Die Langzeitbehandlung des Reizdarms

  • H. Fahrländer
Conference paper
Part of the Interdisziplinäre Gastroenterologie book series (GASTROENTEROLOG)

Zusammenfassung

Im Gegensatz zu den gastroduodenalen Geschwüren, den chronisch-entzündlichen Darmkrankheiten und anderen morphologisch definierbaren, organischen Magen-Darm-Leiden liegt dem Reizdarm kein lichtoder elektronenmikroskopisch faßbares Substrat zugrunde. Die den Reizdarm ausmachenden Beschwerden sind auf Störungen der Darmmotilität, auf nichtinfektiöse Störungen der Sekretion im Dünn- und Dickdarm und mindestens teilweise auf eine abnorme Schmerzperzeption zurückzuführen. Die Ursache dieser Beschwerden liegt immer in einer Störung des seelischen Gleichgewichts. Funktionelle Darmbeschwerden sind eine Form der jedem Menschen zur Verfügung stehenden und damit normalen Körpersprache, mit der psychische Inhalte averbal ausgedrückt werden. Einige häufige andere Formen der Körpersprache sind in Tabelle 1 zusammengestellt. Die Körpersprache zeichnet sich im Gegensatz zum verbalen Ausdruck und zur Mimik und Gestik durch ihren hohen Wahrheitsgehalt und die fehlenden Verstellungsmöglichkeiten aus.

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Literatur

  1. 1.
    Almy TP (1982) The first olive. Gastroenterology 83:701–702PubMedGoogle Scholar
  2. 2.
    Almy TP, Abbott FK, Hinkle LE (1950) Alterations in colonic function in man under stress; hypomotility of sigmoid colon, and its relationship to mechanism of functional diarrhea. Gastroenterology 15:95–103PubMedGoogle Scholar
  3. 3.
    Andersson IH, Levine AS, Levitt MD (1981) Incomplete absorption of the carbohydrate in all-purpose wheat flour. N Engl J Med 304:891–892CrossRefGoogle Scholar
  4. 4.
    Argenzio RA (1981) Short-chain fatty acids and the colon. Dig Dis Sci 26:97–99PubMedCrossRefGoogle Scholar
  5. 5.
    Brodribb AJM, Groves C (1978) Effect of bran particle size on stool weight. Gut 19:60–63PubMedCrossRefGoogle Scholar
  6. 6.
    Brodribb AJM, Condon RE, Cowles V, DeCosse JJ (1979) Effect of dietary fiber on intraluminal pressure and myoelectrical activity of left colon in monkeys. Gastroenterology 77:70–74PubMedGoogle Scholar
  7. 7.
    Burkitt DP, Walker ARP, Painter NS (1974) Dietary fiber and disease. JAMA 229:1068–1074PubMedCrossRefGoogle Scholar
  8. 8.
    Chaudhary NA, Truelove SC (1962) The irritable colon syndrome. A study of the clinical features, predisposing causes and prognosis in 130 cases. Q J Med 31:307–322PubMedGoogle Scholar
  9. 9.
    Cummings JH (1981) Short chain fatty acids in the human colon. Gut 22:763–779PubMedCrossRefGoogle Scholar
  10. 10.
    Cummings JH, Jenkins DJA, Wiggins HS (1976) Measurement of the mean transit time of dietary through the human gut. Gut 17:210–218PubMedCrossRefGoogle Scholar
  11. 11.
    Drossman DA, Sandler RS, McKee DC, Lovitz AJ (1982) Bowel patterns among subjects not seeking health care. Use of a questionnaire to identify a population with bowel dysfunction. Gastroenterology 83:529–534PubMedGoogle Scholar
  12. 12.
    Fahrländer H (1982) Die Nahrungsmittelallergien. Dtsch Med Wochenschr 107:1892–1897PubMedCrossRefGoogle Scholar
  13. 13.
    Ferguson A, Sircus W, Eastwood MA (1977) Frequency of “functional” gastrointestinal disorders. Lancet II:613–614CrossRefGoogle Scholar
  14. 14.
    Fielding JF (1982) The necessity of concurrent high dietary fibre intake when testing for drug efficacy in the irritable bowel syndrome. Gastroenterology 82:1056Google Scholar
  15. 15.
    Findlay JM, Smith AN, Mitchell WD et al. (1974) Effects of unprocessed bran on colon function in normal subjects and in diverticular disease. Lancet I:146–149CrossRefGoogle Scholar
  16. 16.
    Furness JB, Costa M (1980) Types of nerves in the enteric nervous system. Neuroscience 5:1–20PubMedCrossRefGoogle Scholar
  17. 17.
    Gershon MD, Erde SM (1981) The nervous system of the gut. Gastroenterology 80:1571–1594PubMedGoogle Scholar
  18. 18.
    Grace WI, Wolf S, Wolff HG (1951) Life situations, emotions and colonic function. In: Grace WI et al. (eds) The human colon. Hoeber, New York, pp 85–115Google Scholar
  19. 19.
    Hammond EC (1964) Some preliminary findings on physical complaints from a prospective study of 1,064,004 men and women. Am J Publ Health 54:11–23Google Scholar
  20. 20.
    Harvey RF, Pomare EW, Heaton KW (1973) Effects of increased dietary fibre on intestinal transit. Lancet I:1278–1280CrossRefGoogle Scholar
  21. 21.
    Ivey KJ (1975) Are anticholinergics of use in the irritable colon syndrome? Gastroenterology 68:1300–1307PubMedGoogle Scholar
  22. 22.
    Kirwan WO, Smith AN, McConnell AA et al. (1974) Action of different bran preparations on colonic function. Br Med J IV: 187–189CrossRefGoogle Scholar
  23. 23.
    Latimer P, Sarna S, Campbell D et al. (1981) Colonic motor and myoelectrical activity: A comparative study of normal subjects, psychoneurotic patients, and patients with irritable bowel syndrome. Gastroenterology 80:893–901PubMedGoogle Scholar
  24. 24.
    Lux G, Femppel J, Lederer PC et al. (1981) Diagnostik des irritablen Kolons. Manometrische und myographische Untersuchungen. Dtsch Med Wochenschr 106:994–998PubMedCrossRefGoogle Scholar
  25. 25.
    McNeil NI, Cummings JH, James WPT (1978) Short chain fatty acid absorption by the human large intestine. Gut 19:819–822PubMedCrossRefGoogle Scholar
  26. 26.
    McRae S, Younger K, Thompson DG, Wingate DL (1982) Sustained mental stress alters human jejunal motor activity. Gut 23:404–409PubMedCrossRefGoogle Scholar
  27. 27.
    Meunier P, Rochas A, Lambert R (1979) Motor activity of the sigmoid colon in chronic constipation: comparative study with normal subjects. Gut 20:1095–1101PubMedCrossRefGoogle Scholar
  28. 28.
    Narducci F, Snape WJ, Battle WM et al. (1982) Stimulation of colonic myoelectric activity by emotional stress in healthy subjects and the irritable bowel syndrome: Effect of pretreatment with Librium. Gastroenterology 82:137Google Scholar
  29. 29.
    Oddsson E, Rask-Madsen J, Krag E (1978) A secretory epithelium of the small intestine with increased sensitivity to bile acids in irritable bowel syndrome associated with diarrhoea. Scand J Gastroenterol 13:409–416CrossRefGoogle Scholar
  30. 30.
    Palmer KR, Corbett CL, Holdsworth CD (1980) Double-blind cross-over study comparing loperamide codeine and diphenoxylate in the treatment of chronic diarrhea. Gastroenterology 79:1272–1275PubMedGoogle Scholar
  31. 31.
    Payler DK, Pomare EW, Heaton KW, Harvey RF (1975) The effect of wheat bran on intestinal transit. Gut 16:209–213PubMedCrossRefGoogle Scholar
  32. 32.
    Pelemans W, Vantrappen G (1976) A double blind crossover comparison of loperamide with diphenoxylate in the symptomatic treatment of chronic diarrhea. Gastroenterology 70:1030–1034PubMedGoogle Scholar
  33. 33.
    Perman JA, Modler S (1982) Glycoproteins as substrates for production of hydrogen and methane by colonic bacterial flora. Gastroenterology 83:388–393PubMedGoogle Scholar
  34. 34.
    Ritchie JA, Truelove SC (1979) Treatment of irritable bowel syndrome with lorazepam, hyoscine butylbromide and ispaghula husk. Br Med J I:376–378CrossRefGoogle Scholar
  35. 35.
    Roediger WEW (1980) Role of anaerobic bacteria in the metabolic welfare of the colonic mucosa in man. Gut 21:793–798PubMedCrossRefGoogle Scholar
  36. 36.
    Roediger WEW, Moore A (1981) Effect of short-chain fatty acid on sodium absorption in isolated human colon perfused through the vascular bed. Dig Dis Sci 26:100–106PubMedCrossRefGoogle Scholar
  37. 37.
    Sandhu BK, Tripp JH, Candy DCA, Harries JT (1981) Loperamide: studies on its mechanism of action. Gut 22:658–662PubMedCrossRefGoogle Scholar
  38. 38.
    Schultzberg M, Hökfelt T, Nilsson G et al. (1980) Distribution of peptide- and catecholamine-containing neurons in the gastro-intestinal tract of rat and Guinea-pig: Immuno-histochemical studies with antisera to substance P, vasoactive intestinal polypeptide, enkephalins, somatostatin, gastrin/cholecystokinin, neurotensin and dopamine β-hydroxylase. Neuroscience 5:689–744PubMedCrossRefGoogle Scholar
  39. 39.
    Shee CD, Pounder RE (1980) Loperamide, diphenoxylate and codeine phosphate in chronic diarrhoea. Br Med J 280:524PubMedCrossRefGoogle Scholar
  40. 40.
    Snape WJ, Carlson GM, Matarazzo SA, Cohen S (1977) Evidence that abnormal myoelectrical activity produces colonic motor dysfunction in the irritable bowel syndrome. Gastroenterology 72:383–387PubMedGoogle Scholar
  41. 41.
    Stephen AM, Cummings JH (1979) Water-holding by dietary fibre in vitro and its relationship to faecal output in man. Gut 20:722–729PubMedCrossRefGoogle Scholar
  42. 42.
    Switz DM (1976) What the gastroenterologist does all day. A survey of a state society’s practice. Gastroenterology 70:1048–1050PubMedGoogle Scholar
  43. 43.
    Taylor I, Darby C, Hammond P, Basu P (1978) Is there a myoelectrical abnormality in the irritable colon syndrome? Gut 19:391–395PubMedCrossRefGoogle Scholar
  44. 44.
    Taylor I, Basu P, Hammond P et al. (1980) Effect of bile acid perfusion on colonic motor function in patients with the irritable colon syndrome. Gut 21:843–847PubMedCrossRefGoogle Scholar
  45. 45.
    Thompson WG, Heaton KW (1980) Functional bowel disorders in apparently healthy people. Gastroenterology 79:283–288PubMedGoogle Scholar
  46. 46.
    Wood JD (1981) Physiology of the enteric nervous system. In: Johnson LR (ed) Physiology of the gastrointestinal tract. Raven, New York, pp 1–37Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1984

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  • H. Fahrländer

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