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Reizdarmsyndrom – Epidemiologie und Pathophysiologie

Irritable bowel syndrome—epidemiology and pathophysiology

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Zusammenfassung

Das Reizdarmsyndrom (RDS) ist einer der häufigsten Gründe, warum Patienten den Arzt aufsuchen, und stellt hierdurch eine erhebliche sozioökonomische Belastung dar. Das RDS wurde aufgrund der geschichtlichen Entwicklung bisher symptomenbasiert definiert. Diese symptomenbasierte Definition durch Symptomencluster als Krankheit ist problematisch, da sich das hierdurch definierte Patientenkollektiv bezüglich des Krankheitsverlaufs nicht grundsätzlich von anderen Erkrankungen unterscheidet. Neuere Untersuchungen zeigen, dass das RDS mit verschiedenen strukturellen, molekularen, genetischen, immunologischen, nervalen und psychosozialen Veränderungen assoziiert ist. Die vielen heute diskutierten Pathomechanismen spiegeln zum einen den multifaktoriellen Charakter des RDS wider, sind zum anderen aber auch Hinweise auf pathophysiologisch unterschiedliche Erkrankungen. Es ist zu erwarten, dass in Zukunft die weitere Aufklärung pathophysiologisch relevanter Faktoren und insbesondere deren Korrelation mit den klinischen Symptomen die Diagnostik und Therapie des Reizdarmsyndroms verbessert. Es wird ein wesentliches Ziel sein, Biomarker zur Charakterisierung der zahlreichen RDS-Untergruppen zu finden, damit eine spezifische Therapieentscheidung möglich ist.

Abstract

Irritable bowel syndrome (IBS) is one of the most frequent reasons why patients seek medical care and therefore, causes a significant socioeconomic burden. Historically, IBS is primarily a symptom-based diagnosis but such a symptom clustering causes significant problems because it is not clear whether and how IBS differs from other diseases. Recent findings indicate that IBS is associated with well-defined structural, molecular, genetic, immunological, neural and psychosocial abnormalities. The numerous pathophysiological mechanisms of IBS reflect the multifactorial character of this disease and strongly suggest the existence of pathophysiologically different disease entities. It is expected that further insight into the pathophysiological mechanisms and the association with clinical symptoms will improve the diagnostics and therapy of IBS in the future. The major challenge will be the development of biomarkers to characterize IBS subgroups to enable therapeutic strategies which target specific pathomechanisms.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. T. Frieling und M. Schemann weisen auf Vorträge für die Firmen Almirall, Boehringer, Falk, Shire, Steigerwald hin. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Correspondence to T. Frieling or M. Schemann.

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Dieser Beitrag wurde erstpubliziert in Der Gastroenterologe 8:405–416.

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Frieling, T., Schemann, M. Reizdarmsyndrom – Epidemiologie und Pathophysiologie. coloproctology 36, 181–189 (2014). https://doi.org/10.1007/s00053-014-0435-z

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  • DOI: https://doi.org/10.1007/s00053-014-0435-z

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