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  -title: "Colitis ulcerosa: die Bedürfnisse der Betroffenen"
  -teaser: "<p>Die Colitis ulcerosa verläuft meist mild bis moderat. Eine Heilung ist allerdings nicht möglich, weshalb Patient*innen langfristig auf effektive und verträgliche Therapien angewiesen sind.</p>"
  -content: "<h2>Einleitung</h2><p>Die Colitis ulcerosa verläuft meist mild bis moderat. Eine Heilung ist allerdings nicht möglich, weshalb Patient*innen langfristig auf effektive und verträgliche Therapien angewiesen sind. Zudem können das Bewusstsein, an einer chronischen Erkrankung zu leiden, sowie die damit verbundenen Symptome einen hohen seelischen Leidensdruck auslösen. Das Gefühl, Kontrolle über die Erkrankung zu haben und am Therapieplan mitzuwirken, kann helfen, die empfundene Belastung zu reduzieren. Deshalb sind bei der Auswahl der Therapie zum einen die Empfehlungen der Leitlinien, zum anderen aber auch die Präferenzen der betroffenen Patient*innen wichtig.<sup>1,2</sup></p><p>&nbsp;</p><h2>Therapie der Colitis ulcerosa</h2><h3>Therapieoptionen in verschiedenen Erkrankungsphasen</h3><p>Das Ziel der Therapie bei Colitis ulcerosa ist stets, die überschießende Immunreaktion einzudämmen, eine Schädigung der Darmschleimhaut zu verhindern und die rasche Abheilung akuter Entzündungen zu fördern.<sup>2,3</sup></p><p>Milde bis mittelschwere akute Erkrankungsschübe werden üblicherweise mit Aminosalicylaten wie Mesalazin behandelt. Bei schweren Verläufen der Erkrankung ist eine Behandlung mit Cortisonpräparaten erforderlich, da sie die Immunreaktion stärker reduzieren.&nbsp;</p><p>Bringt die Behandlung mit Cortison keine rasche Besserung oder entwickeln die Patient*innen eine Cortisonabhängigkeit – damit ist ein Aufflammen der Erkrankung beim Absetzen der Cortisontherapie gemeint –, stehen weitere Therapiemöglichkeiten zur Verfügung. Dazu gehören klassische Immunsuppressiva (zum Beispiel Azathioprin), Biologika (Anti-TNF-Antikörper, Ustekinumab, Vedolizumab, Mirikizumab) oder Small Molecules (JAK-Inhibitoren, Ozanimod).<sup>2,3,4</sup></p><p>Wie bei allen Medikamenten können auch bei den genannten Präparaten Nebenwirkungen auftreten. Bei Medikamenten, die das Immunsystem unterdrücken, sollten Betroffene insbesondere versuchen, Infektionen zu vermeiden. Sorgfältige Hygiene, etwa regelmäßiges Händewaschen, spielt dabei eine große Rolle.<sup>2</sup></p><p>&nbsp;</p><h3>Darreichung ist oral oder rektal möglich</h3><p>Das bei leichteren Erkrankungsverläufen eingesetzte Mesalazin steht in einer Reihe von Darreichungsformen zur Verfügung: Tabletten und Granulat für die orale Einnahme sowie Zäpfchen, Klysmen oder Schaumpräparate zur rektalen Anwendung.<sup>2,3,5</sup></p><p>Wichtig zu wissen: Mesalazin entfaltet seine Wirkung nur, wenn es in direkten Kontakt mit der Darmschleimhaut kommt. Insbesondere bei der distalen Colitis ulcerosa haben Untersuchungen gezeigt, dass rektale Präparate wie Zäpfchen, Schaum und Klysmen einen Wirksamkeitsvorteil haben. Auch rektale Cortisonpräparate sind mitunter besser verträglich als systemische Corticosteroide. Dennoch werden Präparate zur rektalen Anwendung noch zu selten verordnet.&nbsp;</p><p>Bei einer ausgedehnten Colitis ulcerosa ist eine alleinige rektale Therapie nicht ausreichend. Orale und rektale Therapie können aber kombiniert werden.<sup>2,3</sup>&nbsp;</p><p>&nbsp;</p><h2>Beratung mit Takt und Kompetenz</h2><p>Bei der Beratung von Patient*innen mit Colitis ulcerosa in der Apotheke gilt es zu berücksichtigen, dass es den Betroffenen oft schwerfällt, sich mit jemandem über eine Erkrankung des Darms beziehungsweise eine rektale Therapie auszutauschen. Ein geschützter Rahmen für das Beratungsgespräch, eventuell ein separater Raum, kann es den Patient*innen erleichtern, ihre Fragen, Probleme und Bedürfnisse offen anzusprechen.<sup>1,2,5</sup></p><p>Ein wichtiger Aspekt der Beratung ist die Aufklärung über die verschiedenen Therapieoptionen und Darreichungsformen, die für die Behandlung der Colitis ulcerosa zur Verfügung stehen. Auch die Bedeutung einer guten Adhärenz – also der regelmäßigen Anwendung der Therapie – für den Therapieerfolg sollte zur Sprache kommen.<sup>1,2,5,6</sup></p><p>Die individuellen Bedürfnisse und Präferenzen der Betroffenen spielen für Therapieauswahl und Therapieziele eine entscheidende Rolle. Sie zu berücksichtigen, ist essenziell für eine ausreichende Adhärenz und somit für eine erfolgreiche Therapie.&nbsp;&nbsp;</p><p>Die Beratung in der Apotheke kann den Patient*innen helfen, ihre Therapiewünsche zu erkennen und sie im Arztgespräch selbstbewusst darzulegen. Das Team in der Apotheke sollte sich daher die Zeit nehmen, verschiedene Optionen vorzustellen, die Betroffene mit ihrem Arzt oder ihrer Ärztin weiter erörtern können.<sup>1,2,5,6</sup></p><p>&nbsp;</p><p><strong>Quellen:</strong></p><ol><li>Rettke, Horst; Staudacher, Diana; Schmid-Büchi, Silvia; Habermann, Inis; Spirig, Rebecca; Rogler, Gerhard (2013). Chronisch entzündliche Darmerkrankungen: Erleben von Krankheit, Therapie und Betreuung. Pflege, 26(2):109-118. <a target="_blank" rel="noopener noreferrer" href="https://www.zora.uzh.ch/id/eprint/92847/1/92847.pdf">https://www.zora.uzh.ch/id/eprint/92847/1/92847.pdf</a></li><li>Dr. Falk Pharma GmbH: Colitis ulcerosa und Morbus Crohn – eine Übersicht über die Krankheitsbilder und ihre Behandlung</li><li>Aktualisierte S3-Leitlinie Colitis ulcerosa (Version 6.1) Februar 2023. <a target="_blank" rel="noopener noreferrer" href="https://register.awmf.org/assets/guidelines/021-009l_S3_Colitis-ulcerosa_2023-03.pdf">https://register.awmf.org/assets/guidelines/021-009l_S3_Colitis-ulcerosa_2023-03.pdf</a></li><li>Dr. Falk Pharma GmbH: Immunsuppressive und immunmodulatorische Therapie bei chronisch entzündlichen Darmerkrankungen</li><li>Dr. Falk Pharma GmbH: Rektale Therapie bei chronisch entzündlichen Darmerkrankungen</li><li>Meißner T. Colitis ulcerosa - Adhärenz für Remission wesentlich. <a target="_blank" rel="noopener noreferrer" href="https://link.springer.com/article/10.1007/s11298-018-6943-3">https://link.springer.com/article/10.1007/s11298-018-6943-3</a></li></ol>"
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Symfony\Component\HttpKernel\DataCollector\RequestDataCollector:72
Show trace 
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Symfony\Component\HttpKernel\DataCollector\RequestDataCollector:73
Show trace 
[
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Flashes

Flashes

Key Value
error 
[
  "Sie müssen eingeloggt sein um diesen Artikel lesen zu können!"
]

Server Parameters

Server Parameters

Defined in .env

Key Value
APP_ENV 
"dev"
APP_SECRET 
"a1d687c7188a8bbff1cb1e7504f8f22f"
DATABASE_URL 
"mysql://apofalk-academy:0az5otq1qeT1QVQK@127.0.0.1:3306/apofalk-academy"
GOOGLE_CAPTCHA_KEY 
"6LeMd_8qAAAAAIYtrI1v6HmANQgT4wNKYuMnDZ0c"
MAILER_DSN 
"smtp://apofalk@creatediv-ld.de:trU5MSwFK643w9o1@mail.your-server.de:587"
MAILER_NAME 
"apofalk.de"
MAILER_USER 
"info@creatediv.de"
MESSENGER_TRANSPORT_DSN 
"doctrine://default?auto_setup=0"
POINTS_FOR_ELEARNING 
"20"
POINTS_FOR_QUIZ 
"10"
POINTS_NEEDED_FOR_CLUB 
"60"
WKHTMLTOPDF_PATH 
"/usr/local/bin/wkhtmltopdf"

Defined as regular env variables

Key Value
APP_DEBUG 
"1"
CONTEXT_DOCUMENT_ROOT 
"/var/www/vhosts/dev-plesk.creatediv.local/apofalk-academy.dev-plesk.creatediv.local/htdocs/public"
CONTEXT_PREFIX 
""
DOCUMENT_ROOT 
"/var/www/vhosts/dev-plesk.creatediv.local/apofalk-academy.dev-plesk.creatediv.local/htdocs/public"
FCGI_ROLE 
"RESPONDER"
GATEWAY_INTERFACE 
"CGI/1.1"
HOME 
"/var/www/vhosts/dev-plesk.creatediv.local"
HTTP_ACCEPT 
"*/*"
HTTP_ACCEPT_ENCODING 
"gzip, br, zstd, deflate"
HTTP_CONNECTION 
"close"
HTTP_HOST 
"apofalk-academy.dev-plesk.creatediv.local"
HTTP_USER_AGENT 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
HTTP_X_ACCEL_INTERNAL 
"/internal-nginx-static-location"
HTTP_X_FORWARDED_FOR 
"216.73.216.96"
HTTP_X_FORWARDED_HOST 
"apofalk-academy.dev-creatediv.de"
HTTP_X_FORWARDED_SERVER 
"apofalk-academy.dev-creatediv.de"
HTTP_X_REAL_IP 
"192.168.20.3"
PATH 
"/usr/local/sbin:/usr/local/bin:/usr/sbin:/usr/bin:/sbin:/bin:/snap/bin"
PHP_SELF 
"/index.php"
QUERY_STRING 
""
REDIRECT_STATUS 
"200"
REDIRECT_UNIQUE_ID 
"aUIfKfWOg-kHZxmCSlVIqgAAAAM"
REDIRECT_URL 
"/fachartikel/colitis-ulcerosa-die-beduerfnisse-der-betroffenen"
REMOTE_ADDR 
"192.168.20.3"
REMOTE_PORT 
"51744"
REQUEST_METHOD 
"GET"
REQUEST_SCHEME 
"http"
REQUEST_TIME 
1765941033
REQUEST_TIME_FLOAT 
1765941033.2635
REQUEST_URI 
"/fachartikel/colitis-ulcerosa-die-beduerfnisse-der-betroffenen"
SCRIPT_FILENAME 
"/var/www/vhosts/dev-plesk.creatediv.local/apofalk-academy.dev-plesk.creatediv.local/htdocs/public/index.php"
SCRIPT_NAME 
"/index.php"
SERVER_ADDR 
"192.168.20.6"
SERVER_ADMIN 
"[no address given]"
SERVER_NAME 
"apofalk-academy.dev-plesk.creatediv.local"
SERVER_PORT 
"80"
SERVER_PROTOCOL 
"HTTP/1.0"
SERVER_SIGNATURE 
"<address>Apache Server at apofalk-academy.dev-plesk.creatediv.local Port 80</address>\n"
SERVER_SOFTWARE 
"Apache"
SYMFONY_DOTENV_VARS 
"APP_ENV,APP_SECRET,DATABASE_URL,MESSENGER_TRANSPORT_DSN,MAILER_DSN,MAILER_NAME,MAILER_USER,WKHTMLTOPDF_PATH,GOOGLE_CAPTCHA_KEY,POINTS_NEEDED_FOR_CLUB,POINTS_FOR_QUIZ,POINTS_FOR_ELEARNING"
UNIQUE_ID 
"aUIfKfWOg-kHZxmCSlVIqgAAAAM"
USER 
"dev-plesk"
proxy-nokeepalive 
"1"