Dtsch Med Wochenschr 2019; 144(01): 46-53
DOI: 10.1055/a-0744-7001
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Eosinophile Erkrankungen des Gastrointestinaltrakts

Eosinophilic Gastrointestinal Disorders
Florian Hentschel
,
Stefan Lüth
Further Information

Publication History

Publication Date:
02 January 2019 (online)

Abstract

The global incidence and prevalence of eosinophilic gastrointestinal diseases is rising. Clinically, acute eosinophilic esophagitis cannot be distinguished from other causes of esophagitis. Endoscopic findings like rings, webs or furrows have a lower sensitivity than previously assumed. An improvement of symptoms by proton-pump inhibitors also doesn’t rule out the diagnosis – it has to be confirmed histologically. Early therapy will prevent later complications like strictures and motility disorders. The presentation of eosinophilic gastroenteritris/colitis is even less specific. Common cause seems to be a Th2-mediated food allergy. Successful therapies include allergen-free diets and topic steroids. Additionally, in the case of proton-pump inhibitor-responsive eosinophilic esophagitis, proton pump inhibitors do not only block gastral acid production, but may also have a direct inhibitory effect on Th2-immunity. Therefore, Th2-specific biologicals have theoretical advantages, but they could not really convince in first clinical studies.

Inzidenz und Prävalenz eosinophiler Erkrankungen des Magen-Darm-Trakts steigen weltweit an. Klinisch ist die aktive eosinophile Ösophagitis aber kaum von einer akuten Ösophagitis anderer Genese zu unterscheiden. Auch Endoskopie und das Ansprechen auf Protonenpumpenhemmer sind hier keine sicheren Parameter. Das Bild der eosinophilen Gastroenteritis bzw. Kolitis ist noch unspezifischer. Kompaktes Wissen zu diesem Thema bietet dieser Beitrag.