[Gastroenterologic and hepatologic rehabilitation today--on changes in indications and contents]

The rehabilitation in gastrointestinal diseases has experienced the introduction of new concepts. Regional health resorts (i.e., mineral springs, climate or mud baths) do not play a role anymore. Today, rehabilitation cliniques are teaching and training centers for chronic patients with multiprofessional teams. The need for rehabilitation cannot be derived from the diagnosis alone or the duration of the illness but from the severity of the symptoms and/or additional psychosocial problems. The order of the application of different techniques during medical rehabilitation differs from patient to patient and necessitates a definition of the rehabilitation goal. Chronic inflammatory bowel disease, chronic pancreatitis, and chronic liver diseases are explained as an example. "Rehabilitation of gastrointestinal or metabolic diseases' is often better described with a model of progression than with the traditional model of disablement. Therefore, a network of clinical and ambulant rehabilitation as well as an entanglement of institutions providing hospital care and after-care is required.