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Funktionelle Magen- und Darmerkrankungen

Functional gastrointestinal disorders

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Zusammenfassung

Funktionelle Magen- und Darmerkrankungen sind als chronische oder rezidivierende abdominale Symptome definiert, deren Entstehung nicht durch in der üblichen klinischen Diagnostik identifizierbare strukturelle oder biochemische Veränderungen erklärt ist. Patienten, die unter funktioneller Dyspepsie (Reizmagen) oder Reizdarm, den beiden häufigsten Formen, leiden, haben eine gravierend reduzierte Lebensqualität bei normaler Lebenserwartung. In den pathogenetischen Konzepten dieser beiden Erkrankungen spielen sensomotorische Störungen eine Schlüsselrolle, mögliche Ursachen reichen von stressinduzierten neuroendokrinen Reaktionen bis zu Residuen von Infektionen. Wichtigste diagnostische Maßnahme ist die Anamnese mit gezieltem Erfragen von Alarmsymptomen. Die Therapie kann neben der allgemeinen ärztlichen Beratung und diätetischen Empfehlungen differenzierte symptomorientierte medikamentöse Maßnahmen und psychosoziale Interventionen umfassen.

Abstract

Functional gastrointestinal disorders (FGD) are characterized as chronic or recurrent abdominal symptoms that are not explained by structural or biochemical alterations identified in routine diagnostic procedures. Patients suffering from symptoms of functional dyspepsia or irritable bowel syndrome, the two most prevalent FGD, have significantly reduced quality of life but not reduced life expectancy. Current pathogenetic concepts of both disease entities propose central or peripheral alterations that cause disturbed gastrointestinal function (motility, visceral sensitivity). These alterations are possibly related to psychological (neuroendocrine effects of stress) and biological (microinflammation, postinfectious residuals, altered serotonergic mechanism) influences. The most important diagnostic testing in FGD is careful history taking, especially exploration of the presence of alarm symptoms. Depending on the severity and course of the disease, FGD treatment encompasses general lifestyle and dietary recommendations, symptom-directed medical therapy, and psychosocial interventions.

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Authors and Affiliations

  1. Klinik für Innere Medizin, Martin-Luther Krankenhaus, Caspar-Theyß-Str. 27–31, 14193, Berlin, Deutschland

    H. Mönnikes

  2. Abteilung Innere Medizin, Park-Klinik Weissensee, Schönstr. 80, 13086, Berlin, Deutschland

    S. Müller-Lissner

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  1. H. Mönnikes
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  2. S. Müller-Lissner
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Correspondence to H. Mönnikes or S. Müller-Lissner.

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Mönnikes, H., Müller-Lissner, S. Funktionelle Magen- und Darmerkrankungen. Gastroenterologe 3, 415–427 (2008). https://doi.org/10.1007/s11377-008-0224-8

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