Wie behandelt man die Colitis ulcerosa? – Lokalisation und Schweregrad sind entscheidend

Die Colitis ulcerosa ist neben dem Morbus Crohn die wichtigste chronisch entzündliche Darmerkrankung. Im vorliegenden Artikel werden die Therapieprinzipien in Form eines Algorithmus entsprechend der Deutschen Leitlinie der DGVS und der neuen Europäischen Leitlinie zur Behandlung der Colitis ulcerosa dargestellt. Die Basis der Therapie beruht auf einer Suppression der inflammatorischen Reaktion. Diese kann im Falle der Aminosalicylate je nach Befallsmuster topisch oder systemisch erfolgen. Bei schwerem Befall kommen Steroide zum Einsatz, häufig sind Immunsuppressiva wie Azathioprin, bei refraktären Verläufen auch von Reservemedikamenten wie Cyclosporin, Tacrolimus oder Infliximab indiziert.

Ulcerative colitis represents one of the main chronic inflammatory bowel diseases. This review highlights therapeutic principles according to the National (DGVS) and European (ECCO) guidelines. In general to date therapy relies on the suppression of the inflammatory mucosal process. 5-Aminosalicylates may be given topically and/or systemically according to the localisation and extend of disease. In severe ulcerative colitis systemic steroids represent the mainstay of therapy whereas in refractory disease rescue medication like cyclosporine, tacrolimus or infliximab are indicated.

Key words

Ulcerative colitis - 5-ASA - cylosporine - tacrolimus - azathioprine - infliximab

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