Diagnostik und Therapie des Reizdarmsyndroms vom Diarrhö- und Mischtyp

Symptoms such as diarrhea, meteorism, and abdominal pain are common in everyday clinical practice. The cause is often irritable bowel syndrome (IBS). While the pathogenesis is still unclear, the pathophysiology of the disease is increasingly better understood. Irritable bowel syndrome can be divided into different subgroups. Particularly relevant for clinical practice are IBS with predominant constipation (IBS-C), IBS with predominant diarrhea (IBS-D), and IBS with mixed bowel habits (IBS-M). The diagnosis and therapy of IBS represent a major challenge. The heterogeneous symptoms and the lack of validated biomarkers require comprehensive differential diagnostics. This includes laboratory diagnostic, checking for food allergies, endoscopy, abdominal sonography, H2 breath tests, homocholic acid taurine tests, and psychosomatic diagnostic. There are different therapeutic approaches like nutrition therapy, administration of probiotics and symptom-oriented drug therapies. This article aims to give an overview of the diagnosis and therapy of IBSD and IBS-M in Germany with insights and experiences from clinical practice.