Zusammenfassung
Das Reizdarmsyndrom (RDS) ist eine in der Praxis häufig vorkommende komplexe funktionelle Gesundheitsstörung. Hauptsymptome der Patienten sind Schmerzen, Blähungen, Obstipation, Diarrhö, Meteorismus und abdominale Distension. Die Diagnose erfolgt durch Ausschluss relevanter Differenzialdiagnosen. Man unterscheidet Patienten mit Obstipationsprädominanz, Diarrhöprädominanz und wechselndem/gemischtem Stuhlverhalten. In der Entstehung des RDS werden vielfältige Pathomechanismen diskutiert. Aufgrund der Heterogenität gibt es keine Standardtherapie. Die Behandlung erfolgt stets symptomorientiert. Erfolge bei der Behandlung des RDS konnten mit Ballaststoffen, Laxanzien, Spasmolytika, Antidepressiva, Hypno-/Psychotherapie sowie Antibiotika erzielt werden. Ebenso gelten Probiotika zunehmend als ein sinnvoller therapeutischer Ansatz, wobei hier Wirkungen stammspezifisch und individuell sind und sich somit nicht generalisieren lassen.
Abstract
Irritable bowel syndrome (IBS) represents a common, functional gastrointestinal disorder. Predominant symptoms are pain, flatulence, constipation, diarrhea, meteorism and abdominal distension. The diagnosis is made by exclusion of relevant differential diagnoses. Patients are categorized according to defecation problems into diarrhea predominant, constipation predominant and alternating mixed stool behavior. To date, several pathomechanisms of IBS are under discussion. Owing to its heterogeneity, no standard therapy is available and current therapeutic approaches focus on the main symptoms. Dietary fibre, laxatives, spasmolytics, antidepressants, hypnotherapy/psychotherapy and also antibiotics have been reported to be beneficial in the treatment of IBS. Recently, evidence has accumulated that probiotics represent a useful therapeutic approach in the treatment of IBS although effects are strain-specific and individual and cannot be generally assigned to all patients.
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Interessenkonflikt
Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: Prof. Dr. H. Krammer erhielt Honorar für Vorträge oder Beratung oder Studien von folgenden Firmen: Ardeypharm, Danone, Yakult, Falk Foundation, Shire. Markus Bluhm: keine Interessenkonflikte. PD Dr. Beate Niesler erhielt ein Honorar für die Beratung der Firma HEEL.
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Krammer, H., Bluhm, M. & Niesler, B. Reizdarmsyndrom. coloproctology 34, 157–166 (2012). https://doi.org/10.1007/s00053-011-0218-8
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DOI: https://doi.org/10.1007/s00053-011-0218-8