Klinische Diagnostik

Klinik

Empfehlung

Vor einer weiterführenden Diagnostik sind eine anamnestische Erhebung und eine klinische Untersuchung obligat (C). Bei einer Colitis ulcerosa finden sich anamnestisch häufig eines oder mehrere der folgenden Symptome: blutige Diarrhöen, erhöhte Stuhlfrequenz, vermehrter Stuhldrang, nächtliche Defäkation, Tenesmen, Gefühl der inkompletten Stuhlentleerung, Fieber (B).

Erläuterung

Zunächst soll die Relevanz einer ausführlichen Anamneseerhebung sowie körperlichen Untersuchung vor jeglicher weiterführender Diagnostik unterstrichen werden. Hinsichtlich der anamnestisch erhebbaren Symptome finden sich relativ wenige Studien, die die Häufigkeit einzelner Symptome bei der Colitis ulcerosa untersucht haben. Blutige Diarrhöen stellen in den meisten Fällen das Leitsymptom der Colitis ulcerosa dar. Die Reihenfolge der weiteren Symptome entspricht nicht ihrer Häufigkeit, da hierzu kaum valide Daten existieren [1] [2] [3] [4]. Die Symptomatik lässt nicht sicher auf das zu erwartende Befallsmuster bzw. die Ausdehnung der Erkrankung schließen. Die Daten sind inhomogen, insgesamt scheint jedoch eine stärkere Ausprägung der Symptome mit einer erhöhten endoskopischen Aktivität zu korrelieren [5] [6] [7].

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