Irritable bowel syndrome: diagnostics, etiopathogenesis and treatment AbstractIrritable bowel syndrome is a common disorder that can be associated with significant disability and health care costs.Beyond it is the most common disease diagnosed by gastroenterologists.Diagnosis is based on typical complaints including abdominal pain, bloating, irregularities of bowel movements and defecation.The discussion of different etiopathogenetic models showed that irritable bowel syndrome is a biopsychosocial disorder in which psychosocial factors, altered motility and visceral hypersensitivity interact.When symptoms are moderate to severe and are associated with psychological distress and impaired quality of life, psychological treatments can be considered.Apart from symptomatic treatment with loperamide for diarrhoea and antidepressants for abdominal pain and comorbid psychological symptoms for example cognitive behavioral treatment,hypnotherapy,psychodynamic short-term psychotherapy and functional relaxation are being evaluated. Erleichterung und Schmerzlinderung Für mindestens 12 Wochen bestehende Schmerzen nach Stuhlgang oder Beschwerden Weicher Stuhl einhergehend mit Schmerzen Die mit Stuhlgang nachlassen Darmbewegungen gehen häufig mit Und/oder mit Änderung der Stuhlkonsistenz Schmerzen einher und -frequenz einhergehen Sichtbar aufgeblähtes Abdomen Und mindestens 3 der folgenden Symptome bei 25% der Stuhlgänge aufweisen Schleimauflagerung im Stuhl -Veränderung der Stuhlfrequenz Gefühl der unzureichenden Entleerung -Veränderte Stuhlpassage -Vermehrter Schleimabgang -Blähung | Psychotherapeut 5•2002 262 Abb.2 Modell der Entstehung psychovegetativer Symptome. (Hoffmann u. Hochapfel1999) Abb.3 ᭤ Interaktive Wirkmechanismen im Rahmen des biopsychosozialen Modells. (Stark mod. nach
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