Waxaa laga yaabaa inaad ka fekereyso sababta uu takhtarkaagu u qori doono antidepressant-kaaga mindhicirka mindhicirkaaga (IBS) haddii aadan niyad-jabin. Ama, laga yaabee in badan oo IBS ku dhib badan, waxaad ku xanuunsan kartaa niyad-jabka ama walwalkaaga IBS-daada, sidaa daraadeed fikrad ayaa ka dhigaysa dareen yar, laakiin waxa aad u roon tahay wixii saameyn ku yeesha antidepressant ee ku yeelan kara calaamadahaaga IBS .
Aragtida soo socota ayaa ka jawaabeysa su'aasha ah sababta antidepressants mararka qaarkood loo isticmaalo sida daaweynta IBS iyo in aad wax ka barato sida noocyada antidepressants oo inta badan loo qoro bukaanka IBS.
Maxay tahay sababta antidepressants loo isticmaalo IBS
Inkastoo daawooyinka fasalkaan lagu calaamadiyay inay yihiin antidepressants, waxay leeyihiin saameyn ka baxsan xannibaadda niyad jabka. Dawooyinka liddi ku ah antidepressants ayaa lagu muujiyey inay yaraynayaan welwelka iyo dareemidda xanuun marka ay saameyn xun ku yeelanayaan habka dheef-shiidka .
Dhakhaatiirtu waxay u qori karaan daawada antidepressant-ka ee bukaanka IBS, laakiin tan waxaa loo tixgeliyaa isticmaalka "off-label" ee daroogada, maadaama aysan jirin daweenta antidepressant inuu qaato ansixinta FDA sida daaweynta IBS. Si kastaba ha ahaatee, College College of Gastroenterology, ka dib dib u eegis cilmi baaris ballaaran, ayaa ku soo gabagabeeyey in ay jiraan taageero cilmi-baaris ku filan oo ku saabsan waxtarka laba nooc oo daroogo ah - TCAs iyo SSRIs - inay kugula taliyaan isticmaalkooda daaweynta IBS.
Gaar ahaan, antidepressants ayaa lagu ogaadey inay saameyn togan ku leedahay maskax- bararka iyo isku- buuqa dareemayaasha . Waxaa la qiimeeyay in saameynta faa'iido leh ee daaweynta antidepressants ee calaamadaha IBS ay tahay natiijo ka timid ficilka daawooyinkan ku saabsan neurotransmitters ee laga helay maskaxda iyo xameetada.
Noocyada Daawooyinka Niyad-jabka ah ee lagu isticmaalo IBS Daaweynta
Dawooyinka lidiga ah ee loo isticmaalo IBS ayaa guud ahaan hoos ugu dhacaya mid ka mid ah fasallada soo socda:
Tricyclic Antidepressants (TCAs)
Tricyclic antidepressants waa waayeelka waayeelka ah ee ka hortagga niyadjabka. Waxaa si fiican loo diiwaangeliyay in daawooyinka tricyclic antidepressants ay leeyihiin xanuunka ka hortagga iyo dabeecada gaabis ah, waxayna u muuqdaan in ay sidaan sameeyaan iyagoo ku hawlan serotonin neurotransmitters iyo norepinephrine . Tani waxay hoos u dhigaysaa uur-ku-taallada mindhicirka waxay keeneysaa in TCA-yadu aad ugu habboonaadaan daaweynta shubanka- IBS-da (IBS-D).
Nasiib daro, tallaabo isku mid ah ( saamaynta anticholinergic ) ee keena in ay hoos u dhacdo mindhicirka mindhicirka ayaa mararka qaarkood keeni kara dhibaatooyin soo raaca, oo ay ka mid yihiin lulmidda, afka qalalan, aragga cilladda leh, dhibaatooyinka galmada, wareerka, murqaha, madax-xanuun iyo korodh miisaanka. TCA-yada guud ahaan ayaa lagu qoraa qiyaasaha hoose marka la daaweynayo IBS marka loo eego marka la daaweynayo niyad-jabka. Kuwa soo socda waa tusaalooyinka TCA-yada laga yaabo in loo qoro IBS:
- Elavil (amitriptyline)
- Tofranil (imipramine)
- Norpramin (desipramine)
- Aventyl, Pamelor, Allegron (nortriptyline)
Xakameyn Soo Saarista Serotonin (SSRIs)
Nidaamyada serotonin ee xakameynaya serotonin (SSRIs) waa daawooyin loo qorsheeyay in ay kordhiyaan heerarka serotonin neurotransmitter ee nidaamka dareenka, si loo fududeeyo saameynta faa'iido leh ee niyadda.
Sababtoo ah kaliya serotonin neurotransmitter waa la bartilmaameedsan yahay, SSRIs guud ahaan waxay leedahay saameyno yar oo ka yimaada daaweynta antidepressants ee tricyclic. Waxyeellooyinka caamka ah ee lallabbada, shubanka, walwalka, iyo madax xanuunka inta badan ayaa yareynaya inta jidhku ku habboon yahay daawada. Ficil la'aanta waxtarka adkeysiga waxay ka dhigeysaa SSRs doorasho ka wanaagsan kuwa qaba xanuunka IBS (IBS-C).
SSRI waxay sidoo kale ku dambeyn kartaa dhibaatooyinka sii dheeraaday ee dhibaatooyinka galmada (lumista jinsiga iyo / ama dhibta keenista orgaaniga) iyo miisaan kobaca. Waxaa muhiim ah in la xasuusto in dadka kala duwan ay u dhaqmaan si kala duwan oo qofna u dulqaadan karo nooc ka mid ah SSRI ka khayr badan.
Kuwa soo socda ayaa ah qaar ka mid ah tusaalooyinka sida caadiga ah ee SSRIs loo qoray:
- Celexa (citalopram)
- Lexapro
- Prozac (fluoxetine)
- Paxil (paroxetine)
- Zoloft (sertraline)
5-HT3 oo loogu talagalay Niyad-jabka
Cilmi-baadhayaashu waxay eegeen daawooyinka ujooga goobaha qalliinka ee serotonin gaar ah oo loo yaqaano 5-HT3 reseptors. Lotronex tartamaya ayaa ku jirta qaybtaan.
Sababtoo ah khatarta waxyeellada halista ah, FDA waxay ku soo rogtay xaddiyo adag oo ku saabsan rijeetada Lotronex. Waxaa jira hal 5-HT3 antidepressant, Remeron (mirtazapine). Xogtu way xaddidan tahay sida waxtarka loo yaqaan 'Remeron' ee IBS sidaa daraadeed waxaa dhici karta in aan si caadi ah loo qorin bukaanada IBS.
Ilaha
Ford, A., et.al. " Kulliyadda Maraykanka ee Gastroenterology Sawir Qaadashada Maareynta Calaamadaha Dareenka Sawirka Saxarada iyo Cudurka Dabaysha Xanuunada Xanuunada " " American Journal of Gastroenterology 2014" 109: S2-S26.
Agrawal, A. & Whorwell, PJ "Calaamadaha caloosha ee cirib-tiran: ogaanshaha iyo maareynta" Sayniska Caafimaadka ee Ingiriiska , 2006 332: 280-283.
Jones, J. et.al. "Tilmaamaha Guud ee Bulshada Britishka ee Gastroenterology ee Maareynta Cilladda Saxarada ee Xanuunada" Gut 2000 47: ii1-ii19.
Lacy, B., Weiser, K. & Lee, R. " Daaweynta Cillad Saxarada Xanuunka ah" Horumarinta Therapeutic ee Gastroenterology 2009 2: 221-238.
Sainsbury, A. & Ford, A. "Daaweynta Cudurka Daaljiga Cadaadiska ah: Ka Bixid Wakiilada Fiber iyo Antispasmodic" Horudhaca Ka Soo Kabashada Gastroenterology 2011 4: 115-127.