Irritable bowel Syndrome, lossis IBS, yog ib qho mob uas tsis yog-organic plob tsis so tswj pathology, thaum nws txoj haujlwm ib txwm raug cuam tshuam nrog kev sim tag nrho. Yog li ntawd, nws tseem hu ua plab hnyuv neurosis lossis dyskinesia. Dysfunction manifests nws tus kheej nyob rau hauv spastic plab mob, plab tsis xis nyob, hloov cov quav zaus thiab sib xws.
Qhov tseem ceeb ntawm pathology
Raws li kev txheeb cais, cov hnub nyoog ntawm cov neeg mob yog cov hnub nyoog nruab nrab ntawm cov neeg muaj hnub nyoog tshaj 25 thiab mus txog 40. Tsis tas li ntawd, cov poj niam hauv pab pawg no mob ob zaug ntau dua li cov txiv neej. Thiab tsuas yog tom qab tsib caug xyoo kev qhia txog poj niam txiv neej raug ua raws. Tom qab muaj hnub nyoog rau caum xyoo, tsis tshua muaj mob plab plob tsis so tswj. Cov poj niam feem ntau tuaj yeem piav qhia los ntawm kev xav ntau dua thiab nquag mus ntsib kws kho mob rau ntau yam laj thawj.
Ntau tus neeg tsis xav tias lawv tus kheej muaj mob thiab tsis mus ntsib kws kho mob, vim lawv suav tias muaj teeb meem digestive rau kev ntxhov siab lossis kev noj zaub mov tsis txaus.
ICD-10 code
Raws li ICD-10, IBS nrog raws plab yog teev nyob rau hauv tus lej K58.0. Txawm li cas los xij, muaj lwm tusnpe. IBS tsis muaj raws plab - code K58.9. Xws li cov tsos mob tsis zoo raws li cem quav yog muab rau tus lej K59.0. Qhov no yog qhov cuam tshuam txog kev faib tawm raws li ICD code.
IBS nrog raws plab raws li kev kuaj mob tau muab faib ua ntau hom.
Kev faib tawm
Cov kws kho mob faib cov kab mob raws li cov ntsuas hauv qab no:
- plab hnyuv tsis ua haujlwm;
- pain syndrome;
- flatulence.
Kev kho tus kab mob raws li qhov ua rau hnyav hnyav qhia ntau tus neeg ua rau tus kab mob:
- kev nyuaj siab;
- food;
- after AII infection.
Etiology ntawm qhov tshwm sim
Tsis muaj organic ua rau pom. Niaj hnub no, lub luag haujlwm tseem ceeb yog muab rau qhov kev txiav txim ntawm kev ntxhov siab. Qhov kev xav no tau lees paub los ntawm qhov tseeb tias 60% ntawm cov neeg mob ib txwm muaj cov tsos mob tsis zoo nyob rau hauv daim ntawv ntawm kev ntxhov siab, kev nyuaj siab thiab lwm yam kev tshwm sim neurotic.
Pathology txhim kho ntau ntxiv nrog kev nce siab hauv tib neeg, uas tsis yog qhov tsis tshua muaj ntawm cov poj niam hluas.
Ntxhais! Cov neurogenic etifactor ua rau tsim ib hom vicious vajvoog: kev nyuaj siab - chim siab plob tsis so tswj syndrome - mob IBS - paj hlwb.
Tseem muaj lub sij hawm provocative. Lawv tuaj yeem yog sab nraud thiab sab hauv. Exofactors - malnutrition, dysbacteriosis, hypodynamia, ua hauj lwm nrog ntev zaum nyob rau hauv ib txoj hauj lwm.
Teb chaws:
- hypersensitivity ntawm paj hlwb receptors, nqaij fibers ntawm lub plab hnyuv ib ntsuj av, ua rau kom peristalsis ntxiv;
- hypersensitivity ntawm qee tus neeg mus rau qhov txhaws ntawm lawv cov hnyuv, uasua rau mob plab;
- nce prostaglandins hauv cov poj niam thaum MC;
- genetic feature - nyob rau hauv ib lub genus, txoj kev nyiam rau IBS feem ntau tau txais;
- cuam tshuam rau plab hnyuv microflora ntawm cov tshuaj tua kab mob noj rau ntau yam laj thawj;
- Ib feem peb ntawm cov neeg mob uas muaj IBS tshwm sim thaum lossis tom qab ACD. Nov yog tom qab kis tau IBS.
Qhov tseem ceeb! Niaj hnub no, qhov mob plab plob tsis so tswj tsis yog ib qho mob uas kho tau tag nrho, tab sis nws muaj peev xwm tsim tau tus kab mob mus ntev los ntawm kev tswj hwm txoj kev noj qab haus huv.
Nws tseem yuav tsum tau muab sau tseg tias qhov mob plab hnyuv siab raum tsis ua rau muaj kev phom sij lossis luv luv. Pathology tsis muab cov organic hloov thiab teeb meem, tab sis lub neej zoo zuj zus.
Symptoms of IBS
Mob plab hauv plab, tsis xis nyob ntawm no thiab quav quav yog suav tias yog thawj qhov tshwm sim. Qhov tseem ceeb ntawm lawv yog mob plab. Nws nyob hauv thaj av iliac, tuaj yeem tshwm sim ntawm ib sab.
Palpation ntawm txoj hnyuv ib txwm mob. Mus rau hauv chav dej thiab tso quav tso tseg qhov mob. Yuav luag ib txwm nyob rau hauv cov quav muaj kuab los ntawm txoj hnyuv. Tsis tas li ntawd, muaj plab hnyuv, ib qho kev nkag siab ntawm peristalsis nrog rumbling ntawm qhov deb. Lub spasm tsis tas li, nws hloov pauv ntawm cov hnub sib txawv raws li qhov chaw nyob.
Pab! Txhua qhov chaw hais tias nyob rau hauv chim siab plob tsis so tswj syndrome tag nrho cov tshwm sim tsuas yog nruab hnub, uas yog xam tau tias yog ib tug feature ntawm pathology. Qhia meejCov pov thawj ntawm cov keeb kwm neurogenic ntawm IBS hauv feem coob ntawm cov neeg mob yog tias algia thiab raws plab tsis tshwm sim thaum hmo ntuj thaum pw lossis so.
Nyob rau hauv IBS nrog raws plab, 3 mus rau 5 quav hauv ib hnub. Qee lub sij hawm muaj kev xav, tab sis tsis muaj quav lossis nws yog qhov qub. Qhov no yog pseudodiarrhea. Qhov ntim ntawm cov quav hauv ib hnub tsis pub tshaj 200 g. Kev mob plab tshwm sim thaum sawv ntxov tom qab noj mov - nws yog hu ua thaum sawv ntxov onslaught syndrome; zawv plab yuav tsis tshwm sim thaum nruab hnub.
Nyob rau hauv IBS yam tsis muaj raws plab (nrog cem quav) thaum tus neeg mob zaum ntawm chav dej, nws tau kwv yees tias nws siv 25% ntawm nws lub sijhawm rau straining (dhau). Tej zaum yuav tsis muaj qhov xav kom dhau cov quav, thiab cov neeg mob mus rau laxatives lossis enemas.
Cov quav tsis pub ntau tshaj ob zaug hauv ib lub lis piam, lossis tsawg dua. Tus cwj pwm ntawm cov quav zoo li yaj quav. Feem ntau nrog xeev siab, iab nyob rau hauv lub qhov ncauj, tsub zuj zuj ntawm gases nrog ib tug unpleasant tsw. Muaj, raws li txoj cai, cov tsos mob tsis yog plab hnyuv ntawm lub paj hlwb thiab lub cev tsis muaj zog. Lawv kuj muaj kev tsom ntsoov rau nruab hnub xwb. Ntawm lawv yog:
- cephalgia, feem ntau zoo li migraine;
- coma hauv caj pas;
- mob lumbar;
- myalgia;
- cardialgia;
- txias lim hiam;
- insomnia lossis tsaug zog;
- qee zaum tus neeg mob muaj teeb meem nqus pa;
- nocturia thiab tso zis ntau zaus thaum nruab hnub tuaj yeem cuam tshuam thaum hmo ntuj.
Tus neeg mob yws tias nkees nkees, tej zaum yuav muaj dysmenorrhea. Ntau tshaj li ib nrab ntawm cov neeg mob ib txwm muaj mob cancerophobia (uas yog ib qho zoo heev).
Koj xav tau dab tsi los kuaj xyuas? Cov txheej txheemcov hauv qab no:
- Cov quav tsis tu ncua - tsawg dua peb zaug hauv ib lub lis piam, lossis ntau dua peb zaug hauv ib hnub.
- Kev cuam tshuam ntawm cov quav - khoom lossis kua.
- Kev mob plab zom mov los yog xav tias plab zom mov tsis tiav.
- tseem ceeb hu.
- flatulence, hnoos qeev hauv quav, mob plab hauv plab.
Cov tsos mob ntawm IBS nrog raws plab feem ntau tshwm sim tom qab noj mov lossis thaum muaj kev ntxhov siab.
Nco lub siab lub ntsws kom txhob raws plab. Yuav tsum tau muaj tsawg kawg yog ob yam tsos mob: qhov kev hloov pauv ntawm qhov kev xav hauv tus txheej txheem ntawm defecation thiab tsam plab. Cov saum toj no siv rau IBS nrog thiab tsis muaj raws plab. Tab sis kuj muaj ib daim ntawv sib xyaw. Nws yog tus cwj pwm los ntawm kev hloov raws plab thiab cem quav. Lwm cov tsos mob tsis hloov.
Qhov kev txiav txim siab txog qhov muaj qhov tsis txaus siab ntawm lub plab hnyuv siab raum hauv tus neeg mob tsuas yog ua tau yog tias muaj mob plab ntev ntawm qhov tshwm sim tsis zoo lossis qhov tsis xis nyob hauv plab rau peb hnub txhua lub hlis ua ke nrog lwm cov cim, xws li raws li kev kho mob tom qab defecation, kev hloov pauv ntawm qhov zaus thiab qhov sib xws ntawm cov quav. Cov kab mob zoo li no qhia txog qhov pib ntawm pathology. Cov kev tshwm sim no yuav tsum tau soj ntsuam rau rau lub hlis ua ntej kev kuaj mob.
ntsuas ntsuas
Tsis muaj kev kuaj tshwj xeeb rau kev kuaj mob, vim tias tsis muaj cov organic hloov pauv. Ntshav yog coj mus rau ib qho kev ntsuam xyuas dav dav - txhawm rau txheeb xyuas cov leukocytosis thiab ntshav ntshav, nrog rau kev tshuaj xyuas dav dav ntawm cov quav kom pom cov hnoos qeev thiab rog hauv nws, nrog rau cov ntshav occult. Los ntawm txoj kev, lub xub ntiagfatty acids hauv cov quav qhia tias mob pancreatitis.
Qib ntawm cov thyroid hormones yog txiav txim siab. Rau lactase intolerance, kuaj kev ntxhov siab yog ua. Gastroscopy, irrigoscopy, colonoscopy thiab sigmoidoscopy yog qhia. Kev kuaj mob plab thiab plab pelvic tej zaum yuav raug txiav txim kom txiav tawm lwm cov tsos mob.
Txoj Cai Kev Kho Mob
Nws ib txwm tsuas nyuaj. IBS nrog raws plab yog kho raws li hauv qab no:
- Tshuaj kom qeeb plab hnyuv: "Imodium", "Loperamide", "Stopdiar", "Lopedium" thiab lwm yam.
- "Smecta", "Tanalbin" muaj cov nyhuv sedative ntawm txoj hnyuv.
- IBS nrog raws plab teb zoo rau tshuaj ntsuab - decoctions ntawm pomegranate tev, alder, roob tshauv, noog cherry.
- Sorbents txo cov pa roj hauv txoj hnyuv - Laktofiltrum, Enterosgel, Polysorb, Polyphepan.
- Hnub no, hauv kev kho IBS nrog raws plab, serotonin receptor regulators - Alosetron, Tegaserol, Prucalopride - ib txwm siv.
- IBS nrog cem quav yuav tsum muaj qhov txawv txav: ua kom cov quav thiab ua kom yooj yim dua. Rau lub hom phiaj no, kev npaj lactulose yog siv - Goodluck, Dufalac, Portalak. Lawv ua haujlwm tsuas yog hauv cov hnyuv thiab tsis nqus mus rau hauv cov ntshav. Txhawm rau kom muaj qhov ntim ntau hauv cov hnyuv thiab tshem tawm sai sai, kev npaj raws li cov tshuaj ntsuab tau sau tseg - Solgar, Ispagol, Fiberlex, Mukofalk, thiab lwm yam. Lawv kuj siv.cov khoom uas muaj cellulose dag - "Fibercon", "Fiberal", "Citrucel". Lawv qhia lawv cov nyhuv tom qab 10-11 teev, yog li nws yog qhov zoo dua coj lawv ua ntej yuav mus pw.
- Osmotic laxatives qhia lawv tus kheej sai dua - lawv cov nyhuv tshwm sim tom qab 2-5 teev. Cov tshuaj hauv pawg no suav nrog Macrogol, Forlax, Lavacol, Relaxan, Exportal.
- tshuaj ntsuab laxatives raws li tshuaj ntsuab senna: Senade, Alexandria nplooj, Norgalax, Guttasil, Guttalax, Tsis muaj zog, Tsis muaj zog.
- Raws li nrog raws plab, serotonin modulators raug tshuaj. Cov nyhuv kho kuj tuaj yeem muab los ntawm cov dej ntxhia kho mob xws li "Essentuki 17" uas muaj magnesium ntsev; probiotics los txhim kho plab hnyuv microflora - "Bifiform", "Narine", "Hilak-Forte", "Lactobacterin", "Laktovit" thiab lwm yam.
- Nrog rau qhov mob plab hnyav, pab antispasmodics - "Spazgan", "No-shpa", "Drotaverin", "Niaspam", "Sparex", "Mebeverin". Cov naj npawb ntawm lawv niaj hnub no loj heev. Calcium channel blockers muaj cov nyhuv tib yam: "Spazmomen", "Dicitel". Txhim kho txoj cai ntawm txoj hnyuv motility "Debridat".
- Flatulence ib txwm ua rau muaj kev tsis xis nyob ntau, defoamers siv los txo qhov tsis xis nyob - qhov nrov tshaj plaws yog Espumizan, kuj siv"Zeolate", "Polysilane", activated carbon, fennel tincture.
kho mob
Vim tias cov tsos mob tsis yog plab hnyuv kuj tshwm sim, thiab cov tsos mob ntawm lub paj hlwb thiab kev puas siab puas ntsws muaj feem cuam tshuam nrog lawv, cov tshuaj tiv thaiv kev ntxhov siab tau muab tshuaj. Hauv kev kho mob ntawm IBS nrog raws plab, lawv muaj kev cuam tshuam ob npaug. Lawv tuaj yeem tshem tawm qhov tshwm sim etiological thaum nws los txog rau kev ntxhov siab. Nyob rau tib lub sijhawm, cov tshuaj no tsis tso cai rau kev tshwm sim neurogenic ntxiv.
Ib yam lus, lawv rhuav lub voj voog tseem ceeb uas twb tau hais lawm. Feem ntau siv tshuaj tiv thaiv kev nyuaj siab rau IBS nrog raws plab yog tricyclic antidepressants. Lawv muaj cov nyhuv sedative, muaj txiaj ntsig zoo rau lub hauv paus paj hlwb. normalizes kev sib kis ntawm cov hlab ntsha pathological impulses thiab txo qhov rhiab heev ntawm qhov mob receptors. Cov tsoos tshaj plaws ntawm lawv yog Amitriptyline, Nortriptyline. Lawv tuaj yeem ntxiv nrog lwm cov tshuaj tiv thaiv kev ntxhov siab - tus kws kho mob xaiv.
Txhawm rau muab cov lus teb meej rau cov lus nug ntawm yuav ua li cas kho IBS nrog raws plab, koj yuav tsum xav txog tias nws muaj txiaj ntsig zoo rau lub cev kom tau txais lactobacilli hauv daim ntawv tiav. Eubiotics tau tsim rau qhov no: Linex, Acipol, Narine, Bifikol thiab lwm yam.
Muaj ntau cov tshuaj rau kev kho mob ntawm IBS, tab sis ntau tus nyiam coj cov ntaub ntawv hauv Is Taws Nem raws li kev tshuaj xyuas. Hauv IBS cov neeg mob raws plab, kev tshuaj xyuas txog kev ua tau zoo ntawm cov tshuaj kho mob sib txawv, tab sis cov hauv qab no feem ntau hu ua lwm tus:
- "Tsim nyog","Imodium";
- khoom noj;
- Psychotherapeutic cov tswv yim rau kev so, ua pa kom raug, theem ntawm qhov tsis zoo yog suav tias ua tau zoo heev;
- probiotics;
- "Laktofiltrum", "Polysorb", "Smecta", "No-shpa", "Cholestyramine"
Special Diet
Ntau tus neeg mob IBS sim tsis noj thiab txwv lawv tus kheej hauv txhua txoj hauv kev hauv zaub mov. Qhov no yog qhov yuam kev kiag. Kev noj zaub mov yuav tsum muaj ntau yam, tab sis yog. Kev noj zaub mov rau IBS nrog raws plab suav nrog kev noj cov zaub mov uas txhim kho cov kab mob hauv plab hnyuv - zinc, magnesium, omega-3 thiab omega-6 polyunsaturated fatty acids. Nws tseem yog ib qho tseem ceeb uas yuav tau xaiv cov zaub mov zoo rau koj tus kheej uas tsis muaj kev cuam tshuam rau lub plab zom mov.
Thaum pom cov zaub mov muaj teeb meem zoo li no, lawv yuav tsum raug tshem tawm lossis txwv hnyav. Kev noj zaub mov rau IBS nrog raws plab thiab flatulence yuav tsum tsis lees txais:
- cawv, pastries, yooj yim suab thaj thiab chocolate, caffeinated dej qab zib - tshuaj yej, kas fes;
- soda;
- miv;
- sugar substitutes - xylitol, sorbitol,
- mannitols.
Lawv txhua tus muab cov tshuaj laxative rau cov kab mob uas twb muaj lawm. Tsis tas li, ceev faj thaum siv:
- txiv apples, plums thiab beets - lawv yuav tsis ua rau raws plab;
- legumes - taum, peas;
- cruciferous - txhua hom zaub qhwv;
- txiv hmab txiv ntoo thiab pears, cov khoom no ua rau thiab txhim kho cov txheej txheem fermentation.
Thaum yoog muscem quav yog txwv tsis pub noj cov zaub mov rog thiab kib.
Kev noj zaub mov rau IBS nrog raws plab tshem tawm cov zaub mov ntawm cov khoom noj ntsim, pickles thiab marinades, txiv hmab txiv ntoo tshiab thiab zaub, rye qhob cij, ib hnub kefir thiab qaub cream, qab zib, nqaij rog, dej txias thiab kas fes, pastries.
Nrog rau koj cov zaub mov:
- qaug tshuaj yej, compotes, unsweetened diluted kua txiv, qaib broths;
- zaub thiab txiv hmab txiv ntoo - boiled los yog ci;
- pasta tais;
Cov zaub mov yuav tsum noj tib lub sijhawm tsib mus rau rau zaus hauv ib hnub yam tsis muaj kev noj ntau dhau. Qhov chaw noj mov yuav tsum nyob twj ywm, tsis muaj kev nrawm. Kev kho cua sov - chav los yog ua noj, ci. Ntxiv roj tsuas yog thaum kawg ntawm kev ua noj.
Kev Ntsuas rau IBS yog qhov zoo, yuav luag tsis muaj teeb meem.
ntsuas kev tiv thaiv
Vim IBS tiv thaiv tsis tau, tsis muaj kev tiv thaiv. Tab sis txhawm rau txhim kho koj lub siab ntsws keeb kwm yav dhau thiab normalize nws yog nyob rau hauv lub zog ntawm txhua tus. Muaj txiaj ntsig zoo hauv qhov no yog kev cob qhia txog kev puas siab puas ntsws rau kev so, ua kom muaj kev ntxhov siab, kev xav, ua tiav alpha atherosclerosis hauv lub hlwb.
Qhov no yuav tsum tau ntxiv nrog kev noj zaub mov kom zoo, txhim kho txoj hnyuv microflora, ua kom lub cev muaj zog, tsis txhob noj cov tshuaj laxatives thiab tshuaj kho cov quav ntawm koj tus kheej. Thaum kuaj mob plab hnyuv siab raum, ib tus neeg tuaj yeem tsim cov txheej txheem thiab cov txheej txheem rau nws tus kheej, txawm li cas los xij, tom qab sab laj nrog nws tus kws kho mob.
