Der Gastroenterologe

, Volume 12, Issue 2, pp 141–149 | Cite as

Nichtmedikamentöse Therapie des Reizdarmsyndroms

Schwerpunkt
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Zusammenfassung

Nichtmedikamentöse Therapien des Reizdarmsyndroms (RDS) sind angesichts der wenigen zur Verfügung stehenden Medikamente vermutlich häufig im Gebrauch. Darunter werden hier Ernährungstherapien, Psychotherapien und viele komplementärmedizinische Ansätze verstanden. Bei den Ernährungstherapien spielen v. a. Ballaststoffsupplementierungen und Nahrungsergänzungen durch Probiotika sowie Diäten mit einem niedrigen Anteil an schnell fermentierbaren Zuckern (sog. FOFMAP) eine Rolle. Bei den Psychotherapien sind es die traditionellen verhaltenstherapeutischen und psychodynamischen Ansätze, die darmbezogene Hypnotherapie, Entspannungstherapien, Achtsamkeitstraining und Selbsthilfeprogramme. Bei der Komplementärmedizin steht v. a. die Akupunktur im Vordergrund. Zusammengefasst lässt sich festhalten, dass die Wirksamkeit der Ballaststofftherapie beim RDS nicht nachgewiesen ist, dass nur einzelne probiotische Präparate eine Wirksamkeit beim RDS haben und dass die langfristige Effizienz der Low-FODMAP-Diäten noch gezeigt werden muss. Für die Psychotherapien ist bei der kognitiven Verhaltenstherapie und bei der darmbezogenen Hypnotherapie die Wirksamkeit unbestritten, während für psychodynamische Ansätze zu wenige Studien vorliegen. Die Entspannungstherapie ist beim RDS unwirksam, aber das Achtsamkeitstraining hat therapeutisches Potenzial und Selbsthilfeprogramme sind eine kostengünstige Alternative zu Psychotherapien. Für keines der komplementärmedizinischen Verfahren liegt dagegen eine überzeugende Evidenz der Wirksamkeit vor.

Schlüsselwörter

Gesundheitsdiät Psychotherapie Komplementärmedizin Probiotika Hypnotherapie 

Nonmedicinal therapies of irritable bowel syndrome

Abstract

Nonmedicinal therapies for irritable bowel syndrome (IBS) are frequently used, not the least because of a lack of effective medicines. This implies dietary interventions, psychotherapies, and many complementary and alternative remedies. Among the dietary therapies most important are fibre and probiotic supplements, and more recently diets with a low content of rapidly fermentable sugars (FODMAPs). Psychotherapies include traditional cognitive–behavioral and psychodynamic techniques, gut-directed hypnotherapy, relaxation techniques, mindfulness-based training, and self-help programs. In complementary medicine acupuncture is the most relevant. In summary we can state that the efficacy of fibre supplementation has not been demonstrated, that among the probiotics only a few bacterial strains have proven to be effective in IBS, and that especially long-term efficacy of low-FODMAP diets are still to be shown. Among psychotherapies, cognitive–behavioral interventions and gut-directed hypnotherapy are clearly effective in IBS, while too few studies exist for psychodynamic interventions. Relaxation therapy is definitively ineffective in IBS, but mindfulness-based training is, and self-help programs are a cost-effective alternative to conventional psychotherapy interventions. None of the complementary medicine approaches has delivered convincing evidence for their effectiveness.

Keywords

Healthy diet Psychotherapy Complementary medicine Probiotics Hypnotherapy  

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

P. Enck und N. Mazurak geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag Berlin 2017

Authors and Affiliations

  1. 1.Abteilung Innere Medizin VI: Psychosomatische Medizin und PsychotherapieUniversitätsklinikum TübingenTübingenDeutschland

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