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Colitis ulcerosa

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Definition:
Sich kontinuierlich, vom Rektum aus nach oral ausbreitende Entzündung der Kolonschleimhaut, die zu chronisch entzündlichen Darmerkrankungen gehört.
Häufigkeit:
Inzidenz von 3–4 auf 100.000 Personen in Deutschland.
Symptome:
Blutig-schleimige Diarrhöen mit Tenesmen und imperativem Stuhldrang.
Befunde:
Bauchschmerzen, häufig Zeichen der Mangelernährung mit Anämie, ggf. extraintestinale Manifestationen wie Arthralgien oder Erythema nodosum.
Diagnostik:
Anamnese, körperliche Untersuchung, Labor mit u. a. Calprotectin im Stuhl, Sonografie, Endoskopie mit Biopsien und histopathologischer Aufarbeitung.
Therapie:
Therapie der Wahl Mesalazin, im schweren Schub Steroide und ggf. Eskalation auf Immunmodulatoren, z. B. TNF-alpha-Blocker.
  • Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS). S3-Leitlinie Colitis ulcerosa. AWMF-Leitlinie Nr. 021-009, Stand 2021. register.awmf.org 
  • Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS). S3-Leitlinie Kolorektales Karzinom. AWMF-Leitlinie Nr. 021-007OL, Stand 2017. register.awmf.org 
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  • Lino Witte, Dr. med., Arzt in Weiterbildung Innere Medizin, Frankfurt