Die Rolle der Ernährung in der Pathogenese und bei der Therapie entzündlicher Darmerkrankungen

Zusammenfassung

Angesichts einer chronischen, den Darm betreffenden entzündlichen Erkrankung stellen sowohl Laien als auch Ärzte die Frage nach der Rolle der Ernährung in der Entstehung von M. Crohn und Colitis ulcerosa. Die Daten hierzu sind kontrovers.

Hingegen gibt es gute Evidenz für die Wichtigkeit von Ernährungsinterventionen bei der Behandlung von Kindern und Jugendlichen mit chronisch-entzündlichen Darmerkrankungen (CED). Zunächst müssen Kalorien- und Nährstoffdefizite identifiziert und behandelt werden, vor allem bei den häufigen Problemen Untergewicht und Wachstumsretardierung. Daneben sollten Nahrungsunverträglichkeiten in der Planung der weiteren Ernährung berücksichtigt werden.

Bei limitierter Effektivität und relevantem Nebenwirkungspotenzial der Medikamente spielen Ernährungsinterventionen eine wichtige Rolle bei der Therapie von Kindern und Jugendlichen mit CED. Besonders beim M. Crohn bietet die enterale Ernährungstherapie mit flüssigen Formelnahrungen die Chance, ohne ein relevantes Nebenwirkungsrisiko mit hoher Wahrscheinlichkeit eine klinische Remission zu induzieren. Dabei spielt es nach neueren Daten keine Rolle, in welchem Darmabschnitt die Erkrankung sich manifestiert. Ernährung spielt eine wichtige Rolle bei Kindern und Jugendlichen mit CED. Der Artikel gibt eine Übersicht über den aktuellen Wissensstand zu diesem Thema.

Summary

Representing a chronic disease of the intestine, a role of nutrition in the origin of Crohns disease and ulcerative colitis is suspected by patients and physicians. Up to now, scientific proofs are scarce.

However, there is good evidence for the use of nutritional interventions in the treatment of patients with inflammatory bowel diseases (IBD). Deficiencies of total energy and micro-nutrients have to be identified and treated. This is especially important in frequently oc-curing problems as underweight and growth retardation. Food intolerances, which may accompany IBD, have to be taken into account. In the face of limited efficacy and relevant risk of side effects of pharmaceutical treatments, nutritional therapies play an important role in the treatment of children and adolescents with IBD. This is especially true for Crohns disease. Enteral nutrition treatment with liquid formula has the potential of inducing remission in a high percentage of cases without risk of side effects. The therapeutic effect seems to independent from the site of involvement.

Nutrition plays an important role for children and adolescents with IBD. This paper gives an overview of the current knowledge.

Schlüsselwörter

Colitis ulcerosa - Morbus Crohn - enterale Ernährungstherapie

Keywords

Inflammatory bowel diseases - Crohns disease - ulcerative colitis - enteral nutrition treatment

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