Reizdarmsyndrom – eine Krankheit

Abstract

The irritable bowel syndrome (IBS) counts among the most prevalent chronic diseases. Clinically, the IBS is characterized by abdominal symptoms combined with irregular defecation, which are not explained by routine diagnostic tests. IBS is often triggered by enteric bacterial infections, and its pathogenesis involves disturbed enteric, gut-brain, and cerebral mechanisms. Diagnostic work-up must aim to establish a positive IBS diagnosis, and to exclude serious underlying differential diagnoses (such as neoplasia, inflammatory bowel disease, celiac disease and others). On the other hand, it is important to avoid diagnostic “overkill” including repetitive testing. Successful treatment of IBS usually combines unspecific basic (nutritional, psychological, lifestyle etc.) measures with specific, symptom-oriented medical therapy. Therapeutic efficacy is greatly enhanced by ruling out worrying diagnostic uncertainties (reassurance), and by initiating positive patient guidance.

In der Vergangenheit war das Reizdarmsyndrom (RDS) häufig mit dem Stigma einer harmlosen psychosomatischen Befindlichkeitsstörung behaftet – heute gilt es bei wachsendem Verständnis der Pathophysiologie als „organische Erkrankung“. Auch werden zunehmend moderne, eher zielgerichtete Therapien für das RDS entwickelt. Dieser Beitrag fasst die aktuellen Kenntnisse zu Pathophysiologie, Diagnostik und Therapie dieser häufigsten Darmerkrankung zusammen.

Schlüsselwörter

viszerale Hypersensitivität - Darmerkrankungen - Diarrhö - Obstipation - Bauchschmerzen

Key words

visceral hypersensitivity - bowel disorders - diarrhea - constipation - abdominal pain

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