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Zur ASS- und NSAR-vermittelten lokaltoxischen und systemischen gastrointestinalen Mukosaschädigung

  • W. Bolten
Chapter

Zusammenfassung

NSAR-assoziierte Oberbauchbeschwerden stellen im praktischen Alltag bei der Behandlung von Rheumapatienten ein in seiner individuellen Bedeutung schwer einzuschätzendes Problem dar. Durch geeignete Maßnahmen sollten bei notwendiger und optimierter antirheumatischer Behandlung die Entstehung der NSAR-Gastropathie durch Prostaglandinanaloga verhindert, eine manifeste Mukosaschädigung durch Ulkustherapeutika zur Abheilung gebracht und die Oberbauchsymptomatik durch Prokinetika und Ulkustherapeutika begrenzt werden. Die Rolle der Antacida ist wegen fehlender kontrollierter klinischer Studien bisher nicht endgültig festgelegt. Bei der Behandlung der NSAR-Gastropathie dürfte ihr Einsatzbereich dem anderer Ulkustherapeutika vergleichbar sein. In der Prophylaxe helfen sie möglicherweise vor allem bei additiver Verwendung mit Prostaglandinanaloga, die Entstehung von NSAR-Ulzera zu verhindern.

Local toxic and systemic damage of the gastrointestinal mucosa caused by acetylsalicilic acid and non-steroidal antiinflammatory drugs (NSAID)

Abstract

NSAID-associated stomach and intestinal complaints can present a significant problem in the treatment of individual patients for rheumatism. By the use of appropriate procedures, such as the use of prostaglandin analogues, it should be possible to prevent an NSAID-associated gastropathy in cases of necessary and optimized antirheumatic treatment. A manifestly damaged mucosa can be healed using appropriate ulcer therapeutica and the indigestion restricted through the use of either ulcer therapeutica or prokinetika. The role of antacids in this context has not been finally clarified, since there have been no controlled clinical studies. Their use in the treatment of NSAID-gastropathy should be comparable to that of other ulcer therapeutika. Prophylactically, they could help in combination with prostaglandin analogues to prevent the development of NSAIDassociated ulcers.

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© Springer Fachmedien Wiesbaden 1992

Authors and Affiliations

  • W. Bolten
    • 1
  1. 1.Rheumaklinik Bad RappenauDeutschland

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