoo.

Yog tias ib tug neeg paub tias nws muaj lactose intolerance, ces cov mis nyuj yuav tsum raug cais tawm ntawm kev noj haus. Nws tau ua tiav los ntawm kefir, fermented ci mis nyuj, curdled mis nyuj.

Yog tias koj muaj kab mob celiac, ces koj yuav tsum tso tseg tag nrho cov zaub mov uas muaj gluten.

Ntxiv rau, koj yuav tsum txo qis kev haus cov dej qab zib thiab zom cov pos hniav. Yuav kom normalize plab hnyuv microflora, ib chav kawm ntawm Linex yuav pab.

Yog IBS nrog raws plab

Thaum cov quav tsis tuaj yeem hloov kho los ntawm txoj kev maj mam, thiab qhov mob tshwm sim nrog raws plab, nws yog qhov yuav tsum tau mus rau ntau txoj hauv kev ntawm kev kho mob pathology.

Txawm li cas los xij, koj yuav tsum tsis txhob tso tseg raws plab ntawm koj tus kheej nrog cov tshuaj, vim nws feem ntau tshwm sim los ntawm cov khoom noj. Yog li ntawd, tus kws kho mob gastroenterologist yuav tsum tau sau tshuaj. Hauv tsev, koj tsuas tuaj yeem noj smecta txhawm rau tshem tawm raws plab, thiab teem caij nrog kws kho mob.

Tsis tas li, kev noj tshuaj tas mus li rau lub plab zom mov tuaj yeem ua rau muaj kev phom sij.

Yog IBS cem quav

Txhawm rau tshem tawm cem quav, koj tuaj yeem siv cov tshuaj laxative raws li lactulose, polyethylene glycol. mineral dej enriched nrog magnesium ions muaj ib tug laxative nyhuv. Piv txwv li, Essentuki №17

Ntawm qhov mob thiab spasms hauv IBS

  • Defoamers: pab zom cov pa roj npuas uas feem ntau ua rau mob.
  • Anspasmodics.

Yog tias IBS nrog dysbacteriosis

Yog tias tus neeg mob tau kuaj pom tias muaj dysbacteriosis tiv thaiv keeb kwm yav dhau ntawm lub plab hnyuv siab raum, qhov no ua rau cov kab mob hnyav zuj zus ntxiv, ua rau tsis xis nyob. Qhov mob ua rau khaus, tsam plab thiab quav quav ntxiv. Yog li ntawd, nws yog ib qho tseem ceeb kom tshem tawm dysbacteriosis.

Txhawm rau txhawm rau ua haujlwm tseem ceeb ntawm cov kab mob pathogenic siv:

  • Nitrofurans - nrog rau kev ua kom hnyav ntawm dysbacteriosis.
  • Nrog cov kev kawm tsis sib xws ntawm dysbiosis, koj tuaj yeem hloov nitrofurans nrog probiotics nrog cov tshuaj tua kab mob.
  • Muaj peev xwm muab tshuaj tua kab mob, nruj raws li cov lus qhia.

Thaum chav kawm tsom mus rau tua cov kab mob pathogenic microorganisms tiav, nws yog ib qho tsim nyog yuav tsum siv cov tshuaj kom normalize plab hnyuv microflora. Lawv yuav tsum tau noj thoob plaws lub hli.

Ntxiv rau, cov kws kho mob tau sau cov tshuaj uas tsim cov kev mob zoo rau kev yug me nyuam thiab kev ua haujlwm tseem ceeb ntawm cov kab mob muaj txiaj ntsig hauv cov hnyuv. Nws tuaj yeem yog Khilak-forte thiab Lactulose.

Dr. Berg - 9 kauj ruam los kho IBS:

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