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01.08.2010 | Leitthema

Ernährung und Chirurgie als Säulen der CED-Behandlung

Nichtmedikamentöse Therapieverfahren bei chronisch-entzündlichen Darmerkrankungen im Kindes- und Jugendalter

verfasst von: Dr. M. Claßen

Erschienen in: Monatsschrift Kinderheilkunde | Ausgabe 8/2010

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Zusammenfassung

Bei limitierter Effektivität und relevantem Nebenwirkungspotenzial der medikamentösen Therapie spielen Ernährungsinterventionen und chirurgische Eingriffe bei Kindern und Jugendlichen mit chronisch-entzündlichen Darmerkrankungen (CED) eine wichtige Rolle. Bei allen Betroffenen müssen Kalorien- und Nährstoffdefizite identifiziert und behandelt werden, v. a. bei den häufigen Problemen Untergewicht und Wachstumsretardierung. Beim Morbus Crohn (MC) kann durch eine enterale Ernährungstherapie mit flüssiger Formelnahrung ohne relevantes Nebenwirkungsrisiko mit hoher Wahrscheinlichkeit eine klinische Remission induziert werden. Dabei spielt es laut neueren Daten keine Rolle, in welchem Darmabschnitt sich der MC manifestiert. Eine Operation kommt v. a. bei Patienten mit Komplikationen oder mit einem therapieresistenten Verlauf in Frage: Bei Colitis ulcerosa (CU) kommt es nach Kolektomie zu einer Heilung der Grunderkrankung, allerdings mit relevanten postoperativen Risiken wie Pouchitis. Beim MC werden chirurgische Verfahren v. a. bei Strikturen und Fisteln eingesetzt. Bei einem therapieresistenten Verlauf mit ileozäkalem Befall und Kleinwuchs kann eine sparsame Resektion eine Remission induzieren und ein Aufholwachstum bewirken.
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Metadaten
Titel
Ernährung und Chirurgie als Säulen der CED-Behandlung
Nichtmedikamentöse Therapieverfahren bei chronisch-entzündlichen Darmerkrankungen im Kindes- und Jugendalter
verfasst von
Dr. M. Claßen
Publikationsdatum
01.08.2010
Verlag
Springer-Verlag
Erschienen in
Monatsschrift Kinderheilkunde / Ausgabe 8/2010
Print ISSN: 0026-9298
Elektronische ISSN: 1433-0474
DOI
https://doi.org/10.1007/s00112-010-2197-1

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