Pouchitis - Pathophysiologie und Behandlung

Zusammenfassung

Die Colitis ulcerosa ist durch die Coloproktomucosektomie mit ileoanaler Pouchoperation mit einer guten Lebensqualität heilbar geworden. Allerdings ist der Heilungserfolg durch das postoperative Auftreten einer so genannten Pouchitis relativiert. Diese Pouchitis wird in einer Häufigkeit von 36 % beobachtet. Die einmalige Episode einer Pouchitis ist in der Regel gut mit Metronidazol zu behandeln. Allerdings kommt es in 8-32 % der Pouchanlagen zur Entwicklung der wesentlich problematischeren chronischen Pouchitis. Viele Hinweise deuten darauf hin, dass die Pouchitis eine Remanifestation der Colitis ulcerosa ist. Der Artikel gibt eine umfassende Übersicht über die gegenwärtigen Erkenntnisse zur Pathophysiologie, Pathogenese und Behandlungsmöglichkeiten der Erkrankung. Daneben werden die chirurgischen Aspekte der Erkrankung dargestellt.

Abstract

Ulcerative colitis can be cured with a reasonable quality of life by the complete excision of the colorectum and construction of an ileoanal pouch. The cure is incomplete since there is a certain incidence of a so called pouchitis. Pouchitis occurs with a frequency of 36 %. A single episode of a pouchitis can be cured easily, but in 8-32 % the concerned patients develop a chronic pouchitis. There are many signs that pouchitis might be a remanifestation of ulcerative colitis. This article gives an overview on the actual state of pathophysiology, pathogenesis and therapy of this disease. Apart of that the surgical aspects of the disease are described.

Schlüsselwörter

Colitis ulcerosa - Pouchitis - ileoanaler Pouch - Pathophysiologie

Key words

Ulcerative colitis - pouchitis - ileoanal pouch - pathophysiology

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