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Pharmakotherapie chronisch entzündlicher Darmerkrankungen

Hoffnungen, Enttäuschungen

Therapy of inflammatory bowel diseases

  • Arzneimitteltherapie
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Zusammenfassung

Die Ätiologie chronisch entzündlicher Darmerkrankungen ist unklar. Während die Therapie der ursächlichen Störung nicht möglich scheint, bietet die Pathophysiologie der intestinalen Entzündung zahlreiche Interventionsmöglichkeiten. Ziel ist die langfristige Therapie der Erkrankung und damit eine Beeinflussung des chronischen Krankheitsverlaufs. Die pharmakotherapeutischen Möglichkeiten schließen 5-Aminosalizylate, Glukokortikoide, Immunsuppressiva (Azathioprin, Methotrexat) sowie spezifische Eingriffe in das Immunsystem (monoklonale Antikörper gegen TNF-α) ein. Wichtige supportive Therapieverfahren sind geeignet, die Symptomatik (Schmerzen, Diarrhö) zu beeinflussen. Der Einsatz ernährungstherapeutischer und chirurgischer Verfahren stellt eine wichtige Alternative oder Ergänzung zu pharmakotherapeutischen Interventionen dar.

Abstract

Because the etiology of inflammatory bowel diseases is unclear, no causative therapy is available. However, pathophysiology of the disease offers a lot of possibilities to disrupt the inflammatory cascade that maintains the inflammatory process. The aim of every therapy is to maintain remission as long as possible and to amend the natural course of the disease. Pharmacotherapy includes 5-Aminosalicylates, glucocorticoids, immunosupressants (methotrexate, azathioprine) as well as specific pharmacologic interventions like monoclonal antibodies directed against TNF-alpha (Infliximab). Important supportive tools are available to improve symptoms like diarrhea and pain. Dietetic treatment and surgical procedures represent important alternatives or supplement pharmacotherapeutic interventions.

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  1. Klinik für Allgemeine Innere Medizin, 1. Medizinische Klinik, Campus Kiel des Universitätsklinikums Schleswig-Holstein

    S. Nikolaus, S. Schreiber &  U. R. Fölsch

  2. 1. Medizinische Klinik, Universitätsklinik Schleswig-Holstein, Schittenhelmstraße 12, 24105, Kiel

    U. R. Fölsch

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  1. S. Nikolaus
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Correspondence to U. R. Fölsch.

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Nikolaus, S., Schreiber, S. & Fölsch, U.R. Pharmakotherapie chronisch entzündlicher Darmerkrankungen. Internist 46, 586–591 (2005). https://doi.org/10.1007/s00108-005-1386-9

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