Rheumatologische Erkrankungen und der Gastrointestinaltrakt

Zusammenfassung

Die meisten rheumatologischen Krankheitsbilder können Einfluss auf den Gastrointestinaltrakt haben. Dabei können intestinale Manifestationen (z. B. rheumatoide Vaskulitis, IgG4-assoziierte Pankreatitis, IgG4-assoziierte Cholangitis, Lupus-Enteritis, Polyarteriitis nodosa, Purpura Schoenlein-Henoch, nekrotisierende Vaskulitis), assoziierte intestinale Erkrankungen (chronisch-entzündliche Darmerkrankungen (CED), Zöliakie) und intestinale Komplikationen der rheumatologischen Erkrankung (z. B. Amyloidose, erosive Refluxerkrankung bei Sklerodermie) bzw. ihrer Behandlung (z. B. NSAR-Magenulcus, MTX-Mukositis, Soor-Ösophagitis, intestinale Tuberkulose, ulzerierende HSV-Ösophagitis, CMV-Kolitis) voneinander abgegrenzt werden. Dadurch kommen gastrointestinale Symptome bei Patienten mit rheumatologischen Erkrankungen sehr häufig vor. Die Diagnosestellung (er)fordert Gastroenterologen im interdisziplinären Behandlungsnetzwerk mit Rheumatologen. Insbesondere bei Behandlung von CED ergeben sich für die überschneidenden Zulassungsindikationen der zur Verfügung stehenden Medikamente in der interdisziplinären Absprache zwischen Rheumatologen und Gastroenterologen synergistische Behandlungsoptionen.

Abstract

Most rheumatological disorders may have an impact on the gastrointestinal tract. In this context, intestinal manifestations of rheumatological disease (e. g., rheumatoid vasculitis, IgG4-associated pancreatitis and cholangitis, lupus enteritis, polyarteritis nodosa) should be distinguished from associated intestinal diseases (e. g., inflammatory bowel disease (IBD), celiac disease), intestinal complications of the disease (e. g., amyloidosis, reflux disease in sclerodermia) or intestinal complications of their treatment (e. g., gastrointestinal ulcers (NSAID), mucositis (MTX), oesophageal candidiasis, intestinal tuberculosis, herpes oesophagitis, CMV colitis in immunosuppressive therapy). As a result, gastrointestinal symptoms are very common in patients with rheumatological diseases. The correct diagnosis can be only established by the interdisciplinary approach of gastroenterologists and rheumatologists. Especially in the treatment of IBD, synergistic treatment options arise from the overlapping approval of the available drugs in the interdisciplinary consultation between rheumatologists and gastroenterologists.

Schlüsselwörter

Zöliakie - Gastrointestinaltrakt - chronisch-entzündliche Darmerkrankungen

Key words

Celiac Disease - Gastrointestinal Tract - Inflammatory Bowel Disease

Publikationsverlauf

Artikel online veröffentlicht:
10. November 2021

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