Leitfaden Kurzdarmsyndrom

Zusammenfassung

Das Kurzdarmsyndrom ist ein seltenes und komplexes Krankheitsbild, das meist aufgrund von ausgeprägter Dünndarmresektionen entsteht und zu einem chronischen Darmversagen führen kann. Durch die verminderte intestinale Resorptionsoberfläche kommt es zu einer reduzierten Aufnahme von Makro-, Mikronährstoffen und/oder Flüssigkeit. Dementsprechend entstehen vielfältige Symptome wie Durchfall, Gewichtsverlust, Vitaminmangelerscheinungen, Niereninsuffizienz, Hepatopathie und andere mit großem Effekt auf die Lebensqualität dieser Patienten. Die Therapie dieser Patienten ist komplex und bedarf einer interdisziplinären Zusammenarbeit von verschiedenen Fachdisziplinen wie Diätologie, Gastroenterologie, Chirurgie sowie die zusätzliche engmaschige Betreuung im niedergelassenen Bereich. Oft brauchen Patienten eine dauerhafte (heim-)parenterale Unterstützung. Therapien müssen individuell entschieden und regelmäßig auf Effektivität und Nebenwirkungen überprüft werden. Weiter sind regelmäßige Bestimmungen verschiedener klinischer und laborchemischer Parameter notwendig. Die Morbidität und Mortalität dieser Erkrankung ist hoch und vom Auftreten von Komplikationen geprägt. Dieser Leitfaden soll einen Überblick über die Erkrankung sowie die notwendige Diagnostik und Therapieoptionen geben und die bestmögliche Betreuung dieser komplexen Patienten ermöglichen.

Abstract

Short bowel syndrome is a rare complex disease that mainly develops due to extensive bowel resections and can lead to chronic intestinal failure. Due to the decreased intestinal surface absorption of macronutrient, micronutrient and/or fluids is reduced. Correspondingly manifold symptoms arise as diarrhoea, weight loss, vitamin deficiencies, chronic kidney disease, hepatopathy and others with great impact on quality of life of patients. Therapy is complex and needs interdisciplinary collaboration between dieticians, gastroenterologists, surgeons and also a dense monitoring of general practitioners. Commonly patients need permanent home-parenteral support. Therapies have to be decided individually and have to be reviewed regularly for effectivity and side effects. Furthermore, periodic monitoring of several clinical and laboratory tests should be performed. Morbidity and mortality of this disease complex is high and lead by appearance and management of complications. This practical guide should give an overview about the disease, diagnostics and management and should enable the best possible care of these complex patients.

Schlüsselwörter

Chronisches Darmversagen - Teduglutid - Heim-parenterale Ernährung - Kurzdarmsyndrom - Chronische Darminsuffizienz

Keywords

intestinal failure - teduglutide - home parenteral nutrition - short bowel syndrome - intestinal insufficiency

Publication History

Received: 29 August 2024

Accepted after revision: 24 February 2025

Article published online:
13 May 2025

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