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01.06.2023 | Divertikulitis | Leitthema

Konservative Therapie der Divertikulitis

verfasst von: PD Dr. Stephan K. Böhm

Erschienen in: coloproctology | Ausgabe 3/2023

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Zusammenfassung

Die Divertikelkrankheit/Divertikulitis ist auf Grund von Häufigkeit und Ressourcenverbrauch eines der wichtigsten Krankheitsbilder in der Gastroenterologie. Die in den vergangenen Jahren erreichten Fortschritte in Diagnostik und Therapie spiegeln sich in der 2022 erschienenen S3-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Allgemein- und Viszeralmedizin (DGAV) wieder. Rückgrat der therapeutischen Stratifizierung ist die Classification of Diverticular Disease (CDD), für die korrekte Einordnung der Patienten spielt die Bildgebung einen große Rolle. In der Primärprophylaxe der Divertikulitis haben sich Verzicht auf Rauchen, Normalgewicht, körperliche Aktivität und eine Diät reich an Ballaststoffen und arm an rotem Fleisch als wirksam erwiesen. Die akute unkomplizierte Divertikelkrankheit (CDD Typ 1a/b) kann bei sorgfältig ausgewählten Patienten ambulant und ohne Einsatz von Antibiotika behandelt werden, während die akute komplizierte Divertikelkrankheit (CDD Typ 2a/b) generell eine stationäre Therapie unter Antibiotika-Einsatz erfordert. Eine Ausnahme werden zukünftig möglicherweise Fälle mit perikolischer Luft bilden. Die Ausschöpfung des Potenzials der ambulanten und antibiotikafreien Therapie der Divertikulitis könnte einen großen Beitrag zur Einsparung von Ressourcen und zur „antibiotic stewardship“ leisten. Dennoch sind hier Widerstände spürbar, die möglicherweise auch auf finanzielle Fehlanreize zurückzuführen sind.

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Titel: Konservative Therapie der Divertikulitis
verfasst von: PD Dr. Stephan K. Böhm
Publikationsdatum: 01.06.2023
Verlag: Springer Medizin
Schlagwörter: Divertikulitis
Antibiotika
Konservative Therapie
Erschienen in: coloproctology / Ausgabe 3/2023
Print ISSN: 0174-2442
Elektronische ISSN: 1615-6730
DOI: https://doi.org/10.1007/s00053-023-00704-6

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Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

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