Welche Rolle spielt die Ern�hrung beim Morbus Crohn? Ein Beitrag zur Bedeutung der di�tetischen Therapie der Enteritis regionalis

Abstract

The clinical appearance of Crohn's disease (CD) is especially marked by nutritional deficits and insufficiencies. For a long time the goal of nutritional care was reduced to the readjustment of the nutritional status. The development and clinical use of controlled parenteral nutrition (TPN) and enteral nutritive solutions (EN) did not only emphasize this therapeutical issue, but furthermore showed positive effects on the conservative as well as on the surgical treatment concepts. Therefore today artificial nutritional support is a firm part of therapy in acute, active phases or in the contact of surgical management of CD. This is especially valid in children, where complications in general and growth failure in particular can be reduced. EN is the preferred feeding method in most of the cases, due to a lower complication rate and reduced cost when compared to TPN. The question regarding the importance of nutritional support as primary therapy has also been investigated. The results differ extensively, but point towards the conclusion that patients with solitary small bowel disease do profit from this therapeutical concept. Nevertheless it is unclear, how TPN or EN interfere in the pathophysiology or -biochemistry in this process. A question about reduction e.g. of allergic components of daily diet did stimulate new theories regarding the hypothesis of a possible causal relationship between diet and the pathogenesis of CD. Investigations on dietary habits and daily dietary therapy did not reveal an overall accepted dietary guideline. Nevertheless it seems obvious that dietary counselling has a positive effect on the disease process. It does appear, that today in the acute, active phase as well as in the long term management of Crohn's disease nutritional-care is an important therapeutical method.

Welche Rolle spielt die ern�hrung bei der colitis ulcerosa?

“…Im Vordergrund stand dabei die Remissionsinduktion, die zwar nicht in allen kontrollierten Studien der Ernfihrungstherapie einen vergleichbaren Stellenwert zur alleinigen medikament6sen Behandlung gab [27], aber dennoch soweit erreicht werden konnte, dag die Ern~hrungstherapie als prim~irer Behandlungsansatz Bedeutung gewonnen hat [14]. Somit kann heute eine spezifische Bedeutung der ktinstlichen Ernfihrung in der Therapie des M. Crohn festgehalten werden [35].…”