Zusammenfassung
Obstipation und Diarrhö sind extreme Funktionszustände des Gastrointestinaltraktes, bei denen die Motilität des Darmes eine wesentliche pathogenetische Rolle spielt. Infektionskrankheiten des Dünn- und Dickdarmes sind die häufigsten Ursachen akuter Durchfälle [1], [14]. Die auslösenden meist bakteriellen Erreger rufen eine Reihe verschiedener Funktionsstörungen hervor:
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• Stimulation der Sekretion und/oder Hemmung der Absorption von Elektrolyten und Wasser durch die Darmschleimhaut: dies ist der bekannteste pathogenetische Vorgang [8].
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• Steigerung der propulsiven Motilität oder Reduktion retardierender stationärer Motilität von Dünn- und Dickdarm mit konsekutiver Verkürzung der intestinalen Transitzeit; diese pathophysiologischen Alterationen werden erst seit wenigen Jahren systematisch untersucht [19]. Das verwundert insofern, als „Motilitätshemmer“, wie z. B. Loperamid, seit Jahrzehnten mit Erfolg gegen Durchfälle infektiöser und anderer Ursachen eingesetzt werden [30].
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• Änderungen in Menge und Zusammensetzung der physiologischen Darmflora. Hierüber gibt es nur spärliche Angaben in der Literatur [26]. Dennoch ist die Mitwirkung der nosokomialen Bakterien bei der Entstehung oder Verhinderung von Durchfällen sehr wahrscheinlich. Dafür sprechen vor allem die häufig zu beobachtenden Antibiotika-assoziierten-Diarrhöen [20].
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Ruppin, H. (1993). Wechselwirkungen von Motilität und Bakterien im Magen-Darm-Trakt. In: Zeitz, M., Caspary, W.F., Bockemühl, J., Lux, G. (eds) Ökosystem Darm V. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78733-1_14
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