nach oben

Digestive Diseases and Sciences

Erschienen in:

01.09.2020 | Review

Yoga as a Therapy for Irritable Bowel Syndrome

verfasst von: Adrijana D’Silva, Glenda MacQueen, Yasmin Nasser, Lorian M. Taylor, Jeff K. Vallance, Maitreyi Raman

Erschienen in: Digestive Diseases and Sciences | Ausgabe 9/2020

Einloggen, um Zugang zu erhalten

Abstract

The aim of this state-of-the-art narrative review is to evaluate the current evidence about the effectiveness of yoga as therapy for IBS and explore its potential mechanisms of action. The current literature suggests yoga is effective and safe and may target multiple mechanisms involved in treatment of IBS. Evidence from randomized controlled trials identified yoga as more effective compared to pharmacological treatment and equally effective as dietary interventions or moderate-intensity walking. Improvements were seen in both physical health (IBS symptom severity, gastric motility, autonomic and somatic symptom scores, and physical functioning) and mental health outcomes (depression, anxiety, gastrointestinal-specific anxiety, and quality of life). Given favorable changes in IBS-related physical and mental health outcomes, preliminary data supports yoga as beneficial in this population. However, the relatively low-quality evidence resulting from heterogeneity of study designs, interventions, and outcome measures limit our ability to make specific recommendations about the use of yoga as therapy for patients with IBS.

IBS Global Impact Report. 2018.

Drossman DA. Diagnosis and treating patients with refractory functional gastrointestinal disorders. Ann Intern Med. 1995;123:688–697.CrossRefPubMed

Gracie DJ, Hamlin JP, Ford AC. Longitudinal impact of IBS-type symptoms on disease activity, healthcare utilization, psychological health, and quality of life in inflammatory bowel disease. Am J Gastroenterol. 2018;113:702–712. https://doi.org/10.1038/s41395-018-0021-z.CrossRefPubMed

Whitehead WE, Palsson O, Jones KR. Systematic review of the comorbidity of irritable bowel syndrome with other disorders: What are the causes and implications? Gastroenterology. 2002;122:1140–1156. https://doi.org/10.1053/gast.2002.32392.CrossRefPubMed

Bradford K, Shih W, Videlock EJ, et al. Association between early adverse life events and irritable bowel syndrome. Clin Gastroenterol Hepatol. 2012;10:385-90e1-3. https://doi.org/10.1016/j.cgh.2011.12.018.CrossRef

Miller V, Hopkins L, Whorwell PJ. Suicidal ideation in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol. 2004;2:1064–1068.CrossRefPubMed

Canavan C, West J, Card T. Review article: the economic impact of the irritable bowel syndrome. Aliment Pharmacol Ther. 2014;40:1023–1034. https://doi.org/10.1111/apt.12938.CrossRefPubMed

Staudacher HM, Whelan K, Irving PM, Lomer MC. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet. 2011;24:487–495.CrossRefPubMed

Ford AC, Talley NJ, Spiegel BM, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ. 2008;337:a2313.CrossRefPubMedPubMedCentral

10.

Ford AC, Harris LA, Lacy BE, Quigley EMM, Moayyedi P. Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Aliment Pharmacol Ther. 2018;48:1044–1060. https://doi.org/10.1111/apt.15001.CrossRefPubMed

11.

Black CJ, Burr NE, Quigley EMM, Moayyedi P, Houghton LA, Ford AC. Efficacy of secretagogues in patients with irritable bowel syndrome with constipation: systematic review and network meta-analysis. Gastroenterology. 2018;155:1753–1763. https://doi.org/10.1053/j.gastro.2018.08.021.CrossRefPubMed

12.

Ford AC, Talley NJ, Moayyedi P. Efficacy of antidepressants in irritable bowel syndrome: an updated systematic review and meta-analysis controlling for depression. Gut. 2011;61:A154–A155.CrossRef

13.

Ford AC, Brandt LJ, Young C, Chey WD, Foxx-Orenstein AE, Moayyedi P. Efficacy of 5-HT3 antagonists and 5-HT4 agonists in irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol. 2009;104:1831–1843. https://doi.org/10.1038/ajg.2009.223. (quiz 44).CrossRefPubMed

14.

Krogsgaard LR, Lyngesen M, Bytzer P. Systematic review: quality of trials on the symptomatic effects of the low FODMAP diet for irritable bowel syndrome. Aliment Pharmacol Ther. 2017;45:1506–1513. https://doi.org/10.1111/apt.14065.CrossRefPubMed

15.

Moayyedi P, Quigley EM, Lacy BE, et al. The effect of dietary intervention on irritable bowel syndrome: a systematic review. Clin Transl Gastroenterol. 2015;6:e107. https://doi.org/10.1038/ctg.2015.21.CrossRefPubMedPubMedCentral

16.

Zhou C, Zhao E, Li Y, Jia Y, Li F. Exercise therapy of patients with irritable bowel syndrome: a systematic review of randomized controlled trials. Neurogastroenterol Motil. 2019;31:e13461. https://doi.org/10.1111/nmo.13461.CrossRefPubMed

17.

Camilleri M. Management options for irritable bowel syndrome. Mayo Clin Proc. 2018;93:1858–1872. https://doi.org/10.1016/j.mayocp.2018.04.032.CrossRefPubMed

18.

Harris LR, Roberts L. Treatments for irritable bowel syndrome: patients’ attitudes and acceptability. BMC Complement Altern Med. 2008;8:65. https://doi.org/10.1186/1472-6882-8-65.CrossRefPubMedPubMedCentral

19.

Hofmann SG, Curtiss J, Khalsa SBS, et al. Yoga for generalized anxiety disorder: design of a randomized controlled clinical trial. Contemp Clin Trials. 2015;44:70–76. https://doi.org/10.1016/j.cct.2015.08.003.CrossRefPubMedPubMedCentral

20.

Kong SC, Hurlstone DP, Pocock CY, et al. The incidence of self-prescribed oral complementary and alternative medicine use by patients with gastrointestinal disease. J Clin Gastroenterol. 2005;39:138–141.CrossRefPubMed

21.

Lackner JM, Mesmer C, Morley S, Dowzer C, Hamilton S. Psychological treatments for irritable bowel syndrome: a systematic review and meta-analysis. J Consult Clin Psychol. 2004;72:1100–1113. https://doi.org/10.1037/0022-006X.72.6.1100.CrossRefPubMed

22.

Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive Therapy of Depression. New York: Guilford Press; 1979.

23.

Laird KT, Tanner-Smith EE, Russell AC, Hollon SD, Walker LS. Short-term and long-term efficacy of psychological therapies for irritable bowel syndrome: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2016;14:937-47e4. https://doi.org/10.1016/j.cgh.2015.11.020.CrossRef

24.

Henrich JF, Knittle K, De Gucht V, Warren S, Dombrowski SU, Maes S. Identifying effective techniques within psychological treatments for irritable bowel syndrome: a meta-analysis. J Psychosom Res. 2015;78:205–222. https://doi.org/10.1016/j.jpsychores.2014.12.009.CrossRefPubMed

25.

Gonsalkorale WM, Houghton LA, Whorwell PJ. Hypnotherapy in irritable bowel syndrome: a large-scale audit of clinical service with examination of factor influencing responsiveness. Am J Gastroenterol. 2002;97:954–960.CrossRefPubMed

26.

Chen KW, Berger CC, Manheimer E, et al. Meditative therapies for reducing anxiety: a systematic review and meta-analysis of randomized controlled trials. Depress Anxiety. 2012;29:545–562. https://doi.org/10.1002/da.21964.CrossRefPubMedPubMedCentral

27.

Pascoe MC, Bauer IE. A systematic review of randomised control trials on the effects of yoga on stress measures and mood. J Psychiatr Res. 2015;68:270–282. https://doi.org/10.1016/j.jpsychires.2015.07.013.CrossRefPubMed

28.

Rocha KK, Ribeiro AM, Rocha KC, et al. Improvement in physiological and psychological parameters after 6 months of yoga practice. Conscious Cognit. 2012;21:843–850. https://doi.org/10.1016/j.concog.2012.01.014.CrossRef

29.

Kavuri Raghuram N, Malamud A, Selvan SR. Irritable bowel syndrome: yoga as remedial therapy. Evid Based Complement Alternat Med. 2015;2015:398156. https://doi.org/10.1155/2015/398156.CrossRefPubMedPubMedCentral

30.

Wang CC, Li K, Choudhury A, Gaylord S. Trends in yoga, Tai Chi, and Qigong use among US adults, 2002–2017. Am J Public Health. 2019;109:755–761. https://doi.org/10.2105/AJPH.2019.304998.CrossRefPubMed

31.

Cramer H, Ward L, Saper R, Fishbein D, Dobos G, Lauche R. The safety of yoga: a systematic review and meta-analysis of randomized controlled trials. Am J Epidemiol. 2015;182:281–293. https://doi.org/10.1093/aje/kwv071.CrossRefPubMed

32.

Schumann D, Anheyer D, Lauche R, Dobos G, Langhorst J, Cramer H. Effect of yoga in the therapy of irritable bowel syndrome: a systematic review. Clin Gastroenterol Hepatol. 2016;14:1720–1731. https://doi.org/10.1016/j.cgh.2016.04.026.CrossRefPubMed

33.

Taneja I, Deepak KK, Poojary G, Acharya IN, Pandey RM, Sharma MP. Yogic versus conventional treatment in diarrhea-predominant irritable bowel syndrome: a randomized control study. Appl Psychophysiol Biofeedback. 2004;29:19–33.CrossRefPubMed

34.

Kavuri V, Selvan P, Malamud A, Raghuram N, Selvan SR. Remedial yoga module remarkably improves symptoms in irritable bowel syndrome patients: a 12-week randomized controlled trial. Eur J Integr Med. 2015;7:595–608. https://doi.org/10.1016/j.eujim.2015.11.001.CrossRef

35.

Schumann D, Langhorst J, Dobos G, Cramer H. Randomised clinical trial: yoga vs a low-FODMAP diet in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2018;47:203–211. https://doi.org/10.1111/apt.14400.CrossRefPubMed

36.

Uebelacker LA, Epstein-Lubow G, Gaudiano BA, Tremont G, Battle CL, Miller IW. Hatha yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract. 2010;16:21–35.

37.

Shahabi L, Naliboff BD, Shapiro D. Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study. Psychol Health Med. 2016;21:176–188. https://doi.org/10.1080/13548506.2015.1051557.CrossRefPubMed

38.

Ross A, Thomas SA. The health benefits of yoga and exercise: a review of comparison studies. J Altern Complement Med. 2010;16:3–12.CrossRefPubMed

39.

Sivaramakrishnan D, Fitzsimons C, Kelly P, et al. The effects of yoga compared to active and inactive controls on physical function and health related quality of life in older adults- systematic review and meta-analysis of randomised controlled trials. Int J Behav Nutr Phys Act. 2019;16:33. https://doi.org/10.1186/s12966-019-0789-2.CrossRefPubMedPubMedCentral

40.

Schuch FB, Vancampfort D, Richards J, Rosenbaum S, Ward PB, Stubbs B. Exercise as a treatment for depression: a meta-analysis adjusting for publication bias. J Psychiatr Res. 2016;77:42–51. https://doi.org/10.1016/j.jpsychires.2016.02.023.CrossRefPubMed

41.

Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C. A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol Rev. 2015;9:366–378. https://doi.org/10.1080/17437199.2015.1022901.CrossRefPubMed

42.

Grensman A, Acharya BD, Wandell P, et al. Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: a randomized controlled trial on patients on sick leave because of burnout. BMC Complement Altern Med. 2018;18:80. https://doi.org/10.1186/s12906-018-2141-9.CrossRefPubMedPubMedCentral

43.

Hofmann SG, Curtiss J, Carpenter JK, Kind S. Effect of treatments for depression on quality of life: a meta-analysis. Cognit Behav Ther. 2017;46:265–286. https://doi.org/10.1080/16506073.2017.1304445.CrossRef

44.

Olthuis JV, Watt MC, Bailey K, Hayden JA, Stewart SH. Therapist-supported Internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database Syst Rev. 2016;3:CDO11565. https://doi.org/10.1002/14651858.cd011565.pub2.CrossRef

45.

Carmody J, Baer RA. Relationship between mindfulness practice and levels of mindfullness, medical and psychological symptoms and well-being in a mindfullness-based stress reduction program. J Behav Med. 2008;31:23–33.CrossRefPubMed

46.

Zomorodi S, Rasulzadeh Tabatabaee SK, Arbabi M, Falah PA, Daryani NE. Comparative efficacy of cognitive-behavioral therapy and mindfulness therapy on reducing symptoms and improving quality of life in patients with the irritable bowel syndrome. Biomed Pharmacol J. 2014;7:63–74. https://doi.org/10.13005/bpj/453.CrossRef

47.

Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10:712-21e4. https://doi.org/10.1016/j.cgh.2012.02.029.CrossRef

48.

Mayer EA. Gut feelings: the emerging biology of gut-brain communication. Nat Rev Neurosci. 2011;12:453–466. https://doi.org/10.1038/nrn3071.CrossRefPubMed

49.

Bischoff SC, Barbara G, Buurman W, et al. Intestinal permeability—a new target for disease prevention and therapy. BMC Gastroenterol. 2014;14:189–214.CrossRefPubMedPubMedCentral

50.

Camilleri M. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med. 2012;367:1626–1635. https://doi.org/10.1056/NEJMra1207068.CrossRefPubMed

51.

Keita AV, Soderholm JD. The intestinal barrier and its regulation by neuroimmune factors. Neurogastroenterol Motil. 2010;22:718–733. https://doi.org/10.1111/j.1365-2982.2010.01498.x.CrossRefPubMed

52.

Mayer EA, Bradesi S, Chang L, Spiegel BM, Bueller JA, Naliboff BD. Functional GI disorders: from animal models to drug development. Gut. 2008;57:384–404. https://doi.org/10.1136/gut.2006.101675.CrossRefPubMed

53.

Elenkov IJ, Chrousos GP. Stress system—organization, physiology and immunoregulation. Neuroimmunomodulation. 2006;13:257–267.CrossRefPubMed

54.

Mayer EA, Savidge T, Shulman RJ. Brain-gut microbiome interactions and functional bowel disorders. Gastroenterology. 2014;146:1500–1512. https://doi.org/10.1053/j.gastro.2014.02.037.CrossRefPubMed

55.

Coss-Adame E, Rao SS. Brain and gut interactions in irritable bowel syndrome: new paradigms and new understandings. Curr Gastroenterol Rep. 2014;16:379. https://doi.org/10.1007/s11894-014-0379-z.CrossRefPubMedPubMedCentral

56.

Fichna J, Storr MA. Brain-Gut interactions in IBS. Front Pharmacol. 2012;3:127. https://doi.org/10.3389/fphar.2012.00127.CrossRefPubMedPubMedCentral

57.

Antoni MH, Lutgendorf SK, Blomberg B, et al. Cognitive-behavioral stress management reverses anxiety-related leukocyte transcriptional dynamics. Biol Psychiatry. 2012;71:366–372. https://doi.org/10.1016/j.biopsych.2011.10.007.CrossRefPubMed

58.

Antoni MH, Lechner S, Diaz A, et al. Cognitive behavioral stress management effects on psychosocial and physiological adaptation in women undergoing treatment for breast cancer. Brain Behav Immun. 2009;23:580–591. https://doi.org/10.1016/j.bbi.2008.09.005.CrossRefPubMed

59.

Balasubramaniam M, Telles S, Doraiswamy PM. Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psychiatry. 2012;3:117. https://doi.org/10.3389/fpsyt.2012.00117.CrossRefPubMed

60.

Streeter CC, Gerbarg PL, Saper RB, Ciraulo DA, Brown RP. Effects of yoga on the autonomic nervous system, gamma-aminobutyric-acid, and allostasis in epilepsy, depression, and post-traumatic stress disorder. Med Hypotheses. 2012;78:571–579. https://doi.org/10.1016/j.mehy.2012.01.021.CrossRefPubMed

61.

Streeter CC, Whitfield TH, Owen L, et al. Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. J Altern Complement Med. 2010;16:1145–1152. https://doi.org/10.1089/acm.2010.0007.CrossRefPubMedPubMedCentral

62.

D’Silva S, Poscablo C, Habousha R, Kogan M, Kligler B. Mind-body medicine therapies for a range of depression severity: a systematic review. Psychosomatics. 2012;53:407–423. https://doi.org/10.1016/j.psym.2012.04.006.CrossRefPubMed

63.

Li AW, Goldsmith CA. The effects of yoga on anxiety and stress. Altern Med Rev. 2012;17:21–35.PubMed

64.

Jamieson JP, Nock MK, Mendes WB. Mind over matter: reappraising arousal improves cardiovascular and cognitive responses to stress. J Exp Psychol Gen. 2012;141:417–422. https://doi.org/10.1037/a0025719.CrossRefPubMed

65.

Geisler FC, Kubiak T, Siewert K, Weber H. Cardiac vagal tone is associated with social engagement and self-regulation. Biol Psychol. 2013;93:279–286. https://doi.org/10.1016/j.biopsycho.2013.02.013.CrossRefPubMed

66.

Sauer-Zavala SE, Walsh EC, Eisenlohr-Moul TA, Lykins ELB. Comparing mindfulness-based intervention strategies: differential effects of sitting meditation, body scan, and mindful yoga. Mindfulness. 2012;4:383–388. https://doi.org/10.1007/s12671-012-0139-9.CrossRef

67.

Shapiro SL, Jazaieri H, Goldin PR. Mindfulness-based stress reduction effects on moral reasoning and decision making. J Posit Psychol. 2012;7:504–515. https://doi.org/10.1080/17439760.2012.723732.CrossRef

68.

Innes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with yoga: a systematic review. J Am Board Fam Pract. 2005;18:491–519.CrossRefPubMed

69.

Vera FM, Manzaneque JM, Maldonado EF, et al. Subjective sleep quality and hormonal modulation in long-term yoga practitioners. Biol Psychol. 2009;81:164–168. https://doi.org/10.1016/j.biopsycho.2009.03.008.CrossRefPubMed

70.

Fox KC, Nijeboer S, Dixon ML, et al. Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neurosci Biobehav Rev. 2014;43:48–73. https://doi.org/10.1016/j.neubiorev.2014.03.016.CrossRefPubMed

71.

Holzel BK, Carmody J, Vangel M, et al. Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Res. 2011;191:36–43. https://doi.org/10.1016/j.pscychresns.2010.08.006.CrossRefPubMed

72.

Tang YY, Holzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat Rev Neurosci. 2015;16:213–225. https://doi.org/10.1038/nrn3916.CrossRefPubMed

73.

Kaliman P, Alvarez-Lopez MJ, Cosin-Tomas M, Rosenkranz MA, Lutz A, Davidson RJ. Rapid changes in histone deacetylases and inflammatory gene expression in expert meditators. Psychoneuroendocrinology. 2014;40:96–107. https://doi.org/10.1016/j.psyneuen.2013.11.004.CrossRefPubMed

74.

Li Q, Sarna SK. Developmental origins of irritable bowel syndrome (IBS)-like symptoms: epigenetic dysregulatin. Gastroenterology. 2011;140:S-121.CrossRef

75.

Black DS, Cole SW, Irwin MR, et al. Yogic meditation reverses NF-kappaB and IRF-related transcriptome dynamics in leukocytes of family dementia caregivers in a randomized controlled trial. Psychoneuroendocrinology. 2013;38:348–355. https://doi.org/10.1016/j.psyneuen.2012.06.011.CrossRefPubMed

76.

Creswell JD, Irwin MR, Burklund LJ, et al. Mindfulness-Based Stress Reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial. Brain Behav Immun. 2012;26:1095–1101. https://doi.org/10.1016/j.bbi.2012.07.006.CrossRefPubMedPubMedCentral

77.

Kuo B, Bhasin M, Jacquart J, et al. Genomic and clinical effects associated with a relaxation response mind-body intervention in patients with irritable bowel syndrome and inflammatory bowel disease. PLoS One. 2015;10:e0123861. https://doi.org/10.1371/journal.pone.0123861.CrossRefPubMedPubMedCentral

78.

Bower JE, Greendale G, Crosswell AD, et al. Yoga reduces inflammatory signaling in fatigued breast cancer survivors: a randomized controlled trial. Psychoneuroendocrinology. 2014;43:20–29. https://doi.org/10.1016/j.psyneuen.2014.01.019.CrossRefPubMedPubMedCentral

Titel: Yoga as a Therapy for Irritable Bowel Syndrome
verfasst von: Adrijana D’Silva
Glenda MacQueen
Yasmin Nasser
Lorian M. Taylor
Jeff K. Vallance
Maitreyi Raman
Publikationsdatum: 01.09.2020
Verlag: Springer US
Erschienen in: Digestive Diseases and Sciences / Ausgabe 9/2020
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-019-05989-6

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

23.04.2024 | Ablationstherapie | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Yoga as a Therapy for Irritable Bowel Syndrome

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Europäische Ernährungsgewohnheiten: Das sind die häufigsten Fehler

Hinter dieser Appendizitis steckte ein Erreger

Demenzkranke durch Antipsychotika vielfach gefährdet

Update Innere Medizin

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2020

COVID-2019.2 Reboot: Returning a GI Fellowship to Pre-pandemic Practices

Predictors for Small Bowel Stenosis in Balloon-Assisted Enteroscopy

GLP-2 Acutely Prevents Endotoxin-Related Increased Intestinal Paracellular Permeability in Rats

Medical, Political, and Economic Considerations for the Use of MAC for Endoscopic Sedation: Big Price, Little Justification?

Knowledge and Perceptions of Hepatitis B and Hepatocellular Carcinoma Screening Guidelines Among Trainees: A Tale of Three Centers

Diagnosis of Pre-HCC Disease by Hepatobiliary-Specific Contrast-Enhanced Magnetic Resonance Imaging: A Review

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

Europäische Ernährungsgewohnheiten: Das sind die häufigsten Fehler

Hinter dieser Appendizitis steckte ein Erreger

Demenzkranke durch Antipsychotika vielfach gefährdet

Update Innere Medizin