Reizdarm, Zöliakie, Weizenallergie, Weizensensitivität – die Schwierigkeit, die Spreu vom Weizen zu trennen

Ottmar Leiß

doi:10.1055/s-0043-116500

Aktuelle Ernährungsmedizin, Inhaltsverzeichnis

Aktuelle Ernährungsmedizin 2017; 42(04): 287-303
DOI: 10.1055/s-0043-116500

Übersicht

Reizdarm, Zöliakie, Weizenallergie, Weizensensitivität – die Schwierigkeit, die Spreu vom Weizen zu trennen

Irritable Bowel Syndrome, Celiac Disease, Wheat Allergy, Non-Celiac Gluten Sensitivity – the Difficulty to Sift the Chaff from the Wheat

Ottmar Leiß

ehemals Gastroenterologische Gemeinschaftspraxis Mainz

› Institutsangaben

Abstract

Zusammenfassung

Ernährungsfaktoren spielen eine wichtige Rolle bei Auslösung und Verschlimmerung von Bauchschmerzen, Blähungen und Durchfall bei Patienten mit Reizdarmsyndrom (RDS). Seit Abgrenzung eines neuen Krankheitsbildes zwischen RDS und Zöliakie, der non-celiac gluten sensitivity/Weizensensitivität, und seit Erscheinen eines in Laienkreisen viel beachteten Bestsellers zu negativen gesundheitlichen Effekten von Weizen, hat eine glutenfreie Ernährung seit einigen Jahren erheblich an Popularität zugenommen.

In einer Übersicht werden die Unterschiede zwischen RDS, Zöliakie, Weizenallergie und Weizensensitivität dargestellt und Studien, die den Weizenbestandteilen Gluten oder Fruktanen/FODMAPs (fermentierbaren Oligo-, Di-, Monosacchariden und Polyolen) eine auslösende Rolle zusprechen, erörtert. Vor- und Nachteile einer glutenfreien Diät und FODMAP-armen Ernährung werden diskutiert. Abschließend wird erläutert, bei welchem Patienten zu einer glutenfreien Ernährung und bei welchem Patienten zu einer FODMAP-armen Ernährung geraten werden sollte.

Abstract

Dietary factors play an important role as triggers for abdominal pain, bloating and diarrhea in patients with irritable bowel syndrome (IBS). Following the description of a new disease entity in the „no man’s land“ between IBS and celiac disease, the non-celiac gluten sensitivity (NCGS), and the publication of a popular bestseller on negative health effects of wheat and wheat products, a gluten-free diet (GFD) has gained high popularity in recent years.

Differences between IBS, celiac disease, wheat allergy and NCGS are reviewed and studies supporting a possible role of gluten or fructans/FODMAPs (fermentable oligo-, di-, monosaccharides and polyols) in the pathogenesis of IBS and/or NCGS are mentioned. Advantages and disadvantages of a GFD and a low-FODMAP diet are discussed and recommendations, which patients should follow rather a GFD or a low-FODMAP diet, are given.

Schlüsselwörter

Reizdarmsyndrom - Zöliakie - Weizenallergie - Weizensensitivität - Gluten - Fruktane - FODMAPs

Keywords

irritable bowel syndrome - celiac disease - wheat allergy - non-celiac gluten sensitivity - gluten - fructans - FODMAPs

Volltext

Referenzen

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