Gastroenterologische Differenzialdiagnostik - Diabetes mellitus als unverzichtbarer Bestandteil der ganzheitlichen Behandlungsstrategie

Unter einem wachsenden Anteil an Diabetikern in der Klinik werden eigentlich typische gastroenterologische Leitsymptome verwässert erfasst und falsch interpretiert. Das weite Spektrum der diabetischen Enteropathie bedarf somit einer sorgfältigen Abklärung. Zu den häufigsten Diagnosen zählen Motilitätsstörungen des Intestinums. Zudem weisen Patienten mit Diabetes mellitus vermehrt gastrointestinale Infektionen, infektiöse Komplikationen sowie eine Hepatitis-C-Infektion auf. Epidemiologische Untersuchungen lassen auf eine Häufung kolorektaler Karzinome und Pankreaskarzinome bei Diabetikern schließen. Veränderte Schmerzmuster, zusätzliche Komorbiditäten und differenzierte Begleitmedikationen erschweren die Sicherung der Diagnose und verzögern häufig notwendige therapeutische Interventionen. Gerade in der gastroenterologischen Differenzialdiagnostik relativiert sich die eigentliche Nebendiagnose Diabetes mellitus zum unverzichtbaren Bestandteil der ganzheitlichen Behandlungsstrategie. Daher steht zu Beginn einer jeden ärztlichen Behandlung auch die Frage nach einem möglichen Diabetes mellitus.

Against the background of the increasing numbers of diabetics attending hospital, what are really typical gastroenterological cardinal symptoms are not being adequately diagnosed and properly interpreted. The wide spectrum of diabetic enteropathies therefore needs to be carefully investigated. One of the most common diagnoses is motility disorder of the bowel. Patients with diabetes mellitus also more frequently have gastrointestinal infections, infectious complications and hepatitis C infections. Epidemiological studies indicate an accumulation of colorectal and pancreatic carcinomas in diabetics. Altered pain patterns, additional co-morbidities and differentiated co-medications hamper the diagnosis, and often delay necessary therapeutic interventions. Especially in the gastrointestinal differential diagnosis, diabetes mellitus, which ought really be (merely) a co-diagnosis, becomes a fundamental element of the holistic treatment strategy. Consequently, every medical treatment should be preceded by the clarification of the question: diabetes, yes or no?

Key Words

diabetic enteropathy - motility disorders - gastroparesis - diarrhoea - constipation - gastrointestinal infection - colorectal carcinoma - pancreas carcinoma

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