Dünndarm B pp 388-413 | Cite as

Blindsacksyndrom

  • H. Menge
Part of the Handbuch der inneren Medizin book series (INNEREN, volume 3 / 3 / B)

Zusammenfassung

Das Blindsacksyndrom ist eine Erkrankung, die durch eine bakterielle Überwucherung des Dünndarmlumens gekennzeichnet ist. Infektiöse Enteritiden werden allerdings nicht in dieses Krankheitsbild mit einbezogen. Eine derartige Fehlbesiedlung kann auftreten, wenn durch den Fortfall anatomischer Schranken Bakterien ungehindert ins Darmlumen gelangen können, die Chymuspassage bedeutend verlangsamt ist oder eine Stase von Ingestaanteilen besteht. In der vorliegenden Übersicht sollen zunächst die Erkrankungen diskutiert werden, die zu diesem Krankheitsbild führen können. Im folgenden wird sodann erläutert, über welche Mechanismen die pathologische Bakterienflora ihre krankmachende Wirkung entfaltet und welche Einflüsse hieraus auf die Digestion der hauptsächlichen Nutritiva und auf die Absorptions-Sekretions-Vorgänge der Dünndarmschleimhaut resultieren. Die Erläuterung der pathophysiologischen Geschehnisse nimmt notwendigerweise einen breiten Raum ein, da nur so ein sicheres Verständnis des klinischen Bildes erreicht werden kann. Dieses wird dann in seiner Vielfalt besprochen. Bezüglich der Diagnostik soll besonders auf die Verfahren hingewiesen werden, die unter klinischen Bedingungen ohne großen Aufwand zur Diagnose führen. Die abschließende Besprechung der Therapie soll unterstreichen, daß auch bei einem zeitlebens bestehenden Blindsacksyndrom eine sinnvolle Behandlung durch medikamentöse und diätetische Maßnahmen erreicht werden kann.

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  • H. Menge

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