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Bestimmung von Magenentleerung und Dünndarmtransit

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Funktionsdiagnostik in der Gastroenterologie

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Zusammenfassung

Der Ablauf der Magen- und Dünndarmmotilität von der Aufnahme der Nahrung über Durchmischung, Sekretzugabe und Zerkleinerung bis zur kontrollierten Freigabe von Chymus ins Duodenum und Weitertransport ins Kolon ist ein komplexer Prozess, der durch eine Vielzahl von Faktoren reguliert und beeinflusst wird. Hormonelle Kontrollmechanismen, intrinsische und extrinsische neuronale Regulationen, Beschaffenheit, Temperatur und Kaloriendichte der Mahlzeit sowie intestinale Feedbackmechanismen spielen dabei eine Rolle.

Radioaktiv markierte feste oder flüssige Testmahlzeiten erlauben eine quantitative Bestimmung der Magenentleerungsgeschwindigkeit und der Dünndarmtransitzeit. Die Messung der Radioaktivität über einer definierten „region of interest“, die dem Magen entspricht, gibt die Retention der Testmahlzeit im zeitlichen Verlauf wider. Nach der Entleerung der markierten Testmahlzeit aus dem Magen zeigt die Ankunft von radioaktiv markierten Chymus im Zäkum den Dünndarmtransit an.

Unter Vermeidung jeglicher Strahlenbelastung ist auch der Einsatz von bestimmten 13C-markierten Substraten und Kohlehydraten in Atemtests zur Bestimmung der Magenentleerung und des Dünndarmtransits möglich. Darüberhinaus haben bildgebende Verfahren wie die Sonographie und Magnetresonanztomographie in der Motilitätsdiagnostik an Bedeutung gewonnen, da sie die kontinuierliche Darstellung des Magendarmtraktes samt Inhalt und die quantitative Volumenberechnung im zeitlichen Verlauf erlauben.

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Authors and Affiliations

  1. Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, Großbritannien

    Barbara Braden

  2. Klinik für Gastroenterologie, Onkologie, Ernährungsmedizin, DGD Kliniken Frankfurt-Sachsenhausen, Frankfurt, Deutschland

    Oliver Schröder

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  1. Barbara Braden
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  2. Oliver Schröder
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Correspondence to Barbara Braden .

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Editors and Affiliations

  1. Gastroenterologie/Ernährungsmedizin, FEBG, AGAF DGD Kliniken Frankfurt, Frankfurt/Main, Germany

    Jürgen Stein

  2. Innere Medizin I (Endokrinologie, Gastroenterologie und Rheumatologie), DKD Helios Klinik Wiesbaden, Wiesbaden, Germany

    Till Wehrmann

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Braden, B., Schröder, O. (2020). Bestimmung von Magenentleerung und Dünndarmtransit. In: Stein, J., Wehrmann, T. (eds) Funktionsdiagnostik in der Gastroenterologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59133-8_5

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  • DOI: https://doi.org/10.1007/978-3-662-59133-8_5

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