你的腸易激問題可能是由一種鮮為人知的腸道疾病引起的

你的腸易激問題可能是由一種鮮為人知的腸道疾病引起的

Your gastrointestinal system contains about a hundred trillion bacteria. That may sound scary, but it's actually beneficial because these bacteria help with digestion, immunity and other important functions.

你的腸胃系統(tǒng)大約有一百萬億個細菌。這聽起來很可怕，但實際上是有益的，因為這些細菌有助于消化、免疫和其他重要功能。

Even though they are basically helpful, the bacteria can go astray in disagreeable ways.

盡管它們基本上是有益的，但細菌也會以令人不快的方式誤入歧途。

Small intestinal bacterial overgrowth (SIBO) is a condition where otherwise beneficial bacteria end up in the wrong part of the digestive system, then proliferate and cause unpleasant symptoms such as abdominal pain, gas, bloating, constipation and diarrhea.

小腸細菌過度生長(SIBO)是一種情況，在這種情況下，原本有益的細菌最終會進入消化系統(tǒng)的錯誤部分，然后增殖，并導致不愉快的癥狀，如腹痛、脹氣、便秘和腹瀉。

Bacteria can be healthy and helpful as long as they stay in the large intestine, explains Erica Ilton, a New York dietitian specializing in digestive disorders. "Anything that allows them to get into the small intestine is not great, and predisposes you to SIBO."

專門研究消化系統(tǒng)疾病的紐約營養(yǎng)學家艾麗卡·伊爾頓解釋說:“只要細菌留在大腸內(nèi)，它們就可能是健康有益的。”“任何能讓它們進入小腸的東西都不好吃，而且容易讓你上癮。”

Haven't heard of SIBO yet? You're not alone.

還沒聽說過SIBO嗎?你不是一個人。

It's more recognized now, but I still see patients who say their doctor didn't even know about it, says Hazel Veloso, a gastroenterologist at Johns Hopkins Medicine in Lutherville.

路德維爾約翰霍普金斯醫(yī)學院的胃腸病學家Hazel Veloso說:“現(xiàn)在人們對它有了更多的認識，但我仍然看到病人說他們的醫(yī)生甚至不知道它。”

This condition was once thought to occur in a small number of post-surgical patients, but recent studies suggest it's much more common than previously thought.

這種情況曾被認為只發(fā)生在少數(shù)術(shù)后患者身上，但最近的研究表明，這種情況比之前認為的要普遍得多。

A review in the journal Clinical and Translational Gastroenterology said that SIBO may be found in people who have irritable bowel syndrome, Crohn's disease, celiac disease, diverticulitis, pancreatitis, hypothyroidism, Parkinson's disease, scleroderma, diabetes and coronary artery disease — and this list is not exhaustive.

發(fā)表在《臨床與轉(zhuǎn)化胃腸病學》雜志上的一篇綜述稱，SIBO可能存在于腸易激綜合癥、克羅恩病、腹腔疾病、憩室炎、胰腺炎、甲狀腺功能減退癥、帕金森病、硬皮病、糖尿病和冠狀動脈疾病患者身上，而這一列表并不詳盡。

SIBO can also occur after certain abdominal surgeries, such as a gastric bypass. And it's also common in people who take proton pump inhibitors to reduce stomach acid (reduced acid allows bacteria to flourish).

SIBO也可能發(fā)生在某些腹部手術(shù)后，如胃旁路手術(shù)。這在那些服用質(zhì)子泵抑制劑來減少胃酸的人身上也很常見(減少的胃酸使細菌大量繁殖)。

Veloso says that SIBO is also common among people who use narcotics such as oxycodone and morphine. The use of these medications slows down the passage of food through the gut, which is known as dysmotility. When food sits for longer in the small intestine, there's more time for bacteria to grow, which leads to SIBO.

維羅索說，SIBO在使用羥考酮和嗎啡等麻醉劑的人群中也很常見。這些藥物的使用減慢了食物通過腸道的速度，這被稱為運動障礙。食物在小腸里停留的時間越長，細菌生長的時間就越長，這就導致了SIBO。

We're even now seeing SIBO come from gastrointestinal infections such as food poisoning, Veloso says. "Anything that causes the small bowel to be slow — even radiation for cancer or advancing age — can cause SIBO."

“我們現(xiàn)在甚至看到SIBO來自食物中毒等胃腸道感染，”Veloso說。“任何導致小腸變慢的東西——甚至是癌癥放療或衰老——都可能導致SIBO。”

If you have any of these conditions and suffer from bloating or diarrhea, ask your doctor about being tested for SIBO.

如果你有這些癥狀，并遭受腹脹或腹瀉，問你的醫(yī)生關(guān)于測試SIBO。

The gold-standard test for SIBO is a small bowel aspirate, but it's invasive and expensive, says Veloso. In this test, the doctor uses an endoscope to sample fluid from the small intestine, and tests it for the presence of bacteria that indicate SIBO.

“SIBO的金標準測試是小腸抽吸，但它是侵入性的，而且昂貴，”Veloso說。在這個測試中，醫(yī)生使用內(nèi)窺鏡從小腸中提取液體，并檢測細菌是否存在SIBO。

Whenever my patients say they have bloating, abdominal pain, fatigue, constipation or diarrhea, I order a lactulose breath test, Veloso says. "That's the easier way to test for SIBO, and it is noninvasive," she says.

“每當我的病人說他們有腹脹、腹痛、疲勞、便秘或腹瀉時，我就會要求進行乳果糖呼吸測試，”維羅索說。“這是對SIBO進行檢測的更簡單的方法，而且是無創(chuàng)的，”她說。

For this test, the patient drinks a beverage containing lactulose (a type of sugar), then breathes into test tubes every 20 minutes over a span of three hours. The breath samples are tested to determine whether hydrogen and/or methane gas are being produced from intestinal bacteria.

在這項測試中，患者喝一種含有乳果糖(一種糖)的飲料，然后在三小時的時間里每隔20分鐘向試管中呼氣一次。對呼吸樣本進行測試，以確定氫氣和/或甲烷氣體是否由腸道細菌產(chǎn)生。

Those gases are signs that bacteria are growing in the small intestine. Some doctors also use a glucose breath test, which is similar.

這些氣體是細菌在小腸內(nèi)生長的跡象。一些醫(yī)生也使用類似的葡萄糖呼吸測試。

If you want one of these tests, you should see a doctor instead of ordering a do-it-yourself home test kit. It's too easy to misinterpret the results, and a misdiagnosis certainly won't help you figure out the right treatment.

如果你想做這些檢查，你應(yīng)該去看醫(yī)生，而不是訂購一個自己做的家庭測試包。人們很容易對結(jié)果產(chǎn)生誤解，而誤診肯定不會幫助你找到正確的治療方法。