Kinder- und Jugendmedizin 2007; 7(01): 33-38
DOI: 10.1055/s-0037-1617942
Gastroenterologie
Schattauer GmbH

Diarrhö als Leitsymptom chronisch entzündlicher Darmerkrankungen bei Kindern und Jugendlichen

Diarrhoea as presenting symptom of inflammatory bowel diseases in children and adolescents
Stephan Buderus
1   St.-Marien-Hospital Bonn, Abt. für Pädiatrie
› Author Affiliations
Further Information

Publication History

Eingegangen: 10 October 2006

angenommen: 06 November 2006

Publication Date:
11 January 2018 (online)

Zusammenfassung

Chronisch entzündliche Darmerkrankungen (CED) können Patienten aller Altersgruppen, vom Säugling bis zum Erwachsenen, betreffen. Daher ist es wesentlich, dass auch Kinder- und Jugendärzte diese Krankheitsgruppe bei der Differenzialdiagnostik von Diarrhöen berücksichtigen. Durchfall gehört zu den typischen Manifestationssymptomen bei M. Crohn und bei Colitis ulcerosa. Zusammen mit Bauchschmerzen und Gewichtsverlust liegt eine für den M. Crohn typische Trias vor; blutige Durchfälle ohne Erregernachweis sprechen für eine Colitis ulcerosa. Die Diagnose erfolgt durch eine Kombination klinischer und anamnestischer Angaben, die durch Labor- und bildgebende Befunde weiter charakterisiert wird. Im Zentrum der CED-Diagnostikstehen die Endoskopie des oberen und unteren Verdauungstraktes und die histopathologische Beurteilung der entnommenen Biopsate. Ziel ist es, möglichst frühzeitig eine spezifische Diagnose zu stellen und das Befallsmusterzu erheben, um dann durch eine optimale Therapie die Remission herbeizuführen und möglichst langzeitig zu erhalten.

Summary

Inflammatory bowel diseases (IBD) may manifest in patients of all age groups, from infancy to adulthood. Thus, it is essential that paediatricians, too, take this group of diseases into consideration when evaluating diarrhoea. A triad of diarrhoea, abdominal pain and weight loss is typical of Crohn’s disease, whilst non-infectious bloody diarrhoea is common in ulcerative colitis. The diagnosis is made by a combination of clinical findings and patient history which are further characterized by laboratory and imaging results. Endoscopy of the upper and lower gastrointestinal tract together with the histopathological evaluation of the biopsies are essential for a specific diagnosis. It is the aim to achieve a rapid and accurate diagnosis with a characterisation of the disease distribution in order to induce remission as soon as possible, and to maintain it long-term.

 
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