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Aktueller Stand der konservativen Therapie des Ulcus pepticum

Current medical treatment of peptic ulcer disease

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Zusammenfassung

Grundlagen

In einer Allgemein-bzw. Internistenpraxis liegt der Anteil der Patienten mit gastrointestinalen Beschwerden bei etwa 30 bis 40%. Schätzungsweise leiden rund 15 bis 20% der Menschen an Magen-bzw. Duodenalkrankheiten, bei 6 bis 15% kommt es zu einem Ulcus duodeni.

Methodik

In einer Übersicht werden ätiologische, pathogenetische und diagnostische Aspekte sowie neue konservative Therapiemöglichkeiten des Ulcus pepticum dargestellt.

Ergebnisse

Die Ätiopathogenese von Ulkus und Gastritis erfuhr mit der Wiederentdeckung und Aufklärung des Pathomechanismus von Helicobacter pylori eine revolutionierende Erweiterung. In der Diagnostik hat die Endoskopie einen mittlerweile unbestrittenen Stellenwert erlangt, wobei vor allem die Möglichkeit einer histologischen bzw. bakteriologischen Verifizierung der Diagnose im Hinblick auf die pathogenetische Rolle des Helicobacter pylori und die derzeit geltende Klassifizierung der Gastritis unverzichtbar geworden ist. Mit den angeführten Substanzgruppen bzw. der möglichen antibiotischen Therapie zur Eradikation des Helicobacter pylori stehen wirksame Medikamente zur Schmerzlinderung sowie zur Heilung und Verhinderung von Rezidiven beim Ulcus duodeni und ventriculi zur Verfügung.

Schlußfolgerungen

Beim Problemkreis, „Gastritis—Ulcus duodeni—Ulcus ventriculi” handelt es sich nicht nur um ein gesundheitspolitisches, sondern vor allem auch um ein volks-wirtschaftlich höchst bedeutsames Thema. Die Kenntnis von Pathogenese, Diagnostik und aktuellen konservativen Therapieaspekten ist auch für den gastroenterologisch interessierten Chirurgen von großem Wert.

Summary

Background

About 30 to 40% of all patients have gastrointestinal disorders, 15 to 20% of these with localisation in the upper gastrointestinal tract and 6 to 15% with the diagnosis of duodenal ulcer.

Methods

Besides etiologic, pathogenetic and diagnostic aspects the medical therapeutical options for the treatment of peptic ulcer are summarized in the following overview.

Results

Helicobacter pylori is the most important factor in the pathogenesis of duodenal and gastric ulcer. Endoscopy of the upper gastrointestinal tract is the best diagnostic procedure with histologic and bacterial examination of biopsy specimens. Drugs as listed below are known to reduce gastric and duodenal pain and to treat ulcer disease.

Conclusions

These data show that gastritis and peptic ulcer disease are major issues of public health and political economy. Pathogenesis, diagnosis and medical therapy of ulcer disease are from major importance for the gastroenterologic surgeon.

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Authors and Affiliations

  1. Klinische Abteilung für Gastroenterologie und Hepatologie, Universitätsklinik für Innere Medizin IV, Währinger Gürtel 18-20, A-1090, Wien

    J. Pidlich & A. Gangl

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  1. J. Pidlich
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Pidlich, J., Gangl, A. Aktueller Stand der konservativen Therapie des Ulcus pepticum. Acta Chir Austriaca 28, 33–36 (1996). https://doi.org/10.1007/BF02625953

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