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Erschienen in: coloproctology 3/2014

01.06.2014 | Übersichten

Reizdarmsyndrom – Diagnostik und Therapie

verfasst von: Dr. D. Pohl, H. Heinrich, B. Misselwitz

Erschienen in: coloproctology | Ausgabe 3/2014

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Zusammenfassung

Bis zu 25 % aller gastroenterologischen Patienten leiden unter einem Reizdarmsyndrom (RDS). Bei Neudiagnose eines RDS sind eine fundierte und zielgerichtete Diagnostik entscheidend für den weiteren klinischen Verlauf. Nach Diagnosestellung erbringen erneute Abklärungen, insbesondere repetitive endoskopische Untersuchungen, jedoch praktisch nie zusätzliche Erkenntnisse. Die medikamentöse Therapie ist individuell an den Symptomen des Patienten auszurichten. Nichtmedikamentöse und alternative Therapieverfahren können dabei eine wirksame Ergänzung darstellen.
Literatur
2.
Zurück zum Zitat Bijkerk CJ, Wit NJ de, Muris JW et al (2009) Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ 339: b3154PubMedCentralPubMedCrossRef Bijkerk CJ, Wit NJ de, Muris JW et al (2009) Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ 339: b3154PubMedCentralPubMedCrossRef
3.
Zurück zum Zitat Black TP, Manolakis CS, Di Palma JA (2012) „Red flag“ evaluation yield in irritable bowel syndrome. J Gastrointestin Liver Dis 21: 153–156PubMed Black TP, Manolakis CS, Di Palma JA (2012) „Red flag“ evaluation yield in irritable bowel syndrome. J Gastrointestin Liver Dis 21: 153–156PubMed
4.
Zurück zum Zitat Brandt LJ, Chey WD, Foxx-Orenstein AE et al (2009) An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol 104(Suppl 1): S1–S35PubMedCrossRef Brandt LJ, Chey WD, Foxx-Orenstein AE et al (2009) An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol 104(Suppl 1): S1–S35PubMedCrossRef
5.
Zurück zum Zitat Brinkhaus B, Hentschel C, Von Keudell C et al (2005) Herbal medicine with curcuma and fumitory in the treatment of irritable bowel syndrome: a randomized, placebo-controlled, double-blind clinical trial. Scand J Gastroenterol 40: 936–943PubMedCrossRef Brinkhaus B, Hentschel C, Von Keudell C et al (2005) Herbal medicine with curcuma and fumitory in the treatment of irritable bowel syndrome: a randomized, placebo-controlled, double-blind clinical trial. Scand J Gastroenterol 40: 936–943PubMedCrossRef
6.
Zurück zum Zitat Chey WD, Drossman DA, Johanson JF et al (2012) Safety and patient outcomes with lubiprostone for up to 52 weeks in patients with irritable bowel syndrome with constipation. Aliment Pharmacol Ther 35: 587–599PubMedCrossRef Chey WD, Drossman DA, Johanson JF et al (2012) Safety and patient outcomes with lubiprostone for up to 52 weeks in patients with irritable bowel syndrome with constipation. Aliment Pharmacol Ther 35: 587–599PubMedCrossRef
7.
Zurück zum Zitat Chey WD, Lembo AJ, Lavins BJ et al (2012) Linaclotide for irritable bowel syndrome with constipation: a 26-week, randomized, double-blind, placebo-controlled trial to evaluate efficacy and safety. Am J Gastroenterol 107: 1702–1712PubMedCrossRef Chey WD, Lembo AJ, Lavins BJ et al (2012) Linaclotide for irritable bowel syndrome with constipation: a 26-week, randomized, double-blind, placebo-controlled trial to evaluate efficacy and safety. Am J Gastroenterol 107: 1702–1712PubMedCrossRef
8.
Zurück zum Zitat Dang J, Ardila-Hani A, Amichai MM et al (2012) Systematic review of diagnostic criteria for IBS demonstrates poor validity and utilization of Rome III. Neurogastroenterol Motil 24: 853–e397PubMedCrossRef Dang J, Ardila-Hani A, Amichai MM et al (2012) Systematic review of diagnostic criteria for IBS demonstrates poor validity and utilization of Rome III. Neurogastroenterol Motil 24: 853–e397PubMedCrossRef
9.
Zurück zum Zitat Di Palma JA, Herrera JL (2012) The role of effective clinician-patient communication in the management of irritable bowel syndrome and chronic constipation. J Clin Gastroenterol 46: 748–751CrossRef Di Palma JA, Herrera JL (2012) The role of effective clinician-patient communication in the management of irritable bowel syndrome and chronic constipation. J Clin Gastroenterol 46: 748–751CrossRef
10.
Zurück zum Zitat Drossman DA, Toner BB, Whitehead WE et al (2003) Cognitive-behavioral therapy versus education and desipramine versus placebo for moderate to severe functional bowel disorders. Gastroenterology 125: 19–31PubMedCrossRef Drossman DA, Toner BB, Whitehead WE et al (2003) Cognitive-behavioral therapy versus education and desipramine versus placebo for moderate to severe functional bowel disorders. Gastroenterology 125: 19–31PubMedCrossRef
11.
Zurück zum Zitat Engsbro AL, Begtrup LM, Kjeldsen J et al (2013) Patients suspected of irritable bowel syndrome-cross-sectional study exploring the sensitivity of Rome III criteria in primary care. Am J Gastroenterol 108: 972–980PubMedCrossRef Engsbro AL, Begtrup LM, Kjeldsen J et al (2013) Patients suspected of irritable bowel syndrome-cross-sectional study exploring the sensitivity of Rome III criteria in primary care. Am J Gastroenterol 108: 972–980PubMedCrossRef
12.
Zurück zum Zitat Ford AC, Chey WD, Talley NJ et al (2009) Yield of diagnostic tests for celiac disease in individuals with symptoms suggestive of irritable bowel syndrome: systematic review and meta-analysis. Arch Intern Med 169: 651–658PubMedCrossRef Ford AC, Chey WD, Talley NJ et al (2009) Yield of diagnostic tests for celiac disease in individuals with symptoms suggestive of irritable bowel syndrome: systematic review and meta-analysis. Arch Intern Med 169: 651–658PubMedCrossRef
13.
Zurück zum Zitat Ford AC, Talley NJ, Spiegel BM et al (2008) Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ 337: a2313PubMedCentralPubMedCrossRef Ford AC, Talley NJ, Spiegel BM et al (2008) Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ 337: a2313PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Ford AC, Vandvik PO (2012) Irritable bowel syndrome. Clin Evid (Online) Ford AC, Vandvik PO (2012) Irritable bowel syndrome. Clin Evid (Online)
15.
Zurück zum Zitat Gibson PR, Shepherd SJ (2010) Evidence-based dietary management of functional gastrointestinal symptoms: the FODMAP approach. J Gastroenterol Hepatol 25: 252–258PubMedCrossRef Gibson PR, Shepherd SJ (2010) Evidence-based dietary management of functional gastrointestinal symptoms: the FODMAP approach. J Gastroenterol Hepatol 25: 252–258PubMedCrossRef
16.
Zurück zum Zitat Halpert A, Dalton CB, Diamant NE et al (2005) Clinical response to tricyclic antidepressants in functional bowel disorders is not related to dosage. Am J Gastroenterol 100: 664–671PubMedCrossRef Halpert A, Dalton CB, Diamant NE et al (2005) Clinical response to tricyclic antidepressants in functional bowel disorders is not related to dosage. Am J Gastroenterol 100: 664–671PubMedCrossRef
17.
Zurück zum Zitat Halpert A, Dalton CB, Palsson O et al (2007) What patients know about irritable bowel syndrome (IBS) and what they would like to know. National Survey on Patient Educational Needs in IBS and development and validation of the Patient Educational Needs Questionnaire (PEQ). Am J Gastroenterol 102: 1972–1982PubMedCrossRef Halpert A, Dalton CB, Palsson O et al (2007) What patients know about irritable bowel syndrome (IBS) and what they would like to know. National Survey on Patient Educational Needs in IBS and development and validation of the Patient Educational Needs Questionnaire (PEQ). Am J Gastroenterol 102: 1972–1982PubMedCrossRef
18.
Zurück zum Zitat Halpin SJ, Ford AC (2012) Prevalence of symptoms meeting criteria for irritable bowel syndrome in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol 107: 1474–1482PubMedCrossRef Halpin SJ, Ford AC (2012) Prevalence of symptoms meeting criteria for irritable bowel syndrome in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol 107: 1474–1482PubMedCrossRef
19.
Zurück zum Zitat Harvey RF, Salih SY, Read AE (1983) Organic and functional disorders in 2000 gastroenterology outpatients. Lancet 1: 632–634PubMedCrossRef Harvey RF, Salih SY, Read AE (1983) Organic and functional disorders in 2000 gastroenterology outpatients. Lancet 1: 632–634PubMedCrossRef
20.
Zurück zum Zitat Johannesson E, Simren M, Strid H et al (2011) Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol 106: 915–922PubMedCrossRef Johannesson E, Simren M, Strid H et al (2011) Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol 106: 915–922PubMedCrossRef
21.
Zurück zum Zitat Khan S, Chang L (2010) Diagnosis and management of IBS. Nat Rev Gastroenterol Hepatol 7: 565–581PubMedCrossRef Khan S, Chang L (2010) Diagnosis and management of IBS. Nat Rev Gastroenterol Hepatol 7: 565–581PubMedCrossRef
22.
Zurück zum Zitat Layer P, Andresen V, Pehl C et al (2011) Irritable bowel syndrome: German consensus guidelines on definition, pathophysiology and management. Z Gastroenterol 49: 237–293PubMedCrossRef Layer P, Andresen V, Pehl C et al (2011) Irritable bowel syndrome: German consensus guidelines on definition, pathophysiology and management. Z Gastroenterol 49: 237–293PubMedCrossRef
23.
Zurück zum Zitat Leeds JS, Hopper AD, Sidhu R et al (2010) Some patients with irritable bowel syndrome may have exocrine pancreatic insufficiency. Clin Gastroenterol Hepatol 8: 433–438PubMedCrossRef Leeds JS, Hopper AD, Sidhu R et al (2010) Some patients with irritable bowel syndrome may have exocrine pancreatic insufficiency. Clin Gastroenterol Hepatol 8: 433–438PubMedCrossRef
24.
Zurück zum Zitat Leung WK, Wu JC, Liang SM et al (2006) Treatment of diarrhea-predominant irritable bowel syndrome with traditional Chinese herbal medicine: a randomized placebo-controlled trial. Am J Gastroenterol 101: 1574–1580PubMedCrossRef Leung WK, Wu JC, Liang SM et al (2006) Treatment of diarrhea-predominant irritable bowel syndrome with traditional Chinese herbal medicine: a randomized placebo-controlled trial. Am J Gastroenterol 101: 1574–1580PubMedCrossRef
25.
Zurück zum Zitat Madisch A, Holtmann G, Plein K et al (2004) Treatment of irritable bowel syndrome with herbal preparations: results of a double-blind, randomized, placebo-controlled, multi-centre trial. Aliment Pharmacol Ther 19: 271–279PubMedCrossRef Madisch A, Holtmann G, Plein K et al (2004) Treatment of irritable bowel syndrome with herbal preparations: results of a double-blind, randomized, placebo-controlled, multi-centre trial. Aliment Pharmacol Ther 19: 271–279PubMedCrossRef
26.
Zurück zum Zitat Manheimer E, Wieland LS, Cheng K et al (2012) Acupuncture for irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol 107: 835–847 (quiz 848)PubMedCentralPubMedCrossRef Manheimer E, Wieland LS, Cheng K et al (2012) Acupuncture for irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol 107: 835–847 (quiz 848)PubMedCentralPubMedCrossRef
27.
Zurück zum Zitat Moser G, Tragner S, Gajowniczek EE et al (2013) Long-term success of GUT-directed group hypnosis for patients with refractory irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol 108: 602–609PubMedCrossRef Moser G, Tragner S, Gajowniczek EE et al (2013) Long-term success of GUT-directed group hypnosis for patients with refractory irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol 108: 602–609PubMedCrossRef
28.
Zurück zum Zitat Offner FA, Jao RV, Lewin KJ et al (1999) Collagenous colitis: a study of the distribution of morphological abnormalities and their histological detection. Hum Pathol 30: 451–457PubMedCrossRef Offner FA, Jao RV, Lewin KJ et al (1999) Collagenous colitis: a study of the distribution of morphological abnormalities and their histological detection. Hum Pathol 30: 451–457PubMedCrossRef
29.
Zurück zum Zitat Pan F, Zhang T, Zhang YH et al (2009) Effect of Tongxie Yaofang Granule in treating diarrhea-predominate irritable bowel syndrome. Chin J Integr Med 15: 216–219PubMedCrossRef Pan F, Zhang T, Zhang YH et al (2009) Effect of Tongxie Yaofang Granule in treating diarrhea-predominate irritable bowel syndrome. Chin J Integr Med 15: 216–219PubMedCrossRef
30.
Zurück zum Zitat Park MI, Camilleri M (2006) Is there a role of food allergy in irritable bowel syndrome and functional dyspepsia? A systematic review. Neurogastroenterol Motil 18: 595–607PubMedCrossRef Park MI, Camilleri M (2006) Is there a role of food allergy in irritable bowel syndrome and functional dyspepsia? A systematic review. Neurogastroenterol Motil 18: 595–607PubMedCrossRef
31.
Zurück zum Zitat Pimentel M, Lembo A, Chey WD et al (2011) Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med 364: 22–32PubMedCrossRef Pimentel M, Lembo A, Chey WD et al (2011) Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med 364: 22–32PubMedCrossRef
32.
Zurück zum Zitat Poynard T, Regimbeau C, Benhamou Y (2001) Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 15: 355–361PubMedCrossRef Poynard T, Regimbeau C, Benhamou Y (2001) Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 15: 355–361PubMedCrossRef
33.
Zurück zum Zitat Ruepert L, Quartero AO, Wit NJ de et al (2011) Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome. Cochrane Database Syst Rev: CD003460 Ruepert L, Quartero AO, Wit NJ de et al (2011) Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome. Cochrane Database Syst Rev: CD003460
34.
Zurück zum Zitat Saito YA, Rey E, Almazar-Elder AE et al (2010) A randomized, double-blind, placebo-controlled trial of St John’s wort for treating irritable bowel syndrome. Am J Gastroenterol 105: 170–177PubMedCrossRef Saito YA, Rey E, Almazar-Elder AE et al (2010) A randomized, double-blind, placebo-controlled trial of St John’s wort for treating irritable bowel syndrome. Am J Gastroenterol 105: 170–177PubMedCrossRef
35.
Zurück zum Zitat Shinozaki M, Kanazawa M, Kano M et al (2010) Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial. Appl Psychophysiol Biofeedback 35: 189–198PubMedCrossRef Shinozaki M, Kanazawa M, Kano M et al (2010) Effect of autogenic training on general improvement in patients with irritable bowel syndrome: a randomized controlled trial. Appl Psychophysiol Biofeedback 35: 189–198PubMedCrossRef
36.
Zurück zum Zitat Vahedi H, Merat S, Momtahen S et al (2008) Clinical trial: the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 27: 678–684PubMedCrossRef Vahedi H, Merat S, Momtahen S et al (2008) Clinical trial: the effect of amitriptyline in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 27: 678–684PubMedCrossRef
37.
Zurück zum Zitat Wang G, Li TQ, Wang L et al (2006) Tong-xie-ning, a Chinese herbal formula, in treatment of diarrhea-predominant irritable bowel syndrome: a prospective, randomized, double-blind, placebo-controlled trial. Chin Med J (Engl) 119: 2114–2119 Wang G, Li TQ, Wang L et al (2006) Tong-xie-ning, a Chinese herbal formula, in treatment of diarrhea-predominant irritable bowel syndrome: a prospective, randomized, double-blind, placebo-controlled trial. Chin Med J (Engl) 119: 2114–2119
38.
Zurück zum Zitat Wedlake L, A’Hern R, Russell D et al (2009) Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 30: 707–717PubMedCrossRef Wedlake L, A’Hern R, Russell D et al (2009) Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 30: 707–717PubMedCrossRef
39.
Zurück zum Zitat Whorwell PJ, Prior A, Faragher EB (1984) Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Lancet 2: 1232–1234PubMedCrossRef Whorwell PJ, Prior A, Faragher EB (1984) Controlled trial of hypnotherapy in the treatment of severe refractory irritable-bowel syndrome. Lancet 2: 1232–1234PubMedCrossRef
40.
Zurück zum Zitat Yang J, Lee HR, Low K et al (2008) Rifaximin versus other antibiotics in the primary treatment and retreatment of bacterial overgrowth in IBS. Dig Dis Sci 53: 169–174PubMedCrossRef Yang J, Lee HR, Low K et al (2008) Rifaximin versus other antibiotics in the primary treatment and retreatment of bacterial overgrowth in IBS. Dig Dis Sci 53: 169–174PubMedCrossRef
41.
Zurück zum Zitat Yoon SL, Grundmann O, Koepp L et al (2011) Management of irritable bowel syndrome (IBS) in adults: conventional and complementary/alternative approaches. Altern Med Rev 16: 134–151PubMed Yoon SL, Grundmann O, Koepp L et al (2011) Management of irritable bowel syndrome (IBS) in adults: conventional and complementary/alternative approaches. Altern Med Rev 16: 134–151PubMed
Metadaten
Titel
Reizdarmsyndrom – Diagnostik und Therapie
verfasst von
Dr. D. Pohl
H. Heinrich
B. Misselwitz
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
coloproctology / Ausgabe 3/2014
Print ISSN: 0174-2442
Elektronische ISSN: 1615-6730
DOI
https://doi.org/10.1007/s00053-014-0438-9

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