Zusammenfassung
Körperliche Aktivität hat nicht nur einen hohen präventiven Effekt auf Einflussgrößen des metabolischen Syndroms, sondern auch auf die Inzidenz von Krankheiten des Gastrointestinaltraktes (Abb.
5). Das Risiko für Divertikulose, Adenome und nachfolgend auch für ein kolorektales Karzinom sowie Gallensteinleiden und ein Pankreaskarzinom können durch körperliches Training gesenkt werden. Allerdings können auch Symptome bei (oft latent) vorbestehenden Erkrankungen wie Reizdarm-Syndrom, Laktose-Malabsorption, Zöliakie oder chronisch entzündlichen Darmerkrankungen durch intensive Belastungen verschlimmert werden. Die Beeinträchtigung des Magen-Darm-Traktes ist dabei abhängig von der Belastungsart und -intensität sowie dem individuellen Trainingszustand. Bei einer kompensierten Lebererkrankung ist eine moderate körperliche Aktivität zu empfehlen. Lediglich im Komplikationsstadium der Leberzirrhose gelten Einschränkungen. Zudem kann das Risiko einer weiteren Dekompensation (Zunahme des Blutungsrisikos, Aszites oder Enzephalopathie) durch körperliche Aktivität steigen. Die Kenntnis der spezifischen Veränderungen im Gastrointestinaltrakt durch körperliche Aktivität ermöglicht eine individuelle rationale Empfehlung zur Prävention durch Sport.
Summary
Physical activity has an important preventive effect not only on various factors influencing the metabolic syndrome but also on the incidence of diseases of the gastrointestinal tract. The risk of diverticulosis/diverticulitis, adenoma and subsequently also of colorectal cancer as well as cholelithiasis and pancres carcinoma can be reduced by physical training. But symptoms, often latent, of pre-existing diseases such as irritable bowel syndrome, lactose malabsorption, coeliac disease or chronic inflammatory intestinal disease can worsen by intensive physical activity. Impairment of the gastrointestinal tract depends on the kind and degree of such activity, as well as the person's level of training. Moderate physical activity is recommended in compensated liver disease, limitations exist only if there are complications of liver cirrhosis. In fact, the risk of further decompensation (increased risk of bleeding, ascites or encephalopathy) can be increased by physical activity. A knowledge of specific changes in the gastrointestinal tract by physical activity makes it possible the give individualized recommendations on sport activities as a preventive measure.
Schlüsselwörter
körperliche Aktivität - Gastrointestinaltrakt - Refluxkrankheit - kolorektales Karzinom - Leberzirrhose - Gallensteine - Prävention
Key words
physical activity - gastrointestinal tract - gastroesophageal reflux disease - colorectal carcinoma - liver cirrhosis - gall stones - prevention
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Dr. med. Peter Deibert
Abteilung Präventive und Rehabilitative Sportmedizin, Medizinische Universitätsklinik
Hugstetterstraße 55
79106 Freiburg
Phone: 0761/2707460
Fax: 0761/2707470
Email: peter.deibert@uniklinik-freiburg.de
