Reizdarmsyndrom – eine Krankheit wird zerlegt. Eine Polemik in 13 Schritten.

Zusammenfassung

Die vergangenen 35 Jahre (seit etwa 1980) haben eine Vielzahl von wissenschaftlichen Publikationen zum Thema Reizdarmsyndrom (RDS) erbracht, aber keinen wirklichen Fortschritt: Nach wie vor ist dessen Ätiologie und Pathogenese ungeklärt, und Diagnostik und Therapie sind weitgehend dem individuellen Verständnis der behandelnden Ärztinnen und Ärzte aus Allgemeinmedizin, Gastroenterologie und Psychosomatik/Psychiatrie überlassen. In dieser Glosse rechnen drei prominente Vertreter der Neurogastroenterologie in Deutschland mit ihren eigenen und den Beiträgen ihrer Fachkollegen ab und kontrastieren deren Anspruch mit der klinisch-wissenschaftlichen Realität des RDS.

Abstract

The last 35 years (since about 1985) have produced a vast amount of scientific publications with respect to the irritable bowel syndrome (IBS), but no real progress: The etiology and pathogenesis of IBS is still incompletely understood, and diagnosis and therapy is left to the individual understanding of the treating physicians in general medicine, gastroenterology and psychosomatic/psychiatry. In this gloss, three prominent representatives of neurogastroenterology in Germany assess their own contributions and those of their colleagues and lament the huge gap between ambitions and reality in clinical and basic science in IBS.

Schlüsselwörter

Funktionelle Darmkrankheiten - Neurogastroenterologie - Reizdarmsyndrom

Key words

functional bowel disorders - neurogastroenterology - irritable bowel syndrome

• References

• 1 Klein KB. Controlled treatment trials in the irritable bowel syndrome: a critique. Gastroenterology 1988; 95: 232-241
• 2 Thompson WG. The road to rome. Gastroenterology 2006; 130: 1552-1556
• 3 Drossman DA. Functional Gastrointestinal disorders: History, pathophysiology, clinical features and Rome IV. Gastroenterology 2016; (in press)
• 4 Quigley EM. The 'con' case. The Rome process and functional gastrointestinal disorders: the barbarians are at the gate!. Neurogastroenterology and motility 2007; 19: 793-797
• 5 Wang A, Liao X, Xiong L. et al. The clinical overlap between functional dyspepsia and irritable bowel syndrome based on Rome III criteria. BMC gastroenterology 2008; 8: 43
• 6 Enck P, Aziz Q, Barbara G. et al. Irritable bowel syndrome. Nature reviews disease primers 2016; 2: 16014
• 7 Saito YA, Talley NJ, Melton LJ. et al. The effect of new diagnostic criteria for irritable bowel syndrome on community prevalence estimates. Neurogastroenterology and motility 2003; 15: 687-694
• 8 Devanarayana NM, Adhikari C, Pannala W. et al. Prevalence of functional gastrointestinal diseases in a cohort of Sri Lankan adolescents: comparison between Rome II and Rome III criteria. Journal of tropical pediatrics 2011; 57: 34-39
• 9 Matheis A, Martens U, Kruse J. et al. Irritable bowel syndrome and chronic pelvic pain: a singular or two different clinical syndrome?. World journal of gastroenterology 2007; 13: 3446-3455
• 10 Mujagic Z, Jonkers DM, Hungin AP. et al. Use of Rome criteria for the diagnosis of irritable bowel syndrome in primary care: a survey among European countries. European journal of gastroenterology & hepatology 2017; 29: 651-656
• 11 Schemann M. Reizdarm und Reizmagen – Pathophysiologie und Biomarker. Der Gastroenterologe 2017; 12: 114-129
• 12 Van den Bergh O, Witthoft M, Petersen S. et al. Symptoms and the body: Taking the inferential leap. Neuroscience and biobehavioral reviews 2017; 74: 1 85-203
• 13 Schwille-Kiuntke J, Frick JS, Zanger P. et al. Post-infectious irritable bowel syndrome - a review of the literature. Zeitschrift fur Gastroenterologie 2011; 49: 997-1003
• 14 Futagami S, Itoh T, Sakamoto C. Systematic review with meta-analysis: post-infectious functional dyspepsia. Alimentary pharmacology & therapeutics 2015; 41: 177-188
• 15 Morch K, Hanevik K, Rivenes AC. et al. Chronic fatigue syndrome 5 years after giardiasis: differential diagnoses, characteristics and natural course. BMC gastroenterology 2013; 13: 28
• 16 Donnachie E, Schneider A, Mehring M. et al. Incidence of irritable bowel syndrome and chronic fatigue following gastrointestinal infection: A population-level study using routinely-collected claims data. Gut (in press)
• 17 Persson R, Wensaas KA, Hanevik K. et al. The relationship between irritable bowel syndrome, functional dyspepsia, chronic fatigue and overactive bladder syndrome: a controlled study 6 years after acute gastrointestinal infection. BMC gastroenterology 2015; 15: 66
• 18 Talley NJ. A unifying hypothesis for the functional gastrointestinal disorders: really multiple diseases or one irritable gut?. Reviews in gastroenterological disorders 2006; 6: 72-78
• 19 Andresen V, Whorwell P, Fortea J. et al. An exploration of the barriers to the confident diagnosis of irritable bowel syndrome: A survey among general practitioners, gastroenterologists and experts in five European countries. United European gastroenterology journal 2015; 3: 39-52
• 20 Corsetti M, Van Oudenhove L, Tack J. The quest for biomarkers in IBS-where should it lead us?. Neurogastroenterology and motility 2014; 26: 1669-1676
• 21 Canavan C, West J, Card T. Calculating total health service utilisation and costs from routinely collected electronic health records using the example of patients with irritable bowel syndrome before and after their first gastroenterology appointment. PharmacoEconomics 2016; 34: 181-194
• 22 Slattery SA, Niaz O, Aziz Q. et al. Systematic review with meta-analysis: the prevalence of bile acid malabsorption in the irritable bowel syndrome with diarrhoea. Alimentary pharmacology & therapeutics 2015; 42: 3-11
• 23 Elsenbruch S, Enck P. Placebo effects and their determinants in gastrointestinal disorders. Nature reviews gastroenterology & hepatology 2015; 12: 472-85