Abstract:
:Patients with chronic inflammatory bowel disease (IBD) have a significantly increased risk of clinically relevant clostridial infection (CDI). In turn, CDI can increase IBD activity. Therefore, rapid diagnosis and therapy is required. Many diagnostic and treatment studies on patients with CDI without inflammatory bowel disease are not congruent with IBD patients. This overview summarizes the everyday data of recent years and condenses these into four guiding principles. 1) patients with IBD present a risk population for a CDI. A CDI not only worsens the disease activity in the short term, but also causes increased morbidity and mortality in the long term. 2) If a CDI is suspected, glutamate-dehydrogenase (GDH) detection should be carried out quickly. If this is positive, and the disease activity is high, a therapy against C. difficile already may be initiated and-if necessary-terminated in cases of negative confirmation tests. 3) IBD patients with a proven CDI should be treated primarily with vancomycin. 4) In a relapsing CDI, fecal microbiome transfer is an effective therapeutic measure. However, activation of the IBD must be expected in about 15 % of cases. Consistent adherence to these guidelines may help treat a CDI in IBD patients. :Patienten mit chronisch-entzündlichen Darmerkrankungen (CED) haben ein deutlich erhöhtes Risiko für Clostridioides [Clostridium] difficile Infektionen (CDI). Eine CDI kann ihrerseits die Aktivität der luminalen Entzündung erhöhen. Daher ist eine rasche Diagnostik und Therapie erforderlich. Viele Diagnose- und Behandlungsstudien zu Patienten mit CDI ohne entzündliche Darmerkrankung lassen sich nicht deckungsgleich auf CED-Patienten übertragen. Diese Übersicht fasst deshalb die alltagsrelevanten Daten der letzten Jahre zusammen und kondensiert diese in vier Leitsätzen. 1) Eine CDI verschlechtert nicht nur kurzfristig die Krankheitsaktivität, sondern bedingt langfristig eine erhöhte Morbidität (z. B. Kolektomiegefahr) und Mortalität. 2) Bei Verdacht auf eine CDI sollte rasch ein Glutamat-Dehydrogenase (GDH)-Nachweis geführt werden. Ist dieser positiv und ist die Krankheitsaktivität hoch, ist eine Therapie gegen C. diff. einzuleiten und diese ggf. bei negativen Bestätigungstests zu beenden. 3) CED-Patienten mit einer nachgewiesenen CDI sollten primär mit Vancomycin behandelt werden. 4) Bei einer rezidivierenden CDI bei Patienten mit CED ist der fäkale Mikrobiomtransfer eine effektive Therapiemaßnahme. Allerdings muss in ca. 15 % der Fälle mit einer Aktivierung der CED gerechnet werden. Ein konsequentes Beachten dieser Leitsätze kann im Umgang mit einer CDI bei CED-Patienten helfen.
journal_name
Z Gastroenteroljournal_title
Zeitschrift fur Gastroenterologieauthors
Stallmach A,Reuken PA,Teich Ndoi
10.1055/a-0729-3168subject
Has Abstractpub_date
2018-11-01 00:00:00pages
1369-1377issue
11eissn
0044-2771issn
1439-7803journal_volume
56pub_type
杂志文章,评审abstract::Alcoholic liver disease is the most frequent organ damage encountered in chronic alcoholics and the annual death rate attributed to alcohol-induced end-stage liver disease exceeds that of car accidents. Alcoholic liver damage occurs mainly due to the toxicity of its first metabolite acetaldehyde, and due to interactio...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2003-38646
更新日期:2003-04-01 00:00:00
abstract::Within the last few years intestinal metaplasia at the gastroesophageal junction (Barrett's esophagus) has turned out to be a "shooting star" in the field of gastrointestinal diseases. The detection rate of Barrett's epithelium by the endoscopists and pathologists has raised dramatically as well as the incidence of th...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::We report our experience with a method to evaluate binding and uptake in cells of low density lipoprotein (LDL) from heterozygous patients with familial defective apolipoprotein B-100 (FDB-LDL) and LDL from normolipidemic subjects (nonFDB-LDL). The method is based on competition for binding/uptake in Epstein-Barr Viru...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract::Assessment of the clinical value of the pancreolauryl test (PLT) in the literature range from "useless" to a specifity of 95% and a sensitivity of 98%. In this work, our own data are presented in relation to various reference methods. The results are derived from the largest collective investigated to data, comprising...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1984-12-01 00:00:00
abstract::From 3/1982 to 12/1989 773 patient underwent an elective Cholezystectomy at the Surgical University Hospital of Ulm. In 87% of cases the indication was a symptomatic cholelithiasis, the mean age being 55.4 years for females and 56.6 years for males. Intraoperative complications were rare (2.8%) and of a technical natu...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract::Recently, H. pylori has been associated with several extradigestive diseases such as cardio-vascular, cutaneous, autoimmune, allergic, liver, hematologic disorders, diabetes mellitus, pediatric diseases (sudden infant death syndrome, growth retardation), extragastric MALT-type lymphomas and even colorectal cancer. The...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2001-12872
更新日期:2001-04-01 00:00:00
abstract::We describe a 80-year-old man who presented with progressive dysphagia because of a Zenker's diverticulum. Barium swallow study revealed a large posterior diverticulum with a distal stenosis of the esophagus caused by compression. Because the patient was a poor candidate for surgery an endoscopic therapy was performed...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2002-32798
更新日期:2002-07-01 00:00:00
abstract::The amino acid consumption test (AACT) during exogenous stimulation with secretin and CCK was proposed as a sensitive and highly specific test for detection of exocrine pancreatic insufficiency. To further investigate the diagnostic value of this test we measured the AACT in comparison with the pancreolauryl serum tes...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1992-06-01 00:00:00
abstract::In the last decade, innovative ultrasound technology has become the primary imaging method in Gastroenterology. Compared to other imaging techniques (e. g., computed tomography and magnetic resonance imaging), conventional ultrasound images have the disadvantage of a restricted field-of-view (width), thus producing im...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-2002-36153
更新日期:2002-12-01 00:00:00
abstract::Laboratory diagnostics efficiently applied is of decisive importance for a great deal of questions in spite of the technical and endoscopic methods which are available today in the field of examinations. By means of a screening programme consisting of ALAT, gamma-GT, ChE at a sensitivity of > 90% alterations in both t...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1993-02-01 00:00:00
abstract::In spite of a decrease in the frequency of gastric carcinoma as shown in some statistics this malignoma still is an almost daily challenge in surgery. The prognosis of the gastric cancer, in general, depends upon the time of onset of therapy and the tumor grading. At present, chemotherapy and radiation therapy cannot ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract::Cholesteryl ester storage disease (CESD) is a rare, autosomal recessively inherited disorder resulting from deficient activity of lysosomal acid lipase (LAL). LAL is the key enzyme hydrolyzing cholesteryl esters and triglycerides stored in lysosomes after LDL receptor-mediated endocytosis. Mutations within the LIPA ge...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0033-1350463
更新日期:2013-10-01 00:00:00
abstract::In a randomized, endoscopically controlled double-blind trial the effectiveness of a twice daily dose of the prostaglandin E2-analogue enprostil was compared with pirenzepine given to 97 ambulatory patients with duodenal ulcers. Under 35 micrograms b.i.d. enprostil the ulcer healing rates after 2, 4 and 6 weeks averag...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-05-01 00:00:00
abstract:INTRODUCTION:Data about the nature and pathophysiological relevance of the target antigens reacting with perinuclear antineutrophil cytoplasmatic autoantibodies (p-ANCA) in ulcerative colitis are inconsistent and partly conflicting. In the majority of the previous studies only one singular potential target antigen was ...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1998-08-01 00:00:00
abstract::In spite of modern diagnostic possibilities, the diagnosis of celiac disease is still challenging for the physician. This is due to the great variability of the clinical presentation. Nowadays, the classical symptoms like diarrhea, weight loss and abdominal pain are seen less often. It has become evident that celiac d...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:10.1055/s-2005-858656
更新日期:2005-11-01 00:00:00
abstract::10 patients with right upper quadrant pain were treated with a choleretic agent (Febuprol; 3 X 200 mg t. i. d.) and placebo in a cross-over double dummy technique for 16 weeks. Lithogenic index, bile acid profile and serum lipids were determined every 4 weeks. During Febuprol application the clinical symptoms were rel...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 临床试验,杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract::Localization of gastroenteropancreatic neuroendocrine tumors with conventional imaging techniques can be difficult. With the advent of the somatostatin-receptor scintigraphy the diagnosis of these could be improved. In this study 76 patients with immunohistologically proven neuroendocrine tumors were analysed by compa...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Celiac disease (CD) is a common chronic systemic autoimmune disease in Europe. The prevalence of CD in Hungarian children is estimated at 1.2 - 1.4 %. To date, however, no data on adult CD prevalence has been published. AIMS:Analysis of the serological evidence for CD among Hungarian adults in order to esti...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0033-1335450
更新日期:2013-11-01 00:00:00
abstract::Gastric acid secretion and gastric emptying rate was measured using double marker method and continuous titration of a liquid peptone test meal. Titration rate was significantly reduced by 30 ml of an aluminiumhydroxide- and magnesiumhydroxide containing antacid compound (Maalox). Acidity of gastric contents was reduc...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::We report on a 56-year-old caucasian female, 154 cm, 38 kg, who was admitted to the hospital in extremely poor, cachectic condition with pretibial edemas, ascites and pleural effusion with a history of severe watery diarrhea up to 15 times daily. The patient's history with permanent meteorism, recurrent episodes of wa...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1999-12-01 00:00:00
abstract::Dissolving basic peptides such as insulin, secretin, and somatostatin in albumin-containing solutions increases the biologic potency. As CCK-33 also constitutes a basic peptide, it should have similar qualities. In four conscious dogs with chronic gastric and pancreatic Thomas fistulas, we studied the effect of CCK-33...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::For decades, methylene blue has been used in gastrointestinal endoscopy as an absorbing dye, it was, however, not approved for that purpose and has now been withdrawn from the market. A possible substitute is toluidine blue, an acidophilic, metachromatic dye that selectively stains cell nuclei; accordingly, since 2007...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0028-1110032
更新日期:2010-09-01 00:00:00
abstract::Pneumatosis intestinalis (PI) is identified as the accumulation of gas within the wall of the small or large intestine. It was first described by Du Vernoi in 1783. The pathogenesis is supposed to be multifactorial. It is assumed that there are 3 paths of disease development: mechanical, bacterial and biochemical. Adu...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:10.1055/s-0031-1281680
更新日期:2013-11-01 00:00:00
abstract::The median plasma level of prolactin in 94 women with cirrhosis of the liver did not differ significantly when compared with a control group (8,0 versus 7,2 ng/ml). Nevertheless 22% of the investigated women exhibited a plasma prolactin level higher than 15 ng/ml. The prolactin concentrations correlated to the severen...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1985-08-01 00:00:00
abstract::During the anaerobic metabolism of the colonic bacterial flora short chain fatty acids and the gases hydrogen (H2) and carbon dioxyde (CO2) are produced. In about 50% of a European and North-American population and in 90% of rural black Africans, methane is generated from H2 and CO2. In methane-negative individuals, s...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 00:00:00
abstract::Mild anemia can occasionally be observed during viral hepatitis, but severe hemolysis has previously only been reported in a few patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. We report a case of massive acute hemolysis associated with an acute hepatitis A in a 39-year-old woman in the absence of G...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract::In 19 patients with gastrointestinal tumors the diagnosis was made by ultrasound. 7 patients were examined for further investigation of an abdominal mass; 12 patients, presented with symptoms suggesting malignants, e. g. weight loss, vomiting, fever, abdominal pain, and/or anaemia from bloodloss were first investigate...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract::The results of preoperative ultrasound investigations were compared with the intraoperative findings in 42 patients (27 women, 15 men) operated on because of tumours of the cecum or colon ascendens. In 34 of 42 patients (i.e. 81%) the tumour could be correctly diagnosed by ultrasound. In 3 cases the investigator was n...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1991-02-01 00:00:00
abstract::Between 1981 and 1987 5434 patients were studied by ERCP in Allgemeines Krankenhaus Hamburg-Barmbeck. 26 (i.e. 0.43%) suffered from Mirizze syndrome with the triad of cholelithiasis, cholecystitis and obstructive biliary disease. They were classified in four different types according to the variable localisation and o...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract::Out of 100 patients with early gastric carcinoma 4 cases with a combined benign gastric and/or duodenal ulcer were encountered. Even in long-lasting peptic ulcer history and multiple benign biopsies carcinoma may develop at some site in the ulcer stomach. That's why intermittent therapy based on ulcer symptoms in a pa...
journal_title:Zeitschrift fur Gastroenterologie
pub_type: 杂志文章
doi:
更新日期:1982-12-01 00:00:00