Dyspepsie im Kindes- und Jugendalter

H. Kogler; A. Vécsei

doi:10.1055/s-0038-1629223

Kinder- und Jugendmedizin, Table of Contents

Kinder- und Jugendmedizin 2014; 14(04): 244-251
DOI: 10.1055/s-0038-1629223

Gastroenterologie

Schattauer GmbH

Dyspepsie im Kindes- und Jugendalter

Abklärung und therapeutische OptionenDyspepsia in children and adolescentsDiagnostic workup and therapeutic options

H. Kogler

¹Ambulanz für Gastroenterologie, Hepatologie und Ernährung, St. Anna-Kinderspital, Abteilung für Allgemeine Pädiatrie und Pädiatrische Hämato-Onkologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien

,

A. Vécsei

¹Ambulanz für Gastroenterologie, Hepatologie und Ernährung, St. Anna-Kinderspital, Abteilung für Allgemeine Pädiatrie und Pädiatrische Hämato-Onkologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien

› Author Affiliations

Abstract

Zusammenfassung

Dyspepsie ist ein häufiger Konsultationsgrund in der kinder- und jugendärztlichen Praxis, wobei die Differenzierung zwischen somatischen und funktionellen Ursachen häufig eine Herausforderung darstellt. In einer systematischen, patientenorientierten und ökonomischen Abklärung sind eine ausführliche Anamnese und eine sorgfältige klinische Untersuchung mit besonderem Fokus auf Alarmzeichen von zentraler Bedeutung. Sind Alarmzeichen vorhanden, werden weiterführende Untersuchungen im Hinblick auf organische Ursachen notwendig. Können die dyspeptischen Beschwerden auf eine organische Erkrankung zurückgeführt werden, steht meist eine evidenzbasierte Therapieoption zur Verfügung. Bei Abwesenheit von Alarm-zeichen ist in erster Linie von einer funktionellen Dyspepsie auszugehen, bei der eine umfangreiche apparative Diagnostik entbehrlich ist. Die Therapie der funktionellen Dyspepsie basiert auf einem biopsychosozialen Zugang inklusive psychologisch-psycho-therapeutischer Unterstützung, medikamentöser Therapie und Lebensstilmodifikation.

Summary

Dyspepsia is a common complaint in children and most often due to non-organic causes (i. e., functional dyspepsia). Spotting the rare organic causes may be challenging. A systematic, patient-oriented and economic approach is essential comprising detailed history taking and a careful physical examination as most important first steps. Alarm signs/symptoms and abnormal results of limited basic lab tests are associated with a higher prevalence of organic disease and warrant further investigations. Organic causes can be managed applying evidence-based therapeutic measures. In the absence of alarm signs/symptoms, further investigations are usually of little help to further differentiate between organic and functional dyspepsia. Functional dyspepsia is best treated in the context of a biopsychosocial model of care including psychological/psychotherapeutic support, medical treatments and life style modification.

Schlüsselwörter

Dyspepsie - Helicobacter pylori - Phytopharmaka - Hypnotherapie

Keywords

Dyspepsia - Helicobacter pylori - herbal medicines - hypnotherapy

Full Text

References

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