S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn”

Tab. 1 Teilnehmer der Konsensuskonferenz, Arbeitsgruppen. I. Klinische Diagnostik – Vorsitz: K. Herrlinger (Stuttgart), A. G. Schreyer (Regensburg) S. Koletzko (München), D. Ludwig (Lübeck), M. Ratzlaff (DCCV, Nürtingen), C. Schmidt (Bonn), H. J. Schulz (Berlin) II. Pathologie – Vorsitz: F. Autschbach (Heidelberg) B. Siegmund (Berlin), M. Vieth (Bayreuth), J. Weismüller (Koblenz), C. Wittekind (Leipzig) III. Akuter Schub, steroidrefraktärer Verlauf, Ernährungstherapie – Vorsitz: A. Stallmach (Jena), S. Schreiber (Kiel) R. Behrens (Nürnberg), B. Kaltz (DCCV, Bremen), B. Klump (Stuttgart), S. Nikolaus (Kiel), H. Lochs (Berlin), J. Stein (Frankfurt), E. F. Stange (Stuttgart) IV. Remissionserhaltung, steroidabhängiger Verlauf – Vorsitz: G. Rogler (Zürich), W. Kruis (Köln) B. Bokemeyer (Minden), A. Dignaß (Frankfurt), J. C. Hoffmann (Ludwigshafen), K. M. Keller (Wiesbaden), T. Kucharzik (Lüneburg), D. Lümmen (DCCV, Berlin) V. Chirurgie, Fisteln – Vorsitz: C. F. Krieglstein (Köln), H. J. Buhr (Berlin) E. C. Jehle (Ravensburg), A. J. Kroesen (Köln), B. Sido (Regensburg), M. Zeitz (Berlin) VI. Extraintestinale Manifestation und assoziierte Erkrankungen – Vorsitz: M. Reinshagen (Braunschweig) R. Duchmann (Berlin), U. Fölsch (Kiel), R. Raedsch (Wiesbaden), G. v. Boyen (Ulm) VII. Psychosomatik, komplementäre Therapie – Vorsitz: G. Moser (Wien) W. Häuser (Saarbrücken), G. Jantschek (Lübeck), B. Küppers (Mannheim), J. Langhorst (Essen), H. Matthes (Berlin) VIII. Methodik und Zentrale W. Höhne (Berlin), T. Karge (Berlin)

Inhaltsverzeichnis Seite Teil I Einführung, Methodik, Definitionen 1095 Vorbemerkungen 1095 Ziele der Leitlinie, Gültigkeitsdauer 1096 Methodik 1096 Organisatorischer Ablauf des Konsensusprozesses 1096 Klassifikation der Evidenzklassen, Anwendbarkeit, Konsens, Empfehlungsgrade 1097 Definitionen 1098 Teil II Diagnostik 1099 1. Klinische Diagnostik 1099 Diagnosestellung 1099 Etablierung der Diagnose 1100 Dünndarmdiagnostik 1101 Untersuchungen im Verlauf 1102 Besondere Untersuchungssituationen 1103 Nicht empfohlene Untersuchungen 1103 2. Pathomorphologische Diagnostik 1103 Histopathologische Diagnostik an endoskopischen Biopsien 1103 Pathomorphologische Diagnostik an Operationspräparaten 1105 Histopathologische Diagnostik von intraepithelialen Neoplasien (IEN) 1105 Teil III Therapie 1106 3. Akuter Schub 1106 Einführung 1106 Morbus Crohn mit Ileozökalbefall 1106 Colitis Crohn 1107 Ausgedehnter Dünndarmbefall 1108 Befall des Ösophagus und Magens 1108 Steroidrefraktärer Verlauf 1109 Frührezidiv 1109 Rezidiv nach steroidabhängigem Verlauf 1110 Kinder und Jugendliche 1110 4. Remissionserhaltung 1111 Ziel der Langzeittherapie 1111 Indikation zur remissionserhaltenden Therapie bei Morbus Crohn 1111 Postoperative Remissionserhaltung 1113 Kinder und Jugendliche 1113 5. Medikamente 1113 Budesonid 1113 Systemisch wirksame Steroide 1114 Sulfasalazin 1114 Azathioprin/ 6-Mercaptopurin 1114 Methotrexat 1114 Anti-TNF-α-Antikörper 1114 6. Fertilität und Schwangerschaft 1115 Fertilität 1115 Schwangerschaft 1115 Medikamente in der Stillzeit 1116 7. Schmerztherapie 1116 8. Chirurgie bei Morbus Crohn 1117 Dünndarm oder ileokolische Erkrankung 1118 Morbus Crohn des Kolons 1119 Chirurgie und Medikation 1119 9. Diagnose und Management des fistulierenden Morbus Crohn 1120 Diagnostik von anorektalen und perianalen Fisteln 1120 Behandlung von Fisteln 1121 Teil IV Extraintestinale Manifestationen, Psychosomatik und komplementäre und alternative Therapien 1123 10. Extraintestinale Manifestationen 1123 Gelenkmanifestationen 1124 Osteoporose 1125 Hautmanifestationen 1125 Augenmanifestationen 1126 Hepatobiliäre Erkrankungen 1126 Seltene extraintestinale Manifestationen bei Morbus Crohn 1126 11. Psychosomatik 1126 Krankheitsverlauf beeinflussende psychosoziale Faktoren 1127 Therapeutische Ansätze 1127 Kinder und Jugendliche 1129 12. Komplementäre und alternative Therapien 1129 Definition 1130 Methodik 1130 Anwendung und Prävalenz 1130 Alternative Therapieverfahren 1131 Komplementärmedizinische Verfahren 1131 Danksagung 1132 Literatur 1132

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1 Deutsche Gesellschaft für Chirurgie

1 Deutsche Gesellschaft für Ernährungsmedizin

1 Deutsche Gesellschaft für Innere Medizin

1 Deutsches Kollegium für Psychosomatische Medizin

1 Deutsche Gesellschaft für Koloproktologie

1 Gesellschaft für Pädiatrische Gastroenterologie und Ernährung

1 Deutsche Gesellschaft für Pathologie.

1 Unter Mitarbeit der Deutschen Morbus Crohn/Colitis ulcerosa Vereinigung – DCCV e.V.

1 Die Leitlinie wurde erarbeitet mit Unterstützung des Leitlinien-Entwicklungsportals www.leitlinienentwicklung.de, einem gemeinsamen Forschungsprojekt der Charité – Universitätsmedizin und der Telematikplattform für Medizinische Forschungsnetze (TMF) e. V.

2 Koordinationskommitee.

3 Beide Autoren trugen gleichwertig zu dieser Arbeit bei.