Reizdarmsyndrom – Vom Nihilismus zur pathophysiologisch gesteuerten Therapie

Das Reizdarmsyndrom (RDS) ist eine häufige organische Erkrankung mit erheblicher sozioökonomischer Belastung. Die bisher praktizierte symptomenbasierte Definition des RDS durch Symptomen-Cluster ist unzureichend. Neuere Untersuchungen zeigen, dass das RDS mit verschiedenen strukturellen, molekularen, genetischen, immunologischen, nervalen und psychosozialen Veränderungen assoziiert ist. Die nachgewiesenen unterschiedlichen Pathomechanismen sind ein Hinweis auf den multifaktoriellen Charakter des RDS. Das RDS subsumiert daher pathophysiologisch unterschiedliche Erkrankungen. Es ist zu erwarten, dass in Zukunft die weitere Aufklärung pathophysiologisch relevanter Faktoren, und insbesondere deren Korrelation mit den klinischen Symptomen, die Diagnostik und Therapie des Reizdarmsyndroms verbessert. Es wird ein wesentliches Ziel sein, Biomarker zur Charakterisierung der zahlreichen RDS-Untergruppen zu finden, damit eine spezifische Therapieentscheidung möglich ist.

Irritable bowel syndrome (RDS) is one of the most frequent organic diseases with significant socioeconomic burden. Primarily symptom-based definition of RDS by symptom clustering is insufficient. Recent research indicates that RDS comprises different structural, molecular, genetic, immunological, nerval and psychosocial abnormalities. The finding of numerous pathophysiological causes of RDS are expression of the multifactorial character of RDS and evidence for pathophysiological different disease entities. It is expected that further insight into pathophysiological mechanisms and their association with clinical symptoms will improve diagnostic and therapy of RDS in the future. Major goal will be the development of biomarkers to characterize RDS subgroups and to enable specific therapeutic strategies.

Key words

Irritable Bowel Syndrome - RDS subgroups - organic diseases - socioeconomic burden

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