Zespół jelita drażliwego (ang. Irritable bowel syndrome – IBS) i dyspepsja czynnościowa (Functional dyspepsia – FD) należą do grupy czynnościowych zaburzeń przewodu pokarmowego klasyfikowanych według Kryteriów Rzymskich IV. Są to przewlekłe schorzenia o nieznanej, wieloczynnikowej etiologii. Uważa się, że ważnym czynnikiem wpływającym na obecność objawów jest występowanie dysbiozy jelitowej. Szacuje się, że choroby te mogą występować odpowiednio nawet u 20% i 40% populacji. U chorych powodują znaczne pogorszenie jakości życia i są częstą przyczyną absencji chorobowych. Diagnostyka i leczenie tych chorób jest dużym wyzwaniem dla zespołu wielodyscyplinarnego.
Proces diagnostyczny polega na obserwowaniu i potwierdzeniu występowania dolegliwości i wykluczeniu somatycznych przyczyn. Terapia powinna obejmować farmakoterapię, warto dołączyć też prebiotyki, probiotyki (w połączeniu nazywane są synbiotykami) oraz preparaty ziołowe. Łączenie różnych form leczenia zmniejsza objawy choroby, przy czym nie obserwuje się poważnych działań niepożądanych. Korzyści u takich pacjentów często można osiągnąć przez stosowanie leków przeciwdepresyjnych (trójcykliczne leki przeciwdepresyjne –TLPD i selektywne inhibitory wychwytu serotoniny – SSRI) oraz leczenie psychologiczne (psychoterapia, hipnoterapia, terapia behawioralno-poznawcza). Badania naukowe potwierdzają, że mimo stosowania kompleksowego leczenia, u części pacjentów nie przynosi ono oczekiwanego efektu.
Dostępne są różne formy leczenia. Typowa farmakoterapia skupia się na zmniejszaniu objawów chorobowych, takich jak biegunka, zaparcia, bóle brzucha. Stosowane do tych celów preparaty zazwyczaj wpływają tylko na jeden z objawów. W tej sytuacji często konieczne jest łączenie różnych leków. Wsparciem w opanowaniu objawów chorobowych mogą być prebiotyki, probiotyki (ich połączenie nazywamy synbiotykami), preparaty ziołowe. Należy pamiętać, że są to bezpieczne połączenia […]
Autor: lek. Norbert Nowak
Data publikacji: 2020-02-19
Źródło: "Lek w Polsce" nr 01/2020
Słowa kluczowe: zespół jelita drażliwego, dyspesja czynnościowa, probiotyki, zioła, IBS
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