Dhimbja \u00ebsht\u00eb nj\u00eb nga ankesat m\u00eb t\u00eb vjetra n\u00eb historin\u00eb e mjek\u00ebsis\u00eb, dhe p\u00ebr mij\u00ebra vjet trajtimet jan\u00eb aplikuar me nj\u00eb qasje t\u00eb nj\u00ebjt\u00eb p\u00ebr t\u00eb gjith\u00eb. Vet\u00ebm koh\u00ebt e fundit ekspert\u00ebt e kan\u00eb pranuar zyrtarisht nj\u00eb t\u00eb v\u00ebrtet\u00eb thelb\u00ebsore: grat\u00eb e p\u00ebrjetojn\u00eb dhimbjen ndryshe nga burrat dhe, si rrjedhoj\u00eb, trajtimet e nj\u00ebjta nuk funksionojn\u00eb p\u00ebr t\u00eb dy gjinit\u00eb.<\/p>\n\n\n\n
Hulumtimet e fundit tregojn\u00eb se vajzat dhe grat\u00eb ndjejn\u00eb dhimbje m\u00eb t\u00eb forta se burrat dhe kan\u00eb m\u00eb shum\u00eb gjasa t\u00eb vuajn\u00eb nga s\u00ebmundje kronike si migrena, sindroma e zorr\u00ebs s\u00eb irrituar, fibromialgjia dhe osteoartriti. Megjithat\u00eb, mjek\u00ebt shpesh i n\u00ebnvler\u00ebsojn\u00eb ose i injorojn\u00eb ato, gj\u00eb q\u00eb sjell vonesa n\u00eb trajtim dhe p\u00ebrkeq\u00ebsim t\u00eb dhimbjeve t\u00eb tyre.<\/p>\n\n\n\n
Nj\u00ebkoh\u00ebsisht, disa studime tregojn\u00eb se qet\u00ebsuesit e dhimbjes, si ibuprofeni, steroidet dhe opioid\u00ebt, nuk jan\u00eb aq efektiv\u00eb tek grat\u00eb sa tek burrat. Dhe e v\u00ebrteta \u00ebsht\u00eb se ekspert\u00ebt ende nuk e kuptojn\u00eb pse, thot\u00eb Elizabeth Losin, neuroshkenc\u00ebtare q\u00eb studion dallimet gjinore n\u00eb perceptimin dhe reagimin ndaj dhimbjes.<\/p>\n\n\n\n
Para vitit 1993, studiuesit nuk ishin t\u00eb detyruar t\u00eb p\u00ebrfshinin grat\u00eb n\u00eb hulumtimet klinike t\u00eb financuara nga Instituti Komb\u00ebtar i Sh\u00ebndetit (NIH), institucioni m\u00eb i madh publik q\u00eb financon hulumtime n\u00eb SHBA. Kjo bazohej n\u00eb iden\u00eb se ciklet menstruale t\u00eb grave do t\u00eb ndikonin n\u00eb rezultatet e testeve dhe nga frika se mos d\u00ebmtohej nj\u00eb shtatz\u00ebni e mundshme. N\u00eb vend t\u00eb k\u00ebsaj, studiuesit supozonin se n\u00ebse nj\u00eb ila\u00e7 ishte i sigurt dhe efektiv tek burrat, at\u00ebher\u00eb do t\u00eb ishte edhe tek grat\u00eb.<\/p>\n\n\n\n
Por kjo \u00ebsht\u00eb shum\u00eb larg s\u00eb v\u00ebrtet\u00ebs. \u201cThelbi \u00ebsht\u00eb se ne nuk dim\u00eb aq sa duhet p\u00ebr biologjin\u00eb e grave dhe lidhjen e trupit t\u00eb gruas me dhimbjen,\u201d thot\u00eb Losin, profesoresh\u00eb e asociuar Bennett Pierce p\u00ebr Kujdesin dhe dhembshurin\u00eb n\u00eb mosh\u00ebn e rritur dhe plakje n\u00eb Universitetin Penn State.<\/p>\n\n\n\n
Megjithat\u00eb, shkenc\u00ebtar\u00ebt po zhvillojn\u00eb disa teori p\u00ebr arsyet pse grat\u00eb e p\u00ebrjetojn\u00eb dhimbjen ndryshe dhe si kjo kufizon opsionet e tyre p\u00ebr t\u2019u trajtuar.<\/p>\n\n\n\n
Pse ila\u00e7et kund\u00ebr dhimbjes nuk jan\u00eb aq efektive p\u00ebr grat\u00eb?<\/strong><\/p>\n\n\n\n Shumica e teorive mbi arsyet pse disa ila\u00e7e kund\u00ebr dhimbjes nuk funksionojn\u00eb po aq mir\u00eb tek grat\u00eb lidhen me hormonet seksuale, thot\u00eb Kiran Patel, drejtor i mjek\u00ebsis\u00eb s\u00eb dhimbjes n\u00eb Lenox Hill Hospital Northwell Health n\u00eb Nju Jork.<\/p>\n\n\n\n Estrogjeni, t\u00eb cilin grat\u00eb e prodhojn\u00eb m\u00eb shum\u00eb se burrat, ngadal\u00ebson zbrazjen e stomakut, rrit p\u00ebrqindjen e yndyr\u00ebs trupore dhe ul sasin\u00eb e disa proteinave q\u00eb lidhen me ila\u00e7et n\u00eb plazm\u00ebn e gjakut, t\u00eb gjitha k\u00ebto, sipas hulumtimeve, ndikojn\u00eb n\u00eb m\u00ebnyr\u00ebn se si ila\u00e7et shp\u00ebrndahen dhe shp\u00ebrb\u00ebhen n\u00eb trup.<\/p>\n\n\n\n Sistemi imunitar i grave \u00ebsht\u00eb gjithashtu m\u00eb aktiv krahasuar me at\u00eb t\u00eb burrave, pjes\u00ebrisht p\u00ebr shkak t\u00eb hormoneve seksuale. Si rezultat, grat\u00eb kan\u00eb reagime inflamatore m\u00eb t\u00eb forta, gj\u00eb q\u00eb mund t\u00eb shpjegoj\u00eb pse ato p\u00ebrdorin m\u00eb shpesh qet\u00ebsues t\u00eb dhimbjes t\u00eb p\u00ebrshkruara me recet\u00eb dhe pse u nevojiten doza m\u00eb t\u00eb larta q\u00eb i marrin p\u00ebr periudha m\u00eb t\u00eb gjata sesa burrat.<\/p>\n\n\n\n Dy lloje t\u00eb barnave anti-inflamatore, t\u00eb quajtura glukokortikosteroide dhe NSAID, sipas studimeve duket se u ofrojn\u00eb burrave m\u00eb shum\u00eb leht\u00ebsim nga dhimbja sesa grave.<\/p>\n\n\n\n Studimet kan\u00eb gjetur gjithashtu dallime t\u00eb lidhura me gjinin\u00eb n\u00eb reagimin ndaj opioid\u00ebve, thot\u00eb Amy Baxter, ish-mjeke n\u00eb urgjenc\u00ebn pediatrike dhe hulumtuese e dhimbjes, e cila ka themeluar Pain Care Labs.<\/p>\n\n\n\n Disa kan\u00eb sugjeruar se grat\u00eb kan\u00eb m\u00eb pak receptor\u00eb mu-opioid (receptor\u00ebt mu-opioid jan\u00eb proteina speciale n\u00eb tru dhe sistemin nervor), proteina kryesore q\u00eb lidhet me opioid\u00ebt dhe rregullon dhimbjen. Kjo n\u00ebnkupton se grat\u00eb mund t\u00eb ken\u00eb nevoj\u00eb p\u00ebr \u201cm\u00eb shum\u00eb opioide p\u00ebr t\u00eb pasur t\u00eb nj\u00ebjtin efekt n\u00eb leht\u00ebsimin e dhimbjes\u201d, thot\u00eb Baxter. Por kjo teori mbetet ende e paqart\u00eb, pasi provat jan\u00eb kontradiktore, disa studime nuk kan\u00eb gjetur asnj\u00eb dallim n\u00eb dozat p\u00ebr grat\u00eb q\u00eb p\u00ebrdorin opioide, nd\u00ebrsa t\u00eb tjera kan\u00eb sugjeruar se atyre u nevojiten doza m\u00eb t\u00eb ul\u00ebta.<\/p>\n\n\n\n Pse grat\u00eb kan\u00eb m\u00eb shum\u00eb efekte an\u00ebsore nga qet\u00ebsuesit e dhimbjes?<\/strong><\/p>\n\n\n\n P\u00ebr shkak se historikisht grat\u00eb jan\u00eb p\u00ebrjashtuar nga hulumtimet klinike, shum\u00eb barna kan\u00eb efekte an\u00ebsore dhe rreziqe sigurie t\u00eb panjohura.<\/p>\n\n\n\n Nj\u00eb studim i vitit 2020 zbuloi dallime t\u00eb m\u00ebdha gjinore n\u00eb m\u00ebnyr\u00ebn se si trupi p\u00ebrpunon 86 barna t\u00eb ndryshme, duke p\u00ebrfshir\u00eb morfin\u00ebn dhe prednizonin. Pothuajse t\u00eb gjitha k\u00ebto barna metabolizoheshin m\u00eb ngadal\u00eb tek grat\u00eb se te burrat, gj\u00eb q\u00eb \u00e7onte n\u00eb koncentrime m\u00eb t\u00eb larta t\u00eb barnave n\u00eb gjak dhe m\u00eb shum\u00eb efekte an\u00ebsore, p\u00ebrfshir\u00eb marramendje, dhimbje koke, konvulsione dhe halucinacione.<\/p>\n\n\n\n Efektet an\u00ebsore nga disa barna jan\u00eb her\u00eb pas here kaq t\u00eb r\u00ebnda sa grat\u00eb refuzojn\u00eb t\u00eb marrin doza m\u00eb t\u00eb larta, thot\u00eb Patel, ose nuk e marrin ila\u00e7in fare.<\/p>\n\n\n\n N\u00eb rastet serioze, barnat jan\u00eb t\u00ebrhequr p\u00ebr t\u00eb mbrojtur grat\u00eb nga d\u00ebmet e m\u00ebtejshme. Midis viteve 1997 dhe 2001, Administrata e Ushqimit dhe Barnave (FDA) t\u00ebrhoqi 10 barna me recet\u00eb nga tregu n\u00eb SHBA, 8 prej tyre u t\u00ebrhoq\u00ebn sepse paraqisnin rreziqe m\u00eb t\u00eb m\u00ebdha sh\u00ebndet\u00ebsore p\u00ebr grat\u00eb, sipas nj\u00eb raporti t\u00eb vitit 2001 nga zyra e llogaridh\u00ebnies s\u00eb qeveris\u00eb s\u00eb SHBA-s\u00eb.<\/p>\n\n\n\n Barni Posicor i cili ishte miratuar p\u00ebr trajtimin e angin\u00ebs dhe presionit t\u00eb lart\u00eb t\u00eb gjakut, u zbulua se ngadal\u00ebsonte ose ndalonte rrahjet e zemr\u00ebs tek njer\u00ebzit e sh\u00ebndetsh\u00ebm, ve\u00e7an\u00ebrisht tek grat\u00eb e moshuara. Dy antihistaminik\u00eb t\u00eb shitur n\u00ebn emrat e mark\u00ebs Seldane dhe Hismanal u t\u00ebrhoq\u00ebn sepse rritnin rrezikun e nj\u00eb aritmie t\u00eb zemr\u00ebs potencialisht fatale tek grat\u00eb.<\/p>\n\n\n\n Patel thot\u00eb se k\u00ebto t\u00eb dh\u00ebna reflektojn\u00eb at\u00eb q\u00eb ajo sheh n\u00eb klinik\u00ebn e saj dhe thekson nevoj\u00ebn p\u00ebr t\u00eb dh\u00ebn\u00eb doza t\u00eb ndryshme p\u00ebr burrat dhe grat\u00eb, p\u00ebr t\u00eb shmangur efektet an\u00ebsore t\u00eb panevojshme.<\/p>\n\n\n\n Pasojat e dhimbjes s\u00eb patrajtuar<\/strong><\/p>\n\n\n\n Grat\u00eb q\u00eb nuk marrin leht\u00ebsimin e dhimbjes q\u00eb u nevojitet mund t\u00eb p\u00ebrjetojn\u00eb pasoja gjat\u00eb gjith\u00eb jet\u00ebs. Sipas Patel, gjendja e tyre ka m\u00eb shum\u00eb gjasa t\u00eb p\u00ebrkeq\u00ebsohet, duke zgjatur koh\u00ebn e rikuperimit dhe duke rritur mund\u00ebsin\u00eb e zhvillimit t\u00eb komplikimeve nga procedurat. Nd\u00ebrkoh\u00eb, detyrat e p\u00ebrditshme si puna, larja e rrobave, apo kujdesi p\u00ebr f\u00ebmij\u00ebt b\u00ebhen jasht\u00ebzakonisht t\u00eb v\u00ebshtira ose t\u00eb pamundura p\u00ebr t\u2019u kryer.<\/p>\n\n\n\n Baxter shton se nuk ndihmon fakti q\u00eb grat\u00eb \u201ckan\u00eb m\u00eb shum\u00eb p\u00ebrgjegj\u00ebsi q\u00eb nuk mund t\u00eb negociohen\u201d. P\u00ebr shembull, nj\u00eb sondazh Gallup i vitit 2019 zbuloi se grat\u00eb n\u00eb marr\u00ebdh\u00ebnie heteroseksuale kishin m\u00eb shum\u00eb gjasa t\u00eb gatuanin, pastronin, lanin rrobat dhe en\u00ebt, b\u00ebnin pazarin dhe kujdeseshin p\u00ebr f\u00ebmij\u00ebt \u00e7do dit\u00eb. \u201cN\u00ebse je nj\u00eb burr\u00eb q\u00eb vuan nga dhimbja, \u00ebsht\u00eb shum\u00eb m\u00eb e leht\u00eb n\u00eb shoq\u00ebri t\u00eb pushosh. Por ekzistenca e nj\u00eb gruaje do t\u00eb thot\u00eb se nuk ka m\u00ebnyr\u00eb p\u00ebr t\u2019u t\u00ebrhequr\u2026 dhe kjo mund t\u00eb kontribuoj\u00eb n\u00eb perceptimin ton\u00eb t\u00eb dhimbjes. Dhe p\u00ebr grat\u00eb, t\u00eb qenit i paaft\u00eb \u00ebsht\u00eb nj\u00eb problem m\u00eb i madh\u201d, shton Baxter.<\/p>\n\n\n\n Me kalimin e koh\u00ebs, dhimbja akute mund t\u00eb shnd\u00ebrrohet n\u00eb dhimbje kronike, thot\u00eb Patel. Tek disa njer\u00ebz, kjo mund t\u00eb shfaqet si ankth ose depresion, tek t\u00eb tjer\u00ebt, mund t\u00eb shfaqet si p\u00ebrdorim i l\u00ebnd\u00ebve narkotike n\u00eb nj\u00eb p\u00ebrpjekje p\u00ebr vet\u00eb-mjekim. Dhe kur p\u00ebrfshihen opioid\u00ebt var\u00ebsues, rreziqet jan\u00eb m\u00eb t\u00eb larta, thot\u00eb Baxter.<\/p>\n\n\n\n \u201cP\u00ebr shkak se grat\u00eb kan\u00eb nj\u00eb shkall\u00eb t\u00eb caktuar t\u00eb munges\u00ebs s\u00eb shp\u00ebrblimit, ato jan\u00eb m\u00eb t\u00eb prirura ndaj var\u00ebsis\u00eb dhe mbidoz\u00ebs nga opioid\u00ebt\u201d, thot\u00eb Baxter. \u201cK\u00ebshtu q\u00eb kur grat\u00eb fillojn\u00eb t\u00eb keqp\u00ebrdorin opioid\u00ebt, sasia q\u00eb p\u00ebrdorin rritet m\u00eb shpejt dhe kan\u00eb m\u00eb shum\u00eb d\u00ebshira p\u00ebr t\u2019i p\u00ebrdorur\u201d.<\/p>\n\n\n\n Grat\u00eb gjithashtu mendohet se kan\u00eb nj\u00eb toleranc\u00eb m\u00eb t\u00eb ul\u00ebt ndaj opioideve p\u00ebr shkak t\u00eb dallimeve n\u00eb mas\u00ebn trupore dhe metaboliz\u00ebm. Prandaj, ato mund t\u00eb mbidozojn\u00eb dhe t\u00eb zhvillojn\u00eb var\u00ebsi nga sasi m\u00eb t\u00eb vogla t\u00eb drog\u00ebs.<\/p>\n\n\n\n T\u00eb dh\u00ebnat jan\u00eb shqet\u00ebsuese. Edhe pse m\u00eb shum\u00eb burra vdesin nga mbidozat e opioid\u00ebve me recet\u00eb sesa grat\u00eb \u00e7do vit, vdekjet tek grat\u00eb jan\u00eb rritur me 642% q\u00eb nga viti 1999 krahasuar me 439% tek burrat, sipas NIH.<\/p>\n\n\n\n Cila \u00ebsht\u00eb e ardhmja e leht\u00ebsimit t\u00eb dhimbjes p\u00ebr grat\u00eb?<\/strong><\/p>\n\n\n\n Ekspert\u00ebt thon\u00eb se nevojitet m\u00eb shum\u00eb pun\u00eb p\u00ebr t\u00eb p\u00ebrmir\u00ebsuar transparenc\u00ebn brenda provave klinike, n\u00eb m\u00ebnyr\u00eb q\u00eb grat\u00eb t\u00eb ken\u00eb mund\u00ebsi t\u00eb sigurta dhe efektive p\u00ebr leht\u00ebsimin e dhimbjes.<\/p>\n\n\n\n Megjithat\u00eb, ka pasur disa p\u00ebrmir\u00ebsime. P\u00ebr shembull, studiuesit po p\u00ebrpiqen t\u00eb identifikojn\u00eb biomarker\u00eb q\u00eb mund t\u00eb matin dhimbjen e grave dhe t\u00eb p\u00ebrshpejtojn\u00eb zhvillimin e trajtimeve t\u00eb reja.<\/p>\n\n\n\n Nd\u00ebrkoh\u00eb, vet\u00eb-avokimi \u00ebsht\u00eb thelb\u00ebsore p\u00ebr grat\u00eb q\u00eb p\u00ebrballen me dhimbje, thot\u00eb Losin.<\/p>\n\n\n\n \u201cKur nd\u00ebrveprojm\u00eb me sistemin ton\u00eb sh\u00ebndet\u00ebsor, duhet t\u00eb avokojm\u00eb me t\u00eb v\u00ebrtet\u00eb p\u00ebr veten, sepse kjo nuk ndodh domosdoshm\u00ebrisht vet\u00eb\u201d, thot\u00eb ajo. \u201cJo se duhet t\u00eb jet\u00eb p\u00ebrgjegj\u00ebsia jon\u00eb, por sa m\u00eb shum\u00eb hulumtim q\u00eb t\u00eb b\u00ebni paraprakisht p\u00ebr t\u00eb marr\u00eb pjes\u00eb m\u00eb aktivisht n\u00eb kujdesin tuaj, aq m\u00eb mir\u00eb do t\u00eb jeni\u201d.<\/p>\n\n\n\n