Christoph Högenauer
Gastrointestinale Probleme, Höhe und Alpinspor t Gastrointestinal problems, high altitude and alpine sports S U M M A RY Gastrointestinal disease and symptoms are frequent problems during travels at high altitude. This review summarises the most important gastrointestinal complaints and their postulated mechanisms under these conditions. Observed problems are diarrhea, significant weight loss, dyspeptic diseases, bloating and flatulence. Diarrhea, as the most reported disease during high altitude expeditions is often caused by infectious agents due to a high faecal contamination of trekking (tracking) routs and difficulties in the decontamination of drinking water under high altitude conditions. Other causes for diarrhea are osmotic diarrhea due to a high magnesium content of glacier water and diarrhea due to extreme physical exercise (runner´s diarrhea). Pathophysiological mechanisms of weight loss in high altitudes areas are multifactorial and poorly understood. Probable factors include increase energy exposure due to exercise and cold and impaired appetite, the latter might be caused by alter levels of GI-hormones. Dyspeptic conditions include gastritis, peptic ulcer disease and gastroesophageal reflux disease. These problems are caused by a high rate of H.pylori infection in inhabitants of high altitude areas and by impaired gastrointestinal blood supply due to exercise and probably height exposition. Flatulence and meteorism is a less dangerous however tiresome problem in higher areas. The main mechanism is an increase in intestinal gas volume due to the low air pressure. Although gastrointestinal problems are common at high altitude areas, little scientific publications are available about their pathophysiologic mechanisms. Further publications on the physiologic mechanisms of high altitude influence on the GI-tract remain warranted. Keywords: High altitude, diarrhoea, gastrointestinal tract
Z U S A M M E N FA S S U N G Gastrointestinale Erkrankungen und Symptome sind eine gängige Erscheinung bei Höhenaufenthalten. Diese Übersichtsarbeit fasst die häufigsten gastroin-
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