Chronische Diarrhö bei Nahrungsmittelunverträglichkeiten

Zusammenfassung

Bei Kindern aus Industrienationen ist die häufigste Ursache einer chronischen Diarrhö eine Nahrungsmittelunverträglichkeit, die entweder ein Protein (immunmediierte Nahrungsmittelunverträglichkeit, z. B. bei Zöliakie) oder ein Kohlenhydrat (nicht-immunmediierte Nahrungsmittelunverträglichkeit, z. B. bei Fruktosemalabsorption) betrifft. Die klinische Präsentation kann vielgestaltig sein, wesentliche Folgen der chronischen Diarrhö sind aber Gedeihstörung und Malnutrition. Zur Diagnostik gehören Symptomprotokolle sowie spezifische nicht-invasive (z. B. serologische Zöliakietests) wie auch invasive Untersuchungen (z.B. Endoskopie mit histologischer Analyse). Die Therapie ist diätetisch und die Langzeitprognose bei adäquat eingehaltener Diät in der Regel gut.

Summary

The most frequent cause of chronic diarrhoea in children of western countries is a food intolerance, either concerning a protein (immun-mediated, i. e. celiac disease) or a carbohydrate (non-immun-mediated, i. e. fructose malabsorption). Clinical presentation may be variable, but main sequelae of chronic diarrhoea are failure to thrive and malnutrition. Diagnostic work up includes symptom protocols as well as specific non-invasive (i. e. serological celiac tests) and invasive investigations (i. e. endoscopy with histological examination). Treatment is based on dietary intervention with an excellent prognosis if followed closely.

Schlüsselwörter

Chronische Diarrhö - Zöliakie - Kuhmilch - Fruktosemalabsorption - Laktoseintoleranz

Keywords

Chronic diarrhoea - celiac disease - cow’s milk - fructose malabsorption - lactose intolerance

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