{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T21:33:28Z","timestamp":1755034408248},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"19","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n          Reizdarmsyndrom: Was \u00e4ndert sich?\u2002Folgende Ausf\u00fchrung bezieht sich nur auf das Reizdarmsyndrom (RDS) beim Erwachsenen. Die neue Leitlinie enth\u00e4lt einen eigenst\u00e4ndigen Anteil Reizdarmsyndrom f\u00fcr p\u00e4diatrische Patienten. Das RDS pr\u00e4sentiert sich als heterogenes Bild mit chronisch-abdominellen Beschwerden, die auf den Darm bezogen werden. Diese gehen in der Regel mit Stuhlgangver\u00e4nderungen einher und f\u00fchren zu einer Beeintr\u00e4chtigung der Lebensqualit\u00e4t. Die Genese ist multifaktoriell und es liegen komplexe pathophysiologische Mechanismen zugrunde, die mit einem RDS assoziiert sind. So konnten St\u00f6rungen in verschiedenen Komponenten der Darm-Hirn-Achse und auch die zunehmende Bedeutung des Mikrobioms identifiziert werden. Auch verschiedene psychische Komorbidit\u00e4ten spielen eine Rolle.<\/jats:p><jats:p>\n          Diagnostik\u2002Die Diagnosestellung erfolgt durch eine gr\u00fcndliche Anamnese und symptomorientierten Ausschluss wichtiger Differenzialdiagnosen (Ausschlussdiagnose). Eine Unterteilung in verschiedene Subtypen je nach Hauptsymptom ist f\u00fcr das weitere Management der RDS-Patienten vorteilhaft. Die Diagnose Reizdarmsyndrom sollte m\u00f6glichst fr\u00fch nach zuverl\u00e4ssigem Ausschluss der wichtigen Differenzialdiagnosen erfolgen. Wenn die Diarrh\u00f6 als Symptom dominiert, ist eine ausf\u00fchrliche Differenzialdiagnostik und Funktionsdiagnostik durchzuf\u00fchren.<\/jats:p><jats:p>\n          Therapie\u2002Es gibt keine gesicherte kausale und etablierte Standardtherapie. Aufgrund der variablen Genese und Symptommanifestation des RDS resultiert ein breites Spektrum an Therapiem\u00f6glichkeiten, wobei keine individuelle Vorhersage bez\u00fcglich der Wirksamkeit besteht und daher jede Therapie zun\u00e4chst probatorisch ist. Zu den symptomunabh\u00e4ngigen allgemeinen Therapieverfahren, die f\u00fcr alle Subtypen zur Anwendung kommen k\u00f6nnen, geh\u00f6ren Verfahren der Ern\u00e4hrung (z.\u200aB. die Low-FODMAP-Di\u00e4t), Probiotika, Verfahren der Psychotherapie und der Komplement\u00e4rmedizin. Die Wahl der symptomabh\u00e4ngigen medikament\u00f6sen Behandlungen erfolgt je nach Subtyp\/Hauptsymptom. Bei Diarrh\u00f6 k\u00f6nnen neben Loperamid auch Gallens\u00e4urebinder, das nicht resorbierbare Antibiotikum Rifaximin oder in Einzelf\u00e4llen 5-HT3-Antagonisten eingesetzt werden. Bei der Obstipation haben neben der Verwendung von l\u00f6slichen Ballaststoffen und Makrogol\/anderen Laxanzien auch Prucaloprid und Linaclotid einen Stellenwert. Bei Bauchschmerzen\/Kr\u00e4mpfen zeigt die Studienlage gute Ergebnisse f\u00fcr Spasmolytika, besonders f\u00fcr Pfefferminz\u00f6l, und f\u00fcr Antidepressiva vom Typ der Trizyklika. Beim Hauptsymptom Bl\u00e4hungen konnten Probiotika, Rifaximin und vor allem auch die Low-FODMAP-Di\u00e4t positive Ergebnisse in Studien zeigen.<\/jats:p>","DOI":"10.1055\/a-1331-6478","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T01:01:30Z","timestamp":1632358890000},"page":"1243-1248","source":"Crossref","is-referenced-by-count":4,"title":["Die neue Leitlinie zum Reizdarmsyndrom: Was \u00e4ndert sich?"],"prefix":"10.1055","volume":"146","author":[{"given":"Henrike","family":"von Schassen","sequence":"additional","affiliation":[{"name":"Medizinische Klinik, Israelitisches Krankenhaus, Hamburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viola","family":"Andresen","sequence":"additional","affiliation":[{"name":"Medizinische Klinik, Israelitisches Krankenhaus, Hamburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Layer","sequence":"additional","affiliation":[{"name":"Medizinische Klinik, Israelitisches Krankenhaus, Hamburg"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"ref2","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1053\/j.gastro.2016.03.035","article-title":"Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction","volume":"150","author":"D A Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"ref3","first-page":"17","article-title":"Use of broad-spectrum antibiotics and the development of irritable bowel syndrome","volume":"111","author":"A A Villarreal","year":"2012","journal-title":"WMJ"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.cgh.2008.02.058","article-title":"Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence","volume":"6","author":"S J Shepherd","year":"2008","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1111\/apt.13167","article-title":"Systematic review: dietary fibre and FODMAP-restricted diet in the management of constipation and irritable bowel syndrome","volume":"41","author":"S S Rao","year":"2015","journal-title":"Aliment Pharmacol Ther"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/j.cgh.2015.11.020","article-title":"Short-term and Long-term Efficacy of Psychological Therapies for Irritable Bowel Syndrome: A Systematic Review and Meta-analysis","volume":"14","author":"K T Laird","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1111\/j.1365-2036.2009.04081.x","article-title":"Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea-predominant irritable bowel syndrome","volume":"30","author":"L Wedlake","year":"2009","journal-title":"Aliment Pharmacol Ther"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1038\/ajg.2011.355","article-title":"The efficacy and safety of rifaximin for the irritable bowel syndrome: a systematic review and meta-analysis","volume":"107","author":"S B Menees","year":"2012","journal-title":"Am J Gastroenterol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1111\/apt.12735","article-title":"Safety and tolerability of rifaximin for the treatment of irritable bowel syndrome without constipation: a pooled analysis of randomised, double-blind, placebo-controlled trials","volume":"39","author":"P Schoenfeld","year":"2014","journal-title":"Aliment Pharmacol Ther"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"412","DOI":"10.5056\/jnm16004","article-title":"Use of Prucalopride for Chronic Constipation: A Systematic Review and Meta-analysis of Published Randomized, Controlled Trials","volume":"22","author":"M S Sajid","year":"2016","journal-title":"J Neurogastroenterol Motil"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1038\/ajg.2017.495","article-title":"Efficacy and Tolerability of Guanylate Cyclase-C Agonists for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation: A Systematic Review and Meta-Analysis","volume":"113","author":"E D Shah","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1007\/s10620-015-3858-7","article-title":"A Novel Delivery System of Peppermint Oil Is an Effective Therapy for Irritable Bowel Syndrome Symptoms","volume":"61","author":"B D Cash","year":"2016","journal-title":"Dig Dis Sci"}],"container-title":["DMW - 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